M. Henry Gault

Syndrome associated with the abuse of analgesics.

Abstract Twenty-two patients with renal disease seen over a 4-year period had abused analgesics containing acetylsalicylic acid, phenacetin, caffeine, and in all but one instance codeine. The minim...

Hyperchloremic Acidosis in Early Diagnosis of Renal Allograft Rejection

Abstract Hyperchloremic renal tubular acidosis has been observed to occur in a surprisingly high percentage of episodes of rejection in patients who have had cadaver renal allografts. Impairment of...

Urolithiasis due to 2,8-dihydroxyadenine in an adult.

CARTIER and Hamet1 described a patient with calculi formed by 2,8-dihydroxyadenine in 1974. Such calculi are positive for uric acid with standard wet chemistry tests.2 The poorly soluble purine 2,8...

Endogenous Digoxin-like Substance(s) and Combined Hepatic and Renal Failure

Excerpt To the editor: An endogenous digoxin-like substance has recently been described in the blood of neonates (1), and we read with interest two recent reports in theAnnals. Graves and colleague...

Evaluation of i-STAT Creatinine Assay

Background: We evaluated a new, 2-min blood creatinine method using the hand-held i-STAT analyzer. Good results have already been reported using this analyzer for 10 methods including electrolytes, TCO2, pH, PCO2, bicarbonate, glucose, hemoglobin and urea for uremic blood, hemodialysate and peritoneal effluent. Methods: Evaluation included study of imprecision and accuracy. Results: Imprecision studies gave excellent results, including those for reproducibility of 6 solutions with a mean of 10 repeats and coefficients of variation (CVs) of 0.4–3.4%, and also the mean of the differences between 33 duplicate blood specimens which was 2.2% of the specimen mean. To assess accuracy, we compared results of 149 tests by i-STAT and Beckman Synchron CX7 methods. The difference between the two means was 2.6% and the mean of all differences was 10.9% with i-STAT results higher, especially when blood creatinine values were <100 µmol/l (1.1 mg/dl) indicating the need for a slightly higher upper limit of the normal range. The correlation coefficient between the two methods was 0.99, the slope 1.0 and the intercept –5.0 µmol/l (–0.06 mg/dl). We assessed the recommended creatinine correction for variation in PCO2 above and below 40 mm Hg, but our results did not suggest the need for such a correction in our range of 27–64 mm Hg; omission would remove a major method disadvantage. Assays of hemodialysate and peritoneal effluent were also satisfactory. Conclusions: The i-STAT creatinine method is simple and rapid and our evaluation showed satisfactory accuracy and precision. However, results were on average slightly higher than for the Beckman Synchron CX7 method.

Human adenine phosphoribosyltransferase: characterization from subjects with a deficiency of enzyme activity.

Adenine phosphoribosyltransferase (APRT) was characterized with respect to specific activity and immunoreactive protein (CRM) levels in hemolysate from 18 members of an APRT-deficient kindred. In addition, lymphoblastoid cell lines were established from six of these subjects and APRT from these cells was characterized in a similar fashion. Levels of specific activity and CRM in patients homozygous for the deficiency were less than 1% of normal. Heterozygous subjects had higher levels of activity and CRM in lymphoblasts than in erythrocytes and, in all cases, the APRT present was normal in terms of isoelectric point, subunit molecular weight, and heat stability. The higher levels of activity and CRM found in lymphoblasts may be due either to expression of a mutant gene product stabilized in a normal:mutant dimer or to autologous regulation.