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Nephrol Dial Transplant (1987) 2: 143-148
© 1987 European Renal Association-European Dialysis and Transplant Association

research-article

Diagnosis of Renal Proximal Tubular Injury by Urinary Immunoassay for a Proximal Tubular Antigen, the Adenosine Deaminase Binding Protein

Nina E. Tolkoff-Rubin, R. E. Thompson, Donna J. Piper, W. P. Hansen, N. H. Bander, C. Cordon-Cardo, Connie J. Finstad, L. H. Klotz, L. J. Old and R. H. Rubin

Hemodialysis Unit, Medical Service of the Massachusetts General Hospital, and Department of Medicine, Harvard Medical School Boston, Massachusetts Cambridge Research Laboratory Cambridge, Massachusetts Laboratory of Human Cancer Serology, Memorial-Sloan Kettering Cancer Center New York, USA

Correspondence and offprint requests to: Correspondence and offprint requests to: Dr Nina E. Tolkoff-Rubin, Hemodialysis Unit, Massachusetts General Hospital, Boston, MA 02114

A sandwich ELISA assay has been formatted from two commercially available murine monoclonal antibodies, URO-4 and URO-4a, directed against a 120 000 dalton glycoprotein, the adenosine deaminase binding protein (ABP), found on the brush border of the renal proximal tubular epithial cell. Untimed urine samples from 37 normal individuals and urinary ABP <0.1 AU; 37 patients with pure glomerular disease had ABP <0.4 AU (with 29, or 76% <0.2 AU); 10 patients with pre-renal azotaemia had ABP <0.6 (with 8, or 80% <0.3 AU). In contrast, 79 patientswith post-ischaemic acute tubular necrosis had ABP >0.6 AU. Acute renal failure due to myoglobinuria, contrast dye, and aminogly coside toxicity were all associated with urinary ABP >1.0 AU. In addition, all six patients with acute bacteraemic pyelonephritis had ABP >0.7 AU, as opposed to ABP <0.2 AU in the urines of 12 women with acute cystitis. We conclude that this monoclonal antibody based urinary assay is a sensitive measure of renal proximal tubular injury, reliably distinguishes acute tubular from glbmerular disease, and may be helpful in differentiating forms of urinary tract infection.

Keywords: Monoclonal antibodies; Proximal tubular antigen; ABP (adenosine deaminase binding protein)


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