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2017 ; 28
(5
): 1394-1398
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The Urine Preservative Acetic Acid Degrades Urine Protein: Implications for Urine
Biorepositories and the AASK Cohort Study
#MMPMID28104821
Almaani S
; Hebert LA
; Rovin BH
; Birmingham DJ
J Am Soc Nephrol
2017[May]; 28
(5
): 1394-1398
PMID28104821
show ga
Patients enrolled in the African American Study of Kidney Disease and
Hypertension (AASK) Cohort Study who exhibited overt proteinuria have been
reported to show high nonalbumin proteinuria (NAP), which is characteristic of a
tubulopathy. To determine whether African American Study of Kidney Disease and
Hypertension nephropathy (AASK-N) is a tubulopathy, we obtained urine samples of
37 patients with AASK-N, with 24-hour protein-to-creatinine ratios (milligrams
per milligram) ranging from 0.2 to 1.0, from the National Institute of Diabetes
and Digestive Kidney Diseases repository and tested for seven markers of tubular
proteinuria. By protocol, each sample had been collected in acetic acid (0.5%;
mean final concentration). Compared with samples from patients with lupus
nephritis or healthy black controls, AASK-N samples had lower amounts of six
markers. Four markers (albumin, ?-2-microglobulin, cystatin C, and osteopontin)
were undetectable in most AASK-N samples. Examination by SDS-PAGE followed by
protein staining revealed protein profiles indicative of severe protein
degradation in 34 of 37 AASK-N urine samples. Treatment of lupus nephritis urine
samples with 0.5% acetic acid produced the same protein degradation profile as
that of AASK-N urine. We conclude that the increased NAP in AASK-N is an artifact
of acetic acid-mediated degradation of albumin. The AASK-N repository urine
samples have been compromised by the acetic acid preservative.