Non-Radiologic Assessment of Kidney Stones

oxfordgenomesciences

Non-Radiologic Assessment of Kidney Stones by KIT, a Spot Urine Assay.

 To evaluate the utility of the KIT Assay urinary biomarkers to detect kidney stones and quantify stone burden.</AbstractText><AbstractText>136 spot urine samples from 98 individuals, with and without kidney stone disease, were processed for measuring a pre-defined assay consisting of 6 DNA and protein markers, to generate a risk score for non-invasive detection of nephrolithiasis. From this cohort, 56 individuals had spot, non-timed, urine samples collected at the time of radiographically confirmed kidney stones and 54 demographically matched, healthy controls, without kidney stone disease, also provided spot, non-timed urine samples. Sixteen individuals with persistent stone disease had more than one urine sample.

Using a proprietary microwell based kidney injury test (KIT) assay, we measured cell-free DNA, methylated cell-free DNA, clusterin, creatinine, protein, and CXCL10. A KIT Stone-Score was computed across all markers, using the prior locked KIT algorithm. The KIT Stone-Score, scaled from 0 – 100, was then correlated with demographic variables, kidney stone burden, obstructive kidney stone disease, and urine solutes by 24-hour urine collections.

The scaled KIT stone-score (KITstone), as a composite of all 6 biomarkers, readily discriminated individuals with current or prior radiographically confirmed kidney stones, from healthy controls without kidney stone disease (P < 0.0001). KITstone also correlated in individuals with nephrolithiasis, with radiologically measured stone size (P = 0.0174) and also differentiated patients with a clinical radiological diagnosis of obstructive nephrolithiasis, associated with upper renal tract dilatation (P = 0.0010).

On the other hand, stone burden as assessed by KITstone, did not correlate with the any of the traditional measures of 24-hour urine solutes or the 24-hour urine supersaturation levels. In patients with persistent stone disease, where multiple urine samples were collected over time and different interventions, KITstone could non-invasively track stone burden over time by a spot urine, non-timed urine sample.

A random, spot urine-based assay, KITstone, can non-invasively detect, quantify, and monitor current stone burden, and may thus minimize radiographic exposure for kidney stone detection. The KITstone assay may also help monitor for stone recurrence risk for patients with nephrolithiasis, without the requirement of 24 hour urine collections.

oxfordgenomesciences
oxfordgenomesciences

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A nanocellulose-based colorimetric assay kit for smartphone sensing of iron and iron-chelating deferoxamine drug in biofluids. 

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