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Early diagnosis of Uroperitoneum

​ Abdominal urine​ Immunoassay​ UroabdomenDosage of uromodulinELISA method

Introduction

Uroperitoneum is the collection of urine in the peritoneal or retroperitoneal cavity of a patient. It may occur due to traumatic or iatrogenic events, or following spontaneous ruptures for neoplasms or chronic inflammation at the level of the kidney, ureter, bladder or urethra proximal portion. Within this pathological condition, a biomarker useful for an early diagnosis has been identified, displaying a high sensitivity and specificity in the early phases of uroperitoneum. This innovative method exceeds also the limits and complications of the diagnostic techniques currently in use.

Technical features

The innovative method for the diagnosis of uroperitoneum involves the determination of concentration of a biomarker, uromodulin, in a sample taken from abdominal drainage and a comparison of the value with the uromodulin concentration in a urine sample. The concentration of uromodulin, determined by a conventional ELISA assay, is infinitesimal (<50 ng) in abdominal drainage samples under physiological conditions, while it reaches measurable concentrations since the early stages of uroperitoneum, thus allowing the early diagnosis.​
The dosage of uromodulin overcomes the limitations shown by the diagnostic  techniques applied to date:

  1. the dosage of creatinine, which proved to be a non-sensitive and reliable marker only in an advanced condition of uroperitoneum, or when the urine in abdomen is very abundant;
  2. the computed tomography (CT) of the abdomen, diagnostic tool that requires the movement of the patient, usually bedridden in post-surgical phase in intensive care, and the administration of contrast medium, iodized, which subjects the patient to an increased radiological risk.

Possible Applications

  • Medical biotechnologies;
  • Early diagnosis in surgery: early diagnosis of uroperitoneum, in particular for urological patients who are in a post-operative phase after urological surgery;
  • Early diagnosis in intensive care units.

Advantages

  • Easy detection of uromodulin in biological samples taken from patients in post-surgical conditions;
  • Fast association of uromodulin concentracion in abdominal drainage sample to a pathological situation;
  • Limited invasiveness of the diagnostic method;
  • High sensitivity and specificity of the urine presence in the abdomen;
  • No need of expensive reagents and machinery.