SIGNIFICANCE OF URINARY FIBRIN FIBRINOGEN DEGRADATION PRODUCTS IN RENAL DISEASES MEASURED BY A HIGHLY SENSITIVE ELISA

The urinary fibrin/fibrinogen degradation products (FDP), as sensitive indica tors of various renal disorders, have been measured by several methods. For their determination, a new and highly sensitive enzyme-l inked immunosorbent assay not requiring the urine concentration has be en developed. The study comprised 42 patients with nonnephrotic chroni c glomerulonephritis (CGN), 23 patients with primary nephrotic syndrom e (NS), and 29 healthy adults. The results were as follow: (1) the con tent of urinary FDP in normal subjects was 10.30+/-9.08 ngl mi; (2) th e mean level of urinary FDP in both CGN and NS groups was significantl y higher than in normal subjects; (3) in the CGN group itself there wa s a tendency for an increase of urinary FDP during more active forms o f the disease, and (4) there was a significant correlation between uri nary FDP and urinary protein in the CGN group, whereas no correlation was observed in the NS group. These results suggest that the major par t of urinary FDP in the CGN group derives from the increased filtratio n, while its origin in the NS group is not related to increased filtra tion only, but may also have involved intraglomerular coagulation abno rmalities. The newly developed enzyme-linked immunosorbent assay can d etect urinary FDP levels lower than 3.9 ng/ml. Therefore, this method can be of great value in determining the degree of abnormalities of in traglomerular coagulation and fibrinolysis in renal diseases.