Time-dependent excretion of lithium, sodium, potassium, rubidium, magnesium and strontium in the urine of a multiple sclerosis patient

Urinalysis in patients with neuromyelitis optica spectrum disorder

BACKGROUND AND PURPOSE

Increasing evidence has demonstrated that aquaporin-4 (AQP4) immunoglobulin G causes damage to the kidney in neuromyelitis optica spectrum disorder (NMOSD). However, changes in urinalysis in NMOSD have not been investigated thus far. Our objective was to evaluate the changes in urinalysis in NMOSD patients.

METHODS

Case data were collected from 44 patients with AQP4 antibody-positive NMOSD, 53 patients with multiple sclerosis (MS) and 79 age- and sex-matched healthy controls. Analyses of early morning urine and 24-h urine samples comparing NMOSD with MS patients were conducted.

RESULTS

In the acute phase, urine pH levels (P < 0.001) and urine specific gravity levels (P < 0.001) from NMOSD patients were significantly higher and lower, respectively, than for MS patients. 24-h urine sodium and 24-h urine volume from NMOSD patients were significantly higher than for MS patients (both P = 0.001). A 24-h urine volume higher than 2500 ml (odds ratio 11.7, 95% confidence interval 1.863-73.066) and a 24-h urine sodium higher than 200 mmol (odds ratio 16.0, 95% confidence interval 2.122-120.648) are more likely to occur in NMOSD patients in the acute phase than in MS patients.

CONCLUSIONS

The urinalysis results were significantly different between NMOSD patients and MS patients. The pathophysiological changes in AQP4 antibody-positive NMOSD patients were not limited to the central nervous system.

Measurement of endogenous lithium levels in serum and urine by electrothermal atomic absorption spectrometry: a method with potential clinical applications

A highly sensitive flameless atomic absorption method has been adapted for the determination of endogenous trace lithium levels in serum and urine. With ammonium nitrate as the only matrix modifier, serum levels of Li as low as 0.03 mumol/liter are measured accurately and there is no requirement for standard additions. The need for background correction during analysis was clearly established, and tungsten and Zeeman-effect background corrections were compared. The tungsten correction offered superior sensitivity and linearity of standards. Recoveries in urine and serum average 94.8 +/- 7.7 and 95.3 +/- 6.1% (+/- SD), respectively. The endogenous serum Li levels were 0.16 +/- 0.08 mumol/liter for normal subjects dwelling in the Denver metropolitan area. The mean 24-h excretion rate was 5.24 +/- 1.4 mumol/day. The mean fractional excretion of endogenous Li (clearance Li/clearance creatinine) was 23.2 +/- 3.0%, a value similar to values published for exogenously administered Li and measured by conventional methods.

Lithium, sodium, potassium and rubidium cation concentrations during the development of certain organs of unborn rabbits

The distribution of lithium, sodium, potassium and rubidium in rabbit fetuses was determined during the last two weeks of gestation. Samples of eye, brain, lung, heart, liver and kidney were investigated. Co-actions between the ion pairs Li+/Na+ and K+/Rb+ could be discerned. The essential properties of lithium and rubidium for the fetal development of rabbits were examined by investigating the supply of the fetal organs with these elements. Correlations between organ differentiation processes and metal concentrations were established and compared with the results obtained for the fetal development of other vertebrates.

Determination of rubidium in human serum

Field desorption mass spectrometry (FD-MS) combined with stable isotope dilution has been used to determine rubidium concentrations from human serum. Samples obtained from 110 healthy volunteers (50 males, 60 females) were examined. The rubidium concentrations found varied from 0.96 to 3.56 mumoles/l, the average value being 1.96 mumoles/l. The precision of the measurements within a batch was 0.8%. The time for 1 analysis, including sample preparation is about 30 min, the total sample consumption is 100-200 mul. The corresponding potassium concentrations were also determined from all these serum samples; a weak trend towards higher potassium levels with increasing rubidium concentration is found.

Concentrations of electrolytes and trace metals in amniotic fluid and body tissues of rabbits during the last two weeks of gestation

Uterus and placenta of the mother animals, amniotic fluid as well as skin, ossified bone tissue and skeletal muscle of the fetuses were examined. The natural concentrations of Li+, Na+, K+, Rb+, Mg2+, Sr2+, Ba2+-ions were determined in the third and fourth weeks of gestation. The concentrations of trace metals down to 10(-9) g metal/g tissue could be determined, with a standard deviation of less than +/- 10%, by field desorption mass spectrometry. Correlations between lithium concentrations and bone growth were discerned. Differentiation-processes of the fetal skin were indirectly verified by the marked decrease of all metal ions with the progress of gestation. Concentration changes of metals in uterus tissue during gestation correspond to the changes in maternal serum at the same stage.