concentration procedure is shown. calculation …antihypertensive therapy for early-stage diabetic...

N Mean S.D. CV %Max. Min. 10 4.1 0.08 1.94 4.2 4.0 Level 1 10 51.7 0.26 0.51 52.0 51.1 Level 2 10 118.7 0.71 0.60 120.0 117.9 Level 3 Measurement Value (ng/mL) Within-run Reproducibility Basic Performance Data (Example : Hitachi 7180) Measurement Range Bilirubin F Bilirubin C Hemoglobin Chyle Glucose Ascorbic acid* 20 mg/dL 20 mg/dL 500 mg/dL 2400 Formazin Turbidity Unit 4000 mg/dL 100 mg/dL added volume 4.7 46.1 5.1 47.8 4.4 44.8 4.6 46.1 5.3 49.4 4.4 44.7 Without interferent 4.9 44.7 4.9 46.1 4.7 46.3 4.4 42.4 4.9 47.8 4.8 45.2 With interferent measured value (ng/mL) Interference * Ascorbic acid may interfere with the L-FABP assay from around 100 mg/dL depending on the sample. Assay Procedure * Spot or pooled urine(No acidified pooled or toluene-preserved urine) ** The difference in absorbance between 570 nm and 800 nm. Calibrator: L-FABP Calibrator Manufacture's assigned valueReagent blank: Saline Sample (urine*) 4 μL measurement 1 (absorbance 1**) + R2 50 μL R1 150 μL 37approx. 50 sec 37approx. 5 min measurement 2 (absorbance 2**) Concentration Calculation 37approx. 4 min Other package sizes are available upon request Liver - type Fatty Acid Binding Protein (L-FABP) Reagent Ready-to-use liquid reagent Applicable to various automated analyzers Features 1 2 Assessment of Assay Results 1. The assay range is calculated using the L-FABP concentration ( μg/gCr) within 1 g of Urine Creatinine, and corrected with the Urine Creatinine value. Conversion Formula: L-FABP ( μg/gCr) = L-FABP (ng/mL)/Cr (mg/dL) ×100 2. Reference Range: 8.4 μg/gCr and below (Ref: Kamijo A, et al. Diabetes Care 34 (3), 691, 2011) NORUDIA L-FABP 1.0200 ng/mL(Hitachi 7180) L-FABP Buffer Solution 1 Name NORUDIA L-FABP Assay Principle Package 2- 101 bottle × 18 mL 1 bottle × 7 mL Storage Latex Agglutination Turbidimetry L-FABP Latex Reagent 2 Reagent Kit This product is compatible with various types of automated analyzer. An example of the assay procedure is shown. EIA (ng/mL) Correlation 200 150 100 50 0 140 180 160 120 100 40 60 80 20 N = 65 y = 1.07x + 0.28 r = 0.984 NORUDIA L-FABP (ng/mL) Detection Limit 200 175 150 125 100 75 50 25 0 2.7 2.4 3.9 3.0 3.3 3.6 2.1 1.8 1.5 1.2 0.9 0.6 0.3 Average absorbance (mAbs.) Measured value (ng/mL) Mean±2.6SD n=100.7ng/mL Prozone Measured value (ng/mL) 350 300 250 200 150 100 50 0 3000 2000 1000 0 Theoretical value (ng/mL) Control Level Control Level Control Level Days Calibrated only on day 0On-board Stability Measured value (ng/mL) 140 120 100 80 60 40 20 0 6 8 10 12 2 4 14 16 18 Please note the On-board stability may differ depending on the type of analyzer and measured environment. When use of this product please preform accuracy control, and calibrate as necessary. * Parameters to check for prozone effect are required. 5 concentrations × 1.0 mL Name L-FABP Calibrator L-FABP Control Package 2- 10Storage 2 concentrations × 1.0 mL × 3 vials each Sold Separately For the early detection of kidney injury For more information contact: "NORUDIA" is a trademark owned by SEKISUI MEDICAL CO.,LTD. JAPAN, and is registered in Japan and other countries. Diagnostics Business Unit 1-3, Nihonbashi 2-chome, Chuo-ku, Tokyo 103-0027 JAPAN Tel: +81-3-3272-0828, Fax: +81-3-3272-0907 E-mail: [email protected] Web: www.sekisuimedical.jp/english LF-103 1808 JBA1000

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Page 1: Concentration procedure is shown. Calculation …antihypertensive therapy for early-stage diabetic nephropathy. Chronic Kidney Disease - Monitoring and assessment of treatment Excretion

NMeanS.D.CV(%)Max.Min.

104.1

0.081.944.24.0

Level 1

1051.70.260.5152.051.1

Level 2

10118.70.710.60

120.0117.9

Level 3

Measurement Value (ng/mL)

Within-run Reproducibility

Basic Performance Data (Example : Hitachi 7180)

■ Measurement Range

Bilirubin F

Bilirubin C

Hemoglobin

Chyle

Glucose

Ascorbic acid*

20 mg/dL

20 mg/dL

500 mg/dL

2400 Formazin Turbidity Unit

4000 mg/dL

100 mg/dL

added volume

4.746.15.1

47.84.4

44.84.6

46.15.3

49.44.4

44.7

Without interferent

4.944.74.9

46.14.7

46.34.4

42.44.9

47.84.8

45.2

With interferent

measured value (ng/mL)

Interference

* Ascorbic acid may interfere with the L-FABP assay from around 100 mg/dL depending on the sample.

Assay Procedure

* Spot or pooled urine(No acidified pooled or toluene-preserved urine) ** The difference in absorbance between 570 nm and 800 nm. Calibrator: L-FABP Calibrator(Manufacture's assigned value) Reagent blank: Saline

Sample (urine*) 4 μLmeasurement 1

(absorbance 1**)+ R2 50 μLR1 150 μL37℃

approx. 50 sec37℃

approx. 5 min

measurement 2(absorbance 2**)

ConcentrationCalculation

37℃approx. 4 min

Other package sizes are available upon request

Liver - type Fatty Acid Binding Protein (L-FABP) Reagent

Ready-to-use liquid reagent

Applicable to various automated analyzers

Features

1

2

■ Assessment of Assay Results

1. The assay range is calculated using the L-FABP concentration (μg/gCr) within 1 g of Urine Creatinine, and corrected with the Urine Creatinine value. Conversion Formula: L-FABP (μg/gCr) = L-FABP (ng/mL)/Cr (mg/dL) × 1002. Reference Range: 8.4 μg/gCr and below (Ref: Kamijo A, et al. Diabetes Care 34 (3), 691, 2011)

NORUDIA L-FABP

1.0~200 ng/mL(Hitachi 7180)

L-FABP Buffer Solution 1

Name

NORUDIA L-FABP

Assay Principle Package

2℃ - 10℃1 bottle × 18 mL

1 bottle × 7 mL

Storage

Latex Agglutination TurbidimetryL-FABP Latex Reagent 2

Reagent Kit

This product is compatible with various types of automated analyzer. An example of the assay procedure is shown.

EIA (ng/mL)

Correlation200

150

100

50

0140 18016012010040 60 8020

N = 65 y = 1.07x + 0.28 r = 0.984

NORU

DIA

L-FA

BP (n

g/m

L)

Detection Limit200

175

150

125

100

75

50

25

02.72.4 3.93.0 3.3 3.62.11.81.51.20.90.60.3

Aver

age

abso

rban

ce (m

Abs.

)

Measured value (ng/mL)

Mean±2.6SD(n=10)

0.7ng/mL

Prozone

Mea

sure

d va

lue

(ng/

mL)

350

300

250

200

150

100

50

03000200010000

Theoretical value (ng/mL)Control Level Ⅰ Control Level Ⅱ Control Level Ⅲ

Days (Calibrated only on day 0)

On-board Stability

Mea

sure

d va

lue

(ng/

mL)

140

120

100

80

60

40

20

06 8 10 122 4 14 16 18

Please note the On-board stability may differ depending on the type of analyzer and measured environment. When use of this product please preform accuracy control, and calibrate as necessary.

* Parameters to check for prozone effect are required.

5 concentrations × 1.0 mL

Name

L-FABP CalibratorL-FABP Control

Package

2℃ - 10℃

Storage

2 concentrations × 1.0 mL × 3 vials each

Sold Separately

For the early detectionof kidney injury

For more information contact:

"NORUDIA" is a trademark owned by SEKISUI MEDICAL CO.,LTD. JAPAN, and is registered in Japan and other countries.

Diagnostics Business Unit

1-3, Nihonbashi 2-chome, Chuo-ku, Tokyo 103-0027 JAPANTel: +81-3-3272-0828, Fax: +81-3-3272-0907E-mail: [email protected]: www.sekisuimedical.jp/english LF-103

1808 JBA1000

Page 2: Concentration procedure is shown. Calculation …antihypertensive therapy for early-stage diabetic nephropathy. Chronic Kidney Disease - Monitoring and assessment of treatment Excretion

:p < 0.05 [vs.non-AKI]   :p < 0.05 [vs. before surgery]

Urin

e L-

FABP

(μg/

g-Cr

)

800

600

400

200

0 Before After 3h 6h 24h18h 48h

**

*,

*,

Tubule

Glomerulus

80

100

20

40

60

0

150

160

120

130

140

110Alb L-FABP Systolic blood pressure

■ Before treatment ■ After 6 months ■ After 12 months

Rate

of c

hang

e (%

)

Systolic blood pressure (mm

Hg)

Glomerular injury

Failure of �ltration function

Albumin, Type IV collagen

Tubular reabsorption dysfunction

Injury/In�ammation ofrenal tubule

NAG

α1-MG, β2-MG

Marker for the early stage detection of kidney injury

What is L-FABP ?■ A fatty acid binding protein found in the renal proximal tubule■ Excreted in the urine due to oxidative stress or renal tubule ischemia before kidney injury■ A useful marker for the early diagnosis of renal disease that involves tubular disorder

1000

100

10

1

Healthy individuals70cases

Stage 164 cases

Stage 230 cases

Stage 327 cases

Stage 419 cases

Diabetic Nephropathy

Urine L-FABP level by disease stage (μg/gCr)

Tsukasa Nakamura,et al.Diabetologia 50(2):490-492,2007

Based on Kamijo-Ikemori A,et al.Diabetes Care 34:691-696,2011

Katsuomi Matsui,et al.Circulation Journal 76:213-220,2012

Process: 85 cardiovascular surgery patients were divided into AKI and non-AKI cohorts based on the AKIN criteria. Urine L-FABP and Serum CRE were measured immediately before and at several after points surgery.

Results: With the conventional AKI diagnosis method which uses serum creatinine as an indicator, AKI symptoms were con�rmed 24 hrs after surgery. However, Urine L-FABP shows a signi�cant increase within the AKI patient cohort immediately after surgery. This indicates that Urine L-FABP is a useful marker for predicting AKI at an early stage.

Acute Kidney Injury (AKI) - Prediction of onset

Seru

m c

reat

inin

e (m

g/dL

)

1.8

1.6

1.4

1.2

1.0

0.8

0.6Before After 3h 6h 24h18h 48h

**

***

*,

Urin

e L-

FABP

(μg/

g-Cr

)

Standard deviation mean value

Healthy Stage 1 p<0.05

Healthy Stage 2 p<0.05

Healthy Stage 3 p<0.05

Healthy Stage 4 p<0.05

AKI patient group (48)non-AKI patient group (37)

Mainly re�ects signs of Renal Dysfunction Re�ects signs of stress on torenal tubule before cytotoxicity

L-FABP

L-FABP

Renal tubuleischemia

Oxidative stress

Re�ects the RESULT

of Kidney Injury

Re�ects the CAUSE

of Kidney Injury

Albumin Free fatty acidLipid peroxides

Reactive oxygen, generated due to peritubular ischemia/reperfusion injury, changes free fatty acids to lipid peroxides which are highly toxic to cells.

L-FABP binds with these lipid peroxides and is excreted outside of cells. Thus, it is thought that L-FABP is "renoprotective", and works to protect the kidneys.

1

2

L-FABP

L-FABP Urinary excretion within the proximal tubule cytoplasm

LysosomeMitochondria

To urine Renal tubule lumen

Tubulointerstitual side

Cytoplasm of proximal tubule

Ischemia-reperfusion injury

ReactiveOxygen

Oxidative Stress

Process: The Urine L-FABP levels of 140 Diabetic nephropathy patients were subdivided based on disease stage. The mean and standard deviation values were calculated and compared to those of healthy individuals.

Results: The Urine L-FABP levels of Diabetic nephropathy patients increased with the progress of disease stage. As it shows a signi�cant increase compared to healthy individuals even from the early stages of nephropathy, it can be inferred that L-FABP has utility in the early diagnosis of Diabetic nephropathy.

Diabetic Nephropathy - Early stage diagnosis

Process: Diabetic nephropathy patients with microalbuminuria were given ARB for 12 months. The Urine Albumin levels, Urine L-FABP levels, and systolic blood pressure were monitored to deternire the effects of medical treatment.

Results: Large decrease of Urine Albumin levels, Unine L-FABP levels, and systolic blood pressures were observed after 6 months and 12 months when compared to the start of treatment. Similar to Urine Albumin, Urine L-FABP is effective for the monitoring and assessment of treatment, such as antihypertensive therapy for early-stage diabetic nephropathy.

Chronic Kidney Disease - Monitoring and assessment of treatment

Excretion of

Urinary L-FABP values re�ect the level of stress given to the kidneys

ConventionalRenal Disease Markers