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Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282


ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

BC: Articoli scritti da G. Gambaro

Valutazione della filtrazione glomerulare: riflessione sull’impiego clinico
Evaluation of the glomerular filtration rate from the clinical point of view
G. Gambaro  | 
<p>In this paper I briefly discuss what the nephrologist means by &ldquo;renal function&rdquo; from a clinical point of view, and what can be inferred from the determination of the Glomerular Filtration Rate (GFR). Furthermore, I illustrate the use of serum biomarkers: serum creatinine, and GFR (measured and estimated GFR with different formulas), together with their limitations in different clinical conditions (acute kidney injury versus chronic kidney disease), different ages, different patients (obese, HIV patientsts, different ethnic groups). Forthcoming new methods for the point-of-care, rapid GFR determination are described with their possible implications in the acute kidney injury setting.</p>
Biochimica Clinica ; 45(3) s090-s096
Opinioni - Opinions
Esame fisico, chimico e morfologico delle urine: raccomandazioni per la fase postanalitica del Gruppo Interdisciplinare Laboratorio e Clinica Apparato Urinario (GIAU)
Physical, chemical and morphological urine examination: recommendations for the postanalytical phase from the Interdisciplinary Urinalysis Group (GIAU)
<p>This document of the Interdisciplinary Urinalysis Group (GIAU) is aimed to provide recommendations on how to improve and standardize the postanalytical approach to physical, chemical and morphological urine examination (ECMU). The main tool to emphasize the value of the ECMU is the development of a laboratory report suitable for the clinical needs. As a consequence, these recommendations are mainly related to the structure and content of the report. They include: the layout, the parameters to be included, the measurement units, the reference values, the inclusion of interpretative comments. Really, an important section of the report is dedicated to the interpretative comments: these are a real add-on value and are tailored on the type of laboratory performing the analysis (general or with a specific section dedicated to the urine examination). The different levels of the laboratory competence determine the category of possible comments. The basic one concerns comments that evaluate the non-conformity of the sample (i.e. presence of urethral, seminal, vaginal, faecal contamination; too concentrated/too diluted samples). The second level of comments is dedicated mainly to the reporting of the discrepancies between the biochemical analysis and the microscopy examination (i.e. presence of haemoglobin and no erythrocyte detection; presence of leucocyte esterase and no leucocyte detection). The third level requires a specific competence of the pathologist together with a strict collaboration with the clinic; these comments are elaborated on the basis of a specific clinical request. The detection of the &ldquo;decoy cells&rdquo; in immunosuppressed solid organ transplant recipients, that are typical of a poliomavirus infection, is a good example of the third level of interpretative comments. A final section of the document is dedicated to the opportunity to implement and adopt specific programs of external evaluation of the urinary sediment.<br />After the issuing of the recommendations dedicated to pre-analytical and analytical phases, this GIAU document gives suggestions for the standardisation and harmonisation of post-analytical phase in the attempt to emphasize the diagnostic importance of ECMU.</p>
Biochimica Clinica ; 44(1) 086-099
Documenti SIBioC - SIBioC Documents
Utilità della spettroscopia all’infrarosso per l’analisi dei calcoli urinari
Usefulness of infrared spectroscopy for stone analysis: a case study
<p>A 22-year-old male with recurrent bilateral stone disease and positive family history for stones was referred in March 2015 to the Metabolic Stone Clinic of the Policlinico Gemelli Hospital; a metabolic assessment revealed a number of abnormalities including hypercalciuria, hypocitraturia and abnormally high fasting urine pH. The previously expelled urinary calculus was sent to the clinical laboratory for the biochemical analysis by the infrared method. Fourier transform infrared spectroscopy (FT-IR) analysis identifying brushite and carbapatite, together with the finding of high urine pH, raised the suspicion of distal renal tubular acidosis which was subsequently confirmed by the urinary acidification test. The semiquantitative method of stone composition analysis would have yielded a mixture of calcium, ammonium, phosphate and magnesium, thus likely directing the diagnostic work-up, together with the abnormally high urine pH, towards infectious stones (e.g., by urease-producing bacteria). The information obtained by FT-IR analysis allowed clinicians to correctly hypothesize a urinary acidification deficit, which was subsequently treated with potassium citrate supplements.</p>
Biochimica Clinica ; 41(2) e13-e14
Casi clinici - Case report
Esame fisico, chimico e morfologico delle urine: proposta di linee guida per la fase analitica del Gruppo Intersocietario Analisi delle Urine (GIAU)
Physical, chemical and morphological urine examination: proposed guidelines for the analytical phase by the Intersociety Urinalysis Group
<p>With these guidelines, the Intersociety Urinalysis Group (GIAU) aims to stimulate the following aspects: a) improvement and standardization of the analytical approach to physical, chemical and morphological urine examination (ECMU); b) to emphasize the value added to ECMU by automated analyzers for the study of the morphology of the corpuscular fraction urine; c) improvement of the chemical analysis of urine with particular regard to the reconsideration of the diagnostic significance of parameters that are traditionally evaluated in dipstick analysis, together with an increasing awareness of the limits of sensitivity and specificity of this analytical method; d) to increase the awareness of the importance of professional skills in the field of urinary morphology and of the relationships with clinicians; e) implementation of a policy for the evaluation of the analytical quality by using, in addition to traditional IQC and EQA, a program for the evaluation of morphological competence; f) to stimulate the diagnostic industry to focus research efforts and development methodology and instrumental catering to the needs of clinical diagnosis. The hope is to revalue the enormous diagnostic potential of ECMU, by implementing an urinalysis based on personalized diagnostic needs.</p>
Biochimica Clinica ; 40(4) 353-382
Documenti SIBioC - SIBioC Documents
Ruolo della spettroscopia infrarossa in trasformata di Fourier nella valutazione della calcolosi urinaria
Role of Fourier transform infrared (FT-IR) spectroscopy in the evaluation of urinary stone disease
<p>Nephrolithiasis is a common disease occurring in both industrialized and developing countries and mainly affecting&nbsp;adults aged 20-60 years. The determination of crystalline and molecular composition and the quantification of all&nbsp;stone components are helpful to establish the etiology of urinary stone disease. Different methodologies exist for the&nbsp;analysis of renal stones. In our laboratory, we used the chemical spot test, which is the most popular method for&nbsp;routine stone analysis. However, this method is relatively inaccurate and does not allow distinguishing between the&nbsp;crystalline phases. In this paper, we evaluated the quantitative FT-IR spectroscopy technique for a possible&nbsp;introduction in our laboratory. We analyzed 100 urinary stones, divided into 3 groups: pure stones, mixed stones, and&nbsp;pure stones with substances in trace. Results of each group were compared with those obtained with chemical spot&nbsp;test. A total or partial disagreement between the two methods was observed in 59% of pure stones, in 86.6% of mixed&nbsp;stones and in 100% of pure stones with substances in trace, respectively, suggesting the replacement of the chemical&nbsp;test with FT-IR spectroscopy.</p>
Biochimica Clinica ; 40(1) 28-32
Contributi scientifici - Scientific Papers