C - Chapter VIII: NPN
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FUNCTIONS of the KIDNEYS: 1. Elimination of (?) 2. Elimination of (?) (urea and creatinine) 3. Elimination of (?)like drugs 4. Retention of substances necessary for (?) (proteins & amino acids, glucose) 5. Regulation of (?) of the body fluids) 6. (?) function:
excess body water waste products of metabolism foreign substances normal body function electrolyte balance and osmotic pressure Endocrine
Primary:
production of rennin, prostaglandin and erythropoietin
Secondary:
degradation of insulin, glucagon and aldosterone
Clinically Significant NPN compounds:
• urea – 45% • amino acids – 20% • uric acid – 20% • creatinine – 5 % • creatine – 1-2 % • ammonia – 0.2%
TOTAL NPN METHODOLOGY: TWO STEPS:
• KJELDAHL DIGESTION • MEASUREMENT OF AMMONIA FORMED
MEASUREMENT OF AMMONIA FORMED
A. NESSLERIZATION B. BERTHELOT METHOD C. MONITORING CONSUMPTION OF AMMONIA (Kaplan, Manoukian – Fawaz; Kallet – Cook Reaction)
The nitrogen in a pff of the specimen is converted to ammonia using hot conc. H2SO4 with copper sulfate, mercuric sulfate or selenium oxide as the catalysts.
KJELDAHL DIGESTION
NPN + H2SO4 NH4HSO4
KJELDAHL DIGESTION
NH4HSO4 + NaOH Na2SO4 + NH3 + H2O
KJELDAHL DIGESTION
Nessler’s reagent
double iodide salt of potassium & mercury
– colloidal stabilizer
Gum ghatti
– yellow to orange brown product
Dimercuric ammonium iodide
NH3 + HgI2.2KI NH2Hg2I2 + KI + NH4I
NESSLERIZATION
Reagent: phenol and alkaline hypochlorite
BERTHELOT METHOD
Catalyst: sodium nitroprusside
BERTHELOT METHOD
Product: indophenol blue
BERTHELOT METHOD
NH3 + NaOCl + Phenol Indophenol + NaCl + H2O
BERTHELOT METHOD
NH3 + α – ketoglutarate + NADH + H Glutamate + NAD
MONITORING CONSUMPTION OF AMMONIA (Kaplan, Manoukian – Fawaz; Kallet – Cook Reaction)
Catalyst: Glutamate dehydrogenase
MONITORING CONSUMPTION OF AMMONIA (Kaplan, Manoukian – Fawaz; Kallet – Cook Reaction)
Measure a decrease in the absorbance at 340 nm
Glutamate dehydrogenase
• most abundant NPN compound in plasma
UREA
• major excretory product of protein metabolism
UREA
• synthesized in the liver from CO2 and ammonia that arises from the deamination of amino acids in the reaction of the urea cycle
UREA
UREA STRUCTURE