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Nonprotein Nitrogenous Substances (Creatinine, Urea and Uric Acid) & Kidney Function Tests

NONPROTEIN NITROGENOUS SUBSTANCES The term nonprotein nitrogen (NPN) is historically used due to the method which required the removal of protein from the sample before analysis of nitrogen-containing compounds. The most common NPNs such as Creatinine, Urea and uric acid will be discussed in this report. These substances are cleared from the body by the kidney following glomerular filtration. Measurements of plasma or serum concentration of these substances are commonly used as indicators of kidney function and other conditions. I. CREATININE Creatinine is the cyclic anhydride of creatine that is produced as the final product of decomposition of phosphocreatine. It is excreted in the urine; measurements of plasma creatine & its renal clearance are used as diagnostic indicators of kidney function. A. BIOSYNTHESIS II. UREA Urea is the NPN substance with the highest concentration in the blood. It is the major excretory product of protein metabolism. It is formed in the liver from amino groups (-NH2 ) and free ammonia generated during protein catabolism. The term BUN or blood urea nitrogen is historically based on the measurement of nitrogen to assay urea. A. BIOSYNTHESIS III. URIC ACID Uric acid is the major product of catabolism of the purine nucleic acids. Although it is filtered by the glomerulus and secreted by the distal tubules into the urine, most uric acids are reabsorbed in the proximal tubules and reused. Uric acid is relatively insoluble in plasma and at high concentrations, can be deposited in the joints and tissue, causing painful inflammation. A. BIOSYNTHESIS