Clinical Chemistry
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Clinical Chemistry 19: 315-321, 1973;
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Clinical Chemistry, Vol 19, 315-321, Copyright © 1973 by the American Association for Clinical Chemistry

Urinary Guanidinoacetate / Guanidinosuccinate Ratio: An Indicator of Kidney Dysfunction

Masahide Sasaki 1, Kihachiro Takahara 1, and Samuel Natelson 1

1 Department of Biochemistry, Michael Reese Hospital and Medical Center, Chicago, Ill. 60616.

Five formerly unidentified peaks in the column chromatogram of urinary compounds giving the Sakaguchi reaction appear to be proteins or polypeptides containing arginine. If these substances, salts, and creatine are first removed, then guanidinoacetate (GAA), guanidinosuccinate (GSA), and creatine are readily measured in urine. This technique was applied to the urine of 17 healthy men and 10 healthy women, GAA and GSA being measured by the Sakaguchi reaction (after they were separated by electrophoresis) and creatine by the diacetyl reaction. Creatine and GAA values differ for men and women when corrected for differences in body weight. In mg/24 h/kg body weight, the respective excretions for men and women were: creatine, 0.83 and 1.98; GAA, 0.71 and 1.22. No significant sex-related differences were found for GSA (men, 0.18; women, 0.25) or creatinine (men, 24.7; women, 22.8). The GSA/GAA excretion ratio for healthy men and women was 0.25 and 0.20, respectively. For those with abnormally high blood urea nitrogen and creatinine concentrations, this ratio rose to values ranging from 1.8 to 24, with no overlap with normal. This ratio is evidently a sensitive indicator of kidney function.


Key Words: normal values • renal disease • azotemia • Sakaguchi reaction • diacetyl reaction • paper electrophoresis • cation-exchange chromatography • urinary polypeptides • excretion on body-weight basis • creatine

Submitted on November 14, 1972
Accepted on December 26, 1972






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Copyright © 1973 by the American Association for Clinical Chemistry.