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Sept 7, 1963

Urinary Alkaline Phosphatase Activity: I. Elevated Urinary LDH and Alkaline Phosphatase Activities for the Diagnosis of Renal Adenocarcinomas

Author Affiliations


Research Fellow in Medicine (Dr. Amador), Student Research Fellow (Mr. Zimmerman), and Assistant Professor of Medicine (Dr. Wacker), Harvard Medical School; Assistant in Medicine (Dr. Amador), and Senior Associate in Medicine (Dr. Wacker), Peter Bent Brigham Hospital; Fellow of the Medical Foundation (Dr. Amador); and Investigator, Howard Hughes Medical Institute (Dr. Wacker).

JAMA. 1963;185(10):769-775. doi:10.1001/jama.1963.03060100049016

THE RECOGNITION and removal of an inhibitor(s) of lactic dehydrogenase (LDH) activity of human urine resulted in the development of a method useful for the detection and diagnosis of carcinomas of the kidney and bladder.1,2 These discoveries suggested that other enzymes previously thought to be absent or inconsistently present in urine might similarly be masked by inhibitors.3 Detection and removal of such inhibition might result in further diagnostic procedures useful for the detection of asymptomatic disease. The present study demonstrates that human urine has alkaline phosphatase activity, and that this activity is obscured by a dialyzable inhibitor (s). The removal of the inhibitor(s) has allowed the development of a sensitive diagnostic method for adenocarcinomas of the kidney.4

Alkaline phosphatase, distributed throughout the cells and fluids of the body, is especially abundant in the renal tubules. Histochemically its activity has been shown to be altered markedly by diseases