Pyrophosphate in synovial fluid and urine and its relationship to urinary risk factors for stone disease

N B Roberts, J Dutton, T Helliwell, P J Rothwell, J P Kavanagh

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Inorganic pyrophosphate (PPi) measurement in urine and synovial fluid has been established using the PPi-dependent phosphorylation of fructose-6-phosphate and subsequent reduction of dihydroxyacetone phosphate by NADH. The assay is linear up to 200 mumol/L, easy to perform and gives results comparable to more complex methods. Daily urinary output of PPi was independently related to both age (P = 0.0014) and sex (P = 0.0002). Men had higher values than women and older individuals excreted greater amounts. Male stone formers, younger than 45 years, had lower values than age matched male controls (P = 0.012). Younger female stone formers also tended to have lower values. In stone formers' urine significant and independent correlations were found of PPi excretion with urine volume (P = 0.004) and with phosphate excretion (P = 0.008). Oxalate excretion and that of other urine constituents and the degree of supersaturation with common stone-forming salts were not correlated with PPi. PPi excretion was markedly elevated in the urine of two patients with hypophosphatasia. The PPi concentration in synovial fluid from painful, swollen knee joints was elevated, but unrelated to the presence or absence of PPi or urate crystals.
Original languageEnglish
Pages (from-to)529-534
Number of pages6
JournalAnnals of Clinical Biochemistry
Issue number5
Publication statusPublished - Sep 1992


  • Adolescent
  • Adult
  • Aged
  • Aging
  • Analysis of Variance
  • Child
  • Child, Preschool
  • Dihydroxyacetone Phosphate
  • Diphosphates
  • Female
  • Fructosephosphates
  • Humans
  • Hypophosphatasia
  • Kidney Calculi
  • Knee Joint
  • Male
  • Middle Aged
  • NAD
  • Oxidation-Reduction
  • Phosphorylation
  • Risk Factors
  • Sex Factors
  • Synovial Fluid

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