Uroscopy in the 21st century: high-field NMR spectroscopy

From the experiments described, it can be seen that there are differentresearch approaches that can be taken and these are summarized in Table 1.Whereas much scientific research is principally hypothesis led, thereremains, nevertheless, an important place for exploratory research. Highresolution NMR can measure, directly and simultaneously, a wide range ofendogenous metabolites in biological fluids and has the unique capabilityof providing structural information on the metabolites detected. It hasproved to be a powerful research tool with which to study inheritedmetabolic diseases, renal disease, drug metabolism, and toxicity, and canbe used to monitor the effects of drug therapy. For instance, by using alibrary of experimental toxins one can map the metabolic profile ofsite-specific nephron injury. With this approach in man one couldeventually take an unknown disease such as Balkan nephropathy and predictthe initial site of tubular injury, the mode of injury and therefore thekind of toxin capable of producing that injury. NMR spectroscopictechniques are still advancing rapidly, with ever increasing sensitivityand sophistication of NMR pulse sequences to enhance structural elucidationin complex mixtures. Given the advances in directly coupled HPLC-NMR andeven HPLC-NMR-mass spectroscopy it is likely that these technologies inconjunction with pattern recognition will make major contribution to ourunderstanding of renal processes and provide new diagnostic insights in the21st century.