Evidence map›Paper›PMID 41737922›Full record

ArticleBlood global hematology2026

Urinary carbonic anhydrase 1 excretion is a marker of hemolysis-triggering conditions suitable for point-of-care testing.

Alzbeta Hulikova, Zhenyi Wang, Helen Broomfield, Joanna Robinson, Miryam Healy, Rómulo J Figueroa-Mujíca, Dionicia Gamboa, Katherine Torres, Gopal Ammanath, Deny Hartono and 10 more

Abstract read
In one paragraph

Article in Blood global hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Alzbeta HulikovaDepartment of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0001-8305-2890
Zhenyi WangDepartment of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0009-0007-0545-3358
Helen BroomfieldNeonatal Unit, Evelina London Children's Hospital, St. Thomas' Hospital, London, United Kingdom.
Joanna RobinsonNeonatal Unit, Evelina London Children's Hospital, St. Thomas' Hospital, London, United Kingdom.
Miryam HealyNeonatal Unit, Evelina London Children's Hospital, St. Thomas' Hospital, London, United Kingdom.
Rómulo J Figueroa-MujícaLaboratorio de Fisiología del Transporte de Oxígeno y Adaptación a la Altura-Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Perú.
Dionicia GamboaLaboratorio de Malaria-Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Perú.ORCID https://orcid.org/0000-0002-1420-7729
Katherine TorresLaboratorio de Malaria-Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Perú.ORCID https://orcid.org/0000-0003-0414-7547
Gopal AmmanathCamtech Diagnostics Pte Ltd, Singapore.
Deny HartonoCamtech Diagnostics Pte Ltd, Singapore.
Richard C SiowDepartment of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0003-4603-9763
Sara EngledowDepartment of Haematology, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
Ketsanee SrinamonMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Aniruddha GhoseDepartment of Medicine, Chattogram Medical College Hospital, Chattogram, Bangladesh.ORCID https://orcid.org/0000-0002-5551-6691
Katherine PlewesMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.ORCID https://orcid.org/0000-0002-3596-3267
Arjen M DondorpMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.ORCID https://orcid.org/0000-0001-5190-2395
Noemi B A RoyDepartment of Haematology, Oxford University Hospitals NHS Trust, Oxford, United Kingdom.
Francisco C VillafuerteLaboratorio de Fisiología del Transporte de Oxígeno y Adaptación a la Altura-Laboratorios de Investigación y Desarrollo, Facultad de Ciencias e Ingeniería, Universidad Peruana Cayetano Heredia, Lima, Perú.ORCID https://orcid.org/0000-0003-0731-8911
Hammad KhanNeonatal Unit, Evelina London Children's Hospital, St. Thomas' Hospital, London, United Kingdom.ORCID https://orcid.org/0000-0002-2250-8142
Pawel SwietachDepartment of Physiology, Anatomy, and Genetics, University of Oxford, Oxford, United Kingdom.ORCID https://orcid.org/0000-0002-9945-9473

Funding

Medical Research Council MC_PC_19049
6 · The paper itself

Abstract

Intravascular hemolysis accompanies diverse diseases, yet blood-based markers (eg, plasma-free hemoglobin [PFH], haptoglobin, lactate dehydrogenase [LDH], and bilirubin) are variably sensitive, nonspecific, or impractical for point-of-care use. We evaluated urinary carbonic anhydrase 1 (CA1) as a mechanistically grounded, urine-based marker of hemolysis in a multicenter study spanning the United Kingdom, Bangladesh, and Peru. We enrolled 234 participants: healthy adults and adults with inherited anemias (Oxford), newborns in intensive care (London), children and adults with complicated or uncomplicated malaria (Bangladesh), and adults attending rural clinics for various medical reasons (Peru). Urine CA1 and hemoglobin (Hb) were quantified by enzyme-linked immunosorbent assay and immunoblot, with CA1:Hb stoichiometry used to distinguish intravascular hemolysis from urogenital blood contamination. Relationships with PFH, LDH, bilirubin, Hb, C-reactive protein (CRP), and clinical variables were tested using regression, principal component analysis, and decision tree. Reference urine samples were predominantly CA1-negative/Hb-negative. In inherited anemias, urinary CA1 was highest in sickle cell disease and correlated with serum LDH and inversely with blood Hb. In neonates, longitudinal CA1 trajectories stratified infants into physiological, transient, and sustained hemolysis groups; higher CA1 levels were associated with prematurity, elevated CRP and lower white blood cell count. Urinary CA1 was detected in Bangladeshi patients with elevated PFH and in cases of intravascular hemolysis not identified by PFH. Among Peruvian participants, urinary CA1 correlated with raised CRP level, consistent with inflammation being a prohemolytic trigger. To enable rapid and cost-effective testing, a lateral flow device was developed and verified for excellent sensitivity and specificity. Urinary CA1 provides a sensitive and practical readout of intravascular hemolysis suitable for point-of-care testing globally.

Identifiers

PMID41737922
PMCPMC7618779

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.