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1.
Organ Transplantation ; (6): 74-2022.
Article in Chinese | WPRIM | ID: wpr-907036

ABSTRACT

Objective To evaluate the predictive values of serum neutrophil gelatinase-associated lipocalin (NGAL), urine NGAL, serum cystatin C (Cys-C) and serum creatinine (Scr) for early delayed graft function (DGF) in kidney transplant recipients. Methods Clinical data, blood and urine samples of 159 kidney transplant recipients were collected. All recipients were divided into the DGF group (n=42) and immediate graft function (IGF) group (n=117) according to the incidence of DGF. Clinical data of all recipients were analyzed. The changes of serum NGAL, urine NGAL, Cys-C and Scr levels were statistically compared between two groups. The predictive values of different markers for early DGF were assessed. Results Among 159 kidney transplant recipients, DGF occurred in 42 cases with an incidence rate of 26.4%. There were statistically significant differences in donor age, cold ischemia time of donor kidney and complement-dependent cytoxicity (CDC) between the two groups(all P < 0.05). Within postoperative 2 weeks, the serum NGAL levels in the DGF group were higher than those in the IGF group (all P < 0.05). The Cys-C, Scr and urine NGAL levels in the DGF group were higher compared with those in the IGF group within 3 weeks after kidney transplantation(all P < 0.001). Serum NGAL, urine NGAL, Cys-C and Scr levels had certain predictive values for early DGF in kidney transplant recipients. Cys-C yielded the highest predictive value with a cut-off value of 4.73 mg/L, sensitivity of 0.833, specificity of 0.812 and area under the curve (AUC) of 0.895. Conclusions Cys-C has higher predictive value for early DGF in kidney transplant recipients compared with serum NGAL, urine NGAL and Scr.

2.
Afr. j. health sci ; 35(3): 332-342, 2022. figures, tables
Article in English | AIM | ID: biblio-1380186

ABSTRACT

Acute Kidney Injury (AKI) is considered one of the main public health problems. The effective management of these alterations is based on the early detection of renal lesions. The objective of this study was to evaluate the contribution of the Cystatin C (CysC) assay in the early diagnosis of acute kidney injury (AKI) in children hospitalized in pediatric intensive care units in Brazzaville. MATERIALS AND METHODS Sixty children at high risk of developing AKI were included. Consent form signed was obtained from parents, socio-demographic data, weight and height of children recorded. Creatinine (Cr), CysC and urea were assayed in serum 24 hours after admission. Glomerular filtration clearance was estimated using serum creatinine and CysC. Glomerular filtration rate (GFR) was calculated from CysC and Cr. The diagnostic accuracy was determined by comparing the results of CysC to those of Cr (considered as a reference biomarker). RESULTS The median age was 5 years (with extremes ranging from 1 month to 17 years). Cr, CysC, urea, and GFR/Cr (mean ± standard deviation [range]) were 0.94±1.17 (0.2­ 1.4 mg/dl), 0.14 ± 0.062 (0.053-0.095 mg/l), 46.65±47.75 (15.0­45.0 mg/dl), 81.85±31.90 (≥190 ml/min per 1.73 m2 , respectively. The level of CysC in patients with ARL was significantly higher than that of children with normal renal function (p<0.001). Our results show that the performance of serum CysC in detecting AKI early was superior to that of serum Cr in children hospitalized in pediatric intensive care units in Brazzaville


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Creatinine , Early Diagnosis , Cystatin C , Acute Kidney Injury , Diagnosis , Academic Medical Centers
3.
Organ Transplantation ; (6): 220-2021.
Article in Chinese | WPRIM | ID: wpr-873734

ABSTRACT

Objective To analyze the risk factors and clinical prognosis of acute kidney injury (AKI) early after lung transplantation. Methods Clinical data of 155 recipients undergoing lung transplantation or combined heart-lung transplantation were retrospectively analyzed, and they were divided into the AKI group (n=104) and non-AKI group (n=51) according to the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline. The incidence of AKI early after lung transplantation was summarized. The main indexes of recipients were collected. The risk factors of the occurrence of AKI early after lung transplantation were subjected to univariate and multivariate analysis. The clinical prognosis of lung transplant recipients was evaluated and the survival curve was delineated. Results The incidence of AKI early after lung transplantation was 67.1%(104/155), including 47 recipients with stage 1 AKI, 34 recipients with stage2 AKI and 23 recipients with stage 3 AKI, respectively. Sixteen recipients required continuous renal replacement therapy (CRRT) early after lung transplantation. Preoperative complication with diabetes mellitus, preoperative complication with pulmonary hypertension, intraoperative mean arterial pressure (MAP) < 60 mmHg, intraoperative massive blood transfusion, and treatment with excessive therapeutic concentration of tacrolimus (Tac) within postoperative 1 week were the independent risk factors for the occurrence of AKI early after lung transplantation. Up to the end of follow-up, 66 recipients (42.6%) died, including 50 recipients in the AKI group and 16 recipients in the non-AKI group. The cumulative survival rate in the AKI group was significantly lower than that in the non-AKI group (40% vs. 66%, P < 0.05). With the increase of AKI severity, the cumulative survival rate of lung transplant recipients was decreased. Conclusions AKI develops early after lung transplantation with high incidence and poor clinical prognosis. Preoperative complication with diabetes mellitus and pulmonary hypertension, intraoperative MAP < 60 mmHg and massive blood transfusion, and treatment with excessive therapeutic concentration of Tac within postoperative 1 week are the independent risk factors for the occurrence of AKI early after lung transplantation.

4.
Acta Pharmaceutica Sinica B ; (6): 322-339, 2021.
Article in English | WPRIM | ID: wpr-881139

ABSTRACT

Fibrosis is a pathological reparative process that can occur in most organs and is responsible for nearly half of deaths in the developed world. Despite considerable research, few therapies have proven effective and been approved clinically for treatment of fibrosis. Artemisinin compounds are best known as antimalarial therapeutics, but they also demonstrate antiparasitic, antibacterial, anticancer, and anti-fibrotic effects. Here we summarize literature describing anti-fibrotic effects of artemisinin compounds in

5.
Organ Transplantation ; (6): 733-2021.
Article in Chinese | WPRIM | ID: wpr-904558

ABSTRACT

Objective To investigate the effect and mechanism of artesunate on renal ischemia-reperfusion injury (IRI) in rat. Methods Twenty-five SD rats were randomly divided into the sham operation group (Sham group), model group (IRI group), low-dose artesunate group (ART-L group), high-dose artesunate group (ART-H group) and NLRP3 inflammasome inhibitor group (INF39 group), with 5 rats in each group. The levels of serum creatinine (Scr), blood urea nitrogen (BUN) and pathological damage of renal tissue were analyzed. The levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in serum were quantitatively measured. The expression level of IL-1β in renal tissues was determined by immunohistochemical staining. The expression levels of pyroptosis-related proteins were detected by fluorescent staining and Western blot. Results Compared with the Sham group, the levels of Scr and BUN were higher, the renal tissue injury was aggravated, the expression levels of TNF-α, IL-6 and IL-1βwere higher, and the expression levels of kidney injury molecule (KIM-1), pyroptosis-related protein NOD-like receptor protein 3 (NLRP3), cysteinyl aspartate specific proteinase (Caspase-1), Gasdermin D (GSDMD) and IL-1β proteins were higher in the IRI group. Compared with the IRI group, the levels of Scr and BUN were decreased, the renal tissue injury was mitigated, the expression levels of TNF-α, IL-6 and IL-1β were down-regulated, and the expression levels of KIM-1, NLRP3, Caspase-1, GSDMD and IL-1β proteins were down-regulated in the ART-L, ART-H and INF39 groups. Conclusions Artesunate may inhibit pyroptosis induced by NLRP3 inflammasome, down-regulate the expression levels of pyroptosis -related proteins, reduce the release of inflammatory factors after renal IRI and alleviate renal IRI.

6.
Chinese Journal of Nephrology ; (12): 499-506, 2021.
Article in Chinese | WPRIM | ID: wpr-911879

ABSTRACT

Objective:To assess the impact of kidney damage on the progression and prognosis of coronavirus disease 2019 (COVID-19) patients.Methods:The databases including CNKI, Wanfang Chinese Academic Journal Database, Pubmed, EMBASE and Cochrane databases were searched. The data retrieval period was from December 2019 to June 2020. During this period, RevMan 5.2 was used to extract and analyze data from the literature.Results:In this study, 15 articles, covering 11 448 COVID-19-related cases, were selected from the target databases. Meta-analysis results indicated that, for COVID-19 patients with acute kidney injury (AKI), the proportion of COVID-19 patients with AKI who received intensive care unit (ICU) treatment was significantly higher than that of patients without AKI ( OR=10.83, 95% CI 9.43-12.45, Z=33.53, P<0.001). Among them, the Asian group of COVID-19 patients with AKI accounted for 3.4% of all COVID-19 patients. The Asian group of COVID-19 patients with AKI who received ICU treatment accounted for 74.1% of all COVID-19 patients with AKI. Meta-analysis showed that the proportion of COVID-19 patients with AKI in the Asian group receiving ICU treatment was significantly higher than that of COVID-19 patients without AKI ( OR=18.66, 95% CI 9.85-35.34, Z=8.98, P<0.001). COVID-19 patients with AKI in the European and American groups accounted for 36.5% of all COVID-19 patients, and the European and American groups of COVID-19 patients with AKI who received ICU treatment accounted for 53.3% of all COVID-19 patients with AKI. Meta-analysis showed that the proportion of COVID-19 patients with AKI in the European and American groups receiving ICU treatment was significantly higher than that of COVID-19 patients without AKI ( OR=10.58, 95% CI 9.18-12.21, Z=32.40, P<0.001). The death risk of COVID-19 patients with AKI was significantly higher than that of patients without AKI ( OR=56.46, 95% CI 15.86-200.96, Z=6.23, P<0.001). COVID-19 patients with renal impairment had a higher risk of worsening and death than those without renal impairment ( OR=6.40, 95% CI 4.14-9.90, Z=8.36, P<0.001). Subgroup analysis showed COVID-19 patients with positive urine protein had a higher risk of worsening and death than those without positive urine protein ( OR=6.27, 95% CI 3.88-10.14, Z=7.49, P<0.001), and COVID-19 patients with elevated serum creatinine had a higher risk of worsening and death than those without elevated serum creatinine ( OR=7.13, 95% CI 2.58-19.72, Z=3.79, P<0.001). Conclusions:Patients with COVID-19 combined with AKI or only with positive urine protein and elevated serum creatinine are the risk factors for aggravation and even death. It is recommended that, in the diagnosis and treatment of COVID-19 patients, an optimization plan should be adopted to avoid or reduce the burden on the kidneys, meanwhile the patients' kidney damage should be paid closely attention to for protection and treatment in the early stage to avoid the occurrence of AKI. For patients who already suffered from AKI, replacement therapy, which would prevent these patient's condition from getting worse or even death, should be promptly implemented to alleviate the impact of kidney damage.

7.
Organ Transplantation ; (6): 601-2021.
Article in Chinese | WPRIM | ID: wpr-886790

ABSTRACT

Objective To evaluate the clinical efficacy of adult kidney transplantation from unilateral pediatric donor kidney. Methods Clinical data of pediatric donors (n=10) and adult recipients (n=19) undergoing kidney transplantation were retrospectively analyzed. The changes of renal function, liver function and the maximal diameters of the kidney allografts were compared at 1, 7, 14, 28, 60 d after operation. The short-term survival and incidence of postoperative complications of the recipients were analyzed. Results Ten donors included 6 males and 4 females, aged (7±3) years old, with a body mass index (BMI) of (16.3±3.8) kg/m2. All donors were donation after brain death followed by cardiac death. Among 19 recipients, 12 were males and 7 were females, aged (34±12) years old, with a BMI of (20.3±1.3) kg/m2.An oblique incision was created in the lower right abdomen of the recipients. The arteries and veins of donor kidney were anastomosed with the external iliac arteries and veins of the recipients. The ureter of donor kidney was anastomosed with the bladder of the recipients. After anastomosis, the kidney was placed and fixed in the right iliac fossa. The serum creatinine and blood urea nitrogen levels of the recipients were decreased at 1 week after kidney transplantation, and restored to normal range at postoperative 2 weeks. All parameters related to liver function were normal after operation. At postoperative 1 month, the maximal diameters of the kidney allografts were (9.5±0.3) cm on average, which basically reached those of normal adults. The 1-year survival rate of 19 recipients was 95%. One recipient died from pulmonary infection after ineffective treatment. Two recipients developed rejection, and 1 recipient experienced urinary system infection, who were healed after corresponding treatment. Conclusions Adult kidney transplantation from unilateral pediatric donor kidney is safe, feasible and effective, which can be utilized to enlarge the source of donor kidneys.

8.
Organ Transplantation ; (6): 563-2021.
Article in Chinese | WPRIM | ID: wpr-886785

ABSTRACT

Objective To evaluate the effect of bone marrow mesenchymal stem cell (BMSC) on the expression of interleukin (IL)-10 and tumor necrosis factor (TNF)-α in mice with ischemia-reperfusion acute kidney injury (IR-AKI). Methods All mice were randomly divided into the sham operation group (control group), ischemia-reperfusion injury group (IRI group) and BMSC treatment group (BMSC group), with 6 mice in each group, respectively. The renal function and pathological changes of mice were detected. The cell apoptosis of renal tissues of mice was determined. The expression levels of serum IL-10 and TNF-α of mice were quantitatively measured. The mouse BMSC was randomly divided into the control and hypoxia-reoxygenation groups (IRI group), and the expression levels of IL-10 and TNF-α in cell supernatant were determined. Results The renal structure of mice was normal in the control group, severe damage was observed in the IRI group, and mild damage occurred in the BMSC group. Compared with the control group, the renal tissue injury scores were significantly higher in the IRI and BMSC groups (both P < 0.05). Compared with the IRI group, the renal tissue injury score was significantly lower in the BMSC group (P < 0.05). Compared with the control group, the levels of serum creatinine (Scr) and blood urea nitrogen (BUN) were remarkably up-regulated in the IRI group, and the level of BUN was significantly up-regulated in the BMSC group (all P < 0.05). Compared with the IRI group, the levels of Scr and BUN were significantly down-regulated in the BMSC group (both P < 0.05). In the IRI group, the quantity of apoptotic cells in the renal tissues was considerably higher than those in the BMSC and control groups, and the quantity of apoptotic cells in the BMSC group was significantly higher than that in the control group (all P < 0.05). Compared with the control group, the levels of serum IL-10 and TNF-α were significantly up-regulated in the IRI group, whereas the level of serum TNF-α was significantly down-regulated and the level of serum IL-10 was significantly up-regulated in the BMSC group (all P < 0.05). Compared with the IRI group, the levels of serum IL-10 and TNF-α were significantly down-regulated in the BMSC group (both P < 0.05). The levels of IL-10 and TNF-α in the cell supernatant did not significantly differ between the IRI and control groups (P=0.080、0.627). Conclusions BMSC infusion may reduce the incidence of renal IRI and inflammation, probably via the mechanism of down-regulating TNF-α expression rather than up-regulating IL-10 expression.

9.
Article | IMSEAR | ID: sea-212544

ABSTRACT

Background: Acute kidney injury is a common problem with various causes and consequences like electrolyte disturbances in the form of hypocalcaemia, hypokalemia, hyperkalemia depending on the phase. Hypomagnesaemia is one of the most common electrolyte disturbance found in hospitalized patients especially in the critically ill patients. Prevalence of hypomagnesemia varies from 11 to 65% in different studies. Hence, we decided to conduct a study to evaluate correlation of serum magnesium levels in AKI.Methods: A cross-sectional, hospital based time bound study was conducted between November 2016 and August 2018 with a sample of 100 patients aged 18-65 years and who had AKI were included and patients with diabetes mellitus, multi-organ dysfunction, obstructive uropathy and drug induced AKI were excluded from study. The decrease in magnesium <1.7 mg/L was defined as hypomagnesaemia. AKI was defined as per AKIN criteria. Day 1, day 3 and day 6 magnesium levels were measured.Results: Prevalence of hypomagnesaemia was 53%, 30% and 36% on day 1, day 3 and day 6 respectively. It was observed that there was a positive correlation between serum magnesium, and serum creatinine. Normomagnsemia and hypermagnesemia on day 1, 3 and 6 were significantly associated with recovery of AKI (p<0.001).Conclusions: The prevalence of hypomagnesemia was significantly higher in AKI patients and normal magnesium and hypermagnesium on day 1, 3 and day 6 was associated with recovery than non-recovery. Hypomagnesemia was associated more with non-recovery then recovery.

10.
Article | IMSEAR | ID: sea-211963

ABSTRACT

Background: Acute kidney injury is a multiplex disease with severe morbidity and mortality. The trends of acute kidney injury vary according to the regions and the population under study. The aim of this study is to evaluate the trends of acute kidney injury and its outcome in a tertiary care hospital.Methods: The study was a prospective observational study conducted at a tertiary care hospital in a metropolitan city. A total of 102 patients of acute kidney injury were selected based on the Kidney Disease Improving Global Outcomes guidelines of acute kidney injury. The main trends of acute kidney injury presentation and its outcome were assessed.Results: Of 102 patients admitted, 42 had a sepsis related diagnosis (42.41%), 17 patients (17.16%) had cardiovascular disease related acute kidney injury and 12 patients (12.12%) had developed acute kidney injury due to drugs and poisons. According to RIFLE (risk of renal failure, injury to kidney, failure and loss of function and end-stage kidney disease) category, 43.96% of patients belonged to the risk category and 30.77% to the injury category. Of 34 patients in failure category, 23 recovered and 11 did not recover. Authors compared the trends of acute kidney injury in patients who recovered and who deteriorated. The mean serum creatinine values were 3.42 mg/dl in patients who didn’t recover from acute kidney injury and 2.05 mg/dl in patients who recovered. In patients of the recovered group, the mean urine output value is 783 ml/day; in deterioration group, 445 ml/day.Conclusions: Most common etiologies of acute kidney injury in this study include sepsis, drugs and poisons, cardiovascular diseases and diarrheal diseases in order of occurrence. High serum creatinine at admission and oliguria were the most common factors that contributed to deterioration in acute kidney injury.

11.
Article in English | WPRIM | ID: wpr-876782

ABSTRACT

@#The critical micro-vascular complications of diabetes ultimately result in renal dysfunction known as diabetic nephropathy (DN). Measurement of glomerular filtration rate (GFR) is considered to be an important parameter in renal function assessment, evaluating GFR by Creatinine level. Recently, Cystatin C is used as a substitute indicator in several studies to assess diabetic nephropathy. This work was conceived to determine whether serum cystatinC would replace serum creatinine (Scr) in patients with type2 diabetes for early evaluation of nephropathy. A Case-Control Study was enrolled on 30 Patients with diabetic and 30 apparently healthy as control, aged between 25 - 83 years. Levels of serum cystatine C and serum Creatinine were calculated for both groups. Serum Creatinine, as well as serum cystatin C levels, was significant relationship with diabetic pt. in compared to non-diabetic individuals. ROC analysis noted the cystatinC was more predict indicator in diagnosed Diabetic Nephropathy (DNP) from Serum Creatinine level. In Type 2 diabetics, CystatinC is a good marker for uncontrolled diabetic nephropathy relative to serum creatinine.

12.
Organ Transplantation ; (6): 743-2020.
Article in Chinese | WPRIM | ID: wpr-829690

ABSTRACT

Acute kidney injury (AKI) is one of the common early complications after lung transplantation, which not only increases the short-term and long-term fatality of lung transplant recipients, but also significantly increases the incidence of long-term chronic renal insufficiency after surgery. In recent years, early AKI after lung transplantation has attracted high attention along with the rapid development of lung transplantation in China. In this article, research progresses on diagnosis, incidence, risk factors, prevention and treatment of early AKI after lung transplantation around the globe were reviewed, aiming to better identify the risk factors and poor prognosis of early AKI after lung transplantation, and provide theoretical and practical guidance for early clinical interventions.

13.
Organ Transplantation ; (6): 559-2020.
Article in Chinese | WPRIM | ID: wpr-825571

ABSTRACT

Objective To investigate the dynamic changes of peripheral blood lymphocyte subsets and their correlation with renal function in recipients with stable graft status after renal transplantation. Methods Forty-five recipients who underwent renal transplantation for the first time and had stable graft function within postoperative 6 months were selected. The proportion and absolute value of lymphocyte subsets were detected by flow cytometry (FCM) in 180 peripheral blood samples from recipients at 15 d, 1, 3 and 6 months after renal transplantation. The dynamic changes of lymphocyte subsets with the extension of postoperative time and their correlation with serum creatinine (Scr) and blood urea nitrogen (BUN) were analyzed. Results The Scr levels did not significantly differ at 4 time points after renal transplantation (all P > 0.05). The BUN levels significantly differed between 15 d and 1 month after renal transplantation, and between 1 and 3 months after renal transplantation (P=0.002, P=0.001). The proportion of CD3+CD8+T cells, CD3+CD4+T cells, natural killer (NK) cells and CD4/CD8 ratio at postoperative 15 d significantly differed from those at 1 month after operation (P=0.009, P=0.004, P < 0.001, P=0.004). The proportion of B cells significantly differed between 15 d and 1 month, and between 1 and 3 months after renal transplantation (both P < 0.001). The absolute values of CD3+T cells, CD3+CD8+T cells, CD3+CD4+T cells and NK cells at postoperative 15 d significantly differed from those at 1 month after renal transplantation (P=0.001, P=0.002, P=0.003, P < 0.001). The absolute values of CD3+CD8+T cells significantly differed between 3 and 6 months after operation (P=0.015). The absolute value of B cells at 1 month after renal transplantation significantly differed from that at 3 months after renal transplantation (P=0.001). The proportion and absolute value of lymphocyte subsets were not significantly correlated with the Scr level (both P > 0.05). The proportion and absolute value of CD3+CD8+T cells and NK cells were negatively correlated with BUN (P < 0.001-0.05), whereas the proportion of CD3+CD4+T cells and B cells was positively correlated with the BUN level (P < 0.001-0.05). The absolute value of CD3+T cells was negatively associated with the BUN level (P < 0.05). Conclusions T cells and NK cells in the lymphocyte subsets of stable recipients raise to the stable state within 1 month after renal transplantation, whereas B cells decrease to stable state within 3 months renal transplantation. The dynamic changes of lymphocyte subsets are correlated with the BUN level.

14.
Article | IMSEAR | ID: sea-200384

ABSTRACT

Background: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are being used as first line agents for the treatment of hypertension in haemodialysis patients as well as in the general population. Serious hyperkalemia is common in patients with end-stage renal disease, and is observed in about 10% of haemodialysis patients. Although many research have been done so far to compare the antihypertensive efficacy of ARBs, but such studies to evaluate the effect on serum urea, creatinine and potassium levels are not so common in North India region.Methods: In this open label, prospective, randomized study, we evaluated the effect on serum urea, creatinine and potassium levels with use of ARB’s (olmesartan or telmisartan) in stage 1 hypertensive patients (JNCVII). 60 patients were randomized in to two groups. The odd numbers will be allotted olmesartan 20 mg (group A) and even numbers to telmisartan 40 mg (group B). Impacts on serum urea, creatinine and potassium levels were evaluated after 12 weeks.Results: Our results indicates that there was no statistically significant alterations in mean serum creatinine, blood urea and in mean serum potassium levels compared to baseline within the two groups as well as when mean of both groups were compared, olmesartan showed a better reduction in blood pressure as compared to telmisartan.Conclusions: Olmesartan showed a better reduction in blood pressure with similar effects in biochemical parameters as telmisartan.

15.
Article | IMSEAR | ID: sea-194437

ABSTRACT

Background: In view of the fact that Brightness (B)-mode ultrasound findings in patients with renal parenchymal disease are profoundly non-specific, this study was carried out to determine the efficiency of color Doppler sonography for assessing renal function. In this series, the relationship between the resistive index (RI) of renal interlobar artery and serum creatinine level was analyzed for any relevant association of this color Doppler index with the serum creatinine level.Methods: In this prospective cross-sectional study, 40 patients with renal parenchymal disease having serum creatinine level >1.4 mg/dL were chosen midst routine revisits. The control group comprised of 40 normal subjects with serum creatinine levels <1.4 mg/dL. After assessing the kidneys of these subjects with gray-scale ultrasound for presence of any stones, hydronephrosis, and/or space occupying lesions instead of, they were subsequently interrogated with color Doppler sonography and RI calculated.Results: The mean serum creatinine levels±SD in the case and control groups were 6.7±0.7 mg/dL and 1.0±0.4 mg/dL, respectively. The mean±SD resistive index (RI) was 79.0%±1.8% in the diseased group and 60.3%±0.7% in the healthy subjects (p<0.001). The correlation between the RI and the serum creatinine level was statistically significant (p<0.001).Conclusions: Resistive index (RI) measurement by color doppler ultrasonography is a reasonable prognosticator of functional outcome in patients with renal parenchymal disease.

16.
Article | IMSEAR | ID: sea-204217

ABSTRACT

Background: Acute kidney injury (AKI) is a sudden onset of kidney failure or kidney damage that happens within a few hours or a few days and can also affect other organs such as brain, heart and the lungs. Hence early diagnosis and intervention is needed to improve the outcome of the children. In these studies this objective was to determine if cystatin C is an early marker indicative of renal dysfunction in critically ill children and to determine if Cystatin C can detect Acute kidney injury earlier than serum creatinine.Methods: This prospective cohort study was undertaken in PICU at Jubilee Mission Medical College from December 2016- May 2018. Blood samples were collected from 34 critically ill children for serum creatinine estimation at 0,24 and 48 hours of admission and serum and urine were collected for cystatin C estimation at admission. Children were categorized into AKI and NON-AKI based on pRIFLE criteria. Comparison of cystatin C values with serum creatinine was performed and Statistical analysis was done using IBM SPSS version 20.Results: A total of 34 critically ill children were enrolled in this study, out of which 12 children progressed to AKI during the course of illness according to modified Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE) criteria. We found a strong positive correlation between cystatin C at 0 hours and serum creatinine at 48 hours among AKI groups.Conclusions: Serum and Urine cystatin C are early markers to diagnose AKI in critically ill children. Serum cystatin C is more sensitive than urine cystatin C for the diagnosis of AKI.

17.
Article | IMSEAR | ID: sea-203416

ABSTRACT

Background: Diabetic nephropathy (DN) is one of the majormicrovascular complications of diabetes and it is defined as arise in the urinary albumin excretion rate and abnormal renalfunction. Some patient develop advanced renal impairmentwith normal urinary albumin level thus albuminuria is not theperfect marker for the early detection of Diabetic nephropathy.Cystatin C has been suggested one of such markers. The aimof this study was to examine the usefulness of cystatin C as anearly marker of diabetic nephropathy.Methods: It was a retrospective study to evaluate role ofCystatin C in Diabetic nephropathy. 52 patient’s report fromdepartment of medicine in Hindu Rao Hospital, were analysedand compared with age related controls.Results: Association was observed between increased levelsof blood urea, serum creatinine and cystatin C withalbuminuria. The association was statistically significant (pvalue < .05). The significant sensitivity and specificity range forcystatin C was better as compared to blood urea andcreatinine.Conclusion: Cystatin C appears to be a better marker fordetection of diabetic nephropathy in comparison to blood ureaand serum creatinine.

18.
Medisan ; 23(3)mayo.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1091098

ABSTRACT

Se llevó a cabo un estudio observacional, descriptivo, de serie de casos, en 144 pacientes con diabetes mellitus de tipo 2, atendidos en el Laboratorio Clínico del Hospital Provincial Clinicoquirúrgico Docente Saturnino Lora Torres de Santiago de Cuba, de mayo de 2017 a igual de 2018, procedentes de la consulta de Endocrinología del propio hospital, con vistas a evaluar la utilidad de la cistatina C como biomarcador precoz de daño renal. En la investigación predominaron los pacientes de más de 50 años de edad y del sexo femenino, además de la hipertensión arterial como enfermedad asociada y la neuropatía periférica como complicación. Se concluyó que la cistatina C es útil como biomarcador precoz de daño renal en pacientes con diabetes mellitus de tipo 2, fundamentalmente si existen comorbilidades y complicaciones que pudieran conducir a la enfermedad renal crónica, lo que puede prevenirse.


An observational, descriptive series of cases study, was carried out in 144 patients with diabetes mellitus type 2, assisted in the Clinical Laboratory of Saturnino Lora Torres Teaching Provincial Hospital in Santiago de Cuba from May, 2017 to the same month of 2018, who were from the Endocrinology Service of the same hospital, with the aim of evaluating the utility of the Cystatin C as early biomarker of renal damage. Patients older than 50 years of age and female sex, besides hypertension as associated disease and the outlying neuropathy as complication prevailed in the investigation. It was concluded that Cystatin C is useful as early biomarker of renal damage in patients with diabetes mellitus type 2, fundamentally if there are comorbidities and complications that could cause chronic renal failure, which can be prevented.


Subject(s)
Diabetes Mellitus, Type 2 , Renal Insufficiency, Chronic , Cystatin C
19.
Article | IMSEAR | ID: sea-198509

ABSTRACT

Background: Renal failure (Azotemia) reflects inability of kidneys to maintain normal homeostatic function,simultaneously accompanied with rise in Blood Urea and Serum Creatinine levels. The manifestations maydevelop over days- Acute; or span over weeks to months – Chronic. Gray Scale Ultrasonography is employed, inour Study, to assess kidneys in Acute and Chronic Renal Failure.This study aims to determine the size and location of the kidneys; cortical echogenicity; severity of cortical loss;detection and aetiology of renal obstruction; and finally in the follow-up during and after the management. 200persons were taken as Control, whereas 100 patients – 50 each suffering from Acute and Chronic Renal Failure,were interrogated.Results: Renal dimension, cortical echogenicity with cortico-medullary differentiation of Control (Normal)individuals were observed. The above mentioned renal parameters were assessed both in Acute and Chronicrenal failure.No significant correlation was found between renal length and Serum Creatinine or Blood Urea levels in AcuteRenal Failure. Whereas, a statistically significant correlation between kidney length and Serum Creatinine/Blood Urea levels in Chronic Renal Failure is established. A statistically significant relationship was alsoobserved between renal cortical echogenicity and Serum Creatinine level; but not with Blood Urea level.Conclusion: Non-involvement of ionising radiation, wide spread availability with low-cost imaging modality,makes Gray Scale Ultrasonography, the cornerstone of imaging in Renal Parenchymal Disease.

20.
Acupuncture Research ; (6): 577-582, 2019.
Article in Chinese | WPRIM | ID: wpr-844269

ABSTRACT

OBJECTIVE: To observe the effect of herbal cake-partitioned moxibustion on renal function and expression of connective tissue growth factor (CTGF), integrin-linked kinase (ILK) and bone morphogenetic protein-7 (BMP-7) in chronic renal failure (CRF) rabbits, so as to reveal its mechanisms underlying improvement of CRF. METHODS: Twenty-four male New Zealand rabbits were randomly divided into control, model, medication and herbal cake-partitioned moxibustion (moxibustion) groups (n=6 rabbits in each group). The CRF model was established by gavage of suspension of Adenine (150 mg·kg-1·d-1) for 21 days. Herbal cake-partitioned moxibustion was applied to "Mingmen"(GV4) and bilateral "Shenshu"(BL23), "Pishu"(BL20) and for 5 moxa-cones every time. Rabbits of the medication group was treated by gavage of Losartan Potassium (2.33 mg·kg-1·d-1). All the treatments were conducted once daily,12 times a course for consecutive 3 courses with a two-day rest after each course of treatment. Serum creatinine (Scr), blood urea nitrogen (BUN) and 24 h urine protein contents were detected by using an automatic biochemical analyzer. The expression levels of CTGF, ILK and BMP-7 proteins and mRNA in the kidney tissue were determined by Western blot and quantitative real time-PCR, separately. RESULTS: Following modeling, Scr and BUN and 24 h urine protein contents were significantly increased in the model group in comparison with the control group (P0.05). CONCLUSION: Herbal cake-partitioned moxibustion can improve renal function in CRF rabbits, which may be related to its effects in suppressing the expression of ILK and CTGF, and in up-regulating the expression of BMP-7 in the kidney tissue.

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