Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.752
Filtrar
1.
BMC Womens Health ; 19(1): 117, 2019 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-31590639

RESUMO

BACKGROUND: Women with a higher number of pregnancies have a higher risk of developing cardiovascular diseases. Subtle fluctuations in albumin excretion could be related to pathophysiologic changes in the vascular system. We aimed to investigate the possible association of parity with low-grade albuminuria. METHODS: We conducted a community-based study in 6495 women aged 40 years or older. Low-grade albuminuria was defined according to the highest quartile of urine albumin-to-creatinine ratio in participants free of micro- or macro-albuminuria. RESULTS: Parous women with a higher number of pregnancies had increased age, body mass index (BMI), waist circumference (WC), systolic blood pressure (SBP), fasting plasma glucose (FPG), and fasting insulin, as well as decreased high-density lipoprotein cholesterol (HDL-C), estimated glomerular filtration rate (eGFR) levels, and proportion of menopause. The prevalence of low-grade albuminuria in parous women gradually increased with parity number. Compared with women with one childbirth, those with more than two childbirths were independently associated with a higher prevalent low-grade albuminuria (odds ratios [ORs] 1.41, 95% confidence interval [CI], 1.09-1.81) after multiple adjustments. In subgroup analysis after multiple adjustments, significant relation between parity number and prevalent low-grade albuminuria was detected in subjects age 55 years or older. CONCLUSION: Number of parity is associated with prevalent low-grade albuminuria in middle-aged and elderly Chinese women without micro- or macro-albuminuria.


Assuntos
Albuminúria/epidemiologia , Paridade , Adulto , Idoso , Albuminúria/etiologia , Pressão Sanguínea , Índice de Massa Corporal , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Prevalência , Circunferência da Cintura
2.
Medicine (Baltimore) ; 98(39): e17297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574853

RESUMO

As a modifiable risk factor for cardiovascular disease, presence of hypertension (HT) necessitates the awareness of asymptomatic organ damage (AOD). The aim of this study was to measure plasma micro RNA-21 (miR-21) and the parameters that reflect AOD such as carotid intima-media thickness (CIMT), microalbuminuria (MAU) in hypertensive patients compared with healthy controls. In addition, the aim of this study was to evaluate plasma miR-21 levels in HT patients with AOD.This study was designed as a cross-sectional observational study. The study includes 2 groups: 32 patients with HT and 32 healthy controls. First, we compared these 2 groups. Then, to underline the relationship between plasma miR-21 and HT, hypertensive patients were divided into 2 groups: with AOD and without AOD.Sixteen patients with HT had AOD. MiR-21 levels significantly correlated with clinical systolic and diastolic blood pressure, MAU, C-reactive protein, and CIMT. CIMT, miR-21, and MAU levels were significantly higher in patients with AOD.Our study showed increased miR-21 levels in HT patients with AOD.


Assuntos
Albuminúria , Doenças Cardiovasculares , Hipertensão , MicroRNAs/sangue , Adulto , Albuminúria/diagnóstico , Albuminúria/etiologia , Doenças Assintomáticas/epidemiologia , Pressão Sanguínea/fisiologia , Proteína C-Reativa/análise , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , MicroRNA Circulante/análise , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/genética , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia
3.
Diabetes Metab Syndr ; 13(4): 2633-2639, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405687

RESUMO

BACKGROUND&AIM: Mean platelet volume (MPV) is suggested as a marker of platelet reactivity and tendency for thrombosis and microvascular complications like albuminuria in patients with type 2 DM. We aimed to measure the MPV in patients with type 2 DM and its correlation with albuminuria, body mass index (BMI), duration of DM, hypertension (HTN), stroke, ischemic heart disease (IHD), and HbA1c level. METHODS: A cross sectional study included 100 patients with type 2 DM ≥ 18 y of both genders who were randomly selected from the medical units of Baghdad Teaching Hospital. After taking verbal consents; MPV was measured&correlated with aimed variables. Diabetics with HbA1c ≤ 7% were considered as having adequate control while those with (HbA1c) > 7% as having poor control. Albumin creatinine ratio (ACR) in urine was measured and classified into normal, moderately and severely increased. Odds ratios with 95% CI were calculated and P ≤ 0.05 was considered as statistically significant. RESULTS: The mean MPV was 7.7 fl ±â€¯1.2. Regarding ACR, 42% had normal level, 37% with moderately increased and 21% had severely increased level. Regarding HbA1c, 68% were having poorly controlled DM. Mean platelets' count and MPV were higher in the uncontrolled group with a statistically significant association. There was a statistically significant positive correlation between MPV and albuminuria, duration of DM, HTN, IHD, Stroke, BMI, HbA1c, and platelets count. CONCLUSIONS: The mean MPV was statistically significantly higher in the uncontrolled DM group and there was a statistically significant positive correlation between MPV and albuminuria.


Assuntos
Albuminúria/diagnóstico , Biomarcadores/análise , Diabetes Mellitus Tipo 2/complicações , Hipertensão/diagnóstico , Volume Plaquetário Médio , Acidente Vascular Cerebral/diagnóstico , Albuminúria/etiologia , Glicemia/análise , Índice de Massa Corporal , Estudos Transversais , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Acidente Vascular Cerebral/etiologia
4.
Urology ; 133: 199-203, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31454657

RESUMO

OBJECTIVE: To investigate the role of albuminuria as a clinical marker of early renal disease in children with neurogenic bladder (NGB) in association with commonly used predictors of renal risk. METHODS: Catheterized urine was obtained from 40 patients with NGB at a tertiary pediatric hospital. Albumin-to-creatinine ratio (ACR) was analyzed for associations with estimated glomerular filtration rate, vesicoureteral reflux, hydronephrosis, bladder dynamics, and renal scarring. RESULTS: About 32% (13/40) of NGB patients had elevated ACR (≥30 mg/g. Elevated ACR was associated with Caucasian race, clean intermittent catheterization, hydronephrosis, and vesicoureteral reflux on univariate analysis. In multivariable analysis, presence of vesicoureteral reflux and use of anticholinergic medication were significant predictors of ACR elevation. CONCLUSION: Albuminuria is an established clinical predictor of renal disease and risk for progression to renal failure. The presence of albuminuria in NGB patients with urinary tract abnormalities suggests these patients may be at increased risk for progressive renal disease. This supports the clinical utility of adding ACR to the evaluation of renal risk in pediatric NGB.


Assuntos
Albuminúria/etiologia , Nefropatias/diagnóstico , Nefropatias/etiologia , Bexiga Urinaria Neurogênica/complicações , Adolescente , Albuminúria/urina , Biomarcadores/urina , Criança , Pré-Escolar , Estudos Transversais , Diagnóstico Precoce , Feminino , Humanos , Nefropatias/urina , Masculino , Bexiga Urinaria Neurogênica/urina
5.
BMC Endocr Disord ; 19(1): 84, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382952

RESUMO

BACKGROUND: In patients with diabetes mellitus, the urinary microalbumin-to-urine creatinine ratio (UACR) can not only predict the occurrence of diabetic nephropathy but also can be a risk factor for cardiovascular disease and renal function damage. Current studies on subclinical hypothyroidism (SCH) and UACR are mainly cross-sectional studies, and the results suggest that SCH is an independent risk factor for UACR. To further explore the longitudinal effect of SCH on UACR, we carried out this study. METHODS: This was a retrospective cohort study including 46 patients with type 2 diabetes mellitus and SCH in the Department of Endocrinology, The Affiliated Huai'an Hospital of Xuzhou Medical University from January 2013 to April 2018. At the same time, 96 patients with type 2 diabetes mellitus and euthyroid were chosen according to 1:2 approximately matched with age, sex and duration of diabetes mellitus. Univariate analysis, stratified analysis, and multiple linear regression analysis were used to investigate the effect of SCH on ΔUACR(ΔUACR = UACR after 1 year - baseline UACR) in patients with type 2 diabetes mellitus. RESULTS: There was no significant difference between the baseline UACR, (p > 0.05). However, the ΔUACR was significantly higher in SCH group than euthyroid group, as shown by univariate analysis, stratified analysis and multiple linear regression analysis (ß:-1.071, 95% CI: - 1.713--0.428), and the difference was statistically significant (all p < 0.05). CONCLUSION: SCH is associated with an increased UACR in type 2 diabetes mellitus patients. It is necessary to screen for thyroid function in type 2 diabetes mellitus and increase the follow-up frequency of UACR in patients with SCH.


Assuntos
Albuminúria/etiologia , Biomarcadores/análise , Creatinina/urina , Diabetes Mellitus Tipo 2/fisiopatologia , Nefropatias Diabéticas/etiologia , Hipotireoidismo/complicações , Adolescente , Adulto , Idoso , Albuminúria/diagnóstico , China/epidemiologia , Nefropatias Diabéticas/diagnóstico , Feminino , Seguimentos , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/patologia , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
6.
Int J Mol Sci ; 20(15)2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31362427

RESUMO

Amplification of oxidative stress is present since the early stages of chronic kidney disease (CKD), holding a key position in the pathogenesis of renal failure. Induction of renal pro-oxidant enzymes with excess generation of reactive oxygen species (ROS) and accumulation of dityrosine-containing protein products produced during oxidative stress (advanced oxidation protein products-AOPPs) have been directly linked to podocyte damage, proteinuria, and the development of focal segmental glomerulosclerosis (FSGS) as well as tubulointerstitial fibrosis. Vascular oxidative stress is considered to play a critical role in CKD progression, and ROS are potential mediators of the impaired myogenic responses of afferent renal arterioles in CKD and impaired renal autoregulation. Both oxidative stress and inflammation are CKD hallmarks. Oxidative stress promotes inflammation via formation of proinflammatory oxidized lipids or AOPPs, whereas activation of nuclear factor κB transcription factor in the pro-oxidant milieu promotes the expression of proinflammatory cytokines and recruitment of proinflammatory cells. Accumulating evidence implicates oxidative stress in various clinical models of CKD, including diabetic nephropathy, IgA nephropathy, polycystic kidney disease as well as the cardiorenal syndrome. The scope of this review is to tackle the issue of oxidative stress in CKD in a holistic manner so as to provide a future framework for potential interventions.


Assuntos
Estresse Oxidativo , Insuficiência Renal Crônica/etiologia , Insuficiência Renal Crônica/metabolismo , Albuminúria/etiologia , Albuminúria/metabolismo , Animais , Biomarcadores , Gerenciamento Clínico , Modelos Animais de Doenças , Progressão da Doença , Fibrose , Humanos , Glomérulos Renais/metabolismo , Glomérulos Renais/patologia , Microvasos/metabolismo , Microvasos/patologia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/terapia
7.
Diabetes Metab Syndr ; 13(2): 1041-1046, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336441

RESUMO

BACKGROUND: Obesity-related to metabolic syndrome was associated with a greater risk for development of chronic kidney disease (CKD). We aimed to assess the association between obesity and micro/macroalbuminuria in hypertensive patients with a poor estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2. METHODS: One hundred old patients (median age 79 years ±â€¯inter-quartile range 68-84.7) with manifested hypertension (systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 85 mmHg) and a permanently poor eGFR for a duration time more than 3 months were enclosed. Albuminuria was defined as urinary albumin-to-creatinine ratio (ACR) ≥ 30 mg/gr and it was classified according to KDIGO 2012. The obesity was defined by a high body mass index (BMI>30 kg/m2). The waist circumference, HDL-C, triglycerides and serum glucose were measured. Chi-square tests and an adjusted model were performed. RESULTS: Chi-square tests showed significant association between classified albuminuria and both obesity and high serum triglycerides (x2 = 7.2, p = 0.02 and x2 = 8.3, p = 0.01 respectively). However, the adjusted model for the prediction of albuminuria showed that the presence of a high BMI was a non-significant risk factor, although diabetes mellitus and eGFR value were found to be significant risk factors (p = 0.03, OR = 4.3, 1.2-22.07 and p = 0.04, OR = 0.9, 0.9-1.007 respectively) adjusting to covariates including the high waist circumference. CONCLUSION: Obesity defined by a high BMI was not found to be a significant risk factor for micro/macroalbuminuria in hypertensive patients with a poor estimated glomerular filtration rate, when diabetes mellitus and the low eGFR value act as confounders.


Assuntos
Albuminúria/etiologia , Índice de Massa Corporal , Diabetes Mellitus/etiologia , Taxa de Filtração Glomerular , Hipertensão/complicações , Obesidade/fisiopatologia , Insuficiência Renal Crônica/etiologia , Idoso , Idoso de 80 Anos ou mais , Albuminúria/metabolismo , Albuminúria/patologia , Biomarcadores/análise , Estudos Transversais , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Feminino , Seguimentos , Humanos , Hipertensão/metabolismo , Hipertensão/patologia , Testes de Função Renal , Masculino , Prognóstico , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/patologia , Fatores de Risco , Circunferência da Cintura
8.
Diabetes Metab Syndr ; 13(2): 1245-1250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336472

RESUMO

OBJECTIVE: To assess serum leptin in diabetic nephropathy male patients from Gaza Strip. MATERIALS AND METHODS: This case-control study comprised 132 type 2 diabetic patients and 44 non-diabetic controls. The diabetic patients were classified into three groups; 44 normoalbuminurics, 44 microalbuminurics and 44 macroalbuminurics. Data were obtained from questionnaire interview, and biochemical analysis of blood and urine samples. Patients and controls were matched for age and body mass index (BMI). RESULTS: Serum leptin was significantly higher in micro- and macro-albuminuric patients (14.6 ±â€¯11.7 and 15.6 ±â€¯13.5 ng/ml) than controls and normoalbuminurics (5.9 ±â€¯4.0 and 8.1 ±â€¯7.6 ng/ml) with P < 0.05. In general, serum glucose, urea, createnine, cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), urinary albumin and albumin creatinine ratio (ACR) were increased in diabetic groups compared to non-diabetics, and reaching their maximum increase in macroalbuminurics whereas high density lipoprotein cholesterol (HDL-C), urinary creatinine and glomerular filtration rate (GFR) were decreased reaching its maximum decrease in macroalbuminurics. Serum leptin showed significant positive correlations with diabetes duration (r = 0.188, P = 0.020), glucose (r = 0.298, P < 0.001), cholesterol (r = 0.323, P < 0.001), triglycerides (r = 0.361, P < 0.001), LDL-C (r = 0.248, P = 0.001) and urinary albumin (r = 0.256, P = 0.001) whereas negative significant correlations were found with HDL-C (r = -0.313, P < 0.001) and urinary creatinine (r = -0.202, P = 0.007). CONCLUSION: The comitant raise of serum leptin with urinary albumin combined with decrease in GFR makes leptin eligible candidate as a biomarker for progression towards diabetic nephropathy in type 2 diabetes.


Assuntos
Albuminúria/diagnóstico , Biomarcadores/análise , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/sangue , Taxa de Filtração Glomerular , Leptina/sangue , Adulto , Albuminúria/etiologia , Índice de Massa Corporal , Estudos de Casos e Controles , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/urina , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio , Prognóstico
9.
Diabetes Metab Syndr ; 13(2): 1491-1496, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31336511

RESUMO

AIMS: Albuminuria is an established marker for endothelial dysfunction and cardiovascular risk in diabetes and prediabetes. So we aimed to explore the prevalence of albuminuria (microalbuminuria and macroalbuminuria) in patients with type2 diabetes mellitus (DM) in the Palestinian community and to determine the association between albuminuria and other health care and biochemical indicators. MATERIALS AND METHODS: A cross-sectional study was carried out at private health care center. A total of 550 diabetic patients aged 35 years and above with type 2 diabetes mellitus who attended the clinic from May 2017 through February 2018 were included. Socio-demographic, clinical, and laboratory data were obtained from the medical records of patients. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS, version 23). RESULTS: Out of the 550 patients recruited, the mean age and duration of diabetes were 57.8 years and 9.5 years, respectively. Approximately 62% were being managed by oral hypoglycemic agents alone, 4.3% by insulin alone, 31.7% were on a combination of oral hypoglycemic agents and insulin and slightly less than 2% were on dietary measures alone. The mean value for HbA1c was 7.71%. The overall prevalence of albuminuria among participants was found to be 34.6%; microalbuminuria (29.3%) and macroalbuminuria (5.3%). CONCLUSION: Albuminuria is highly prevalent among Palestinian population with type 2 diabetes. This calls for early and universal screening of urinary albumin. There is also an urgent need for measures that target tight glycemic and optimal blood pressure control and the use of renin-angiotensin system blockade.


Assuntos
Albuminúria/epidemiologia , Biomarcadores/análise , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/etiologia , Idoso , Albuminúria/etiologia , Albuminúria/patologia , Glicemia/análise , Estudos Transversais , Nefropatias Diabéticas/patologia , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Prevalência , Prognóstico , Fatores de Risco
10.
Afr Health Sci ; 19(1): 1607-1616, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31148990

RESUMO

Background: The aim of this study was to determine the prevalence and factors associated with microalbuminuria among newly diagnosed diabetic patients in Mulago National Referral Hospital, Uganda. Methods: In this cross-sectional study conducted between June 2014 and January 2015, we collected information on patients' socio-demographics, biophysical profile, blood pressure, biochemical testing and echocardiographic findings using a pre-tested questionnaire. Bivariate and multivariate logistic regression analyses were used to investigate the association of several factors with microalbuminuria. Results: Of the 175 patients recruited, males were 90(51.4%) and the mean age was 46±15 years. Majority of patients had type 2 DM 140 (80.0%) and the rest had type 1 DM 35 (20.0%). Mean glycated hemoglobin (HbA1C) was 13.9±5.3%. Mean duration of diabetes was 2 months. Prevalence of microalbuminuria was 47.4 % (95% CI: 40.0%-54.9%) overall. Pregnancy was associated with microalbuminuria (OR7.74[95%CI.1.01-76.47] P=0.050) while mild and moderate physical activity at work were inversely associated with microalbuminuria respectively (OR0.08[95%CI0.01-0.95] P=0.046) and (OR0.07[95%CI0.01-0.77] P=0.030). Conclusion: Prevalence of microalbuminuria was high in this group. Physical activity at work may be protective against microalbuminuria and this calls for longitudinal studies. Early detection and management of microalbuminuria in diabetics may slow progression to overt diabetic nephropathy (DN).


Assuntos
Albuminúria/diagnóstico , Creatinina/sangue , Creatinina/urina , Diabetes Mellitus Tipo 2/epidemiologia , Adolescente , Adulto , Albuminúria/epidemiologia , Albuminúria/etiologia , Biomarcadores/urina , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Hemoglobina A Glicada/análise , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Uganda/epidemiologia
11.
Ren Fail ; 41(1): 540-546, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31234687

RESUMO

Low serum 25 hydroxyvitamin D (25 OH D) is common among chronic kidney disease (CKD) patients. This cross-sectional study is looking for the different factors associated with serum 25 OH D among pre-dialysis CKD. 1624 adult stage 3-5 CKD patients were studied beside 200 normal control subjects. All candidates were tested for body mass index (BMI), estimated glomerular filtration rate (eGFR), calcium (Ca), phosphorus (P), parathormone (PTH), 25 OH D, albumin, and uric acid (UA), and urine albumin/creatinine ratio (ACR). Multivariate linear regression analysis was done to determine predictors of 25 OH D. 98.6% of CKD patients have inadequate level of 25 OH D vs 48% of normal subjects. Serum 25 OH D was significantly lower in CKD patients (mean ± S.D = 16.54 ± 5.8 vs 37.79 ± 3.58 ng/mL for CKD vs control group respectively, p < .001). Serum level of 25 OH D has significant positive correlation with Ca (r = 0.337, p < .001), and significant negative correlation with P, PTH, UA, and ACR (r = -0.440, -0. 679, -0.724, and -0.781respectively, p < .001 in all). The independent predictors of 25 OH D were Ca, P, UA, PTH, and ACR (R square = 0.7, ß = -0.087, -0.226, -0.313, -0.253, and -0.33 respectively, p < .001 in all). In conclusion, pre-dialysis CKD patients frequently suffer low 25 OH D. Among the different abnormalities related to CKD, urine albumin excretion rate and UA are the most important predictors of 25 OH D in these patients.


Assuntos
Albuminúria/urina , Insuficiência Renal Crônica/complicações , Ácido Úrico/sangue , Deficiência de Vitamina D/diagnóstico , Vitamina D/análogos & derivados , Adolescente , Adulto , Albuminas/análise , Albuminúria/sangue , Albuminúria/etiologia , Estudos Transversais , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/sangue , Insuficiência Renal Crônica/urina , Vitamina D/sangue , Deficiência de Vitamina D/etiologia , Adulto Jovem
12.
Clin Nephrol ; 92(2): 81-88, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31232268

RESUMO

BACKGROUND: This study was performed to determine whether the urinary albumin excretion rate (%UAE) could distinguish myeloma cast nephropathy (MCN) without glomerular amyloid deposition from MCN with glomerular amyloid deposition. MATERIALS AND METHODS: We retrospectively reviewed clinicopathological data on 16 patients with MCN diagnosed by renal biopsy at Toranomon Hospital from 2004 to 2014. RESULTS: A total of 10 patients had pure MCN without glomerular amyloid deposition (group 1), and 6 patients had MCN with glomerular amyloid deposition (group 2). In all 10 patients from group 1, the underlying disease was multiple myeloma (MM), while 4 patients had MM, and 2 patients had lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) in group 2. Total protein did not show a significant difference between the two groups, but serum albumin was significantly higher in group 1 than group 2 (p = 0.0101). Serum-adjusted calcium did not show a significant difference between the groups, while serum creatinine (Cre) was significantly higher in group 1 than group 2 (p = 0.0343). Although urinary protein excretion did not differ significantly between the groups, the %UAE was significantly lower in group 1 than group 2 (p = 0.00198). In group 2, 3 of the 4 patients with MM died within 15 months of diagnosis, but the 2 patients with LPL/WM are alive after 32 months. In group 1, only 1 patient died (of unknown causes) within 15 months after diagnosis. CONCLUSION: In patients with MCN, %UAE may be a useful marker for the detection of coexistence of glomerular lesions, such as amyloidosis, which are associated with a poor outcome.


Assuntos
Albuminúria/diagnóstico , Nefropatias/diagnóstico , Nefropatias/metabolismo , Mieloma Múltiplo/complicações , Idoso , Albuminúria/etiologia , Biomarcadores/metabolismo , Creatinina/sangue , Feminino , Humanos , Nefropatias/etiologia , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/diagnóstico , Mieloma Múltiplo/metabolismo , Estudos Retrospectivos , Albumina Sérica/metabolismo
13.
Medicine (Baltimore) ; 98(22): e15773, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31145298

RESUMO

Arterial hypertension is considered to be an inflammatory condition with low intensity. Therefore, an elevated concentration of inflammatory cytokines can be expected in patients with systemic arterial hypertension, including tumor necrosis factor (TNF).The study included a group of 96 persons aged 18 to 65 years: 76 patients with primary arterial hypertension and 20 healthy individuals (control group). Blood pressure was measured in all individuals using the office and ambulatory blood pressure monitoring (ABPM) measurement, blood was collected for laboratory tests [tumor necrosis factor (TNF), tumor necrosis factor receptor 1 (TNFR1)], and 24-hour urine collection was performed in which albuminuria and TNF concentration were assessed. Moreover, assessment of the intima-media thickness (IMT) in ultrasonography and left ventricular mass index (LVMI) in echocardiography were carried out.Statistically elevated TNF concentration in the blood serum (P = .0001) and in the 24-hour urine collection (P = .0087) was determined in patients with hypertension in comparison with the control group. The TNF and TNFR1 concentration in the serum and TNF in the 24-hour urine in the group of patients with arterial hypertension and organ damages and without such complications did not differ statistically significantly.We observed a positive and statistically significant correlation between TNFR1 concentration in the serum and TNF urine excretion in patients with hypertension (r = 0.369, P < .05)Patients with arterial hypertension are characterized by higher TNF concentrations in blood serum and higher TNF excretion in 24-hour urine than healthy persons.TNF and TNFR1 concentration in blood serum and TNF excretion in 24-hour urine in patients with early organ damages due to arterial hypertension do not differ significantly from those parameters in patients with arterial hypertension without organ complications.There is a positive correlation between TNFR1 concentration in the serum and TNF urine excretion in patients with hypertension.


Assuntos
Albuminúria/urina , Hipertensão/sangue , Hipertensão/urina , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/urina , Adolescente , Adulto , Idoso , Albuminúria/etiologia , Monitorização Ambulatorial da Pressão Arterial , Espessura Intima-Media Carotídea , Estudos de Casos e Controles , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Receptores Tipo I de Fatores de Necrose Tumoral/urina , Adulto Jovem
14.
J Nepal Health Res Counc ; 17(1): 61-65, 2019 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-31110390

RESUMO

BACKGROUND: Diabetic nephropathy is one of the dreaded complications of diabetes leading to chronic kidney disease and end stage renal failure globally. Microalbuminuria is the most sensitive marker of early recognition of the diabetic nephropathy. This study was carried out to find out the prevalence and potential risk factors of microalbuminuria which is the marker of diabetic nephropathy among diabetes patients in Nepal. METHODS: A cross-sectional study was conducted on a random sample of 227 in T2DM patients in private diabetic clinics and Bir hospital in Kathmandu. Data were collected using standard questionnaire format to collect demography, anthropometry, and laboratory assessment of, HbA1c, post prandial, fasting glucose and micro albumin in urine. Micro albuminuria was measured using early morning urine specimen. Micro albuminuria was considered positive when urinary albumin to creatinine ratio was found to be 30-300 mg/g creatinine in preferably an early morning or a spot urine sample. The entire lab test will be done by applying the internationally accepted standards of tools and techniques.Those that were reported >30mg/mL of micro albumin were considered as positive. RESULTS:   Out of total 217 diabetic patients, 56.2% (122/217) were male and 43.8% (95/217) were female. Among all age groups, maximum patients enrolled were between the age group 41 to 80 (95%).Of the total, 20% (44/217)) patientswereMA positive. A statistical significant association was seen between MA and BMI (p=0.029), duration of DM (p=<0.001, hypertension (p=<0.001, smoking (p=<0.001) and physical activity (p=<0.001). CONCLUSIONS: Diabetic patients in Nepal have prevalence of 20.3% microalbuminurea. Hypertension, obesity, sedentary lifestyles, duration more than 5 years of illness are found the most important risk factors for the development of microalbuminurea in diabetes.     Keywords:  Mellitus; microalbuminuria; type 2 diabetes.


Assuntos
Albuminúria/etiologia , Diabetes Mellitus Tipo 2/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Creatinina/urina , Estudos Transversais , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/etiologia , Exercício , Feminino , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Prevalência , Fatores de Risco , Fumar/efeitos adversos , Inquéritos e Questionários
15.
Blood Press Monit ; 24(5): 221-224, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31116153

RESUMO

INTRODUCTION: Microalbuminuria is a common early hypertension-mediated organ damage, which correlates with the overall cardiovascular risk and development of end-stage renal damage. Lately, blood pressure variability has shown an additive value over traditional BP measurement in prediction of cardiovascular and renal involvement. AIM: Investigate the relation between short-term blood pressure variability and microalbuminuria in controlled hypertensive patients. PATIENTS AND METHODS: Ninety non-diabetic hypertensive patients with controlled blood pressure and normal estimated glomerular filtration rate had 24-hour ambulatory blood pressure monitoring with calculation of short-term blood pressure variability indices (SD, coefficient of variation and average reading variability of systolic and diastolic blood pressure for 24-hour, daytime and nighttime], and measurement of the albumin/creatinine ratio. RESULTS: Patients were classified into group 1 (61 patients without microalbuminuria) and group 2 (29 patients with microalbuminuria). No significant difference was observed between both groups regarding age, sex, body mass index, office blood pressure, average 24-hour ambulatory blood pressure monitoring readings and dipping status, but significantly longer duration of hypertension in group 2. All blood pressure variability indices were significantly higher in group 2, which showed strong positive correlations with microalbuminuria level. Multivariate analysis represented an average reading variability of 24-hour systolic blood pressure as the most powerful independent predictor for microalbuminuria (r = 0.516, P = 0.001). Receiver operating characteristic curve analysis revealed that average reading variability of 24-hour systolic blood pressure (>12.55) could predict microalbuminuria (sensitivity = 89.7%, specificity = 88.5%, area under curve = 0.949, P = 0.001). CONCLUSION: Short-term blood pressure variability correlated well with early renal effects in controlled hypertensive patients. Average reading variability of 24-hour systolic blood pressure was the strongest predictor for microalbuminuria in such patients.


Assuntos
Albuminúria/etiologia , Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Hipertensão/complicações , Hipertensão/fisiopatologia , Rim/fisiopatologia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/fisiologia , Feminino , Taxa de Filtração Glomerular , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Sístole
16.
Nat Commun ; 10(1): 1835, 2019 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-31015435

RESUMO

Diabetic kidney disease is a major cause of renal failure that urgently necessitates a breakthrough in disease management. Here we show using untargeted metabolomics that levels of phenyl sulfate, a gut microbiota-derived metabolite, increase with the progression of diabetes in rats overexpressing human uremic toxin transporter SLCO4C1 in the kidney, and are decreased in rats with limited proteinuria. In experimental models of diabetes, phenyl sulfate administration induces albuminuria and podocyte damage. In a diabetic patient cohort, phenyl sulfate levels significantly correlate with basal and predicted 2-year progression of albuminuria in patients with microalbuminuria. Inhibition of tyrosine phenol-lyase, a bacterial enzyme responsible for the synthesis of phenol from dietary tyrosine before it is metabolized into phenyl sulfate in the liver, reduces albuminuria in diabetic mice. Together, our results suggest that phenyl sulfate contributes to albuminuria and could be used as a disease marker and future therapeutic target in diabetic kidney disease.


Assuntos
Albuminúria/etiologia , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/sangue , Microbioma Gastrointestinal/fisiologia , Ésteres do Ácido Sulfúrico/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Albuminúria/sangue , Albuminúria/tratamento farmacológico , Albuminúria/patologia , Animais , Animais Geneticamente Modificados , Estudos de Coortes , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/urina , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 2/sangue , Nefropatias Diabéticas/etiologia , Nefropatias Diabéticas/patologia , Cães , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Células Madin Darby de Rim Canino , Masculino , Metabolômica/métodos , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Transportadores de Ânions Orgânicos/genética , Podócitos/metabolismo , Podócitos/patologia , Ratos , Estreptozocina/toxicidade , Ésteres do Ácido Sulfúrico/sangue , Tirosina Fenol-Liase/antagonistas & inibidores , Tirosina Fenol-Liase/metabolismo , Adulto Jovem
17.
Transplant Proc ; 51(3): 692-700, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30979452

RESUMO

BACKGROUND: Adequate kidney donor management after donation is increasingly emphasized due to concerns of renal function impairment after nephrectomy with increasing life expectancy. In this study, the clinical impact of a protocolized kidney donor follow-up system by nephrologists was evaluated. METHODS: A total of 427 living kidney donors underwent nephrectomy from January 2010 to December 2014 and were followed for at least 2 years at the Samsung Medical Center. Donors were followed-up by nephrologists after the establishment of a donor clinic with systemized protocols in January 2013. The primary outcomes were incidence of post-donation low estimated glomerular filtration rate (eGFR) and renal function adaptability. Secondary outcomes were changes in compliance and incidence of hyperuricemia and microalbuminuria. RESULTS: The patients were divided into 2 groups according to the time of nephrectomy: the pre-donor clinic period (n = 182) and the donor clinic period (n = 172). Preoperative eGFR in patients in the pre-donor clinic period was higher than that in patients in the donor clinic period. After donation, poor renal adaptation was less frequent in the donor clinic period compared to the pre-donor clinic period. Low eGFR tended to be less common during the donor clinic period. Shorter mean outpatient clinic visit intervals with more visits within 6 months after donation and earlier detection of de novo hyperuricemia were found during the donor clinic period. CONCLUSION: A protocolized donor clinic run by nephrologists may improve post-nephrectomy renal outcomes and compliance and facilitate better management of potential risk factors of chronic kidney disease in donors.


Assuntos
Doadores Vivos , Nefrectomia/efeitos adversos , Adulto , Albuminúria/epidemiologia , Albuminúria/etiologia , Estudos de Coortes , Feminino , Seguimentos , Taxa de Filtração Glomerular , Humanos , Hiperuricemia/epidemiologia , Hiperuricemia/etiologia , Rim/fisiopatologia , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/etiologia , Estudos Retrospectivos , Fatores de Risco
18.
PLoS One ; 14(4): e0214728, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31017918

RESUMO

OBJECTIVE: The objective was to assess the association between 25-hydroxyvitamin D (25OHD) level and diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes. METHODS: Data pertaining to 351 in-patients with type 2 diabetes were collected. Subjects were classified into three groups based on the level of urinary albumin-to-creatinine ratio (UACR). UACR < 30 mg/g was defined as normoalbuminuria, while UACR levels of 30-300 mg/g and ≥ 300 mg/g were defined as microalbuminuria and macroalbuminuria, respectively. Serum 25OHD and other clinical characteristics among various UACR groups were compared. The relationship between albuminuiria and 25OHD was analyzed. RESULTS: The prevalence of 25OHD insufficiency in the microalbuminuria group was significantly higher than that in the normoalbuminuria group (25.1% vs. 19.6%; P < 0.05); patients with macroalbuminuria had the highest prevalence of 25OHD deficiency (37.8%; P < 0.01 versus normoalbuminuria). Logistic regression analyses demonstrated that low 25OHD levels were associated with DKD [odds ratio (OR) = 1.51, 95% confidence interval (CI) 1.16-1.97). The association was more robust after adjusting for sex, hypertension, increased systolic blood pressure, glycemic status, and hyperuricemia (OR = 1.62, 95% CI 1.19-2.20). CONCLUSIONS: The prevalence of vitamin D insufficiency/deficiency in patients with albuminuria was overtly higher than that in patients without albuminuria among Chinese adults with type 2 diabetes. Vitamin D insufficiency/deficiency was independently associated with DKD in type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2/patologia , Nefropatias Diabéticas/diagnóstico , Vitamina D/análogos & derivados , Adulto , Idoso , Albuminas/análise , Albuminúria/etiologia , Grupo com Ancestrais do Continente Asiático , China , Creatinina/urina , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/complicações , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Vitamina D/sangue
19.
Int J Med Sci ; 16(2): 285-291, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30745809

RESUMO

Background: Non-alcoholic fatty liver disease (NAFLD) is associated with the dysregulation of multiple metabolic and inflammatory pathways. These can lead to extrahepatic disorders involving the kidney, a vulnerable organ responsible for extra-renal complications. Evaluating the association between NAFLD and low-grade albuminuria as a renal complication would be helpful to better understand the pathophysiology and extra-hepatic complications of NAFLD. Patients and Methods: Our study extracted data from database obtained a representative population sample. Overall, 3867 men were included in this survey. Our study included only men without diabetes mellitus, with a urinary albumin/creatinine ratio < 30 mg/g (n = 1390). Low-grade albuminuria was defined by a urinary albumin/creatinine ratio within the highest quartile. The fatty liver index was calculated in accordance with Bedogni's equation. We defined the NAFLD group as patients with a fatty liver index of ≥ 60. Results: In the multivariate analysis, the urinary albumin/creatinine ratio in the non-NAFLD and NAFLD groups was 3.05 ± 0.14 and 5.19 ± 0.42, respectively (P < 0.001). The correlation coefficients between the fatty liver index and urinary albumin/creatinine ratio were 0.124 in the Pearson's correlation test and 0.084 in the partial correlation test (P < 0.001 and P = 0.002, respectively). Linear regression analysis showed a positive association between the fatty liver index and the urinary albumin/creatinine ratio on multivariate analysis. Logistic regression analysis showed that the odds ratio for low-grade albuminuria with NAFLD was 2.31 (95% confidence interval, 1.47-3.61; P < 0.001) on the multivariate analysis. Subgroup analyses according to the presence of metabolic syndrome or age (< 50 or ≥ 50 years) showed that the association between NAFLD and the urinary albumin/creatinine ratio was stronger for participants without metabolic syndrome and in those aged < 50 years. Conclusion: NAFLD was associated with low-grade albuminuria in men without diabetes mellitus in this study. Therefore, men with a relatively high fatty liver index or NAFLD should be closely monitored for low-grade albuminuria, especially in absence of metabolic syndrome.


Assuntos
Albuminúria/etiologia , Hepatopatia Gordurosa não Alcoólica/urina , Adulto , Idoso , Humanos , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/complicações , Inquéritos Nutricionais
20.
Kidney Blood Press Res ; 44(1): 33-42, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30808835

RESUMO

BACKGROUND/AIMS: Association between cigarette smoke and albuminuria (UA) was already demonstrated in cross-sectional studies and in selected population samples (i.e diabetic patients). This study aims to evaluate, prospectively, the relationship between cigarette smoke and UA in a male adult population sample, with basal normal kidney function, participating in the Olivetti Heart Study (OHS). METHODS: Among 994 participants, examined in both 1994-95 and 2002-04, were selected those resulted in both visits smokers (n=221) and non-smokers (n=416) and with basal normal kidney function (GFR> 60 mL/min) and basal albumin/creatinine ratio (ACR< 30 mg/g). RESULTS: At baseline, the prevalence of hypertension was 41%, diabetes affected 6.3% and obesity 17% of the whole sample. Smokers showed statistically significant lower levels of systolic (SBP) and diastolic blood pressure (DBP) and BMI (p< 0.001) compared to non-smokers. There were not basal differences in UA, GFR and metabolic profile. However, at follow-up examination, smokers showed a statistically significant increase in SBP and DBP (p< 0.05), but not in GFR and BMI. Moreover, smokers showed a higher risk compared to non-smokers to be in the higher median levels group of UA (OR: 2.17, C.I.95%: 1.51-3.13; p < 0.001), even after correction for major confounding factors. Further adjustment for basal antihypertensive and hypoglycemic treatment did not change these patterns of association. CONCLUSION: In a selected male adult population sample, cigarette smoke was independently associated with the development of higher levels of albuminuria over time.


Assuntos
Albuminúria/etiologia , Fumar Cigarros/efeitos adversos , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Índice de Massa Corporal , Seguimentos , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Risco , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA