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1.
Genet Sel Evol ; 54(1): 27, 2022 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-35436852

RESUMO

Blood urea nitrogen (BUN) is an indicator trait for urinary nitrogen excretion. Measuring BUN level requires a blood sample, which limits the number of records that can be obtained. Alternatively, BUN can be predicted using mid-infrared (MIR) spectroscopy of a milk sample and thus records become available on many more cows through routine milk recording processes. The genetic correlation between MIR predicted BUN (MBUN) and BUN is 0.90. Hence, genetically, BUN and MBUN can be considered as the same trait. The objective of our study was to perform genome-wide association studies (GWAS) for BUN and MBUN, compare these two GWAS and detect quantitative trait loci (QTL) for both traits, and compare the detected QTL with previously reported QTL for milk urea nitrogen (MUN). The dataset used for our analyses included 2098 and 18,120 phenotypes for BUN and MBUN, respectively, and imputed whole-genome sequence data. The GWAS for MBUN was carried out using either the full dataset, the 2098 cows with records for BUN, or 2000 randomly selected cows, so that the dataset size is comparable to that for BUN. The GWAS results for BUN and MBUN were very different, in spite of the strong genetic correlation between the two traits. We detected 12 QTL for MBUN, on bovine chromosomes 2, 3, 9, 11, 12, 14 and X, and one QTL for BUN on chromosome 13. The QTL detected on chromosomes 11, 14 and X overlapped with QTL detected for MUN. The GWAS results were highly sensitive to the subset of records used. Hence, caution is warranted when interpreting GWAS based on small datasets, such as for BUN. MBUN may provide an attractive alternative to perform a more powerful GWAS to detect QTL for BUN.


Assuntos
Estudo de Associação Genômica Ampla , Locos de Características Quantitativas , Animais , Nitrogênio da Ureia Sanguínea , Bovinos/genética , Feminino , Estudo de Associação Genômica Ampla/veterinária , Leite/química , Nitrogênio , Fenótipo , Polimorfismo de Nucleotídeo Único
2.
J Vet Diagn Invest ; 34(3): 496-503, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35412397

RESUMO

We evaluated a saliva urea test strip (Kidney-Chek; SN Biomedical), as a rapid, noninvasive method to screen for azotemia. The test is a semiquantitative method that assesses 7 levels of saliva urea concentration, and indirectly serum urea, from <3 to >17 mmol/L. Ninety-two dogs (14 azotemic) with serum urea of 1.3-37 mmol/L and 56 cats (16 azotemic) with serum urea of 4.1-89.3 mmol/L were enrolled. A positive correlation was found for saliva urea against serum urea in each species (dogs: rs = 0.30, p < 0.005; cats: rs = 0.50, p < 0.001). After turning the semiquantitative data into continuous data by attributing to each level the midpoint of the described range, a receiver operating characteristic curve analysis showed good performance for detecting serum urea above the upper limit of the laboratory RI (dogs: 2.1-11.1 mmol/L; cats: 5-12.9 mmol/L), with an area under the curve of 0.81 in dogs and 0.83 in cats. We recommend that the test be used as an exclusion test, given that it cannot confidently confirm azotemia with higher test results. Additional investigations are recommended for dogs with a test strip reading of ≥9-11 mmol/L and for cats with a test strip reading of ≥12-14 mmol/L.


Assuntos
Azotemia , Doenças do Gato , Doenças do Cão , Animais , Azotemia/veterinária , Nitrogênio da Ureia Sanguínea , Doenças do Gato/diagnóstico , Gatos , Doenças do Cão/diagnóstico , Cães , Feminino , Masculino , Projetos Piloto , Saliva/química , Ureia/análise
3.
Molecules ; 27(7)2022 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-35408581

RESUMO

Cisplatin (CP) is a conventional chemotherapeutic agent with serious adverse effects. Its toxicity was linked to the stimulation of oxidative stress and inflammation. As a result, this study explored the protective effect of baicalein and alpha-tocopherol in nephrotoxicity induced by cisplatin. Until receiving an intraperitoneal injection of CP (3 mg/kg BW), rats were given baicalein orally 100 mg/kg for seven days or/and a single intraperitoneal injection of α-tocopherol 250 mg/kg. Renal function was tested to explore whether baicalein and α-tocopherol have any beneficial effects; blood urea nitrogen (BUN), serum creatinine, malondialdehyde (MDA) content, antioxidant activity biomarkers and histopathology of renal tissue, oxidative stress biomarkers, inflammatory response markers, and histopathological features of kidney architecture were measured. Cisplatin treatment resulted in extreme renal failure, as measured by high serum creatinine and BUN levels and severe renal changes. Cisplatin therapy resulted in increased lipid peroxidation and decreased glutathione and superoxide dismutase levels, reflecting oxidative stress. Upon treatment with α-tocopherol, baicalein, and combined therapy, there was augmentation in the antioxidant status as well as a reduction in IL-6, NF-κB, TNF, TLR2, and TLR4 and a significant increase in Keap-1 and NRF-2. The combined treatment was the most effective and the nearest to the normal status. These findings suggest that baicalein and α-tocopherol may be useful in preventing cisplatin-induced nephrotoxicity.


Assuntos
Antineoplásicos , Insuficiência Renal , Animais , Antineoplásicos/farmacologia , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Biomarcadores/metabolismo , Nitrogênio da Ureia Sanguínea , Cisplatino/farmacologia , Creatinina/metabolismo , Flavanonas , Rim , Estresse Oxidativo , Ratos , Insuficiência Renal/metabolismo , Insuficiência Renal/patologia , Tocoferóis/farmacologia , Receptores Toll-Like/metabolismo , alfa-Tocoferol/metabolismo , alfa-Tocoferol/farmacologia
4.
Dis Markers ; 2022: 7785497, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35392494

RESUMO

Objectives: To explore independent risk factors with good and early predictive power for SAP severity and prognosis. Methods: Patients with SAP were enrolled at Central South University Xiangya Hospital between April 2017 and May 2021 and used as the training cohort. From June 2021 to February 2022, all patients with SAP were defined as external patients for validation. Patients were grouped by survival status at a 30-day posthospital admission and then compared in terms of basic information and laboratory tests to screen the independent risk factors. Results: A total of 249 patients with SAP were enrolled in the training cohort. The all-cause mortality rate at a 30-day postadmission was 25.8% (51/198). Blood urea nitrogen (BUN) levels were significantly higher in the mortality group (20.45 [interquartile range (IQR), 19.7] mmol/L) than in the survival group (6.685 [IQR, 6.3] mmol/L; P < 0.001). After propensity score matching (PSM), the BUN level was still higher in the mortality group than in the survival group (18.415 [IQR, 19.555] mmol/L vs. 10.63 [IQR, 6.03] mmol/L; P = 0.005). The area under the curve (AUC) of the receiver operating characteristic curve (ROC) of BUN was 0.820 (95% confidence interval, 0.721-0.870; P < 0.001). The optimal BUN level cut-off for predicting a 30-day all-cause mortality was 10.745 mmol/L. Moreover, patients with SAP were grouped according to BUN levels and stratified according to optimal cut-off value. Patients with high BNU levels were associated with significantly higher rates of invasive mechanical ventilation (before PSM: 61.8% vs. 20.6%, P < 0.001; after PSM: 71.1% vs. 32%, P = 0.048) and a 30-day all-cause mortality (before PSM: 44.9% vs. 6.9%, P < 0.001; after PSM: 60% vs. 34.5%, P = 0.032) than those with low BNU levels before or after PSM. The effectiveness of BUN as a prognostic marker was further validated using ROC curves for the external validation set (n = 49). The AUC of BUN was 0.803 (95% CI, 0.655-0.950; P = 0.011). It showed a good ability to predict a 30-day all-cause mortality in patients with SAP. We also observed similar results regarding disease severity, including the Acute Physiology and Chronic Health Evaluation II score (before PSM: 16 [IQR, 8] vs. 8 [IQR, 6], P < 0.001; after PSM: 18 [IQR, 10] vs. 12 [IQR, 7], P < 0.001), SOFA score (before PSM: 7 [IQR, 5] vs. 3 [IQR, 3], P < 0.001; after PSM: 8 [IQR, 5] vs. 5 [IQR, 3.5], P < 0.001), and mMarshall score (before PSM: 4 [IQR, 3] vs. 3 [IQR, 1], P < 0.001; after PSM: 5 [IQR, 2.5] vs. 3 [IQR, 1], P < 0.001). There was significant increase in intensive care unit occupancy in the high BUN level group before PSM (93.3% vs. 73.1%, P < 0.001), but not after PSM (97.8% vs. 86.2%, P = 0.074). Conclusions: Our results showed that BUN levels within 24 h after hospital admission were independent risk factors for a 30-day all-cause death in patients with SAP.


Assuntos
Pancreatite , Doença Aguda , Nitrogênio da Ureia Sanguínea , Humanos , Pancreatite/diagnóstico , Prognóstico , Curva ROC , Estudos Retrospectivos
5.
J Infect Chemother ; 28(6): 767-773, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35272941

RESUMO

INTRODUCTION: Previous studies have revealed that blood urea nitrogen-to-serum albumin ratio (BUN/ALB) is one of major risk factors of mortality in pneumonia. However, there are fewer scientific research about the correlation between BUN/ALB ratio and outcome of pneumonia in patients receiving glucocorticoids. This study was undertaken to explore the prognostic value of BUN/ALB ratio for mortality of pneumonia in patients receiving glucocorticoids. METHODS: The present study was a retrospective cohort study. 1397 subjects receiving glucocorticoids alone or glucocorticoids and other immunosuppressants from six secondary and tertiary academic hospitals in China were analyzed. The endpoint of the study was 30-day mortality. It was noted that the entire study was completed by Li et al. and uploaded the data to the DATADRYAD website. The author only used this data for secondary analysis. RESULTS: After adjusting potential confounders (age, sex, WBC, persistent lymphocytopenia, PLT, ALT, AST, Cr, high-dose steroid use, and COPD), non-linear relationship was detected between BUN/ALB ratio and 30-day mortality, whose point was 0.753. The effect sizes and the confidence intervals on the left and right sides of inflection point were 23.110 (7.157, 74.623) and 0.410 (0.074, 2.283), respectively. Subgroup analysis revealed the positive association was stronger among subjects with connective tissue disease. CONCLUSIONS: The relationship between BUN/ALB ratio and 30-day mortality of pneumonia in patients receiving glucocorticoids is non-linear. BUN/ALB ratio is positively related with 30-day mortality when BUN/ALB ratio is less than 0.753.


Assuntos
Glucocorticoides , Pneumonia , Nitrogênio da Ureia Sanguínea , Glucocorticoides/efeitos adversos , Humanos , Pneumonia/tratamento farmacológico , Prognóstico , Estudos Retrospectivos , Albumina Sérica
6.
Ther Apher Dial ; 26(3): 507-514, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35247221

RESUMO

INTRODUCTION: Animal-model experimental systems capable of reflecting the effects of devices for continuous renal replacement therapy (CRRT) on living organisms are limited; thus, aimed to construct an animal model of AKI-CRRT using pigs. METHODS: Pigs were subjected to renal artery ischemia-reperfusion injury (IRI) and then to a maximum of 24 h of continuous hemodiafiltration (CHDF)-type CRRT. RESULTS: Post-IRI, pigs' creatinine levels rose threefold, and they exhibited 24 h of anuria and clear aggravation of oxidative stress, demonstrating successful induction of AKI for CRRT. Post-CRRT, no significant changes in their vital signs or hematological parameters were observed. Creatinine and blood urea nitrogen clearance, as well as suppression of increases in oxidative stress, were also confirmed. CONCLUSION: We believe that the use of our model can enable the preclinical evaluation of the effects of under-development CRRT devices on living organisms under conditions similar to those encountered in an actual clinical setting.


Assuntos
Injúria Renal Aguda , Terapia de Substituição Renal Contínua , Hemodiafiltração , Injúria Renal Aguda/terapia , Animais , Nitrogênio da Ureia Sanguínea , Creatinina , Feminino , Humanos , Masculino , Terapia de Substituição Renal , Suínos
8.
Clin Neurol Neurosurg ; 215: 107204, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35299071

RESUMO

BACKGROUND: Blood urea nitrogen (BUN)/creatinine (Cr) ratio was an independent predictor of stroke-in-evolution (SIE) among patients who had suffered an acute ischemic stroke. We investigated the association of changes in BUN/Cr on stroke outcome during hospitalization after acute ischemic stroke (AIS). METHODS: AIS patients admitted within 3 days from stroke onset (2020-2021) were included in the study. Baseline data, including BUN and Cr levels, were collected. Univariate linear regression and a multivariate regression model were applied to assess the relationship between the change of BUN/Cr and short-term outcomes. RESULTS: One hundred and eighty-one patients were included. The mean increase of BUN/Cr level was - 2.0 ± 1.78. Univariate linear regression suggested that baseline NIHSS, thrombolysis, change of BUN/Cr, and history of atrial fibrillation, statin use, and antiplatelet therapy was associated with the decrease in NIHSS during hospitalization (P < 0.05). After adjusting for potential confounders, multivariate regression analysis revealed the associations between the decrease in BUN/Cr and favorable outcome are significant (ß = 0.21, 95% CI = 0.14,-0.28). CONCLUSION: The decrease in BUN/Cr is positively correlated with a better early neurological improvement in AIS patients.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Nitrogênio da Ureia Sanguínea , Isquemia Encefálica/complicações , Creatinina , Humanos , Prognóstico , Estudos Retrospectivos , Acidente Vascular Cerebral/terapia
9.
Ren Fail ; 44(1): 482-489, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35285393

RESUMO

BACKGROUND: The urea clearance index (Kt/V) is an important index for predicting the clinical outcome of peritoneal dialysis (PD) patients, but it changes with time depending on the clinical condition. This study aimed to investigate the association between the Kt/V reach rate (defined as the percentage of Kt/V measurements that reached ≥ 1.70) and clinical outcome in incident PD patients. METHODS: In this retrospective cohort study, 210 patients were enrolled from the First Affiliated Hospital of Zhengzhou University from 1 January 2013 to 31 October 2019. The target Kt/V reach rate in the first year was applied as the predictor variable. Kaplan-Meier survival curves were drawn to evaluate differences in prognosis. The association between Kt/V reach rate and the composite clinical outcome (death or transfer to hemodialysis) was tested by Cox regression analysis. RESULTS: The dialysis adequacy group (Kt/V reach rate 3/3 times) and the dialysis intermittent adequacy group (1/3 or 2/3 times) had significantly better clinical outcomes than the dialysis inadequacy group (0/3 times). There was no difference in clinical outcome between the lower-rate group (reach rate 1/3 times) and the higher-rate group (2/3 times). Compared with the dialysis inadequacy group, the dialysis intermittent adequacy group and dialysis adequacy group had significantly lower risks of the composite outcome (HR 0.487, 95% CI 0.244-0.971, p = 0.041; HR 0.150, 95% CI 0.043-0.520, p = 0.003) in the fully adjusted analysis. CONCLUSION: Higher Kt/V reach rates are associated with a better prognosis in incident PD patients.


Assuntos
Diálise Peritoneal , Ureia , Nitrogênio da Ureia Sanguínea , Humanos , Diálise Renal , Estudos Retrospectivos
10.
Pak J Pharm Sci ; 35(1(Special)): 343-347, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35236645

RESUMO

Pediatric upper gastrointestinal bleeding refers to an acute massive hemorrhage of the upper digestive tract and biliary tract, which is a common clinical emergency in pediatrics. This study aimed to evaluate the clinical effect of octreotide combined with omeprazole in pediatric upper gastrointestinal bleeding. Totally 84 cases of pediatric upper gastrointestinal bleeding admitted to Ningbo Women and Children's Hospital from November 2019 to April 2021 were divided into groups according to the admission order. The control group received omeprazole treatment and the observation group received octreotide plus. The total clinical effective rate of children in the observation group was higher than that of the control group. The observation group was superior to the control group with respect to the average hemostasis time, hemostasis rate, rebleeding rate and length of stay after treatment. The observation group witnessed a significantly better quality of life than the control group. For children with acute upper gastrointestinal bleeding, the combination of omeprazole and octreotide yields a promising effect in the adjustment of blood creatinine and serum urea nitrogen levels and hemostasis, which is worthy of clinical application.


Assuntos
Nitrogênio da Ureia Sanguínea , Creatinina/sangue , Hemorragia Gastrointestinal/tratamento farmacológico , Octreotida/uso terapêutico , Omeprazol/uso terapêutico , Adolescente , Criança , Pré-Escolar , Quimioterapia Combinada , Feminino , Fármacos Gastrointestinais/administração & dosagem , Fármacos Gastrointestinais/uso terapêutico , Humanos , Masculino , Octreotida/administração & dosagem , Omeprazol/administração & dosagem
11.
BMC Endocr Disord ; 22(1): 50, 2022 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-35227230

RESUMO

BACKGROUND: High Blood Urea Nitrogen (BUN) and high Serum Creatinine (SCr) levels are risk factors for Coronary Artery Disease (CAD). However, the relationship between the Blood Urea Nitrogen to Creatinine (BUN/SCr) ratio (UCR) and the risk of CAD in patients living with new-onset diabetes is unclear. This study aimed to examine the relationship between blood UCR and the risk of CAD in patients living with new-onset type 2 diabetes mellitus (T2DM). METHODS: We analyzed the data from the cohort of 12,299 patients living with type 2 diabetes mellitus. Primary endpoints were the events of CAD. The ANOVA test (continuous indicators) and χ2 test (categorical indicators) were used to assess the differences of baseline characteristics across the groups of UCR. In order to understand the correlation between variables, we performed correlation analysis on variables that have significant differences between CAD group and non-CAD group. Multivariate-adjusted Cox proportional hazard regression models were applied to estimate the association of the blood UCR with the risk of CAD in patients living with T2DM. The Kaplan-Meier survival function plotting and the log-rank test were used to evaluate the event-free survival according to the groups of UCR. The restricted cubic spline model was used to show the adjusted association between blood UCR and risk of CAD in patients living with T2DM. RESULTS: During a median follow-up of 2.66 years, 1173 CAD were recorded with an event rate of 28.49 events per 1000 person-years. In multivariate-adjusted Cox regression models, elevated blood urea nitrogen to creatinine ratio (UCR) was associated with higher risk of CAD in patients living with T2DM [hazard ratio (HR), 1.782; 95% confidence interval (CI), 1.237-2.567]. The Kaplan-Meier survival curves indicated that the high group of UCR tended to have a lower event-free survival than the low group and medium group. There was a nonlinear trend toward increasing risk of CAD across the groups of UCR. And cubic spline function graph suggested that the influence of UCR level on HR for CAD increased significantly at UCR levels above 6.67. CONCLUSIONS: An elevated UCR was significantly associated with an increased risk for CAD in patients living with T2DM.


Assuntos
Nitrogênio da Ureia Sanguínea , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/epidemiologia , Creatinina/sangue , Diabetes Mellitus Tipo 2/complicações , Adulto , Idoso , China/epidemiologia , Estudos de Coortes , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Fatores de Risco , Análise de Sobrevida
12.
Life Sci ; 296: 120441, 2022 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-35240160

RESUMO

AIMS: Investigating the impact of 17ß estradiol (E2) and its endogenous non-hormonal metabolite 2-methoxyestradiol (2ME) on renal ischemia-reperfusion (RIR) induced kidney injury in ovariectomized (OVX) rats and the role of catechol-O-methyltransferase (COMT) in their effects. MAIN METHODS: Eighty female rats were allocated into eight groups. Control group, Sham group, OVX group, OVX and RIR group, OVX + RIR + E2 group, OVX + RIR + 2ME group, OVX + RIR + E2 + Entacapone group and OVX + RIR + 2ME + Entacapone group, respectively. Twenty-four hours post RIR, creatinine (Cr) and blood urea nitrogen (BUN) were determined in serum, while malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), Glutathione (GSH), myeloperoxidase (MPO), as well as the expressions of COMT, hypoxia inducible factor-1α (HIF-1α) and tyrosine hydroxylase (TH) were assessed in the kidney tissues. KEY FINDINGS: Serum Cr, BUN, MPO, as well as HIF-1α and TH expressions were significantly higher with concomitant decrease in COMT expression, SOD and CAT activities and GSH content observed in OVX and RIR group compared to sham group. E2 and 2ME treatment significantly ameliorated all parameters measured in OVX and RIR rats. On the other hand, Entacapone significantly decreased the effect of E2, with no effect on 2ME treatment. SIGNIFICANCE: E2 ameliorates RIR-induced kidney injury and this effect is mediated, at least in part, via its COMT-mediated conversion to 2ME. Thus, 2ME by the virtue of its pleiotropic pharmacological effects can be used as a safe and effective treatment of RIR injury.


Assuntos
2-Metoxiestradiol/farmacologia , Estradiol/farmacologia , Rim/efeitos dos fármacos , Substâncias Protetoras/farmacologia , Traumatismo por Reperfusão/prevenção & controle , 2-Metoxiestradiol/metabolismo , Animais , Nitrogênio da Ureia Sanguínea , Peso Corporal/efeitos dos fármacos , Catecol O-Metiltransferase/metabolismo , Catecóis/farmacologia , Enzimas/metabolismo , Estradiol/farmacocinética , Feminino , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Rim/irrigação sanguínea , Rim/patologia , Nitrilas/farmacologia , Ovariectomia , Ratos Sprague-Dawley
13.
Nutrients ; 14(3)2022 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-35276846

RESUMO

BACKGROUND: In medicine, "compliance" indicates that the patient complies with the prescriber's recommendations, "adherence" means that "the patient matches the recommendations" and "concordance" means "therapeutic alliance" between patient and clinician. While a low protein diet (LPD) is a cornerstone treatment of chronic kidney disease (CKD), monitoring the actual performance of LPD is a challenge. PATIENTS: Fifty-seven advanced CKD adult patients were enrolled and LPD prescribed. Compliance was evaluated through the normalized protein catabolic rate (nPCR), adherence by the dietitian by means of a 24-h dietary recall and concordance by the nephrologist during consultations. Traditional parameters as well as total p-Cresyl Sulphate (t-PCS), total Indoxyl Sulphate (t-IS) and Lipoprotein-associated phspholipase A2 (Lp-PLA2) were compared between adherent/not adherent and concordant/not concordant subjects at enrolment and after two months. RESULTS: nPCR, blood urea nitrogen, cholesterol and triglycerides significantly decreased in all patients. t-PCS and t-IS decreased among adherent subjects. Lp-PLA2, t-PCS, free-PCS and t-IS decreased among concordant subjects, while these increased in non-concordant ones. CONCLUSION: This study demonstrates that LPD may improve the control of traditional uremic toxins and atherogenic toxins in "adherent" and "concordant" patients. A comprehensive and multidisciplinary approach is needed to evaluate the compliance/adherence/concordance to LPD for optimizing nutritional interventions.


Assuntos
Insuficiência Renal Crônica , Toxinas Biológicas , Adulto , Nitrogênio da Ureia Sanguínea , Dieta com Restrição de Proteínas , Humanos , Cooperação do Paciente
14.
Ren Fail ; 44(1): 184-190, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35166184

RESUMO

OBJECTIVES: This study aimed to explore the relationship between the blood urea nitrogen/creatinine (BUN/Cre) ratio and all-cause or cause-specific mortality in the general population. METHODS: Participants were enrolled from the National Health and Nutrition Examination Survey (NHANES) during 1999 to 2014. Baseline variables were acquired from questionnaires and examinations. Death status were ascertained from National Death Index records. Cox proportional hazards models with cubic spines were used to estimate hazard ratios (HRs) and 95% confidence interval (CI) of all-cause mortality, cardiovascular and cancer mortality. RESULTS: A total of 42038 participants were enrolled in the study with a median 8.13 years of follow-up. Older people and women tend to have a higher BUN/Cre ratio. After multivariable adjustment, BUN/Cre ratio between 11.43 and 14.64 was associated with the lowest all-cause mortality compared with the participants with the lowest quartile (HR 0.83 [0.76, 0.91]; p < 0.001). The highest quartile of BUN/Cre ratio was associated with the lowest risk of cancer mortality (HR 0.64 [0.53, 0.78]; p < 0.001). Restricted cubic splines showed BUN/Cre was nonlinearly associated with all-cause mortality and linearly associated with cancer mortality. CONCLUSIONS: This study confirmed a U-shape relationship between BUN/Cre ratio and all-cause mortality in the general population.


Assuntos
Nitrogênio da Ureia Sanguínea , Doenças Cardiovasculares/mortalidade , Creatinina/sangue , Neoplasias/mortalidade , Adulto , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/sangue , Causas de Morte , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Inquéritos Nutricionais , População , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores de Tempo , Estados Unidos/epidemiologia
15.
J Infect Dev Ctries ; 16(1): 166-172, 2022 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-35192534

RESUMO

INTRODUCTION: To evaluate the prognostic value of serum markers predicting in-hospital mortality among community acquired pneumonia patients. METHODOLOGY: Total 134 patients admitted in Sir Ganga Ram Hospital Lahore Pakistan during 2014-16 included. Serum markers recorded upon admission included blood urea nitrogen, albumin, creatinine, blood urea nitrogen/albumin ratio and blood urea nitrogen/creatinine ratio. Patients were observed for the incidence of mortality during hospitalization. Comparison between survivors and non-survivors for means by t test; odds ratios by contingency tables; and effectiveness of predictors by receiver operating characteristic curve analyses were assessed. RESULTS: Overall mean age was 50 ± 21 years; males 45.5%; and in-hospital mortality 9.7%. For in-hospital mortality, creatinine ≥ 2.8 mg/dL showed the highest odds (OR = 7.656, 95% CI = 2.281-25.692; p = 0.001); followed by CURB-65 score ≥ 4 (OR = 4.958, 95% CI = 0.418-58.784; p = 0.266); and blood urea nitrogen ≥ 24.7 mg/dL (OR = 3.364, 95% CI = 1.033-10.954; p = 0.062). Serum creatinine was a fair predictor of in-hospital mortality (AUC = 0.721) showed 53.0% sensitivity and 87.0% specificity at cut-off 2.8 mg/dL. Blood urea nitrogen (AUC = 0.691) and blood urea nitrogen/albumin ratio (AUC = 0.675) were poor predictors; whereas albumin (AUC = 0.424) and blood urea nitrogen/creatinine ratio (AUC = 0.403) failed to predict in-hospital mortality. CONCLUSIONS: Among five serum markers, raised serum creatinine was a better predictor of in-hospital mortality in adults with community acquired pneumonia.


Assuntos
Infecções Comunitárias Adquiridas , Pneumonia , Adulto , Idoso , Biomarcadores , Nitrogênio da Ureia Sanguínea , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia/diagnóstico , Prognóstico , Curva ROC , Estudos Retrospectivos
16.
Sci Rep ; 12(1): 1802, 2022 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-35110626

RESUMO

Atherosclerotic lesions of the coronary arteries are still in charge of significant annual morbidity and mortality despite intense therapeutic advancements. Genome-born elements contribute substantially to the atherosclerosis process. ANRIL is one of the long non-coding RNAs with outstanding functions particularly regulation of genes involved in atherosclerosis development. In this study, we measured ANRIL expression (circular-, linear-, and circular/linear ratio) in hypertensive patients with coronary artery disease (CAD) compared with peers without CAD. Among hypertensive patients who were candidates of angiography, 25 subjects with CAD and the equal number without CAD were considered as the case and control groups, respectively. Different categories of data were recorded through a predefined questionnaire. Before angiography, blood samples were obtained. After RNA extraction and cDNA synthesis, quantitative PCR was performed using specific primers for circular and linear ANRIL. Age and gender were not different between the groups. Most of the parameters of the lipid profile besides creatinine and blood urea nitrogen were remarkably worse in the case group. Circular ANRIL was significantly lower in the case group while linear counterparts were significantly higher in this group. Circular/linear ratio was also significantly lower in the case group. To overcome growing devastating trend of CAD, scrutinizing different factors involved in the initiation and development of atherosclerosis is a must. Atheroprotective role of circular ANRIL and atheroprogressive role of linear ANRIL were shown in our patients with hypertension.


Assuntos
Doença da Artéria Coronariana/genética , Hipertensão/genética , RNA Circular/genética , RNA Longo não Codificante/genética , Adulto , Idoso , Nitrogênio da Ureia Sanguínea , Estudos de Casos e Controles , Angiografia Coronária , Doença da Artéria Coronariana/sangue , Doença da Artéria Coronariana/diagnóstico , Creatinina/sangue , Predisposição Genética para Doença , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/sangue , Hipertensão/diagnóstico , Lipídeos/sangue , Pessoa de Meia-Idade , Fenótipo , Fatores de Proteção , RNA Circular/sangue , RNA Longo não Codificante/sangue , Medição de Risco
17.
Medicine (Baltimore) ; 101(5): e28752, 2022 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-35119032

RESUMO

ABSTRACT: The aim of this study was to establish a prediction model for 30-day deaths of cirrhotic patients in intensive care unit.A case-control study involving 1840 patients was conducted in the Medical Information Mart of the Intensive Care Database III version 1.4. The logistic regression with L1 regularization was used to screen out the variables. The 30-day in-hospital death was used as the dependent variable and the selected variables were used as the independent variable to build a random forest model. The performance of the model was validated by the internal validation.The variables screened by logistic regression analysis were the age, heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, Oxygen saturation, white blood cells, platelets, red cell distribution width, glucose, blood urea nitrogen, bicarbonate, total bilirubin, hematocrit, alanine transaminase, aspartate transaminase, bilirubin, Simplified Acute Physiology Score II and Sequential Organ Failure Assessment. The areas under the curve of the random forest model based on these variables was 0.908, and the performance of this model were internally validated with an areas under the curve of 0.801. The random forest model displayed that Simplified Acute Physiology Score, Sequential Organ Failure Assessment, blood urea nitrogen, total bilirubin and bilirubin were more important predictors for the 30-day death of cirrhotic patients in intensive care unit.A prediction model for death of cirrhotic patients was developed based on a random forest analysis, providing a tool to evaluate the patients with a high risk of 30-day in-hospital deaths to help clinician make preventive intervention to decrease the mortality.


Assuntos
Mortalidade Hospitalar , Hospitalização , Unidades de Terapia Intensiva , Cirrose Hepática/mortalidade , Bilirrubina/sangue , Nitrogênio da Ureia Sanguínea , Estudos de Casos e Controles , Humanos , Prognóstico , Estudos Retrospectivos
18.
ESC Heart Fail ; 9(2): 1360-1369, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35146943

RESUMO

AIMS: Chronic heart failure (CHF) is often a common comorbidity in critically ill patients admitted to the intensive care unit (ICU) and carries an extremely poor prognosis. The study aimed to investigate the relationship between the blood urea nitrogen to serum albumin ratio (BAR) and the prognosis of patients with CHF admitted to the ICU. METHODS AND RESULTS: This retrospective cohort study included 1545 critically ill patients with CHF as a diagnosed comorbidity admitted to the ICU deposited in the MIMIC-III database, of whom 90 day all-cause mortality was 27.6% (n = 427) and in-hospital mortality was 17.3% (n = 267). The results of multiple logistic regression analysis indicated that BAR is an independent risk factor for in-hospital mortality in critically ill patients with CHF [compared with BAR ≤ 0.83; 0.83 < BAR ≤ 1.24: odds ratio (OR) 2.647, 95% confidence interval (CI) 1.797-3.900, P < 0.001; BAR ≥ 1.24: OR 3.628, 95% CI 2.604-5.057, P < 0.001]. Multiple COX regression analysis found a relationship between BAR and all-cause mortality at 90 day follow-up (0.83 < BAR ≤ 1.24: OR 1.948, 95% CI 1.259-3.014, P < 0.003; BAR ≥ 1.24: OR 1.807, 95% CI 1.154-2.830, P < 0.01; BAR ≤ 0.83 as a reference). Kaplan-Meier curves also showed similar results as well (P < 0.001). The areas under the receiver operating characteristic curves for predicting in-hospital mortality and 90 day all-cause mortality were 0.622 and 0.647, respectively. CONCLUSIONS: BAR is an independent risk factor for in-hospital mortality and 90 day mortality in critically ill patients with CHF admitted to the ICU.


Assuntos
Insuficiência Cardíaca , Albumina Sérica , Nitrogênio da Ureia Sanguínea , Humanos , Prognóstico , Estudos Retrospectivos
19.
Biomed Pharmacother ; 147: 112701, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35131657

RESUMO

Sustained usage of the chemotherapeutic drug cisplatin may lead to chronic kidney disease (CKD). Despite cisplatin being toxic to the kidneys, the efficiency of its therapeutic effects cannot be completely replaced with other drugs. Probiotics can produce various strain-specific health-promoting effects and suppress many specific diseases. In this study, we present the alleviation of cisplatin-induced CKD with a probiotic, Lactobacillus rhamnosus GKLC1. Intermittent low doses of cisplatin were given to male CB57BL/6 mice (n = 6), which induced CKD symptoms such as weight loss, lesions in kidney tissue, and increases in blood urea nitrogen (BUN) and creatinine (CRE) in serum. The rats received two weeks of L. rhamnosus GKLC1 orally at doses of 125, 250, and 500 mg/kg B.W./day. After the treatment, significant dose-dependent reductions were observed in the kidney index, histopathological scoring, serum BUN, and CRE. An LLC-PK1 kidney cell assay revealed that L. rhamnosus GKLC1 suppressed the nephrotoxicity of cisplatin by reducing the inflammation via the MAPKs/NF-ĸB/COX-2 pathway, inhibiting apoptosis via the p53/Bax/Caspase-3 pathway, and ameliorating fibrosis via the STAT3 pathway. We conclude that L. rhamnosus GKLC1 could be applied as an agent to ameliorate the development of CKD.


Assuntos
Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/patologia , Antineoplásicos/efeitos adversos , Cisplatino/efeitos adversos , Lactobacillus rhamnosus , Probióticos/farmacologia , Animais , Apoptose/efeitos dos fármacos , Nitrogênio da Ureia Sanguínea , Caspase 3/efeitos dos fármacos , Creatinina/sangue , Relação Dose-Resposta a Droga , Inflamação/patologia , Mediadores da Inflamação/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Quinases Ativadas por Mitógeno/efeitos dos fármacos , Probióticos/administração & dosagem , Ratos , Transdução de Sinais/efeitos dos fármacos , Proteína X Associada a bcl-2/efeitos dos fármacos
20.
Int J Mol Sci ; 23(3)2022 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-35163466

RESUMO

Ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury (AKI) and progression to chronic kidney disease (CKD). However, no effective therapeutic intervention has been established for ischemic AKI. Endothelial progenitor cells (EPCs) have major roles in the maintenance of vascular integrity and the repair of endothelial damage; they also serve as therapeutic agents in various kidney diseases. Thus, we examined whether EPCs have a renoprotective effect in an IRI mouse model. Mice were assigned to sham, EPC, IRI-only, and EPC-treated IRI groups. EPCs originating from human peripheral blood were cultured. The EPCs were administered 5 min before reperfusion, and all mice were killed 72 h after IRI. Blood urea nitrogen, serum creatinine, and tissue injury were significantly increased in IRI mice; EPCs significantly improved the manifestations of IRI. Apoptotic cell death and oxidative stress were significantly reduced in EPC-treated IRI mice. Administration of EPCs decreased the expression levels of NLRP3, cleaved caspase-1, p-NF-κB, and p-p38. Furthermore, the expression levels of F4/80, ICAM-1, RORγt, and IL-17RA were significantly reduced in EPC-treated IRI mice. Finally, the levels of EMT-associated factors (TGF-ß, α-SMA, Snail, and Twist) were significantly reduced in EPC-treated IRI mice. This study shows that inflammasome-mediated inflammation accompanied by immune modulation and fibrosis is a potential target of EPCs as a treatment for IRI-induced AKI and the prevention of progression to CKD.


Assuntos
Injúria Renal Aguda/prevenção & controle , Células Progenitoras Endoteliais/transplante , Inflamassomos/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Traumatismo por Reperfusão/prevenção & controle , Injúria Renal Aguda/metabolismo , Animais , Apoptose/efeitos dos fármacos , Nitrogênio da Ureia Sanguínea , Células Cultivadas , Creatinina/sangue , Modelos Animais de Doenças , Células Progenitoras Endoteliais/citologia , Células Progenitoras Endoteliais/imunologia , Células Progenitoras Endoteliais/metabolismo , Humanos , Masculino , Camundongos , Estresse Oxidativo/efeitos dos fármacos , Traumatismo por Reperfusão/imunologia , Traumatismo por Reperfusão/metabolismo
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