COVID-19-related acute kidney injury; incidence, risk factors and outcomes in a large UK cohort.

BACKGROUND: Acute kidney injury (AKI) is common among patients hospitalised with COVID-19 and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre. METHODS: We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020. RESULTS: Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2, and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24-4,18; p <  0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27-2.53; p <  0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19-2.13) for stage 1; p < 0.005, 2.71(95%CI 1.82-4.05); p < 0.001for stage 2 and 2.99 (95%CI 2.17-4.11); p < 0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months. CONCLUSIONS: This large UK cohort demonstrated a high AKI incidence and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3-6 months.

ML-CKDP: Machine learning-based chronic kidney disease prediction with smart web application.

Chronic kidney diseases (CKDs) are a significant public health issue with potential for severe complications such as hypertension, anemia, and renal failure. Timely diagnosis is crucial for effective management. Leveraging machine learning within healthcare offers promising advancements in predictive diagnostics. In this paper, we developed a machine learning-based kidney diseases prediction (ML-CKDP) model with dual objectives: to enhance dataset preprocessing for CKD classification and to develop a web-based application for CKD prediction. The proposed model involves a comprehensive data preprocessing protocol, converting categorical variables to numerical values, imputing missing data, and normalizing via Min-Max scaling. Feature selection is executed using a variety of techniques including Correlation, Chi-Square, Variance Threshold, Recursive Feature Elimination, Sequential Forward Selection, Lasso Regression, and Ridge Regression to refine the datasets. The model employs seven classifiers: Random Forest (RF), AdaBoost (AdaB), Gradient Boosting (GB), XgBoost (XgB), Naive Bayes (NB), Support Vector Machine (SVM), and Decision Tree (DT), to predict CKDs. The effectiveness of the models is assessed by measuring their accuracy, analyzing confusion matrix statistics, and calculating the Area Under the Curve (AUC) specifically for the classification of positive cases. Random Forest (RF) and AdaBoost (AdaB) achieve a 100% accuracy rate, evident across various validation methods including data splits of 70:30, 80:20, and K-Fold set to 10 and 15. RF and AdaB consistently reach perfect AUC scores of 100% across multiple datasets, under different splitting ratios. Moreover, Naive Bayes (NB) stands out for its efficiency, recording the lowest training and testing times across all datasets and split ratios. Additionally, we present a real-time web-based application to operationalize the model, enhancing accessibility for healthcare practitioners and stakeholders. Web app link: https://rajib-research-kedney-diseases-prediction.onrender.com/.

Genetic damage induced by lead chloride in different tissues of fresh water climbing perch Anabas testudineus (Bloch).

The present investigation was undertaken to study the induction of DNA damage by lead chloride (PbCl(2)) in freshwater climbing perch Anabas testudineus using alkaline single cell gel electrophoresis (comet assay). Based on the LC(50) values of lead chloride of A. testudineus three different concentrations viz., 0.1, 1.0 and 2.0 mg/L were selected to expose fish. The DNA damage was observed in the gill, kidney and liver tissue as the percentage of DNA in comet tails and comet heads in the tissue of the exposed fish. DNA damage at different concentrations showed sensitivity to particular tissue. The liver tissue exhibited significantly (p < 0.01) higher DNA damage, followed by kidney and gill. However, the DNA damage was found to be dose dependent; at 2 mg/L of PbCl(2) the tail and head DNA of liver tissue were 57.84% and 39.49%, in kidney tissue the values were 52.36% and 44.97% whereas in gill tissue the values were 48.86% and 48.96% respectively. The current study explored the utility of the comet assay for in vivo laboratory studies using A. testudineus species for screening the genotoxic potential of lead chloride.

Arsenic induced toxicity and histopathological changes in gill and liver tissue of freshwater fish, tilapia (Oreochromis mossambicus).

Acute toxicity of arsenic to tilapia (Oreochromis mossambicus) and its histopathological impacts on gill and liver tissue were evaluated. The median lethal concentration (96 h; LC50) of arsenic (NaAsO2) was calculated as 28.22 ppm in repeated semi static test method. Fish were exposed to 3 ppm, 28 ppm and 56 ppm concentrations of NaAsO2 and gill and liver samples were collected after 48 h, 96 h and 192 h of exposure. The changes in gill were characterized by epithelial hyperplasia, epithelial lifting and oedema, lamellar fusion, aneurism, desquamation and necrosis, whereas, the liver tissue showed focal lymphocytic and macrophage infiltration, congestion, vacuolization and shrinkage of hepatocytes, dilation of sinusoids, cloudy swelling, vacuolar degeneration, focal necrosis and nuclear hypertrophy. The result showed that acute arsenic toxicity severely affects the normal behavior and vital organs which is deleterious for the exposed fish.

Assessing the genotoxic potentials of arsenic in tilapia (Oreochromis mossambicus) using alkaline comet assay and micronucleus test.

This experiment was conducted to study the genotoxic potentials of sodium arsenite (NaAsO(2)) in freshwater fish Oreochromis mossambicus by using alkaline comet assay and micronucleus (MN) test. Fish were exposed to three different concentrations (3 ppm, 28 ppm and 56 ppm) of arsenic and gill, liver and blood tissue samples were collected after 48 h, 96 h and 192 h of exposure. Arsenic exposure induced DNA damage in all tissues examined in a concentration dependent manner. A significant (p<0.05) increase in the comet tail DNA (%) of the exposed fish liver, gill, and blood was observed after 48 h and 96 h of exposure, but a decline in DNA damage was recorded in all the tissues at all the three concentrations studied after 192 h of exposure. Liver tissue exhibited significantly (p<0.05) higher DNA damage at all the concentrations examined, followed by gill and blood. Higher liver tail DNA (51.38 ± 0.21%) refers that it is more prone to injury to arsenic toxicity than the gill and blood. In blood samples arsenic induced micronucleus formation in a concentration dependent manner and highest (5.8 ± 0.46%) value was recorded in 56 ppm after 96 h of exposure, whereas, it was decreased after 192 h of exposure at all the three concentrations of NaAsO(2) examined which refers to the DNA repairing ability of fish to arsenic toxicity. The results of this study depict the genotoxic potentials of arsenic to fish which in turns provide insight on advanced study in aquatic toxicology.

Measurements of genotoxic potential of cadmium in different tissues of fresh water climbing perch Anabas testudineus (Bloch), using the comet assay.

The present investigation was undertaken to study the induction of DNA damage by CdCl(2) in freshwater climbing perch Anabas testudineus (Bloch) using alkaline single cell gel electrophoresis (comet assay). The DNA damage was measured in the tissue of gill, kidney and liver as the percentage of DNA in comet tails and comet heads in the tissue of the fish specimens exposed to 0.1, 1.0, 2.0mgL(-1) concentrations of CdCl(2). It was found that at all the concentrations of CdCl(2), the liver tissue exhibited significantly (p<0.01) higher DNA damage, followed by kidney and gill tissue. The DNA damage was found to be concentration dependent, with the highest DNA damage at 2mgL(-1) concentration, followed by 1.0 and 0.1mgL(-1). At the concentration of 2mgL(-1) of CdCl(2), the tail and head DNA of liver tissue were 38.81% and 59.49%, in kidney tissue the values were 32.37% and 64.66% whereas in gill tissue the values were 31.30% and 66.40% respectively. This study conclude that comet assay can be used for in vivo laboratory experiment using fish as model for screening the genotoxic potential of cadmium.