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  1. Glomerular filtration rate (GFR) and estimation of the GFR (eGFR) in ...

    African Journals Online (AJOL)

    The GFR is the best overall measure of renal function. Jocelyn Naicker, BSc ... in both health and disease.1 Measurement of the GFR is based ... Plasma clearance markers may be endogenous .... ethnicity factor was removed.10 In the eGFR.

  2. Prediction of hospital mortality by changes in the estimated glomerular filtration rate (eGFR).

    LENUS (Irish Health Repository)

    Berzan, E

    2015-03-01

    Deterioration of physiological or laboratory variables may provide important prognostic information. We have studied whether a change in estimated glomerular filtration rate (eGFR) value calculated using the (Modification of Diet in Renal Disease (MDRD) formula) over the hospital admission, would have predictive value. An analysis was performed on all emergency medical hospital episodes (N = 61964) admitted between 1 January 2002 and 31 December 2011. A stepwise logistic regression model examined the relationship between mortality and change in renal function from admission to discharge. The fully adjusted Odds Ratios (OR) for 5 classes of GFR deterioration showed a stepwise increased risk of 30-day death with OR\\'s of 1.42 (95% CI: 1.20, 1.68), 1.59 (1.27, 1.99), 2.71 (2.24, 3.27), 5.56 (4.54, 6.81) and 11.9 (9.0, 15.6) respectively. The change in eGFR during a clinical episode, following an emergency medical admission, powerfully predicts the outcome.

  3. Preliminary Findings of Serum Creatinine and Estimated Glomerular Filtration Rate (eGFR) in Adolescents with Intellectual Disabilities

    Science.gov (United States)

    Lin, Jin-Ding; Lin, Lan-Ping; Hsieh, Molly; Lin, Pei-Ying

    2010-01-01

    The present study aimed to describe the kidney function profile--serum creatinine and estimated glomerular filtration rate (eGFR), and to examine the relationships of predisposing factors to abnormal serum creatinine in people with intellectual disabilities (ID). Data were collected by a cross-sectional study of 827 aged 15-18 years adolescents…

  4. Feasibility study of high-resolution DCE-MRI for glomerular filtration rate (GFR) measurement in a routine clinical modal.

    Science.gov (United States)

    Zhang, Yu-Dong; Wu, Chen-Jiang; Zhang, Jing; Wang, Xiao-Ning; Liu, Xi-Sheng; Shi, Hai-Bin

    2015-10-01

    Dynamic contrast enhanced (DCE) MR renography has been identified as an interesting tool to determine single-kidney GFR. However, a fundamental issue for the applicability of MR-based estimate of single-kidney GFR is selecting a balance between spatial and temporal resolution of DCE-MRI data. The purpose is to assess the feasibility of GFR estimate from high-resolution (HR) dynamic contrast-enhanced (DCE) MRI in a routine clinical modal. Standard MR renography (2.4s/phase, total 4min; 4-ml Gd) and five-phase, HR-based imaging protocol (0, 30, 70, 120, and 240s; 0.05mmol/kg Gd) were prospectively performed in twelve volunteers who were scheduled for routine renal MRI. Data were plotted with Patlak, two-compartment modified Tofts model (2CTM), and two-compartment filtration model (2CFM) for GFR estimate. During all the measurements, only the signal intensities in the aorta and whole kidney parenchyma were considered. Standard 2CFM and 2CTM produced lower residuals over the fitted interval than HR-based measures (pGFR and higher residuals than that plots with 0-120s data points (pGFR with HR-based DCE-MRI and appreciate kinetic model. Patlak plots from 0, 30, 70, and 120s data points is better than plots from 0, 30, 70, 120, and 240s data points.

  5. Glomerular filtration rate

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/007305.htm Glomerular filtration rate To use the sharing features on this page, please enable JavaScript. Glomerular filtration rate (GFR) is a test used to check ...

  6. A Comparative Study of Sonographic Grading of Renal Parenchymal Changes and Estimated Glomerular Filtration Rate (eGFR) using Modified Diet in Renal Disease Formula

    Science.gov (United States)

    Shivalli, Siddharudha; Pai, B.H. Santhosh; Acharya, Koteshwara Devadasa; Gopalakrishnan, Ravichandra; Srikanth, Vivek; Reddy, Vishwanath; Haris, Arafat

    2016-01-01

    Introduction The sonographic findings are of help in evaluating the nephrological diseases. Glomerular filtration rate is another parameter for assessing the reserved renal function and an indicator of prognosis. In clinical practice GFR estimation (eGFR) is done by using a mathematical formula. In our study, we compared the sonographic grading of renal parenchymal changes with eGFR calculated using Modified Diet in Renal Diseases formula based on serum creatinine, age, gender and ethnicity. Aim To evaluate the relevance of sonographic grading of renal parenchymal changes in assessing the severity of the renal disease and comparing it to the eGFR calculated using MDRD formula based on the age, gender and serum creatinine value of the patient. Materials and Methods The adult patients with suspected kidney disease referred for sonography of abdomen were our study participants. As per our study design following strict inclusion and exclusion criteria, patients were selected as study participants and for each of the patient’s renal parenchymal status, serum creatinine, age, gender and ethnicity were documented. Results A total of 70 patients were our study participants, out of which 67.1% were males and 32.9% were females. Our study showed a linear correlation between sonographic grading of renal parenchymal changes with eGFR. Conclusion We conclude that by evaluating the kidneys with sonography and calculating eGFR using MDRD formula the renal status will be more accurately interpreted. PMID:27042555

  7. Accuracy of GFR estimation formula in determination of glomerular filtration rate in kidney donors: Comparison with 24 h urine creatinine clearance

    Directory of Open Access Journals (Sweden)

    Abdul Rauf Hafeez

    2016-01-01

    Full Text Available To determine the accuracy of estimated glomerular filtration rate (eGFR using the modification of diet in renal disease (MDRD, Cockcroft-Gault (CG, and chronic kidney disease epidemiology (CKD-EPI formulas in potential kidney donors compared with 24-h urine creatinine clearance, we studied 207 potential live kidney donors in our center. There were 126 (60.9% males and 81 (39.1% females. Male:female ratio was 1.6:1. The age of the donors ranged from 18-58 years, with mean age of 35.30 ± 9.23 years and most of the individuals were below 40 years of age. The body mass index (BMI was calculated and venous blood samples were obtained for the measurement of serum creatinine and every study participant was instructed to collect 24-h urine. GFR was calculated based on 24-h urine creatinine clearance and the formulas. The accuracy of GFR estimation formula was taken as positive if the GFR calculated by the formulas and urine creatinine clearance fell between 90-120 mL/min/1.73 m 2 . The accuracy of the MDRD formula was 48.8% and the CG formula was 41.5% whereas the accuracy of the CKD-EPI formula was 78.2%. The accuracy of the eGFR using the MDRD formula was significantly higher in males than females (57.9% vs. 33.3% P = 0.001, while there was no statistically significant difference in the eGFR between them in case of the use of the CG and the CKD-EPI formulas. BMI and obesity had no effect on the accuracy of eGFR by the use of the different formulas. The performance of GFR estimation formulas was sub optimal and these either underestimated and/or over-estimated the GFR in healthy subjects. CKD-EPI is closer to 24 -h urinary creatinine clearance in the calculation of eGFR. However, none of the eGFR formulas can be used in renal transplant donors because of their low accuracy, and 24-h urine creatinine clearance should be used for evaluation of the GFR in this population.

  8. Accuracy of GFR estimation formula in determination of glomerular filtration rate in kidney donors: Comparison with 24 h urine creatinine clearance.

    Science.gov (United States)

    Hafeez, Abdul Rauf; Idrees, Muhammad Khalid; Akhtar, Syed Fazal

    2016-03-01

    To determine the accuracy of estimated glomerular filtration rate (eGFR) using the modification of diet in renal disease (MDRD), Cockcroft-Gault (CG), and chronic kidney disease epidemiology (CKD-EPI) formulas in potential kidney donors compared with 24-h urine creatinine clearance, we studied 207 potential live kidney donors in our center. There were 126 (60.9%) males and 81 (39.1%) females. Male:female ratio was 1.6:1. The age of the donors ranged from 18-58 years, with mean age of 35.30 ± 9.23 years and most of the individuals were below 40 years of age. The body mass index (BMI) was calculated and venous blood samples were obtained for the measurement of serum creatinine and every study participant was instructed to collect 24-h urine. GFR was calculated based on 24-h urine creatinine clearance and the formulas. The accuracy of GFR estimation formula was taken as positive if the GFR calculated by the formulas and urine creatinine clearance fell between 90-120 mL/min/1.73 m(2). The accuracy of the MDRD formula was 48.8% and the CG formula was 41.5% whereas the accuracy of the CKD-EPI formula was 78.2%. The accuracy of the eGFR using the MDRD formula was significantly higher in males than females (57.9% vs. 33.3% P = 0.001), while there was no statistically significant difference in the eGFR between them in case of the use of the CG and the CKD-EPI formulas. BMI and obesity had no effect on the accuracy of eGFR by the use of the different formulas. The performance of GFR estimation formulas was sub optimal and these either underestimated and/or over-estimated the GFR in healthy subjects. CKD-EPI is closer to 24 -h urinary creatinine clearance in the calculation of eGFR. However, none of the eGFR formulas can be used in renal transplant donors because of their low accuracy, and 24-h urine creatinine clearance should be used for evaluation of the GFR in this population.

  9. Impact of urine concentration adjustment method on associations between urine metals and estimated glomerular filtration rates (eGFR) in adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Weaver, Virginia M., E-mail: vweaver@jhsph.edu [Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Johns Hopkins University School of Medicine, Baltimore, MD (United States); Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Vargas, Gonzalo García [Faculty of Medicine, University of Juárez of Durango State, Durango (Mexico); Secretaría de Salud del Estado de Coahuila, Coahuila, México (Mexico); Silbergeld, Ellen K. [Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Rothenberg, Stephen J. [Instituto Nacional de Salud Publica, Centro de Investigacion en Salud Poblacional, Cuernavaca, Morelos (Mexico); Fadrowski, Jeffrey J. [Johns Hopkins University School of Medicine, Baltimore, MD (United States); Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (United States); Rubio-Andrade, Marisela [Faculty of Medicine, University of Juárez of Durango State, Durango (Mexico); Parsons, Patrick J. [Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY (United States); Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, NY (United States); Steuerwald, Amy J. [Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY (United States); and others

    2014-07-15

    Positive associations between urine toxicant levels and measures of glomerular filtration rate (GFR) have been reported recently in a range of populations. The explanation for these associations, in a direction opposite that of traditional nephrotoxicity, is uncertain. Variation in associations by urine concentration adjustment approach has also been observed. Associations of urine cadmium, thallium and uranium in models of serum creatinine- and cystatin-C-based estimated GFR (eGFR) were examined using multiple linear regression in a cross-sectional study of adolescents residing near a lead smelter complex. Urine concentration adjustment approaches compared included urine creatinine, urine osmolality and no adjustment. Median age, blood lead and urine cadmium, thallium and uranium were 13.9 years, 4.0 μg/dL, 0.22, 0.27 and 0.04 g/g creatinine, respectively, in 512 adolescents. Urine cadmium and thallium were positively associated with serum creatinine-based eGFR only when urine creatinine was used to adjust for urine concentration (β coefficient=3.1 mL/min/1.73 m{sup 2}; 95% confidence interval=1.4, 4.8 per each doubling of urine cadmium). Weaker positive associations, also only with urine creatinine adjustment, were observed between these metals and serum cystatin-C-based eGFR and between urine uranium and serum creatinine-based eGFR. Additional research using non-creatinine-based methods of adjustment for urine concentration is necessary. - Highlights: • Positive associations between urine metals and creatinine-based eGFR are unexpected. • Optimal approach to urine concentration adjustment for urine biomarkers uncertain. • We compared urine concentration adjustment methods. • Positive associations observed only with urine creatinine adjustment. • Additional research using non-creatinine-based methods of adjustment needed.

  10. A genome-wide search for linkage of estimated glomerular filtration rate (eGFR in the Family Investigation of Nephropathy and Diabetes (FIND.

    Directory of Open Access Journals (Sweden)

    Farook Thameem

    Full Text Available OBJECTIVE: Estimated glomerular filtration rate (eGFR, a measure of kidney function, is heritable, suggesting that genes influence renal function. Genes that influence eGFR have been identified through genome-wide association studies. However, family-based linkage approaches may identify loci that explain a larger proportion of the heritability. This study used genome-wide linkage and association scans to identify quantitative trait loci (QTL that influence eGFR. METHODS: Genome-wide linkage and sparse association scans of eGFR were performed in families ascertained by probands with advanced diabetic nephropathy (DN from the multi-ethnic Family Investigation of Nephropathy and Diabetes (FIND study. This study included 954 African Americans (AA, 781 American Indians (AI, 614 European Americans (EA and 1,611 Mexican Americans (MA. A total of 3,960 FIND participants were genotyped for 6,000 single nucleotide polymorphisms (SNPs using the Illumina Linkage IVb panel. GFR was estimated by the Modification of Diet in Renal Disease (MDRD formula. RESULTS: The non-parametric linkage analysis, accounting for the effects of diabetes duration and BMI, identified the strongest evidence for linkage of eGFR on chromosome 20q11 (log of the odds [LOD] = 3.34; P = 4.4 × 10(-5 in MA and chromosome 15q12 (LOD = 2.84; P = 1.5 × 10(-4 in EA. In all subjects, the strongest linkage signal for eGFR was detected on chromosome 10p12 (P = 5.5 × 10(-4 at 44 cM near marker rs1339048. A subsequent association scan in both ancestry-specific groups and the entire population identified several SNPs significantly associated with eGFR across the genome. CONCLUSION: The present study describes the localization of QTL influencing eGFR on 20q11 in MA, 15q21 in EA and 10p12 in the combined ethnic groups participating in the FIND study. Identification of causal genes/variants influencing eGFR, within these linkage and association loci, will open new avenues for functional analyses

  11. One-sample determination of glomerular filtration rate (GFR) in children. An evaluation based on 75 consecutive patients

    DEFF Research Database (Denmark)

    Henriksen, Ulrik Lütken; Kanstrup, Inge-Lis; Henriksen, Jens Henrik Sahl

    2013-01-01

    Abstract Background and aim. From a clinical point of view determination of glomerular filtration rate (clearance) is important. The aim of the present study was to compare the one-sample clearance to reference multiple-sample (51)Cr-EDTA clearance in consecutively referred children suspected of ...

  12. Estimating glomerular filtration rate (GFR) in children. The average between a cystatin C- and a creatinine-based equation improves estimation of GFR in both children and adults and enables diagnosing Shrunken Pore Syndrome.

    Science.gov (United States)

    Leion, Felicia; Hegbrant, Josefine; den Bakker, Emil; Jonsson, Magnus; Abrahamson, Magnus; Nyman, Ulf; Björk, Jonas; Lindström, Veronica; Larsson, Anders; Bökenkamp, Arend; Grubb, Anders

    2017-09-01

    Estimating glomerular filtration rate (GFR) in adults by using the average of values obtained by a cystatin C- (eGFRcystatin C) and a creatinine-based (eGFRcreatinine) equation shows at least the same diagnostic performance as GFR estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparison of eGFRcystatin C and eGFRcreatinine plays a pivotal role in the diagnosis of Shrunken Pore Syndrome, where low eGFRcystatin C compared to eGFRcreatinine has been associated with higher mortality in adults. The present study was undertaken to elucidate if this concept can also be applied in children. Using iohexol and inulin clearance as gold standard in 702 children, we studied the diagnostic performance of 10 creatinine-based, 5 cystatin C-based and 3 combined cystatin C-creatinine eGFR equations and compared them to the result of the average of 9 pairs of a eGFRcystatin C and a eGFRcreatinine estimate. While creatinine-based GFR estimations are unsuitable in children unless calibrated in a pediatric or mixed pediatric-adult population, cystatin C-based estimations in general performed well in children. The average of a suitable creatinine-based and a cystatin C-based equation generally displayed a better diagnostic performance than estimates obtained by equations using only one of these analytes or by complex equations using both analytes. Comparing eGFRcystatin and eGFRcreatinine may help identify pediatric patients with Shrunken Pore Syndrome.

  13. Effect of canagliflozin on serum electrolytes in patients with type 2 diabetes in relation to estimated glomerular filtration rate (eGFR).

    Science.gov (United States)

    Weir, Matthew R; Kline, Irina; Xie, John; Edwards, Robert; Usiskin, Keith

    2014-09-01

    Effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on serum electrolytes were evaluated using pooled data from studies of patients with type 2 diabetes mellitus (T2DM). Analyses were performed using two datasets, each including four placebo-controlled studies: Population 1 (N = 2215), patients with baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m(2) (mean = 89.6 mL/min/1.73 m(2)) and Population 2 (N = 721), patients with baseline eGFR ≥45 and canagliflozin 100 and 300 mg or placebo. Potassium changes were further evaluated based on baseline therapy with anti-hypertensive agents that interfere with potassium excretion (renin-angiotensin aldosterone system-acting agents and/or potassium-sparing diuretics). Mean percent changes from baseline in potassium with canagliflozin 100 and 300 mg and placebo were 0.6%, 1.0%, and 0.5%, respectively (Week 26; Population 1); and 1.7%, 2.8%, and 0.7%, respectively (Week 18/26; Population 2). The proportion of patients who had potassium elevations meeting pre-defined outlier criteria (>5.4 mmol/L [5.4 mEq/L] and >15% increase from baseline) with canagliflozin 100 and 300 mg and placebo was 4.5%, 6.8%, and 4.7% (Population 1); and 5.2%, 9.1%, and 5.5% (Population 2). In both populations, potassium elevations were usually canagliflozin or placebo; elevations ≥6.5 mmol/L were rare but more frequent in patients taking anti-hypertensive agents that affect potassium excretion in both the canagliflozin and placebo groups. Small mean percent changes in sodium, bicarbonate, and calcium were seen across groups in both populations; small mean percent increases in magnesium and phosphate were seen with canagliflozin vs placebo, but without an increase in patients meeting outlier criteria. Adverse events related to changes in electrolytes were low across groups. In patients with T2DM, canagliflozin was generally associated with small mean percent changes in serum

  14. Effects of pitavastatin (LIVALO tablet) on the estimated glomerular filtration rate (eGFR) in hypercholesterolemic patients with chronic kidney disease. Sub-analysis of the LIVALO Effectiveness and Safety (LIVES) Study.

    Science.gov (United States)

    Kimura, Kenjiro; Shimano, Hitoshi; Yokote, Koutaro; Urashima, Mitsuyoshi; Teramoto, Tamio

    2010-06-30

    In addition to the risk of progression to end-stage renal disease (ESRD), chronic kidney disease (CKD) is also known to be associated with an elevated risk of cardiovascular disease (CVD). Statins may improve renal function in CKD patients. The database of the LIVALO Effectiveness and Safety (LIVES) Study, a large-scale (n=20,279), long-term (104 weeks), prospective post-marketing surveillance study of hypercholesterolemic patients treated with pitavastatin, was used to evaluate the effects of pitavastatin on the estimated glomerular filtration rate (eGFR). Of the 19,925 patients enrolled in the aforementioned study, data from 3,119 patients were analyzed to evaluate the effects of pitavastatin treatment for 104 weeks on the eGFR. In this subanalysis, 958 patients with a baseline eGFR of less than 60 mL/min/1.73 m(2) (30.7%) were analyzed. A significant increase of the eGFR (+5.4 mL/min/1.73 m(2)) was observed after 104 weeks of pitavastain treatment (p analysis of the time-course of changes in the eGFR in response to pitavastatin treatment, the eGFR was elevated by 2.4 mL/min/1.73 m(2) after 12 weeks' treatment, and by 5.6 mL/min/1.73 m(2) after 104 weeks' treatment (p multivariate analysis identified the presence/absence of proteinuria and the amount change of HDL-C as clinical factors associated with increased eGFR during pitavastatin treatment. Increased eGFR was noted after 104 weeks of treatment with pitavastatin, which suggests a possible effect of the statin on CKD.

  15. The correlation between effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) with renal scintigraphy 99mTc-DTPA study

    Science.gov (United States)

    Ratnasari, D.; Nazir, F.; Toresano, L. O. H. Z.; Pawiro, S. A.; Soejoko, D. S.

    2016-03-01

    The prevalence of chronic renal diseases in Indonesia has an increasing annual trend, because it is frequently unrecognized and often co-exists with other disease. GFR and ERPF are parameters currently utilized to estimate renal function at routine renal scintigraphy 99m-Tc DTPA study. This study used 99m-Tc DTPA to measure GFR and ERPF. The purpose of this study was to find the correlation between ERPF and GFR, for ERPF analysis with Schlegel's method, and GFR analysis with Gate's method, as well as to find correction factor between both variables. Analysis of renal scintigraphy has been performed at Department of Nuclear Medicine Pertamina Center Hospital to thirty patient images acquired from 2014 to 2015 which were analyzed retrospectively data, using gamma camera dual head with counting method from renal scintigraphy 99m-Tc DTPA study. The calculation was executed by means of both display and manual calculation. Pearson's statistical analysis resulted on Positive Correlation for all data, with ERPF and GFR (display) showing Strongly Positive Correlation (r = 0.82; p- value < 0.05). Standard deviation was found to be 27.58 and 107.64 for GFR and ERPF (display), respectively. Our result indicated that the use of 99mTc-DTPA measure ERPF was not recommended.

  16. Reliability of estimated glomerular filtration rate in patients treated with platinum containing therapy

    DEFF Research Database (Denmark)

    Lauritsen, Jakob; Gundgaard, Maria G; Mortensen, Mette S

    2014-01-01

    Estimates of glomerular filtration rate (eGFR) are widely used when administering nephrotoxic chemotherapy. No studies performed in oncology patients have shown whether eGFR can safely substitute a measured GFR (mGFR) based on a marker method. We aimed to assess the validity of four major formula...

  17. Radionuclide Renal Dynamic Imaging GFR (glomerular filtration rate) to Evaluate Renal Function and Serum Creatinine (Scre) Evaluation Comparison of Renal Clearance%核素肾动态显像GFR测定与肌酐清除率评价肾功能的相关性比较

    Institute of Scientific and Technical Information of China (English)

    张晓; 孙莲华

    2014-01-01

    Objective:To study radionuclide renal dynamic imaging GFR ( glomerular filtration rate ) to evaluate renal function and se-rum creatinine ( Scre) evaluation comparison of renal clearance .Methods:First estimation of normal reference value of my GFR in the control group;when renal function damage of 80 cases, measurement of GFR and creatinine clearance rate comparison of measurement val-ues.Results:80 cases patients of GFR and muscle anhydride cleared rate contrast , GFR and serum muscle anhydride are exception who 63 cases, its GFR value 81.3 ±12.8ml/min and muscle anhydride cleared rate 85.5 ±11.3ml/min, differences no significantly sexual meaning (P>0.05);12 cases chronic kidney damage patients , muscle anhydride cleared rate 70.1 ±8.3ml/min,GFR value 50.2 ± 6.8ml/min, differences has significantly sexual meaning ( P<0.01); Value of 5 patients with severe hydronephrosis GFR 19.1 ±7. 3ml/min, 23.6 ±5.8ml/min creatinine clearance rate, the difference has a significant meaning (P<0.01).Radionuclide renal dynam-ic values of GFR and creatinine clearance rate more in line with;early GFR and impaired renal function creatinine clearance rate of earlier abnormal changes .Conclusion:Radionuclide renal dynamic checking GFR determination can better reflect the change rate of Glomerular filtration function in early stage , a more accurate estimation of renal function .%目的:探讨放射性核素肾动态显像GFR(肾小球滤过率)评价肾功能与血清肌酐( Scre)清除率评价肾功能的比较。方法:首先对照组估算我科GFR的正常参考值;80例当肾功能受损害时,GFR的测量值与血清肌酐清除率测定值的比较。结果:80例患者的GFR与肌酐清除率对比,GFR和血清肌酐均异常者63例,其GFR值81.3±12.8ml/min与肌酐清除率85.5±11.3ml/min,差异无显著性意义(P>0.05);12例慢性肾损害患者,肌酐清除率70.1±8.3ml/min,GFR值50.2±6.8ml

  18. Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Yoshimi Iwasaki; Tokihiko Sawada; Shozo Mori; Yukihiro Iso; Masato Katoh; Kyu Rokkaku; Junji Kita; Mitsugi Shimoda; Keiichi Kubota

    2009-01-01

    AIM: To compare creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) in preoperative renal function tests in patients undergoing hepatectomy. METHODS: The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied, and preoperative Ccr, a three-variable equation for eGFR (eGFR3) and a five-variable equation for eGFR (eGFR5) were calculated. Abnormal values were defined as Ccr < 50 mL/min, eGFR3 and eGFR5 < 60 mL/min per 1.73 m2. The maximum increases in the postoperative serum creatinine (post Cr) level and postoperative rate of increase in the serum Cr level (post Cr rate) were compared. RESULTS: There were 37 patients (18.8%) withabnormal Ccr, 31 (15.7%) with abnormal eGFR3, and 40 (20.3%) with abnormal eGFR5. Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr, eGFR3 and eGFR5 values, the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients ( P < 0.0001). Post Cr level tended to be higher in patients with Ccr abnormality ( P = 0.0936 and P = 0.0875, respectively). CONCLUSION: eGFR5 and the simpler eGFR3, rather than Ccr, are recommended as a preoperative renal function test in patients undergoing hepatectomy.

  19. Rapid decline in glomerular filtration rate during the first weeks following heart transplantation

    DEFF Research Database (Denmark)

    Hornum, M; Andersen, Mads Jønsson; Gustafsson, F

    2011-01-01

    We hypothesized that a decrease in renal function is seen immediately after heart transplantation (HTX) with little recovery over time. Twelve consecutive patients had their glomerular filtration rate (GFR) measured using (51)Cr-ethylenediaminetetraacetic acid (EDTA) measured GFR (mGFR) before tr...

  20. Assessment of Glomerular Filtration Rate on Coronary Artery Lesions by Cockcroft_Gault Equation%Cockcroft_Gault 方程估算 GFR 对冠状动脉病变的评估

    Institute of Scientific and Technical Information of China (English)

    郑家胜; 俎德玲; 诸葛毅; 屠晓鸣; 金奇志

    2015-01-01

    目的:探讨Cockcroft_Gault方程估算肾小球滤过率与冠状动脉狭窄程度的研究。方法冠状动脉造影确定为冠心病者253例为冠心病组,以Gensini积分对冠状动脉病变程度进行评分并分级,168例冠状动脉粥样硬化狭窄程度<50%患者为对照组,通过Cockcroft_Gault方程估算两组患者的肾小球滤过率,分析冠状动脉病变与估算肾小球滤过率之间的关系。结果冠心病组与对照组的估算肾小球滤过率分别为:(61.13±11.10)[mL/(min ×1.73m2)]和(77.92±11.80)[mL/(min ×1.73m2)]( P<0.05),差异有统计学意义。冠状动脉轻度、中度和重度病变组,估算肾小球滤过率分别为(66.73±14.56)[mL/(min ×1.73m2)],(63.83±15.45)[mL/(min ×1.73m2)]和(57.23±14.37)[mL/(min ×1.73m2)],差异有统计学意义( P<0.05)。结论 Cockcroft_Gault方程估算的肾小球滤过率可作为评估冠状动脉病变的临床参考指标。%Objective To discuss the research of the relationship between estimated glomerular filtration rate by Cockcroft_Gault equa-tion and coronary artery stenosis degree in patients with coronary heart disease.Methods 253 patients with coronary heart disease were confirmed by coronary angiography as coronary heart disease group ,and were graded the degree of coronary artery lesion by Gensini score ,168 cases of patients with degree of coronary atherosclerosis stenosis <50% were selected as control group.Glomerular filtra-tion rate of the patients from two groups were estimated by Cockcroft_Gault equation ,and the relationship between coronary artery dis-ease and glomerular filtration rate were analyzed. Results The glomerular filtration rate of coronary heart disease group and control group were(61.13 ± 11.10) [mL/(min × 1.73m2 )] and (77.92 ± 11.80) [mL/(min × 1.73m2 )] ( P<0.05) respectively ,there were statistical significant differences.The glomerular filtration

  1. Maternal glomerular filtration rate in pregnancy and fetal size.

    Directory of Open Access Journals (Sweden)

    Nils-Halvdan Morken

    Full Text Available BACKGROUND: The relationship of maternal glomerular filtration rate (GFR in pregnancy to fetal size needs to be better characterized as it impacts an ongoing debate about confounding effect of maternal GFR in investigations of important environmental contaminants. We aimed to characterize the size of the association between maternal GFR and infant birth weight. MATERIALS AND METHODS: A sub-cohort of 953 selected women (470 women with and 483 women without preeclampsia in the Norwegian Mother and Child Cohort (MoBa, recruited during 2003-2007 were analyzed. GFR in the second trimester was estimated based on plasma creatinine. Birth weight was ascertained from the Medical Birth Registry of Norway. Multivariate linear regression was used to evaluate the association between maternal GFR in second trimester (estimated by the Cockroft-Gault [GFR-CG] and the modification of diet in renal disease [GFR-MDRD] formulas and infant birth weight. Partial correlation coefficients were also calculated. RESULTS: Maternal GFR-CG (β: 0.73 g/ml/min, p = 0.04 and GFR-MDRD (β: 0.83 g/ml/min, p = 0.04 were associated with infant birth weight in models adjusted for maternal weight in kilograms, preeclampsia, and gestational age at delivery (days. Partial correlation coefficients for the association between infant birth weight and GFR were 0.07 for both formulas. Although the birth weight-GFR association was stronger among the women with preeclampsia, the difference from women without preeclampsia was not statistically significant. CONCLUSION: These data support an association between GFR during pregnancy and infant birth weight, and indicate that GFR may confound selected epidemiologic associations.

  2. 慢性肾功能衰竭患者血清瘦素水平与肾小球滤过率及炎症递质的相关性研究%The Study on the Relation between Serum Leptin Levels,Glomerular Filtration Rate (GFR),and Inflammatory Mediators in Patients with Chronic Renal Failure

    Institute of Scientific and Technical Information of China (English)

    朱承松

    2011-01-01

    目的 探讨慢性肾功能衰竭(CRF)患者高瘦素血症与肾小球滤过率(GFR)及炎症之间的相关性.方法 对120例不同程度CRF患者进行血清瘦素、GFR、C-反应蛋白(CRP)、IL-6及IL-8检测,观察CRP、IL-6及IL-8与高瘦素血症的相关性.结果 不同程度CRF患者与对照者比较,GFR、瘦素、CRP、IL-6及IL-8水平间差异均有统计学意义(P<0.05).血清瘦素水平与GFR呈负相关(r=-0.23,P<0.001),与BMI呈正相关(r=0.36,P<0.001),而GFR与BMI之间无相关性(r=4.65,P>0.05).血清瘦素与CRP、IL-6及IL-8之间均呈正相关(r分别为0.54、0.47和0.51,均P<0.001).结论 CRF患者血清瘦素水平升高与GFR下降所导致的瘦素清除减少有关,全身微炎症反应也可引起高瘦素血症.%Objective To study the relationship between hyperleptindemia, GFR and inflammatory in patients with chronic renal failure. Methods Serum leptin levels, glomerular filtration rate ( GFR ), CRP, IL - 6 and IL - 8 of 120 patients having different degrees of renal failure were measured. Then the relationship between CRP, IL- 6, IL - 8 and serum leptin levels was analyzed. Results The level of serum leptin, CRP, IL- 6 and IL - 8 varied significantly in middle damaged group and severe damaged group ( P < 0. 001 ), while the level of IL - 6 and IL - 8 in middle damaged group and severe damaged group also varied significantly with that of the control group ( P < 0. 001 ). The levels of GFR, serum leptin, CRP, IL - 6 and IL - 8 in patients with different stage of kidney failure had statistical differences ( P <0. 05 ). The level of serum leptin had a negative correlation with GFR ( r = - 0. 23 , P < 0. 001 ), and positive correlation with BMI ( r = 0. 36, P < 0. 001 ), while there was no correlation between GFR and BMI ( r =4. 65, P >0. 05 ). The level of serum leptin had a positive correlation with CRP, IL -6 and IL -8 ( r = 0. 54, 0. 47, 0. 51, P <0. 001 ). Conclusion The study shows that serum

  3. Rapid decline in glomerular filtration rate during the first weeks following heart transplantation

    DEFF Research Database (Denmark)

    Hornum, M; Andersen, M; Gustafsson, F

    2011-01-01

    We hypothesized that a decrease in renal function is seen immediately after heart transplantation (HTX) with little recovery over time. Twelve consecutive patients had their glomerular filtration rate (GFR) measured using (51)Cr-ethylenediaminetetraacetic acid (EDTA) measured GFR (mGFR) before...... transplantation and at 1, 2, 3, and 26 weeks after transplantation. The mGFR decreased by 28% and 24% during the first 3 and 26 weeks, respectively, with mean blood cyclosporine concentration as an independent risk factor for the decrease in mGFR. The identification of cyclosporine A (CsA) as the most important...

  4. The glomerular filtration rate during pregnancy : Saline infusion enhances the glomerular filtration rate in the pregnant rat

    NARCIS (Netherlands)

    Faas, MM; Schuiling, GA; Klok, PA; Valkhof, N; Bakker, WW

    1996-01-01

    The glomerular filtration rate (GFR) of pregnant rats is generally believed to exceed non-pregnant values. This notion is primarily based upon standard inulin clearances. However, the inulin clearance requires continuous infusion of inulin usually dissolved in saline. Since saline infusion per se in

  5. Glomerular filtration rate in cows estimated by a prediction formula.

    Science.gov (United States)

    Murayama, Isao; Miyano, Anna; Sato, Tsubasa; Iwama, Ryosuke; Satoh, Hiroshi; Ichijyo, Toshihiro; Sato, Shigeru; Furuhama, Kazuhisa

    2014-12-01

    To testify the relevance of Jacobsson's equation for estimating bovine glomerular filtration rate (GFR), we prepared an integrated formula based on its equation using clinically healthy dairy (n=99) and beef (n=63) cows, and cows with reduced renal function (n=15). The isotonic, nonionic, contrast medium iodixanol was utilized as a test tracer. The GFR values estimated from the integrated formula were well consistent with those from the standard multisample method in each cow strain, and the Holstein equation prepared by a single blood sample in Holstein dairy cows. The basal reference GFR value in healthy dairy cows was significantly higher than that in healthy beef cows, presumably due to a breed difference or physiological state difference. It is concluded that the validity for the application of Jacobsson's equation to estimate bovine GFR is proven and it can be used in bovine practices.

  6. Applicability of estimating glomerular filtration rate equations in pediatric patients: comparison with a measured glomerular filtration rate by iohexol clearance.

    Science.gov (United States)

    Deng, Fang; Finer, Gal; Haymond, Shannon; Brooks, Ellen; Langman, Craig B

    2015-03-01

    Estimating glomerular filtration rate (eGFR) has become popular in clinical medicine as an alternative to measured GFR (mGFR), but there are few studies comparing them in clinical practice. We determined mGFR by iohexol clearance in 81 consecutive children in routine practice and calculated eGFR from 14 standard equations using serum creatinine, cystatin C, and urea nitrogen that were collected at the time of the mGFR procedure. Nonparametric Wilcoxon test, Spearman correlation, Bland-Altman analysis, bias (median difference), and accuracy (P15, P30) were used to compare mGFR with eGFR. For the entire study group, the mGFR was 77.9 ± 38.8 mL/min/1.73 m(2). Eight of the 14 estimating equations demonstrated values without a significant difference from the mGFR value and demonstrated a lower bias in Bland-Altman analysis. Three of these 8 equations based on a combination of creatinine and cystatin C (Schwartz et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol 2009;20:629-37; Schwartz et al. Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C. Kidney Int 2012;82:445-53; Chehade et al. New combined serum creatinine and cystatin C quadratic formula for GFR assessment in children. Clin J Am Soc Nephrol 2014;9:54-63) had the highest accuracy with approximately 60% of P15 and 80% of P30. In 10 patients with a single kidney, 7 with kidney transplant, and 11 additional children with short stature, values of the 3 equations had low bias and no significant difference when compared with mGFR. In conclusion, the 3 equations that used cystatin C, creatinine, and growth parameters performed in a superior manner over univariate equations based on either creatinine or cystatin C and also had good applicability in specific pediatric patients with single kidneys, those with a kidney transplant, and short stature. Thus, we suggest that eGFR calculations in pediatric clinical practice

  7. Impaired autoregulation of the glomerular filtration rate in patients with nondiabetic nephropathies

    DEFF Research Database (Denmark)

    Christensen, P K; Hommel, E E; Clausen, P

    1999-01-01

    BACKGROUND: The ability of the kidney to maintain constancy of the glomerular filtration rate (GFR) over a wide range of renal perfusion pressures is termed autoregulation. Defective autoregulation of GFR has been demonstrated in diabetic nephropathy. Whether this is also the case in patients...

  8. Decline in 51Cr-labelled EDTA measured glomerular filtration rate following lung transplantation

    DEFF Research Database (Denmark)

    Hornum, Mads; Burton, Christopher M; Iversen, Martin

    2007-01-01

    BACKGROUND: The nephrotoxity of calcineurin inhibitors in lung-transplanted patients is well described, but previous studies have estimated rather than directly measured glomerular filtration rate (GFR). This study describes the decline of measured GFR in a large cohort of lung-transplanted patie...

  9. Assessing glomerular filtration rate in healthy adult potential kidney donors in Bangladesh: a comparison of various prediction equations with measured glomerular filtration rate by diethylentriamine pentaacetic acid renogram.

    Science.gov (United States)

    Jahan, F; Chowdhury, M N U; Mahbub, T; Arafat, S M; Jahan, S; Hossain, M; Khan, M F

    2013-08-01

    To ensure that potential kidney donors in Bangladesh have no renal impairment, it is extremely important to have accurate methods for evaluating the glomerular filtration rate (GFR). We evaluated the performance of serum creatinine based GFR in healthy adult potential kidney donors in Bangladesh to compare GFR determined by DTPA with that determined by various prediction equations. In this study GFR in 61 healthy adult potential kidney donors were measured with 99mTc-diethylenetriamine penta-acetic acid (DTPA) renogram. We also estimated GFR using a four variable equation modification of diet in renal disease (MDRD), Cockcroft-Gault creatinine clearance (CGCrCl), Cockcroft-Gault glomerular filtration rate (CG-GFR). The mean age of study population was 34.31 +/- 9.46 years and out of them 65.6% was male. In this study mean mGFR was 85.4 +/- 14.8. Correlation of estimated GFR calculated by CG-CrCl, CG-GFR and MDRD were done with measured GFR DTPA using quartile. Kappa values were also estimated which was found to be 0.104 for (p = 0.151), 0.336 for (p = 0.001) and 0.125 for (p = 0.091) respectively. This indicates there is no association between estimated GFR calculated by CG-CrCl, CG-GFR, MDRD with measured GFR DTPA. These results show poor performance of these equations in evaluation of renal function among healthy population and also raise question regarding validity of these equations for assessment of renal function in chronic kidney disease in our population.

  10. Indexing Glomerular Filtration Rate to Body Surface Area

    DEFF Research Database (Denmark)

    Redal-Baigorri, Belén; Rasmussen, Knud; Heaf, James Goya

    2014-01-01

    BACKGROUND: Kidney function is mostly expressed in terms of glomerular filtration rate (GFR). A common feature is the expression as ml/min per 1.73 m(2) , which represents the adjustment of the individual kidney function to a standard body surface area (BSA) to allow comparison between individuals....... We investigated the impact of indexing GFR to BSA in cancer patients, as this BSA indexation might affect the reported individual kidney function. METHODS: Cross-sectional study of 895 adults who had their kidney function measured with (51) chrome ethylene diamine tetraacetic acid. Mean values of BSA...

  11. Height-independent estimation of glomerular filtration rate in children: an alternative to the Schwartz equation.

    Science.gov (United States)

    Blufpand, Hester N; Westland, Rik; van Wijk, Joanna A E; Roelandse-Koop, Elianne A; Kaspers, Gertjan J L; Bökenkamp, Arend

    2013-12-01

    To compare the diagnostic performance of 2 height-independent equations used to calculate estimated glomerular filtration rate (eGFR), those of Pottel (eGFR-Pottel) and the British Columbia Children's Hospital (BCCH) (eGFR-BCCH), with the commonly used Schwartz equation (eGFR-Schwartz). We externally validated eGFR-Pottel and eGFR-BCCH in a well-characterized pediatric patient population (n = 152) and compared their diagnostic performance with that of eGFR-Schwartz using Bland-Altman analysis. All patients underwent glomerular filtration rate measurement using the gold standard single-injection inulin clearance method (GFR-inulin). Median GFR-inulin was 92.0 mL/min/1.73 m² (IQR, 76.1-107.4 mL/min/1.73 m²). Compared with GFR-inulin, the mean bias for eGFR-Schwartz was -10.1 mL/min/1.73 m(2) (95% limits of agreement [LOA], -77.5 to 57.2 mL/min/1.73 m(2)), compared with -12.3 mL/min/1.73 m² (95% LOA, -72.6 to 47.9 mL/min/1.73 m(2)) for eGFR-Pottel and -22.1 mL/min/1.73 m² (95% LOA, -105.0 to 60.8 mL/min/1.73 m(2)) for eGFR-BCCH. eGFR-Pottel showed comparable accuracy to eGFR-Schwartz, with 77% and 76% of estimates within 30% of GFR-inulin, respectively. eGFR-BCCH was less accurate than eGFR-Schwartz (66% of estimates within 30% of GFR-inulin; P Schwartz. eGFR-Pottel is a valid alternative to eGFR-Schwartz in children and could be reported by the laboratory if height data are not available. Copyright © 2013 Mosby, Inc. All rights reserved.

  12. An acute fall in estimated glomerular filtration rate during treatment with losartan predicts a slower decrease in long-term renal function

    DEFF Research Database (Denmark)

    Holtkamp, Frank A; de Zeeuw, Dick; Thomas, Merlin C

    2011-01-01

    Intervention in the renin-angiotensin-aldosterone-system (RAAS) is associated with slowing the progressive loss of renal function. During initiation of therapy, however, there may be an acute fall in glomerular filtration rate (GFR). We tested whether this initial fall in GFR reflects a renal hem......GFR, during losartan treatment, the slower the rate of long-term eGFR decline. Hence, interpretation of trial results relying on slope-based GFR outcomes should separate the initial drug-induced GFR change from the subsequent long-term effect on GFR....

  13. Estimating Glomerular Filtration Rate in Older People

    Directory of Open Access Journals (Sweden)

    Sabrina Garasto

    2014-01-01

    Full Text Available We aimed at reviewing age-related changes in kidney structure and function, methods for estimating kidney function, and impact of reduced kidney function on geriatric outcomes, as well as the reliability and applicability of equations for estimating glomerular filtration rate (eGFR in older patients. CKD is associated with different comorbidities and adverse outcomes such as disability and premature death in older populations. Creatinine clearance and other methods for estimating kidney function are not easy to apply in older subjects. Thus, an accurate and reliable method for calculating eGFR would be highly desirable for early detection and management of CKD in this vulnerable population. Equations based on serum creatinine, age, race, and gender have been widely used. However, these equations have their own limitations, and no equation seems better than the other ones in older people. New equations specifically developed for use in older populations, especially those based on serum cystatin C, hold promises. However, further studies are needed to definitely accept them as the reference method to estimate kidney function in older patients in the clinical setting.

  14. GFR estimation: from physiology to public health.

    Science.gov (United States)

    Levey, Andrew S; Inker, Lesley A; Coresh, Josef

    2014-05-01

    Estimating glomerular filtration rate (GFR) is essential for clinical practice, research, and public health. Appropriate interpretation of estimated GFR (eGFR) requires understanding the principles of physiology, laboratory medicine, epidemiology, and biostatistics used in the development and validation of GFR estimating equations. Equations developed in diverse populations are less biased at higher GFRs than equations developed in chronic kidney disease (CKD) populations and are more appropriate for general use. Equations that include multiple endogenous filtration markers are more precise than equations including a single filtration marker. The CKD-EPI (CKD Epidemiology Collaboration) equations are the most accurate GFR estimating equations that have been evaluated in large diverse populations and are applicable for general clinical use. The 2009 CKD-EPI creatinine equation is more accurate in estimating GFR and prognosis than the 2006 MDRD (Modification of Diet in Renal Disease) Study equation and provides lower estimates of prevalence of decreased eGFR. It is useful as a "first test" for decreased eGFR and should replace the MDRD Study equation for routine reporting of serum creatinine-based eGFR by clinical laboratories. The 2012 CKD-EPI cystatin C equation is as accurate as the 2009 CKD-EPI creatinine equation in estimating GFR, does not require specification of race, and may be more accurate in patients with decreased muscle mass. The 2012 CKD-EPI creatinine-cystatin C equation is more accurate than the 2009 CKD-EPI creatinine and 2012 CKD-EPI cystatin C equations and is useful as a confirmatory test for decreased eGFR as determined by serum creatinine-based eGFR. Further improvement in GFR estimating equations will require development in more broadly representative populations, including diverse racial and ethnic groups, use of multiple filtration markers, and evaluation using statistical techniques to compare eGFR to "true GFR."

  15. Measurement of glomerular filtration rate in the conscious rat.

    Science.gov (United States)

    Pestel, Sabine; Krzykalla, Volker; Weckesser, Gerhard

    2007-01-01

    Glomerular filtration rate (GFR) is an important parameter for studying drug-induced impairments on renal function in rats. The GFR is calculated from the concentration of creatinine and blood urea nitrogen (BUN) in serum and in urine, respectively. Following current protocols serum and urine samples must be taken from the same animal. Thus, in order to determine time-dependent effects it is necessary to use for each time point one separated group of animals. We developed a statistical test which allows analyzing the GFR from two different groups of animals: one used for repeated serum and the other one used for repeated urine analysis. Serum and urine samples were taken from two different sets of rats which were otherwise treated identically, i.e. drug doses, routes of administration (per os or per inhalation) and tap water loading. For each dose group GFR mean, standard deviation and statistical analysis to identify differences between the dose groups were determined. After determination of the optimal time points for measurements, the effect on GFR of the three reference compounds, furosemide, hydrochlorothiazide and formoterol, was calculated. The results showed that the diuretic drugs furosemide and hydrochlorothiazide decreased the GFR and the antidiuretic drug formoterol increased the GFR, as counter regulation on urine loss or urine retention, respectively. A mathematical model and the corresponding algorithm were developed, which can be used to calculate the GFR, and to test for differences between groups from two separated sets of rats, one used for urine, and the other one for serum analysis. This new method has the potential to reduce the number of animals needed and to improve the quality of data generated from various groups of animals in renal function studies.

  16. Measured GFR Does Not Outperform Estimated GFR in Predicting CKD-related Complications

    Science.gov (United States)

    Propert, Kathleen; Xie, Dawei; Hamm, Lee; He, Jiang; Miller, Edgar; Ojo, Akinlolu; Shlipak, Michael; Teal, Valerie; Townsend, Raymond; Weir, Matthew; Wilson, Jillian; Feldman, Harold

    2011-01-01

    Although many assume that measurement of glomerular filtration rate (GFR) using a marker such as iothalamate (iGFR) is superior to equation-estimated GFR (eGFR), each of these methods has distinct disadvantages. Because physicians often use renal function to guide the screening for various CKD-associated complications, one method to compare the clinical utility of iGFR and eGFR is to determine the strength of their association with CKD-associated comorbidities. Using a subset of 1214 participants in the Chronic Renal Insufficiency Cohort (CRIC) Study, we determined the cross-sectional associations between known complications of CKD and iGFR, eGFR estimated from serum creatinine (eGFR_Cr), and eGFR estimated from cystatin C (eGFR_cysC). We found that none of the measures of renal function strongly associated with CKD complications and that the relative strengths of associations varied according to the outcome of interest. For example, iGFR demonstrated better discrimination than eGFR_Cr and eGFR_cysC for outcomes of anemia and hemoglobin concentration; however, both eGFR_Cr and eGFR_cysC demonstrated better discrimination than iGFR for outcomes of hyperphosphatemia and phosphorus level. iGFR and eGFR had similar strengths of association with hyperkalemia/potassium level and with metabolic acidosis/bicarbonate level. In conclusion, iothalamate measurement of GFR is not consistently superior to equation-based estimations of GFR in explaining CKD-related comorbidities. These results raise questions regarding the conventional view that iGFR is the “gold standard” measure of kidney function. PMID:21921144

  17. A comparison of GFR by modified gates method with measured creatinine clearance rate (CCR) & MDRD formula based estimation in type 2 diabetic subjects with nephropathy.

    Science.gov (United States)

    Haque, M F; Iqbal, M M; Ahmed, Z; Sultan, T; Rahman, M; Quddus, S; Rahman, M Q; Ahmed, N N

    2013-10-01

    Accurate estimation of the glomerular filtration rate (GFR) is essential for the evaluation of patient with chronic kidney disease (CKD). The present study was a comparison between modified gates GFR with laboratory measured CCR & MDRD formula based estimated GFR method. Pre-diagnosed 180 diabetic nephropathy patients were selected. All the time of evaluation the blood glucose of the patients were controlled and serum creatinine was stable. Then CCR was done and GFR was estimated by Modified Gates method & MDRD method. All the patients were categorized in 5 stages of CKD. They were matched for age, BMI, blood pressure, duration of diabetes, the blood sugar and HbA1C levels. The Gates GFR in stage-2 (70±13) & stage-3 (48±12) was closer with MDRD in stage-2 (77±8) and stage 3 (43±7). The CCR is closer in stage-1 (110±52) & stage-4 (30±10) with MDRD in stage-1 (112±13) and stage-4 (21±4). Association study showed MDRD GFR had highest correlation with Gates GFR (r=0.86; pGFR) in different methods varied significantly between each other at different stages of chronic kidney disease (CKD) in type 2 diabetic nephropathy subjects.

  18. Measurement of glomerular filtration rate in adults: accuracy of five single-sample plasma clearance methods

    DEFF Research Database (Denmark)

    Rehling, M; Rabøl, A

    1989-01-01

    After an intravenous injection of a tracer that is removed from the body solely by filtration in the kidneys, the glomerular filtration rate (GFR) can be determined from its plasma clearance. The method requires a great number of blood samples but collection of urine is not needed. In the present...

  19. An overview of glomerular filtration rate testing in dogs and cats

    Science.gov (United States)

    Von Hendy-Willson, Vanessa E.; Pressler, Barrak M.

    2010-01-01

    Determination of glomerular filtration rate (GFR) is a valuable, yet underused, diagnostic tool for evaluating renal function in dogs and cats. This article first reviews the hormonal and hemodynamic factors which contribute to GFR, followed by a description of considerations when selecting a pharmacokinetic model and methods of animal-to-animal standardization. The best-characterized existing GFR markers, including creatinine, radiolabeled markers, and iohexol, are reviewed in depth, as well as alternative but lesser-used techniques. A weighted means analysis of reported GFR measurements in healthy dogs and cats and a review of selected studies that have examined GFR alterations in animals with naturally-occurring and experimental diseases provide the reader with preliminary guidelines on expected GFR results in these species and disease conditions. PMID:20541957

  20. Comparison between Cystatin C- and Creatinine-Estimated Glomerular Filtration Rate in Cardiology Patients

    Science.gov (United States)

    Åkerblom, Axel; Helmersson-Karlqvist, Johanna; Flodin, Mats; Larsson, Anders

    2015-01-01

    Objective Estimation of the glomerular filtration rate (GFR) is essential for identification, evaluation and risk prediction in patients with kidney disease. Estimated GFR (eGFR) is also needed for the correct dosing of drugs eliminated by the kidneys and to identify high-risk individuals in whom coronary angiography or other procedures may lead to kidney failure. Both cystatin C and creatinine are used for the determination of GFR, and we aimed to investigate if eGFR by the two methods differ in cardiology patients. Methods We compared cystatin C and creatinine (CKD-EPI) eGFR calculated from the same request from a cardiology outpatient unit (n = 2,716), a cardiology ward (n = 980), a coronary care unit (n = 1,464), and an advanced coronary care unit (n = 518) in an observational, cross-sectional study. Results The median creatinine eGFR results are approximately 10 ml/min/1.73 m2 higher than the median cystatin C eGFR that is up to 90 ml/min/1.73 m2, irrespective of the level of care. Creatinine eGFR resulted in a less advanced eGFR category in the majority of patients with a cystatin C eGFR <60 ml/min/1.73 m2. Conclusions Our study demonstrates a difference between creatinine and cystatin C eGFR in cardiology patients. It is important to be aware of which marker is used for the reported eGFR to minimize erroneous interpretations of the test results, as this could lead to under- or overmedication. Further studies are needed to determine the best method of estimating the GFR in cardiology units. PMID:26648945

  1. Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study

    DEFF Research Database (Denmark)

    Mathiesen, E R; Feldt-Rasmussen, B; Hommel, E

    1997-01-01

    OBJECTIVE: To investigate the long-term course of glomerular filtration rate (GFR) in IDDM patients with microalbuminuria in order to identify patients with stable or declining kidney function over a 5-year study. RESEARCH DESIGN AND METHODS: Forty normotensive (129 +/- 11/80 +/- 8 mmHg) IDDM...... min-1.1 x 73 m-2. RESULTS: Using multiple regression analysis, the rate of decline in GFR was independently correlated to onset of diabetic nephropathy (P ... x min-1 x year-1; NS). The difference in the rate of decline of GFR was significant (mean 2.7 ml x min-1 x year-1; P

  2. Glomerular filtration rate estimated from the uptake phase of 99mTc-DTPA renography in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    1999-01-01

    The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea.......The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea....

  3. Glomerular filtration rate estimated from the uptake phase of 99mTc-DTPA renography in chronic renal failure

    DEFF Research Database (Denmark)

    Petersen, L J; Petersen, J R; Talleruphuus, U

    1999-01-01

    The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea.......The purpose of the study was to compare the estimation of glomerular filtration rate (GFR) from 99mTc-DTPA renography with that estimated from the renal clearance of 51Cr-EDTA, creatinine and urea....

  4. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data

    NARCIS (Netherlands)

    Matsushita, K.; Coresh, J.; Sang, Y.; Chalmers, J.; Fox, C.; Guallar, E.; Jafar, T.; Jassal, S.K.; Landman, G.W.; Muntner, P.; Roderick, P.; Sairenchi, T.; Schottker, B.; Shankar, A.; Shlipak, M.; Tonelli, M.; Townend, J.; Zuilen, A. van; Yamagishi, K.; Yamashita, K.; Gansevoort, R.; Sarnak, M.; Warnock, D.G.; Woodward, M.; Arnlov, J.; Wetzels, J.F.M.

    2015-01-01

    BACKGROUND: The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a

  5. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes : a collaborative meta-analysis of individual participant data

    NARCIS (Netherlands)

    Matsushita, Kunihiro; Coresh, Josef; Sang, Yingying; Chalmers, John; Fox, Caroline; Guallar, Eliseo; Jafar, Tazeen; Jassal, Simerjot K.; Landman, Gijs W. D.; Muntner, Paul; Roderick, Paul; Sairenchi, Toshimi; Schoettker, Ben; Shankar, Anoop; Shlipak, Michael; Tonelli, Marcello; Townend, Jonathan; van Zuilen, Arjan; Yamagishi, Kazumasa; Yamashita, Kentaro; Gansevoort, Ron; Sarnak, Mark; Warnock, David G.; Woodward, Mark; Arnlov, Johan; de Zeeuw, Dick

    Background The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a

  6. Comparison of risk prediction using the CKD-EPI equation and the MDRD study equation for estimated glomerular filtration rate.

    NARCIS (Netherlands)

    Matsushita, K.; Mahmoodi, B.K.; Woodward, M.; Emberson, J.R.; Jafar, T.H.; Jee, S.H.; Polkinghorne, K.R.; Shankar, A.; Smith, D.H.; Tonelli, M.; Warnock, D.G.; Wen, C.P.; Coresh, J.; Gansevoort, R.T.; Hemmelgarn, B.R.; Levey, A.S.; Wetzels, J.F.

    2012-01-01

    CONTEXT: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation more accurately estimates glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) Study equation using the same variables, especially at higher GFR, but definitive evidence of its risk

  7. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes : a collaborative meta-analysis of individual participant data

    NARCIS (Netherlands)

    Matsushita, Kunihiro; Coresh, Josef; Sang, Yingying; Chalmers, John; Fox, Caroline; Guallar, Eliseo; Jafar, Tazeen; Jassal, Simerjot K.; Landman, Gijs W. D.; Muntner, Paul; Roderick, Paul; Sairenchi, Toshimi; Schoettker, Ben; Shankar, Anoop; Shlipak, Michael; Tonelli, Marcello; Townend, Jonathan; van Zuilen, Arjan; Yamagishi, Kazumasa; Yamashita, Kentaro; Gansevoort, Ron; Sarnak, Mark; Warnock, David G.; Woodward, Mark; Arnlov, Johan; de Zeeuw, Dick

    2015-01-01

    Background The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a meta-

  8. Estimated glomerular filtration rate and albuminuria for prediction of cardiovascular outcomes: a collaborative meta-analysis of individual participant data

    NARCIS (Netherlands)

    Matsushita, K.; Coresh, J.; Sang, Y.; Chalmers, J.; Fox, C.; Guallar, E.; Jafar, T.; Jassal, S.K.; Landman, G.W.; Muntner, P.; Roderick, P.; Sairenchi, T.; Schottker, B.; Shankar, A.; Shlipak, M.; Tonelli, M.; Townend, J.; Zuilen, A. van; Yamagishi, K.; Yamashita, K.; Gansevoort, R.; Sarnak, M.; Warnock, D.G.; Woodward, M.; Arnlov, J.; Wetzels, J.F.M.

    2015-01-01

    BACKGROUND: The usefulness of estimated glomerular filtration rate (eGFR) and albuminuria for prediction of cardiovascular outcomes is controversial. We aimed to assess the addition of creatinine-based eGFR and albuminuria to traditional risk factors for prediction of cardiovascular risk with a meta

  9. GFR Estimating Equations and Liver Disease.

    Science.gov (United States)

    Beben, Tomasz; Rifkin, Dena E

    2015-09-01

    It is important to accurately assess the glomerular filtration rate (GFR) of patients with liver disease to deliver care and allocate organs for transplantation in a way that improves outcomes. The most commonly used methods to estimate GFR in this population are based on creatinine, which is biased by these patients' low creatinine production and potentially by elevated serum bilirubin and decreased albumin levels. None of the creatinine-based estimated glomerular filtration rate (eGFR) equations have been specifically modified for a population with liver disease, and even measurement of a 24-hour creatinine clearance has limitations. In liver disease, all creatinine-based estimates of GFR overestimate gold standard-measured GFR, and the degree of overestimation is highest at lower measured GFR values and in more severe liver disease. Cystatin C-based eGFR has shown promise in general population studies by demonstrating less bias than creatinine-based eGFR and improved association with clinically important outcomes, but results in the liver disease population have been mixed, and further studies are necessary. Ultimately, specific eGFR equations for liver disease or novel methods for estimating GFR may be necessary. However, for now, the limitations of currently available methods need to be appreciated to understand kidney function in liver disease.

  10. Estimation of single-kidney glomerular filtration rate without exogenous contrast agent.

    Science.gov (United States)

    He, Xiang; Aghayev, Ayaz; Gumus, Serter; Ty Bae, K

    2014-01-01

    Measurement of single-kidney filtration fraction and glomerular filtration rate (GFR) without exogenous contrast is clinically important to assess renal function and pathophysiology, especially for patients with comprised renal function. The objective of this study is to develop a novel MR-based tool for noninvasive quantification of renal function using conventional MR arterial spin labeling water as endogenous tracer. The regional differentiation of the arterial spin labeling water between the glomerular capsular space and the renal parenchyma was characterized and measured according to their MR relaxation properties (T1ρ or T2 ), and applied to the estimation of filtration fraction and single-kidney GFR. The proposed approach was tested to quantify GFR in healthy volunteers at baseline and after a protein-loading challenge. Biexponential decay of the cortical arterial spin labeling water MR signal was observed. The major component decays the same as parenchyma water; the minor component decays much slower as expected from glomerular ultra-filtrates. The mean single-kidney GFR was estimated to be 49 ± 9 mL/min at baseline and increased by 28% after a protein-loading challenge. We developed an arterial spin labeling-based MR imaging method that allows us to estimate renal filtration fraction and singe-kidney GFR without use of exogenous contrast. Copyright © 2013 Wiley Periodicals, Inc.

  11. Transcutaneous measurement of glomerular filtration rate in small rodents: through the skin for the win?

    Science.gov (United States)

    Ellery, Stacey J; Cai, Xiaochu; Walker, David D; Dickinson, Hayley; Kett, Michelle M

    2015-03-01

    Rodent models of renal physiology and pathology are crucial to our understanding of the molecular, histological and functional sequelae that contribute to kidney diseases. One of the most important measures of renal function is glomerular filtration rate (GFR). While the accurate determination of GFR is pivotal to understanding the progression of disease and/or the benefits of treatment strategies, in rodents the conventional methods for assessment of GFR are inconvenient and cumbersome, not the least because they involve stress and often anaesthesia. The legitimacy of assay-based assessment of plasma and urine markers of GFR in mice has also been heavily scrutinized for their insensitivity to minor declines in GFR and inaccurate detection of renal biomarkers. While infusion-based clearance methods of GFR assessment are thus the gold standard in terms of accuracy, they are limited by the fact that they are primarily non-recovery procedures. This presents a dilemma when trying to document the progression of renal disease, as these measures cannot be taken in the same experimental subject. Here we review a technique of transcutaneous measurement of fluorescein isothiocyanate-labelled sinistrin to calculate GFR in small rodents, using a non-invasive clearance device (NIC-Kidney Device). This is a recently validated non-invasive technique for measuring GFR in small rodents that allows for the real-time measurement of GFR in conscious animals, without the need for plasma and urine assays.

  12. A re-evaluation of the determinants of glomerular filtration rate.

    Science.gov (United States)

    Karlsen, F M; Holstein-Rathlou, N H; Leyssac, P P

    1995-12-01

    Several factors are potentially able to change the glomerular filtration rate (GFR) and thereby participate in its regulation, but only a few factors seem to be physiologically important. The variable nature of proximal tubular pressure should be recognized as important in the regulation of GFR. It is argued that a distinction should be made between the terms 'autoregulation of GFR' and 'regulation of GFR'. The tubuloglomerular feedback mechanism (TGF) is an important factor for autoregulatory control of GFR. When perturbations result in major increases in tubular flow, the TGF saturates. Proximal tubular pressure then increases and becomes the major factor responsible for the stabilization of GFR. Changes in the proximal reabsorption rate (APR) are important for long-term variations in GFR (regulation of GFR). Small changes in the APR cause near parallel changes in the GFR mainly through the TGF mechanism, while larger changes in the APR cause near parallel changes in the GFR mainly because of the effect on tubular pressure. The hydraulic resistance in the distal nephron segments is an additional factor in regulating GFR, through its effect on proximal tubular pressure. The stimulus to the TGF mechanism also depresses renin release. The resulting local angiotensin II concentration has effects both on the arteriolar resistances and on the APR. The renin-angiotensin system and TGF are therefore considered to be integrated parts of a common control system regulating GFR. According to the hypothesis advocated here, TGF-mediated changes in afferent arteriolar resistance and angiotensin-mediated changes in efferent arteriolar resistance and APR cooperate in counteracting perturbations in proximal tubular pressure and Henle loop flow. However, because of the biphasic proximal effect of angiotensin II, a major unresolved question is whether physiological increases in endogenous local angiotensin II concentrations stimulate or inhibit proximal reabsorption.

  13. GFR estimating equations: getting closer to the truth?

    Science.gov (United States)

    Rule, Andrew D; Glassock, Richard J

    2013-08-01

    The application of serum creatinine and cystatin C in patients with CKD has been limited to using estimated glomerular filtration rate (eGFR). Criteria for choosing the best GFR estimating equation are 1) accuracy in estimating measured GFR, 2) optimal discrimination of clinical outcomes, and 3) association with CKD risk factors and outcomes similar to that of measured GFR. Notably, these criteria are often not in agreement; and while the last criterion is the most important, it has been widely overlooked. The primary problem with eGFR is that the non-GFR determinants of serum creatinine and cystatin C, as well as their surrogates (age, sex, and race), associate with CKD risk factors and outcomes. This leads to a distorted understanding of CKD, though eGFR based on serum creatinine appears to be less biased than eGFR based on cystatin C. Because of this problem, the use of eGFR should be limited to settings where knowing actual GFR is relevant and eGFR is more informative about GFR than serum creatinine or cystatin C alone. Such settings include staging CKD severity by GFR and dosing medications cleared by glomerular filtration. Alternatively, the diagnosis of CKD, the longitudinal progression of CKD, and prognostic models for CKD are settings where serum creatinine and cystatin C can be better applied and interpreted without eGFR.

  14. Multicenter study of creatinine- and/or cystatin C-based equations for estimation of glomerular filtration rates in Chinese patients with chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Jia-fu Feng

    Full Text Available OBJECTIVE: To establish equations for the estimation of glomerular filtration rates (eGFRs based on serum creatinine (SCr and/or serum cystatin C (SCysC in Chinese patients with chronic kidney disease (CKD, and to compare the new equations with both the reference GFR (rGFR and the literature equations to evaluate their applicability. METHODS: The 788 Chinese CKD patients were randomly divided into two groups, the training group and the testing group, to establish new eGFR-formulas based on serum CysC and to validate the established formulas, respectively. (99mTc-DTPA clearance (as the rGFR, serum Cr, and serum CysC were determined for all patients, and GFR was calculated using the Cockcroft-Gault equation (eGFR1, the MDRD formula (eGFR2, the CKD-EPI formulas (eGFR3, eGFR4, and the Chinese eGFR Investigation Collaboration formulas (eGFR5, eGFR6. The accuracy of each eGFR was compared with the rGFR. RESULTS: The training and testing groups' mean GFRs were 50.84±31.36 mL/min/1.73 m(2 and 54.16±29.45 mL/min/1.73 m(2, respectively. The two newly developed eGFR formulas were fitted using iterative computation: [Formula: see text] and [Formula: see text]. Significant correlation was observed between each eGFR and the rGFR. However, proportional errors and constant errors were observed between rGFR and eGFR1, eGFR2, eGFR4, eGFR5 or eGFR6, and constant errors were observed between eGFR3 and rGFR, as revealed by the Passing & Bablok plot analysis. The Bland-Altman analysis illustrated that the 95% limits of agreement of all equations exceeded the previously accepted limits of <60 mL/min •1.73 m(2, except the equations of eGFR7 and eGFR8. CONCLUSION: The newly developed formulas, eGFR7 and eGFR8, provide precise and accurate GFR estimation using serum CysC detection alone or in combination with serum Cr detection. Differences in detection methods should be carefully considered when choosing literature eGFR equations to avoid misdiagnosis and

  15. High rates of albuminuria but not of low eGFR in Urban Indigenous Australians: the DRUID Study

    Directory of Open Access Journals (Sweden)

    Zimmet Paul Z

    2011-05-01

    Full Text Available Abstract Background Indigenous Australians have an incidence of end stage kidney disease 8-10 times higher than non-Indigenous Australians. The majority of research studies concerning Indigenous Australians have been performed in rural or remote regions, whilst the majority of Indigenous Australians actually live in urban settings. We studied prevalence and factors associated with markers of kidney disease in an urban Indigenous Australian cohort, and compared results with those for the general Australian population. Methods 860 Indigenous adult participants of the Darwin Region Urban Indigenous Diabetes (DRUID Study were assessed for albuminuria (urine albumin-creatinine ratio≥2.5 mg/mmol males, ≥3.5 mg/mmol females and low eGFR (estimated glomular filtration rate 2. Associations between risk factors and kidney disease markers were explored. Comparison was made with the AusDiab cohort (n = 8,936 aged 25-64 years, representative of the general Australian adult population. Results A high prevalence of albuminuria (14.8% was found in DRUID, whilst prevalence of low eGFR was 2.4%. Older age, higher HbA1c, hypertension, higher C-reactive protein and current smoking were independently associated with albuminuria on multiple regression. Low eGFR was independently associated with older age, hypertension, albuminuria and higher triglycerides. Compared to AusDiab participants, DRUID participants had a 3-fold higher adjusted risk of albuminuria but not of low eGFR. Conclusions Given the significant excess of ESKD observed in Indigenous versus non-Indigenous Australians, these findings could suggest either: albuminuria may be a better prognostic marker of kidney disease than low eGFR; that eGFR equations may be inaccurate in the Indigenous population; a less marked differential between Indigenous and non-Indigenous Australians for ESKD rates in urban compared to remote regions; or that differences in the pathophysiology of chronic kidney disease exist

  16. Verification on the use of the Inoue method for precisely determining glomerular filtration rate in Philippine pediatrics

    Science.gov (United States)

    Magcase, M. J. D. J.; Duyan, A. Q.; Carpio, J.; Carbonell, C. A.; Trono, J. D.

    2015-06-01

    The objective of this study is to validate the Inoue method so that it would be the preferential choice in determining glomerular filtration rate (GFR) in Philippine pediatrics. The study consisted of 36 patients ranging from ages 2 months to 19 years old. The subjects used were those who were previously subjected to in-vitro method. The scintigrams of the invitro method was obtained and processed for split percentage uptake and for parameters needed to obtain Inoue GFR. The result of this paper correlates the Inoue GFR and In-vitro method (r = 0.926). Thus, Inoue method is a viable, simple, and practical technique in determining GFR in pediatric patients.

  17. Evaluation of cystatin C as an endogenous marker of glomerular filtration rate in dogs.

    Science.gov (United States)

    Almy, Frederic S; Christopher, Mary M; King, Don P; Brown, Scott A

    2002-01-01

    Cystatin C is a cysteine protease inhibitor produced by all nucleated cells. It is freely filtered by the glomerulus and is unaffected by nonrenal factors such as inflammation and gender. Because of greater sensitivity and specificity, cystatin C has been proposed to replace creatinine as a marker of glomerular filtration rate (GFR) in humans. The aims of this study were to validate an automated assay in canine plasma and to evaluate the usefulness of cystatin C as a marker of GFR in dogs. Western blotting was used to demonstrate cross-reactivity of an anti-human cystatin C antibody. An immunoturbidimetric assay was used to detect cystatin C in 25 clinically healthy dogs and 25 dogs with renal failure. Mean cystatin C concentration in the healthy dogs and the dogs with renal failure was 1.08 +/- 0.16 mg/L and 4.37 +/- 1.79 mg/L respectively. Intra- and interassay variability was exogenous creatinine clearance had been determined previously. In the remnant kidney model, cystatin C was better correlated with GFR than creatinine (r = .79 versus .54) but was less well correlated with GFR in volume-depleted dogs (r = .54 versus .95). GFR measurements were repeated in the remnant kidney model dogs 60 days after initial GFR measurements. At this time, cystatin C and creatinine concentrations correlated equally well with GFR (r = .891 versus .894, respectively). Cystatin C concentration is a reasonable alternative to creatinine for screening dogs with decreased GFR due to chronic renal failure.

  18. Rosiglitazone Did Not Induce Acute Kidney Injury in Normocholesterolemic Rats Despite Reduction in Glomerular Filtration Rate

    Directory of Open Access Journals (Sweden)

    Cristiano Dias

    2014-04-01

    Full Text Available Background/Aims: Rosiglitazone (RGL has been used to ameliorate lipids homeostasis and also to treat inflammatory diseases. However, RGL may reduce renal blood flow and glomerular filtration rate (GFR predisposing to acute kidney injury (AKI. We investigated whether the treatment with RGL induces AKI in normocholesterolemic (NC and hypercholesterolemic (HC rats. Methods: We measured GFR by inulin clearance technique and we quantified urinary neutrophil gelatinase-associated lipocalin (uNGAL in all groups at baseline and during Ang II-stimulated vasoconstriction. Moreover, we evaluated the presence of renal damaged by histologic examination. Results: At baseline, NC and HC had normal and similar GFR. RGL treatment reduced GFR only in NC+RGL. Unexpectedly, HC+RGL showed high levels of uNGAL although GFR was at normal range. During Ang II-stimulated vasoconstriction, all groups showed reduction in GFR to the same range and we found high levels of uNGAL and high score of renal damage in HC and HC+RGL. Conclusion: RGL acts distinctly in normocholesterolemia and in hypercholesterolemia. Reduction in GFR provoked by RGL treatment did not allow the diagnosis of AKI in NC even in the presence of ANG II-stimulated vasoconstriction. However, AKI was diagnosed in HC+RGL at baseline although GFR was within normal range.

  19. Decrease of Glomerular Filtration Rate may be Attributed to the Microcirculation Damage in Renal Artery Stenosis

    Institute of Scientific and Technical Information of China (English)

    Hao-Jian Dong; Cheng Huang; De-Mou Luo; Jing-Guang Ye; Jun-Qing Yang; Guang Li; Jian-Fang Luo

    2015-01-01

    Background:The decrease of glomerular filtration rate has been theoretically supposed to be the result of low perfusion in renal artery stenosis (RAS).But the gap between artery stenosis and the glomerular filtration ability is still unclear.Methods:Patients with selective renal artery angiogram were divided by the degree of renal artery narrowing,level of estimated glomerular filtration rate (eGFR),respectively.The different levels of eGFR,renal microcirculation markers,and RAS severity were compared with each other,to determine the relationships among them.Results:A total of 215 consecutive patients were enrolled in the prospective cohort study.Concentrations of microcirculation markers had no significant difference between RAS group (RAS ≥ 50%) and no RAS group (RAS < 50%) or did not change correspondingly to RAS severity.The value of eGFR in RAS group was lower than that in the no RAS group,but it did not decline parallel to the progressive severity of RAS.The microcirculation markers presented integral difference if grouped by different eGFR level with negative tendency,especially that plasma cystatin C (cysC) and urinary microalbumin to creatinine ratio (mACR) increased with the deterioration of eGFR,with strong (r =-0.713,P < 0.001) and moderate (r =-0.580,P < 0.001) correlations.In the subgroup analysis of severe RAS (RAS ≥ 80%),the levels of plasma cysC and urinary mACR demonstrated stronger negative associations with eGFR,(r =-0.827,P < 0.001) and (r =-0.672,P < 0.001) correlations,respectively.Conclusions:Severity of RAS could not accurately predict the value of eGFR,whereas microcirculation impairment may substantially contribute to the glomerular filtration loss in patients with RAS.

  20. Decrease of Glomerular Filtration Rate may be Attributed to the Microcirculation Damage in Renal Artery Stenosis

    Directory of Open Access Journals (Sweden)

    Hao-Jian Dong

    2015-01-01

    Full Text Available Background: The decrease of glomerular filtration rate has been theoretically supposed to be the result of low perfusion in renal artery stenosis (RAS. But the gap between artery stenosis and the glomerular filtration ability is still unclear. Methods: Patients with selective renal artery angiogram were divided by the degree of renal artery narrowing, level of estimated glomerular filtration rate (eGFR, respectively. The different levels of eGFR, renal microcirculation markers, and RAS severity were compared with each other, to determine the relationships among them. Results: A total of 215 consecutive patients were enrolled in the prospective cohort study. Concentrations of microcirculation markers had no significant difference between RAS group (RAS ≥ 50% and no RAS group (RAS < 50% or did not change correspondingly to RAS severity. The value of eGFR in RAS group was lower than that in the no RAS group, but it did not decline parallel to the progressive severity of RAS. The microcirculation markers presented integral difference if grouped by different eGFR level with negative tendency, especially that plasma cystatin C (cysC and urinary microalbumin to creatinine ratio (mACR increased with the deterioration of eGFR, with strong (r = −0.713, P < 0.001 and moderate (r = −0.580, P < 0.001 correlations. In the subgroup analysis of severe RAS (RAS ≥ 80%, the levels of plasma cysC and urinary mACR demonstrated stronger negative associations with eGFR, (r = −0.827, P < 0.001 and (r = −0.672, P < 0.001 correlations, respectively. Conclusions: Severity of RAS could not accurately predict the value of eGFR, whereas microcirculation impairment may substantially contribute to the glomerular filtration loss in patients with RAS.

  1. Measurement of glomerular filtration rate by impulse synthesis: Clinical validation and optimization

    Energy Technology Data Exchange (ETDEWEB)

    Palagi, B.; Verga, P.; Broggi, A.; Picozzi, R.; Villa, F.; Guzzini, F.; Cozzi, C.; Tomasi, A.

    1988-08-01

    Impulse synthesis is a technique which relies upon the logic of continuous infusion but extracts the clearance value from single-injection data by shifting and adding them until an asymptotic value is attained. This study has been aimed at validating and optimizing clinically the measurement of glomerular filtration rate by impulse synthesis. A single intravenous injection of /sup 51/Cr-EDTA has been made in 32 patients and plasma activity monitored over the next 6 h. Glomerular filtration rate computed by a single-exponential fit method (GFR-SEF) has been shown to be significantly (p<0.001) overestimated when compared with the glomerular filtration rate obtained by the impulse synthesis technique (GFR-IS) in spite of an excellent (r=0.989) linear correlation between the two sets of data. On the other hand, the comparison between GFR-IS and 24-h creatinine clearance has not shown any significant difference. Moreover, we have found that in patients with severe renal failure GFR-IS is overestimated when the sampling time span is shortened to 3 h. On the other hand, GFR-IS is slightly underestimated in patients with severe renal failure when the convolution time interval is increased over a few minutes.

  2. Metabolic and Hormonal Determinants of Glomerular Filtration Rate and Renal Hemodynamics in Severely Obese Individuals

    Directory of Open Access Journals (Sweden)

    Edoardo Vitolo

    2016-10-01

    Full Text Available Objective: Renal function is often compromised in severe obesity. A true measurement of glomerular filtration rate (GFR is unusual, and how estimation formulae (EstForm perform in such individuals is unclear. We characterized renal function and hemodynamics in severely obese individuals, assessing the reliability of EstForm. Methods: We measured GFR (mGFR by iohexol plasma clearance, renal plasma flow (RPF by 123I-ortho-iodo-hippurate, basal and stimulated vascular renal indices, endothelium-dependent and -independent vasodilation using flow-mediated dilation (FMD as well as metabolic and hormonal profile in morbid, otherwise healthy, obese subjects. Results: Compared with mGFR, the better performing EstForm was CKD-EPI (5.3 ml/min/1.73 m2 bias by Bland-Altman analysis. mGFR was directly related with RPF, total and incremental glucose AUC, and inversely with PTH and h8 cortisol. Patients with mGFR below the median shown significantly higher PTH and lower vitamin D3. Basal or dynamic renal resistive index, FMD, pulse wave velocity were not related with mGFR. In an adjusted regression model, renal diameter and plasma flow remained related with mGFR (R2 = 0.67, accounting for 15% and 21% of mGFR variance, respectively. Conclusions: CKD-EPI formula should be preferred in morbid obesity; glucose increments during oral glucose tolerance test correlate with hyperfiltration; RPF and diameter are independent determinants of mGFR; slightly high PTH values, frequent in obesity, might influence mGFR.

  3. A re-evaluation of the determinants of glomerular filtration rate

    DEFF Research Database (Denmark)

    Karlsen, F M; Holstein-Rathlou, N H; Leyssac, P P

    1995-01-01

    mechanism, while larger changes in the APR cause near parallel changes in the GFR mainly because of the effect on tubular pressure. The hydraulic resistance in the distal nephron segments is an additional factor in regulating GFR, through its effect on proximal tubular pressure. The stimulus to the TGF...... advocated here, TGF-mediated changes in afferent arteriolar resistance and angiotensin-mediated changes in efferent arteriolar resistance and APR cooperate in counteracting perturbations in proximal tubular pressure and Henle loop flow. However, because of the biphasic proximal effect of angiotensin II......Several factors are potentially able to change the glomerular filtration rate (GFR) and thereby participate in its regulation, but only a few factors seem to be physiologically important. The variable nature of proximal tubular pressure should be recognized as important in the regulation of GFR...

  4. Iohexol plasma clearance for measuring glomerular filtration rate in clinical practice and research: a review. Part 1: How to measure glomerular filtration rate with iohexol?

    Science.gov (United States)

    Delanaye, Pierre; Ebert, Natalie; Melsom, Toralf; Gaspari, Flavio; Mariat, Christophe; Cavalier, Etienne; Björk, Jonas; Christensson, Anders; Nyman, Ulf; Porrini, Esteban; Remuzzi, Giuseppe; Ruggenenti, Piero; Schaeffner, Elke; Soveri, Inga; Sterner, Gunnar; Eriksen, Bjørn Odvar; Bäck, Sten-Erik

    2016-01-01

    While there is general agreement on the necessity to measure glomerular filtration rate (GFR) in many clinical situations, there is less agreement on the best method to achieve this purpose. As the gold standard method for GFR determination, urinary (or renal) clearance of inulin, fades into the background due to inconvenience and high cost, a diversity of filtration markers and protocols compete to replace it. In this review, we suggest that iohexol, a non-ionic contrast agent, is most suited to replace inulin as the marker of choice for GFR determination. Iohexol comes very close to fulfilling all requirements for an ideal GFR marker in terms of low extra-renal excretion, low protein binding and in being neither secreted nor reabsorbed by the kidney. In addition, iohexol is virtually non-toxic and carries a low cost. As iohexol is stable in plasma, administration and sample analysis can be separated in both space and time, allowing access to GFR determination across different settings. An external proficiency programme operated by Equalis AB, Sweden, exists for iohexol, facilitating interlaboratory comparison of results. Plasma clearance measurement is the protocol of choice as it combines a reliable GFR determination with convenience for the patient. Single-sample protocols dominate, but multiple-sample protocols may be more accurate in specific situations. In low GFRs one or more late samples should be included to improve accuracy. In patients with large oedema or ascites, urinary clearance protocols should be employed. In conclusion, plasma clearance of iohexol may well be the best candidate for a common GFR determination method. PMID:27679715

  5. Establishment and evaluation of estimated glomerular filtration rate by serum cystatin C alone and in combination with serum creatinine in patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    杨渝伟

    2013-01-01

    Objective To establish equations for estimating glomerular filtration rate(GFR)based on serum Cystatin C (CysC) and creatinine(Cr) concentration in Chinese adult patients with chronic kidney disease(CKD)

  6. Insulin's acute effects on glomerular filtration rate correlate with insulin sensitivity whereas insulin's acute effects on proximal tubular sodium reabsorption correlate with salt sensitivity in normal subjects

    NARCIS (Netherlands)

    ter Maaten, JC; Bakker, SJL; Serne, EH; ter Wee, PM; Gans, ROB

    1999-01-01

    Background. Insulin induces increasing distal tubular sodium reabsorption. Opposite effects of insulin to offset insulin-induced sodium retention are supposedly increases in glomerular filtration rate (GFR) and decreases in proximal tubular sodium reabsorption. Defects in these opposing effects coul

  7. Insulin's acute effects on glomerular filtration rate correlate with insulin sensitivity whereas insulin's acute effects on proximal tubular sodium reabsorption correlate with salt sensitivity in normal subjects

    NARCIS (Netherlands)

    ter Maaten, JC; Bakker, SJL; Serne, EH; ter Wee, PM; Gans, ROB

    1999-01-01

    Background. Insulin induces increasing distal tubular sodium reabsorption. Opposite effects of insulin to offset insulin-induced sodium retention are supposedly increases in glomerular filtration rate (GFR) and decreases in proximal tubular sodium reabsorption. Defects in these opposing effects coul

  8. How reliable is estimation of glomerular filtration rate at diagnosis of type 2 diabetes?

    Science.gov (United States)

    Chudleigh, Richard A; Dunseath, Gareth; Evans, William; Harvey, John N; Evans, Philip; Ollerton, Richard; Owens, David R

    2007-02-01

    The Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) equations previously have been recommended to estimate glomerular filtration rate (GFR). We compared both estimates with true GFR, measured by the isotopic (51)Cr-EDTA method, in newly diagnosed, treatment-naïve subjects with type 2 diabetes. A total of 292 mainly normoalbuminuric (241 of 292) subjects were recruited. Subjects were classified as having mild renal impairment (group 1, GFR /=90 ml/min per 1.73 m(2)). Estimated GFR (eGFR) was calculated by the CG and MDRD equations. Blood samples drawn at 44, 120, 180, and 240 min after administration of 1 MBq of (51)Cr-EDTA were used to measure isotopic GFR (iGFR). For subjects in group 1, mean (+/-SD) iGFR was 83.8 +/- 4.3 ml/min per 1.73 m(2). eGFR was 78.0 +/- 16.5 or 73.7 +/- 12.0 ml/min per 1.73 m(2) using CG and MDRD equations, respectively. Ninety-five percent CIs for method bias were -11.1 to -0.6 using CG and -14.4 to -7.0 using MDRD. Ninety-five percent limits of agreement (mean bias +/- 2 SD) were -37.2 to 25.6 and -33.1 to 11.7, respectively. In group 2, iGFR was 119.4 +/- 20.3 ml/min per 1.73 m(2). eGFR was 104.4 +/- 26.3 or 92.3 +/- 18.7 ml/min per 1.73 m(2) using CG and MDRD equations, respectively. Ninety-five percent CIs for method bias were -17.4 to -12.5 using CG and -29.1 to -25.1 using MDRD. Ninety-five percent limits of agreement were -54.4 to 24.4 and -59.5 to 5.3, respectively. In newly diagnosed type 2 diabetic patients, particularly those with a GFR >/=90 ml/min per 1.73 m(2), both CG and MDRD equations significantly underestimate iGFR. This highlights a limitation in the use of eGFR in the majority of diabetic subjects outside the setting of chronic kidney disease.

  9. A short-term antihypertensive treatment-induced fall in glomerular filtration rate predicts long-term stability of renal function

    NARCIS (Netherlands)

    Apperloo, AJ; deZeeuw, D; deJong, PE

    1997-01-01

    In long-term intervention studies on renal function outcome an initial decline in the glomerular filtration rate (GFR) may occur after starting therapy. If this initial GFR decline is the result of a treatment-induced hemodynamic change reflecting a fall in intraglomerular pressure, it should be rev

  10. Automatic Reporting of Creatinine-Based Estimated Glomerular Filtration Rate in Children: Is this Feasible?

    Directory of Open Access Journals (Sweden)

    Andrew Lunn

    2016-07-01

    Full Text Available Creatinine, although widely used as a biomarker to measure renal function, has long been known as an insensitive marker of renal impairment. Patients with reduced renal function can have a creatinine level within the normal range, with a rapid rise when renal function is significantly reduced. As of 1976, the correlation between height, the reciprocal of creatinine, and measured glomerular filtration rate (GFR in children has been described. It has been used to derive a simple formula for estimated glomerular filtration rate (eGFR that could be used at the bedside as a more sensitive method of identifying children with renal impairment. Formulae based on this association, with modifications over time as creatinine assay methods have changed, are still widely used clinically at the bedside and in research studies to assess the degree of renal impairment in children. Adult practice has moved in many countries to computer-generated results that report eGFR alongside creatinine results using more complex, but potentially more accurate estimates of GFR, which are independent of height. This permits early identification of patients with chronic kidney disease. This review assesses the feasibility of automated reporting of eGFR and the advantages and disadvantages of this in children.

  11. Reduced glomerular filtration rate and its association with clinical outcome in older patients at risk of vascular events: secondary analysis.

    LENUS (Irish Health Repository)

    Ford, Ian

    2009-01-20

    Reduced glomerular filtration rate (GFR) is associated with increased cardiovascular risk in young and middle aged individuals. Associations with cardiovascular disease and mortality in older people are less clearly established. We aimed to determine the predictive value of the GFR for mortality and morbidity using data from the 5,804 participants randomized in the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).

  12. On determinants of glomerular filtration rate after inhibition of proximal tubular reabsorption

    DEFF Research Database (Denmark)

    Leyssac, P P; Karlsen, F M; Holstein-Rathlou, N H

    1994-01-01

    The carbonic anhydrase inhibitor acetazolamide (ACZ) inhibits the absolute rate of proximal reabsorption (APR), causes a reduction in glomerular filtration rate (GFR), and activates the tubuloglomerular feedback mechanism (TGF) resulting in afferent vasoconstriction. The quantitative importance...... vasoconstriction seen after carbonic anhydrase inhibition fails to restore GFR to its control value. This is due to the high flow resistance in the distal nephron segments during the increased tubular flow rates seen after ACZ. The high distal flow resistance causes a parallel change in Pgc and Pprox and thus...... leaves delta P nearly unchanged. The present study highlights the importance of the distal flow resistance in determining delta P and therefore GFR during conditions where tubular flow rate is increased....

  13. Effect of Cisplatin on Glomerular Filtration Rate and Effective Renal Plasma Flow

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Sang Moo; Hong, Sung Woon; Kim, Young Hyun; Hong, Weon Seon; Song, Jae Kwan; Kim, Young Whan; Lee, Jhin Oh; Kang, Tae Woong [Korea Cancer Canter Hospital, Seoul (Korea, Republic of)

    1989-03-15

    While cisplatin has been widely used in the treatment of a variety of cancers, nephrotoxicity is one of the major problems which frequently limit clinical usefulness of cisplatin. This study has been conducted to investigate nephrotoxicity of cisplatin in terms of changes in glomerular filtration rate (GFR) and effective renal plasma flow (EFPF) measured by the simultaneous use of {sup 99m}Tc-DTPP and {sup 131}I-OIH, before and after administration of cisplatin, in 12 patients with lung cancer and four patients with esophageal cancer. Cisplatin was administrated at total doses of 75-100 mg/m{sup 2} with two hour hydration and diuresis method. GFR determined by the use of {sup 99m}Tc-DTPA had a good correlation with 24-hour creatinine clearance rate (r=0.77, p<0.001). GFR and filtration fraction decreased immediately after administration of cisplatin, however, they showed a tendency to be in completely recovered four weeks after administration. ERPF was not changed immediately after and four weeks after administration of cisplatin. GFR before and immediately after administration of cisplatin were analyzed with regard to age, sex, performance status, previous administration of cisplatin and method of administration. None of these factors had any influence on the rate of decrease in GFR except method of administration. Administration of cisplatin as a single dose lowered GFR more compared with that as divided doses. In this study, we have also demonstrated that the simultaneous use of {sup 99m}Tc-DTPA and {sup 131}I-OIH was a useful tool for the measurement of GFR and ERPF respectively.

  14. Validation of predictive equations for glomerular filtration rate in the Saudi population

    Directory of Open Access Journals (Sweden)

    Al Wakeel Jamal

    2009-01-01

    Full Text Available Predictive equations provide a rapid method of assessing glomerular filtration rate (GFR. To compare the various predictive equations for the measurement of this parameter in the Saudi population, we measured GFR by the Modification of Diet in Renal Disease (MDRD and Cockcroft-Gault formulas, cystatin C, reciprocal of cystatin C, creatinine clearance, reciprocal of creatinine, and inulin clearance in 32 Saudi subjects with different stages of renal disease. We com-pared GFR measured by inulin clearance and the estimated GFR by the equations. The study included 19 males (59.4% and 13 (40.6% females with a mean age of 42.3 ± 15.2 years and weight of 68.6 ± 17.7 kg. The mean serum creatinine was 199 ± 161 μmol/L. The GFR measured by inulin clearance was 50.9 ± 33.5 mL/min, and the estimated by Cockcroft-Gault and by MDRD equations was 56.3 ± 33.3 and 52.8 ± 32.0 mL/min, respectively. The GFR estimated by MDRD revealed the strongest correlation with the measured inulin clearance (r= 0.976, P= 0.0000 followed by the GFR estimated by Cockcroft-Gault, serum cystatin C, and serum creatinine (r= 0.953, P= 0.0000 (r= 0.787, P= 0.0001 (r= -0.678, P= 0.001, respectively. The reciprocal of cystatin C and serum creatinine revealed a correlation coefficient of 0.826 and 0.93, respectively. Cockroft-Gault for-mula overestimated the GFR by 5.40 ± 10.3 mL/min in comparison to the MDRD formula, which exhibited the best correlation with inulin clearance in different genders, age groups, body mass index, renal transplant recipients, chronic kidney disease stages when compared to other GFR predictive equations.

  15. Relationship between islet α-cell function and glomerular filtration rate in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    王晓宇

    2013-01-01

    Objective To analyze the isletα-cell function in type 2 diabetic patients with different levels of glomerular filtration rate (eGFR) .Methods Three hundred and eighty-eight cases of type 2 diabetic patients were classified into four groups according to eGFR:glomerular hyperfiltration group,normal renal function group,mild renal dysfunction group and moderate-severe renal dysfunction group.Oral glucose tolerance test,insulin releasing test and glucagon releasing test were conducted to compare

  16. Association between the glomerular filtration rate of renal dysfunction and metabolic syndrome: an age-stratified analysis

    Institute of Scientific and Technical Information of China (English)

    宋慧

    2014-01-01

    Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome(MS),stratified by age.Methods People took part in physical check-up in a certain tertiary hospital from March 2010to September 2012,were enrolled in this study.Estimated glomerular filtration rate(e GFR),—a renal dysfunction indicator,was calculated by modified MDRD

  17. Comparison of measured glomerular filtration rates with isotope infusion and with the modification of diet in renal disease equation in cancer patients with raised serum creatinine

    Directory of Open Access Journals (Sweden)

    Amrah Javaid

    2015-01-01

    Full Text Available To compare the measured glomerular filtration rate (rGFR using [99mTc] diethylene triamine pentacetic acid (DTPA clearance or estimated GFR (eGFR by the Modification of Diet in Renal Disease (MDRD equation in cancer patients with raised serum creatinine level, we studied 100 cancer patients; 50 patients with normal serum creatinine (control group and 50 patients with abnormal serum creatinine (study group. History of patients, including site of cancer, chemotherapy regime and dose of chemotherapy, was recorded. The rGFR and eGFR were increased in the study group as compared with the control group, but the GFR recorded by the MDRD formula or DTPA revealed similar values. It is therefore concluded that the MDRD equation may be recommended for eGFR estimation even with abnormal creatinine, without the need for exposure to radiation.

  18. Association between the delta estimated glomerular filtration rate and the prevalence of monoclonal gammopathy of undetermined significance in Korean males.

    Science.gov (United States)

    Jeong, Tae-Dong; Lee, Woochang; Chun, Sail; Min, Won-Ki

    2014-01-01

    We investigated the association between the reduction in the estimated glomerular filtration rate (eGFR) and the prevalence of monoclonal gammopathy of undetermined significance (MGUS) in Korean males. We enrolled 723 healthy Korean males. Serum creatinine concentration, serum electrophoresis, serum immunofixation, and the serum free light chain assay were performed. We calculated delta eGFR per year (ΔeGFR/yr). The prevalence of MGUS was compared based on the ΔeGFR/yr and age group. Thirteen (1.8%) of 723 participants exhibited the monoclonal band on serum immunofixation. Prevalence of MGUS by age group was 0.00% (0/172 for 40 years), 1.63% (6/367 for 60 years), and 3.80% (7/184 for >60 years). The median decrease in ΔeGFR/yr was 5.3%. The prevalence of MGUS in participants in their 50s with >5.3% decline in ΔeGFR/yr was significantly higher than those with 5.3% decrease in ΔeGFR/yr was similar to that of healthy males in their 60s. Using the rate of reduction in ΔeGFR/yr in healthy Korean males who had their serum creatinine level checked regularly may increase the MGUS detection rate in clinical practice.

  19. Improved measurement of the glomerular filtration rate from Tc-99m DTPA scintigraphy in patients following nephrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong-il; Ha, Seunggyun [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seongnam-si, Gyeonggi-do (Korea, Republic of); So, Young [Konkuk University School of Medicine, Department of Nuclear Medicine, Chungju (Korea, Republic of); Lee, Won Woo [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of); Seoul National University Bundang Hospital, Department of Nuclear Medicine, Seongnam-si, Gyeonggi-do (Korea, Republic of); Byun, Seok-Soo [Seoul National University College of Medicine, Department of Urology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Kim, Sang Eun [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Seoul National University, Institute of Radiation Medicine, Medical Research Center, Seoul (Korea, Republic of)

    2014-02-15

    We aimed to improve Tc-99m DTPA glomerular filtration rate (GFR) scintigraphy (Gates' method) in a prospective study using Cr-51 EDTA GFR test as a gold standard. Fifty-seven Tc-99m DTPA GFR scintigrams in 45 subjects (male/female = 33:12, age = 45.9 ± 17.6 years, 14 healthy volunteers and 31 nephrectomised patients) were compared using Cr-51 EDTA GFR tests. Using the %renal uptake of Tc-99m DTPA and Cr-51 EDTA GFR, a revised equation for GFR was established through linear regression analysis. The revised equation for improved GFR was GFR(mL/min) = (%renal uptake x 11.7773) - 0.7354. Gates' original GFRs (70.1 ± 20.5 mL/min/1.73 m{sup 2}) were significantly lower than Cr-51 EDTA GFRs (97.0 ± 31.9 mL/min/1.73 m{sup 2}; P < 0.0001), but the improved GFRs (98.0 ± 26.3 mL/min/1.73 m{sup 2}) were not different from (P = 0.7360) and had a significant correlation with (r = 0.73, P < 0.0001) the Cr-51 EDTA GFRs. The revised GFR equation effectively demonstrated perioperative GFR changes in kidneys that were operated on and the contralateral kidneys at 3 and 6 months post-partial nephrectomy (n = 25). GFR measurement using Tc-99m DTPA scintigraphy could be significantly improved by a revised equation derived from the comparison with Cr-51 EDTA GFR. (orig.)

  20. Use of computed tomography assessed kidney length to predict split renal GFR in living kidney donors

    Energy Technology Data Exchange (ETDEWEB)

    Gaillard, Francois; Fournier, Catherine; Leon, Carine; Legendre, Christophe [Paris Descartes University, AP-HP, Hopital Necker-Enfants Malades, Renal Transplantation Department, Paris (France); Pavlov, Patrik [Linkoeping University, Linkoeping (Sweden); Tissier, Anne-Marie; Correas, Jean-Michel [Paris Descartes University, AP-HP, Hopital Necker-Enfants Malades, Radiology Department, Paris (France); Harache, Benoit; Hignette, Chantal; Weinmann, Pierre [Paris Descartes University, AP-HP, Hopital Europeen Georges Pompidou, Nuclear Medicine Department, Paris (France); Eladari, Dominique [Paris Descartes University, and INSERM, Unit 970, AP-HP, Hopital Europeen Georges Pompidou, Physiology Department, Paris (France); Timsit, Marc-Olivier; Mejean, Arnaud [Paris Descartes University, AP-HP, Hopital Europeen Georges Pompidou, Urology Department, Paris (France); Friedlander, Gerard; Courbebaisse, Marie [Paris Descartes University, and INSERM, Unit 1151, AP-HP, Hopital Europeen Georges Pompidou, Physiology Department, Paris (France); Houillier, Pascal [Paris Descartes University, INSERM, Unit umrs1138, and CNRS Unit erl8228, AP-HP, Hopital Europeen Georges Pompidou, Physiology Department, Paris (France)

    2017-02-15

    Screening of living kidney donors may require scintigraphy to split glomerular filtration rate (GFR). To determine the usefulness of computed tomography (CT) to split GFR, we compared scintigraphy-split GFR to CT-split GFR. We evaluated CT-split GFR as a screening test to detect scintigraphy-split GFR lower than 40 mL/min/1.73 m{sup 2}/kidney. This was a monocentric retrospective study on 346 potential living donors who had GFR measurement, renal scintigraphy, and CT. We predicted GFR for each kidney by splitting GFR using the following formula: Volume-split GFR for a given kidney = measured GFR*[volume of this kidney/(volume of this kidney + volume of the opposite kidney)]. The same formula was used for length-split GFR. We compared length- and volume-split GFR to scintigraphy-split GFR at donation and with a 4-year follow-up. A better correlation was observed between length-split GFR and scintigraphy-split GFR (r = 0.92) than between volume-split GFR and scintigraphy-split GFR (r = 0.89). A length-split GFR threshold of 45 mL/min/1.73 m{sup 2}/kidney had a sensitivity of 100 % and a specificity of 75 % to detect scintigraphy-split GFR less than 40 mL/min/1.73 m{sup 2}/kidney. Both techniques with their respective thresholds detected living donors with similar eGFR evolution during follow-up. Length-split GFR can be used to detect patients requiring scintigraphy. (orig.)

  1. Glomerular filtration rate is associated with burden of coronary atherosclerosis in patients with acute coronary syndrome.

    Science.gov (United States)

    Duran, Mustafa; Uysal, Onur Kadir; Gunebakmaz, Ozgur; Baran, Oguzhan; Turfan, Murat; Ornek, Ender; Cetin, Mustafa; Murat, Sani Namik; Yarlioglues, Mikail; Karadeniz, Muhammed; Kurtul, Alpaslan; Kaya, Mehmet Gungor

    2014-04-01

    We aimed to elucidate the relationship between mild to moderate renal impairements and burden of atherosclerosis in patients with acute coronary syndrome (ACS). A total of 380 patients with ACS were included in the study. Gensini and SYNTAX scores were also calculated. Kidney function was classified based on estimated glomerular filtration rate (eGFR) into stage 1: eGFR >90, stage 2: 60 to 89, and stage 3: 30 to 60 mL/min per 1.73 m(2). Gensini and SYNTAX scores were higher in stages 2 and 3 than in stage 1. Also, the number of diseased vessels, number of critical lesions (>50 and 70%), left main disease, and number of total occlusion vessels were higher in stages 2 and 3 than in stage 1. Multivariate linear regression analysis demonstrated that a decreased eGFR was an independent risk factor for SYNTAX and Gensini scores together with age and male gender.

  2. Association of Hepatitis C Virus Infection with Proteinuria and Glomerular Filtration Rate.

    Science.gov (United States)

    Kurbanova, Nargiza; Qayyum, Rehan

    2015-10-01

    Despite several studies, the extent to which hepatitis C virus (HCV) infection is associated with chronic kidney disease (CKD) remains controversial. Thus, we examined the relationship between HCV and CKD using the continuous National Health and Nutrition Examination Survey (1999-2012). Specimens positive for anti-HCV antibodies were retested and confirmed with recombinant immunoblot assay (RIBA). Proteinuria was defined as urine albumin creatinine ratio > 30 mg/g. CKD was defined as estimated glomerular filtration rate (GFR) proteinuria (OR = 1.40, p = 0.01 and OR = 1.50, p = 0.02, respectively). In both unadjusted and adjusted analyses, individuals with HCV had significantly higher GFR than individuals without (1.4 mL/min, p = 0.04 and 2.7 mL/min, p proteinuria and high GFR but not with CKD. The biological mechanism of the observed association needs further study. © 2015 Wiley Periodicals, Inc.

  3. Estimation of glomerular filtration rate from plasma creatinine concentration in children.

    Science.gov (United States)

    Counahan, R; Chantler, C; Ghazali, S; Kirkwood, B; Rose, F; Barratt, T M

    1976-11-01

    The relation between the true plasma creatinine concentration (Pc) and the glomerular filtration rate corrected for body surface area (GFR/SA) was investigated in 108 individuals, and the following formula was derived: GFR/SA (ml/min per 1-73m2SA) = 0-43 Ht (cm)/Pc (mg/100 ml). This formula was tested in a second group of 83 children, and its accuracy and precision was compared to the 24-hour creatinine clearance. It was found to be superior to the creatinine clearance overall, and was as good, even if all results involving suspect 24-hour-urine collections were eliminated from analysis. The formula in SI usage is: GFR/SA (ml/min per 1-73 m2SA) = 38 Ht (cm)1Pc (mumol/l).

  4. Association of glomerular filtration rate with arterial stiffness in Chinese women with normal to mildly impaired renal function

    Institute of Scientific and Technical Information of China (English)

    Su-Yan Bian; Hong-Yang Guo; Ping Ye; Lei-Ming Luo; Hong-Mei Wu; Wen-Kai Xiao; Li-Ping Qi; He-Peng Yu; Liu-Fa Duan

    2012-01-01

    Objective Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women. Methods In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m2 estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties. Results The mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m2. Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75. Conclusions In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.

  5. Depression and Quality of Life in Relation to Decreased Glomerular Filtration Rate Among Adults with Hypertension in Rural Northeast China

    Directory of Open Access Journals (Sweden)

    Xiaofan Guo

    2015-02-01

    Full Text Available Background/Aims: We aim to investigate the extent to which depression and quality of life might be associated with decreased glomerular filtration rate (GFR in a large hypertensive population in rural Northeast China. Methods: A total of 5566 hypertensive participants aged 35 years and older were screened with a stratified cluster multistage sampling scheme in rural areas of Liaoning Province during 2012-2013. Decreased GFR was defined as estimated GFR 2. Results: The overall prevalence of decreased GFR was 3.2%. In the multivariable regression model, participants with moderate or greater depression had a greater risk for having a decreased GFR (OR: 1.739, 95%CI: 1.004 to 3.014 after full adjustment. Every 1-point increase of all the domains in WHOQOL-BREF, except for physical and environment domains, was significantly related to a lower risk for decreased GFR adjusting for age, gender and race. However, after fully adjustment, only social relations remained significant (OR: 0.899, 95%CI: 0.820 to 0.985. Increasing in total scores of WHOQOL-BREF was a protective factor against decreased GFR after fully adjustment. Conclusion: We found that moderate or greater depression and lower quality of life were associated with higher risks for developing decreased GFR.

  6. A Comprehensive Software and Database Management System for Glomerular Filtration Rate Estimation by Radionuclide Plasma Sampling and Serum Creatinine Methods.

    Science.gov (United States)

    Jha, Ashish Kumar

    2015-01-01

    Glomerular filtration rate (GFR) estimation by plasma sampling method is considered as the gold standard. However, this method is not widely used because the complex technique and cumbersome calculations coupled with the lack of availability of user-friendly software. The routinely used Serum Creatinine method (SrCrM) of GFR estimation also requires the use of online calculators which cannot be used without internet access. We have developed user-friendly software "GFR estimation software" which gives the options to estimate GFR by plasma sampling method as well as SrCrM. We have used Microsoft Windows(®) as operating system and Visual Basic 6.0 as the front end and Microsoft Access(®) as database tool to develop this software. We have used Russell's formula for GFR calculation by plasma sampling method. GFR calculations using serum creatinine have been done using MIRD, Cockcroft-Gault method, Schwartz method, and Counahan-Barratt methods. The developed software is performing mathematical calculations correctly and is user-friendly. This software also enables storage and easy retrieval of the raw data, patient's information and calculated GFR for further processing and comparison. This is user-friendly software to calculate the GFR by various plasma sampling method and blood parameter. This software is also a good system for storing the raw and processed data for future analysis.

  7. Applicability of Estimating GFR Equations in Pediatric Patients: Comparison to a Measured GFR by Iohexol Clearance

    Science.gov (United States)

    Deng, Fang; Finer, Gal; Haymond, Shannon; Brooks, Ellen; Langman, Craig B.

    2014-01-01

    Estimates of glomerular filtration rate (eGFR) have become popular in clinical medicine as an alternative to measuring GFR (mGFR) but there are few studies comparing them in clinical practice. We determined mGFR by iohexol clearance in 81 consecutive children in routine practice and calculated eGFR from 14 standard equations using serum creatinine, cystatin C, and urea nitrogen that were collected at the time of the mGFR procedure. Non-parametric Wilcoxon test, Spearman Correlation, Bland–Altman analysis, bias (median difference) and accuracy (P15, P30) were used to compare mGFR to eGFR. For the entire study group, the mGFR was 77.9±38.8mL/min/1.73 m2. Eight of the 14 estimating equations demonstrated values without a significant difference from the mGFR value and demonstrated a lower bias in Bland–Altman analysis. Three of these eight equations based on a combination of creatinine and cystatin C, (Schwartz et al. 2009, 2012; Chehade et al.), had the highest accuracy with approximately 60% of P15 and 80% of P30. In 10 patients with a single kidney, seven with kidney transplant, and 11 additional children with short stature, values of the three equations had low bias and no significant difference when compared with mGFR. In conclusion, the three equations that employed cystatin C, creatinine, and growth parameters performed in a superior manner over univariate equations based on either creatinine or cystatin C, and also had good applicability in specific pediatric patients with single kidneys, those with a kidney transplant, and/or short stature. Thus, we suggest that eGFR calculations in pediatric clinical practice employ only a multivariate equation. PMID:25445208

  8. Comparison of three empirical formulae for calculating the glomerular filtration rate of patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Xiao-mei LUO

    2011-07-01

    Full Text Available Objective To compare the values of 3 empirical formulae,namely Modification of Diet in Renal Disease(MDRD study equation,Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI equation,and cystatin C(Cys C single variable equations(eGFR-Cys,on predicting the glomerular filtration rate(GFR of patients with chronic kidney disease.Methods Ninety three patients with chronic kidney disease were enrolled in present study.The plasma clearance of 99mTc-diethylenetriamine pentaacetic acid(DTPA was measured the golden standard of GFR(rGFR,and estimated GFR(eGFR was calculated with the MDRD equation,CKD-EPI equation and eGFR-Cys equation,respectively.The result of rGFR with that of various eGFR was compared.Results Compared with rGFR,the mean bias of eGFR in CKD-EPI equation,eGFR-Cys equation and MDRD study equation were-3.4±10.7ml/(min·1.73m2,-4.8±11.9ml/(min·1.73m2 and-5.4±10.4ml/(min·1.73m2,respectively,and no significant difference was noted among the 3 values.The 30% accuracy of 3 equations was 74.2%,72.0% and 64.5%,respectively,no significant difference was found among the 3 values.The 30% accuracy of CKD-EPI equation was higher than that of MDRD study equation(75.7%±5.1% vs 54.1%±7.7%,P 60ml/(min·1.73m2.With 60ml/(min·1.73m2 as the diagnostic cut-off point of GFR damage,the area under receiver operating characteristic(ROC curve was 0.862 in MDRD study equation,0.863 in CKD-EPI equation and 0.877 in eGFR-Cys equation,respectively,and no significant difference was found among the 3 values.Conclusions There are no significant differences among the 3 equations in predicting the GFR of patients with CKD.However,further studies are needed to investigate whether MDRD study equation could be replaced by the CKD-EPI equation and eGFR-Cys equation.

  9. Determination of representative renal depth for accurate attenuation corred in measurement of glomerular filtration rate in transplanted kidney

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Soon Nam; Kim, Sung Hoon; Rha, Sung Eun; Chung, Yong An; Yoo, Ie Ryung; Sohn, Hyung Sun; Lee, Sung Young; Chung, Soo Kyo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2002-08-01

    To measure reliable glomerular filtration rate by using the representative values of transplanted renal depths, which are measured with ultrasonography. We included 54 patients (26 men, 28 women), with having both renal scintigraphy and ultrasonography after renal transplantation. We measured DFR with Gates' method using the renal depth measured by ultrasonography, and median and mean ones in each patient. We compared GFR derived from ultrasonography-measured renal depth with GFR derived from median and mean renal depths. The correlation coefficients were obtained among GFR derived from ultrasonography-measured renal depths, median and mean renal depth under linear regression analysis. We determined whether GFR derived from median or mean renal depth could substitute GFR derived from ultrasonography-measured renal depth with Bland-Altman method. We analyze the expected errors of the GFR using representative renal depth in terms of age, sex, weight, height, creatinine value, and body surface. The transplanted renal depths range from 3.20 cm to 5.96 cm. The mean value and standard deviation of renal depths measured by ultrasonography are 4.09{+-}0.65 cm in men, and 4.24{+-}0.78 cm in women. The median value of renal depths measured by ultrasonography is 4.36 cm in men and 4.14 cm in women. The GFR derived from median renal depth is more consistent with GFR derived from ultrasonography-measured renal depth than GFR derived from mean renal depth. Differences of GFR derived from median and ultrasonography-measured renal depth are not significantly different in the groups classified with creatinine value, age, sex, height, weight and body surface. When median value is adapted as a representative renal depth, we could obtain reliable GFR in transplanted kidney simply.

  10. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality

    NARCIS (Netherlands)

    Coresh, J.; Turin, T.C.; Matsushita, K.; Sang, Y.; Ballew, S.H.; Appel, L.J.; Arima, H.; Chadban, S.J.; Cirillo, M.; Djurdjev, O.; Green, J.A.; Heine, G.H.; Inker, L.A.; Irie, F.; Ishani, A.; Ix, J.H.; Kovesdy, C.P.; Marks, A.; Ohkubo, T.; Shalev, V.; Shankar, A.; Wen, C.P.; Jong, P.E. de; Iseki, K.; Stengel, B.; Gansevoort, R.T.; Levey, A.S.; Wetzels, J.F.M.

    2014-01-01

    IMPORTANCE: The established chronic kidney disease (CKD) progression end point of end-stage renal disease (ESRD) or a doubling of serum creatinine concentration (corresponding to a change in estimated glomerular filtration rate [GFR] of -57% or greater) is a late event. OBJECTIVE: To characterize th

  11. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality

    NARCIS (Netherlands)

    Coresh, Josef; Turin, Tanvir Chowdhury; Matsushita, Kunihiro; Sang, Yingying; Ballew, Shoshana H.; Appel, Lawrence J.; Arima, Hisatomi; Chadban, Steven J.; Cirillo, Massimo; Djurdjev, Ognjenka; Green, Jamie A.; Heine, Gunnar H.; Inker, Lesley A.; Irie, Fujiko; Ishani, Areef; Ix, Joachim H.; Kovesdy, Csaba P.; Marks, Angharad; Ohkubo, Takayoshi; Shalev, Varda; Shankar, Anoop; Wen, Chi Pang; de Jong, Paul E.; Iseki, Kunitoshi; Stengel, Benedicte; Gansevoort, Ron T.; Levey, Andrew S.

    2014-01-01

    IMPORTANCE: The established chronic kidney disease (CKD) progression end point of end-stage renal disease (ESRD) or a doubling of serum creatinine concentration (corresponding to a change in estimated glomerular filtration rate [GFR] of −57% or greater) is a late event. OBJECTIVE: To characterize th

  12. Outcome Assessment of a Computer-Animated Model for Learning about the Regulation of Glomerular Filtration Rate

    Science.gov (United States)

    Gookin, Jody L.; McWhorter, Dan; Vaden, Shelly; Posner, Lysa

    2010-01-01

    The regulation of the glomerular filtration rate (GFR) is a particularly important and challenging concept for students to integrate into a memorable framework for building further knowledge and solving clinical problems. In this study, 76 first-year veterinary students and 19 veterinarians in clinical specialty training (house officers)…

  13. Pregnancy reduces the accuracy of the estimated glomerular filtration rate based on Cockroft-Gault and MDRD formulas

    NARCIS (Netherlands)

    Koetje, P.M.; Spaan, J.J.; Kooman, J.P.; Spaanderman, M.E.A.; Peeters, L.L.

    2011-01-01

    OBJECTIVE: This study aims to determine the effect of pregnancy on the accuracy of 3 commonly used methods to estimate glomerular filtration rate ([GFR] creatinine clearance, the Cockroft-Gault, and modification of diet in renal disease [MDRD] formulas) using the inulin clearance as a reference. DES

  14. Cystatin C enhances GFR estimating Equations in Kidney Transplant Recipients

    Science.gov (United States)

    Kukla, Aleksandra; Issa, Naim; Jackson, Scott; Spong, Richard; Foster, Meredith C.; Matas, Arthur J.; Mauer, Michael S.; Eckfeldt, John H.; Ibrahim, Hassan N.

    2014-01-01

    Background The glomerular filtration rate (GFR) estimating equation incorporating both cystatin C and creatinine perform better than those using creatinine or cystatin C alone in patients with reduced GFR. Whether this equation performs well in kidney transplant recipients cross-sectionally, and more importantly, over time has not been addressed. Methods We analyzed four GFR estimating equations in participants of the Angiotensin II Blockade for Chronic Allograft Nephropathy Trial (NCT 00067990): Chronic Kidney Disease Epidemiology Collaboration equations based on serum cystatin C and creatinine (eGFR (CKD-EPI-Creat+CysC)), cystatin C alone (eGFR (CKD-EPI-CysC)), creatinine alone (eGFR (CKD-EPI-Creat)) and the Modification of Diet in Renal Disease study equation (eGFR(MDRD)). Iothalamate GFR served as a standard (mGFR). Results mGFR, serum creatinine, and cystatin C shortly after transplant were 56.1 ± 17.0 mL/min/1.73 m2, 1.2 ± 0.4 mg/dL, and 1.2 ± 0.3 mg/L respectively. eGFR (CKD-EPI-Creat+CysC) was most precise (R2=0.50) but slightly more biased than eGFR (MDRD); 9.0 ± 12.7 ml/min/1.73m2 vs. 6.4 ± 15.8 ml/min/1.73m2, respectively. This improved precision was most evident in recipients with mGFR >60 ml/min/1.73m2. For relative accuracy, eGFR (MDRD) and eGFR (CKD-EPI-Creat+CysC) had the highest percentage of estimates falling within 30% of mGFR; 75.8% and 68.9%, respectively. Longitudinally, equations incorporating cystatin C most closely paralleled the change in mGFR. Conclusion eGFR (CKD-EPI-Creat+CysC) is more precise and reflects GFR change over time reasonably well. eGFR (MDRD) had superior performance in recipients with mGFR between 30–60 ml/min/1.73m2. PMID:24457184

  15. MDRD or CKD-EPI for glomerular filtration rate estimation in living kidney donors.

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    Burballa, Carla; Crespo, Marta; Redondo-Pachón, Dolores; Pérez-Sáez, María José; Mir, Marisa; Arias-Cabrales, Carlos; Francés, Albert; Fumadó, Lluis; Cecchini, Lluis; Pascual, Julio

    2017-04-12

    The evaluation of the measured Glomerular Filtration Rate (mGFR) or estimated Glomerular Filtration Rate (eGFR) is key in the proper assessment of the renal function of potential kidney donors. We aim to study the correlation between glomerular filtration rate estimation equations and the measured methods for determining renal function. We analysed the relationship between baseline GFR values measured by Tc-(99)m-DTPA (diethylene-triamine-pentaacetate) and those estimated by the four-variable Modification of Diet in Renal Disease (MDRD4) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in a series of living donors at our institution. We included 64 donors (70.6% females; mean age 48.3±11 years). Baseline creatinine was 0.8±0.1 mg/dl and it was 1.1±0.2 mg/dl one year after donation. The equations underestimated GFR when measured by Tc(99)m-DTPA (MDRD4-9.4 ± 25ml/min, P<.05, and CKD-EPI-4.4 ± 21ml/min). The correlation between estimation equations and the measured method was superior for CKD-EPI (r=.41; P<.004) than for MDRD4 (r=.27; P<.05). eGFR decreased to 59.6±11 (MDRD4) and 66.2±14ml/min (CKD-EPI) one year after donation. This means a mean eGFR reduction of 28.2±16.7 ml/min (MDRD4) and 27.31±14.4 ml/min (CKD-EPI) at one year. In our experience, CKD-EPI is the equation that better correlates with mGFR-Tc(99)m-DTPA when assessing renal function for donor screening purposes. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  16. Creatinine clearance as a substitute for the glomerular filtration rate in the assessment of glomerular hemodynamics.

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    Okada, N; Imanishi, M; Yoshioka, K; Konishi, Y; Okumura, M; Tanaka, S; Fujii, S

    1999-11-01

    A method for the clinical assessment of glomerular hemodynamics has been published previously. We here examined whether, when using this method, renal creatinine clearance (Ccr) can be substituted for the glomerular filtration rate (GFR). The study subjects comprised 57 inpatients from Osaka City General Hospital: 30 with type 2 diabetes mellitus and 27 with chronic glomerulonephritis. During the 2-wk study, patients received a high-salt diet for 1 wk and a low-salt diet for 1 wk. Urinary sodium excretion and systemic blood pressure were measured daily. The renal plasma flow, Ccr, and plasma total protein concentration were also evaluated simultaneously on the last day of the high-salt diet. The GFR was also calculated from the fractional renal accumulation of 99mTc-diethylenetriaminepentaacetic acid (DTPA). Glomerular hemodynamics, represented by the glomerular capillary hydraulic pressure and the resistance of afferent and efferent arterioles, were calculated using the renal clearance, the plasma total protein concentration, and the pressure-natriuresis relationship. Values for renal hemodynamics with the Ccr-derived GFR were compared with those from the 99mTc-DTPA-derived GFR. Ccr values of 53 to 169 ml/min correlated with the 99mTc-DTPA-derived clearance of 39 to 179 ml/min (n=57, r=.71, presistances of afferent and efferent arterioles calculated using the Ccr-derived GFR correlated significantly with those calculated using the 99mTc-DTPA-derived GFR (r=.99, p<.001 and r=.99, p<.001, respectively). These results indicate that the Ccr is an accurate representation of the GFR for use in glomerular hemodynamic analysis of the pressure-natriuresis relationship.

  17. Proenkephalin, Neutrophil Gelatinase-Associated Lipocalin, and Estimated Glomerular Filtration Rates in Patients With Sepsis.

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    Kim, Hanah; Hur, Mina; Lee, Seungho; Marino, Rossella; Magrini, Laura; Cardelli, Patrizia; Struck, Joachim; Bergmann, Andreas; Hartmann, Oliver; Di Somma, Salvatore

    2017-09-01

    Proenkephalin (PENK) has been suggested as a novel biomarker for kidney function. We investigated the diagnostic and prognostic utility of plasma PENK in comparison with neutrophil gelatinase-associated lipocalin (NGAL) and estimated glomerular filtration rates (eGFR) in septic patients. A total of 167 septic patients were enrolled: 99 with sepsis, 37 with septic shock, and 31 with suspected sepsis. PENK and NGAL concentrations were measured and GFR was estimated by using the isotope dilution mass spectrometry traceable-Modification of Diet in Renal Disease (MDRD) Study and three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations: CKD-EPI(Cr), CDK-EPI(CysC), and CKD-EPI(Cr-CysC). The PENK, NGAL, and eGFR results were compared according to sepsis severity, presence or absence of acute kidney injury (AKI), and clinical outcomes. The PENK, NGAL, and eGFR results were significantly associated with sepsis severity and differed significantly between patients with and without AKI only in the sepsis group (all P<0.05). PENK was superior to NGAL in predicting AKI (P=0.022) and renal replacement therapy (RRT) (P=0.0085). Regardless of the variable GFR category by the different eGFR equations, PENK showed constant and significant associations with all eGFR equations. Unlike NGAL, PENK was not influenced by inflammation and predicted the 30-day mortality. PENK is a highly sensitive and objective biomarker of AKI and RRT and is useful for prognosis prediction in septic patients. With its diagnostic robustness and predictive power for survival, PENK constitutes a promising biomarker in critical care settings including sepsis.

  18. A lower baseline glomerular filtration rate predicts high mortality and newly cerebrovascular accidents in acute ischemic stroke patients.

    Science.gov (United States)

    Dong, Kai; Huang, Xiaoqin; Zhang, Qian; Yu, Zhipeng; Ding, Jianping; Song, Haiqing

    2017-02-01

    Chronic kidney disease (CKD) is gradually recognized as an independent risk factor for cardiovascular and cardio-/cerebrovascular disease. This study aimed to examine the association of the estimated glomerular filtration rate (eGFR) and clinical outcomes at 3 months after the onset of ischemic stroke in a hospitalized Chinese population.Totally, 972 patients with acute ischemic stroke were enrolled into this study. Modified of Diet in Renal Disease (MDRD) equations were used to calculate eGFR and define CKD. The site and degree of the stenosis were examined. Patients were followed-up for 3 months. Endpoint events included all-cause death and newly ischemic events. The multivariate logistic model was used to determine the association between renal dysfunction and patients' outcomes.Of all patients, 130 patients (13.4%) had reduced eGFR (stroke patients. A low baseline eGFR was also a strong independent predictor for newly ischemic events in ICAS patients.

  19. Estimated Glomerular Filtration Rate Correlates Poorly with Four-Hour Creatinine Clearance in Critically Ill Patients with Acute Kidney Injury

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    Christopher J. Kirwan

    2013-01-01

    Full Text Available Introduction. RIFLE and AKIN provide a standardised classification of acute kidney injury (AKI, but their categorical rather than continuous nature restricts their use to a research tool. A more accurate real-time description of renal function in AKI is needed, and some published data suggest that equations based on serum creatinine that estimate glomerular filtration rate (eGFR can provide this. In addition, incorporating serum cystatin C concentration into estimates of GFR may improve their accuracy, but no eGFR equations are validated in critically ill patients with AKI. Aim. This study tests whether creatinine or cystatin-C-based eGFR equations, used in patients with CKD, offer an accurate representation of 4-hour creatinine clearance (4CrCl in critically ill patients with AKI. Methods. Fifty-one critically ill patients with AKI were recruited. Thirty-seven met inclusion criteria, and the performance of eGFR equations was compared to 4CrCl. Results. eGFR equations were better than creatinine alone at predicting 4CrCl. Adding cystatin C to estimates did not improve the bias or add accuracy. The MDRD 7 eGFR had the best combination of correlation, bias, percentage error and accuracy. None were near acceptable standards quoted in patients with chronic kidney disease (CKD. Conclusions. eGFR equations are not sufficiently accurate for use in critically ill patients with AKI. Incorporating serum cystatin C does not improve estimates. eGFR should not be used to describe renal function in patients with AKI. Standards of accuracy for validating eGFR need to be set.

  20. Symptomatic hyponatremia during glomerular filtration rate testing

    OpenAIRE

    2010-01-01

    Hyponatremia affects nearly one in five of all hospitalized patients. Severe hyponatremia is associated with significant morbidity and mortality, and is therefore important to recognize. Prior reports have linked duloxetine with hyponatremia, but it is uncommon. In this case report, we describe a research subject taking duloxetine who developed severe symptomatic hyponatremia during glomerular filtration rate testing despite having undergone such testing uneventfully in the past.

  1. 24-hour creatinine clearance reliability for estimation of glomerular filtration rate in different stages of chronic kidney disease

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    El-Minshawy Osama

    2010-01-01

    Full Text Available Glomerular Filtration Rate (GFR is considered the best overall index of renal function currently used. Measurement of 24 hours urine/plasma creatinine ratio (UV/P is usually used for estimation of GFR. However little is known about its accuracy in different stages of Chronic Kidney Disease (CKD aim: is to evaluate performance of UV/P in classification of CKD by comparing it with isotopic GFR (iGFR. 136 patients with CKD were enrolled in this study 80 (59% were males, 48 (35% were diabetics. Mean age 46 ± 13. Creatinine Clearance (Cr.Cl estimated by UV/P and Cockroft-Gault (CG was done for all patients, iGFR was the reference value. Accuracy of UV/P was 10%, 31%, 49% within ± 10%, ± 30%, ± 50% error respectively, r 2 = 0.44. CG gave a better performance even when we restrict our analysis to diabetics only, the accuracy of CG was 19%, 47%, 72% in ± 10%, ± 30% and ± 50% errors respectively, r 2 = 0.63. Both equations gave poor classification of CKD. In conclusion, UV/P has poor accuracy in estimation of GFR, The accuracy worsened as kidney disease becomes more severe. We conclude 24 hours CrCl. is not good substitute for measurement of GFR in patients with CKD.

  2. Prognostic abilities of different calculation formulas for the glomerular filtration rate in elderly Chinese patients with coronary artery disease

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    Fu S

    2013-02-01

    Full Text Available Shihui Fu, Yuan Liu, Bing Zhu, Tiehui Xiao, Shuangyan Yi, Yongyi Bai, Ping Ye, Leiming LuoDepartment of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, People's Republic of ChinaObjective: As a standard indicator of renal function, the glomerular filtration rate (GFR is vital for the prognostic analysis of elderly patients with coronary artery disease (CAD. Thus, the search for the calculation equation of GFR with the best prognostic ability is an important task. The most commonly used Modification of Diet in Renal Disease (MDRD equation and the Chinese version (CMDRD of the MDRD equation has many shortcomings. The newly developed Mayo Clinic quadratic (Mayo and Chronic Kidney Disease (CKD Epidemiology Collaboration (CKD-EPI equations may overcome these shortcomings. Because the populations involved in these equation-related studies are almost completely devoid of subjects > 70 years of age, there are more debates on the performance of these equations in the elderly. This study was designed to compare the prognostic abilities of different calculation formulas for the GFR in elderly Chinese patients with CAD.Methods: This study included 1050 patients (≥60 years of age with CAD. The endpoint was all-cause mortality over a mean follow-up period of 417 days.Results: The median age was 86 years (60–104 years. The median values for the MDRD-GFR, CMDRD-GFR, CKD-EPI-GFR, and Mayo-GFR were 66.0, 69.2, 65.6, and 75.8 mL/minute/1.73 m2, respectively. The prevalence of GFR < 60 mL/minute/1.73 m2 based on these measures was 39.3%, 35.4%, 43.0%, and 28.7%, respectively. Their area under the curve values for predicting death were 0.611, 0.610, 0.625, and 0.632, respectively. Their cut-off points for predicting death were 54.1, 53.5, 48.0, and 57.4 mL/minute/1.73 m2, respectively. Compared with the MDRD-GFR, the net reclassification improvement values of the CMDRD-GFR, CKD-EPI-GFR, and Mayo-GFR were 0.02, 0.10, and 0.14, respectively

  3. Longitudinal association between serum leptin concentration and glomerular filtration rate in humans.

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    Claudio Pedone

    Full Text Available Obesity is a risk factor for decline in glomerular filtration rate (GFR. One proposed mechanism leading to glomerulopathy is an increase in leptin levels. However, the association between leptin and GFR has never been demonstrated. The aim of this study is to verify whether higher levels of leptin are associated with longitudinal changes of estimated GFR (eGFR.We selected 744 participants in the InCHIANTI study (416 women. The association between eGFR and leptin changes over a 6-years follow-up was assessed using random effect models including leptin as a time-varying covariate and adjusted for potential confounders. We also compared the proportion of patients with rapid decline of renal function across tertiles of change in serum leptin between baseline and 6-years follow-up. Mean baseline eGFR was 82.2 ml/min/1.73 m, 78.7 ml/min/1.73 m, and 75.4 ml/min/1.73 m in the first, second and third tertile of baseline serum leptin concentration, respectively. After adjustment for potential confounders, leptin concentration was inversely associated with changes of eGFR over time (β for log-leptin: -1.288, 95% CI: -2.079 - -0.497. Relative to baseline levels, the estimated change in eGFR for unit-increase in log-leptin was -1.9% (95% CI: -2.977 - -0.761. After stratification by sex, the results were confirmed in women only. In women we also found an association between increasing leptin concentration over time and rapid decline of renal function.In women, serum leptin may contribute to eGFR decline independently from obesity and diabetes mellitus, although a cause-effect relationship cannot be established due to the observational nature of our study. A better characterization of adipokine profile of obese individuals may shed light on the accelerated renal function decline reported in a proportion of high-risk obese individuals.

  4. Glomerular filtration rate in examined population of Bosnian Posavina - region of Balkan Endemic Nephropathy.

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    Alecković, Mirna; Mesić, Enisa; Trnacević, Senaid; Stipancić, Zelimir; Hamidović, Damir; Hasanović, Evlijana

    2010-04-01

    Balkan endemic nephropathy (BEN) is chronic tubulointersticial nephritis of unknown aetiology characterized by an insidious onset and gradual progression to end stage renal disease (ESRD). Endemic regions of Bosnia and Herzegovina are Posavina and Semberija, sited at basin of Sava River. In BEN, just like in other chronic renal diseases (CKD), glomerular filtration rate (GFR), is assumed a marker of overall renal function. The aim of this study was to compare GFR in examinees of endemic and non-endemic region for BEN, and between examinees with and without risk factors for BEN within endemic region. Study included 603 inhabitants of Bosnian Posavina, out of whom 386 (65%) from endemic (Domaljevac) and 217 (36%) from non-endemic (Svilaj) village, and it was performed in two phases. The first phase encompassed obtaining anamnestic data (demographic, personal and family history), measurement of arterial blood pressure, and urine dipstick testing (specific gravity, pH, proteins, leukocytes, glucose, ketones, and microalbuminuria). In the second phase, besides repeated urine dipstick test, laboratory blood testing and abdominal ultrasound, with special attention to urinary tract, was also performed. We have compared GFR between examinees of endemic and non-endemic regions for BEN, and between examinees with and without family burden for BEN within endemic region, using MDRD formula for calculating GFR, with cut-off value (5th percentile) based on result of studies performed in European Caucasians in screening for CKD and for establishing stages of CKD in BEN. Medical was used for statistical testing. Out of total number of examined inhabitants (603), 145 examinees were included in the second phase. After exclusion of 17 diabetic patients, 94 (73%) examinees from endemic and 34 (27%) examinees from non-endemic region remained. In the endemic region there were 46 (49%) examinees with and 48 (51%) without family burden for BEN. Overall GFR in examined groups was within

  5. Effect of prenatal programming and postnatal rearing on glomerular filtration rate in adult rats.

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    Lozano, German; Elmaghrabi, Ayah; Salley, Jordan; Siddique, Khurrum; Gattineni, Jyothsna; Baum, Michel

    2015-03-01

    The present study examined whether a prenatal low-protein diet programs a decrease in glomerular filtration rate (GFR) and an increase in systolic blood pressure (BP). In addition, we examined whether altering the postnatal nutritional environment of nursing neonatal rats affected GFR and BP when rats were studied as adults. Pregnant rats were fed a normal (20%) protein diet or a low-protein diet (6%) during the last half of pregnancy until birth, when rats were fed a 20% protein diet. Mature adult rats from the prenatal low-protein group had systolic hypertension and a GFR of 0.38 ± 0.03 versus 0.57 ± 0.05 ml·min(-1)·100 g body wt(-1) in the 20% group (P < 0.01). In cross-fostering experiments, mothers continued on the same prenatal diet until weaning. Prenatal 6% protein rats cross-fostered to a 20% mother on day 1 of life had a GFR of 0.53 ± 0.05 ml·min(-1)·100 g body wt(-1), which was not different than the 20% group cross-fostered to a different 20% mother (0.45 ± 0.04 ml·min(-1)·100 g body wt(-1)). BP in the 6% to 20% group was comparable with the 20% to 20% group. Offspring of rats fed either 20% or 6% protein diets during pregnancy and cross-fostered to a 6% mother had elevated BP but a comparable GFR normalized to body weight as the 20% to 20% control group. Thus, a prenatal low-protein diet causes hypertension and a reduction in GFR in mature adult offspring, which can be modified by postnatal rearing.

  6. Automating and estimating glomerular filtration rate for dosing medications and staging chronic kidney disease

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    Trinkley KE

    2014-05-01

    Full Text Available Katy E Trinkley,1 S Michelle Nikels,2 Robert L Page II,1 Melanie S Joy11Skaggs School of Pharmacy and Pharmaceutical Sciences, 2School of Medicine, University of Colorado, Aurora, CO, USA Objective: The purpose of this paper is to serve as a review for primary care providers on the bedside methods for estimating glomerular filtration rate (GFR for dosing and chronic kidney disease (CKD staging and to discuss how automated health information technologies (HIT can enhance clinical documentation of staging and reduce medication errors in patients with CKD.Methods: A nonsystematic search of PubMed (through March 2013 was conducted to determine the optimal approach to estimate GFR for dosing and CKD staging and to identify examples of how automated HITs can improve health outcomes in patients with CKD. Papers known to the authors were included, as were scientific statements. Articles were chosen based on the judgment of the authors.Results: Drug-dosing decisions should be based on the method used in the published studies and package labeling that have been determined to be safe, which is most often the Cockcroft–Gault formula unadjusted for body weight. Although Modification of Diet in Renal Disease is more commonly used in practice for staging, the CKD–Epidemiology Collaboration (CKD–EPI equation is the most accurate formula for estimating the CKD staging, especially at higher GFR values. Automated HITs offer a solution to the complexity of determining which equation to use for a given clinical scenario. HITs can educate providers on which formula to use and how to apply the formula in a given clinical situation, ultimately improving appropriate medication and medical management in CKD patients.Conclusion: Appropriate estimation of GFR is key to optimal health outcomes. HITs assist clinicians in both choosing the most appropriate GFR estimation formula and in applying the results of the GFR estimation in practice. Key limitations of the

  7. Reduced cystatin C-estimated GFR and increased creatinine-estimated GFR in comparison with iohexol-estimated GFR in a hyperthyroid patient: A case report

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    Karawajczyk Malgorzata

    2008-02-01

    Full Text Available Abstract Introduction Estimation of the glomerular filtration rate (GFR is essential for the evaluation of patients with kidney disease, and for treating patients with drugs that are eliminated from the circulation by the kidneys. Cystatin C has been shown to be superior to creatinine for estimating GFR in several studies. However, studies showing that thyroid function has an impact on cystatin C have not addressed the question of whether the changes in cystatin C levels are due to changes in GFR or in cystatin C synthesis. Case presentation We report an account of a hyperthyroid patient with a discrepancy between the GFR estimates from cystatin C and creatinine. The cystatin C concentration (1.36 mg/L was higher and gave an estimated GFR which was lower (51 mL/min/1.73 m2, while the creatinine concentration was lower (36 μmol/L and gave a corresponding creatinine-estimated GFR that was higher (145 mL/min/1.73 m2 than the iohexol-estimated GFR (121 mL/min/1.73 m2 during the hyperthyroid period. After thyroidectomy, the creatinine concentration was 36 μmol/L and creatinine-estimated GFR was calculated as 73 mL/min/1.73 m2, while the cystatin C concentration and cystatin C-calculated GFR was 0.78 mg/L and 114 mL/min/1.73 m2, respectively. Conclusion In contrast to creatinine, cystatin C levels rose in the hyperthyroid state as compared to the euthyroid state. The cystatin C-estimated GFR was reduced compared to the iohexol-estimated GFR. This patient case shows that the hyperthyroid-associated changes in cystatin C levels are not due to changes in GFR. Thyroid function should thus be considered when both cystatin C and creatinine are used as markers of kidney function.

  8. CKD-EPI方程估算肾小球滤过率的评价%Assessment of CKD-EPI equation for estimating glomerular filtration rate

    Institute of Scientific and Technical Information of China (English)

    王宏斌; 夏先考; 吴建华

    2011-01-01

    Objective To compare the applicability of CKD-EPI equation with MDRD equation in predicting glomerular filtration rate(GFR)in patients with chronic kidney disease(CKD) and healthy controls, and the relative risk factor of the decrease of GFR was analyzed by CKD-EPI equation. Methods GFR of 91 cases of hospitalized patients with CKD and 198 cases of healthy controls were estimated by CKD-FPI and MDRD equation respectively[denoted as GFR( CKD-EPI) and GFR( MDRD) ]. Correlation and consistency between GFR (CKD-FPI) and GFR ( MDRD) were analyzed by Person correlation analysis and Bland-Altman analytic process. CKD stage of subj ects was assessed according to GFR( MDRD) . Scr, GFR( MDRD) and GFR(CKDEPI) of each stage were compared. Correlation between GFR(CKD-FPI) and other items were also analyzed. Results There was no significant difference of age,Scr,GFR(MDRD)and GFR(CKDEPI) between male an female group(P<O. 05). There was fine correlation between GFR ( MDRD) and GFR( CKD-FPI) [GFR( MDRD) = 0. 944×GFR( CKD-FPI) +0. 612 , r2 = 0. 960 ( P<O. 001) ]. BlandAltman analytic process indicated that there was fine consistency between GFR( MDRD) and GFR(CKD-EPI). All subjects were classified into 5 CKD stages according to GFR(MDRD). Compared with GFR( MDRD) ,.mean of GFR(CKD-EPI) in CKD Ⅰ、 Ⅱ、Ⅲ stage increased 0. 15,7. 34 and l. 60 mL. min-1 . (1. 73 m2 )-1 respectively, mean of GFR(CKD-FPI) in CKD Ⅳ、Ⅴ stage decreased 0. 25 and 0. 41 mL. min-1 ( 1. 73 m2) -1 respectively. GFR ( CKD-EPI) was negatively correlative to age , systolic blood pressure ( SBP) , diastolic blood pressure( DBP) ,serum creatinine( Scr) , serum uric acid( SUA) , fasting blood glucose( FBG) , urine protein( UP) and urine protein-to-creatinine ratio( UP/Ucr) , was positively correlative to total cholesterol( TC) and urine uric acid ( P<O. 05) , but was not correlative to gender and triglyceride(P>O. 05). Conclusion The application of CKD-FPI equation to estimate GFR could reduce

  9. Factors Affecting Changes in the Glomerular Filtration Rate after Unilateral Nephrectomy in Living Kidney Donors and Patients with Renal Disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hye Ok; Chae, Sun Young; Back, Sora; Moon, Dae Hyuk [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2010-04-15

    We evaluated the factors affecting changes in the postoperative glomerular filtration rate (GFR) after unilateral nephrectomy in living kidney donors and patients with renal disease. We studied 141 subjects who underwent living donor nephrectomy for renal transplantation (n=75) or unilateral nephrectomy for renal diseases (n=66). The GFR of the individual kidney was determined by Tc-99m DTPA scintigraphy before and after nephrectomy. By performing multiple linear regression analysis, we evaluated the factors that are thought to affect changes in GFR, such as age, sex, body mass index (BMI), preoperative GFR, preoperative creatinine level, operated side, presence of diabetes mellitus (DM), presence of hypertension (HTN), and duration of follow-up. In both the donor nephrectomy and the disease nephrectomy groups, GFR increased significantly after nephrectomy (46.9{+-}8.4 to 58.1{+-}12.5 vs. 43.0{+-}9.6 to 48.6{+-}12.8 ml/min, p<0.05). In the donor nephrectomy group, age was significantly associated with change in GFR ({beta}=-0.3, P<0.005). In the disease nephrectomy group, HTN, preoperative creatinine level, and age were significantly associated with change in GFR ({beta}=-6.2, p<0.005; {beta}=-10.9, p<0.01; {beta}=-0.2, p<0.01, respectively). This compensatory change in GFR was not significantly related to sex, duration of follow-up, or operated side in either group. The compensatory change in the GFR of the remaining kidney declined with increasing age in both living kidney donors and patients with renal disease.

  10. Relative performance of two equations for estimation of glomerular filtration rate in a Chinese population having chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    LI Jiang-tao; XUN Chen; CUI Chun-li; WANG Hui-fang; WU Yi-tai; YUN Ai-hong; JIANG Xiao-feng; MA Jun

    2012-01-01

    Background The new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was developed to address the systematic underestimation of glomerular filtration rate (GFR) by the Modification of Diet in Renal Disease (MDRD) Study equation in patients with relatively well-preserved kidney function.Performance of the new equation in the Chinese population is unknown.The goal of the present study was to compare performance of these two equations in Chinese patients with chronic kidney disease (CKD).Methods We enrolled 450 Chinese patients (239 women and 211 men) with CKD in the present study.The renal dynamic imaging method was used to measure the referenced standard GFR (rGFR) for comparison with estimations using the two equations.Their overall performance was assessed with the Bland-Altman method and receiver-operating characteristics (ROC) analysis.Performance of the two equations in lower and higher estimated GFR (eGFR) subgroups was further investigated.Results Both eGFRs correlated well with rGFR (r=0.88,0.81,P<0.05).In overall performance,the CKD-EPI equation showed less bias,higher precision and improved accuracy,and was better for detecting CKD.In the higher-eGFR subgroup,the CKD-EPI equation corrected the underestimation of GFR by the abbreviated MDRD equation.Conclusions The CKD-EPI equation outperformed the abbreviated MDRD equation not only in overall performance but also in the subgroups studied.For the present,the CKD-EPI equation appears to be the first-choice prediction equation for estimating GFR.

  11. Factors affecting change in glomerular filtration rate after unilateral nephrectomy in living kidney donors and patients with renal disease

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hye Ok; Back, So Ra; Kim, Euy Nyong; Lee, Jang Han; Yang, Won Seok; Kim, Soon Bae; Moon, Dae Hyuk [Asan Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    We evaluated factors affecting change in glomerular filtration rate (GFR) after unilateral nephrectomy in living kidney donors and patients with renal disease. We retrospectively reviewed the 435 individuals who underwent unilateral nephrectomy in 2006. Among them, we enrolled 141 patients who had performed 99mTc-DTPA scans before and after surgery. The study population consisted of 75 living donors (M=43, F=32) and 66 patients with renal disease (M=46, F=20). We evaluated factors affecting the GFR change by multiple linear regression analysis. The renal disease group was significantly older than the donors at baseline (53.9{+-}12.9 vs. 37.8{+-}11.1yr, P<0.05) and had higher preoperative Cr level (0.95{+-}0.20 vs. 0.85{+-}0.18mg/dL, p<0.05). The mean duration of the follow-up was 7.3{+-}3.3 months, (p<0.05). The disease group and donors significantly increased the GFR after nephrectomy (43.0{+-}9.6 to 48.6{+-}12.8 vs. 46.9{+-}8.4 to 58.1{+-}12.5 ml/min, respectively, P<0.05). The disease group had significantly lesser mean GFR change than the doners. (5.6{+-}7.2 vs. 11.1{+-}8.5 ml/min, respectively, p<0.05). In the renal disease group, multiple regression analysis showed that preop Cr level and age were significantly associated with GFR change ({beta} =-12.53, p=0.003; {beta} =-0.19, p=0.004). In the donor group, age was significantly associated with the GFR change ({beta} =-0.265, p=0.002). But change of GFR was not associated with sex, preop GFR, BMI, duration of follow-up, site of nephrectomy in both groups. Age and preoperative renal function were predictive factors affecting change in GFR after unilateral nephrectomy.

  12. Effect of primary care physicians' use of estimated glomerular filtration rate on the timing of their subspecialty referral decisions

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    Jaar Bernard G

    2011-01-01

    Full Text Available Abstract Background Primary care providers' suboptimal recognition of the severity of chronic kidney disease (CKD may contribute to untimely referrals of patients with CKD to subspecialty care. It is unknown whether U.S. primary care physicians' use of estimated glomerular filtration rate (eGFR rather than serum creatinine to estimate CKD severity could improve the timeliness of their subspecialty referral decisions. Methods We conducted a cross-sectional study of 154 United States primary care physicians to assess the effect of use of eGFR (versus creatinine on the timing of their subspecialty referrals. Primary care physicians completed a questionnaire featuring questions regarding a hypothetical White or African American patient with progressing CKD. We asked primary care physicians to identify the serum creatinine and eGFR levels at which they would recommend patients like the hypothetical patient be referred for subspecialty evaluation. We assessed significant improvement in the timing [from eGFR 2 of their recommended referrals based on their use of creatinine versus eGFR. Results Primary care physicians recommended subspecialty referrals later (CKD more advanced when using creatinine versus eGFR to assess kidney function [median eGFR 32 versus 55 mL/min/1.73m2, p Conclusions Primary care physicians recommended subspecialty referrals earlier when using eGFR (versus creatinine to assess kidney function. Enhanced use of eGFR by primary care physicians' could lead to more timely subspecialty care and improved clinical outcomes for patients with CKD.

  13. Measurement of glomerular filtration rate, renal plasma flow, and endogenous creatinine clearance in cheetahs (Acinonyx jubatus jubatus).

    Science.gov (United States)

    Holder, Erin Hall; Citino, Scott B; Businga, Nancy; Cartier, Leslie; Brown, Scott A

    2004-06-01

    Glomerular filtration rate (GFR), renal plasma flow (RPF), and the endogenous creatinine clearance (CCr) rate were determined in 13 captive cheetahs, Acinonyx jubatus jubatus (seven females and six males, 1.5-7.5 yr of age, x = 5.02 yr), during general anesthesia with Telazol and isoflurane by measuring the urinary clearances of inulin, para-aminohipppuric acid, and endogenous creatinine, respectively. Methods to determine GFR, RPF, and endogenous CCr in captive cheetahs were evaluated, and the relationship between GFR and CCr for this species was determined. The GFR and the RPF were stable during the procedure, with mean values of 1.59+/-0.17 ml/min/kg body weight and 5.12+/-1.15 ml/min/kg body weight, respectively. Although the mean value for CCr (1.47+/-0.20 ml/min/kg body weight) was significantly less than the corresponding value for GFR, the mean difference (0.11+/-0.02 ml/min/kg weight) between the two measurements was slight, and the values were highly correlated (R2 = 0.928; P cheetahs should provide a reliable estimate of GFR, facilitating the early detection of renal disease in this species.

  14. Decreased glomerular filtration rate is associated with mortality and cardiovascular events in patients with hypertension: a prospective study.

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    Rui Zhang

    Full Text Available BACKGROUND: Few studies reported the associations between decreased glomerular filtration rate (GFR and mortality, coronary heart disease (CHD, and stroke in hypertensive patients. We aim to assess the associations between GFR and mortality, CHD, and stroke in hypertensive patients and to evaluate whether low GFR can improve the prediction of these outcomes in addition to conventional cardiovascular risk factors. METHODS AND FINDINGS: This is an observational prospective study and 3,711 eligible hypertensive patients aged ≥5 years from rural areas of China were used for the present analysis. The associations between eGFR and outcomes, followed by a median of 4.9 years, were evaluated using Cox proportional hazards models adjusting for other potential confounders. Low eGFR was independently associated with risk of all-cause mortality, cardiovascular mortality, and incident stroke [multivariable adjusted hazard ratios (95% confidence intervals for eGFR <60 ml/min/1.73 m(2 relative to eGFR ≥90 ml/min/1.73 m(2 were 1.824 (1.047-3.365, 2.371 (1.109-5.068, and 2.493 (1.193-5.212, respectively]. We found no independent association between eGFR and the risk of CHD. For 4-year all-cause and cardiovascular mortality, integrated discrimination improvement (IDI was positive when eGFR were added to traditional risk factors (1.51%, P = 0.016, and 1.99%, P = 0.017, respectively. For stroke and CHD events, net reclassification improvements (NRI were 5.9% (P = 0.012 and 1.8% (P = 0.083 for eGFR, respectively. CONCLUSIONS: We have established an inversely independent association between eGFR and all-cause mortality, cardiovascular mortality, and stroke in hypertensive patients in rural areas of China. Further, addition of eGFR significantly improved the prediction of 4-year mortality and stroke over and above that of conventional risk factors. We recommend that eGFR be incorporated into prognostic assessment for patients with hypertension in

  15. Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Kirk, Ole; Reiss, Peter

    2010-01-01

    OBJECTIVES:: Chronic kidney disease (CKD) in HIV-positive persons might be caused by both HIV and traditional or non-HIV-related factors. Our objective was to investigate long-term exposure to specific antiretroviral drugs and CKD. DESIGN:: A cohort study including 6843 HIV-positive persons...... with at least three serum creatinine measurements and corresponding body weight measurements from 2004 onwards. METHODS:: CKD was defined as either confirmed (two measurements >/=3 months apart) estimated glomerular filtration rate (eGFR) of 60 ml/min per 1.73 m or below for persons with baseline eGFR of above...... 60 ml/min per 1.73 m or confirmed 25% decline in eGFR for persons with baseline eGFR of 60 ml/min per 1.73 m or less, using the Cockcroft-Gault formula. Poisson regression was used to determine factors associated with CKD. RESULTS:: Two hundred and twenty-five (3.3%) persons progressed to CKD during...

  16. Comparison between Cockcroft-Gault and MDRD formulas to estimated glomerular filtration rate in diabetic people

    Directory of Open Access Journals (Sweden)

    María Elena Romero Y.

    2013-04-01

    Full Text Available INTRODUCTION: Diabetic Nephropathy is a significant complication of Diabetes Mellitus. That’s why, the American Diabetes Association (ADA recommended for screening the determination of the glomerular filtration rate (GFR. MDRD (Modification of Diet in Renal Disease, is a formula which allows a very exactly estimation of GFR. Permanently, it had always been compared with Cockcroft-Gault formula. OBJECTIVE: Compare both formulas in the local reality. MATERIAL AND METHOD: It was done a retrospective studio over 243 patients, randomly selected, of a total of 1,057 type 2 diabetes patients registered in Cardiovascular program of San Rafael CESFAM that had serial measurement of plasmatic creatinine in their periodic controls. It was considered the most recent values of plasmatic creatinine taken between January 2010 – October 2011. RESULTS: Of the patients selected, 158 women (65% and 85 men (35%, with average age of 53 years (SD 8,08, the GFR estimated with MDRD was of 89 ml/min/1.73 m2 (SD 21 and 108 ml/min (SD 32 for Cockcroft-Gault formula, p<0.001. We realized a correlation studio between both formulas. DISCUSSION: Both formulas demonstrated an acceptable correlation to estimated GFR, although obese patients had higher estimations with Cockcroft-Gault formula, on the other side, elderly patients had elevated results with MDRD.

  17. [Consensus document: recommendations for the use of equations to estimate glomerular filtration rate in children].

    Science.gov (United States)

    Montañés Bermúdez, R; Gràcia Garcia, S; Fraga Rodríguez, G M; Escribano Subias, J; Diez de Los Ríos Carrasco, M J; Alonso Melgar, A; García Nieto, V

    2014-05-01

    The appearance of the K/DOQI guidelines in 2002 on the definition, evaluation and staging of chronic kidney disease (CKD) have led to a major change in how to assess renal function in adults and children. These guidelines, recently updated, recommended that the study of renal function is based, not only on measuring the serum creatinine concentration, but this must be accompanied by the estimation of glomerular filtration rate (GFR) obtained by an equation. However, the implementation of this recommendation in the clinical laboratory reports in the paediatric population has been negligible. Numerous studies have appeared in recent years on the importance of screening and monitoring of patients with CKD, the emergence of new equations for estimating GFR, and advances in clinical laboratories regarding the methods for measuring plasma creatinine and cystatin C, determined by the collaboration between the departments of paediatrics and clinical laboratories to establish recommendations based on the best scientific evidence on the use of equations to estimate GFR in this population. The purpose of this document is to provide recommendations on the evaluation of renal function and the use of equations to estimate GFR in children from birth to 18 years of age. The recipients of these recommendations are paediatricians, nephrologists, clinical biochemistry, clinical analysts, and all health professionals involved in the study and evaluation of renal function in this group of patients.

  18. Measurement of glomerular filtration rate in adults: accuracy of five single-sample plasma clearance methods

    DEFF Research Database (Denmark)

    Rehling, M; Rabøl, A

    1989-01-01

    After an intravenous injection of a tracer that is removed from the body solely by filtration in the kidneys, the glomerular filtration rate (GFR) can be determined from its plasma clearance. The method requires a great number of blood samples but collection of urine is not needed. In the present......-acetate) was determined simultaneously. Using these clearance values as reference the accuracy of six simplified methods were studied: five single-sample methods and one five-sample method. The standard error of estimate (SEE) of the single-sample methods ranged from 4.2 to 7.5 ml min-1 using EDTA, and from 3.8 to 6.3 ml...... min-1 using DTPA. SEE of the five-samples method was 3.0 ml min-1 (EDTA) and 3.1 ml min-1 (DTPA). The single-sample methods given by Christensen & Groth (1986) and by Tauxe (1986) are recommended for daily use, as SEE was small even at low GFR values. In patients with GFR less than 80 ml min-1...

  19. eGFR is a reliable preoperative renal function parameter in patients with gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Takayuki; Kosuge; Tokihiko; Sawada; Yoshimi; Iwasaki; Junji; Kita; Mitsugi; Shimoda; Nobumi; Tagaya; Keiichi; Kubota

    2010-01-01

    AIM: To evaluate the validity of the estimated glomerular filtration rate (eGFR) as a preoperative renal function parameter in patients with gastric cancer. METHODS: A retrospective study was conducted in 147 patients with gastric cancer. Preoperative creatinine clearance (Ccr), eGFR, and preand postoperative serum creatinine (sCr) data were examined. Preoperative Ccr and eGFR were then compared for their reliability in predicting postoperative renal dysfunction. RESULTS: Among 110 patients with normal preo...

  20. Is the new GFR equation using inulin clearance a more accurate method for Asian patients?

    Science.gov (United States)

    Kim, Beom Seok; Lee, Yong Kyu; Choi, Hoon Young; Choi, Seung Ok; Shin, Sug Kyun; Ha, Sung Kyu; Lee, Kang Wook; Kim, Yang Wook; Kim, Yong Lim; Yasuda, Yoshinari; Imai, Enyu; Horio, Masaru; Tomino, Yasuhiko; Matsuo, Seiichi; Lee, Ho Yung

    2015-12-01

    Recently, a new glomerular filtration rate (GFR) equation for the Japanese population was proposed using measured inulin clearance. To expand its applicability to other Asian populations, we performed a comparative study in the Korean population. Inulin clearance was measured in 166 patients from seven participating medical centers in Korea. Patient's sera and urine were collected, and baseline clinical characteristics were measured to provide an estimated GFR (eGFR) by the Japanese GFR equation using inulin clearance (Japanese-GFR equation), the Modification of Diet in Renal Disease (MDRD) study equation, and the Chronic Kidney Disease - Epidemiology Collaboration (CKD-EPI) equation. We compared the results to determine which equation best estimated the measured GFR (mGFR). Accuracy (95% CI) within 30% of mGFR by the Japanese-GFR equation, the CKD-EPI equation and the MDRD study equation were 66 (58 - 72), 51 (43 - 58), and 55 (47 - 62)%, respectively. Bias (mGFR minus eGFR) were 3.4 ± 22.4, -12.0 ± 22.1, and -9.7 ± 23.8 mL/min/1.73 m2, respectively. The accuracy of the Japanese-GFR equation was significantly better than MDRD study equation in subjects with mGFR < 60 mL/min/1.73 m2 and in total subjects. The bias of the Japanese-GFR equation was significantly smaller compared with other two equations in total subjects. The Japanese-GFR equation has a higher accuracy with less bias than the other equations in estimating GFR in Korean populations. Further studies are required to determine if the current Japanese-GFR equation could represent the standard eGFR for other Asian populations.

  1. Relationship of arterial compliance and blood pressure with microalbuminuria and mildly decreased glomerular filtration rate: a Chinese community-based analysis.

    Directory of Open Access Journals (Sweden)

    Shihui Fu

    Full Text Available This analysis is designed to determine the prevalence of microalbuminuria (MAU and mildly decreased glomerular filtration rate (GFR; to investigate the association of augmentation index (AIx, central blood pressure (cBP and peripheral blood pressure (pBP with MAU and mildly decreased GFR; and to compare the association strength of cBP and pBP with MAU and mildly decreased GFR.This community-based analysis included 2071 Chinese residents. Urine albumin-to-creatinine ratio (UACR, GFR, and pulse wave measurements were performed. UACR of 30-299 mg/g and GFR of 60-89 ml/min/1.73 m2 were identified as MAU and mildly decreased GFR.The prevalence of MAU and mildly decreased GFR was 21.3% and 33.2%. The AIx, cBP and pBP were significantly higher in participants with MAU compared with those without MAU, and in participants with mildly decreased GFR compared with those without mildly decreased GFR (all P<0.001. After participants were categorized into four subgroups based on the presence or absence of MAU and mildly decreased GFR, Aix, cBP and pBP progressively increased from the subgroup without both of MAU and mildly decreased GFR to the subgroups with either one of them, and arrived at top in the subgroup with both of them (all P<0.001. Compared with the reference category without MAU and mildly decreased GFR, the odd ratio values significantly increased from the category with either one of MAU and mildly decreased GFR to the category with both of them (all P<0.001. The AIx, cBP and pBP were all independently associated with MAU and mildly decreased GFR after full adjustment (all P<0.05, and the association strength of MAU and mildly decreased GFR with cBP was similar to those with pBP.In Chinese community-dwelling population, there was a high prevalence of MAU and mildly decreased GFR. The AIx, cBP and pBP were all independently associated with MAU and mildly decreased GFR; meanwhile, cBP did not exhibit stronger association with MAU and mildly

  2. Prognostic value of estimated glomerular filtration rate in hospitalized elderly patients.

    Science.gov (United States)

    De La Higuera, Laura; Riva, Emma; Djade, Codjo Djignefa; Mandelli, Sara; Franchi, Carlotta; Marengoni, Alessandra; Salerno, Francesco; Corrao, Salvatore; Pasina, Luca; Tettamanti, Mauro; Marcucci, Maura; Mannucci, Pier Mannuccio; Nobili, Alessandro

    2014-10-01

    A multicenter observational study, REPOSI (REgistro POliterapie Società Italiana di Medicina Interna), was conducted to assess the prognostic value of glomerular filtration rate (eGFR) on in-hospital mortality, hospital re-admission and death within 3 months, in a sample of elderly patients (n = 1,363) admitted to 66 internal medicine and geriatric wards. Based on eGFR, calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, subjects at hospital admission were classified into three groups: group 1 with normal eGFR (≥60 ml/min/1.73 m(2), reference group), group 2 with moderately reduced eGFR (30-59 ml/min/1.73 m(2)) and group 3 with severely reduced eGFR (<30 ml/min/1.73 m(2)). Patients with the lowest eGFR (group 3) on admission were more likely to be older, to have a greater cognitive and functional impairment and a high rate of comorbidities. Multivariable logistic regression analysis showed that severely reduced eGFR at the time of admission was associated with in-hospital mortality (OR 3.00; 95% CI 1.20-7.39, p = 0.0230), but not with re-hospitalization (OR 0.97; 95% CI 0.54-1.76, p = 0.9156) or mortality at 3 months after discharge (OR 1.93; 95% CI 0.92-4.04, p = 0.1582). On the contrary, an increased risk (OR 2.60; 95% CI 1.13-5.98, p = 0.0813) to die within 3 months after discharge was associated with decreased eGFR measured at the time of discharge. Our study demonstrates that severely reduced eGFRs in elderly patients admitted to hospital are strong predictors of the risk of dying during hospitalization, and that this measurement at the time of discharge helps to predict early death after hospitalization.

  3. Simplified methods for assessment of renal function as the ratio of glomerular filtration rate to extracellular fluid volume

    DEFF Research Database (Denmark)

    Jødal, Lars; Brøchner-Mortensen, Jens

    2012-01-01

    Background: Instead of scaling glomerular filtration rate (GFR) to a body surface area of 1.73m2, it has been suggested to scale GFR to extracellular fluid volume (ECV). The ratio GFR/ECV has physiological meaning in that it indicates how often ‘that which is to be regulated’ (i.e. ECV) comes...... into contact with the ‘regulator’ (i.e. the kidneys). Aim: The aim of the present study was as follows: to analyse two published calculation methods for determining ECV and GFR/ECV; to develop a new simple and accurate formula for determining ECV; and to compare and evaluate these methods. Materials...... and methods: GFR was determined as 51Cr-EDTA clearance. The study comprised 128 individuals (35 women, 66 men and 27 children) with a full 51Cr-EDTA plasma concentration curve, determined from injection until 4–5 h p.i. Reference values for GFR and ECV were calculated from the full curve. One...

  4. Association of glomerular filtration rate with slow coronary flow in patients with normal to mildly impaired renal function.

    Science.gov (United States)

    Akin, Fatih; Celik, Omer; Ayça, Burak; Yalçin, Ahmet Arif; Altun, Ibrahim; Köse, Nuri

    2014-10-01

    We evaluated the association between estimated glomerular filtration rate (eGFR) and slow coronary flow (SCF) in patients with normal to mildly impaired renal function; 211 patients with angiographically proven SCF and 219 controls were studied. Patients were categorized based on the angiographic findings as with or without SCF. We used the Modification of Diet in Renal Disease equation to calculate eGFR. The frequency of mildly decreased eGFR, serum uric acid levels, and eGFR was higher in the SCF group. Patients with mildly impaired renal function had higher thrombolysis in myocardial infarction frame counts in 3 major coronary arteries. In logistic regression analysis, uric acid (odds ratio [OR] = 1.323, 95% confidence interval [CI] = 1.109-1.572, P = .002) and eGFR (OR = 0.972, 95% CI = 0.957-0.987, P < .001) were independent correlates of SCF. In conclusion, eGFR was significantly correlated with SCF in patients with normal to mildly impaired renal function.

  5. Potential Effect of Substituting Estimated Glomerular Filtration Rate for Estimated Creatinine Clearance for Dosing of Direct Oral Anticoagulants.

    Science.gov (United States)

    Schwartz, Janice B

    2016-10-01

    To determine the potential effect of substituting glomerular filtration rate (GFR) estimates for renal clearance estimated using the Cockcroft-Gault method (CrCL-CG) to calculate direct oral anticoagulant (DOAC) dosing. Simulation and retrospective data analysis. Community, academic institution, nursing home. Noninstitutionalized individuals aged 19 to 80 from the National Health and Nutrition Examination Survey (NHANES) (2011/12) (n = 4,687) and medically stable research participants aged 25 to 105 (n = 208). Age, height, weight, sex, race, serum creatinine, CrCL-CG, and GFR (according to the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations). Outcome measures were dosing errors if GFR were to be substituted for CrCL-CG. Renal clearance estimates according to all methods were highly correlated (P < .001), although at lower clearances, substitution of GFR estimates for CrCL-CG resulted in failure to recognize needs for dose reductions of rivaroxaban or edoxaban in 28% of NHANES subjects and 47% to 56% of research subjects. At a CrCL-CG of less than 30 mL/min, GFR estimates missed indicated dosage reductions for dabigatran in 18% to 21% of NHANES subjects and 57% to 86% of research subjects. Age and weight contributed to differences between renal clearance estimates (P < .001), but correction of GFR for body surface area (BSA) did not reduce dosing errors. At a CrCL-CG greater than 95 mL/min, edoxaban is not recommended, and GFR esimates misclassified 24% of NHANES and 39% of research subjects. Correction for BSA reduced misclassification to 7% for NHANES and 14% in research subjects. Substitution of GFR estimates for estimated CrCl can lead to failure to recognize indications for reducing DOAC dose and potentially higher bleeding rates than in randomized trials. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  6. The effects of cimetidine on creatinine excretion, glomerular filtration rate and tubular function in renal transplant recipients

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal; Ladefoged, S D; Feldt-Rasmussen, B;

    1989-01-01

    The renal clearance of endogenous creatinine (CCr), sodium (CNa) and lithium (CLi) was determined before and after a single intravenous bolus of cimetidine in nine renal transplant recipients. The glomerular filtration rate (GFR) was measured with 125I-iothalamate clearance (CTh). The initial CCr...... of sodium decreased throughout the study (p less than 0.05); CLi was unchanged. In conclusion cimetidine, when measured during 1-h clearance periods, interferes with tubular creatinine secretion in the denervated kidney of transplant recipients without affecting the glomerular filtration rate or proximal...

  7. The effects of cimetidine on creatinine excretion, glomerular filtration rate and tubular function in renal transplant recipients

    DEFF Research Database (Denmark)

    Olsen, N V; Ladefoged, S D; Feldt-Rasmussen, B;

    1989-01-01

    The renal clearance of endogenous creatinine (CCr), sodium (CNa) and lithium (CLi) was determined before and after a single intravenous bolus of cimetidine in nine renal transplant recipients. The glomerular filtration rate (GFR) was measured with 125I-iothalamate clearance (CTh). The initial CCr...... of 65 ml/min (median) was reduced to a nadir of 46 ml/min (p less than 0.01) during the first 2 h after infusion of cimetidine. GFR remained unchanged, and thus the fractional clearance of creatinine (CCr/CTh) was reduced from 1.43 (median) to 1.03 (p less than 0.01). CNa and the fractional excretion...... of sodium decreased throughout the study (p less than 0.05); CLi was unchanged. In conclusion cimetidine, when measured during 1-h clearance periods, interferes with tubular creatinine secretion in the denervated kidney of transplant recipients without affecting the glomerular filtration rate or proximal...

  8. Tubular markers do not predict the decline in glomerular filtration rate in type 1 diabetic patients with overt nephropathy

    DEFF Research Database (Denmark)

    Nielsen, Stine E; Andersen, Steen; Zdunek, Dietmar

    2011-01-01

    Recent studies have shown that both glomerular and tubulointerstitial damage are important factors in the pathophysiology and progression of diabetic nephropathy. To examine whether markers of tubular damage are useful in monitoring the progression of disease, we measured urinary levels...... associated with a faster decline in GFR, but not after adjustment for known promoters of progression. Urinary LFABP was not related to decline in GFR. Losartan treatment (100 mg/day) reduced urinary KIM-1 by 43% over a 12-month period. Thus, urine biomarker measurements in patients with type 1 diabetic...... of neutrophil gelatinase-associated lipocalin (NGAL), liver-fatty acid-binding protein (LFABP), and kidney injury molecule-1 (KIM-1) in a 3-year intervention study of 63 type 1 diabetic patients with kidney disease. The baseline mean glomerular filtration rate (GFR) was 87 ml/min per 1.73 m(2) and urinary...

  9. Renal uptake of dimercaptosuccinic acid and glomerular filtration rate in chronic nephropathy at angiotensin converting enzyme inhibition

    DEFF Research Database (Denmark)

    Kamper, A L; Thomsen, H S; Nielsen, S L;

    1990-01-01

    Glomerular filtration rate (GFR) and renal uptake of dimercaptosuccinic acid (DMSA) were measured in 31 patients with progressive chronic nephropathy before and immediately after the start of treatment with angiotensin converting enzyme (ACE) inhibitor in order to control adverse effects on kidney...... function. Scintigrams of the kidneys showed an unaltered distribution of DMSA during treatment. GFR estimated by 51Cr-EDTA plasma clearance fell by 14% (P less than 0.01), but renal uptake of 99mTc-DMSA increased by 10% (P less than 0.01). It is concluded that DMSA in chronic renal failure is mainly taken...... up by the tubular cells from the peritubular capillaries since the uptake was unaffected by the acute decrease in GFR....

  10. The evaluation of gluomerular filtration rate in chronic kidney disease patients based on serum CysC

    Institute of Scientific and Technical Information of China (English)

    刘红春

    2014-01-01

    Objective To evaluate the applicability of several formulas for gluomerular filtration rate(GFR)evaluation based on serum CystatinC(CysC)in patients with chronic kidney disease(CKD).Methods According to the method of laboratory appliance reseach,three hundred and four hospitalized CKD patients(162 males,142 females,aged from 14-year-old to 80-year-old)in the First Affiliated Hospital of Zhengzhou University hospital dating from October 2010 to October 2011 were selected.

  11. Salt sensitivity of renin secretion, glomerular filtration rate and blood pressure in conscious Sprague-Dawley rats

    DEFF Research Database (Denmark)

    Isaksson, G L; Stubbe, J; Hansen, Per Lyngs;

    2014-01-01

    We hypothesized that in normal rats in metabolic steady state, (i) the plasma renin concentration (PRC) is log-linearly related to Na(+) intake (NaI), (ii) the concurrent changes in mean arterial pressure (MABP) and glomerular filtration rate (GFR) are negligible and (iii) the function PRC = f(Na...... = f(NaI) is altered by β1 -adrenoceptor blockade (metoprolol) and surgical renal denervation (DNX)....

  12. Serum creatinine is a poor marker of GFR in nephrotic syndrome.

    NARCIS (Netherlands)

    Branten, A.J.W.; Vervoort, G.M.M.; Wetzels, J.F.M.

    2005-01-01

    BACKGROUND: In daily clinical practice creatinine clearance is used as marker of glomerular filtration rate (GFR). As a result of the tubular secretion process endogenous creatinine clearance (ECC) overestimates glomerular filtration rate, particularly in patients with impaired renal function. It ha

  13. GFR Prediction From Cystatin C and Creatinine in Children

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Boegsted, Martin;

    2012-01-01

    predicted 98% within ±30% of reference GFR and 66% within ±10%, which was higher than for any other model. The weight model predicted 97.5% within ±30% of reference GFR and 62% within ±10%. The BCM model had the highest R2 and the smallest root mean square error. Limitations Included only 9 children......Background Aiming to develop a more accurate cystatin C–based model for estimation of glomerular filtration rate (GFR) in children, we hypothesized that inclusion of body cell mass (BCM) would increase the accuracy of the GFR estimate in comparison to a well-established GFR reference method. Study...... Design Diagnostic test accuracy study. Settings & Participants 119 children (mean age, 8.8; range, 2.3-14.9 years) referred for GFR measurement by chromium 51 ethylenediaminetetraacetic acid (51Cr-EDTA) clearance (mean GFR, 98; range, 13.7-147.4 mL/min/1.73 m2). Index Test GFR estimations by the 2...

  14. Prevalence of estimated GFR reporting among US clinical laboratories.

    Science.gov (United States)

    Accetta, Nancy A; Gladstone, Elisa H; DiSogra, Charles; Wright, Elizabeth C; Briggs, Michael; Narva, Andrew S

    2008-10-01

    Routine laboratory reporting of estimated glomerular filtration rate (eGFR) may help clinicians detect kidney disease. The current national prevalence of eGFR reporting in clinical laboratories is unknown; thus, the extent of the situation of laboratories not routinely reporting eGFR with serum creatinine results is not quantified. Observational analysis. National Kidney Disease Education Program survey of clinical laboratories conducted in 2006 to 2007 by mail, web, and telephone follow-up. A national random sample, 6,350 clinical laboratories, drawn from the Federal Clinical Laboratory Improvement Amendments database and stratified by 6 major laboratory types/groupings. Laboratory reports serum creatinine results. Reporting eGFR values with serum creatinine results. Percentage of laboratories reporting eGFR along with reporting serum creatinine values, reporting protocol, eGFR formula used, and style of reporting cutoff values. Of laboratories reporting serum creatinine values, 38.4% report eGFR (physician offices, 25.8%; hospitals, 43.6%; independents, 38.9%; community clinics, 47.2%; health fair/insurance/public health, 45.5%; and others, 43.2%). Physician office laboratories have a reporting prevalence lower than other laboratory types (P laboratories reporting eGFR, 66.7% do so routinely with all adult serum creatinine determinations; 71.6% use the 4-variable Modification of Diet in Renal Disease Study equation; and 45.3% use the ">60 mL/min/1.73 m(2)" reporting convention. Independent laboratories are least likely to routinely report eGFR (50.6%; P laboratories across all strata are more likely to report eGFR (P laboratories, federal database did not have names of laboratory directors/managers (intended respondents), assumed accuracy of federal database for sample purposes. Routine eGFR reporting with serum creatinine values is not yet universal, and laboratories vary in their reporting practices.

  15. Physical Activity Is not Associated with Estimated Glomerular Filtration Rate among Young and Middle-Aged Adults : Results from the Population-Based Longitudinal Doetinchem Study

    NARCIS (Netherlands)

    Herber-Gast, Gerrie-Cor M.; Hulsegge, Gerben; Hartman, Linda; Verschuren, W. M. Monique; Stehouwer, Coen D. A.; Gansevoort, Ron T.; Bakker, Stephan J. L.; Spijkerman, Annemieke M. W.

    2015-01-01

    There is debate as to whether physical inactivity is associated with reduced kidney function. We studied the prospective association of (changes in) physical activity with estimated glomerular filtration rate (eGFR) in adult men and women. We included 3,935 participants aged 26 to 65 years from the

  16. Coffee and tea consumption in relation to estimated glomerular filtration rate : results from the population-based longitudinal Doetinchem Cohort Study

    NARCIS (Netherlands)

    Herber-Gast, Gerrie-Cor M.; van Essen, Hanneke; Verschuren, W. M. Monique; Stehouwer, Coen D. A.; Gansevoort, Ron T.; Bakker, Stephan J. L.; Spijkerman, Annemieke M. W.

    2016-01-01

    Background: Although coffee consumption and tea consumption have been linked to diabetes, the relation with kidney function is less clear and is underresearched. Objective: We investigated the prospective associations of coffee and tea consumption with estimated glomerular filtration rate (eGFR). De

  17. Cumulative and current exposure to potentially nephrotoxic antiretrovirals and development of chronic kidney disease in HIV-positive individuals with a normal baseline estimated glomerular filtration rate

    DEFF Research Database (Denmark)

    Mocroft, Amanda; Lundgren, Jens D; Ross, Michael

    2016-01-01

    of exposure to antiretrovirals and the development of chronic kidney disease in people with initially normal renal function, as measured by estimated glomerular filtration rate (eGFR). METHODS: In this prospective international cohort study, HIV-positive adult participants (aged ≥16 years) from the D...

  18. The kinetic basis of glomerular filtration rate measurement and new concepts of indexation to body size

    Energy Technology Data Exchange (ETDEWEB)

    Peters, A.M. [Department of Nuclear Medicine, Addenbrooke' s Hospital, Hills Road, Box 170, CB2 2QQ, Cambridge (United Kingdom)

    2004-01-01

    As measurement of glomerular filtration rate (GFR) is now generally the responsibility of departments of nuclear medicine, it is important for nuclear medicine physicians and scientists to understand the pharmacokinetics of the indicators and radiotracers that are used, generally known as filtration markers. The single-injection, non-steady state technique is almost universally used, departments varying in how many blood samples are taken: rarely multisample clearance, which does not assume a single compartment of tracer distribution, commonly clearance based on a limited number of blood samples between 2 and 4 h after injection, which assumes a single compartment of distribution, and often a single sample at a defined time point. The volume of distribution, V{sub d}, of a filtration marker is close to extracellular fluid volume (ECFV). GFR and ECFV are both overestimated by the assumption of a single compartment by amounts that are functions of the rate of plasma clearance, Z. Residence time, T, of tracer in its V{sub d} is equal to V{sub d} divided by Z. Z and T can both be measured from a multisample clearance curve, whereupon V{sub d} is the product of Z and T. GFR is usually indexed to patient size by expressing it in relation to body surface area (BSA), which in turn is calculated from an equation based on the patient's height and weight. An equation in common use was described by Haycock et al. and is BSA=0.024265 x weight{sup 0.5378} x height{sup 0.3964}. An alternative indexation variable is ECFV. GFR per unit ECFV is close to the rate constant, {alpha}{sub 3}, of the terminal exponential of the plasma clearance curve. It is in fact slightly higher than this rate constant by an amount that is a function of the rate constant itself. The discrepancy between GFR/ECFV and {alpha}{sub 3} arises from the development of a concentration gradient between interstitial fluid and plasma, which in turn produces an extrarenal veno-arterial gradient throughout the

  19. Additive effect of polymorphisms in the β2 -adrenoceptor and NADPH oxidase p22 phox genes contributes to the loss of estimated glomerular filtration rate in Chinese.

    Science.gov (United States)

    Wang, Tao; Zhang, Yan; Ma, JingTao; Feng, Zhen; Niu, Kai; Liu, Bing

    2014-09-01

    Because increased oxidative stress may mediate the detrimental actions of enhanced sympathetic nervous activity on renal function and vice versa, we investigated the effect of the polymorphic Arg16Gly in the β2 -adrenoceptor (ADRB2) gene, Trp64Arg in the β3 -adrenoceptor (ADRB3) gene and C242T in the NADPH oxidase p22phox (CYBA) gene on estimated glomerular filtration rate (eGFR) in a Chinese population. Initially recruited from different outpatient services of HeBei General Hospital in northern China, 668 individuals were finally included in the study, with complete demographic information. Laboratory tests were performed and estimated glomerular filtration rate (eGFR) was derived from the Modification of Diet in Renal Disease (MDRD) equation for the Chinese population. Plasma noradrenaline levels and genotype were determined by HPLC and the TaqMan method, respectively. Only across the Arg16Gly polymorphism did eGFR show significant difference: it was lower in individuals with the Gly16Gly variation, who also had the highest plasma noradrenaline levels. This polymorphism remained a significant determinant of eGFR after multivariate analysis. Of importance, the multifactor dimensionality reduction method further detected a significant synergism between the Arg16Gly and C242T polymorphisms in reducing eGFR. These observations clarify the effects of the studied polymorphisms on eGFR and exemplify gene-gene interactions influencing renal function.

  20. The MDRD formula does not reflect GFR in ESRD patients

    NARCIS (Netherlands)

    D.C. Grootendorst; W.M. Michels; J.D. Richardson; K.J. Jager; E.W. Boeschoten; F.W. Dekker; R.T. Krediet

    2011-01-01

    The Modification of Diet in Renal Disease (MDRD) equation is widely used for the estimation of glomerular filtration rate (GFR) from plasma creatinine. It has been well validated in patients with various degrees of impaired kidney function, but not in patients with end-stage renal disease (ESRD). Pl

  1. Plasma hemoglobin concentration was related to estimated glomerular filtration rate in elderly patients with ischemic Cardiomyopatny

    Institute of Scientific and Technical Information of China (English)

    Gang Li; Zhihua Wang; Canjing Zhang; Yang Wang

    2008-01-01

    Objectlves To stuaythe relationship between plasma hemoglobin concentration and estimated glomerular filtration rate (eGFR)in elderly patients with ischemic cardiomyopathy (ICM).Methods Clinical data of patients with coronary heart disease who weredischarged from The First Affiliated Hospital,Chongqing Medicai University between 2005 and 2007 were analyzed retrospectively.Echocardiography resuIts.plasma hemoglobin and creatinine concentration were abstracted from the medical records.The study included235 Chinese Han patients with age 60 years and older with angiography confwmed coronary heart disease.silent myocardial ischemia orangina pectoris,of whom 154 had ICM defined as left ventricular end-diastolic diameter(LVDd),male≥56mm,female≥51 mm(63.51±7.70 mm)measured by M-mode echocardiography.The differences in plasma hemoglobin concentration were analyzed retrospec-were no significant changes in plasma hemoglobin concentration and eGFR;however,plasma hernoglobin concentration was related toeGFR significantly positively in elderly patients with ICM due to coronary heart disease.

  2. Beta thalassemia major: The effect of age on glomerular filtration rate

    Directory of Open Access Journals (Sweden)

    Majid Malaki

    2011-01-01

    Full Text Available Thalassemia is a common hereditary hemoglobinopathy disorder that affects many organs in the body. Estimation of kidney function is important, as it is the vital organ that plays the major role in the elimination of accumulated iron as well as the chelating drugs that have to be used as therapy. Sixty- three patients aged 1-29 years, with a mean ± SD of 14 ± 6.7 years, affected with beta- thalassemia major in Tabriz Children′s Hospital were evaluated for their renal function on the basis of their age, serum iron, serum ferritin and serum creatinine levels along with two methods of estimating glomerular filtration rate (GFR; by Schwartz method for those under 18 years old and using Modification of Diet in Renal Disease (MDRD formula for those who were 18 years and above. Elevation of serum creatinine denoting renal dysfunction was not seen in our patients, but hyperfiltration was a common finding. An increasing GFR was observed, which corresponded to age, but no relationships were seen between serum iron, serum ferritin, regular blood transfusion, chelating therapy to GFR.

  3. Difference between CKD-EPI and MDRD equations in calculating glomerular filtration rate in patients with cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Yu-Wei Chen; Han-Hsiang Chen; Tsang-En Wang; Ching-Wei Chang; Chen-Wang Chang; Chih-Jen Wu

    2011-01-01

    AIM: To evaluate the difference between the performance of the (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations in cirrhotic patients. METHODS: From Jan 2004 to Oct 2008, 4127 cirrhotic patients were reviewed. Patients with incomplete data with respect to renal function were excluded; thus, a total of 3791 patients were included in the study. The glomerular filtration rate (GFR) was estimated by the 4-variable MDRD (MDRD-4), 6-variable MDRD (MDRD-6), and CKD-EPI equations. RESULTS: When serum creatinine was 0.7-6.8 mg/dL and 0.6-5.3 mg/dL in men and women, respectively, a significantly lower GFR was estimated by the MDRD-6 than by the CKD-EPI. Similar GFRs were calculated by both equations when creatinine was > 6.9 mg/dL and > 5.4 mg/dL in men and women, respectively. In predicting in-hospital mortality, estimated GFR obtained by the MDRD-6 showed better accuracy [81.72%; 95% confidence interval (CI), 0.94-0.95] than that obtained by the MDRD-4 (80.22%; 95%CI, 0.96-0.97), CKD-EPI (79.93%; 95%CI, 0.96-0.96), and creatinine (77.50%; 95%CI, 2.27-2.63). CONCLUSION: GFR calculated by the 6-variable MDRD equation may be closer to the true GFR than that calculated by the CKD-EPI equation.

  4. Functional evaluation of hydronephrosis by diffusion-weighted MR imaging: Relationship between apparent diffusion coefficient and split glomerular filtration rate

    Energy Technology Data Exchange (ETDEWEB)

    Toyoshima, S.; Noguchi, K.; Seto, H.; Shimizu, M.; Watanabe, N. [Toyama Medical and Pharmaceutical Univ. (Japan). Dept. of Radiology

    2000-11-01

    To determine the relationship between apparent diffusion coefficient (ADC) values measured by diffusion-weighted MR imaging and split renal function determined by renal scintigraphy in patients with hydronephrosis. Material and Methods: Diffusion-weighted imaging on a 1.5 T MR unit and renal scintigraphy were performed in 36 patients with hydronephrosis (45 hydronephrotic kidneys, 21 non-hydronephrotic kidneys). ADC values of the individual kidneys were measured by diffusion-weighted MR imaging. Split renal function (glomerular filtration rate (GFR)) was determined by renal scintigraphy using {sup 99m}Tc-DTPA. The relationship between ADC values and split GFR was examined in 66 kidneys. The hydronephrotic kidneys were further classified into three groups (severe renal dysfunction, GFR <10 ml/min, n=7; moderate renal dysfunction, GFR 10-25 ml/min, n=10; normal renal function, GFR >25 ml/min, n=28), and mean values for ADCs were calculated. Results: In hydronephrotic kidneys, there was a moderate positive correlation between ADC values and split GFR (R2=0.56). On the other hand, in non-hydronephrotic kidneys, poor correlation between ADC values and split GFR was observed (R2=0.08). The mean values for ADCs of the dysfunctioning hydronephrotic kidneys (severe renal dysfunction, 1.32x10{sup -3}{+-}0.18x10{sup -3} mm{sup 2}/s; moderate renal dysfunction, 1.38x10{sup -3}{+-}0.10x10{sup -3} mm2/s) were significantly lower than that of the normal functioning hydronephrotic kidneys (1.63x10{sup -3}{+-}0.12{+-}10{sup -3} mm{sup 2}/s). Conclusion: These results indicated that measurement of ADC values by diffusion-weighted MR imaging has a potential value in the evaluation of the functional status of hydronephrotic kidneys.

  5. Effect of Proteinuria and Glomerular Filtration Rate on Renal Outcome in Patients with Biopsy-Proven Benign Nephrosclerosis.

    Science.gov (United States)

    Sumida, Keiichi; Hoshino, Junichi; Ueno, Toshiharu; Mise, Koki; Hayami, Noriko; Suwabe, Tatsuya; Kawada, Masahiro; Imafuku, Aya; Hiramatsu, Rikako; Hasegawa, Eiko; Yamanouchi, Masayuki; Sawa, Naoki; Fujii, Takeshi; Ohashi, Kenichi; Takaichi, Kenmei; Ubara, Yoshifumi

    2016-01-01

    Reduced estimated glomerular filtration rate (eGFR) and proteinuria are risk factors for end-stage renal disease (ESRD), of which benign nephrosclerosis is a common cause. However, few biopsy-based studies have assessed these associations. We performed retrospective cohort study of 182 Japanese patients who underwent renal biopsy from June 1985 through March 2014 and who were diagnosed with benign nephrosclerosis. Competing risk regression analyses were used to investigate the effect of eGFR and proteinuria levels at the time of renal biopsy on the risk for renal events (ESRD or a 50% decline in eGFR from baseline). During a median 5.8-year follow-up, 63 (34.6%) patients experienced renal events. The incidence of renal events increased with lower baseline eGFR and greater baseline proteinuria levels. After adjustment for baseline covariates, lower eGFR levels (subhazard ratios [SHRs], 1.30; 95% confidence interval [CI], 1.01-1.67, per 10 mL/min/1.73 m2) and higher proteinuria levels (SHR, 1.52; 95% CI, 1.23-1.87, per 1.0 g/day) at the time of renal biopsy were associated independently with higher risk for renal events. Lower levels of serum albumin (SHR, 2.07; 95% CI, 1.20-3.55 per 1.0 g/dL) were also associated with renal events. Patients with both eGFR proteinuria ≥0.5 g/day had a 26.7-fold higher risk (95% CI, 3.97-179.4) of renal events than patients with both eGFR ≥60 mL/min/1.73 m2 and proteinuria proteinuria as well as lower serum albumin at the time of renal biopsy are independent risk factors for renal events among patients with biopsy-proven benign nephrosclerosis.

  6. Diagnostic accuracy of various glomerular filtration rates estimating equations in patients with chronic kidney disease and diabetes

    Institute of Scientific and Technical Information of China (English)

    LI Hai-xia; XU Guo-bin; WANG Xue-jing; ZHANG Xu-chu; YANG Jian-mei

    2010-01-01

    Background The equations for estimating glomerular filtration rate (GFR) based on creatinine have been found to have limitations and have not been generalizable across all populations. Equations based on cystatin C provide an alternative method to estimate GFR. Whether the equation based on cystatin C alone or combined creatinine would improve GFR estimates has not been validated among Chinese patients with chronic kidney disease (CKD) and diabetes. The aim of this study was to compare the performance of the modification of diet in renal disease (MDRD) equation based on creatinine with the five cystatin C-based formulae for estimation of GFR in patients with CKD and diabetes. Methods A total of 166 patients with CKD and 91 patients with type 2 diabetes were enrolled in this study. Cystatin C was measured by using the particle-enhanced immunonephelometric method and estimated formulae proposed by five different investigator teams (Stevens, Ma, Rule, Macisaac and Perkins). The plasma clearance of ~(99m)Tc-DTPA was determined as measured GFR (mGFR).Results For CKD patients, the bias and accuracy for the Ma and Macisaac equations were superior compared with the MDRD, and the mean results for the Ma formula were closer to mGFR than the other equations in CKD stages 2-5. The differences between Macisaac and mGFR in CKD stages 2-4 were significantly less than those in CKD stage 1 or 5.Stevens and Rule's formulae revealed a similar bias and accuracy compared with the MDRD equation. The MDRD formula had a higher accuracy in CKD stages 3-5 as compared with the results in other stages. For diabetic patients, the mean results between Macisaac and mGFR were closer than those of other equations in mGFR≥90 ml.min~(-1).1.73 m~(-2) stage, in GFR 60-89 ml·min~(-1)·1.73 m~(-2) stage, the MDRD formula showed the smallest difference compared with other equations. All equations overestimated GFR in the cases with GFR <60 mi.min~(-1)·1.73 m~(-2) stages. The MDRD formula had a

  7. Effects of body mass index and age on N-terminal pro brain natriuretic peptide are associated with glomerular filtration rate in chronic heart failure patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kistorp, Caroline N

    2007-01-01

    BACKGROUND: Obesity is a state characterized by glomerular hyperfiltration and age-related decreases in glomerular filtration rate (GFR). Body mass index (BMI), age, and GFR are associated with plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) in chronic heart failure...... (CHF) patients. We hypothesized that the effects of BMI and age on plasma concentrations of NT-proBNP are associated with GFR. METHODS: We obtained clinical data and laboratory test results from 345 CHF patients at the baseline visit in our heart failure clinic and examined the hypothesis using...... multiple linear regression models. RESULTS: Age (P = 0.0184), BMI (P = 0.0098), hemoglobin (P = 0.0043), heart rhythm (P proBNP). After adjustment for GFR estimated by the Cockcroft and Gault equation, the parameter...

  8. Comparison of the predictive performance of eGFR formulae for mortality and graft failure in renal transplant recipients.

    LENUS (Irish Health Repository)

    He, Xiang

    2009-02-15

    To date, efforts have focused on assessing estimated glomerular filtration rate (eGFR) formulae against measured GFR. However, a more appropriate clinical gold standard is one conveying a defined clinical disadvantage. In renal transplantation, these measures are mortality and graft failure.

  9. Use of spiral CT and the contrast medium iohexol to determine in one session aortorenal morphology and the relative glomerular filtration rate of each kidney

    Energy Technology Data Exchange (ETDEWEB)

    Frennby, B.; Almen, T. [Malmoe Allmaenna Sjukhus (Sweden). Dept. of Radiology

    2001-11-01

    The aim of this study was to determine the relative glomerular filtration rate (GFR), i.e. the GFR of each kidney in percent of total GFR, by spiral CT. In 41 patients, who were part of a follow-up program after endoluminal stent grafting of aortic aneurysm, spiral CT with the contrast medium iohexol was used to evaluate the morphology of the aorta and kidneys. The opportunity was taken to utilize the already injected iohexol to determine the relative GFR with an extra CT sequence. In each patient two determinations were made, 6 or 12 months apart. The amount of a GFR marker accumulating in Bowman's space, tubuli, and renal pelvis within 2-3 min after i.v. injection, before any marker had left the kidney via the ureter, was defined as proportional to the GFR of that kidney. The renal accumulation of iohexol was obtained by spiral CT using 10-mm collimation and a table speed of 10 mm/s (pitch ratio 1:1) from the upper to the lower poles. The correlation coefficient between the relative GFR of each kidney determined at the first and second examination was excellent (r=0.99) with a median (range) difference of 1% (0-6%) of total GFR. The radiation dose calculated as the mean absorbed dose to the kidneys was 50 mGy and the effective dose 5 mSv. The morphology of aorta and kidneys and the relative GFR of each kidney can be determined in one session with spiral CT using iohexol as both angiographic contrast medium and as a GFR marker. It is also possible to take some plasma samples in the same session to determine iohexol concentration to calculate the body clearance of iohexol (or take plasma and urine samples to calculate the renal clearance of iohexol). (orig.)

  10. Importance of urinary NGAL, serum creatinine standardization and estimated glomerular filtration rate in resistant hypertension.

    Science.gov (United States)

    Prkacin, Ingrid; Ozvald, Ivan; Cavrić, Gordana; Balenović, Diana; Bulum, Tomislav; Flegar-Mestrić, Zlata

    2013-09-01

    In patients with resistant hypertension (RH) we investigated the importance of urinary neutrophil gelatinase-associated lipocalin (uNGAL- a chemiluminescent microparticle immunoassay (CMIA) method became using (Abbott Diagnostics) for the measurement of NGAL in urine samples) and incidence of chronic kidney disease using the Modification of Diet in Renal Disease Study (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in estimating glomerular filtration rate (eGFR) based on standardised serum creatinine method traceable to isotope dilution mass spectrometry (IDMS) method. It would have been difficult to predict that levels of these biomarker would perform better organ damage than traditional measurements of kidney function such as standardised serum creatinine, MDRD, or CKD-EPI equations in special population such as RH. Serum creatinine concentrations were measured in 50 patients (24M:26F from RH Registar in Clinical Hospital Merkur) by the kinetic Jaffe method. There were no significant differences between the GFR values derived by MDRD and CKD-EPI equations in the group of patients with RH. 62% of patients have eGFR > 60 mL/minl/1.73 m2, while a 38% of patients have eGFR < 60 mL/min/1.73 m2. The measurement of NGAL in urine samples of 40 patients with RH showed no difference and seems to be of no use in further determination of renal impairement. Higher value of uNGAL in some resistant hypertension patients could have link in the repair stage after AKI and would reveal pathways that could link AKI and CKD.

  11. Pentosidine levels in nonproteinuric diabetes associated with both low estimated glomerular filtration rate and cataract

    Directory of Open Access Journals (Sweden)

    Lim XL

    2012-06-01

    Full Text Available Xiu-Li Lim,1,* Boon-Wee Teo,2,* Bee-Choo Tai,1 Tien Y Wong,3 Daniel P-K Ng1 1Department of Epidemiology and Public Health, 2Department of Medicine, Yong Loo Lin School of Medicine, National University Health System, 3Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore*Joint first authorsBackground: The main objective of this study was to investigate whether plasma pentosidine levels were associated with cataract and low estimated glomerular filtration rate (eGFR in nonproteinuric type 2 diabetic patients.Methods: We characterized 888 nonproteinuric type 2 diabetic patients residing in Singapore according to their eGFR values. Proteinuria was excluded on the basis of multiple urinalyses. Patients with low renal function (cases, n = 125 and controls (n = 763 were defined as having eGFR < and ≥60 mL/min/1.73 m2, respectively. Pentosidine levels were measured by enzyme-linked immunosorbent assay. Multinomial logistic regression was used to test the association between plasma pentosidine levels and the joint phenotype of cataract and low eGFR.Results: Cases had higher triacylglycerol values, higher systolic blood pressure, and were more likely to be treated with two or more antihypertensive medications. In univariate analysis, cases were potentially more than twice as likely to have had a history of cataract compared with controls. This association persisted in multivariate analyses after adjusting for the significant covariates, hypertension and triacylglycerol, but was attenuated when age was included in the model. Plasma pentosidine levels were significantly higher in cases with low eGFR who also had a history of cataract. This association persisted in multivariate analyses that included the covariates, glycosylated hemoglobin, hypertension, and diabetic retinopathy, as well as age.Conclusion: Carbonyl stress, as reflected by pentosidine levels, is present in a subset of nonproteinuric diabetic patients

  12. Relationship between low glomerular filtration rate, hypertension, and microalbuminuria in type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Vasović Olga

    2005-01-01

    Full Text Available Aim. To investigate the influence of low glomerular filtration rate, as well as of systolic and diastolic hypertension, on microalbuminuria in patients with type 1 diabetes mellitus. Methods. Twenty seven patients with type 1 diabetes mellitus (18 males, 9 females were studied. All of the patients were below 50 years of age. In 93% of the cases, the duration of diabetes was less than 15 years. GFR was determined, after intravenous injection in the lying position, by using a 99m-Tc-DTPA, while microalbuminuria was calculated for the 24-hour urine using the nephelometric immunoassay (30−300 mg/24 h. The patients were divided into 3 groups according to the value of GFR. The values ranged from 90 to 125 ml/min/1.73 m2 were considered normal (in 63% of the patients in group 1, those above that range were considered as hyperfiltration (in 22.2% of the patients in group 2, while those below that range were considered as hypofiltration (in 13.8% of the patient in group 3. Results. Data analyzed with the one-way ANOVA, indicated a significant statistical difference between the 3 groups in the duration of diabetes (p < 0.05, microalbuminuria (p < 0.01, systolic BP (p < 0.01, diastolic BP (p < 0.05, fructosamine (p = 0.50, urea (p < 0.05, creatinine (p = 0.05, and uric acid (p < 0.05. Microalbuminuria correlated with the age of patients (p <0.05 (Spearman's rho, diabetes mellitus duration (p < 0.01, systolic BP (p < 0.05, diastolic BP (p < 0.05, LDL cholesterol (p < 0.05. There was no statistically significant correlation between GFR and the other parameters. Hypertension, microalbuminuria, and the duration of diabetes correlated positively with the reduction of GFR, revealing the most frequent reduction of GFR in the patients with more than 15-year duration of diabetes. Conclusions. Hypertension and low GFR were associated with microalbuminuria in type 1 diabetes, while the duration of diabetes was shown to be the independent risk factor for the

  13. Association of CYBA rs7195830 polymorphism with estimated glomerular filtration rate in an adult Han sample from Jiangsu province, China

    Institute of Scientific and Technical Information of China (English)

    FAN Kuan-lu; ZHANG Hai-feng; ZHU Zhen-yan; YAO Wen-ming; SHEN Jie; LIANG Ning-xia; GONG Lei

    2013-01-01

    Background Reactive oxygen species are thought to contribute to the development of renal damage.The P22phox subunit of nicotinamide adenine dinucleotide phosphate (NAPDH) oxidase,encoded by the cytochrome b245α polypeptide gene,CYBA,plays a key role in superoxide anion production.We investigated the association of CYBA rs7195830 polymorphism with estimated glomerular filtration rate (eGFR) and the role it plays in the pathogenesis of chronic kidney disease (CKD) in a Han Chinese sample.Methods The Gaoyou study enrolled 4473 participants.Serum levels of creatinine were measured and eGFR was estimated using the Chronic Kidney Disease Epidemiology Collaboration equations.The CYBA polymorphisms were genotyped.Then we investigated the association between eGFR and the rs7195830 polymorphism in the recessive model.Results The AA genotype of rs7195830 was associated with significantly lower values of eGFR compared with the GG and AG genotypes ((102.76±17.07) ml·min-1·1.73 m2 vs.(105.08±16.30) ml·min-1·1.73 m-2).The association remained significant in the recessive model after adjusting for age,gender,body mass index,smoking,hypertension,diabetes mellitus,uric acid,triglyceride,low density lipoprotein cholesterol and high density lipoprotein cholesterol (β=1.666,P=0.031).The rs7195832 AA genotype was an independent risk factor for CKD:eGFR <60 ml·min-1·1.73 m2 (odds ratio=3.32; 95% C/=1.21-9.13).Conclusion The AA genotype of rs7195830 is independently associated with lower estimated glomerular filtration rate and is significantly associated with CKD.

  14.  A Comparison of Serum Cystatin C and Creatinine with Glomerular FiltrationRate in Indian Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Ramanathan Kumaresan

    2011-11-01

    Full Text Available  Objectives: There is no literature available on the performance of cystatin C in Chronic Kidney Disease (CKD patients of Indian population based on age group. Hence, this study is aimed to compare the diagnostic performance of serum cystatin C and creatinine with measured glomerular filtration rate (GFR and estimated GFR (eGFR in subjects of Indian origin. Methods: The study was carried out at Tiruchirappalli, South India during the period of September 2010 to march 2011. One hundred and six CKD patients (82 males, 24 females were enrolled and categorized into three groups based on age. The eGFR was calculated using Cockcroft-Gault (CG and Modification of Diet in Renal Disease (MDRD formulae. Serum cystatin C was measured with a particle-enhanced nephelometric immunoassay (PENIA method. GFR was measured using 99mTC - diethylene triamine penta aceticacid (DTPA renal scan method. Results: Serum cystatin C showed significant correlation with measured GFR in all the three groups (r=-0.9735, r=-0.8975 and r=-0.7994 respectively than serum creatinine (r=-0.7380, r=- 0.6852 and r=-0.5127 respectively. Conclusion: Serum cystatin C showed a high correlation with measured GFR in young and older patients with CKD than creatinine. Thus, cystatin C is a good alternative marker to creatinine in CKD patients.

  15. Is Increased Echogenicity Related to a Decrease in Glomerular Filtration Rate? Objective Measurements in Pediatric Solitary Kidney Patients--A Retrospective Analysis.

    Directory of Open Access Journals (Sweden)

    Yong Seung Lee

    Full Text Available Quantitative measurements of renal echogenicity using a graphic program show close correlation with renal histology in adult patients, but this has neither been applied in pediatric patients nor correlated with glomerular filtration rate (GFR. To determine the direct relationship between echogenicity and GFR, we retrospectively analyzed 91 patients with a solitary functioning kidney under the age of 10, who underwent ultrasonography and serum cystatin C evaluation on a single day between January 2013 and December 2014. Echogenicity was quantified as previously reported. Echogenicity and kidney length were correlated with age-matched values of serum cystatin C-based GFR. Evaluation was performed at a median age of 17.1 months. GFR was low for age in eight of 54 right solitary kidney patients and four of 37 left solitary kidney patients. The right kidney-liver ratio was significantly elevated in the right decreased GFR group, while the left kidney-spleen ratio was not different in the left decreased GFR group. Age-matched longitudinal kidney length ratios were similar between the decreased and normal GFR groups for both sides. This is the first report to objectively prove the relationship between echogenicity and renal function in patients with a right solitary kidney. The right kidney-liver echogenicity ratio, measured objectively, showed feasibility in clinical practice as it showed a close relationship with decreased renal function when increased. However, absolute kidney echogenicity values, or the left kidney-spleen echogenicity ratio, were not independent markers for decreased renal function.

  16. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys...

  17. GFR prediction from cystatin C and creatinine in children: body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys...

  18. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys...

  19. Glomerular filtration rate and proteinuria: association with mortality and renal progression in a prospective cohort of a community-based elderly population.

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    Se Won Oh

    Full Text Available Limited prospective data are available on the importance of estimated glomerular filtration rate (GFR and proteinuria in the prediction of all-cause mortality (ACM in community-based elderly populations. We examined the relationship between GFR or proteinuria and ACM in 949 randomly selected community-dwelling elderly subjects (aged ≥65 years over a 5-year period. A spot urine sample was used to measure proteinuria by the dipstick test, and GFR was estimated using the chronic kidney disease-epidemiology collaboration (CKD-EPI equation. Information about mortality and causes of death was collected by direct enquiry with the subjects and from the national mortality data. Compared to subjects without proteinuria, those with proteinuria of grade ≥1+ had a 1.725-fold (1.134-2.625 higher risk of ACM. Compared to subjects with GFR ≥90 ml/min/1.73 m2, those with GFR<45 ml/min/1.73 m2 had a 2.357 -fold (1.170-4.750 higher risk for ACM. Among the 403 subjects included in the analysis of renal progression, the annual rate of GFR change during follow-up period was -0.52±2.35 ml/min/1.73 m2/year. The renal progression rate was 7.315-fold (1.841-29.071 higher in subjects with GFR<60 ml/min/1.73 m2 than in those with GFR ≥60 ml/min/1.73 m2. Among a community-dwelling elderly Korean population, decreased GFR of <45 ml/min/1.73 m2 and proteinuria were independent risk factors for ACM.

  20. The giraffe kidney tolerates high arterial blood pressure by high renal interstitial pressure and low glomerular filtration rate.

    Science.gov (United States)

    Damkjaer, M; Wang, T; Brøndum, E; Østergaard, K H; Baandrup, U; Hørlyck, A; Hasenkam, J M; Smerup, M; Funder, J; Marcussen, N; Danielsen, C C; Bertelsen, M F; Grøndahl, C; Pedersen, M; Agger, P; Candy, G; Aalkjaer, C; Bie, P

    2015-08-01

    The tallest animal on earth, the giraffe (Giraffa camelopardalis) is endowed with a mean arterial blood pressure (MAP) twice that of other mammals. The kidneys reside at heart level and show no sign of hypertension-related damage. We hypothesized that a species-specific evolutionary adaption in the giraffe kidney allows normal for size renal haemodynamics and glomerular filtration rate (GFR) despite a MAP double that of other mammals. Fourteen anaesthetized giraffes were instrumented with vascular and bladder catheters to measure glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). Renal interstitial hydrostatic pressure (RIHP) was assessed by inserting a needle into the medullary parenchyma. Doppler ultrasound measurements provided renal artery resistive index (RI). Hormone concentrations as well as biomechanical, structural and histological characteristics of vascular and renal tissues were determined. GFR averaged 342 ± 99 mL min(-1) and ERPF 1252 ± 305 mL min(-1) . RIHP varied between 45 and 140 mmHg. Renal pelvic pressure was 39 ± 2 mmHg and renal venous pressure 32 ± 4 mmHg. A valve-like structure at the junction of the renal and vena cava generated a pressure drop of 12 ± 2 mmHg. RI was 0.27. The renal capsule was durable with a calculated burst pressure of 600 mmHg. Plasma renin and AngII were 2.6 ± 0.5 mIU L(-1) and 9.1 ± 1.5 pg mL(-1) respectively. In giraffes, GFR, ERPF and RI appear much lower than expected based on body mass. A strong renal capsule supports a RIHP, which is >10-fold that of other mammals effectively reducing the net filtration pressure and protecting against the high MAP. © 2015 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  1. Variability of glomerular filtration rate estimation equations in elderly Chinese patients with chronic kidney disease

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    Liu X

    2012-10-01

    Full Text Available Xun Liu,1,2,* Mu-hua Cheng,3,* Cheng-gang Shi,1 Cheng Wang,1 Cai-lian Cheng,1 Jin-xia Chen,1 Hua Tang,1 Zhu-jiang Chen,1 Zeng-chun Ye,1 Tan-qi Lou11Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yet-sun University, Guangzhou, China; 2College of Biology Engineering, South China University of Technology, Guangzhou, China; 3Department of Nuclear Medicine, The Third Affiliated Hospital of Sun Yet-sun University, Guangzhou, China *These authors contributed equally to this paperBackground: Chronic kidney disease (CKD is recognized worldwide as a public health problem, and its prevalence increases as the population ages. However, the applicability of formulas for estimating the glomerular filtration rate (GFR based on serum creatinine (SC levels in elderly Chinese patients with CKD is limited.Materials and methods: Based on values obtained with the technetium-99m diethylenetriaminepentaacetic acid (99mTc-DTPA renal dynamic imaging method, 319 elderly Chinese patients with CKD were enrolled in this study. Serum creatinine was determined by the enzymatic method. The GFR was estimated using the Cockroft–Gault (CG equation, the Modification of Diet in Renal Disease (MDRD equations, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI equation, the Jelliffe-1973 equation, and the Hull equation.Results: The median of difference ranged from −0.3–4.3 mL/min/1.73 m2. The interquartile range (IQR of differences ranged from 13.9–17.6 mL/min/1.73 m2. Accuracy with a deviation less than 15% ranged from 27.6%–32.9%. Accuracy with a deviation less than 30% ranged from 53.6%–57.7%. Accuracy with a deviation less than 50% ranged from 74.9%–81.5%. None of the equations had accuracy up to the 70% level with a deviation less than 30% from the standard glomerular filtration rate (sGFR. Bland–Altman analysis demonstrated that the mean difference ranged from −3.0–2.4 mL/min/1.73 m2. However, the

  2. Application of creatinine- and/or cystatin C-based glomerular filtration rate estimation equations in elderly Chinese

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    Ye XS

    2014-09-01

    Full Text Available Xiaoshuang Ye,1 Lu Wei,1 Xiaohua Pei,1 Bei Zhu,1 Jianqing Wu,2 Weihong Zhao1 1Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China; 2Division of Respiration, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China Background: No conventional creatinine- or cystatin C-based glomerular filtration rate (GFR estimation equation performed consistently outstandingly in elderly Chinese in our previous studies. This research aimed to further evaluate the performance of some recently proposed estimation equations based on creatinine and cystatin C, alone or combined, in this specific population. Materials and methods: The equations were validated in a population totaling 419 participants (median age 68 [range 60–94] years. The estimated GFR (eGFR calculated separately by ten equations was compared with the reference GFR (rGFR measured by the 99mTc-DTPA renal dynamic imaging method. Results: Median serum creatinine, cystatin C, and rGFR levels were 0.93 mg/L, 1.13 mg/L, and 74.20 mL/min/1.73 m2, respectively. The Chinese population-developed creatinine- and cystatin C-based (Cscr-cys equation yielded the least median absolute difference (8.81 vs range 9.53–16.32, P<0.05, vs the Chronic Kidney Disease Epidemiology Collaboration serum creatinine equation, the highest proportion of eGFR within 15% and 30% of rGFR (P15 and P30, 55.13 and 85.44, P<0.05 and P<0.01, vs the Chronic Kidney Disease Epidemiology Collaboration serum creatinine equation, and the lowest root mean square error (14.87 vs range 15.30–22.45 in the whole cohort. A substantial agreement of diagnostic consistency between eGFR and rGFR (with a kappa 0.61–0.80 was also observed with the Cscr-cys equation. Moreover, measures of performance in the Cscr-cys equation were consistent across normal to mildly

  3. Association of metabolic syndrome with decreased glomerular filtration rate among 75,468 Chinese adults: a cross-sectional study.

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    Hui Song

    Full Text Available The impact of the various elements of metabolic syndrome (MetS on chronic kidney disease (CKD has been conflicting. Therefore, in the present study we aimed to examine the association of MetS and its components with decreased glomerular filtration rate (GFR.A total of 75,468 urban workers who underwent annual health examinations under the auspices of the local governments between March 2010 and September 2012 at the health examination center of Xuzhou center hospital were enrolled in the cross-sectional survey. Decreased GFR was defined as an estimated GFR <60 mL/min per 1.73 m2. The definition of MetS was based on the most-recent interim joint consensus definition, requiring any three of the five components, consisting of elevated blood pressure (BP, fasting plasma glucose (FPG, or triglycerides (TG, reduced high density lipoprotein-cholesterol (HDL-c, and obesity.MetS was related to the reduced GFR with an odds ratio [95% confidence interval (CI] of 1.43 (1.13-1.83. In multivariable analyses, individual components of MetS that were independently associated with decreased GFR were elevated BP (OR 1.34, 95% CI 1.00-1.78, low HDL-c (OR 1.88, 95% CI 1.44-2.43, and elevated FPG (OR 1.42, 95% CI 1.09-1.85. The age-adjusted population-attributable risk percent (PARP for reduced GFR was 27.55%, 19.67% and14.31% for elevated BP, low HDL-c and elevated FPG respectively. The multivariate-adjusted odds ratios (95% CI of decreased GFR were 1.70(1.11-2.60, 2.38(1.53-3.71, or 4.11(2.42-6.98 for those with 1, 2, or 3 critical elements (versus zero, respectively. The corresponding multivariate-adjusted odds ratios (95% CI of decreased GFR were 1.11(0.84-1.48 and 0.89(0.63-1.27 for those with 1 or 2 noncritical components (versus zero, respectively.We concluded that various elements of MetS and the cumulative number of MetS should not be considered indiscriminately as risk factors for reduced GFR.

  4. Correlation between Serum Lipid Levels and Measured Glomerular Filtration Rate in Chinese Patients with Chronic Kidney Disease

    Science.gov (United States)

    Wang, Caixia; Ye, Zengchun; Li, Shaomin; Liu, Qiong; Lou, Tanqi

    2016-01-01

    Introduction Dyslipidemia is often detected in patients with chronic kidney disease (CKD). Previous studies of the relationship between lipid profiles and kidney function have yielded variable results. We aimed to investigate the correlation between serum lipid levels and kidney function evaluated by measured glomerular filtration rate (mGFR) in Chinese patients with CKD. Methods A cross-sectional study was conducted on 2036 Chinese CKD patients who had mGFR. Linear regression analysis was performed to evaluate the correlation between different serum lipid levels and mGFR, while logistic regression analysis was used to investigate the association between CKD stages and the risk of different types of dyslipidemia. Results The mean age was 55 years and the mean mGFR was 63 mL/min/1.73m2. After adjusting for some confounders (age, gender, body mass index, a history of diabetes, fasting glucose, a history of hypertension, systolic blood pressure, diastolic blood pressure, smoking status, hemoglobin, serum potassium, serum albumin, and serum uric acid), serum triglyceride level showed a negative correlation with mGFR (β = -0.006, P = 0.006) in linear regression analysis, and CKD stages were positively related to the risk of hypertriglyceridemia (odds ratios were 1.329, 1.868, 2.514 and P were 0.046, < 0.001, < 0.001 for CKD stage 2, 3, 4/5, respectively) in logistic regression anlysis. Conclusions Serum triglyceride level is independently association with mGFR. Patients with reduced kidney function are more likely to have higher serum triglyceride levels. Further longitudinal, multicenter and well-conducted studies are needed to provide more evidence. PMID:27695128

  5. Comparison of glomerular filtration rate measured between anterior and posterior image processing using Gates’ method in an ectopic pelvic kidney

    Science.gov (United States)

    Li, Na; Li, Baojun; Liang, Wenli

    2016-01-01

    Objective The aim of this study was to evaluate the difference in measured glomerular filtration rate (GFR) of an ectopic pelvic kidney between anterior and posterior image processing using Gates’ method of renal dynamic imaging. Methods A total of 10 patients were studied retrospectively, with a single ectopic kidney in the pelvic cavity and a contralateral kidney at its normal anatomical position confirmed by ultrasound, computed tomography, renal dynamic imaging, etc. All images of ectopic kidneys were processed, and GFRs were measured using anterior and posterior Gates’ method of renal dynamic imaging, respectively. The contralateral normal kidney was only processed on posterior imaging. The total GFRant of one patient, which was equal to the sum of the GFR of a normal kidney on posterior imaging and the GFR of an ectopic kidney on anterior imaging, was compared with the total GFRpost of two kidneys on posterior imaging, with the GFRtwo-sample from the two-sample method, and with the estimated GFR in the Chronic Kidney Disease Epidemiology Collaboration equation. All correlation analyses were carried out between GFRs obtained from three methods, and all patients were followed up. For statistical analysis, nonparametric rank tests were used, Bland-Altman graphs were plotted. Results The mean GFR of the ectopic kidney on anterior imaging was 27.48±12.24 ml/min/1.73 m2. It was higher than the GFR (10.71±4.74 ml/min/1.73 m2) on posterior imaging (t=−2.803, P0.05), but there were statistical differences in the accuracy within 10% of the total GFRant and that of the total GFRpost (Pectopic pelvic kidney in renal dynamic imaging. PMID:26867167

  6. Independent or synergistic relationship of proteinuria and glomerular filtration rate on patient and renal survival in patients with glomerulonephritis?

    Science.gov (United States)

    Haider, Dominik G; Masghati, Salome; Goliasch, Georg; Fuhrmann, Valentin; Soleiman, Afschin; Wolzt, Michael; Baierl, Andreas; Druml, Wilfred; Hörl, Walter H

    2014-12-01

    Glomerular filtration rate (GFR) in patients with chronic kidney disease (CKD) identifies patients at risk for death or end-stage renal disease (ESRD). CKD staging by GFR should incorporate proteinuria to augment risk stratification. We therefore tested the predictive power of the combination of GFR with proteinuria in patients with different histologically-diagnosed types of glomerulonephritis (GN). In a retrospective analysis, 2,687 patients with different forms of GN from 123 Austrian centres were investigated. Full data sets were available from 1,892 subjects. Classes of CKD on the basis of estimated GFR (eGFR) and of proteinuria grouped as 3.5 g/24 h were tested for their association with all-cause mortality and ESRD. During a median follow-up of 130 months [interquartile range (IQR) 90; 178] 478 patients (25.3 %) died. Median eGFR was 49 ml/min/1.73 m(2) (IQR 24; 81) and proteinuria 3.8 g/24 h (IQR 1.7; 8.0). Adjusted multivariate Cox regression indicated that renal survival but not overall survival is related to proteinuria >3.5 g/24 h [as opposed to proteinuria >3.5 g/24 h exists only in patients with immunoglobulin (Ig)A GN (HR 4.93), miscellaneous GN (HR 1.74), and CKD stage 5 (HR 2.50). Additionally, proteinuria is a risk factor for renal survival in males more than in females with GN and proteinuria >3.5 g/24 h (HR 1.91). Proteinuria is a strong risk factor for renal survival particularly in patients with proteinuria >3.5 g/24 but not for all types of GN, nor for all CKD stages. Proteinuria is not a risk factor for overall survival in patients with GN.

  7. Improved equations estimating GFR in children with chronic kidney disease using an immunonephelometric determination of cystatin C.

    Science.gov (United States)

    Schwartz, George J; Schneider, Michael F; Maier, Paula S; Moxey-Mims, Marva; Dharnidharka, Vikas R; Warady, Bradley A; Furth, Susan L; Muñoz, Alvaro

    2012-08-01

    The Chronic Kidney Disease in Children study is a cohort of about 600 children with chronic kidney disease (CKD) in the United States and Canada. The independent variable for our observations was a measurement of glomerular filtration rate(GFR) by iohexol disappearance (iGFR) at the first two visits 1 year apart and during alternate years thereafter. In a previous report, we had developed GFR estimating equations utilizing serum creatinine, blood urea nitrogen, height, gender, and cystatin C measured by an immunoturbidimetric method; however, the correlation coefficient of cystatin C and GFR(0.69) was less robust than expected. Therefore, 495 samples were re-assayed using immunonephelometry. The reciprocal of immunonephelometric cystatin C was as well correlated with iGFR as was height/serum creatinine (both 0.88). We developed a new GFR estimating equation using a random 2/3 of 965 person-visits and applied it to the remaining 1/3 as a validation data set. In the validation dataset, the correlation of the estimated GFR with iGFR was 0.92 with high precision and no bias; 91 and 45% of eGFR values were within 30 and 10% of iGFR, respectively. This equation works well in children with CKD in a range of GFR from 15 to 75 ml/min per 1.73 m2. Further studies are needed to establish the applicability to children of normal stature and muscle mass, and higher GFR.

  8. Limited value of cystatin-C over estimated glomerular filtration rate for heart failure risk stratification.

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    Elisabet Zamora

    Full Text Available BACKGROUND: To compare the prognostic value of estimated glomerular filtration rate, cystatin-C, an alternative renal biomarker, and their combination, in an outpatient population with heart failure. Estimated glomerular filtration rate is routinely used to assess renal function in heart failure patients. We recently demonstrated that the Cockroft-Gault formula is the best among the most commonly used estimated glomerular filtration rate formulas for predicting heart failure prognosis. METHODOLOGY/PRINCIPAL FINDINGS: A total of 879 consecutive patients (72% men, age 70.4 years [P(25-75 60.5-77.2] were studied. The etiology of heart failure was mainly ischemic heart disease (52.7%. The left ventricular ejection fraction was 34% (P(25-75 26-43%. Most patients were New York Heart Association class II (65.8% or III (25.9%. During a median follow-up of 3.46 years (P(25-75 1.85-5.05, 312 deaths were recorded. In an adjusted model, estimated glomerular filtration rate and cystatin-C showed similar prognostic value according to the area under the curve (0.763 and 0.765, respectively. In Cox regression, the multivariable analysis hazard ratios were 0.99 (95% CI: 0.98-1, P = 0.006 and 1.14 (95% CI: 1.02-1.28, P = 0.02 for estimated glomerular filtration rate and cystatin-C, respectively. Reclassification, assessed by the integration discrimination improvement and the net reclassification improvement indices, was poorer with cystatin-C (-0.5 [-1.0;-0.1], P = 0.024 and -4.9 [-8.8;-1.0], P = 0.013, respectively. The value of cystatin-C over estimated glomerular filtration rate for risk-stratification only emerged in patients with moderate renal dysfunction (eGFR 30-60 ml/min/1.73 m(2, chi-square 12.9, P<0.001. CONCLUSIONS/SIGNIFICANCE: Taken together, the results indicate that estimated glomerular filtration rate and cystatin-C have similar long-term predictive values in a real-life ambulatory heart failure population. Cystatin-C seems to

  9. Sampling Rate Independent Filtration Approach for Automatic ECG Delineation

    CERN Document Server

    Chereda, Hryhorii; Tymoshenko, Yury

    2016-01-01

    In this paper different types of ECG automatic delineation approaches were overviewed. A combination of these approaches was used to create sampling rate independent filtration algorithm for automatic ECG delineation that is capable of distinguishing different morphologies of T and P waves and QRS complexes. Created filtration algorithm was compared with algorithme \\`a trous. It was investigated that continuous wavelets transform with proposed automatic adaptation for different sampling rates procedure can be used for delineation problem.

  10. Estimated glomerular filtration rate is a poor predictor of the concentration of middle molecular weight uremic solutes in chronic kidney disease.

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    Nathalie Neirynck

    Full Text Available BACKGROUND: Uremic solute concentration increases as Glomerular Filtration Rate (GFR declines. Weak associations were demonstrated between estimated GFR (eGFR and the concentrations of several small water-soluble and protein-bound uremic solutes (MW500 Da. MATERIALS AND METHODS: In 95 CKD-patients (CKD-stage 2-5 not on dialysis, associations between different eGFR-formulae (creatinine, Cystatin C-based or both and the natural logarithm of the concentration of several LMWP's were analyzed: i.e. parathyroid hormone (PTH, Cystatin C (CystC, interleukin-6 (IL-6, tumor necrosis factor-alpha (TNF-α, leptin, retinol binding protein (RbP, immunoglobin light chains kappa and lambda (Ig-κ and Ig-λ, beta-2-microglobulin (β(2M, myoglobin and fibroblast growth factor-23 (FGF-23. RESULTS: The regression coefficients (R(2 between eGFR, based on the CKD-EPI-Crea-CystC-formula as reference, and the examined LMWP's could be divided into three groups. Most of the LMWP's associated weakly (R(2 0.7. Almost identical R(2-values were found per LMWP for all eGFR-formulae, with exception of CystC and β(2M which showed weaker associations with creatinine-based than with CystC-based eGFR. CONCLUSION: The association between eGFR and the concentration of several LMWP's is inconsistent, with in general low R(2-values. Thus, the use of eGFR to evaluate kidney function does not reflect the concentration of several LMWP's with proven toxic impact in CKD.

  11. Comparing Results of Five Glomerular Filtration Rate-Estimating Equations in the Korean General Population: MDRD Study, Revised Lund-Malmö, and Three CKD-EPI Equations

    Science.gov (United States)

    Ji, Misuk; Lee, Yoon-Hee; Kim, Hyesun; Cho, Han-Ik; Yang, Hyun Suk; Navarin, Silvia; Di Somma, Salvatore

    2016-01-01

    Background Estimated glomerular filtration rate (eGFR) is a widely used index of kidney function. Recently, new formulas such as the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations or the Lund-Malmö equation were introduced for assessing eGFR. We compared them with the Modification of Diet in Renal Disease (MDRD) Study equation in the Korean adult population. Methods The study population comprised 1,482 individuals (median age 51 [42-59] yr, 48.9% males) who received annual physical check-ups during the year 2014. Serum creatinine (Cr) and cystatin C (CysC) were measured. We conducted a retrospective analysis using five GFR estimating equations (MDRD Study, revised Lund-Malmö, and Cr and/or CysC-based CKD-EPI equations). Reduced GFR was defined as eGFR <60 mL/min/1.73 m2. Results For the GFR category distribution, large discrepancies were observed depending on the equation used; category G1 (≥90 mL/min/1.73 m2) ranged from 7.4-81.8%. Compared with the MDRD Study equation, the other four equations overestimated GFR, and CysC-based equations showed a greater difference (-31.3 for CKD-EPICysC and -20.5 for CKD-EPICr-CysC). CysC-based equations decreased the prevalence of reduced GFR by one third (9.4% in the MDRD Study and 2.4% in CKD-EPICysC). Conclusions Our data shows that there are remarkable differences in eGFR assessment in the Korean population depending on the equation used, especially in normal or mildly decreased categories. Further prospective studies are necessary in various clinical settings. PMID:27578504

  12. Impact of nucleos(t)ide analogues on the estimated glomerular filtration rate in patients with chronic hepatitis B: a prospective cohort study in China.

    Science.gov (United States)

    Qi, X; Wang, J-Y; Mao, R-C; Zhang, J-M

    2015-01-01

    Chronic hepatitis B therapy with nucleos(t)ide analogues, particularly tenofovir or adefovir, may affect renal function. To date, there has not been a head-to-head controlled study to assess estimated glomerular filtration rate (eGFR) fluctuations in nucleos(t)ide-treated CHB patients. We aimed to evaluate the long-term effects of nucleos(t)ide on eGFR in Chinese patients with chronic hepatitis B. This prospective cohort study included 275 patients. Patient subgroups included those treated with lamivudine (n = 50), adefovir (n = 60), telbivudine (n = 68) and entecavir (n = 61); untreated patients (n = 36) served as control. After an average follow-up duration of 23 months, eGFR calculated by Cockcroft-Gault and Modification of Diet in Renal Disease formulas increased by 18.35 mL/min and 19.34 mL/min (P < 0.0001) in the telbivudine group, respectively, and decreased by 10.95 mL/min and 12.17 mL/min (P = 0.0001) in the adefovir group, respectively. Even if renal function was normal or mildly impaired at baseline, eGFR increased significantly more in the telbivudine group than in the other groups (P < 0.001). More patients in the adefovir group (23%) had a ≥20% decrease in eGFR than the other groups (P < 0.0001). More patients in the telbivudine group (31%) had a ≥20% increase in eGFR than the other groups (P < 0.0001). In conclusion, prolonged telbivudine therapy resulted in improved eGFR, while adefovir therapy was associated with decreased eGFR. Lamivudine and entecavir therapy did not significantly influence eGFR.

  13. Triglyceride levels are closely associated with mild declines in estimated glomerular filtration rates in middle-aged and elderly Chinese with normal serum lipid levels.

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    Xinguo Hou

    Full Text Available OBJECTIVE: To investigate the relationship between lipid profiles [including total cholesterol (TC, triglyceride (TG, low-density lipoprotein cholesterol (LDL-C and high-density lipoprotein cholesterol (HDL-C] and a mild decline in the estimated glomerular filtration rate (eGFR in subjects with normal serum lipid levels. DESIGN AND METHODS: In this study, we included 2647 participants who were ≥ 40 years old and had normal serum lipid levels. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI equation was used to estimate the GFR. A mildly reduced eGFR was defined as 60-90 mL/min/1.73 m(2. First, multiple linear regression analysis was used to estimate the association of lipid profiles with the eGFR. Then, the levels of each lipid component were divided into four groups, using the 25th, 50th and 75th percentiles as cut-off points. Finally, multiple logistic regression analysis was used to investigate the association of different lipid components with the risk of mildly reduced eGFR. RESULTS: In the group with a mildly reduced eGFR, TG and LDL-C levels were significantly increased, but HDL-C levels were significantly decreased. After adjusting for age, gender, body mass index (BMI, systolic blood pressure (SBP, glycated hemoglobin (HbA1c, smoking and drinking, only TC and TG were independently related to the eGFR. Additionally, only TG showed a linear relationship with an increased risk of a mildly reduced eGFR, with the highest quartile group (TG: 108-150 mg/dl [1.22-1.70 mmol/L] having a significantly increased risk after adjusting for the above factors. CONCLUSIONS: Triglyceride levels are closely associated with a mildly reduced eGFR in subjects with normal serum lipid levels. Dyslipidemia with lower TG levels could be used as new diagnostic criteria for subjects with mildly reduced renal function.

  14. Estimating kidney function in HIV-infected adults in Kenya: comparison to a direct measure of glomerular filtration rate by iohexol clearance.

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    Christina M Wyatt

    Full Text Available BACKGROUND: More than two-thirds of the world's HIV-positive individuals live in sub-Saharan Africa, where genetic susceptibility to kidney disease is high and resources for kidney disease screening and antiretroviral therapy (ART toxicity monitoring are limited. Equations to estimate glomerular filtration rate (GFR from serum creatinine were derived in Western populations and may be less accurate in this population. METHODS: We compared results from published GFR estimating equations with a direct measure of GFR by iohexol clearance in 99 HIV-infected, ART-naïve Kenyan adults. Iohexol concentration was measured from dried blood spots on filter paper. The bias ratio (mean of the ratio of estimated to measured GFR and accuracy (percentage of estimates within 30% of the measured GFR were calculated. RESULTS: The median age was 35 years, and 60% were women. The majority had asymptomatic HIV, with median CD4+ cell count of 355 cells/mm(3. Median measured GFR was 115 mL/min/1.73 m(2. Overall accuracy was highest for the Chronic Kidney Disease Epidemiology Consortium (CKD-EPI equation. Consistent with a prior report, bias and accuracy were improved by eliminating the coefficient for black race (85% of estimates within 30% of measured GFR. Accuracy of all equations was poor in participants with GFR 60-90 mL/min/1.73 m(2 (<65% of estimates within 30% of measured GFR, although this subgroup was too small to reach definitive conclusions. CONCLUSIONS: Overall accuracy was highest for the CKD-EPI equation. Eliminating the coefficient for race further improved performance. Future studies are needed to determine the most accurate GFR estimate for use in individuals with GFR <90 mL/min/1.73 m(2, in whom accurate estimation of kidney function is important to guide drug dosing. Direct measurement of GFR by iohexol clearance using a filter paper based assay is feasible for research purposes in resource-limited settings, and could be used to develop more accurate

  15. Estimated glomerular filtration rate in sickle cell anemia is associated with polymorphisms of bone morphogenetic protein receptor 1B.

    Science.gov (United States)

    Nolan, Vikki G; Ma, Qianli; Cohen, Herbert T; Adewoye, Adeboye; Rybicki, Anne C; Baldwin, Clinton; Mahabir, Rhea N; Homan, Erica P; Wyszynski, Diego F; Fabry, Mary E; Nagel, Ronald L; Farrer, Lindsay A; Steinberg, Martin H

    2007-03-01

    Renal disease is common in sickle cell anemia. In this exploratory work, we used data from a longitudinal study of the natural history of sickle cell disease to examine the hypothesis that polymorphisms (SNPs) in selected candidate genes are associated with glomerular filtration rate (GFR). DNA samples and clinical and laboratory data were available for 1,140 patients with sickle cell anemia. GFR was estimated using the Cockcroft-Gault and Schwartz formulas for adults and children, respectively. We examined approximately 175 haplotype tagging (ht) SNPs in about 70 genes of the TGFbeta/BMP pathway for their association with GFR using linear regression. Four SNPs in BMPR1B, a bone morphogenetic protein (BMP) receptor gene, yielded statistically significant associations (P values ranging from 0.015 to 0.046). Three haplotypes in this gene were also associated with GFR. The TGF-beta/BMP pathway has been associated with the development of diabetic nephropathy, which has some features in common with sickle cell nephropathy. Our results suggest that, as with other subphenotypes of sickle cell disease, renal function may be genetically modulated.

  16. Increased kidney size, glomerular filtration rate and renal plasma flow in short-term insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Christiansen, JS; Gammelgaard, J; Frandsen, M;

    1981-01-01

    Glomerular filtration rate (GFR), renal plasma flow (RPF) and kidney volume were measured in thirteen male subjects (mean age 30 years) with short-term insulin-dependent diabetes (mean duration of disease 2.4 years) and fourteen normal male subjects (mean age 29 years). GFR and RPF were measured...... by constant infusion technique using I125-iothalamate and 131I-hippuran. Kidney size was determined by means of ultrasound. GFR, RPF and kidney volume were increased in the diabetic patients compared to the normal controls, 144 versus 113 ml/min X 1.73 m2 (p less than 0.0005), 627 versus 523 ml/min X 1.73 m2...... (p less than 0.0025) and 278 versus 224 ml/1.73 m2 (p less than 0.0005) respectively. Combining results from diabetic patients and controls revealed a positive correlation between kidney size and GFR (r = 0.70, p less than 0.001) and between kidney size and RPF (r = 0.61, p less than 0.001). Within...

  17. Association between serum insulin-like growth factor I or IGF-binding protein 3 and estimated glomerular filtration rate: results of a population-based sample

    Directory of Open Access Journals (Sweden)

    Dittmann Kathleen

    2012-12-01

    Full Text Available Abstract Background Insulin-like growth factor I (IGF-I, which is mostly carried in blood by IGF-binding protein 3 (IGFBP-3, was associated to the glomerular filtration rate and chronic kidney disease in a multiethnic study among US adults. The aim of the present study was to investigate whether serum IGF-I or IGFBP-3 are associated with estimated glomerular filtration rate (eGFR in a population-based study of Caucasian adults. Methods Data from 4028 subjects (2048 women aged 20 to 81 years from the Study of Health in Pomerania (SHIP were analyzed. Total serum IGF-I and IGFBP-3 concentrations were determined by chemiluminescence immunoassays and categorized into sex- and age-specific quartiles. Results After adjusting for age, waist circumference and type 2 diabetes mellitus, analysis of variance (ANOVA revealed inverse associations between serum IGF-I concentrations and eGFR in men as well as between serum IGFBP-3 concentrations and eGFR in men and women. Logistic regression analyses confirmed these findings and showed that high IGF-I or IGFBP-3 concentrations were associated with an increased risk of decreased eGFR (2 in men or women. These relations became stronger when lower eGFR cut-offs were used for the analyses. Conclusion Our data revealed associations of increased serum IGF-I concentrations and decreased eGFR in men but not in women and an association of increased serum IGFBP-3 concentrations and decreased eGFR in both sexes.

  18. Angiotensin II and renal prostaglandin release in the dog. Interactions in controlling renal blood flow and glomerular filtration rate.

    Science.gov (United States)

    Bugge, J F; Stokke, E S

    1994-04-01

    The relationship between angiotensin II and renal prostaglandins, and their interactions in controlling renal blood flow (RBF) and glomerular filtration rate (GFR) were investigated in 18 anaesthetized dogs with acutely denervated kidneys. Intrarenal angiotensin II infusion increased renal PGE2 release (veno-arterial concentration difference times renal plasma flow) from 1.7 +/- 0.9 to 9.1 +/- 0.4 and 6-keto-PGF1 alpha release from 0.1 +/- 0.1 to 5.3 +/- 2.1 pmol min-1. An angiotensin II induced reduction in RBF of 20% did not measurably change GFR whereas a 30% reduction reduced GFR by 18 +/- 8%. Blockade of prostaglandin synthesis approximately doubled the vasoconstrictory action of angiotensin II, and all reductions in RBF were accompanied by parallel reductions in GFR. When prostaglandin release was stimulated by infusion of arachidonic acid (46.8 +/- 13.3 and 15.9 +/- 5.4 pmol min-1 for PGE2, and 6-keto-PGF1 alpha, respectively), angiotensin II did not change prostaglandin release, but had similar effects on the relationship between RBF and GFR as during control. In an ureteral occlusion model with stopped glomerular filtration measurements of ureteral pressure and intrarenal venous pressure permitted calculations of afferent and efferent vascular resistances. Until RBF was reduced by 25-30% angiotensin II increased both afferent and efferent resistances almost equally, keeping the ureteral pressure constant. At greater reductions in RBF, afferent resistance increased more than the efferent leading to reductions in ureteral pressure. This pattern was not changed by blockade of prostaglandin synthesis indicating no influence of prostaglandins on the distribution of afferent and efferent vascular resistances during angiotensin II infusion. In this ureteral occlusion model glomerular effects of angiotensin II will not be detected, and it might well be that the shift from an effect predominantly on RBF to a combined effect on both RBF and GFR induced by inhibition

  19. Effect of benazepril, robenacoxib and their combination on glomerular filtration rate in cats.

    Science.gov (United States)

    King, Jonathan N; Panteri, Alessandro; Graille, Melanie; Seewald, Wolfgang; Friton, Gabriele; Desevaux, Cyril

    2016-06-23

    Combined use of angiotensin-converting enzyme inhibitors and nonsteroidal anti-inflammatory drugs may induce acute kidney injury in humans, especially when combined with diuretics. The objective of this investigation was to evaluate the effects of benazepril, robenacoxib and their combination in healthy cats. In each of two studies (study 1 followed by study 2), 32 healthy cats were randomised to one of four groups (n = 4 male and 4 female cats per group) in a parallel-group design. The groups received orally once daily for 7 days either placebo (control group), benazepril, robenacoxib or benazepril plus robenacoxib. In study 2, all groups received in addition 0.5 mg/kg furosemide twice daily by subcutaneous injection for 7 days. Benazepril, robenacoxib and their combination were well tolerated as evidenced from lack of clinical signs and no negative effects on body weight, feed consumption and clinical chemistry, haematology and urinalysis variables. The primary endpoint of the study was the glomerular filtration rate (GFR), which was estimated from the plasma clearance of iohexol. In the absence of furosemide, GFR was significantly higher in cats receiving the combination of benazepril plus robenacoxib compared to the other three groups, and was also significantly higher in females receiving only benazepril compared to the control. Administration of furosemide induced diuresis, reduced GFR and activated the renin-aldosterone-angiotensin system, evidenced from increased plasma renin activity and plasma aldosterone concentrations. Compared to the control group in cats treated with furosemide, GFR was increased by benazepril (females only) but decreased by robenacoxib (males only). Benazepril, robenacoxib and their combination significantly inhibited the increase in plasma aldosterone induced by furosemide. The combination of benazepril and robenacoxib was well tolerated and either increased or had a neutral effect on GFR in healthy cats without or with

  20. A prospective study of glomerular filtration rate and arterial blood pressure in insulin-dependent diabetics with diabetic nephropathy

    DEFF Research Database (Denmark)

    Parving, H H; Smidt, U M; Friisberg, B

    1981-01-01

    nephropathy. Twelve of the 14 patients had normal serum creatinine levels. None of the patients received antihypertensive treatment. During the mean observation period of 26 months (range 23 to 33 months) GFR decreased from 107 to 87 ml/min/1.73 m2 (p less than 0.001), serum creatinine remained unchanged: 107...... in arterial blood pressure to a hypertensive level is an early feature of diabetic nephropathy in young insulin-dependent diabetics.......Glomerular filtration rate (GFR, single bolus 51Cr-EDTA technique), serum creatinine, proteinuria and arterial blood pressure have been measured prospectively in 14 young onset insulin-dependent diabetics selected by of persistent proteinuria (greater than 0.5 g/day) secondary to diabetic...

  1. Aging and physiological changes of the kidneys including changes in glomerular filtration rate.

    Science.gov (United States)

    Musso, Carlos G; Oreopoulos, Dimitrios G

    2011-01-01

    In addition to the structural changes in the kidney associated with aging, physiological changes in renal function are also found in older adults, such as decreased glomerular filtration rate, vascular dysautonomia, altered tubular handling of creatinine, reduction in sodium reabsorption and potassium secretion, and diminished renal reserve. These alterations make aged individuals susceptible to the development of clinical conditions in response to usual stimuli that would otherwise be compensated for in younger individuals, including acute kidney injury, volume depletion and overload, disorders of serum sodium and potassium concentration, and toxic reactions to water-soluble drugs excreted by the kidneys. Additionally, the preservation with aging of a normal urinalysis, normal serum urea and creatinine values, erythropoietin synthesis, and normal phosphorus, calcium and magnesium tubular handling distinguishes decreased GFR due to normal aging from that due to chronic kidney disease.

  2. Self-reported sleep duration is associated with reduced glomerular filtration rate among adults with hypertension: a population-based study from rural northeast China.

    Science.gov (United States)

    Guo, Xiaofan; Yu, Shasha; Li, Zhao; Guo, Liang; Zheng, Liqiang; Yang, Hongmei; Zou, Lu; Hu, Wenyu; Zhou, Ying; Zhu, Luoning; Zhang, Yonghong; Sun, Yingxian

    2015-06-01

    Short sleep duration has been found recently to be a predictor of proteinuria. However, population-based investigations addressing the association between self-reported sleep duration and glomerular filtration rate (GFR) among hypertensive patients are lacking. We therefore sought to investigate the extent to which self-reported sleep duration might be associated with reduced GFR in a large hypertensive population in rural northeast China. A total of 5555 hypertensive participants, aged ≥35 years, in rural areas of Liaoning Province, China, were screened between January 2012 and August 2013, using a stratified, cluster multi-stage sampling scheme. Anthropometric measurements, self-reported sleep duration, blood biochemical indexes and other health-related variables were collected by medically trained personnel. Reduced GFR was defined as the estimated GFR (eGFR) 7 and ≤8 h day(-1) ). We concluded that short self-reported sleep duration (≤6 h per night) was related significantly to an increased risk of reduced GFR in a hypertensive population. This novel risk factor should be taken into consideration during daily management of hypertension to prevent chronic kidney disease.

  3. Escaping the correction for body surface area when calculating glomerular filtration rate in children

    Energy Technology Data Exchange (ETDEWEB)

    Piepsz, Amy; Tondeur, Marianne [CHU St. Pierre, Department of Radioisotopes, Brussels (Belgium); Ham, Hamphrey [University Hospital Ghent, Department of Nuclear Medicine, Ghent (Belgium)

    2008-09-15

    {sup 51}Cr ethylene diamine tetraacetic acid ({sup 51}Cr EDTA) clearance is nowadays considered as an accurate and reproducible method for measuring glomerular filtration rate (GFR) in children. Normal values in function of age, corrected for body surface area, have been recently updated. However, much criticism has been expressed about the validity of body surface area correction. The aim of the present paper was to present the normal GFR values, not corrected for body surface area, with the associated percentile curves. For that purpose, the same patients as in the previous paper were selected, namely those with no recent urinary tract infection, having a normal left to right {sup 99m}Tc MAG3 uptake ratio and a normal kidney morphology on the early parenchymal images. A single blood sample method was used for {sup 51}Cr EDTA clearance measurement. Clearance values, not corrected for body surface area, increased progressively up to the adolescence. The percentile curves were determined and allow, for a single patient, to estimate accurately the level of non-corrected clearance and the evolution with time, whatever the age. (orig.)

  4. Risk of intravenous contrast material-mediated acute kidney injury: a propensity score-matched study stratified by baseline-estimated glomerular filtration rate.

    Science.gov (United States)

    McDonald, Jennifer S; McDonald, Robert J; Carter, Rickey E; Katzberg, Richard W; Kallmes, David F; Williamson, Eric E

    2014-04-01

    To determine the effect of baseline estimated glomerular filtration rate (eGFR) on the causal association between intravenous iodinated contrast material exposure and subsequent development of acute kidney injury (AKI) in propensity score-matched groups of patients who underwent contrast material-enhanced or unenhanced computed tomography (CT). This retrospective study was HIPAA compliant and institutional review board approved. All patients who underwent contrast-enhanced (contrast material group) or unenhanced (non-contrast material group) CT between 2000 and 2010 were identified and stratified according to baseline eGFR by using Kidney Disease Outcomes Quality Initiative cutoffs for chronic kidney disease into subgroups with eGFR of 90 or greater, 60-89, 30-59, and less than 30 mL/min/1.73 m(2). Propensity score generation and 1:1 matching of patients were performed in each eGFR subgroup. Incidence of AKI (serum creatinine [SCr] increase of ≥0.5 mg/dL [≥44.2 μmol/L] above baseline) was compared in the matched subgroups by using the Fisher exact test. A total of 12 508 propensity score-matched patients with contrast-enhanced and unenhanced scans met all inclusion criteria. In this predominantly inpatient cohort, the incidence of AKI significantly increased with decreasing baseline eGFR (P material and non-contrast material groups in any eGFR subgroup; for the subgroup with eGFR of 90 or greater (n = 1642), odds ratio (OR) was 0.91 (95% confidence interval [CI]: 0.38, 2.15), P = .82; for the subgroup with eGFR of 60-89 (n = 3870), OR was 1.03 (95% CI: 0.66, 1.60), P = .99; for the subgroup with eGFR of 30-59 (n = 5510), OR was 0.94 (95% CI: 0.76, 1.18), P = .65; and for the subgroup with eGFR of less than 30 mL/min/1.73 m(2) (n = 1486), OR was 0.97 (95% CI: 0.72, 1.30), P = .89. Diminished eGFR is associated with an increased risk of SCr-defined AKI following CT examinations. However, the risk of AKI is independent of contrast material exposure, even in

  5. Importance of glomerular filtration rate change as surrogate endpoint for the future incidence of end-stage renal disease in general Japanese population: community-based cohort study.

    Science.gov (United States)

    Kanda, Eiichiro; Usui, Tomoko; Kashihara, Naoki; Iseki, Chiho; Iseki, Kunitoshi; Nangaku, Masaomi

    2017-09-07

    Because of the necessity for extended period and large costs until the event occurs, surrogate endpoints are indispensable for implementation of clinical studies to improve chronic kidney disease (CKD) patients' prognosis. Subjects with serum creatinine level for a baseline period over 1-3 years were enrolled (n = 69,238) in this community-based prospective cohort study in Okinawa, Japan, and followed up for 15 years. The endpoint was end-stage renal disease (ESRD). The percent of estimated glomerular filtration rate (%eGFR) change was calculated on the basis of the baseline period. Subjects had a mean ± SD age, 55.59 ± 14.69 years; eGFR, 80.15 ± 21.15 ml/min/1.73 m(2). Among the subjects recruited, 15.81% had a low eGFR (changes over 2 or 3 years in the high- and low-eGFR groups. The specificities and positive predictive values for ESRD based on a cutoff value of %eGFR change of less than -30% over 2 or 3 years were high in the high- and low-eGFR groups. %eGFR change tends to be associated with the risk of ESRD. %eGFR change of less than -30% over 2 or 3 years can be a candidate surrogate endpoint for ESRD in the general Japanese population.

  6. Estimation of Glomerular Filtration Rate in Elderly Chronic Kidney Disease Patients: Comparison of Three Novel Sophisticated Equations and Simple Cystatin C Equation.

    Science.gov (United States)

    Bevc, Sebastjan; Hojs, Nina; Hojs, Radovan; Ekart, Robert; Gorenjak, Maksimiljan; Puklavec, Ludvik

    2017-04-01

    Estimating glomerular filtration rate (GFR) in elderly patients is a problem, since they are poorly represented in studies developing GFR equations. Serum cystatin C is a better indicator of GFR than serum creatinine in elderly patients. Therefore the aim of our study was to compare frequently used serum cystatin C based GFR equations with a gold standard ((51) CrEDTA clearance) in elderly chronic kidney disease (CKD) patients. 106 adult Caucasian patients, older than 65 years (58 women, 48 men; mean age 72.5 years), were included. In each patient (51) CrEDTA clearance, serum creatinine (IDMS traceable method) and serum cystatin C (immunonephelometric method) were determined. GFR was estimated using the Simple cystatin C, CKD-EPI cystatin C, CKD-EPI creatinine-cystatin C and BIS2 equation. Mean serum creatinine of our patients was 141.4 ± 41.5 μmol/L, mean serum cystatin C 1.79 ± 0.6 mg/L, mean (51) CrEDTA clearance was 52.2 ± 15.9 mL/min per 1.73 m(2) . Statistically significant correlations between (51) CrEDTA clearance and all formulas were found (P C and BIS2 equation underestimated and CKD-EPI cystatin C and Simple cystatin C equation overestimated measured GFR. All equations lacked precision. Analysis of ability to correctly predict patient's GFR below or above 45 mL/min per 1.73 m(2) showed similar ability for all equations (P = 0.24-0.89). All equations are equally accurate for estimating GFR in elderly Caucasian CKD patients. For daily practice Simple cystatin C equation is most practical.

  7. Relationship between the estimated glomerular filtration rate and kidney shear wave speed values assessed by acoustic radiation force impulse elastography: a pilot study.

    Science.gov (United States)

    Bob, Flaviu; Bota, Simona; Sporea, Ioan; Sirli, Roxana; Popescu, Alina; Schiller, Adalbert

    2015-04-01

    The aim of the study was to establish the relationship between the estimated glomerular filtration rate (GFR) and kidney shear wave speed values assessed by acoustic radiation force impulse (ARFI) elastography. Our study included 104 patients with or without chronic kidney disease in which the kidney shear wave speed was evaluated by ARFI elastography and correlated with the estimated GFR. Five ARFI measurements were performed in the parenchyma of each kidney. A median value expressed as meters per second was calculated. Five valid ARFI elastographic measurements were obtained in the right kidney in all patients and in the left kidney in 97.1% of patients. The mean kidney shear wave speed values ± SD in the right and left kidneys were similar: 2.17 ± 0.81 versus 2.06 ± 0.75 m/s (P = .30). The mean kidney shear wave speed decreased with the decrease in the estimated GFR. Statistically significant differences were obtained only when kidney shear wave speed values obtained in patients with an estimated GFR of greater than 90 mL/min/1.73 m(2) were compared to values in patients with stage 4 (estimated GFR, 15-29 mL/min/1.73 m(2)) and stage 5 (estimated GFR, wave speed had 86.7% sensitivity, 48.3% specificity, a 22.1% positive predictive value, and a 95.6% negative predictive value (area under the receiver operating characteristic curve, 0.692; P = .008) for predicting the presence of an estimated GFR of less than 30 mL/min/1.73 m(2). Kidney shear wave speed values obtained by ARFI elastography decrease with the decrease in the estimated GFR. © 2015 by the American Institute of Ultrasound in Medicine.

  8. [Diagnostic ability of Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease-4 equations to estimate glomerular filtration rate in with multimorbidity patients].

    Science.gov (United States)

    Cabrerizo-García, José Luis; Díez-Manglano, Jesús; García-Arilla, Ernesto; Revillo-Pinilla, Paz; Ramón-Puertas, José; Sebastián-Royo, Mariano

    2015-01-06

    The Modification of Diet in Renal Disease (MDRD) equation is recommended by most scientific societies to calculate the estimated glomerular filtration rate (GFR). Recently the group Chronic Kidney Disease Epidemiology Collaboration (CKP-EPI) has published a new, more precise and accurate equation. We have analyzed its behavior in a group of polypathological patients (PP) and compared it with the classic MDRD-4.version Multicenter, observational, descriptive and transversal study. We calculated GFR by MDRD-4 and CKD-EPI in 425 PP. Each stage was assigned according to the GFR: 1:>90; 2: 60-89; 3: 30-59; 4: 15-29; and 5 renal insufficiency, especially in older women. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  9. Estimated glomerular filtration rate by serum creatinine or standardized cystatin C in Japanese patients with Graves׳ disease.

    Science.gov (United States)

    Suzuki, Yoshitake; Matsushita, Kazuyuki; Seimiya, Masanori; Yoshida, Toshihiko; Sawabe, Yuji; Ogawa, Makoto; Nomura, Fumio

    2015-12-01

    Glomerular filtration rate (eGFR) by serum creatinine (eGFRCr) or standardized cystatin C (eGFRCysC) were estimated in Japanese patients with Graves׳ disease (GD) of different sex. Clinical samples were collected from patients with GD with normal renal function to accurately validate eGFRCr and eGFRCysC levels and evaluate how hyperthyroidism affects renal function. Levels of eGFRCr and eGFRCysC showed clinical usefulness in successfully treated euthyroid patients with GD regardless of sex. The article includes detailed experimental methods and data used in our analysis. The data relates to the "Paradoxical effect of thyroid function on the estimated glomerular filtration rate by serum creatinine or standardized cystatin C in Japanese Graves' disease patients" (Suzuki et al., 2015) [1].

  10. RENAL RESERVE FILTRATION CAPACITY IN GROWTH-HORMONE DEFICIENT SUBJECTS

    NARCIS (Netherlands)

    DULLAART, RPF; MEIJER, S; MARBACH, P; SLUITER, WJ

    In normal subjects, the glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) acutely increase in response to infusion of amino acids and to low doses of dopamine. It is uncertain whether circulatory growth hormone (GH) is a permissive factor for these stimulatory effects. GFR and

  11. Comparison between a serum creatinine-and a cystatin C-based glomerular filtration rate equation in patients receiving amphotericin B.

    Science.gov (United States)

    Karimzadeh, Iman; Khalili, Hossein

    2016-06-06

    Serum cystatin C (Cys C) has a number of advantages over serum creatinine in the evaluation of kidney function. Apart from Cys C level itself, several formulas have also been introduced in different clinical settings for the estimation of glomerular filtration rate (GFR) based upon serum Cys C level. The aim of the present study was to compare a serum Cys C-based equation with Cockcroft-Gault serum creatinine-based formula, both used in the calculation of GFR, in patients receiving amphotericin B. Fifty four adult patients with no history of acute or chronic kidney injury having been planned to receive conventional amphotericin B for an anticipated duration of at least 1 week for any indication were recruited. At three time points during amphotericin B treatment, including days 0, 7, and 14, serum cystatin C as well as creatinine levels were measured. GFR at the above time points was estimated by both creatinine (Cockcroft-Gault) and serum Cys C based equations. There was significant correlation between creatinine-based and Cys C-based GFR values at days 0 (R = 0.606, P = 0.001) and 7 (R = 0.714, P creatinine-and a cystatin C-based glomerular filtration rate equation in patients receiving amphotericin B.

  12. Mechanism of reduced glomerular filtration rate in chronic malnutrition.

    Science.gov (United States)

    Ichikawa, I; Purkerson, M L; Klahr, S; Troy, J L; Martinez-Maldonado, M; Brenner, B M

    1980-05-01

    To determine the physiological basis for the low glomerular filtration rate in chronic malnutrition, micropuncture studies were performed in Munich-Wistar rats chronically pair-fed isocaloric diets of either low (group 1, nine rats) or high protein content (group 2, nine rats). Despite the absence of hypoalbuminemia, average values for single nephron and total kidney glomerular filtration rate were nearly 35% lower in group 1 than in group 2. Mean values for glomerular capillary and Bowman's space hydraulic pressures were essentially identical in the two groups, thereby excluding glomerular transcapillary hydraulic pressure difference as the cause for the low filtration rates in group 1 animals. On the other hand, average glomerular capillary plasma flow rate and glomerular capillary ultrafiltration coefficient were significantly lower (by approximately 25 and approximately 50%, respectively) in group 1 than in group 2. The fall in glomerular capillary plasma flow rate was the consequence of increased afferent and efferent arteriolar resistances. Plasma and erythrocyte volumes were found to be equal in five additional pairs of group 1 and group 2 rats. Thus, the substantial alterations in the ultrafiltration coefficient, glomerular capillary plasma flow rate, and renal arteriolar resistances responsible for the low filtration rate in group 1 animals were not merely a consequence of decreased circulating blood or plasma volumes. Mean values for glomerular cross sectional area were significantly lower in group 1 than in group 2 despite similar values for kidney weight in the two groups. This reduction in glomerular cross sectional area in group 1 rats is presumed to reflect a decrease in effective filtration surface area and therefore likely accounts, at least in part, for the decline in ultrafiltration coefficient observed in this group.Finally, since the daily caloric intake of group 2 animals was restricted because of pair feeding requirements tied to the group 1

  13. Impact of glucose level on estimated glomerular filtration rate in diabetic patients%血糖水平对糖尿病患者肾小球滤过率估算公式的影响

    Institute of Scientific and Technical Information of China (English)

    陈海冰; 项坤三; 贾伟平; 张磊; 包玉倩; 李青; 张锋; 李鸣; 于浩泳; 周健; 卢逢娣

    2010-01-01

    算效应要优于CG公式.%Objective To investigate the influence of blood glucose level on the estimated glomeruhr filtration rate(eGFR)by Cockcroft-Gault(CG)and Modification of Diet in Renal Disease(MDRD)formula in diabetic patients,and to explore the difference between CG and MDRD formula to estimate GFR in different levels of blood glucose in the diagnosis of moderate renal insufficiency.Methods A total of 1210 diabetic patients(650 males and 560 females)were enrolled in this study.HbAlc,Scr and isotopic GFR(iGFR)((99m)~ Tc-DTPA)were measured.CG and MDRD formula were used to estimate the GFR(eGFR_(CG),eGFR_(MDRD)).The patients were divided into normal GFR group[NGFR,n=589,iGFR≥90 ml·min~(-1)·(1.73 m~2)~(-1)],gently decreased GFR group[GGFR,n=470,60≤iGFR<90 ml·min~(-1)·(1.73 m~2)~(-1)],moderate and sever decreased GFR group[MGFR,n=151,30≤iGFR<60 ml·min~(-1)·(1.73 m~2)~(-1)]based on the K/DOQI suggestion. According to the quartile HbAlc level(7.1%,10.5%),patients were divided into four groups.Patients with HbAlc<7.1% were defined as well-controlled group,with HbAlc≥10.5% as poorly-controlled group.Spearman correlation,t test,Bland-Altman analysis and ROC curve were applied to investigate the bias and accuracy of formula,and the influence of blood glucose on eGFR.Results HbAlc was correlated with iGFR(r=0.17,P<0.01),eGFR_(CG)(r=0.22,P<0.01),eGFR_(MDRD)(r=0.29,P<0.01).The correlation between eGFR_(MDRD) and HbAlc was the strongest.eGFR_(MDRD) seemed to overestimate GFR.However,eGFR_(CG) seemed to underestimate GFR in well-controlled group.Bland-Altman analysis indicated that the bias of eGFR_(MDRD) with iGFR in poorly-controlled group was higher than that in well-controlled group.Compared with poorly-controlled group,the 15% and 30% accuracies of eGFR_(MDRD) in well-controlled group were significantly higher.There was no significant difference between poorly-controlled group and well-controlled group in eGFR_(CG).The bias of eGFR_(CG) with iGFR was significantly higher than that of eGFR

  14. Screening for decreased glomerular filtration rate and associated risk factors in a cohort of HIV-infected patients in a middle-income country.

    Directory of Open Access Journals (Sweden)

    Patrícia Santiago

    Full Text Available With the introduction of combined active antiretroviral therapy and the improved survival of HIV-infected patients, degenerative diseases and drug toxicity have emerged as long-term concerns. We studied the prevalence of decreased glomerular filtration rate (GFR and associated risk factors in a cohort of HIV-infected patients from a middle-income country. Our cross-sectional study included all adult patients who attended an urban outpatient clinic in 2008. GFR was estimated using the CKD-EPI equation. The prevalence ratio (PR of decreased GFR (defined as <60 mL/min/1.73 m(2 was estimated using generalizing linear models assuming a Poisson distribution. We analyzed data from 1,970 patients, of which 82.9% had been exposed to ART. A total of 249 patients (12.6% had a GFR between 60 and 89 mL/min/1.73 m(2, 3.1% had a GFR between 30 and 59, 0.3% had a GFR between 15 and 29, and 0.4% had a GFR <15. Decreased GFR was found in only 74 patients (3.8%. In the multivariate regression model, the factors that were independently associated with a GFR below 60 mL/min/1.73 m(2 were as follows: age ≥ 50 years (PR = 3.4; 95% CI: 1.7-6.8, diabetes (PR = 2.0; 95% CI: 1.2-3.4, hypertension (PR = 2.0; 95% CI: 1.3-3.2, current CD4+ cell count <350 cells/mm3 (PR = 2.1; 95% CI: 1.3-3.3, past exposure to tenofovir (PR = 4.7; 95% CI: 2.3-9.4 and past exposure to indinavir (PR =1.7; 95% CI: 1.0-2.8. As in high-income countries, CKD was the predominant form of kidney involvement among HIV-infected individuals in our setting. The risk factors associated with decreased glomerular filtration were broad and included virus-related factors as well as degenerative and nephrotoxic factors. Despite the potential for nephrotoxicity associated with some antiretroviral drugs, in the short-term, advanced chronic renal disease remains very rare.

  15. Factors Associated with the Decline of Kidney Function Differ among eGFR Strata in Subjects with Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Shu Meguro

    2012-01-01

    Full Text Available Introduction. There is no report about risk factors for renal deterioration according to the clinical stage, divided by the estimated glomerular filtration rate (eGFR in type 2 diabetes. Materials and Methods. We evaluated the factors correlated with the annual eGFR decline in 1303 subjects with type 2 diabetes whose eGFR was ≥30 mL/min/1.73 m2. eGFR strata were defined by baseline eGFR value as follows: stratum 1: ≥90, stratum 2: ≥60, <90, and stratum 3: ≥30, <60. Results. The annual eGFR decline was 2.3±5.4 mL/min/1.73 m2 in overall subjects. Multiple linear regression analysis demonstrated that age, male sex, systolic blood pressure, logarithmically transformed albumin excretion rate (AER, eGFR strata, and hemoglobin concentration were significantly correlated with the annual eGFR decline. When stratified by eGFR, the factors that showed a significant correlation were different among eGFR strata. AER was significantly correlated with annual eGFR decline in all eGFR strata. Hemoglobin concentration showed a significant correlation only in the advanced eGFR stratum. Conclusion. The factors correlated with the annual eGFR decline were different among eGFR strata in type 2 diabetes mellitus, and hemoglobin concentration and AER were important factors for renal deterioration, especially in the advanced eGFR stratum.

  16. Sex differences in serum CK activity but not in glomerular filtration rate after resistance exercise: is there a sex dependent renal adaptative response?

    Science.gov (United States)

    Amorim, Mayra Z; Machado, Marco; Hackney, Anthony C; de Oliveira, Wilkes; Luz, Carla Patrícia Novais; Pereira, Rafael

    2014-01-01

    We investigated differences in sex responses in serum CK activity and renal function measured by glomerular filtration rate (GFR) after an exercise session. Twenty-two healthy and trained volunteers (11 males and 11 females) performed 17 resistance exercises with 3 × 12 repetitions in a circuit training fashion. Subjects provided blood samples prior to exercise session, and at 24, 48, and 72 h following exercise sessions for creatine kinase and creatinine. Twenty-four-hour urine samples were collected before and 72 h after the exercise. Estimate (e) GFR was obtained by using the Chronic Kidney Disease Epidemiology Collaboration equation adjusted for males and females. After the exercise session, males showed greater serum CK activity than females (p  0.05) between sex for serum and urinary creatinine. eGFR decreased significantly for males (~10 %) and females (~8 %), but also without a difference between the sexes (p > 0.05). The correlation between CK and eGFR was significant for males (r = -0.794; p = 0.003), and females (r = -0.8875; p < 0.001). A significant negative correlation between CK activity and the eGFR indice of renal function in both males and females was observed. Additionally, the renal function compromise was similar for both sexes, despite males presenting greater exercise-induced skeletal muscle damage when compared to females.

  17. Estimating GFR Among Participants in the Chronic Renal Insufficiency Cohort (CRIC) Study

    Science.gov (United States)

    Anderson, Amanda Hyre; Yang, Wei; Hsu, Chi-yuan; Joffe, Marshall M.; Leonard, Mary B.; Xie, Dawei; Chen, Jing; Greene, Tom; Jaar, Bernard G.; Kao, Patricia; Kusek, John W.; Landis, J. Richard; Lash, James P.; Townsend, Raymond R.; Weir, Matthew R.; Feldman, Harold I.

    2012-01-01

    Background Glomerular filtration rate (GFR) is considered the best measure of kidney function, but repeated assessment is not feasible in most research studies. Study Design Cross-sectional study of 1,433 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study (i.e., the GFR subcohort) to derive an internal GFR estimating equation using a split sample approach. Setting & Participants Adults from 7 US metropolitan areas with mild to moderate chronic kidney disease; 48% had diabetes and 37% were black. Index Test CRIC GFR estimating equation Reference Test or Outcome Urinary 125I-iothalamate clearance testing (measured GFR) Other Measurements Laboratory measures including serum creatinine and cystatin C, and anthropometrics Results In the validation dataset, the model that included serum creatinine, serum cystatin C, age, gender, and race was the most parsimonious and similarly predictive of mGFR compared to a model additionally including bioelectrical impedance analysis phase angle, CRIC clinical center, and 24-hour urinary creatinine excretion. Specifically, the root mean square errors for the separate model were 0.207 vs. 0.202, respectively. The performance of the CRIC GFR estimating equation was most accurate among the subgroups of younger participants, men, non-blacks, non-Hispanics, those without diabetes, those with body mass index <30 kg/m2, those with higher 24-hour urine creatinine excretion, those with lower levels of high-sensitivity C-reactive protein, and those with higher mGFR. Limitations Urinary clearance of 125I-iothalamate is an imperfect measure of true GFR; cystatin C is not standardized to certified reference material; lack of external validation; small sample sizes limit analyses of subgroup-specific predictors. Conclusions The CRIC GFR estimating equation predicts measured GFR accurately in the CRIC cohort using serum creatinine and cystatin C, age, gender, and race. Its performance was best among younger and healthier

  18. The clearance concept with special reference to determination of glomerular filtration rate in patients with fluid retention.

    Science.gov (United States)

    Henriksen, Ulrik L; Henriksen, Jens H

    2015-01-01

    In subjects without fluid retention, the total plasma clearance of a renal filtration indicator (inulin, (99m) Tc-DTPA, (51) Cr-EDTA) is close to the urinary plasma clearance. Conversely, in patients with fluid retention (oedema, pleural effusions, ascites), there is a substantial discrepancy between the total plasma clearance and the urinary plasma clearance. This is owing to delayed indicator distribution to smaller or larger parts of the interstitial space, which in patients with ascites may simulate a peritoneal dialysator. In patients with fluid retention, urinary plasma clearance should be assessed to obtain a correct measurement of the glomerular filtration rate (GFR). In theory, total plasma clearance with late samples (24-h, 48-h) may be applied in patients with fluid retention, but validation hereof has not been performed. Until such studies are completed, it is recommended that patients with fluid retention have their GFR measured by a urinary plasma clearance technique with controlled quantitative urinary sampling within a few hours after indicator injection.

  19. Estimated GFR Decline as a Surrogate End Point for Kidney Failure

    DEFF Research Database (Denmark)

    Lambers Heerspink, Hiddo J; Weldegiorgis, Misghina; Inker, Lesley A;

    2014-01-01

    A doubling of serum creatinine value, corresponding to a 57% decline in estimated glomerular filtration rate (eGFR), is used frequently as a component of a composite kidney end point in clinical trials in type 2 diabetes. The aim of this study was to determine whether alternative end points defined...

  20. Estimated GFR, Albuminuria, and Cognitive Performance : The Maastricht Study

    NARCIS (Netherlands)

    Martens, Remy J H; Kooman, Jeroen P; Stehouwer, Coen D A; Dagnelie, Pieter C; van der Kallen, Carla J H; Koster, Annemarie; Kroon, Abraham A; Leunissen, Karel M L; Nijpels, Giel; van der Sande, Frank M; Schaper, Nicolaas C; Sep, Simone J S; van Boxtel, Martin P J; Schram, Miranda T; Henry, Ronald M A

    2016-01-01

    BACKGROUND: Reduced estimated glomerular filtration rate (eGFR) and albuminuria have been associated with worse cognitive performance. However, few studies have examined whether these associations are confined to older individuals or may be extended to the middle-aged population. STUDY DESIGN: Cross

  1. Circulating CD34-positive cells, glomerular filtration rate and triglycerides in relation to hypertension.

    Science.gov (United States)

    Shimizu, Yuji; Sato, Shimpei; Koyamatsu, Jun; Yamanashi, Hirotomo; Nagayoshi, Mako; Kadota, Koichiro; Maeda, Takahiro

    2015-11-01

    Serum triglycerides have been reported to be independently associated with the development of chronic kidney disease (CKD), which is known to play a role in vascular disturbance. On the other hand, circulating CD34-positve cells, including endothelial progenitor cells, are reported to contribute to vascular repair. However, no studies have reported on the correlation between triglycerides and the number of CD34-positive cells. Since hypertension is well known factor for vascular impairment, the degree of correlation between serum triglycerides and circulating CD34-positve cells should account for hypertension status. We conducted a cross-sectional study of 274 elderly Japanese men aged ≥ 60 years (range 60-79 years) undergoing general health checkups. Multiple linear regression analysis of non-hypertensive subjects adjusting for classical cardiovascular risk factors showed that although triglyceride levels (1SD increments; 64 mg/dL) did not significantly correlate with glomerular filtration rate (GFR) (β = -2.06, p = 0.163), a significant positive correlation was seen between triglycerides and the number of circulating CD34-positive cells (β = 0.50, p = 0.004). In hypertensive subjects, a significant inverse correlation between triglycerides and GFR was observed (β = -2.66, p = 0.035), whereas no significant correlation between triglycerides and the number of circulating CD34-positive cells was noted (β = -0.004, p = 0.974). Since endothelial progenitor cells (CD34-positive cells) have been reported to contribute to vascular repair, our results indicate that in non-hypertensive subjects, triglycerides may stimulate an increase in circulating CD34-positive cells (vascular repair) by inducing vascular disturbance. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Cystatin C, vascular biomarkers and measured glomerular filtration rate in patients with unresponsive hypertensive phenotype: a pilot study.

    Science.gov (United States)

    Čabarkapa, Velibor; Ilinčić, Branislava; Đerić, Mirjana; Vučaj Ćirilović, Viktorija; Kresoja, Milena; Žeravica, Radmila; Sakač, Vladimir

    2017-11-01

    Biomarkers are commonly used to estimate the presence of subclinical cardiovascular disease (CVD) in patients with essential arterial hypertension (HT). In addition to known association between cystatin C and glomerular filtration rate (GFR), elucidating the association between cystatin C and vascular biomarkers (intima-media thickness of common carotid arteries (CCIMT), carotid plaque and renal artery resistance index (RRI)) in patients with unresponsive hypertensive phenotype could be of significant clinical interest. Participants (n = 200, median age 58 (52-64) years, 49% female) under treatment with antihypertensive drugs were stratified into two subgroups based on their blood pressure level as having responsive hypertension (RHT - compliant and responsive to treatment, n = 100), or nonresponsive (URHT - compliant but nonresponsive to treatment, n = 100). GFR was measured by isotopic (slope-intercept) method (99m Tc diethylene triamine penta-acetic acid - mGFR). The URHT group had significantly higher median cystatin C serum concentration (p = 0.02) and CCIMT (p = 0.00) compared to the RHT group, with no significant difference in RRI (p = 0.51) and mGFR among subgroups [69.9 ± 28.2 vs 76.74 ± 23.61 ml/min/1.73m(2), p = 0.27]. In the URHT group, cystatin C was found to be associated with CCIMT (p = 0.02), hsCRP (p = 0.01) and duration of HT (p = 0.02), independently of mGFR and age. Independent predictors of URHT phenotype were CCIMT (p= 0.02) and hsCRP (p= 0.04). In addition to GFR, cystatin C serum concentration is positively and independently associated with CCIMT in patient with URHT phenotype and subclinical CVD. Prospective larger studies should further investigate the clinical importance of this relationship.

  3. COMPARISON OF ESTIMATED GLOMERULAR FILTRATION RATE MEAN VALUE OF HARUS 15-30-60, HADI, AND ASIAN FOMULA ACCURACY IN DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    Sylvia Rachmayati

    2015-03-01

    Full Text Available Objective: To compare the accuracy of HARUS 15-30-60, HADI, and Asian Formulas (Chinese-equation (Ch-E, Japanese-equation (Jp-E, and Thai- equation (Th-E for estimated glomerular filtration rate (eGFR. Methods: The Kidney Dialysis Outcome Quality Initiative (KDOQI has published a guideline to measure renal function, which is based on glomerular filtration rate (GFR. This procedure is complicated and expensive, therefore an estimated GFR (eGFR has been proposed. The modification of diet in renal disease (MDRD study prediction equation is the most frequently eGFR used. This method still have a weakness in accuracy, so the chronic kidney disease epidemiology collaboration (CKD-EPI formula is developed. Since CKD-EPI is not practical for daily use, the MDRD is published for Asian population that includes Ch-E, Jp-E, and Th-E. In Indonesia, the MDRD formula has not been validated using any gold standard, therefore 2 new formulas have been developed, i.e. HARUS 15-30-60 and HADI formulas. In this study, we analyzed 102 medical records of Diabetes Mellitus Type 2 (DMT2 patients who visited Dr. Hasan Sadikin General Hospital, Bandung during the period of 2012 to 2013. We analyzed the data using HARUS 15-30-60, HADI, Asian formulas, and then compared them to CKD-EPI to see the accuracy. Statistical analysis used was paired t-test in SPSS-17 program. Results: The accuracy of the different formulas are as follows: HADI (p=0.173, HARUS 15-30-60 (p=0.060, Ch-E (p=0.001, Th-E (p=0.000, and Jp-E (p=0.000. Conclusions: HADI is the most accurate formula, followed by HARUS Formula, Ch-E, and Th-E and Jp-E, respectively.

  4. An epidemiologic model to project the impact of changes in glomerular filtration rate on quality of life and survival among persons with chronic kidney disease.

    Science.gov (United States)

    Levy, Adrian R; Perkins, Robert M; Johnston, Karissa M; Sullivan, Sean D; Sood, Vipan C; Agnese, Wendy; Schnitzler, Mark A

    2014-01-01

    Predicting the timing and number of end-stage renal disease (ESRD) cases from a population of individuals with pre-ESRD chronic kidney disease (CKD) has not previously been reported. The objective is to predict the timing and number of cases of ESRD occurring over the lifetime of a cohort of hypothetical CKD patients in the US based on a range of baseline estimated glomerular filtration rate (eGFR) values and varying rates of eGFR decline. A three-state Markov model - functioning kidney, ESRD, and death - with an annual cycle length is used to project changes in baseline eGFR on long-term health outcomes in a hypothetical cohort of CKD patients. Using published eGFR-specific risk equations and adjusting for predictive characteristics, the probability of ESRD (eGFR projected over the cohort's lifetime under two scenarios: an acute drop in eGFR (mimicking acute kidney injury) and a reduced hazard ratio for ESRD (mimicking an effective intervention). Among CKD patients aged 50 years, an acute eGFR decrement from 45 mL/minute to 35 mL/minute yields decreases of 1.6 life-years, 1.5 quality-adjusted life-years (QALYs), 0.8 years until ESRD, and an increase of 183 per 1,000 progressing to ESRD. Among CKD patients aged 60 years, lowering the hazard ratio of ESRD to 0.8 yields values of 0.2, 0.2, 0.2, and 46 per 1,000, respectively. Incremental cost-effectiveness ratios are higher (ie, less favorable) for higher baseline eGFR, indicating that interventions occurring later in the course of disease are more likely to be economically attractive. Both acute kidney injury and slowing the rate of eGFR decline produce substantial shifts in expected numbers and timing of ESRD among CKD patients. This model is a useful tool for planning management of CKD patients.

  5. Serum Adiponectin and Glomerular Filtration Rate in Patients with Type 2 Diabetes.

    Directory of Open Access Journals (Sweden)

    Lorena Ortega Moreno

    Full Text Available High serum adiponectin has been increased in several conditions of kidney disease. Only sparse and conflicting results have been reported in patients with type 2 diabetes (T2D, a subgroup of individuals who are at high risk for renal dysfunction. The aim of this study was to fill up this gap of knowledge by investigating such association in a large sample of Italian diabetic patients. The association between serum adiponectin levels and estimated glomerular filtration rate (eGFR by Chronic Kidney Disease-Epidemiology Collaboration CKD-EPI equation was investigated in 1,243 patients with T2D from two cross-sectional Italian studies: 878 from San Giovanni Rotondo (SGR and 365 from Foggia (FG. Serum adiponectin was inversely associated with eGFR in SGR [β (standard error, SE for 1 standard deviation (SD of adiponectin = -3.26 (0.64] and in FG [β(SE=-5.70(1.28] sample, as well as in the two studies combined [β(SE=-3.99(0.59];(p<0.0001 for all. In this combined analysis, the association was still significant after adjusting for sex, smoking habits, body mass index (BMI, waist circumference, diabetes duration, glycated hemoglobin (HbA1c, albumin creatinine ratio (ACR and anti-hyperglycemic, anti-hypertensive and anti-dyslipidemic treatments [β (SE= -2.19 (0.59, p = 0.0001]. A stronger association between each SD adiponectin increment and low eGFR was observed among patients with micro-/macro-albuminuria, as compared to those with normo-albuminuria [adjusted β(SE=-4.42(1.16 ml/min/1.73m2 vs. -1.50 (0.67 ml/min/1.73m2, respectively; p for adiponectin-by-albuminuric status = 0.022]. For each adiponectin SD increment, the odds of having eGFR < 60 ml/min/1.73m2 increased by 41% (odds ratio, OR = 1.41; 95% confidence interval, CI 1.21-1.64 in SGR sample, 53% (OR = 1.53; 95% CI 1.21-1.94 in FG sample, and 44% (OR = 1.44; 95%CI 1.27-1.64 in the two studies considered together (p<0.0001 for all. In the combined sample, further adjustment for the above

  6. Determination of appropriate sampling frequency and time of multiple blood sampling dual exponential method with {sup 99m}Tc-DTPA for calculating GFR

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chung Ho; O, Joo Hyun; Chung, Yong An; Yoo, Le Ryung; Sohn, Hyung Sun; Kim, Sung Hoon; Chung, Soo Kyo; Lee, Hyoung Koo [Catholic University of Korea, Seoul (Korea, Republic of)

    2006-02-15

    To determine appropriate sampling frequency and time of multiple blood sampling dual exponential method with {sup 99m}Tc-DTPA for calculating glomerular filtration rate (GFR). Thirty four patients were included in this study. Three mCi of {sup 99m}Tc-DTPA was intravenously injected and blood sampling at 9 different times, 5 ml each, were done. Using the radioactivity of serum, measured by gamma counter, the GFR was calculated using dual exponential method and corrected with the body surface area. Using spontaneously chosen 2 data points of serum radioactivity, 15 collections of 2-sample GFR were calculated. And 10 collections of 3-sample GFR and 12 collections of 4-sample GFR were also calculated. Using the 9-sample GFR as a reference value, degree of agreement was analyzed with Kendall's {tau} correlation coefficients, mean difference and standard deviation. Although some of the 2-sample GFR showed high correlation coefficient, over or underestimation had evolved as the renal function change. The 10-120-240 min 3-sample GFR showed a high correlation coefficient {tau} =0.93), minimal difference (Mean{+-}SD= -1.784{+-}3.972), and no over or underestimation as the renal function changed. Th 4-sample GFR showed no better accuracy than the 3-sample GFR. Int the wide spectrum or renal function, the 10-120-240 min 3-sample GFR could be the best choice for estimating the patients' renal function.

  7. New normal values not related to age and sex, of glomerular filtration rate by (99m)Tc-DTPA renal dynamic imaging, for the evaluation of living kidney graft donors.

    Science.gov (United States)

    Zhao, Xiuyi; Shao, Yahui; Wang, Yanming; Tian, Jun; Sun, Ben; Ru, Yanhui; Zhang, Aimin; Hao, Junwen

    2012-01-01

    The aim of this study was to investigate the normal values of glomerular filtration rate (GFR) by technetium-99m diaethylene-triamine-pentaacetic acid ((99m)Tc-DTPA) renal dynamic imaging for living kidney graft donors. In a total of 212 candidate donors, GFR was examined using (99m)Tc-DTPA renal dynamic imaging. Donors with GFR≥80mL/(min×1.73m(2)) and as low as with GFR≥70mL/(min×1.73m(2)) but a normal endogenous creatinine clearance rate (CCr) were quantified for living kidney donation. Differences in GFR levels based on sex and age were analyzed using rank correlation coefficient. Out of the 212 candidates, 161 were finally selected as kidney graft donors. The double kidney total GFR between the male and female donor groups, the GFR levels among differently-aged donor groups, and the GFR levels between the elderly (>55 years) and young- and middle-aged (≤55 years) donor groups did not show any significant difference (P>0.05). After kidney donation, renal function measured by blood urea nitrogen (BUN) and serum creatinine of all donors returned to normal within one week, and no serious complications were noticed. In conclusion, renal dynamic imaging by (99m)Tc-DTPA had a good accuracy and repeatability in GFR evaluation for living kidney donors. Candidate donors with GFR between 70mL/(min×1.73m(2)) and 80mL/(min×1.73m(2)) can be selected as kidney donors after strict screening. In living kidney donors GFR is not significantly correlated with age or sex.

  8. Correlation between glomerular filtration rate and urinary N acetyl-beta-D glucosaminidase in children with persistent proteinuria in chronic glomerular disease

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    Jeong Deok Hong

    2012-04-01

    Full Text Available Purpose: Urinary excretion of N acetyl-beta-D glucosaminidase (NAG and ?#11437;microglobulin (?#11437;M was increased in the presence of proximal tubular damage. Based on these urinary materials, we investigated the ability of expecting renal function in chronic glomerular diseases. In this study, we evaluated the relationship between glomerular filtration rate (GFR urinary NAG, and urinary ?#11437;M. Methods: We evaluated 52 children with chronic kidney disease at the Chung-Ang University Hospital between January 2003 and August 2009. We investigated the 24-hour urinalysis and hematologic values in all 52 patients. Serum creatinine, creatinine clearance (Ccr, serum cystatin C, urinary ?#11437;M and urinary NAG were measured. Results: Out of 52 patients, there were 13 children with minimal change in disease, 3 children with focal segmental glomerulosclerosis, 17 children with immunoglobulin A nephropathy, 15 children with Henoch-Schonlein purpua nephritis, 3 children with poststreptococcal glomerulonephritis, and 1 child with thin glomerular basement membrane disease. In these patients, there were significant correlation between the Ccr and urinary NAG (r=-0.817; P&lt;0.01, and between the GFR (as determined by Schwartz method and urinary NAG (r=- 0.821; P&lt;0.01. In addition, there was a significant correlation between the GFR (as determined by Bokencamp method and urinary NAG (r=- 0.858; P&lt;0.01. Conclusion: In our study, there was a significant correlation between the GFR and urinary NAG, but there was no correlation between the GFR and urinary ?#11437;M, suggesting that the GFR can be predicted by urinary NAG in patients with chronic glomerular disease.

  9. Vitamin D status in renal transplant recipients living in a low-latitude city: association with body fat, cardiovascular risk factors, estimated glomerular filtration rate and proteinuria.

    Science.gov (United States)

    Rosina, Kelli T C; Menna Barreto, Ana Paula M; Pontes, Karine S S; Martins, Cyro J M; Souza, Edison; Bregman, Rachel; Barreto Silva, Maria Inês; Klein, Márcia R S T

    2017-05-01

    Recent evidence suggests that vitamin D deficiency is associated with CVD, impaired kidney function and proteinuria. To date, no study has evaluated these associations in renal transplant recipients (RTR) adjusting for body adiposity assessed by a 'gold standard' method. This study aimed to evaluate the vitamin D status and its association with body adiposity, CVD risk factors, estimated glomerular filtration rate (eGFR) and proteinuria in RTR, living in Rio de Janeiro, Brazil (a low-latitude city (22°54'10"S)), taking into account body adiposity evaluated by dual-energy X-ray absorptiometry (DXA). This cross-sectional study included 195 RTR (114 men) aged 47·6 (sd 11·2) years. Nutritional evaluation included anthropometry and DXA. Risk factors for CVD were hypertension, diabetes mellitus, dyslipidaemia and the metabolic syndrome. eGFR was evaluated using the Chronic Kidney Disease Epidemiology Collaboration equation. Serum 25-hydroxyvitamin D (25(OH)D) concentration was used to define vitamin D status as follows: 10 % (n 19) had vitamin D deficiency (30 ng/ml). Percentage of body fat (DXA) was significantly associated with vitamin D deficiency independently of age, sex and eGFR. Lower 25(OH)D was associated with higher odds of the metabolic syndrome and dyslipidaemia after adjustment for age, sex and eGFR, but not after additional adjustment for body fat. Hypertension and diabetes were not related to 25(OH)D. Lower serum 25(OH)D was associated with increasing proteinuria and decreasing eGFR even after adjustments for age, sex and percentage of body fat. This study suggests that in RTR of a low-latitude city hypovitaminosis D is common, and is associated with excessive body fat, decreased eGFR and increased proteinuria.

  10. Association between serum uric acid and different states of glucose metabolism and glomerular filtration rate

    Institute of Scientific and Technical Information of China (English)

    CAI Xiao-ling; HAN Xue-yao; JI Li-nong

    2010-01-01

    Background Recently, it has been suggested that the serum uric acid (SUA) level decreased in diabetic patients. The aim of this study was to explore the association between SUA level and different state of glucose metabolism and glomerular filtration rate (GFR) reflected by the simplified Modification of Diet in Renal Disease (MDRD) equation and to test the hypothesis that high MDRD is one of the determinants of SUA level.Methods This cross-sectional study included 2373 subjects in Beijing who underwent a 75 g oral glucose tolerance test (OGTT) for screening of diabetes. According to the states of glucose metabolism, they were divided into normal glucose tolerance, impaired glucose regulation and diabetes.Results Multiple stepwise linear regression analysis showed that adjusted by gender, SUA was positively correlated with body mass index (BMI), waist/hippo ratio, systolic blood pressure (SBP) and triglyceride, meanwhile negatively correlated with age, hemoglobin A1c, fasting insulin and MDRD. There was an increasing trend in SUA concentration and a decreasing trend in MDRD when the levels of fasting plasma glucose (FPG) increased from low to high up to the FPG level of 8.0 mmol/L; thereafter, the SUA concentration started to decrease with further increases in FPG levels, and the MDRD started to increase with further increases in FPG levels.Conclusion This study confirmed the previous finding that SUA decreased in diabetes and provided the supporting evidence that the increased MDRD might contribute to the fall of SUA.

  11. Impact of creatinine production on the agreement between glomerular filtration rate estimates using cystatin C-derived, and 4- and 6-variable Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations

    Science.gov (United States)

    Hermida-Cadahia, Esperanza F.; Lampon, Natalia

    2012-01-01

    Background. It has recently been reported that patient selection has a strong impact on the agreement between glomerular filtration rate (GFR) estimates from serum cystatin C and creatinine. The aim of our study was to evaluate the effect of creatinine production rate (CPR) on this subject. Material and methods. GFR was estimated from serum cystatin C and from creatinine using the 4- and 6-variable Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in 50 healthy subjects, 43 patients with renal failure, 794 kidney and 104 liver transplant recipients, 61 patients with heart failure, 59 patients with biliary obstruction, and 113 critically ill patients. Results. In the 295 patients with impaired CPR ( 900 mg/24 h/1.73 m2), greater discordances than 40% between GFRMDRD4 and GFRcystatinC were observed in 8% of cases, between GFRMDRD6 and GFRcystatinC in 9%, and between GFRCKD-EPI and GFRcystatinC in 7% (in the major part of cases due to GFR overestimation from cystatin C). Conclusion. The main source of differences of more than 40% between GFR estimates from serum creatinine and cystatin C is a GFR overestimation in patients with low CPR and GFR underestimation in patients with high CPR by the creatinine-derived equations. PMID:22746300

  12. 慢性肾脏病患者肾小球滤过率与血清Cystatin C相关性分析%Correlation Analysis Between Glomerular Filtration Rate and Serum Cystatin C in Patients with Chronic Kidney Disease

    Institute of Scientific and Technical Information of China (English)

    杨斌

    2011-01-01

    To explore the correlation between glomerular filtration rate (GFR) and serum cystatin C in patients with chronic kidney disease ( CKD). The serum cystatin C levels in 340 patients with CKD and 60 health controls were determined by particles enhance turbidimetric immune analysis. The GFR was calculated by the simplified equation derived from the modification of diet in renal disease study (MDRD). The results showed thatthe CFR was significant negatively correlated with cystatin C and SCr (P <0.01) and cystatin C had a stronger correlations with GFR. There was significant statistical difference between cystatin C and SCr ( P < 0.05 ). The reflect glomerular filtration function of cystatin C was more accurately than that SCr, it may be useful for the early diagnosis of CFR function in the patients with chronic kidney disease.%探讨慢性肾脏病(chronic kidney disease,CKD)患者肾小球滤过率(glomentlar filtration rate,GFR)与血清半胱氨酸蛋白酶抑制剂C(cystatin C)的相关性.采用颗粒增强免疫浊度分析法测定340例CKD组患者和60名对照组血清cystatin C,全自动生化分析仪检测血清SCr,采用校正eMDRD方程计算GFR,比较各指标与GFR间的相关性.结果表明:GFR与cystatin C、SCr间呈明显负相关(P<0.01),且与cystatin C相关最为密切.cystatin C与SCr有显著性差异(P<0.05).血清cystatin C能准确反映CKD患者GFR,对早期诊断CKD患者肾小球滤过功能有价值.

  13. Comparison of the performance of the updated Schwartz, combined Schwartz and the Grubb glomerular filtration rate equations in a general pediatric population.

    Science.gov (United States)

    Gheissari, Alaleh; Roomizadeh, Peyman; Kelishadi, Roya; Abedini, Amin; Haghjooy-Javanmard, Shaghayegh; Abtahi, Seyed-Hossein; Mehdikhani, Bahareh

    2014-09-01

    To determine the performance of the updated Schwartz, combined Schwartz and Grubb glomerular filtration rate (GFR) equations in a relatively large number of healthy children with no known renal disease, we studied 712 students aged between seven and 18 years from the Isfahan province of Iran by random cluster sampling between 2009 and 2010. Blood investigations included blood urea nitrogen, creatinine and cystatin C. For each participant, GFR was calculated based on the three equations. We used Bland-Altman plots and weighted kappa statistics to compare the performance of the study equations. The mean age of the children was 12.2 ± 2.4 years. A high concordance in estimating GFR (mean difference: 0 ± 12.7 mL/min/1.73 m 2 ) and a very good agreement in defining chronic kidney disease (CKD) and non-CKD individuals (weighted kappa: 0.85; 95% confidence intervals: 0.69-1) were observed between the updated Schwartz and the combined Schwartz equations. Poor agreement was observed between the Grubb equation and two Schwartz equations in estimating GFR and defining CKD. There was no systematic deviation between the updated Schwartz and the combined Schwartz equations in children with normal renal function. The Grubb equation was highly inconsistent with both Schwartz equations in this population. We conclude that the updated Schwartz equation is simpler and more accessible than the combined Schwartz equation in daily clinical practice and CKD screening programs.

  14. Comparison of the performance of the updated Schwartz, combined Schwartz and the Grubb glomerular filtration rate equations in a general pediatric population

    Directory of Open Access Journals (Sweden)

    Alaleh Gheissari

    2014-01-01

    Full Text Available To determine the performance of the updated Schwartz, combined Schwartz and Grubb glomerular filtration rate (GFR equations in a relatively large number of healthy children with no known renal disease, we studied 712 students aged between seven and 18 years from the Isfahan province of Iran by random cluster sampling between 2009 and 2010. Blood investigations included blood urea nitrogen, creatinine and cystatin C. For each participant, GFR was calculated based on the three equations. We used Bland-Altman plots and weighted kappa statistics to compare the performance of the study equations. The mean age of the children was 12.2 ± 2.4 years. A high concordance in estimating GFR (mean difference: 0 ± 12.7 mL/min/1.73 m 2 and a very good agreement in defining chronic kidney disease (CKD and non-CKD individuals (weighted kappa: 0.85; 95% confidence intervals: 0.69-1 were observed between the updated Schwartz and the combined Schwartz equations. Poor agreement was observed between the Grubb equation and two Schwartz equations in estimating GFR and defining CKD. There was no systematic deviation between the updated Schwartz and the combined Schwartz equations in children with normal renal function. The Grubb equation was highly inconsistent with both Schwartz equations in this population. We conclude that the updated Schwartz equation is simpler and more accessible than the combined Schwartz equation in daily clinical practice and CKD screening programs.

  15. Gender-specific association of decreased estimated glomerular filtration rate and left vertical geometry in the general population from rural Northeast China.

    Science.gov (United States)

    Dai, Dongxue; Chang, Ye; Chen, Yintao; Yu, Shasha; Guo, Xiaofan; Sun, Yingxian

    2017-01-13

    Left ventricular hypertrophy (LVH) is common and associated with cardiovascular outcomes among patients with known chronic kidney disease (CKD). However, the link between decreased estimated glomerular filtration rate (eGFR) and left ventricular (LV) geometry remains poorly explored in general population. In this study, we examined the gender-specific association between eGFR and LVH in the general population from rural Northeast China. This survey was conducted from July 2012 to August 2013. A total of 10907 participants (5,013 men and 5,894 women) from the rural Northeast China were randomly selected and examined. LV mass index (LVMI) was used to define LVH (LVMI > 46.7 g/m(2.7) in women; > 49.2 g/m(2.7) in men). LV geometry was defined as normal, or with concentric remodeling, eccentric or concentric hypertrophy, according to relative wall thickness (RWT) and LVMI. Mildly decreased eGFR was defined as eGFR ≥ 60 and geometry. Only in men, mildly decreased eGFR was associated with concentric remodeling [odds ratio (OR): =1.58; 95% CI: 1.14-2.20; P geometry in men, and a gender-specific difference should be taken into account in clinical practice.

  16. Dietary acid reduction with fruits and vegetables or bicarbonate attenuates kidney injury in patients with a moderately reduced glomerular filtration rate due to hypertensive nephropathy.

    Science.gov (United States)

    Goraya, Nimrit; Simoni, Jan; Jo, Chanhee; Wesson, Donald E

    2012-01-01

    The neutralization of dietary acid with sodium bicarbonate decreases kidney injury and slows the decline of the glomerular filtration rate (GFR) in animals and patients with chronic kidney disease. The sodium intake, however, could be problematic in patients with reduced GFR. As alkali-induced dietary protein decreased kidney injury in animals, we compared the efficacy of alkali-inducing fruits and vegetables with oral sodium bicarbonate to diminish kidney injury in patients with hypertensive nephropathy at stage 1 or 2 estimated GFR. All patients were evaluated 30 days after no intervention; daily oral sodium bicarbonate; or fruits and vegetables in amounts calculated to reduce dietary acid by half. All patients had 6 months of antihypertensive control by angiotensin-converting enzyme inhibition before and during these studies, and otherwise ate ad lib. Indices of kidney injury were not changed in the stage 1 group. By contrast, each treatment of stage 2 patients decreased urinary albumin, N-acetyl β-D-glucosaminidase, and transforming growth factor β from the controls to a similar extent. Thus, a reduction in dietary acid decreased kidney injury in patients with moderately reduced eGFR due to hypertensive nephropathy and that with fruits and vegetables was comparable to sodium bicarbonate. Fruits and vegetables appear to be an effective kidney protective adjunct to blood pressure reduction and angiotensin-converting enzyme inhibition in hypertensive and possibly other nephropathies.

  17. Late acceleration of glomerular filtration rate decline is a risk for hemodialysis catheter use in patients with established nephrology chronic kidney disease care.

    Science.gov (United States)

    Chin, Andrew I; Nguyen, Tuan A; Dinesh, Kumar P; Morfin, José A

    2015-07-01

    Chronic kidney disease (CKD) patients with established nephrology care have a high rate of tunneled dialysis catheters (TDC) as first vascular access when transitioning to hemodialysis (HD). We sought to identify factors associated with this problem. Patients who started HD and had prior CKD care within our renal clinic were categorized according to access type at incident HD. Clinical factors, all estimated glomerular filtration rates (eGFR), renal clinic attendance records, hospital admissions in the 6 months preceding HD start, and patient participation in predialysis education course were analyzed. Three hundred thirty-eight patients initiated HD, 107 received pre-HD CKD care within our clinics. Seventy patients started with a TDC. All groups started HD at similar eGFR values. The trajectory of eGFR decline in the 6 months prior to HD start was significantly more rapid in the TDC group. Patients in the TDC group had more acute health events in the prior 6 months. Multivariate modeling showed that failure to attend a predialysis education course and having a more rapid rate of eGFR decline in the 6 months prior to dialysis initiation were both associated with TDC use. Patients with CKD nephrology care who initiated HD with a TDC as first vascular access had a more rapid rate of decline in eGFR in the months preceding dialysis start and were less likely to have attended our predialysis education course. This appears to correspond with the observed increased number of emergency and hospital visits in the 6 months prior to end-stage renal disease.

  18. Cystatin C相关方程在慢性肾脏病患者的应用评价%Cystatin-C Based Equations for Estimation of Glomerular Filtration Rate in Patients with Chronic Kidney Disease

    Institute of Scientific and Technical Information of China (English)

    李芝帆; 吴小燕; 曾真

    2011-01-01

    Objective: To evaluate the clinical application value of the serum Cystatin-C (Cys C) based equations in calculating glomerular filtration rate (GFR) for patients with chronic kidney disease.Methods: A total of 179 patients with chronic kidney disease were selected, and patients' glomerular filtration rate (GFR) was calculated with MDRD equation, simplified MDRD equation, Hock equation and equations(c-cGFR1, c-cGFR2) recommended by Chinese Society of Nephrology in 2006. These values were compared with the GFR value measured by 99mTc-DTPA renal dynamic imaging examination(sGFR). Results: The results of GFR calculated by the different equations and sGFR were significantly positively correlated, moreover, the results of c-c GFR2 had a higher correlation. Bland-Airman analysis shows that the results of simplified MDRD equation had the highest consistency. Conclusion: Cystatin C as a variable markers of GFR calculated using the second equation recommended by Chinese Soctely of Nephrology in 2006(c-cGFR2) has a higher correlation and consistency with GFR measured by 99mTc-DTPA renal dynamic imaging examination. It can be used to calculate GFR clinically in patients with chronic kidney disease.%目的:评价血清半胱氨酸蛋白酶抑制剂-C(Cys C)相关方程在慢性肾脏病(CKD)患者肾小球滤过率(GFR)计算中的临床应用价值.方法:选取179例慢性肾脏病患者,运用MDRD方程、MDRD简化方程、Hoek方程、2006年中华医学会肾脏病学分会推荐的两个方程计算GFR,与99mTc-DTPA肾动态显像测得的GFR相比较.结果:各方程估算的GFR和99mTc-DTPA肾动态显像测得的GFR均呈相关,其中2006年中华医学会推荐方程2计算的GFR与99mTc-DTPA肾动态显像测得的GFR相关性最好.Bland-Altman分析显示MDRD简化方程计算的GFR和99mTc-DTPA肾动态显像测得的GFR一致性最好.结论:在Cys C相关方程中,2006年中华医学会肾脏病分会推荐公式2计算的GFR,与99mTc-DTPA肾动态显像测

  19. Glomerular filtration rate, cardiovascular risk factors and insulin resistance Filtrado glomerular, riesgo cardiovascular y resistencia a la insulina

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    Martín R. Salazar

    2009-10-01

    Full Text Available The aim of this paper was to study the estimated glomerular filtration rate (eGFR, its changes with age, and its association with systolic blood pressure (SBP and diastolic BP (DBP, indicators of obesity, dyslipemia, insulin resistance and inflammation on a random population sample. BP, weight, size and waist circumference (WC were recorded at home. Fasting morning blood samples were analysed. The eGFR was calculated with MDRD (eGFR-MDRD, Cockroft-Gault (eGFR-CG adjusted to 1.73 m² and reciprocal of serum creatinine (100/serum cretinine. A total of 1016 individuals, 722 females (41.97 ± 0.66 years old and 294 males (42.06 ± 0.99 years old, completed the laboratory tests. The mean of 100/Scr was 115.13 ± 0.60 (dl/mg, the mean eGFR-CG was 98.48 ± 0.82 ml/min/1.73 m²; the mean eGFR-MDRD was 85.15 ± 0.58 ml/min/1.73 m². The eGFR-MDRD decreased with age and with the number of risk factors in both sexes. The eGFR-MDRD El objetivo fue evaluar en una muestra poblacional aleatoria el filtrado glomerular estimado (FGe, sus cambios con la edad y su asociación con presión arterial sistólica (PAS y diastólica (PAD, indicadores de obesidad, dislipemia, resistencia a la insulina e inflamación. En cada domicilio fueron medidos presión arterial, peso y talla y perímetro de la cintura (PC. Se analizaron muestras de sangre en ayunas y fue calculado el FGe usando las fórmulas de MDRD (FGe-MDRD y Cockroft-Gault (FGe-CG ajustado a 1.73 m², y la inversa de la creatinina sérica (100/CrS. Completaron el protocolo de laboratorio 1016 sujetos, 722 mujeres (41.97 ± 0.66 años y 294 varones (42.06 ± 0.99 años. La media de 100/Crs fue 115.13 ± 0.60 (dl/mg, la del FGe-CG 98.48 ± 0.82 ml/min/1.73 m² y la del FGe-MDRD 85.15 ± 0.58 ml/min/1.73 m² (CI 95% 84.00-86.29. El FGe-MDRD disminuyó con la edad y con el número de factores de riesgo cardiovascular en ambos sexos. La prevalecencia ajustada de FGe-MDRD < 60 ml/min/1.73 m² fue 6.2 por 100

  20. Serum resistin and glomerular filtration rate in patients with type 2 diabetes.

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    Lorena Ortega Moreno

    Full Text Available High serum levels of the pro-inflammatory adipokine resistin have been associated with decreased renal function in the general population. The goal of this study was to investigate whether such association is also present among diabetic subjects, who are at increased risk of renal function loss.The cross-sectional association between serum resistin levels and estimated glomerular filtration rate (eGFR was investigated in 1,560 type 2 diabetic (T2D patients of European ancestry comprised in two different cohorts: 762 patients from San Giovanni Rotondo (SGR; Italy and 798 patients from Boston (US.Serum resistin was inversely associated with eGFR in SGR [β (SE for one SD of resistin increment = -1.01 (0.70 ml/min/1.73 m(2, p = 0.019] and in Boston [β (SE = -5.31 (0.74 ml/min/1.73 m(2, p < 0.001] samples, as well as in the two studies combined [β (SE = -3.42 (0.52 ml/min/1.73 m(2, p < 0.001]. The association was unaffected by adjustment for smoking habits, BMI, waist circumference, diabetes duration, HbA1c, insulin treatment, hypertension and lipid-lowering therapy: β (SE for one SD of resistin increment = -1.07 (0.70, p = 0.02; -5.50 (0.88, p < 0.001; and -2.81 (0.55 ml/min/1.73 m(2, p < .001, in SGR, Boston and the two studies combined, respectively. The association was significantly stronger in men than in women (p for resistin-by-gender interaction = 0.003. For each resistin SD increment, the odds of having eGFR < 0 ml/min/1.7 3m(2 increased by 22% (OR = 1.22; 95% CI 1.02-1.44; p = 0.025 in SGR sample, 69% (OR = 1.69; 95% CI 1.38-2.07; p < 0.001 in Boston sample, and 47% (OR = 1.47; 95% CI 1.29-1.68; p < 0.001 in the two studies considered together. Similar associations were observed in the adjusted model: OR 95% CI for each SD resistin increment being 1.23 (1.03-1.46, p = 0.021; 1.52 (1.20-1.92, p < 0.001; 1.33 (1.16-1.53, p < 0.001, in SGR, Boston and the two studies combined, respectively.This is the first report of an association between

  1. Comparison of Glomerular Filtration Rate Estimation from Serum Creatinine and Cystatin C in HNF1A-MODY and Other Types of Diabetes

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    Magdalena Szopa

    2015-01-01

    Full Text Available Introduction. We previously showed that in HNF1A-MODY the cystatin C-based glomerular filtration rate (GFR estimate is higher than the creatinine-based estimate. Currently, we aimed to replicate this finding and verify its clinical significance. Methods. The study included 72 patients with HNF1A-MODY, 72 with GCK-MODY, 53 with type 1 diabetes (T1DM, 70 with type 2 diabetes (T2DM, and 65 controls. Serum creatinine and cystatin C levels were measured. GFR was calculated from creatinine and cystatin C using the CKD-EPI creatinine equation (eGRF-cr and CKD-EPI cystatin C equation (eGFR-cys, respectively. Results. Cystatin C levels were lower (p<0.001 in the control (0.70±0.13 mg/L, HNF1A (0.75±0.21, and GCK (0.72±0.16 mg/L groups in comparison to those with either T1DM (0.87±0.15 mg/L or T2DM (0.9±0.23 mg/L. Moreover, eGFR-cys was higher than eGRF-cr in HNF1A-MODY, GCK-MODY, and the controls (p=0.004; p=0.003; p<0.0001. This corresponded to 8.9 mL/min/1.73 m2, 9.7 mL/min/1.73 m2, and 16.9 mL/min/1.73 m2 of difference. Additionally, T1DM patients had higher eGFR-cr than eGFR-cys (11.6 mL/min/1.73 m2; p=0.0004; no difference occurred in T2DM (p=0.91. Conclusions. We confirmed that eGFR-cys values in HNF1A-MODY patients are higher compared to eGFR-cr. Some other differences were also described in diabetic groups. However, none of them appears to be clinically relevant.

  2. Association of glomerular filtration rate with high-sensitivity cardiac troponin T in a community-based population study in Beijing.

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    Fan Wang

    Full Text Available BACKGROUND: Reduced renal function is an independent risk factor for cardiovascular disease mortality, and persistently elevated cardiac troponin T (cTnT is frequently observed in patients with end-stage renal disease. In the general population the relationship between renal function and cTnT levels may not be clear because of the low sensitivity of the assay. In this study, we investigated the level of cTnT using a highly sensitive assay (hs-cTnT and evaluated the association of estimated glomerular filtration rate (eGFR with detectable hs-cTnT levels in a community-based population. METHODS: The serum hs-cTnT levels were measured in 1365 community dwelling population aged ≥45 years in Beijing, China. eGFR was determined by the Chinese modifying modification of diet in renal disease (C-MDRD equation. RESULTS: With the highly sensitive assay, cTnT levels were detectable (≥3pg/mL in 744 subjects (54.5%. The result showed that eGFR was associated with Log hs-cTnT (r = -0.14, P20% and other prognostic indicators, moderate to severe reduced eGFR was independently associated with detectable hs-cTnT, whereas normal to mildly reduced eGFR was not independently associated with detectable hs-cTnT. In addition, after adjustment for other risk factors, the high predicted Framingham CHD risk was associated with detectable hs-cTnT in the subjects with different quartile levels of eGFR. CONCLUSION: The levels of hs-cTnT are detectable in a community-based Chinese population and low eGFR is associated with detectable hs-cTnT. Moreover, eGFR and high predicted Framingham CHD risk are associated with detectable hs-cTnT in subjects with moderate-to-severe reduced renal function.

  3. Modified Glomerular Filtration Rate-Estimating Equations Developed in Asiatic Population for Chinese Patients with Type 2 Diabetes

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    Xun Liu

    2014-01-01

    Full Text Available Objectives. To evaluate eight modified equations developed in Asiatic populations in type 2 diabetic patients in China. Methods. A total of 209 Chinese patients with type 2 diabetes were recruited. Using the technetium—99m diethylenetriaminepentaacetic acid—glomerular filtration rate (GFR to act as the reference, comparisons of their efficiency to estimate GFR in the subjects were made between various equations. Results. Median of difference of the Chinese equation 1 was the lowest (median of difference, 0.51 mL/min/1.73 m2. Median percent of absolute difference of the Chinese equation 2 was less than those of the other equations (26.97 versus ranged from 32.54 to 37.61 mL/min/1.73 m2, [P<0.001 for all]. Precision of the simplified reexpressed MDRD equation was the best (92.9 mL/min/1.73 m2. Accuracies of the Chinese equation 2 were greater (P<0.05 for all. There was also an improvement in chronic kidney disease (CKD stage misclassification of the Chinese equation 2 (55.0 versus ranged from 61.2 to 64.6%, [P<0.001 for all]. However, the 30% accuracies of all the equations were less than 70%. Conclusions. Our study highlighted a limitation in the use of the above equations in the majority of Chinese diabetic subjects. A better equation is needed in order to give an accurate estimation of GFR in type 2 diabetic patients in China.

  4. Mortality rates across 25-hydroxyvitamin D (25[OH]D levels among adults with and without estimated glomerular filtration rate <60 ml/min/1.73 m2: the third national health and nutrition examination survey.

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    Holly Kramer

    Full Text Available BACKGROUND: Previous studies exploring the association between 25[OH]D levels and mortality in adults with and without kidney disease utilized 25[OH]D thresholds that have recently been scrutinized by the Institute of Medicine Committee to Review Dietary References Intakes for Vitamin D and Calcium. OBJECTIVE: We explored all-cause mortality rates across the spectrum of 25[OH]D levels over an eighteen-year follow-up among adults with and without an estimated glomerular filtration rate (eGFR 20 ng/ml after adjustment for all covariates. CONCLUSIONS: Regardless of presence of eGFR <60 ml/min/1.73 m(2, mortality rates across groups with 25[OH]D levels 20-40 ng/ml are similar.

  5. C-Terminal to Intact Fibroblast Growth Factor 23 Ratio in Relation to Estimated Glomerular Filtration Rate in Elderly Population

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    Maria Bożentowicz-Wikarek

    2016-08-01

    Full Text Available Background/Aims: An analytical equivalence between intact fibroblasts growth factor(iFGF23 and C-terminal(cFGF23 assays is logically expected, however, numerous studies demonstrate lack of a strong association between them. Previously, we have demonstrated the increase in cFGF23 slightly precedes the increase of iFGF23 with the impairment of kidney excretory function; without actually analyzing the ratio between both assays, which are postulated to be affected by declining kidney function. Therefore, the aim of this study was to analyze the ratio between C and iFGF23 in relation to the estimated glomerular filtration rate (eGFR in an elderly population. Methods: We analysed the variability of c/iFGF23 ratio in the population of 3264 elderly PolSenior study participants (≥ 65years in the relation to eGFR calculated according full Modification of Diet in Renal Disease, serum levels of C-reactive protein (hs-CRP, and iron. Results: The log10(c/i FGF23 ratio increased in the subsequent CKD stages. Serum iron and CRP levels reduced the log10 and increased it with age in multivariate regression analysis. Conclusions: Our results suggest impairment in the cleavage of the C-terminal FGF23 fragments with the deterioration of kidney excretory function and age in the elderly population. Inflammation and low serum iron level seems to diminish degradation capacity of FGF23 fragments.

  6. Measuring and estimating GFR and treatment effect in ADPKD patients: results and implications of a longitudinal cohort study.

    Science.gov (United States)

    Ruggenenti, Piero; Gaspari, Flavio; Cannata, Antonio; Carrara, Fabiola; Cella, Claudia; Ferrari, Silvia; Stucchi, Nadia; Prandini, Silvia; Ene-Iordache, Bogdan; Diadei, Olimpia; Perico, Norberto; Ondei, Patrizia; Pisani, Antonio; Buongiorno, Erasmo; Messa, Piergiorgio; Dugo, Mauro; Remuzzi, Giuseppe

    2012-01-01

    Trials failed to demonstrate protective effects of investigational treatments on glomerular filtration rate (GFR) reduction in Autosomal Dominant Polycystic Kidney Disease (ADPKD). To assess whether above findings were explained by unreliable GFR estimates, in this academic study we compared GFR values centrally measured by iohexol plasma clearance with corresponding values estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) and abbreviated Modification of Diet in Renal Disease (aMDRD) formulas in ADPKD patients retrieved from four clinical trials run by a Clinical Research Center and five Nephrology Units in Italy. Measured baseline GFRs and one-year GFR changes averaged 78.6±26.7 and 8.4±10.3 mL/min/1.73 m(2) in 111 and 71 ADPKD patients, respectively. CKD-Epi significantly overestimated and aMDRD underestimated baseline GFRs. Less than half estimates deviated by GFR changes did not detect measured changes. Both formulas underestimated GFR changes by 50%. Less than 9% of estimates deviated GFR changes. In ADPKD, prediction formulas unreliably estimate actual GFR values and fail to detect their changes over time. Direct kidney function measurements by appropriate techniques are needed to adequately evaluate treatment effects in clinics and research.

  7. Estimating glomerular filtration rate equation and medical laboratory%估算肾小球滤过率的建立与医学检验

    Institute of Scientific and Technical Information of China (English)

    潘柏申

    2014-01-01

    Estimating glomerular filtration rate is very useful in the management of chronic kidney disease.The clinical laboratories should understand these eGFR equations.%估算肾小球滤过率在慢性肾脏疾病的诊断治疗中有着重要临床意义。了解这些eGFR公式的发展和临床应用过程,可以得到一些有价值的启示。(中华检验医学杂志,2014,37:401-403)

  8. Estimated Glomerular Filtration Rate Trajectories in HIV-Infected Subjects Treated With Different Ritonavir-Boosted Protease Inhibitors and Tenofovir Disoproxil Fumarate or Abacavir.

    Science.gov (United States)

    Gianotti, Nicola; Galli, Laura; Poli, Andrea; Salpietro, Stefania; Nozza, Silvia; Carbone, Alessia; Merli, Marco; Ripa, Marco; Lazzarin, Adriano; Castagna, Antonella

    2016-05-01

    The aim of the study was to evaluate in human immunodeficiency virus (HIV)-infected patients estimated glomerular filtration rate (eGFR) trajectories during treatment with different protease inhibitors (PIs) or a non-nucleoside reverse transcriptase inhibitor (NNRTI) plus tenofovir (TDF) or abacavir (ABC) and lamivudine or emtricitabine (xTC).Retrospective study of patients followed at a single clinical center; all patients who started TDF or ABC for the first time with a NNRTI or lopinavir/r (LPV/r) or atazanavir/r (ATV/r) or darunavir/r (DRV/r), for whom at least 1 eGFR value before the start and during the studied treatment was known, were included in this analysis. eGFR was calculated by means of the CKD-EPI formula. Univariate and multivariate mixed linear model (MLM) was applied to estimate eGFR slope with the considered antiretroviral treatment.In the 1658 patients treated with TDF/xTC (aged 43 [37-48] years, with an eGFR of 105 [96; 113] mL/min/1.73 m, 80% males, 92% Caucasians, 10% coinfected with HCV, 4% with diabetes, 11% with hypertension, 38% naive for antiretroviral therapy (ART), 37% with HIV-RNA <50 copies/mL) the median follow-up was 2.5 (1.2-4.6) years. Their adjusted eGFR slopes (95% CI) were -1.26 (-1.58; -0.95), -0.43 (-1.20; +0.33), -0.86 (-1.28; -0.44), and -0.20 (-0.42; +0.02) mL/min/1.73 m per year in patients treated with ATV/r, DRV/r, LPV/r, and NNRTI, respectively. Patients receiving ATV/r or LPV/r had a greater adjusted decline in eGFR compared with those receiving NNRTIs (difference -1.06 [-1.44; -0.69] mL/min/1.73 m per year, P <0.001; and -0.66 [-1.13; -0.20] mL/min/1.73 m per year, P = 0.005, respectively); adjusted eGFR slopes were similar in patients receiving DRV/r and in those receiving NNRTIs. Patients receiving ATV/r had a greater adjusted eGFR decline than those treated with DRV/r (difference -0.83 [-1.65; -0.02] mL/min/1.73 m per year; P = 0.04), but not than those receiving LPV/r; no significant difference was

  9. GFR Decline and Subsequent Risk of Established Kidney Outcomes : A Meta-analysis of 37 Randomized Controlled Trials

    NARCIS (Netherlands)

    Lambers Heerspink, Hiddo J.; Tighiouart, Hocine; Sang, Yingying; Ballew, Shoshana; Mondal, Hasi; Matsushita, Kunihiro; Coresh, Josef; Levey, Andrew S.; Inker, Lesley A.

    2014-01-01

    Background: The currently established end points for clinical trials of progression of chronic kidney disease (CKD) are end-stage renal disease and doubling of serum creatinine level, which approximates a 57% decline in estimated glomerular filtration rate (eGFR). There is increased interest in usin

  10. A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury

    NARCIS (Netherlands)

    James, Matthew T.; Grams, Morgan E.; Woodward, Mark; Elley, C. Raina; Green, Jamie A.; Wheeler, David C.; de Jong, Paul; Gansevoort, Ron T.; Levey, Andrew S.; Warnock, David G.; Sarnak, Mark J.; de Zeeuw, Dick; Bakker, Stephan J. L.; van der Harst, Pim; Heerspink, Hiddo J.

    2015-01-01

    Background: Diabetes mellitus and hypertension are risk factors for acute kidney injury (AKI). Whether estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (ACR) remain risk factors for AKI in the presence and absence of these conditions is uncertain. Study Design:

  11. A Meta-analysis of the Association of Estimated GFR, Albuminuria, Age, Race, and Sex With Acute Kidney Injury

    NARCIS (Netherlands)

    Grams, Morgan E.; Sang, Yingying; Ballew, Shoshana H.; Gansevoort, Ron T.; Kimm, Heejin; Kovesdy, Csaba P.; Naimark, David; Oien, Cecilia; Smith, David H.; Coresh, Josef; Sarnak, Mark J.; Stengel, Benedicte; Tonelli, Marcello; de Zeeuw, Dick; Bakker, Stephan J. L.; van der Harst, Pim; Heerspink, Hiddo J.; Hillege, Hans L.

    2015-01-01

    Background: Acute kidney injury (AKI) is a serious global public health problem. We aimed to quantify the risk of AKI associated with estimated glomerular filtration rate (eGFR), albuminuria (albumin-creatinine ratio [ACR]), age, sex, and race (African American and white). Study Design: Collaborativ

  12. Predictive capacity of pre-donation GFR and renal reserve capacity for donor renal function after living kidney donation

    NARCIS (Netherlands)

    Rook, M; Hofker, HS; van Son, WJ; van der Heide, JJH; Ploeg, RJ; Navis, GJ

    2006-01-01

    Kidney transplantation from living donors is important to reduce organ shortage. Reliable pre-operative estimation of post-donation renal function is essential. We evaluated the predictive potential of pre-donation glomerular filtration rate (GFR) (iothalamate) and renal reserve capacity for post-do

  13. Feasibility and impact of the measurement of extracellular fluid volume simultaneous with GFR by I-125-iothalamate

    NARCIS (Netherlands)

    Visser, Folkert W.; Muntinga, Jaap H. J.; Dierckx, Rudi A.; Navis, Gerjan

    2008-01-01

    The feasibility, validity, and possible applications of the assessment of extracellular fluid volume (ECFV) simultaneous with glomerular filtration rate (GFR) were assessed in a series of validation studies using the constant infusion method of I-125-iothalamate (IOT). In 48 subjects with a broad ra

  14. Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts.

    Science.gov (United States)

    van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C; Woodward, Mark; Levey, Andrew; de Jong, Paul; Gansevoort, Ron T; van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C; Woodward, Mark; Levey, Andrew S; de Jong, Paul E; Gansevoort, Ron T; Levey, Andrew; El-Nahas, Meguid; Eckardt, Kai-Uwe; Kasiske, Bertram L; Ninomiya, Toshiharu; Chalmers, John; Macmahon, Stephen; Tonelli, Marcello; Hemmelgarn, Brenda; Sacks, Frank; Curhan, Gary; Collins, Allan J; Li, Suying; Chen, Shu-Cheng; Hawaii Cohort, K P; Lee, Brian J; Ishani, Areef; Neaton, James; Svendsen, Ken; Mann, Johannes F E; Yusuf, Salim; Teo, Koon K; Gao, Peggy; Nelson, Robert G; Knowler, William C; Bilo, Henk J; Joosten, Hanneke; Kleefstra, Nanno; Groenier, K H; Auguste, Priscilla; Veldhuis, Kasper; Wang, Yaping; Camarata, Laura; Thomas, Beverly; Manley, Tom

    2011-06-01

    Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative meta-analysis of 10 cohorts with 266,975 patients selected because of increased risk for chronic kidney disease, defined as a history of hypertension, diabetes, or cardiovascular disease. Risk for all-cause mortality was not associated with eGFR between 60-105 ml/min per 1.73 m², but increased at lower levels. Hazard ratios at eGFRs of 60, 45, and 15 ml/min per 1.73 m² were 1.03, 1.38 and 3.11, respectively, compared to an eGFR of 95, after adjustment for albuminuria and cardiovascular risk factors. Log albuminuria was linearly associated with log risk for all-cause mortality without thresholds. Adjusted hazard ratios at albumin-to-creatinine ratios of 10, 30 and 300 mg/g were 1.08, 1.38, and 2.16, respectively compared to a ratio of five. Albuminuria and eGFR were multiplicatively associated with all-cause mortality, without evidence for interaction. Similar associations were observed for cardiovascular mortality. Findings in cohorts with dipstick data were generally comparable to those in cohorts measuring albumin-to-creatinine ratios. Thus, lower eGFR and higher albuminuria are risk factors for all-cause and cardiovascular mortality in high-risk populations, independent of each other and of cardiovascular risk factors.

  15. Treatment of metabolic acidosis in patients with stage 3 chronic kidney disease with fruits and vegetables or oral bicarbonate reduces urine angiotensinogen and preserves glomerular filtration rate.

    Science.gov (United States)

    Goraya, Nimrit; Simoni, Jan; Jo, Chan-Hee; Wesson, Donald E

    2014-11-01

    Alkali therapy of metabolic acidosis in patients with chronic kidney disease (CKD) with plasma total CO2 (TCO2) below 22 mmol/l per KDOQI guidelines appears to preserve estimated glomerular filtration rate (eGFR). Since angiotensin II mediates GFR decline in partial nephrectomy models of CKD and even mild metabolic acidosis increases kidney angiotensin II in animals, alkali treatment of CKD-related metabolic acidosis in patients with plasma TCO2 over 22 mmol/l might preserve GFR through reduced kidney angiotensin II. To test this, we randomized 108 patients with stage 3 CKD and plasma TCO2 22-24 mmol/l to Usual Care or interventions designed to reduce dietary acid by 50% using sodium bicarbonate or base-producing fruits and vegetables. All were treated to achieve a systolic blood pressure below 130 mm Hg with regimens including angiotensin converting enzyme inhibition and followed for 3 years. Plasma TCO2 decreased in Usual Care but increased with bicarbonate or fruits and vegetables. By contrast, urine excretion of angiotensinogen, an index of kidney angiotensin II, increased in Usual Care but decreased with bicarbonate or fruits and vegetables. Creatinine-calculated and cystatin C-calculated eGFR decreased in all groups, but loss was less at 3 years with bicarbonate or fruits and vegetables than Usual Care. Thus, dietary alkali treatment of metabolic acidosis in CKD that is less severe than that for which KDOQI recommends therapy reduces kidney angiotensin II activity and preserves eGFR.

  16. The Cluster of Abnormalities Related to Metabolic Syndrome Is Associated With Reduced Glomerular Filtration Rate and Raised Albuminuria in Patients With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Kurata, Miki; Takenouchi, Akiko; Tsuboi, Ayaka; Minato, Satomi; Takeuchi, Mika; Kitaoka, Kaori; Fukuo, Keisuke; Kazumi, Tsutomu

    2017-09-01

    As association of metabolic syndrome (MS) with chronic kidney disease (CKD) has not been extensively studied in patients with type 2 diabetes, we addressed these issues. Intrapersonal means of 12 measurements of waist circumference, blood pressure and high-density lipoprotein (HDL) cholesterol and those of six measurements of fasting triglycerides during 12 months were calculated in a cohort of 168 previously reported Japanese patients with type 2 diabetes. Based on these means, MS was diagnosed according to the modified National Cholesterol Education Program Adult Treatment Panel III criteria with the Asian definition of abdominal obesity. CKD was defined as the presence of low estimated glomerular filtration rate (eGFR < 60 mL/min/1.73 m(2)), albuminuria (urinary albumin/creatinine ratio (ACR) ≥ 30 mg/g) or both. Of 168 patients, 77 patients (46 %) had MS and 67 (40 %) had CKD. As the number of MS components increased from 1 through 5, the prevalence of albuminuria (9%, 38%, 30%, 41%, and 50%, P < 0.001), low eGFR (0%, 10%, 24%, 22%, and 50%, P < 0.001) and consequently, CKD increased (9%, 41%, 48%, 52%, and 75%, P < 0.001). Urinary ACR increased and eGFR decreased as a function of the number of MS components. As compared to patients without MS, prevalence of low eGFR (26% vs. 7%, P = 0.001) and CKD (52% vs. 30%, P = 0.005) was higher in patients with MS but prevalence of albuminuria did not differ (36% vs. 27%, P = 0.2). In Japanese patients with type 2 diabetes, the cluster of abnormalities related to MS was associated not only with higher prevalence of albuminuria, reduced kidney function and hence the increase in CKD but also with corresponding changes in urinary ACR and eGFR.

  17. Enzymatic creatinine assays allow estimation of glomerular filtration rate in stages 1 and 2 chronic kidney disease using CKD-EPI equation.

    Science.gov (United States)

    Kuster, Nils; Cristol, Jean-Paul; Cavalier, Etienne; Bargnoux, Anne-Sophie; Halimi, Jean-Michel; Froissart, Marc; Piéroni, Laurence; Delanaye, Pierre

    2014-01-20

    The National Kidney Disease Education Program group demonstrated that MDRD equation is sensitive to creatinine measurement error, particularly at higher glomerular filtration rates. Thus, MDRD-based eGFR above 60 mL/min/1.73 m² should not be reported numerically. However, little is known about the impact of analytical error on CKD-EPI-based estimates. This study aimed at assessing the impact of analytical characteristics (bias and imprecision) of 12 enzymatic and 4 compensated Jaffe previously characterized creatinine assays on MDRD and CKD-EPI eGFR. In a simulation study, the impact of analytical error was assessed on a hospital population of 24084 patients. Ability using each assay to correctly classify patients according to chronic kidney disease (CKD) stages was evaluated. For eGFR between 60 and 90 mL/min/1.73 m², both equations were sensitive to analytical error. Compensated Jaffe assays displayed high bias in this range and led to poorer sensitivity/specificity for classification according to CKD stages than enzymatic assays. As compared to MDRD equation, CKD-EPI equation decreases impact of analytical error in creatinine measurement above 90 mL/min/1.73 m². Compensated Jaffe creatinine assays lead to important errors in eGFR and should be avoided. Accurate enzymatic assays allow estimation of eGFR until 90 mL/min/1.73 m² with MDRD and 120 mL/min/1.73 m² with CKD-EPI equation.

  18. Effect of Vitamin D Receptor Activators on Glomerular Filtration Rate: A Meta-Analysis and Systematic Review.

    Directory of Open Access Journals (Sweden)

    Qian Zhang

    Full Text Available Vitamin D receptor activators (VDRAs can protect against mineral bone disease, but they are reported to elevate serum creatinine (SCr and may also reduce glomerular filtration rate (GFR.We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs to evaluate the effect of VDRAs on kidney function and adverse events. MEDLINE, EMBASE, the Cochrane Controlled Trials Register were searched for RCTs that evaluate vitamin D receptor activators (alfacalcidol, calcitriol, doxercalciferol, falecalcitriol, maxacalcitol and paricalcitol up to March 2015.We included 31 studies, all of which were performed between 1976 and 2015, which enrolled 2621 patients. Patients receiving VDRAs had lower eGFR (weighted mean difference WMD -1.29 mL/min /1.73 m2, 95% CI -2.42 to -0.17 and elevated serum creatinine (WMD 7.03 μmol/L, 95% CI 0.61 to 13.46 in sensitivity analysis excluding studies with dropout rate more than 30%. Subgroup analysis of the 5 studies that not use SCr-based measures did not indicated lower GFR in the VDRAs group(WMD -0.97 mL/min/1.73 m2, 95% CI -4.85 to 2.92. Compared with control groups, there was no difference in all-cause mortality (relative risk RR 1.41, 95% CI 0.58 to 3.80, cardiovascular disease (RR 0.84, 95% CI 0.42 to 1.71, and severe adverse events (RR 1.15, 95% CI 0.75 to 1.77 for the VDRAs groups. Episodes of hypercalcemia (RR 3.29, 95% CI 2.02 to 5.38 were more common in the VDRAs group than in the control group.Administration of VDRAs increased serum creatinine levels. Subgroup analysis of studies that did not use SCr-based measures did not indicate a lower GFR in the VDRA group. Future studies with non-SCr-based measures are needed to assess whether the mild elevations of serum creatinine are of clinical significance.

  19. Applicability of Glomerular Filtration Rate Estimated with Three Equations in Chinese Patients with Chronic Kidney%三种肾小球滤过率评估方程在中国慢性肾脏病患者的适用性评价

    Institute of Scientific and Technical Information of China (English)

    史育红; 雷远东; 何清; 李俊凌; 黄慧

    2011-01-01

    目的 评价简化肾脏病膳食改良试验(MDRDa)方程以及国内两个改良MDRD方程(中国方程1、2)预测中国慢性肾脏病患者肾小球滤过率(glomerular filtration rate,GFR)的适用性.方法 选择2008年1-12月住院慢性肾病患者250例,用Tc-DTPA肾动态显像法测定GFR(sGFR),同时测定血清肌酐、尿素氮,根据年龄和性别分别用简化MDRD方程、中国方程1和中国方程2预测GFR,即eGFRa(简化MDRD方程)、eGFRl(中国方程1)和eGFR2(中国方程2),以sGFR为参考值,将估计的eGFRs进行比较.结果 各方程eGFRs与sGFR之间呈显著相关关系.其中中国方程2的估箅eGFR2与sGFR具有良好的一致性,总体偏差最小,准确性最高.结果 中国方程2优于简化MDRD方程和中国方程1,可用于中国慢性肾病人群eGFR的计算.%Objective To evaluate the applicability of three equations for glomerular filtration rate (GFR) in Chinese patients with chronic kidney disease (CKD).Methods A total of 250 patients with CKD which were diagnosed according to K/DAQI guidelines between January and December 2008 were selected.GFR were estimated with Chinese equation 1 (eGFR1), Chinese equation 2 (eGFR2) and abbreviated MDRD (eGFRa) separately, and the results were compared with that of 99mTc-DTPA(sGFR).Results The eGFRs of the three equations were correlated significantly with sGFR.Chinese equation 2 seemed to be the best; eGFR2 showed less bias and higher accuracy than other equations.Conclusions Chinese equation 2 for estimation of GFR may be more accurate in Chinese CKD patients.

  20. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki (Dept. of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)), email: utsunomi@kumamoto-u.ac.jp; Awai, Kazuo (Dept. of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima Univ., Hiroshima (Japan)); Funama, Yoshinori (Dept. of Medical Physics, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan))

    2011-06-15

    Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 +- 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m2) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 < =eGFR < 90, 45 < =eGFR < 60, 30 < =eGFR < 45 and eGFR < 30, respectively. Results Of the 6586 patients, 1.6%, 3.7%, 13.7%, and 54.2% were judged to present with severe, moderate-b, moderate-a, and mild RI, respectively. While moderate-b-to-severe RI was recorded in 133 (3.2%) of 4161 patients aged 70 years or less, it was observed in 218 (9.0%) of the 2425 patients who were 71 years or older. Among the 829 CVD patients, 9.9% manifested moderate-b-to-severe- and 73.0% mild-to-moderate-a RI. The corresponding rates were 4.4% and 68.9% for oncologic disease, 16.9% and 61.2% for DM, and 4.8% and 71.5% for CLD patients. By univariate analysis, there was a significant association between moderate-b-to-severe RI and the advanced age, CVD, DM, and non-oncologic disease. Multivariate analysis showed that the advanced age, DM, and non-oncologic disease were statistically associated with moderate-b-to-severe RI. Conclusion The incidence of RI of eGFR < 45mL/min/1.73 m2 at baseline was high in patients with advanced age, CVD and DM and

  1. Fluctuations in eGFR in relation to unenhanced and enhanced MRI and CT outpatients

    DEFF Research Database (Denmark)

    Azzouz, Manal; Rømsing, Janne; Thomsen, Henrik S

    2014-01-01

    OBJECTIVE: To study fluctuations in estimated glomerular filtration rate (eGFR) in relation to contrast medium (CM) enhanced magnetic resonance imaging (MRI) and computed tomography (CT) compared to control groups in outpatients. MATERIALS AND METHODS: eGFR was determined right before the imaging...... relevant rise in eGFR after three days in all four groups. The average eGFR variation was 4.8ml/min/1.73m(2). There were large variations in eGFR between the two measurements in 45.8% of the patients as they had a change greater than ±10ml/min/1.73m(2). Only three patients fulfilled the contrast......-induced nephropathy (CIN) requirement when the definition s-creatinine ≥44μmol/l (0.5mg/dl) was used. CONCLUSIONS: eGFR in outpatients undergoing MRI or CT did vary independently of whether the patient received contrast or not. The findings probably reflect the natural variations in s-creatinine levels. This should...

  2. Fluctuations in eGFR in relation to unenhanced and enhanced MRI and CT outpatients

    Energy Technology Data Exchange (ETDEWEB)

    Azzouz, Manal, E-mail: manalazzouz@gmail.com [Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK 2730 Herlev (Denmark); Rømsing, Janne [Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen Ø (Denmark); Thomsen, Henrik S. [Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK 2730 Herlev (Denmark)

    2014-06-15

    Objective: To study fluctuations in estimated glomerular filtration rate (eGFR) in relation to contrast medium (CM) enhanced magnetic resonance imaging (MRI) and computed tomography (CT) compared to control groups in outpatients. Materials and methods: eGFR was determined right before the imaging procedure and three days later at the department or at the patient's home. The iodine-based and gadolinium-based contrast media were the same as used for all other examinations at the department. Results: A total of 716 patients completed the study. There was a statistically significant, but not clinically relevant rise in eGFR after three days in all four groups. The average eGFR variation was 4.8 ml/min/1.73 m{sup 2}. There were large variations in eGFR between the two measurements in 45.8% of the patients as they had a change greater than ±10 ml/min/1.73 m{sup 2}. Only three patients fulfilled the contrast-induced nephropathy (CIN) requirement when the definition s-creatinine ≥44 μmol/l (0.5 mg/dl) was used. Conclusions: eGFR in outpatients undergoing MRI or CT did vary independently of whether the patient received contrast or not. The findings probably reflect the natural variations in s-creatinine levels. This should be taken into consideration when CIN is studied.

  3. Research progress of estimating glomerular filtration rate in chronic kidney disease%估算肾小球滤过率在慢性肾脏疾病诊疗中的研究现状

    Institute of Scientific and Technical Information of China (English)

    王蓓丽; 郭玮; 潘柏申

    2014-01-01

    The mortality of chronic kidney disease (CKD) is increasing because of renal failure,cardiovascular diseases and other reasons which has been a global public health problem.Glomerular filtration rate (GFR) is the important biomarker of kidney function evaluation and early diagnosis of CKD,whose direct measurement methods cannot be widely applied in clinical laboratory.With the development of studies on estimating glomerular filtration rate (eGFR) equations,eGFR has been a biomarker of kidney function evaluation in clinical diagnosis.The current paper reviews the research progress and clinical application of different eGFR equations.%慢性肾脏疾病(CKD)患者由于肾功能衰竭、心血管疾病等原因死亡率较高,已成为社会广泛关注的医疗问题.肾小球滤过率(GFR)是评估肾脏功能和早期诊断CKD的重要标志物,但GFR直接检测法无法广泛应用于临床常规检测.随着各类估算肾小球滤过率(eGFR)公式的研究报道,eGFR已成为临床评估患者肾脏功能的重要指标之一.本文综述了不同估算肾小球滤过率公式的研究进展及其在临床诊疗中的应用.

  4. Avaliação do ritmo de filtração glomerular Assessment of glomerular filtration rate

    Directory of Open Access Journals (Sweden)

    Gianna Mastroianni Kirsztajn

    2007-08-01

    Full Text Available A medida do ritmo de filtração glomerular (RFG é a prova laboratorial mais utilizada na avaliação da função renal. Para tanto, usam-se marcadores indiretos, como as determinações de creatinina e cistatina C no sangue, ou procede-se à determinação do RFG propriamente dito, com indicadores como inulina; contrastes iodados, marcados ou não; e outras substâncias. O exame mais solicitado para avaliação do RFG no laboratório de patologia clínica é a dosagem da creatinina sérica. Em algumas condições, entretanto, o resultado encontrado da creatinina sérica deve ser corrigido (através da utilização de fórmulas que levam em consideração características próprias do indivíduo para ser devidamente interpretado. De fato, a inulina ainda é vista como marcador ideal de filtração glomerular, mas seu uso não se destina à prática clínica, de modo que ainda hoje persiste a busca por testes adequados para uso rotineiro.Glomerular filtration rate (GFR determination is the most frequently used laboratorial test to evaluate renal function. Indirect markers as blood determination of creatinine and cystatin C are used with this purpose, as well as the direct determination of GFR, with indicators like inulin; iodated contrasts, radioactive or not; and others. Serum creatinine is the test that is most commonly performed in order to evaluate GFR in the clinical pathology laboratory. However, in some conditions, aiming at the adequate interpretation of the test, the result of serum creatinine must be corrected (by using formulas that include individual characteristics of the subjects. In fact, inulin is still seen as the ideal marker of glomerular filtration, but its use is not directed to clinical practice; then the search for appropriate tests for routine use continues.

  5. Measurement of the ratio of glomerular filtration rate to plasma volume from the technetium-99m diethylene triamine pentaacetic acid renogram: comparison with glomerular filtration rate in relation to extracellular fluid volume

    Energy Technology Data Exchange (ETDEWEB)

    Peters, A.M. (Dept. of Diagnostic Radiology, Hammersmith Hospital, London (United Kingdom)); Allison, H. (Dept. of Diagnostic Radiology, Hammersmith Hospital, London (United Kingdom)); Ussov, W.Yu. (Dept. of Diagnostic Radiology, Hammersmith Hospital, London (United Kingdom))

    1994-04-01

    We describe a technique which does not require a blood sample, is already normalised for plasma volume and uses the robust Patlak plot for measuring renal uptake. The rate of kidney uptake, dR(t)/dt, at time = 0, as a fraction of the injected dose, is equal to the fraction of the plasma volume (PV) filtered per minute, i.e. IKGFR/PV. The gradient dR(0)/dt cannot be accurately measured directly but is equal to [[alpha] . LV(0)], where [alpha] is the renal uptake constant (proportional to IKGFR) and LV is the count rate over a left ventricular ROI. LV(0) was obtained by extrapolation of LV(t), while [alpha] is the slope of the Patlak plot up to 3 min. GFR/PV (i.e. right plus left kidneys) in patients with normal renal function was about 0.04 min[sup -1], as would be expected from normal values of GFR (120 ml/min) and plasma volume (3 l). GFR/PV correlated significantly with the ratio of GFR to extracellular fluid volume (ECV), measured from the terminal exponential of the plasma clearance curve (GFR/PV = 3.2.GFR/ECV + 5.3 ml/min/l [r = 0.82, n = 82]). GFR/PV (r = 0.74) and GFR/ECV (r = 0.82) both correlated inversely and non-linearly with plasma creatinine in 43 studies where the measurement was made within 1 week of the [sup 99m]Tc-DTPA study. They also correlated significantly with the plasma cyclosporin trough level in 14 patients with dermatomyositis on the 30 occasions when this measurement was made within 1 week of the renogram (r = -0.38, P < 0.05 for GFR/PV and r = -0.77, P < 0.001 for GFR/ECV). The ratio of GFR/PV to GFR/ECV is the ratio of extracellular fluid volume to plasma volume, and this was 4.0 (SD 0.99). We conclude that both GFR/PV and GFR/ECV can be easily measured with [sup 99m]Tc-DTPA and are physiologically valid expressions of GFR. (orig./MG)

  6. Associations of blood lead, cadmium, and mercury with estimated glomerular filtration rate in the Korean general population: Analysis of 2008-2010 Korean National Health and Nutrition Examination Survey data

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yangho [Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of); Lee, Byung-Kook, E-mail: bklee@sch.ac.kr [Institute of Environmental and Occupational Medicine, Soonchunhyang University 646 Eupnae-ri, Shinchang-myun, Asan-si, Choongnam 336-745 (Korea, Republic of)

    2012-10-15

    Introduction: The objective of this study was to evaluate associations between blood lead, cadmium, and mercury levels with estimated glomerular filtration rate in a general population of South Korean adults. Methods: This was a cross-sectional study based on data obtained in the Korean National Health and Nutrition Examination Survey (KNHANES) (2008-2010). The final analytical sample consisted of 5924 participants. Estimated glomerular filtration rate (eGFR) was calculated using the MDRD Study equation as an indicator of glomerular function. Results: In multiple linear regression analysis of log2-transformed blood lead as a continuous variable on eGFR, after adjusting for covariates including cadmium and mercury, the difference in eGFR levels associated with doubling of blood lead were -2.624 mL/min per 1.73 m Superscript-Two (95% CI: -3.803 to -1.445). In multiple linear regression analysis using quartiles of blood lead as the independent variable, the difference in eGFR levels comparing participants in the highest versus the lowest quartiles of blood lead was -3.835 mL/min per 1.73 m Superscript-Two (95% CI: -5.730 to -1.939). In a multiple linear regression analysis using blood cadmium and mercury, as continuous or categorical variables, as independent variables, neither metal was a significant predictor of eGFR. Odds ratios (ORs) and 95% CI values for reduced eGFR calculated for log2-transformed blood metals and quartiles of the three metals showed similar trends after adjustment for covariates. Discussion: In this large, representative sample of South Korean adults, elevated blood lead level was consistently associated with lower eGFR levels and with the prevalence of reduced eGFR even in blood lead levels below 10 {mu}g/dL. In conclusion, elevated blood lead level was associated with lower eGFR in a Korean general population, supporting the role of lead as a risk factor for chronic kidney disease.

  7. Applicability of the Schwartz Equation and the Chronic Kidney Disease in Children Bedside Equation for Estimating Glomerular Filtration Rate in Overweight Children.

    Science.gov (United States)

    Lewis, Teresa V; Harrison, Donald L; Gildon, Brooke L; Carter, Sandra M; Turman, Martin A

    2016-06-01

    To determine if significant correlations exist between glomerular filtration rate (GFR) prediction equation values, derived by using the original Schwartz equation and the Chronic Kidney Disease in Children (CKiD) bedside equation with a 24-hour urine creatinine clearance (Clcr ) value normalized to a body surface area of 1.73 m(2) in overweight and obese children. Prospective analysis (20 patients) and retrospective analysis (43 patients). Pediatric inpatient ward and pediatric nephrology clinic at a comprehensive academic medical center. Sixty-three pediatric patients (aged 5-17 years), of whom 27 were overweight (body mass index [BMI] at the 85th percentile or higher) and 36 were not overweight (BMI lower than the 85th percentile [controls]) between 2007 and 2012. Data from the overweight patients were compared with nonoverweight controls. GFR values were calculated by using the original Schwartz equation and the CKiD bedside equation. Each patient's 24-hour urine Clcr value normalized to a body surface area of 1.73 m(2) served as the index value. A Pearson correlation coefficient model was used to determine association between the 24-hour urine Clcr value (index value) with the Schwartz and CKiD GFR estimations. Significant correlation was found to exist between the Schwartz and CKiD bedside GFR estimations relative to the 24-hour urine Clcr in the control subjects (r = 0.85, pSchwartz and CKiD bedside GFR values with the 24-hour urine Clcr value in overweight subjects (r = 0.86, pSchwartz equation estimated average GFR 21.75 ml/minute/1.73 m(2) higher than 24-hour urine Clcr (pSchwartz and CKiD bedside estimations of GFR correlated with 24-hour urine Clcr values in both overweight and nonoverweight children. Compared with the Schwartz equation, which tended to overestimate renal function, the CKiD bedside equation appeared to approximate 24-hour urine Clcr more closely in overweight children with kidney disorder. © 2016 Pharmacotherapy Publications, Inc.

  8. Evaluation of glomerular filtration rate in people greater than 60 years old in Jiangsu China%江苏两个地区60岁以上人群肾小球滤过率的评估

    Institute of Scientific and Technical Information of China (English)

    孙妍蓓; 刘必成

    2012-01-01

    Objective To compare the values reported by four methods of original abbreviated MDRD equation(eGFRa),the modified abbreviated MDRD equation(c-aGFR3),the refitting MDRD equation (M-MDRD-GFR) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine equation in estimation of glomerular filtration rate(GFR) in the people greater than 60 years old. Methods A total of 1404 residents aged 60 to 94 years old was randomly recruited from the community population in Jiangsu province. The values of GFR were estimated in three age groups and three complicated diseases groups. Results GFR estimated by CKD-EPI equation was decreased as age increased(P<0. 01). The patients with hypertention,diabetes and hypemricemia showed a certain decrease in GFR estimated by all equations. C-aGFR3, M-MDRD-GFR and CKD-EPI equations revealed a significant decrease of GFR in the people with hyperuricemia than in healthy people. The agreements in Kappa values on GFR estimation between c-aGFR3, M-MDRD-GFR,CKD-EPI formulas and eGFRa equation were very good, which were 0. 775,0. 883,0. 912,respectively(P<0. 01). There was a close correlation in GFR estimated by CKD-EPI equation and simplified MDRD equation with higher accuracy and less bias. Conclusion The GFR estimated by all four equations has a tendency of decrease with aging in the elder population in Jiangsu, of which CKD-EPI equation may be more suitable.%目的 比较简化MDRD方程(eGFRa)、中国方程(c-aGFR3)、瑞金方程(M-MDRD-GFR)及CKD-EPI公式对60岁以上人群肾功能的评估价值.方法 选取江苏两地1404名60-94岁常住居民,分为三个年龄组和三个合并症按上述方法测定肾小球滤过率(GFR),评价其与年龄的相关性,比较各方程测量肾功能的差异.结果 CKD-EPI公式计算GFR值随增龄而下降(P<0.01).在60岁以上高血压、糖尿病及高尿酸血症人群中较低.中国方程、瑞金方程和CKD-EPI公式计算得到的高尿酸血症人群GFR值低于

  9. Clinical study of the new intelligent determination and analysis system for glomerular filtration rate%数字化智能检测分析系统测定肾小球滤过率的临床研究

    Institute of Scientific and Technical Information of China (English)

    曾昭球; 吴锡信

    2011-01-01

    Objective To discuss the clinical application value of determining glomerular filtration rate (GFR)with the new intelligent determination and analysis system for GFR(B&G System).Methods GFR of 216 hospitalized patients suffering from the different diseases was determined accurately by clearance rate of 99mTc-diethylene triamine pentoacetic acid(99mTc-DTPA)(Tc-GFR),and the serum creatinine(SCr)and blood urea nitrogen(BUN)were also determined.At the same time GFR was determined by B&G system and Robert formula(B&G-GFR,Robert-GFR),and creatinine clearance rate(CCr)and GFR were calculated by Cockcroft/Gault formula(CG-CCr-GFR).All the results were compared,and correlation analysis was done for the three groups of data.Results Among 216 patients,B&G-GFR and Tc-GFR in 106 patients with renal insufficiency and 110 patients with normal renal function showed no significant (P0.05),而Robert-GFR(ml·min-1·1.73 m-2:21.45±15.67、93.54±30.01)、CG-CCr-GFR(ml·min-1·1.73 m-2:11.87±8.69、86.27±21.44)均明显低于Tc-GFR (P<0.05或P<0.01).肾功能不全组B&G-GFR、Robert-GFR、CG-CCr-GFR与Tc-GFR差值绝对值(ml·min-1·1.73 m-2:6.15±14.07、13.83±11.36、23.41±24.34)均明显低于肾功能正常组(7.65±6.54、24.94±13.24、32.21±21.81,均P<0.05).两组B&G-GFR、Robert-GFR、CG-CCr-GFR与Tc-GFR 均呈正相关(P<0.05或P<0.01),与SCr均呈负相关(P<0.05或P<0.01).结论 B&G-GFR、RobertGFR、CG-CCr-GFR均能在一定程度上准确反映GFR,而以B&G-GFR更准确,可代替Tc-GFR应用于临床.B&G系统较其他GFR检测方法具有更准确、简便、快速、安全而廉价的优势,值得临床推广应用.

  10. Effect of lithium therapy on glomerular filtration rate.

    Science.gov (United States)

    Decina, P; Oliver, J A; Sciacca, R R; Colt, E; Fieve, R R

    1983-08-01

    Patients taking lithium had a slightly higher serum creatinine concentration than controls. Creatinine concentration was independent of lithium level or therapy length, suggesting that lithium decreases glomerular filtration but that this effect is small, noncumulative, and of marginal clinical significance.

  11. Impaired autoregulation of glomerular filtration rate in type 1 (insulin-dependent) diabetic patients with nephropathy

    DEFF Research Database (Denmark)

    Parving, H H; Kastrup, Helge; Smidt, U M;

    1984-01-01

    served as controls. Renal function was assessed by glomerular filtration rate (single bolus 51Cr-EDTA technique) and urinary albumin excretion rate (radial immunodiffusion). The study was performed twice within 2 weeks, with the subjects receiving an intravenous injection of either clonidine (225...... arterial blood pressure in all three groups (16-18 mmHg). While glomerular filtration rate and urinary albumin excretion rate remained unchanged in both control groups after clonidine injection, glomerular filtration rate diminished from 78 to 71 ml/min per 1.73 m2 (p les than 0.01), and urinary albumin...... excretion declined from 1707 to 938 micrograms/min (p less than 0.01) in the patients with diabetic nephropathy. Our results suggest that an intrinsic vascular (arteriolar) mechanism underlying the normal autoregulation of glomerular filtration rate, i.e. the relative constancy of glomerular filtration rate...

  12. 肾动态显像测定肾小球滤过率%Application of renal dynamic imaging in the determination of glomerular filtration rate

    Institute of Scientific and Technical Information of China (English)

    解朋; 李冬雪; 黄建敏

    2012-01-01

    测定肾小球滤过率(GFR)能够为评估肾脏病患者肾功能状态、观察治疗效果、调整治疗方案及判断预后等提供重要参考.肾动态显像测定GFR无创、操作简便、准确性高,并能评价分肾功能,因而广泛应用于临床.本文就目前肾动态显像测定GFR的现状做一综述.%As one of the most important index to evaluate the renal function, assess the treatment effectiveness, help to correct the treatment strategy and predict the prognosis, glomerular filtration rate (GFR) can be determined by several methods. Renal dynamic imaging possesses the advantage of non-invasive examination, easy operation, and high accuracy and the split renal function, therefore has been applied widely. The current status of GFR determined by renal dynamic imaging were reviewed in this article.

  13. Simple Cystatin C Formula for Estimation of Glomerular Filtration Rate in Overweight Patients with Diabetes Mellitus Type 2 and Chronic Kidney Disease

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    Sebastjan Bevc

    2012-01-01

    Full Text Available In clinical practice the glomerular filtration rate (GFR is estimated from serum creatinine-based equations like the Cockcroft-Gault formula (C&G and Modification of Diet in Renal Disease formula (MDRD. Recently, serum cystatin C-based equations, the newer creatinine formula (The Chronic Kidney Disease Epidemiology Collaboration formula (CKD-EPI, and equation that use both serum creatinine and cystatin C (CKD-EPI creatinine & cystatin formula were proposed as new GFR markers. Present study compares serum creatinine-based equations, combined (including both serum creatinine and cystatin C equation, and serum simple cystatin C formula (100/serum cystatin C against 51CrEDTA clearance in 113 adult overweight Caucasians with diabetes mellitus type 2 (DM2 and chronic kidney disease (CKD. The results of present study demonstrated that the simple cystatin C formula could be a useful tool for the evaluation of renal function in overweight patients with DM2 and impaired kidney function in daily clinical practice in hospital and especially in outpatients. Despite the advantages of the simple cystatin C formula, cystatin C-based equations cannot completely replace the “gold standard” for estimation of the GFR in a population of DM2 patients with CKD, but may contribute to a more accurate selection of patients requiring such invasive and costly procedures.

  14. Association of Estimated Glomerular Filtration Rate with Hemoglobin Level in Korean Adults: The 2010-2012 Korea National Health and Nutrition Examination Survey.

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    Sang Youb Han

    Full Text Available Little is known about anemia in patients with early renal dysfunction. We aimed to investigate the association of hemoglobin level and anemia prevalence with estimated glomerular filtration rate (eGFR decline using a nation-wide representative sample of the adult Korean population.In total, 17,373 participants (7,296 men; weighted n = 18,330,187; mean age, 44.2±0.3 years; 9,886 women, weighted n = 18,317,454; mean age, 46.9±0.3 years were included. eGFR was divided into 5 groups: Group 1, ≥105; Group 2, 90-104; 75-89; Group 4, 60-74; and Group 5, <60 mL/min/1.73m2.The weighted anemia prevalence rates were 2.6% in men and 12.8% in women. In men, the weighted hemoglobin level increased with a decrease in eGFR; this value peaked at an eGFR of 60-89 mL/min/1.73m2 and decreased thereafter at an eGFR of <60 mL/min/1.73m2 (15.19±0.03, 15.35±0.03, 15.53±0.03, 15.52±0.06, and 14.90±0.12 g/dL from Groups 1 to 5 after adjustment for age, college graduation, cancer history, current smoking, waist circumference, serum cholesterol level, serum triglyceride level, and diastolic blood pressure. In women, the weighted hemoglobin level increased with a decrease in eGFR; this value peaked with an eGFR of 75-89 mL/min/1.73m2 and decreased thereafter (12.90±0.03, 13.08±0.02, 13.20±0.04, 13.14±0.05, and 12.47±0.11 g/dL from Groups 1 to 5 after adjustment for menstruation, pregnancy, estrogen replacement, and the above-mentioned variables. In both sexes, the weighted prevalence of anemia with an eGFR of 60-104 mL/min/1.73m2 was significantly lower than that with an eGFR of ≥105 mL/min/1.73m2 (men, 3.2±0.4%, 1.9±0.3%, 1.8±0.3%, 2.0±0.9%, and 18.1±3.1%; women, 14.0±0.8%, 11.2±0.7%, 10.5±1.0%, 13.2±1.6%, and 32.3±3.2% from Groups 1 to 5.We noted a compensatory increase in the hemoglobin level with a minor decline in kidney function (in the range of eGFR ≥60 mL/min/1.73m2 prior to a marked decrease in hemoglobin level with severe renal

  15. Glomerular filtration rate measured by 51Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

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    Anna Alice Rolim Chaves

    2010-01-01

    Full Text Available INTRODUCTION: Renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid (51Cr-EDTA could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. METHODS: This prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21 and without renal artery stenosis, (n=20. In vitro glomerular filtration rate analysis (51Cr-EDTA and 99mTc-DMSA scintigraphy were performed before and after captopril administration in all patients. RESULTS: The mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m² in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m² in the group without renal artery stenosis (p=0.04. Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/kg/1.73m², p=0.001 and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m², p=0.68. Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA did not show

  16. Glomerular Filtration Rate Measured by 51Cr-EDTA Clearance: Evaluation of Captopril-Induced Changes in Hypertensive Patients with and without Renal Artery Stenosis

    Science.gov (United States)

    Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit

    2010-01-01

    INTRODUCTION: Renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid (51Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. METHODS: This prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis (51Cr-EDTA) and 99mTc-DMSA scintigraphy were performed before and after captopril administration in all patients. RESULTS: The mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m2 in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m2 in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/ kg/1.73m2, p=0.001) and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m2, p=0.68). Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA) did not show significant

  17. Glomerular filtration rate measured by {sup 51}Cr-EDTA clearance: evaluation of captopril-induced changes in hypertensive patients with and without renal artery stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Chaves, Anna Alice Rolim; Buchpiguel, Carlos Alberto; Praxedes, Jose Nery; Bortolotto, Luiz Aparecido; Sapienza, Marcelo Tatit, E-mail: annaalice100@yahoo.com.b [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia

    2010-07-01

    Introduction: renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid ({sup 51}Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using {sup 51}Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis. Methods: this prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis ({sup 51}Cr-EDTA) and {sup 99m}Tc-DMSA scintigraphy were performed before and after captopril administration in all patients. Results: the mean baseline glomerular filtration rate was 48.6+-21.8 ml/kg/1.73 m{sup 2} in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1+-28.7 ml/kg/1.73m{sup 2} in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6+-14.8 ml/kg/1.73m{sup 2}, p=0.001) and an insignificant change in the group without RAS (to 62.2+-23.6 ml/kg/1.73m{sup 2}, p=0.68). Scintigraphy with technetium-99m dimercapto

  18. Study of cystatin C (Cys C in relation to the calculation of the glomerular filtration rate and bioelectrical impedance analysis parameters in obese patients with and without type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Mario Liani

    2012-01-01

    Full Text Available IntroductionAssessment of renal function based on quantification of the glomerular filtration rate (GFR is essential for early detection of damage and progression of renal diseases. The purpose of our study was to determine the value of cystatin C (Cys C assays in the calculation of the GFR and bioelectrical impedance analysis parameters in obese subjects aged 30-70 years with moderately damaged renal function.Materials and methodsCys C levels were measured with a new immunoturbidimetric kit (Roche Diagnostics and an automated Cobas c6000 analyzer. In the GFR calculation, creatinine and Cys C levels were included. The GFR calculated with the equation that included Cys C in obese and normal-weight patients is not affected by changes in the lean body mass.ResultsObese patients (N = 70 had a mean (± SD serum creatinine level of 1.52 ± 1.0 mg/dL and a mean Cys C level of 1.28 ± 0.59 mg/L. In this group, the GFR calculated on the basis of MDRD, Cys C, and creatinine clearance values showed similar filtered values between MDRD and Cys C and a DS value smaller in the case of Cys C. The correlation (R2 between GFR and its metabolite is higher in the case of Cys C when somatotype parameters (measured with bioelectrical impedance analysis were introduced into the equation.ConclusionsWhen Cys C is included in calculations of GFR, the result shows a higher correlation degree compared to the MDRD system. Given that Cys C shows less intra-individual variability than creatinine, it can be applied in routine diagnostics in a larger number of patients.

  19. Long-Term Follow-Up of Proteinuria and Estimated Glomerular Filtration Rate in HIV-Infected Patients with Tubular Proteinuria.

    Science.gov (United States)

    Peyriere, Hélène; Cournil, Amandine; Casanova, Marie-Laure; Badiou, Stéphanie; Cristol, Jean-Paul; Reynes, Jacques

    2015-01-01

    The objective of this prospective observational study was to describe the evolution of tubular proteinuria detected in HIV-infected patients, and to evaluate the impact of tenofovir disoproxil fumarate (TDF) discontinuation. Proteinuria and estimated glomerular filtration rate (eGFR) were followed during a median duration of 32 months, in 81 HIV-infected patients with tubular proteinuria and eGFR ≥ 60 ml/min/1.73 m2 (determined using the Chronic Kidney Disease Epidemiology (CKD-EPI) Collaboration equation). Tubular proteinuria was defined by urine protein to creatinine ratio (uPCR) ≥200 mg/g and albumin to protein ratio (uAPR) proteinuria: TDF continuation was the main factor associated with this persistence [OR 9.0; 95%CI: 1.9-41.4; p = 0.01]. Among the 23 patients who discontinued TDF, uPCR returned below the threshold of 200 mg/g in 11 patients. Overall, eGFR decreased with a mean rate of decline of 3.8 ml/min/1.73m2/year. The decline in eGFR was lesser after discontinuation of TDF (5.8 ml/min/1.73m2/year during TDF exposure versus 3 ml/min/1.73m2/year after TDF discontinuation; p = 0.01). The continuation of TDF was the main factor associated with the persistence of proteinuria. Moreover, proteinuria was normalized in only half of the patients who discontinued TDF. The clinical significance of TDF-related low level of proteinuria as a factor associated with renal disease progression and bone loss remains poorly understood.

  20. Clinical use of estimated glomerular filtration rate for evaluation of kidney function

    DEFF Research Database (Denmark)

    Broberg, Bo; Lindhardt, Morten; Rossing, Peter;

    2013-01-01

    Estimating glomerular filtration rate by the Modification of Diet in Renal Disease or Chronic Kidney Disease Epidemiology Collaboration formulas gives a reasonable estimate of kidney function for e.g. classification of chronic kidney disease. Additionally the estimated glomerular filtration rate...

  1. Association of Microalbuminuria and Estimated Glomerular Filtration Rate With Carotid Intima-Media Thickness in Patients With Type 2 Diabetes Mellitus

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    Dehdashti Shahrokh

    2015-04-01

    Full Text Available Background Atherosclerosis is the main cause of cardiovascular diseases, and its risk enhances in type 2 diabetes mellitus. Objectives This study aimed to evaluate Carotid Intima-Media Thickness (CIMT by carotid artery ultrasonography and assess its correlation with microalbuminuria and estimated Glomerular Filtration Rate (eGFR in the patients with type 2 diabetes mellitus. Patients and Methods This cross-sectional study was included 205 patients with Type 2 Diabetes Mellitus (T2DM. We recorded clinical and biochemical data such as FBS, lipid profile, and urinary albumin. Intima-media thickness of carotid arteries was measured in all patients by high frequency ultrasound. Results In simple correlation coefficients analysis, CIMT was significantly associated with total cholesterol (r = 0.197, P = 0.008, serum creatinine (r = 0.240, P = 0.001, and urinary albumin (r = 0.420, P = 0.000. Also, CIMT elevated significantly with the stage progression of chronic kidney disease (0.67 ± 0.15 mm in stage 1, 0.73 ± 0.22 mm in stage 2, and 0.82 ± 0.21 mm in stage 3 (P value = 0.024. In multivariate linear regression analysis, the duration of diabetes, weight, HDL, serum creatinine, urinary albumin, and estimated Glomerular Filtration Rate (eGFR were independently associated with CIMT (P value < 0.05 for all. Conclusions Our study shows a relationship between CIMT and renal parameters, including eGFR and albuminuria. This study confirms the importance of intensive examinations for early detection of atherosclerosis and treatment of risk factors.

  2. Comparison of the Schwartz and CKD-EPI Equations for Estimating Glomerular Filtration Rate in Children, Adolescents, and Adults: A Retrospective Cross-Sectional Study.

    Science.gov (United States)

    Selistre, Luciano; Rabilloud, Muriel; Cochat, Pierre; de Souza, Vandréa; Iwaz, Jean; Lemoine, Sandrine; Beyerle, Françoise; Poli-de-Figueiredo, Carlos E; Dubourg, Laurence

    2016-03-01

    Estimating kidney glomerular filtration rate (GFR) is of utmost importance in many clinical conditions. However, very few studies have evaluated the performance of GFR estimating equations over all ages and degrees of kidney impairment. We evaluated the reliability of two major equations for GFR estimation, the CKD-EPI and Schwartz equations, with urinary clearance of inulin as gold standard. The study included 10,610 participants referred to the Renal and Metabolic Function Exploration Unit of Edouard Herriot Hospital (Lyon, France). GFR was measured by urinary inulin clearance (only first measurement kept for analysis) then estimated with isotope dilution mass spectrometry (IDMS)-traceable CKD-EPI and Schwartz equations. The participants' ages ranged from 3 to 90 y, and the measured GFRs from 3 to 160 ml/min/1.73 m2. A linear mixed-effects model was used to model the bias (mean ratio of estimated GFR to measured GFR). Equation reliability was also assessed using precision (interquartile range [IQR] of the ratio) and accuracy (percentage of estimated GFRs within the 10% [P10] and 30% [P30] limits above and below the measured GFR). In the whole sample, the mean ratio with the CKD-EPI equation was significantly higher than that with the Schwartz equation (1.17 [95% CI 1.16; 1.18] versus 1.08 [95% CI 1.07; 1.09], p Schwartz equation were closer to 1 than the mean ratios with the CKD-EPI equation whatever the age class (1.02 [95% CI 1.01; 1.03] versus 1.15 [95% CI 1.13; 1.16], p Schwartz equation had a better precision and was also more accurate than the CKD-EPI equation at GFR values under 60 ml/min/1.73 m2 (IQR: 0.32 [95% CI 0.28; 0.33] versus 0.40 [95% CI 0.36; 0.44]; P30: 81.4 [95% CI 78.1; 84.7] versus 63.8 [95% CI 59.7; 68.0]) and also at GFR values of 60-89 ml/min/1.73 m2. In all patients aged ≥65 y, the CKD-EPI equation performed better than the Schwartz equation (IQR: 0.33 [95% CI 0.31; 0.34] versus 0.40 [95% CI 0.38; 0.41]; P30: 77.6 [95% CI 75.7; 79

  3. A Pilot Study to Evaluate Renal Hemodynamics in Cirrhosis by Simultaneous Glomerular Filtration Rate, Renal Plasma Flow, Renal Resistive Indices and Biomarkers Measurements

    Science.gov (United States)

    Mindikoglu, Ayse L.; Dowling, Thomas C.; Wong-You-Cheong, Jade J.; Christenson, Robert H.; Magder, Laurence S.; Hutson, William R.; Seliger, Stephen L.; Weir, Matthew R.

    2014-01-01

    Background Renal hemodynamic measurements are complicated to perform in patients with cirrhosis; yet they provide the best measure of risk to predict hepatorenal syndrome (HRS). Currently, there are no established biomarkers of altered renal hemodynamics in cirrhosis validated by measured renal hemodynamics. Methods In this pilot study, simultaneous measurements of glomerular filtration rate (GFR), renal plasma flow (RPF), renal resistive indices and biomarkers were performed to evaluate renal hemodynamic alterations in 10 patients with cirrhosis (3 patients without ascites, 5 with diuretic sensitive and 2 diuretic refractory ascites). Results Patients with diuretic refractory ascites had the lowest mean GFR (36.5 ml/min/1.73m2) and RPF (133.6 ml/min/1.73m2) when compared to those without ascites (GFR=82.9 ml/min/1.73m2, RPF=229.9 ml/min/1.73m2) and with diuretic-sensitive ascites (GFR=82.3 ml/min/1.73m2, RPF=344.1 ml/min/1.73m2). A higher mean filtration fraction (FF= GFR/RPF=0.36) was noted among those without ascites compared to those with ascites. Higher FF in patients without ascites is most likely secondary to the vasoconstriction in the efferent glomerular arterioles (normal FF≃0.20). In general, renal resistive indices were inversely related to FF. While patients with ascites had lower FF and higher right kidney main and arcuate artery resistive indices, those without ascites had higher FF and lower right kidney main and arcuate artery resistive indices. While cystatin C and beta-2 microglobulin performed better compared to Cr in estimating RPF; beta-trace protein, beta-2 microglobulin, SDMA, and (SDMA+ADMA) performed better in estimating right kidney arcuate artery resistive index. Conclusion The results of this pilot study showed that identification of non-invasive biomarkers of reduced RPF and increased renal resistive indices can identify cirrhotics at risk for HRS at a stage more amenable to therapeutic intervention, and reduce mortality from kidney

  4. Comparison of estimated glomerular filtration rate equations at the time of hemodialysis initiation

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    Min-Jeong Lee

    2015-12-01

    Conclusions: The eGFR at HD initiation are significantly different according to the used eGFR equations, and the corrected Cockcroft–Gault equation may be the best in defining the eGFR at HD initiation.

  5. 酶法检测肌酐值估算的肾小球滤过率分析%Estimation of Glomerular Filtration Rate with Enzymatic-assayed Serum Creatinine Values

    Institute of Scientific and Technical Information of China (English)

    傅辰生; 冯欣慧; 张晓丽; 严震文; 叶志斌

    2012-01-01

    目的:通过重新表达的MDRD公式(reexpressed modification of diet in renal disease study equation,rMDRD公式),以酶法检测肌酐值估测肾小球滤过率(glomerular filtration rate,GFR),分析rMDRD公式应用于中国慢性肾脏病(chronic kidney disease,CKD)患者所得估算的GFR(estimated GFR,eGFR)的精确度及准确性.方法:回顾分析893例CKD患者的临床资料,以同位素法测定的GFR为标准,分析酶法检测肌酐值代入rMDRD公式所得eGFR的精确度及准确性,并评价适当数据转换是否可以提高该公式应用于中国CKD患者的效能.结果:rMDRD公式直接应用于中国CKD患者时精确度和准确性均较低,进行数据转换后,估测效能有所提高,但仍显著低于西方人群.结论:rMDRD公式不适合直接应用于中国CKD患者,亟待开发基于酶法检测肌酐值的eGFR公式.%Objective:To evaluate the performance of the rccxprcsscd modification of diet in renal disease (rMDRD) study equation in estimating giomcruiar filtration rate (cGFR) from enzymatic-assayed scrum crcatininc values in Chinese chronic kidney disease (CKD) patients. Methods: Data of 893 Chinese CKD patients were retrospectively collected. The cGFR estimated by rMDRD equation with enzymatic-assayed scrum crcatininc values in these patients were analyzed, with GFR obtained by isotope scanning as standard. Data transformation was done to improve the performance of the equation. Results: The performance of rMDRD equation in Chinese CKD patients was not satisfying, even if the data was transformed. Conclusions: The rMDRD equation is not good enough for Chinese CKD patients. It is expected to explore an cGFR equation suitable for Chinese CKD patients with enzymatic-assayed scrum crcatininc values.

  6. Urinary neutrophil gelatinase-associated lipocalin and cystatin C compared to the estimated glomerular filtration rate to predict risk in patients with suspected acute myocardial infarction.

    Science.gov (United States)

    von Jeinsen, Beatrice; Kraus, Daniel; Palapies, Lars; Tzikas, Stergios; Zeller, Tanja; Schauer, Anne; Drechsler, Christiane; Bickel, Christoph; Baldus, Stephan; Lackner, Karl J; Münzel, Thomas; Blankenberg, Stefan; Zeiher, Andreas M; Keller, Till

    2017-10-15

    Impaired renal function, reflected by estimated glomerular filtration rate (eGFR) or cystatin C, is a strong risk predictor in the presence of acute myocardial infarction (AMI). Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is an early marker of acute kidney injury. uNGAL might also be a good predictor of outcome in patients with cardiovascular disease. Aim of the present study was to evaluate the prognostic value of uNGAL compared to eGFR and cystatin C in patients with suspected AMI. 1818 patients were enrolled with suspected AMI. Follow-up information on the combined endpoint of death or non-fatal myocardial infarction was obtained 6months after enrolment and was available in 1804 patients. 63 events (3.5%) were registered. While cystatin C and eGFR were strong risk predictors for the primary endpoint even adjusted for several variables, uNGAL was not independently associated with outcome: When applied continuously uNGAL was associated with outcome but did not remain a statistically significant predictor after several adjustments (i.e. eGFR). By adding cystatin C or uNGAL to GRACE risk score variables, only cystatin C could improve the predictive value while uNGAL showed no improvement. We could show that cystatin C is an independent risk predictor in patients with suspected AMI and cystatin C can add improvement to the commonly used GRACE risk score. In contrast uNGAL is not independently associated with outcome and seems not to add further prognostic information to GRACE risk score. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Inflammation and renal function after a four-year follow-up in subjects with unimpaired glomerular filtration rate: results from the observational, population-based CARLA cohort.

    Directory of Open Access Journals (Sweden)

    Daniel Medenwald

    Full Text Available There is evidence that chronic inflammation is associated with the progression/development of chronic renal failure; however, relations in subjects with preserved renal function remain insufficiently understood.To examine the association of inflammation with the development of renal failure in a cohort of the elderly general population.After excluding subjects with reduced estimated glomerular filtration rate (eGFR<60 mL/min/1.73 m2 and missing data, the cohort incorporated 785 men and 659 women (aged 45-83 years. Follow-up was performed four years after baseline. Covariate adjusted linear and logistic regression models were used to assess the association of plasma/serum concentrations of soluble tumour necrosis factor receptor 1 (sTNF-R1, C-reactive protein (CRP, and interleukin 6 (IL-6 with change in eGFR/creatinine. The areas under the curve (AUCs from receiver operating characteristics (ROCs were estimated.In adjusted models sTNF-R1 was distinctively associated with a decline in eGFR in men (0.6 mL/min/1.73 m2 per 100 pg/mL sTNF-R1; 95% CI: 0.4-0.8, but not in women. A similar association could not be found for CRP or IL-6. Estimates of sTNF-R1 in the cross-sectional analyses were similar between sexes, while CRP and IL-6 were not relevantly associated with eGFR/creatinine.In the elderly male general population with preserved renal function sTNF-R1 predicts the development of renal failure.

  8. Two-year follow-up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate.

    Science.gov (United States)

    Roveran Genga, K; Lo, C; Cirstea, M; Zhou, G; Walley, K R; Russell, J A; Levin, A; Boyd, J H

    2017-05-01

    Sepsis is associated with decreased levels of high-density lipoprotein (HDL) cholesterol. HDL has anti-inflammatory properties, and the use of Apo A-I mimetic peptides is associated with renal function improvement in animal models of sepsis. However, it is not known whether decreased HDL level results in impaired renal function in human sepsis. We investigated whether low levels of HDL conferred an increased risk of sepsis-associated acute kidney injury (AKI) or long-term decreased estimated glomerular filtration rate (eGFR) after sepsis. HDL concentration (mg dL(-1) ) was measured in plasma samples from 180 patients with septic shock at admission to the Emergency Department (ED). We divided the patients using median HDL as a cut-off value and assessed the frequency of sepsis-associated AKI and long-term decreased eGFR after sepsis. Univariate and multivariate analyses were performed. Patients with low HDL had a significantly greater frequency of KDIGO 2 or 3 sepsis-associated AKI [39/90 (43.3%) vs. 12/90 (13.3%), P HDL. The adjusted OR for sepsis-associated AKI and decreased eGFR after sepsis in the lower HDL group was 2.80 (95% CI 1.08-7.25, P = 0.033) and 5.45 (95% CI 1.57-18.93, P = 0.008), respectively. Low HDL levels during sepsis are associated with increased risk of sepsis-associated AKI, and/or subsequent decreased eGFR. These results suggest that HDL may be involved and/or may be a marker of kidney injury during and after sepsis. © 2017 The Association for the Publication of the Journal of Internal Medicine.

  9. An epidemiologic model to project the impact of changes in glomerular filtration rate on quality of life and survival among persons with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Levy AR

    2014-07-01

    Full Text Available Adrian R Levy,1,2 Robert M Perkins,3 Karissa M Johnston,2 Sean D Sullivan,4 Vipan C Sood,5 Wendy Agnese,5 Mark A Schnitzler61Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada; 2Oxford Outcomes Ltd, Vancouver, BC, Canada; 3Center for Health Research and Division of Nephrology, Geisinger Health System, Danville, PA, USA; 4School of Pharmacy, University of Washington, Seattle, WA, USA; 5Mitsubishi Tanabe Pharma America, Jersey City, NJ, USA; 6Departments of Internal Medicine and Community Health, Saint Louis University, St Louis, MO, USAPurpose: Predicting the timing and number of end-stage renal disease (ESRD cases from a population of individuals with pre-ESRD chronic kidney disease (CKD has not previously been reported. The objective is to predict the timing and number of cases of ESRD occurring over the lifetime of a cohort of hypothetical CKD patients in the US based on a range of baseline estimated glomerular filtration rate (eGFR values and varying rates of eGFR decline.Methods: A three-state Markov model – functioning kidney, ESRD, and death – with an annual cycle length is used to project changes in baseline eGFR on long-term health outcomes in a hypothetical cohort of CKD patients. Using published eGFR-specific risk equations and adjusting for predictive characteristics, the probability of ESRD (eGFR <10, time to death, and incremental cost-effectiveness ratios for hypothetical treatments (costing US$10, $5, and $2/day, are projected over the cohort's lifetime under two scenarios: an acute drop in eGFR (mimicking acute kidney injury and a reduced hazard ratio for ESRD (mimicking an effective intervention.Results: Among CKD patients aged 50 years, an acute eGFR decrement from 45 mL/minute to 35 mL/minute yields decreases of 1.6 life-years, 1.5 quality-adjusted life-years (QALYs, 0.8 years until ESRD, and an increase of 183 per 1,000 progressing to ESRD. Among CKD patients aged 60 years, lowering

  10. Correlation of carotid intimal-medial thickness with estimated glomerular filtration rate and cardiovascular risk factors in chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Nitesh Chhajed

    2014-01-01

    Full Text Available Carotid intimal-medial thickness (CIMT predicts future vascular events in the general population. However, the correlation of traditional cardiovascular risk factors and stages of chronic kidney disease (CKD with CIMT is not studied extensively. To determine the correlation of CIMT with traditional cardiovascular risk factors like age, body mass index (BMI, dyslipidemia and various stages of CKD patients, CIMT was measured by means of high-resolution B-mode ultrasonography in 70 CKD patients and compared with the 30 healthy controls. The mean CIMT in patients was 0.86 ± 0.21 mm vs 0.63 ± 0.17 mm in healthy age- and sex-matched controls (P <0.001. There was a significant univariate positive correlation between CIMT and age (r = 0.605, P <0.001, BMI (r = 0.377, P = 0.001, total cholesterol (r = 0.236, P ≤0.018 and serum triglyceride (r = 0.387, P ≤0.001. No statistically significant correlation was found between mean CIMT and estimated glomerular filtration rate (eGFR (r = -0.02, P = 0.30, very low-density lipoprotein and high-density lipoprotein-cholesterol. Atherosclerotic changes very well correlate with the traditional cardiovascular risk factors like age, BMI, serum total cholesterol and serum triglyceride level in CKD patients. Even though CIMT was marginally more in the late stages of CKD patients, no statistically significant correlation was found with CIMT and eGFR.

  11. Clinical application of the estimation of glomerular filtration rate in diabetes mellitus patients%糖尿病患者肾小球滤过率评估方法的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    李丽; 杨帆; 毛客自; 陆怡德

    2012-01-01

    Objective To investigate the suitable equation of glomerular filtration rate (GFR) in estimating renal function for type 2 diabetes mellitus patients,and to compare the application effects of modification of diet in renal disease (MDRD) ,reexpressed modification of diet in renal disease (rMDRD) ,chronic kidney disease epidemiology collaboration (CKD-EPI) and cystatin C(Cys C)-based equations for GFR. Methods Clinical data from 178 type 2 diabetes mellitus patients were collected for the detection of serum creatinine ( SCr) level,Cys C level and renal clearance of 99mTc-diethylenetriamine pentaacetic acid-deoxyglucose ( 99mTo-DTPA) which was used as the reference of isotopic GFR (iGFR). According to the standard of the American Diabetes Association (ADA) ,the 178 patients were classified into 3 groups [ GFR: 15-59,60-89 and ≥ 90 mL/( min · 1. 73 m2 ) ]. The equations for estimated GFR (eGFR) were compared with iGFR by paired t test,linear analysis,Bland and Altaian procedures ,receiver operating characteristic ( ROC) curves and 15% ,30% and 50% coincidences. Results When GFR < 60 miy( min · 1.73 m ) ,there was no significant difference between eGFR and iGFR in MDRD equation ,but when GFR ≥ 60mL/ (min·1.73 m ),there was significant difference (P < 0. 001). There was no significant difference of eGFR for rMDRD equation in accuracy and diagnostic sensitivity . When GFR ≥ 90 mL/(min·1.73 m ) ,the coincidences were higher in CKD-EPI equation than those in MDRD and rMDRD equation ,but when GFR 60-89 mL/(min·1. 73 m2 ) ,they were lower than those in Cys C GFR equation. The Cys C GFR equation had a better correlation with eGFR and iGFR,a less bias,a higher deviation and a higher coincidence than those in MDRD and rMDRD equations ,especially when GFR ≥ 90 mL/(min·1.73 m ) ,only there was no significant difference between eGFR and iGFR ,and Cys C GPR equation was better than the other 3 equations. Conclusions The 4 equations can estimate GFR accurately for type

  12. Arterial hypertension treated with angiotensin converting enzyme inhibitors and glucocorticoids are independent risk factors associated with decreased glomerular filtration rate in systemic sclerosis.

    Science.gov (United States)

    Ostojic, Predrag; Stojanovski, Natasa

    2017-03-01

    The aim of this study was to estimate prevalence and severity of renal insufficiency in systemic sclerosis (SSc) and to assess risk factors associated with reduced glomerular filtration rate (GFR) in SSc patients. Seventy-three consecutive patients with SSc (67 women and 6 men), mean age 56.2 years, mean disease duration 6.7 years, were included in this cross-sectional study. GFR was measured by creatinine clearance (CCr) in all patients, as well as 24-h proteinuria. We assessed frequency and severity of renal insufficiency in our patients with SSc and estimated the association of renal insufficiency with age, disease duration, subtype of the disease, earlier diagnosed arterial hypertension, and medications for which we assumed to affect renal function-cytostatics, nonsteroidal anti-inflammatory drugs, glucocorticoids, ACE inhibitors, diuretics, and calcium channel blockers (CCB). Fifty-six out of 73 patients with SSc (76.7%) had reduced GFR (CCr lower than 90 ml/min), compared to 17/73 (23.3%) of patients with normal renal function. Mild renal insufficiency was noticed in 28/73 (38.4%), moderate in 21/73 (28.8%) and severe renal insufficiency in 5/73 (6.8%). End-stage renal disease (CCr arterial hypertension and treatment with glucocorticoids are independent risk factors for reduced GFR. On the other hand, age, disease duration, disease form, as well as antibodies (anticentromere antibodies-ACA and anti-topoisomerase I antibodies-ATA) were excluded as independent risk factors. Patients with SSc and arterial hypertension treated with CCB had significantly higher mean CCr than patients treated with diuretics (90.4 vs 53.5 ml/min, p = 0.03), or patients treated with ACE inhibitors (90.4 vs 41.7 ml/min, p = 0.001). Decreased GFR is common in SSc. Most of patients have mild or moderate renal insufficiency. Previously diagnosed arterial hypertension, especially when treated with ACE inhibitors or diuretics, and glucocorticoids are independent risk factors

  13. The Correlation Between the GFR and the Renal Dimensions in Glomerulopathy Patients: Comparison of 2D and 3D Ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Gyoung Min [Seoul National University Hospital, Seoul (Korea, Republic of); Lee, Hak Jong; Hwang, Sung Il; Chin, Ho Jun [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2011-03-15

    We wanted to determine the correlation between the renal length as measured on two dimensional (2D) ultrasonography (US) and the renal parenchymal volume as measured with a new three-dimensional (3D) volume probe ultrasound system. We also wanted to determine the correlation between the renal length or renal parenchymal volume and the glomerular filtration rate (GFR) in patients with glomerulopathy. From July 2007 to December 2007, 26 patients who were pathologically confirmed to have glomerulopathy by biopsy were enrolled. Renal length was measured with 2D US and the renal parenchymal volume was measured with 3D US just prior to biopsy. The GFR was obtained from the electronic medical records. Pearson's correlation coefficients were used to analyze the correlation between the renal length and the renal parenchymal volume, the correlation between the renal length and the GFR and the correlation between the renal parenchymal volume and the GFR. The renal length and the renal parenchymal volume showed strong positive correlation (r = 0.850, p = 0.0001). The correlation coefficient between the renal length and the GFR was 0.623 (p = 0.0007) and the correlation coefficient between the renal volume and the GFR was 0.590 (p = 0.0015). Both the renal length and renal parenchymal volume showed apparently positive correlations with the GFR in glomerulopathy patients. The renal length showed strong positive correlations with the renal parenchymal volume. Both the renal length and the renal parenchymal volume showed apparently positive correlations with the GFR in glomerulopathy patients. In glomerulopathy patients, the renal dimensions measured by ultrasound can reflect the status of the GFR, and the measurement of the 2D renal length could be sufficient for follow up. Further studies are needed to evaluate the role of 3D US for assessing patients with renal disease

  14. PCSK9 Plasma Concentrations Are Independent of GFR and Do Not Predict Cardiovascular Events in Patients with Decreased GFR.

    Directory of Open Access Journals (Sweden)

    Kyrill S Rogacev

    Full Text Available Impaired renal function causes dyslipidemia that contributes to elevated cardiovascular risk in patients with chronic kidney disease (CKD. The proprotein convertase subtilisin/kexin type 9 (PCSK9 is a regulator of the LDL receptor and plasma cholesterol concentrations. Its relationship to kidney function and cardiovascular events in patients with reduced glomerular filtration rate (GFR has not been explored.Lipid parameters including PCSK9 were measured in two independent cohorts. CARE FOR HOMe (Cardiovascular and Renal Outcome in CKD 2-4 Patients-The Forth Homburg evaluation enrolled 443 patients with reduced GFR (between 90 and 15 ml/min/1.73 m2 referred for nephrological care that were prospectively followed for the occurrence of a composite cardiovascular endpoint. As a replication cohort, PCSK9 was quantitated in 1450 patients with GFR between 90 and 15 ml/min/1.73 m2 enrolled in the Ludwigshafen Risk and Cardiovascular Health Study (LURIC that were prospectively followed for cardiovascular deaths.PCSK9 concentrations did not correlate with baseline GFR (CARE FOR HOMe: r = -0.034; p = 0.479; LURIC: r = -0.017; p = 0.512. 91 patients in CARE FOR HOMe and 335 patients in LURIC reached an endpoint during a median follow-up of 3.0 [1.8-4.1] years and 10.0 [7.3-10.6] years, respectively. Kaplan-Meier analyses showed that PCSK9 concentrations did not predict cardiovascular events in either cohort [CARE FOR HOMe (p = 0.622; LURIC (p = 0.729]. Sensitivity analyses according to statin intake yielded similar results.In two well characterized independent cohort studies, PCSK9 plasma levels did not correlate with kidney function. Furthermore, PCSK9 plasma concentrations were not associated with cardiovascular events in patients with reduced renal function.

  15. 肾小球滤过率智能检测分析系统的研制及临床应用研究%Preparation and clinical application of an intelligent determination and analysis system for glomerular filtration rate

    Institute of Scientific and Technical Information of China (English)

    吴锡信; 屈敏; 冯敏坚; 石俊; 陈江林; 彭健; 吴一武; 郑志雄

    2008-01-01

    目的 研制肾小球滤过率(GFR)智能检测分析系统(GFRBMAS),并探讨其检测GFR的临床应用价值.方法 采用VB 6.0软件编程,并配置好GFRBMAS.采用99锝m-二:乙烯三胺五乙酸(99Tcm-DTPA)清除率准确测定79例不同疾病住院患者GFR(Tc-GFR),检测并比较GFRBMAS与日立7170S全自动生化仪所测得的血清肌酐(SCr)、尿素氮(BUN)、血尿酸(Uric)、血清钙(Ca)和血清磷(P)值,同时以GFRBMAS、Robert公式测定或测算GFR(GFRBMAS-GFR、Robert-GFR),以Cockcroft/Gault公式计算内生肌酐清除率(CG-CCr),所得数据进行相关分析与对比研究.结果 两种检测方法测得的SCr、BUN、Uric、Ca、P值差异均无统计学意义(P均>0.05),且两者均呈显著正相关(P均<0.01).肾功能正常组和不全组Robert-GFR、CG-CCr值均明显小于Tc-GFR值,差异有统计学意义(P均<0.01),而GFRBMAS-GFR值与Tc-GFR值相近.相关分析显示,肾功能不全组及正常组GFRBMAS-GFR、Robert-GFR、CG-CCr与Tc-GFR值均呈显著正相关,与SCr、BUN均呈负相关(P<0.05或P<0.01).结论 GFRBMAS-GFR、Robert-GFR、CG-CCr均能在一定程度上准确反映GFR,而GFRBMAS-GFR可代替Tc-GFR应用于临床.%Objective To prepare an intelligent determination and analysis system for renal glomerular filtration rate(GFRBMAS),and to explore its value in clinical setting.Methods GFRBMAS was prepared by programming with VB 6.0 software.GFR of 79 inhospital patients suffering from the different diseases was determined accurately by using clearance rate of 99Tcm-diethylene triamine pentoacetic acid(DTPA) (Tc-GFR).The serum creatinine(SCr),blood urea nitrogen(BUN),serum uric acid(Uric),serum calcium(Ca)and serum phosphorus(P)were determined with both GFRBMAS and 7170S automatic biochemistry determination apparatus(ititachi),and the result of GFR was compared with that determined by using GFRBMAS and 7170S automatic biochemical determination apparatus.At the same time GFR was determined by using

  16. Longitudinal changes in estimated and measured GFR in type 1 diabetes.

    Science.gov (United States)

    de Boer, Ian H; Sun, Wanjie; Cleary, Patricia A; Lachin, John M; Molitch, Mark E; Zinman, Bernard; Steffes, Michael W

    2014-04-01

    Estimation of GFR from serum concentrations of creatinine and cystatin C has been refined using cross-sectional data from large numbers of people. However, the ability of the improved estimating equations to identify changes in GFR within individuals over time has not been rigorously evaluated, particularly within the normal range of GFR. In cross-sectional and longitudinal analyses of 1441 participants in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study with type 1 diabetes, we compared GFR estimated from creatinine (eGFR(Cr)), cystatin C (eGFR(Cys)), or both (eGFR(Cr+Cys)) with iothalamate GFR (iGFR), including changes in each over time. Mean (SD) iGFR was 122.7 (21.0) ml/min per 1.73 m(2). In cross-sectional analyses, eGFR(Cr+Cys) estimated iGFR with the highest correlation (r=0.48 versus 0.39-0.42), precision, and accuracy. In longitudinal analyses, change in eGFR(Cr+Cys) best estimated change in iGFR; however, differences between estimates were small, and no estimate accurately classified change in iGFR. Over a median 23 years of follow-up, mean rate of change in eGFR was similar across estimates of eGFR(Cr), eGFR(Cys), and eGFR(Cr+Cys) (-1.37, -1.11, and -1.29 ml/min per 1.73 m(2) per year, respectively). Associations of BP and hemoglobin A1c with change in eGFR were strongest for eGFR(Cys) and eGFR(Cr+Cys). Together, these results suggest that the addition of cystatin C to creatinine to estimate GFR may improve identification of the causes and consequences of GFR loss in type 1 diabetes, but may not meaningfully improve the tracking of GFR in clinical care.

  17. 慢性肾脏病患者肾小球滤过率经验公式比较%Comparison of three empirical formulae for calculating the glomerular filtration rate of patients with chronic kidney disdisease

    Institute of Scientific and Technical Information of China (English)

    罗效梅; 李新; 贺勇

    2011-01-01

    目的 比较肾脏疾病饮食改良研究方程式(MDRD)、新慢性肾脏疾病流行病学合作研究方程式(CKD-EPI)以及胱抑素C(Cys C)估算公式(eGFR-Cys)对慢性肾脏病(CKD)患者肾小球滤过率(GFR)的预测性能.方法 测定93例CKD患者的99mTc-二乙烯三胺戊乙酸(DTPA)血浆清除率(rGFR)作为GFR金标准,另用MDRD、CKD-EPI和eGFR-Cys公式分别计算GFR估测值(eGFR),并将rGFR与3种公式计算的eGFR进行比较.结果 相对于rGFR,CKD-EPI公式偏倚为-3.4±10.7ml/(min·1.73m2),eGFRCys公式为-4.8±11.9ml/(min·1.73m2),MDRD公式为-5.4±10.4ml/(min·1.73m2),三者间差异均无统计学意义.对于rGFR测定值30%误差范围内GFR估测值的百分率,CKDEPI公式、eGFR-Cys公式、MDRD公式分别为74.2%、72.0%和64.5%,差异无统计学意义.当rGFR>60ml/(min·1.73m2)时,CKD-EPI公式30%准确度(75.7%±5.1%)明显高于MDRD公式(54.1%±7.7%,P<0.05).以放射性核素法的GFR作为标准,以rGFR≤60ml/(min·1.73m2)作为GFR受损标准,进行3种eGFR诊断GFR受损性能的受试者工作特征(ROC)曲线分析,MDRD eGFR的ROC曲线下面积为0.862,CKD-EPI为0.863,eGFR-Cys为0.877,3个曲线下面积的差异无统计学意义.结论 3个公式对GFR的估算能力基本相似.CKDEPI公式和eGFR-Cys公式是否可以取代MDRD公式尚需进一步研究.%Objective To compare the values of 3 empirical formulae, namely Modification of Diet in Renal Disease (MDRD) study equation, Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, and cystatin C (Cys C) single variable equations (eGFR-Cys), on predicting the glomerular filtration rate (GFR) of patients with chronic kidney disease. Methods Ninety three patients with chronic kidney disease were enrolled in present study. The plasma clearance of 99?Tc-diethylenetriamine pentaacetic acid (DTPA) was measured the golden standard of GFR (rGFR), and estimated GFR (eGFR) was calculated with the MDRD equation, CKD-EPI equation

  18. Creatinine, eGFR and association with myocardial infarction, ischemic heart disease and early death in the general population

    DEFF Research Database (Denmark)

    Sibilitz, Kirstine L; Benn, Marianne; Nordestgaard, Børge G

    2014-01-01

    OBJECTIVE: We tested the hypothesis that moderately elevated plasma creatinine levels and decreased levels of estimated glomerular filtration rate (eGFR) are associated with increased risk of myocardial infarction, ischemic heart disease, and early death in the general population. METHODS: We...... studied 10,489 individuals with a plasma creatinine measurement and calculated eGFR from the Danish general population, of which 1498 developed myocardial infarction, 3001 ischemic heart disease, and 7573 died during 32 years follow-up. RESULTS: Cumulative incidences of myocardial infarction and ischemic...... heart disease as a function of age increased with increasing levels of creatinine, and survival decreased (log-rank trends: creatinine levels

  19. 螺旋CT多期扫描测定肾移植供体肾功能的价值%Glomerular filtration rate in living renal donor measured by helical CT multi-phase scanning

    Institute of Scientific and Technical Information of China (English)

    窦鑫; 周科峰; 李丹燕; 胡安宁; 杨尚文; 郭宏骞; 刘铁石; 朱斌

    2011-01-01

    目的:评价多层螺旋CT多期扫描测定肾移植供体肾功能的方法及应用.方法:58例活体肾移植供体行腹部多层螺旋CT多期(动脉期、实质期、排泄期)扫描,在动脉期与实质期之间插入5个低剂量全肾扫描序列,数据传入AW4.2工作站进行测量,根据全肾Patlak方程,计算单侧肾小球滤过率(glomerular filtration rate,GFR),同时与单光子发射计算机体层成像(single photon emission computed tomography,SPECT)所测定的单侧GFR相对照,进行直线回归与相关分析.结果:两种方法测定的GFR相关性良好,总肾的GFR相关系数r=0.904,直线回归方程为GFR(CT)=20.841+0.753×GFR(ECT),n=58,单侧GFR相关系数r=0.946,直线回归方程为GFR(CT)=7.086+0.864×GFR(ECT),n=116,配对t检验显示,两者测定的单侧及双侧GFR之间均无显著性差异(P>0.05).结论:螺旋CT多期扫描测定的移植肾供体的GFR结果准确,可以和同位素测定结果相互替代.%Objective:To evaluate the technique and application for measuring glomerular filtration rate in living renal donor by 16-slice spiral CT multi-phase scanning. Methods:58 living renal donors were underwent abdominal multi-phase enhancement CT scan, between the arterial and parenchymal phase. 5 continuous low dose kidney series were inserted. Using the known patlak equation, the GFR in a single kidney was calculated in CT scan and the exact information of GFR was gained by performing renal SPECT with Tc99m-TDPA. GFR of the two groups were analyzed by linear regression analysis. Results: Linear regression analysis show that the two groups GFR had very well associativity. The correlation coefficient of whole kidney and divided one is 0. 904 and 0. 946. With a line of regression GFR(CT) = 20. 841 + 0. 753 × GFR (ECT).n=58(the whole kidney); GFR(CT)=7. 086 + 0. 864 XGFR(ECT) .n= 116 (the divided kidney), they had no statistical significance in pair t test( P >0. 05). Conclusion:The GRF measured by multi-phase CT

  20. GFR Decline as an Alternative End Point to Kidney Failure in Clinical Trials : A Meta-analysis of Treatment Effects From 37 Randomized Trials

    NARCIS (Netherlands)

    Inker, Lesley A.; Lambers Heerspink, Hiddo J.; Mondal, Hasi; Schmid, Christopher H.; Tighiouart, Hocine; Noubary, Farzad; Coresh, Josef; Greene, Tom; Levey, Andrew S.

    2014-01-01

    Background: There is increased interest in using alternative end points for trials of kidney disease progression. The currently established end points of end-stage renal disease and doubling of serum creatinine level, equivalent to a 57% decline in estimated glomerular filtration rate (eGFR), are

  1. Optimising drug prescribing and dispensing in subjects at risk for drug errors due to renal impairment : improving drug safety in primary healthcare by low eGFR alerts

    NARCIS (Netherlands)

    Joosten, Hanneke; Drion, Iefke; Boogerd, Kees J.; van der Pijl, Emiel V.; Slingerland, Robbert J.; Slaets, Joris P. J.; Jansen, Tiele J.; Schwantje, Olof; Gans, Reinold O. B.; Bilo, Henk J. G.

    2013-01-01

    Objectives: To assess the risk of medication errors in subjects with renal impairment (defined as an estimated glomerular filtration rate (eGFR) Design: Clinical survey. Setting: The city of Zwolle, The Netherlands, in a primary care setting including 22 community pharmacists and 65 general practiti

  2. Clinical value of NGAL, L-FABP and albuminuria in predicting GFR decline in type 2 diabetes mellitus patients.

    Directory of Open Access Journals (Sweden)

    Kuei-Mei Chou

    Full Text Available OBJECTIVES: Neutrophil gelatinase-associated lipocalin (NGAL and liver-type fatty acid binding protein (L-FABP are emerging as excellent biomarkers in the urine and plasma for the early prediction of acute and chronic kidney injury. The aims of this prospective study were to determine the role of albuminuria, and that of serum and urine levels of NGAL and L-FABP as predictors of a decline in the glomerular filtration rate (GFR in patients with type 2 diabetes. METHODS: A longitudinal cohort study with one hundred forty type 2 diabetic patients was conducted. Serum and urine levels of NGAL and L-FABP, and the urine albumin excretion rate were determined. The correlation between the kidney injury biomarkers and rate of GFR decline was analyzed. RESULTS: The eGFR of study subjects decreased significantly as the study progressed (86.4±31.1 vs. 74.4±27.3 ml/min/1.73 m(2, P<0.001, and the urine albumin excretion rate increased significantly (264.9±1060.3 vs. 557.7±2092.5 mg/day, P = 0.009. The baseline urine albumin excretion rate and serum L-FABP level were significantly correlated with baseline eGFR (P<0.05. The results of regression analysis for the correlations between the rate of eGFR change and the baseline levels of NGAL and L-FABP, and the urine albumin excretion rate showed that only the urine albumin excretion rate was significantly correlated with the rate of eGFR change (standardized coefficients: -0.378; t: -4.298; P<0.001. CONCLUSIONS: Tubular markers, such as NGAL and L-FABP, may not be predictive factors associated with GFR decline in type 2 diabetic patients.

  3. Application of the Different Estimation Formulas for Calculating Glomerular Filtration Rate of Chinese Patients With Diabetes%不同肾小球滤过率估算公式对中国糖尿病患者肾功能的临床应用评价

    Institute of Scientific and Technical Information of China (English)

    王丽; 毕娅欣; 金国玺

    2015-01-01

    目的:评估不同肾小球滤过率( GFR)估算公式在我国糖尿病患者中的临床应用价值。方法选取2014年2—10月蚌埠医学院第一附属医院内分泌科入院的225例糖尿病患者,记录其性别、年龄、病程等资料,检测血清胱抑素C ( Cys-C)、血肌酐( SCr),使用GFR估算公式MDRD、 rMDRD、 CKD-EPI、瑞金方程、 Macisaac计算GFR估计值( eGFR),同时行同位素99m Tc-DTPA肾动态显像法得出GFR参考值( ECT-GFR)。结果 MDRD-eGFR、rMDRD-eGFR、 SQRT CKD-EPI-eGFR、瑞金方程-eGFR、 SQRT Macisaac-eGFR均高于ECT-GFR,差异有统计学意义(t=18.149、17.964、11.952、12.766、6.404, P<0.05)。不同GFR分期、性别、年龄、病程的患者各估算公式eGFR与ECT-GFR均呈直线正相关(P<0.01)。利用Bland-Altman作图法评价各eGFR与GFR之间的一致程度,结果显示使用Macisaac公式Cys-C计算的eGFR与GFR的偏差值均数最小,表明二者相符程度较好。结论采用各公式估算GFR时,以Macisaac公式评价GFR适用性相对较好,5种GFR评估公式在我国糖尿病人群中的临床应用均有一定局限性,有待进一步改进。%Objective To investigate the application value of different estimation formulas for calculating glomerular filtration rate ( GFR) in Chinese patients with diabetes. Methods We enrolled 225 patients with diabetes who were admitted into the Department of Endocrinology of the First Affiliated Hospital of Bengbu Medical College from February to October 2014. Gender, age and disease course were recorded; Cys -C and SCr were detected; eGFR was calculated using MDRD, rMDRD, CKD-EPI, M-MDRD-GFR and Macisaac, and the reference value of GFR was worked out by 99m Tc-DTPA renal dynamic imaging. Results MDRD -eGFR, rMDRD -eGFR, SQRT CKD -EPI -eGFR, M -MDRD -GFR -eGFR and SQRT Macisaac-eGFR were higher than ECT -GFR (t =18. 149, 17. 964, 11. 952, 12. 766, 6. 404; P <0. 05). eGFR values worked out by different formulas and of patients

  4. Impact of interobserver variation in region-of-interest drawing on the measurement of glomerular filtration rates with Gates' method%不同操作者对Gates法测定肾小球滤过率的影响

    Institute of Scientific and Technical Information of China (English)

    艾虎; 张建飞; 孙福成; 姚稚明; 郑建国

    2011-01-01

    Objective To investigate the influence of different region-of-interest (ROI) drawing on the measurement of glomerular filtration rate (GFR) with Gates' method.Methods Dynamic renal imaging was performed in 55 patients.GFR was calculated from different ROI drawed by two different observers and was compared by using linear regression analysis.Results No significant difference was observed in GFR obtained from two observers(49.94 ± 18.81 vs.49.78 ± 18.48,P >0.05).The correlation coefficient of GFR from 2 observers was 0.961 (P<0.01 ).Conclusion The measurement of GFR in Gates'method displays good interobserver reproducibility.%目的 探讨不同操作者进行勾划设置感兴趣区对Gates法测定肾小球滤过率的影响.方法 对55例患者行肾动态显像,2位勾划者设置感兴趣区并得出肾动态显像测定肾小球滤过率(GFR).比较2次勾划所得GFR的相关性.结果 2次勾划所得GFR差异无统计学意义(49.94±18.81比49.78±18.48,P>0.05),相关系数为0.961(P<0.01).结论 Gates法测定肾小球滤过率有较好的重复性,受勾划者影响较小.

  5. Estimated Visceral Adipose Tissue, but Not Body Mass Index, Is Associated with Reductions in Glomerular Filtration Rate Based on Cystatin C in the Early Stages of Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Ana Karina Teixeira da Cunha França

    2014-01-01

    Full Text Available Information on the association between obesity and initial phases of chronic kidney disease (CKD is still limited, principally those regarding the influence of visceral adipose tissue. We investigated whether the visceral adipose tissue is more associated with reductions in glomerular filtration rate (GFR than total and abdominal obesity in hypertensive individuals with stage 1-2 CKD. A cross-sectional study was implemented which involved 241 hypertensive patients undergoing treatment at a primary health care facility. GFR was estimated using equations based on creatinine and cystatin C levels. Explanatory variables included body mass index (BMI, waist circumference (WC, and estimated visceral adipose tissue (eVAT. The mean age was 59.6±9.2 years old and 75.9% were female. According to BMI, 28.2% of subjects were obese. Prevalence of increased WC and eVAT was 63.9% and 58.5%, respectively. Results from the assessment of GFR by BMI, WC, and eVAT categories showed that only women with increased eVAT (≥150 cm2 had a lower mean GFR by Larsson (P=0.016, Levey 2 (P=0.005, and Levey 3 (P=0.008 equations. The same result was not observed when the MDRD equation was employed. No association was found between BMI, WC, eVAT, and GFR using only serum creatinine. In the early stages of CKD, increased eVAT in hypertensive women was associated with decreased GFR based on cystatin C.

  6. 成年健康个体肾小球滤过率正常范围的研究%The normal range of Glomerular Filtration Rate in Chinese apparently healthy adults

    Institute of Scientific and Technical Information of China (English)

    马迎春; 左力; 陈亮; 宿志梅; 孟申; 张春丽; 王海燕

    2011-01-01

    目的 探讨成年健康个体肾小球滤过率(GFR)的正常范围.方法 收集不同地域的成年健康个体,以双血浆法锝-二乙三胺五乙酸(Tc-DTPA)血浆清除率为GFR参考值(rGFR).结果 入选健康个体301名.50岁之前rGFR保持恒定;50岁之后rGFR平均每10年下降12.2 ml/min.50岁之前女性的rGFR高于男性;>50岁之后,女性的rGFR均低于男性,但差异无显著性(P>0.05).结论 50岁以后,成年健康个体GFR真实值随着年龄的增加逐渐下降;50岁之前,女性GFR平均值高于男性.%Objectives Studies show that Glomerular Filtration Rate(GFR) decrease with the increase of age, but the normal reference range of GFR by age groups in healthy Chinese adults is still unknown. The aim of this study was to investigate the normal GFR reference range by age groups in healthy Chinese adults,and to explore sex and age- related differences in GFR. Methods Three hundred and one Chinese healthy adults were enrolled. All eligible subjects were: ( 1 ) no positive finding by physical examination; (2)without any kinds of chronic disease; (3)fasting plasma glucose was normal and urinary dipstick test and sediments examination were negative. Reference GFR(rGFR) was measured using dual plasma sampling method of plasma clearance of 99mTc-DTPA. Results The normal reference of GFR kept constant with age up to 50 years, and showed a decline after the age of 50 years with the increase of age in healthy Chinese adults,the decreased average value of rGFR after the age of 50 years was 12.2 ml/min/l0 years(P<0.001 compared with those of age up to 50 years). In the age of 18to 49 years old,the mean GFR values of females was higher than those of males ( P < 0. 05 in the age 18 to 29, without significant difference in the age 30 to49) ;after the age of 50,the mean GFR values of female was lower than those of male,but without significant difference. Conclusions We firstly report of the reference GFR range and sex- and age- related

  7. Removal of Cryptosporidium sized particle under different filtration temperature, flow rate and alum dosing

    Institute of Scientific and Technical Information of China (English)

    XU Guo-ren; Fitzpatrick S. B. Caroline; Gregory John; DENG Lin-yu

    2007-01-01

    Recent Cryptosporidium outbreaks have highlighted concerns about filter efficiency and in particular particle breakthrough. It is essential to ascertain the causes of Cryptosporidium sized particle breakthrough for Cryptosporidium cannot be destroyed by conventional chlorine disinfection. This research tried to investigate the influence of temperature, flow rate and chemical dosing on particle breakthrough during filtration. The results showed that higher temperatures and coagulant doses could reduce particle breakthrough. The increase of filtration rate made the residual particle counts become larger. There was an optimal dose in filtration and was well correlated to ζ potential.

  8. Donor-estimated GFR as an appropriate criterion for allocation of ECD kidneys into single or dual kidney transplantation.

    Science.gov (United States)

    Snanoudj, R; Rabant, M; Timsit, M O; Karras, A; Savoye, E; Tricot, L; Loupy, A; Hiesse, C; Zuber, J; Kreis, H; Martinez, F; Thervet, E; Méjean, A; Lebret, T; Legendre, C; Delahousse, M

    2009-11-01

    It has been suggested that dual kidney transplantation (DKT) improves outcomes for expanded criteria donor (ECD) kidneys. However, no criteria for allocation to single or dual transplantation have been assessed prospectively. The strategy of DKT remains underused and potentially eligible kidneys are frequently discarded. We prospectively compared 81 DKT and 70 single kidney transplant (SKT) receiving grafts from ECD donors aged >65 years, allocated according to donor estimated glomerular filtration rate (eGFR): DKT if eGFR between 30 and 60 mL/min, SKT if eGFR greater than 60 mL/min. Patient and graft survival were similar in the two groups. In the DKT group, 13/81 patients lost one of their two kidneys due to hemorrhage, arterial or venous thrombosis. Mean eGFR at month 12 was similar in the DKT and SKT groups (47.8 mL/min and 46.4 mL/min, respectively). Simulated allocation of kidneys according to criteria based on day 0 donor parameters such as those described by Remuzzi et al., Andres et al. and UNOS, did not indicate an improvement in 12-month eGFR compared to our allocation based on donor eGFR.

  9. Studies on filtration rate in four species of suspension feeding bivalves

    Institute of Scientific and Technical Information of China (English)

    林元烧; 罗文新; 曹文清; 郭东晖; 郑爱榕; 黄长江

    2002-01-01

    The filtration rates of four kinds of bivalves that were cultivated dominantly around Xiamen sea area were measured by using a laboratory flowing system. The experimental results were shown below: (1) Filtration rates were measured in the range of 54~74.8 ml/ (g@min) among the four bivalves, sequencing descently Saccostrea cucullata > Sinonovacula constricta > Mytilus viridis > Ruditapes philippinarum. (2) The relationship between filtration rates on individual size showed a negative exponential function (FR = aWb, FR' = aWb-1), with b - 1 = - 0.435 6 and - 0.392. (3) Filtration rates on Skeletonema costatum were much higher than on Alexandrium tamarensis and Scrippsilla trochoidea inS. Cucullata and R. Philippinarum. (4) FR'on algal densities was also shown a negative function(FR' = aDb-1), with b-1 =-0.143 and-0.215 2 in S.cucullata and R.philippinarum, respectively.

  10. Estimating glomerular filtration rates in elderly Chinese patients with chronic kidney disease: performance of six modified formulae developed in Asian populations

    Directory of Open Access Journals (Sweden)

    Liu X

    2013-07-01

    Full Text Available Xun Liu,1,2,* Haixia Xu,3,* Zebin Zheng,4,5,* Cheng Wang,1 Cailian Cheng,1 Chenggang Shi,1 Yihong Gong,4,5 Ming Li,1 Tanqi Lou1 1Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, 2College of Biology Engineering, South China University of Technology, 3Division of Endocrinology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China; 4Department of Biomedical Engineering, School of Engineering, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China; 5Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instruments, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China *These authors contributed equally to this work Objectives: The aim of the present study was to evaluate modified glomerular filtration rate (GFR prediction formulae in an elderly Chinese population with chronic kidney disease (CKD. Methods: A total of 378 elderly Chinese patients with CKD were enrolled. The GFR was estimated with six modified GFR prediction formulae. The performances of the estimated GFRs were compared with those of the standard GFRs measured by technetium-99m diethylenetraminepentaacetic acid. Results: Biases were similar for Chinese formula 1, the Asian formula, and Chinese formula 2 (median difference, 2.22 mL/min/1.73 m2 and 2.59 mL/min/1.73 m2 for Chinese formula 1 and the Asian formula, respectively, versus (vs 3.69 mL/min/1.73 m2 for Chinese formula 2 [P = 0.298 and P = 0.913, respectively]. Precision was improved with the Japanese formula (interquartile range of the difference, 3.14 mL/min/1.73 m2 of the Japanese formula versus 15.53–23.06 mL/min/1.73 m2 of the other formulae. The accuracy of Chinese formula 2 was the highest (30% accuracy, 59.3% vs range 37.8–54.0% [P < 0.05 for all comparisons]. However, none of the modified formulae surpassed the acceptable

  11. Associations between proteinuria, systemic hypertension and glomerular filtration rate in dogs with renal and non-renal diseases.

    Science.gov (United States)

    Wehner, A; Hartmann, K; Hirschberger, J

    2008-02-02

    Proteinuria and systemic hypertension are well recognised risk factors in chronic renal failure (CRF). They are consequences of renal disease but also lead to a further loss of functional kidney tissue. The objectives of this study were to investigate the associations between proteinuria, systemic hypertension and glomerular filtration rate (GFR) in dogs with naturally occurring renal and non-renal diseases, and to determine whether proteinuria and hypertension were associated with shorter survival times in dogs with CRF. Measurements of exogenous creatinine plasma clearance (ECPC), urine protein:creatinine ratio (UPC), and Doppler sonographic measurements of systolic blood pressure (SBP) were made in 60 dogs with various diseases. There was a weak but significant inverse correlation between UPC and ECPC, a significant inverse correlation between SBP and ECPC and a weak but significant positive correlation between UPC and SBP. Some of the dogs with CRF were proteinuric and almost all were hypertensive. Neoplasia was commonly associated with proteinuria in the dogs with a normal ECPC. CRF was the most common cause leading to hypertension. In the dogs with CRF, hypertension and marked proteinuria were associated with significantly shorter survival times.

  12. A comparison of the effect of ramipril, felodipine and placebo on glomerular filtration rate, albuminuria, blood pressure and vasoactive hormones in chronic glomerulonephritis. A randomized, prospective, double-blind, placebo-controlled study over two years.

    Science.gov (United States)

    Pedersen, E B; Bech, J N; Nielsen, C B; Kornerup, H J; Hansen, H E; Spencer, E S; Sølling, J; Jensen, K T

    1997-12-01

    The effects of an ACE-inhibitor (ramipril), a calcium antagonist (felodipine) and placebo on glomerular filtration rate (GFR), urinary albumin/creatinine ratio, blood pressure (BP) and vasoactive hormones were investigated in a randomized, prospective, double-blind, placebo-controlled study of patients with chronic glomerulonephritis and hypertension, with measurements at entrance and after 12 and 24 months. In total, 33 patients were included: 21 completed the study with 7 patients in each group. GFR was measured as 51Cr-EDTA clearance and the vasoactive hormones with radioimmunoassays. The reduction in GFR was significantly more pronounced in the felodipine group (-7 ml/min) than in the ramipril group (0 ml/min) but the same as in the placebo group (-6 ml/min). The urinary albumin/creatinine ratio was significantly more reduced in the ramipril group (-74 mg/mmol) than in the placebo group (-11 mg/mmol), which did not deviate from the felodipine group (-10 mg/mmol). BP was significantly reduced by ramipril and felodipine, but not by placebo. Angiotensin II and aldosterone in plasma increased or tended to increase in the felodipine and placebo groups, but were unchanged in the ramipril group. Endothelin increased only in the placebo group, and vasopressin, atrial natriuretic peptide, and brain natriuretic peptide were not significantly changed in any of the groups. It is concluded that ramipril seems to be superior to felodipine in chronic glomerulonephritis owing to better preservation of GFR.

  13. 脓毒症并发急性肾损伤患者 RAAS 水平与 GFR 的关系%The relationship between the levels of RAAS and GFR in patients with AKI induced by sepsis

    Institute of Scientific and Technical Information of China (English)

    叶声; 方丽; 王迪芬; 唐忠平

    2016-01-01

    Objective To explore the relationship between the levels of rennin angiotensin aldosterone system (RAAS),cystatin C (Cys C)and glomerular filtration rate (GFR)in patients with acute kidney injury (AKI)in-duced by sepsis.Methods Determination of the levels of RAAS,serum creatinine(SCr),CysC and estimated patients'GFR in ICU patients with AKI induced by sepsis.And GFR about the correlation between each index was evalua-ted.Result The levels of renin,angiotensin I,Cys C was negatively correlated with GFR.Cys C was positively cor-related with SCr.Conclusion CysC in patients with AKI induced by sepsis is as an endogenous marker of GFR and the levels of RAAS may affect GFR in patients with AKI induced by sepsis.%目的:探讨脓毒症并发急性肾损伤(AKI)患者肾素—血管紧张素—醛固酮系统(RAAS)、胱抑素 C (cystatin C,Cys C)水平与肾小球滤过率(GFR)的关系。方法测定 ICU 脓毒症 AKI 患者的 RAAS 水平、血清肌酐(serum creatinine,SCr)与 Cys C 水平,并评估 GFR,分析各指标间的相关性。结果 Cys C、肾素、血管紧张素 I 浓度与 GFR 呈负相关;Cys C 和血清肌酐正相关。结论脓毒症 AKI 患者 Cys C 是 GFR 的内源性标志物,RAAS 水平可能影响 GFR。

  14. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys......) aged 2-14 years. GFR was 14-147 mL/min/1.73m2. BCM was estimated using bioimpedance spectroscopy. Log-transformed data on BCM/CysC, serum creatinine (SCr), body-surface-area (BSA), height×BSA/SCr, CysC, weight, sex, age, height, serum urea and albumin were considered possible explanatory variables...

  15. Prediction of renal function (GFR) from cystatin C and creatinine in children: Body cell mass increases accuracy of the estimate

    DEFF Research Database (Denmark)

    Andersen, Trine Borup; Jødal, Lars; Bøgsted, Martin

    AIM: To derive an accurate prediction model for estimating glomerular filtration rate (GFR) in children based primarily on the endogenous renal function marker cystatin C (CysC) and body cell mass (BCM). THEORY: Cystatin C is produced at a constant rate in all cells of the body and is excreted...... by glomerular filtration followed by catabolization in the tubular cells. We hypothesized that production rate is proportional to body cell mass (BCM) and inferred GFR (mL/min) to be proportional to BCM/CysC. MATERIAL AND METHODS: GFR was determined with 51Cr-EDTA-clearance in 131 children (52 girls, 79 boys......) aged 2-14 years (mean 8.8 years). GFR was 14-147 mL/min/1.73m2 (mean 97 mL/min/1.73m2). BCM was estimated using bioimpedance spectroscopy (Xitron Hydra 4200). Log-transformed data on BCM/CysC, serum creatinine (SCr), body-surface-area (BSA), height x BSA/SCr, serum CysC, weight, sex, age, height, serum...

  16. Evaluation of the various methods in detecting glomerular filtration rate%肾小球滤过功能检查方法评价

    Institute of Scientific and Technical Information of China (English)

    辛岗; 李惊子

    2002-01-01

    @@ 肾小球的主要功能为滤过作用,反映其滤过功能的主要客观指标为肾小球滤过率(glomerular filtration rate,GFR).肾小球滤过率是指单位时间(min)从双肾滤过的血浆的毫升数.GFR不能直接测定,只能通过某种标志物的清除率的测定而得知.标志物的清除率是指单位时间内肾脏排出这种物质的总量,计算公式如下:

  17. Fasting blood glucose--a missing variable for GFR-estimation in type 1 diabetes?

    Directory of Open Access Journals (Sweden)

    Petter Bjornstad

    Full Text Available Estimation of glomerular filtration rate (eGFR is one of the current clinical methods for identifying risk for diabetic nephropathy in subjects with type 1 diabetes (T1D. Hyperglycemia is known to influence GFR in T1D and variability in blood glucose at the time of eGFR measurement could introduce bias in eGFR. We hypothesized that simultaneously measured blood glucose would influence eGFR in adults with T1D.Longitudinal multivariable mixed-models were employed to investigate the relationships between blood glucose and eGFR by CKD-EPI eGFRCYSTATIN C over 6-years in the Coronary Artery Calcification in Type 1 diabetes (CACTI study. All subjects with T1D and complete data including blood glucose and cystatin C for at least one of the three visits (n = 616, 554, and 521, respectively were included in the longitudinal analyses.In mixed-models adjusting for sex, HbA1c, ACEi/ARB, protein and sodium intake positive associations were observed between simultaneous blood glucose and eGFRCYSTATIN C (β±SE:0.14±0.04 per 10 mg/dL of blood glucose, p<0.0001, and hyperfiltration as a dichotomous outcome (OR: 1.04, 95% CI: 1.01-1.07 per 10 mg/dL of blood glucose, p = 0.02.In our longitudinal data in subjects with T1D, simultaneous blood glucose has an independent positive effect on eGFRCYSTATIN C. The associations between blood glucose and eGFRCYSTATIN C may bias the accurate detection of early diabetic nephropathy, especially in people with longitudinal variability in blood glucose.

  18. Glomerular filtration rate after alpha-radioimmunotherapy with 211At-MX35-F(ab')2: a long-term study of renal function in nude mice

    DEFF Research Database (Denmark)

    Back, T.; Haraldsson, B.; Hultborn, R;

    2009-01-01

    and animals bearing subcutaneous xenografts of the human ovarian cancer cell line, OVCAR-3, were used. The animals received approximately 0.4, 0.8, or 1.2 MBq in one, two, or three fractions. The mean absorbed doses to the kidneys ranged from 1.5 to 15 Gy. The renal function was studied by serial GFR...... of the glomerular filtration rate (GFR). The renal toxicity was evaluated at levels close to the dose limit for the bone marrow and well within the range for therapeutic efficacy on tumors. Astatinated MX35-F(ab')(2) monoclonal antibodies were administered intravenously to nude mice. Both non-tumor-bearing animals...... manifested late. Examination of the kidney sections showed histologic changes that were overall subdued. Following alpha-RIT with (211)At-MX35-F(ab')(2) at levels close to the dose limit of severe myelotoxicity, the effects found on renal function were relatively small, with only minor to moderate reductions...

  19. Cystatin C Falsely Underestimated GFR in a Critically Ill Patient with a New Diagnosis of AIDS

    Directory of Open Access Journals (Sweden)

    Caitlin S. Brown

    2016-01-01

    Full Text Available Cystatin C has been suggested to be a more accurate glomerular filtration rate (GFR surrogate than creatinine in patients with acquired immunodeficiency syndrome (AIDS because it is unaffected by skeletal muscle mass and dietary influences. However, little is known about the utility of this marker for monitoring medications in the critically ill. We describe the case of a 64-year-old female with opportunistic infections associated with a new diagnosis of AIDS. During her course, she experienced neurologic, cardiac, and respiratory failure; yet her renal function remained preserved as indicated by an eGFR ≥ 120 mL/min and a urine output > 1 mL/kg/hr without diuresis. The patient was treated with nephrotoxic agents; therefore cystatin C was assessed to determine if cachexia was resulting in a falsely low serum creatinine. Cystatin C measured 1.50 mg/L which corresponded to an eGFR of 36 mL/min. Given the >60 mL/min discrepancy, serial 8-hour urine samples were collected and a GFR > 120 mL/min was confirmed. It is unclear why cystatin C was falsely elevated, but we hypothesize that it relates to the proinflammatory state with AIDS, opportunistic infections, and corticosteroids. More research is needed before routine use of cystatin C in this setting can be recommended.

  20. Correlation between lacunar infarction and glomeruar filtration rate in elderly patients%老年患者腔隙性脑梗死与肾小球滤过率的关系

    Institute of Scientific and Technical Information of China (English)

    李娜; 李辉; 胡新国; 程玲; 吴卫平; 管维平

    2012-01-01

    [Objective To study the correlation between lacunar infarction(LI) and glomeruar filtration rate(GFR) in elderly patients. Methods One hundred and twenty-seven MRI-confirmed male LI patients aged ≥80 years were divided into single lesion group(n = 35) and multiple lesion group(w = 92) according to the number of lesions. Following clinical data were collected,including 24 hdynamic blood pressure,age,BMI,and history of smoking,alcohol dinking,hypertension,diabetes mellitus,heart disease,and serum creatinine(SCr) and blood-lipid levels. GFR was estimated according to the Cockcroft-Gault equation. Correlation between GFR and LI level was analyzed by multiple logistic regression analysis. Results The SCr level was significantly higher while the GFR was significantly lower in multiple lesion group with its GFR <60 ml/(min ? 1. 73 m2) than in single lesion group(P<0. 05). Logistic regression analysis showed that the low GFR was closely correlated with the LI level, and the lower the GFR was, the higher the incidence of LI was (OR = 2. 14,P = 0. Oil). Conclusion Low GFR is an important risk factor for LI in elderly patients and can thus be used as a warning factor for LI.%目的 探讨老年(≥80岁)患者腔隙性脑梗死(lacunar infarction,LI)与肾小球滤过率(glomeruar filtration rate,GFR)的相关性.方法 选择经头颅MRI证实的老年男性LI患者127例,根据病灶数目分为单发组35例和多发组92例.采集患者的24 h动态血压、年龄、体重指数、吸烟、饮酒、血清肌酐、高血压、血脂、糖尿病、心脏病等临床资料,采用Cockcroft-Gault公式估算GFR.采用多因素logistic回归分析LI与GFR的相关性.结果 与单发组比较,多发组患者血清肌酐、GFR<60 ml/(min·1.73 m2)明显升高(P<0.01),GFR明显降低(P<0.05).logistic回归分析显示,GFR降低与LI的发生密切相关(P<0.05),GFR降低越严重,LI发生率越高(OR=2.14,P=0.011).结论 GFR降低可能为老年LI的重要危险因素,或可成为LI的预警因素.

  1. Effect of filtration rate on coal-sand dual-media filter performances for microalgae removal.

    Science.gov (United States)

    Sabiri, Nour-Eddine; Monnier, Elodie; Raimbault, Virginie; Massé, Anthony; Séchet, Véronique; Jaouen, Pascal

    2017-02-01

    This study tested the efficiency of granular filtration using a bilayer sand filter for microalgae removal from culture dilutions ranging from 10,000 to 17,000 cells/mL. The objective is to evaluate the removal capacity of the filter without chemical coagulation. Two filter media, sand and anthracite, with mean grain sizes of 0.395 and 1.2 mm, respectively, were used in constant-flow-rate experiments (down-flow mode) with suspensions containing Heterocapsa triquetra microalga. The conventional rapid filtration which usually operates at a constant rate of approximately 5 m(3)/m(2) h is compared to high-rate filtration. Two filtration velocities (5 and 10 m/h) were investigated with bed depth of 1100 mm. Average microalgal cell removal rates were 90% at 5 m/h and 68% at 10 m/h. Turbidity removal was more than 71% at 5 m/h but just 57% at 10 m/h. Head losses did not increase significantly, and values measured at process end were 32 mbar at 5 m/h and 78 mbar at 10 m/h. Retention probabilities were calculated from experimental data. A theoretical model was used to evaluate the contributions of the different drivers of microalgae removal. Hypotheses are developed on the understanding of change in the mechanisms of retention as a function of filtration velocity.

  2. Mannitol clearance for the determination of glomerular filtration rate-a validation against clearance of (51) Cr-EDTA.

    Science.gov (United States)

    Kiss, Katalin; Molnár, Miklós; Söndergaard, Sören; Molnár, Gyula; Ricksten, Sven-Erik

    2016-06-03

    We studied the agreement between plasma clearance of mannitol and the reference method, plasma clearance of (51) Cr-EDTA in outpatients with normal to moderately impaired renal function. Forty-one patients with a serum creatinine clearance was measured with the standard bolus injection technique and glomerular filtration rate (GFR) was calculated by the single-sample method described by Jacobsson. Mannitol, 0·25 g kg(-1) body weight (150 mg ml(-1) ), was infused for 4-14 min and blood samples taken at 1-, 2-, 3- and 4-h (n = 24) or 2-, 3-, 3·5- and 4-h after infusion (n = 17). Mannitol in serum was measured by an enzymatic method. Plasma clearance for mannitol and its apparent volume of distribution (Vd) were calculated according to Brøchner-Mortensen. Mean plasma clearance (±SD) for (51) Cr-EDTA was 59·7 ± 18·8 ml min(-1) . The mean plasma clearance for mannitol ranged between 57·0 ± 20·1 and 61·1 ± 16·7 ml min(-1) and Vd was 21·3 ± 6·2% per kg b.w. The between-method bias ranged between -0·23 and 2·73 ml min(-1) , the percentage error between 26·7 and 39·5% and the limits of agreement between -14·3/17·2 and -25·3/19·9 ml min(-1) . The best agreement was seen when three- or four-sample measurements of plasma mannitol were obtained and when sampling started 60 min after injection. Furthermore, accuracy of plasma clearance determinations was 88-96% (P30) and 41-63% (P10) and was highest when three- or four-sample measurements of plasma mannitol were obtained, including the first hour after the bolus dose. We conclude that there is a good agreement between plasma clearances of mannitol and (51) Cr-EDTA for the assessment of GFR.

  3. The correlation of albuminuria and glomerular filtration rate with diabetic retinopathy in type 2 diabetes%尿白蛋白、肾小球滤过率与2型糖尿病视网膜病变的相关性研究

    Institute of Scientific and Technical Information of China (English)

    蔡芸莹; 马中书; 邱明才

    2012-01-01

    目的 比较T2DM视网膜病变(DR)不同时期,尿蛋白、肾小球滤过率(GFR)变化,寻找早期筛查DR的指标. 方法 采用回顾性病历研究,根据散瞳眼底检查分组,同期测定各组24h尿白蛋白定量,以MDRD公式计算GFR. 结果 与正常眼底组相比,DR组患者的GFR明显减低(P<0.05),且尿白蛋白(UAlb)、GFR均与DR呈显著独立相关(P<0.05). 结论 UAlb、GFR均与DR密切相关,其联合筛查有利于DR早期检出.%Objective To compare changes of urinary albumin and eGFR between different stages of diabetic retinopathy(DR) to look for early screening diabetic retinopathy indicators. Methods The clinical data were analyzed retrospectively. Diabetic retinopathy was assessed by mydriatic ophthalmoscopy. While determinating the urinary albumin quantitative for 24 hours, the estimated glomerular filtration rate(GFR) was measured by MDRD formula Results The levels of GFR were significantly lower in two DR groups than in normal retina group(P< 0. 05). Both urinary albumin(Ualb) and GFR were independently risks for diabetic retinopathy. Conclusion Ualb and GFR are closely associated with diabetic retinopathy. Clinicians need to check both urinary albumin and eGFR to screen for early diabetic retinopathy.

  4. Influence of renal function on the measurement of glomerular filtration rate with Gates method%肾功能对Gates法肾小球滤过率实测值的影响

    Institute of Scientific and Technical Information of China (English)

    杨仪; 唐军; 田金玲; 陆文栋; 刘增礼

    2012-01-01

    Objective To investigate the influence of renal function on the measurement of glomerular filtration rate(GFR) with Gates method. Methods In 155 cases with different kidney disease(95 male, 60 female; 19-83 years old) , having impairment of re-nal function to varying degrees,renal dynamic imaging was performed by 99Tcm-DTPA and GFR was measured twice using Gates method both by two different manipulators in 73 cases and by the same manipulator at more than 3 months interval in 82 cases. Two groups of cases were divided into A stages according to mean GFR. All GFR at different stages in two groups were analyzed with the matched t-test to reveal if there were significant differences between the before-and-after GFR measured by different manipulators or by same manipulator at different time. Coefficient of variation(CV) of GFR at different stages was obtained to explore the rela-tionship between CV and renal function(mean GFR). Results There were not statistically significant differences of GFR between the before-and-after GFR measured by different manipulators or by same manipulator at different time in all cases(P>0. 05). With decline of renal function from stage Ⅰ to stage Ⅳ of chronic kidney disease(CKD) ,CV became larger. They were in negative corre-lation and the regression equations were Y= -0. 09X+10. 22(r=0. 60)by two different manipulators and Y= - 0. 11X311. 23(r = 0. 66)by the same manipulator. Conclusion Deviation at different extent in measuring GFR with Gates method exists at different stages of renal function. The worse the renal function is,the greater the deviation rises.%目的 探讨肾功能对Gates法测定肾小球滤过率(GFR)实测值的影响.方法 对155例慢性肾脏病(CKD)患者进行99Tcm-DTPA肾动态显像,采用Gates法测定GFR,其中73例由两位不同操作者进行肾脏ROI的勾画,82例由同一操作者在不同的时间进行两次ROI勾画,将所得的GFR进行分析比较,观察在不同的肾功能状态下由于肾

  5. Relationships of pancreatic beta-cell function with microalbuminuria and glomerular filtration rate in middle-aged and elderly population without type 2 diabetes mellitus: a Chinese community-based analysis

    Science.gov (United States)

    Fu, Shihui; Zhou, Shanjing; Luo, Leiming; Ye, Ping

    2017-01-01

    Background Relationships of pancreatic beta-cell function abnormality with microalbuminuria (MA) and glomerular filtration rate (GFR) may differ by age, ethnicity and accompanied diseases. Previous studies were generally conducted in Western adult patients with type 2 diabetes mellitus (T2DM), and it is uncertain whether pancreatic beta-cell function is associated with MA and GFR in Chinese community-dwelling middle-aged and elderly population without T2DM. We therefore examined the relationships of pancreatic beta-cell function with two indices of renal damage, MA and GFR, in Chinese community-dwelling middle-aged and elderly population without T2DM. Methods This analysis focused on 380 Beijing residents older than 45 years who were free of T2DM and completed the evaluation of pancreatic beta-cell function. Results Median age was 67 (49–80) years. Levels of triglyceride, diastolic blood pressure and homeostasis model assessment-beta (HOMA-beta) index were positively related to urine microalbumin (P0.05 for all). Conclusion Modeling the pancreatic beta-cell function with different adjusted variables provided the same conclusion of association with MA; beta-cell function was positively associated with MA. Additionally, there was a specific difference in the adjusted associations of pancreatic beta-cell function with MA and GFR <60 mL/min/1.73 m2; beta-cell function was not independently associated with GFR <60 mL/min/1.73 m2. This result indicated that abnormal pancreatic beta-cell function plays an important role in the development of MA. PMID:28496313

  6. Effects of smoking and its cessation on creatinine- and cystatin C-based estimated glomerular filtration rates and albuminuria in male patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry.

    Science.gov (United States)

    Ohkuma, Toshiaki; Nakamura, Udai; Iwase, Masanori; Ide, Hitoshi; Fujii, Hiroki; Jodai, Tamaki; Kaizu, Shinako; Kikuchi, Yohei; Idewaki, Yasuhiro; Sumi, Akiko; Hirakawa, Yoichiro; Kitazono, Takanari

    2016-10-01

    Cigarette smoking is an important modifiable risk factor for lifestyle diseases. The smoking rate remains high, and the prevalence of diabetes mellitus is increasing in Asian countries; however, few studies have examined the effects of smoking on chronic kidney disease (CKD) in Asian diabetic patients. The aim of the present study was to investigate the association between smoking and its cessation with CKD and its components in patients with type 2 diabetes. A total of 2770 Japanese male patients with type 2 diabetes aged ⩾20 years were divided according to the amount of cigarette smoking and the years since cessation. The associations with CKD, the urinary albumin-creatinine ratio (UACR) and the estimated glomerular filtration rate (eGFR) were cross-sectionally examined. The proportions of CKD and the mean UACR dose-dependently increased with increases in both the number of cigarettes per day and the Brinkman index compared with the never smokers. The creatinine-based eGFR also increased with increases in the amount of smoking, whereas the cystatin C-based eGFR decreased, and their average did not significantly change. These parameters exhibited inverse associations with the years after smoking cessation compared with the association with the amount of smoking. A dose-dependent association of active smoking and a graded inverse association of the years since quitting with CKD enhance the merit of smoking cessation in patients with type 2 diabetes.

  7. Comparison of glomerular filtration rates by dynamic renal scintigraphy and dual-plasma sample clearance method in diabetic nephropathy%肾动态显像法与双血浆法测定糖尿病肾病患者GFR的比较

    Institute of Scientific and Technical Information of China (English)

    解朋; 黄建敏; 潘莉萍; 刘晓梅; 魏玲格; 高建青

    2010-01-01

    目的 以双血浆法测得的肾小球滤过率(GFR)为参考标准,评价99Tcm-DTPA肾动态显像法测得的糖尿病肾病患者GFR的可靠性及准确性.方法 选择46例确诊为糖尿病肾病的患者,分别采用肾动态显像法和双血浆法测定其GFR(GFR肾动态法和GFR双血浆法).用配对t检验分析经体表面积标准化(1.73 m-2)的GFR肾动态法与GFR双血浆法间的差异有无统计学意义,并行相关性分析.结果 46例糖尿病肾病患者的GFR肾动态法范围为11.87~107.00 ml·min-1,均值为(51.08±26.78)ml·min-1;GFR双血浆法范围为4.17~118.56ml·min-1,均值为(44.06±29.43)ml·sin-1;两者间差异有统计学意义(t=4.209,P=0.000),前者略高于后者,且两者呈显著正相关(r=0.923,P=0.000),直线回归方程为GFR双血浆法=1.015×GFR肾动态法-7.773(F=254.656,P=0.000).结论 GFR肾动志法与GFR双血浆法的差异有统计学意义,对于糖尿病肾病患者尚不能用GFR肾动态法代替GFR双血浆法;但肾动态显像法能够较准确评价糖尿病肾病患者的肾滤过功能.%Objective To evaluate the accuracy of renal scintigraphy for the estimation of glomerular filtration rates (dGFR) in patients with diabetic nephropathy as compared to the conventional dual-plasma sample clearance method (pscGFR). Methods Forty-six patients with diabetic nephropathy underwent both dynamic renal scintigraphy and dual-plasma sample measurement after 99Tcm-DTPA injection. Paired student t-test and correlation analysis were performed to compare dGFR and pscGFR (normalized to body surface area,1.73 m-2). Results The mean dGFR was higher than mean pscGFR ((51.08±26.78)ml·min-1vs (44.06±29.43)ml·min-1,t=4.209,P=0.000). The dGFR correlated with pscGFR ( r=0.923,P=0.000) linearly (regression equation:pscGFR=1.015×dGFR-7.773,F=254. 656,P=0.000).Conclusions dGFR correlated well with pscGFR. Although it could not absolutely replace the latter in patients with diabetic nephropathy,dGFR could

  8. Evaluation of the application of modified glomerular filtration rate estimation equations in chronic kidney disease%中国肾小球滤过率评估方程在慢性肾脏病患者的应用评价

    Institute of Scientific and Technical Information of China (English)

    刘迅; 唐骅; 汤颖; 陈珠江; 彭晖; 娄探奇

    2009-01-01

    目的 评价现有在中国人群基础上开发的肾小球滤过率(GFR)评估方程在慢性肾脏病(CKD)患者的适用性.方法 选择327例CKD患者,用中国方程、瑞金方程分别预测GFR值,与体表面积标准化99mTc-DTPA测的GFR(sGFR)进行比较.结果 Bland-Altman分析显示瑞金方程估计的GFR和sGFR的一致性最好,但所有方程估计的GFR和sGFR的一致性限度均超过事先规定的专业界值.线性回归结果显示,瑞金方程和MDRD-1方程估测的GFR与X轴的斜率较其他方程更小.在所有方程中,瑞金方程估测GFR 15%符合率、30%符合率和50%符合率均最高,但瑞金方程估测GFR 30%符合率依然低于70%.在CKD的不同分期中,瑞金方程估测GFR 15%符合率、30%符合率和50%符合率均较高.结论 当血肌酐的测定方法为酶法时,如果直接应用目前在中国人群基础上开发出的GFR评估方程预测GFR,可能会产生明显的偏差.有必要进行更大规模试验,进一步评估和验证中国方程和瑞金方程在中国人群的适用性.%Objective To evaluate the applicability of modified formulas based on plasma creatinine levels in Chinese patients with chronic kidney disease (CKD). Methods A total of 327 CKD patients were investigated. Glomerular filtration rate (GFR) was estimated with Chinese equations and Ruijin equation. The accuracy of estimated GFR was compared with 99mTc-DTPA-GFR (sGFR) in CKD patients. Results Bland-Ahman analysis demonstrated that Ruijin equation was more consistent with sGFR than the other equations. But all the equations were not well consistent with sGFR. Linear regression showed that the slopes of Ruijin equation and MDRD-1 equation were closer to the identical line. 15%, 30% and 50% accuracy of Ruijin equation were higher than the other equations. But 30% accuracy of Ruijin equation was still less than 70%. When the accuracy of estimated GFRs was compared with sGFR in different stages of CKD, GFR estimated by Ruijin

  9. Rate of filtration by Perna viridis pre-exposed to heavy metals

    OpenAIRE

    Prabhudeva, K.N.; Menon, N. R.

    1985-01-01

    Perna viridis exposed to different concentrations of copper and zinc for varying periods and then the rate of filtration estimated under metal free culture conditions. The concentrations under which the animals were maintained before the experiments were 0.025 to 0.150 p.p.m. of zinc and 0.005 to 0.08 p.p.m. of copper.

  10. Glomerular Filtration Rate Estimation in Renal and Non-Renal Solid Organ Transplantation

    DEFF Research Database (Denmark)

    Hornum, Mads; Feldt-Rasmussen, Bo

    2017-01-01

    or estimates of renal function in these patients, in order to accurately and safely dose immunosuppressive medication and perform and adjust the treatment and prophylaxis of renal dysfunction. This is a short overview and discussion of relevant studies and possible caveats of estimated glomerular filtration...... rate methods for use in renal and non-renal TX....

  11. An empirical research of four equations for estimated glomerular filtration rate among mass samples%4个肾小球滤过率估计公式的人群实证研究

    Institute of Scientific and Technical Information of China (English)

    汪秀英; 黄蕾蕾; 宋慧; 丁伟洁; 陈茂杰; 卓朗

    2011-01-01

    Objective To investigate the features of each glomerular filtration rate (GFR) equation in calculating the estimated glomerular filtration rate (eGFR) among mass samples, and to provide guidance to the appropriate equation selections of in the estimation of eGFR. Methods The mass samples were based on the physical examination data in recent years in Xuzhou. Simplified MDRD equation, modified MDRD equation, racial coefficient equation and Ruijin equation were designated to compare differences in statistic indexes and evaluate each equation via dynamic diagrammatic trends. Results Of the four equations, the means of eGFR by simplified MDRD equation were approximate to those by modified MDRD equation, with those by Ruijin equation at the nadir and those by racial coefficient equation at the peak.The standardized rate of reduced renal function was 0.53%, 0.45%, 0.62% and 0. 17%, respectively. The standardized rate of chronic kidney disease (CKD) was 11.71%, 11.66%, 11.81% and 11.46%, respectively. Conclusion The CKD in population study consists in hematuria and proteinuria, with little bias between different equations. Simplified MDRD equation or modified MDRD equation is still preferable in the study of the prevalence of CKD until new biochemical indicator is adopted to substitute serum creatinine so as to facilitate horizontal and vertical comparisons among relevant studies.%目的 通过使用不同的肾小球滤过率(GFR)公式估计人群的估计GFR(eGFR),了解不同公式的特征,指导正确选用公式有效估计eGFR.方法 本研究使用徐州地区近年来健康体检者的资料,比较简化MDRD公式、国内改良MDRD公式、种族系数公式和瑞金方程,比较各种统计指标之间的差异,通过图表的动态变化来判断各公式的价值.结果 简化MDRD公式的eGFR值与国内改良MDRD公式接近,瑞金方程最低,种族系数公式最高.肾功能下降标化患病率依次为0.53%、0.45%、0.62%、0.17%,慢

  12. Application of glomerular filtration rate estimating equations in patients with diabetes%肾小球滤过率估算公式在糖尿病患者中的应用

    Institute of Scientific and Technical Information of China (English)

    吴楠

    2011-01-01

    Diabetic kidney disease (DKD) is the most common microvascular complications of diabetes and the main cause of chronic kidney disease and end-stage renal disease (ESRD). Because of its incidence of occult, poor prognosis and high cost, it is essential to raising awareness of DKD, making a reasonable assessment of golmerular filtration rate (GFR) and taking effective intervention to prevent disease progression as early as possible, which is also important for preventing serious complications of the kidney. Many clinicians have recognized the importance of stratifying chronic kidney disease (CKD)in diabetic subjests. This article reviews recent literature of application of equations to estimate GFR in patients with diabetes to wake a general review.%糖尿病肾脏疾病(diabetic kidney disease,DKD)是糖尿病最常见的微血管并发症,是慢性肾脏疾病及终末期肾病(end-stage renal disease,ESRD)的首因,其发病隐匿且预后不佳,治疗费用极为昂贵.提高对DKD的早期认识,对GFR进行合理性评估,早期采取有力干预手段能预防疾病恶化.目前越来越多的临床医师认识到进行慢性肾脏疾病(chronic kidney disease,CKD)分期的重要性,但目前尚未确立适合于糖尿病患者的肾小球滤过率(glomerular filtration rate,GFR)评估公式.本文回顾近年来的文献资料,就GFR估算公式在糖尿病患者中的应用做一系统综述.

  13. The single-plasma-sample method for determining the glomerular filtration rate with Tc-99m-diethylenetriamine pentaacetic acid in childhood and adolescence. Is it age-dependent?

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, Kazuo [JR Sapporo General Hospital (Japan); Matsuyama, Takeshi [Tokyo Metropolitan National Health Insurance Organization Fussa Hospital (Japan)

    2002-12-01

    The aim of this study is to assess the accuracy of the pre-existing single-plasma-sample method (SPSM) to measure the glomerular filtration rate (GFR) with Tc-99m-diethylenetriamine pentaacetic acid (Tc-99m-DTPA) in children and adolescents. In addition, the age-independent SPSM is evaluated with two algorithms (Bubeck and Russell) applied for Tc-99m-mercaptoacetyltriglycine (Tc-99m-MAG3) SPSM. The study was performed on 14 patients (12 men and 2 women; age range 3 to 19 yr) with renal diseases. Tc-99m-DTPA (5 MBq/kg) was injected intravenously and thereafter blood samples were taken at 5, 15, 60, 90, 120, 150 and 180 min via the indwelling tube. Radioactivity in the injection syringe and plasma was measured by means of a double-well single-plastic scintillation counter. The true'' GFR as a reference was determined by two methods: 2-exponential curve fitting 7 samples (GFR{sub 7}) and 1-exponential curve fitting 3 samples between 90 and 150 min (GFR{sub 3}) in a slow clearance phase. The GFR{sub 7} and GFR{sub 3} were searched for to the clearance (GFR{sub 1}) estimated from a plasma concentration at various sample times by means of 3 equations designed for children (Groth and Aasted, Ham-I and -II) and 3 for adults (Christensen and Groth, Jacobsson, Itoh). All the SPSM showed close correlations (r>0.95) with the reference methods. Among them, Jacobsson's equation at sample time=120 min tended to be the most accurate (r=0.9826, root mean squared error (RMSE)=7.8 ml/min). On the other hand, Ham-I's equation at sample time=120 min was the most accurate, when it was referred to GFR{sub 3} in correction for overestimation (r=0.9951, RMSE=4.60 ml/min). The Bubeck and Russells' algorithms showed that the regression equation between the GFR{sub 7} and the estimates was different in 2 groups of adults (49 cases) and children/adolescents. Our study indicates that Jacobsson's and Christensen and Groth's equations designed for adults are

  14. Relationships of pancreatic beta-cell function with microalbuminuria and glomerular filtration rate in middle-aged and elderly population without type 2 diabetes mellitus: a Chinese community-based analysis

    Directory of Open Access Journals (Sweden)

    Fu S

    2017-05-01

    Full Text Available Shihui Fu,1,2 Shanjing Zhou,3 Leiming Luo,1 Ping Ye1 1Department of Geriatric Cardiology, 2Department of Cardiology and Hainan Branch, 3Department of Traditional Chinese Medicine and Hainan Branch, Chinese People’s Liberation Army General Hospital, Beijing, People’s Republic of China Background: Relationships of pancreatic beta-cell function abnormality with microalbuminuria (MA and glomerular filtration rate (GFR may differ by age, ethnicity and accompanied diseases. Previous studies were generally conducted in Western adult patients with type 2 diabetes mellitus (T2DM, and it is uncertain whether pancreatic beta-cell function is associated with MA and GFR in Chinese community-dwelling middle-aged and elderly population without T2DM. We therefore examined the relationships of pancreatic beta-cell function with two indices of renal damage, MA and GFR, in Chinese community-dwelling middle-aged and elderly population without T2DM.Methods: This analysis focused on 380 Beijing residents older than 45 years who were free of T2DM and completed the evaluation of pancreatic beta-cell function.Results: Median age was 67 (49–80 years. Levels of triglyceride, diastolic blood pressure and homeostasis model assessment-beta (HOMA-beta index were positively related to urine microalbumin (P<0.05 for all. Age, low-density lipoprotein cholesterol levels and HOMA-beta index were inversely correlated with GFR, while high-density lipoprotein cholesterol levels were positively correlated with GFR (P<0.05 for all. In all three adjustment models, there was a significant positive association between HOMA-beta index and MA; subjects with higher beta-cell function had higher odds of MA (P<0.05 for all. There was no association between HOMA-beta index and GFR <60 mL/min/1.73 m2 in any model (P>0.05 for all.Conclusion: Modeling the pancreatic beta-cell function with different adjusted variables provided the same conclusion of association with MA; beta

  15. 估算肾小球滤过率在健康体检中的应用及相关因素分析%APPLICATION OF ESTIMATED GLOMERULAR FILTRATION RATE IN HEALTH EXAMINATION AND ANALYSIS OF RELEVANT FACTORS

    Institute of Scientific and Technical Information of China (English)

    李宝全; 李贵连; 安翠平; 杨燕; 崔文丽; 周琰

    2013-01-01

    Objective To validate the application of estimated glomerular filtration rate ( eGFR ) calculated with chronic kidney disease epidemiology collaboration predictive equation based on serum creatinine ( SCr ) and cystatin C ( Cys C ) in health examination and analyze its relevant factors. Methods The concentration of SCr and Cys C were measured and the eGFR was estimated with the SCr/ Cys C combinated equation of Chinese eGFR Investigation Collaborative Group in 571 healthy examination persons. The Spearman correlation analysis was performed and all data were analyzed. Results The eGFR was negatively correlated with body mass index, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, γ-glutamyltransferase, uric acid, total cholesterol, triglyceride, low density lipoprotein-cholesterol( P < 0. 01 ), but was positively correlated with the pH value, high density lipoprotein-cholesterol and urine β2 microglobulin /creatinine ( P < 0. 01 ). Conclusion The results of this study indicated that the application of eGFR is sensitive to evaluate the renal function in health examination.%目的 应用血清肌酐(serum creatinine,SCr)和胱抑素C(cystatin C,Cys C)的联合方程估算肾小球滤过率(estimated glomerular filtration rate,eGFR),探讨eGFR在健康体检中的应用,并对eGFR相关因素进行分析,旨在早期发现肾功能受损.方法 测量571例健康体检者SCr和Cys C浓度,应用中国eGFR 课题协作组公式计算eGFR,对eGFR结果及相关因素进行分析.结果 eGFR与体质量指数、收缩压、舒张压、血丙氨酸转氨酶、谷氨酰转移酶、尿酸、胆固醇、三酰甘油、低密度脂蛋白胆固醇均呈负相关,差异有统计学意义(P<0.01);eGFR与尿液pH、高密度脂蛋白胆固醇、尿β2微球蛋白肌酐比值均呈正相关,差异有统计学意义(P<0.01).结论 应用eGFR可早期提示肾功能异常,对其相关危险因素早期进行干预,可提高健康水平.

  16. Increased glomerular filtration rate after withdrawal of long-term antihypertensive treatment in diabetic nephropathy

    DEFF Research Database (Denmark)

    1995-01-01

    Initiation of antihypertensive treatment (AHT) in hypertensive insulin-dependent diabetic (IDDM) patients with diabetic nephropathy (DN) induces a faster initial (0 to 6 months) and a slower subsequent (6 months to end of observation) decline in GFR [delta GFR (ml/min/month) approximately 1.5 vs. 0...

  17. GFR decline as an end point for clinical trials in CKD: a scientific workshop sponsored by the National Kidney Foundation and the US Food and Drug Administration.

    Science.gov (United States)

    Levey, Andrew S; Inker, Lesley A; Matsushita, Kunihiro; Greene, Tom; Willis, Kerry; Lewis, Edmund; de Zeeuw, Dick; Cheung, Alfred K; Coresh, Josef

    2014-12-01

    The US Food and Drug Administration currently accepts halving of glomerular filtration rate (GFR), assessed as doubling of serum creatinine level, as a surrogate end point for the development of kidney failure in clinical trials of kidney disease progression. A doubling of serum creatinine level generally is a late event in chronic kidney disease (CKD); thus, there is great interest in considering alternative end points for clinical trials to shorten their duration, reduce sample size, and extend their conduct to patients with earlier stages of CKD. However, the relationship between lesser declines in GFR and the subsequent development of kidney failure has not been well characterized. The National Kidney Foundation and Food and Drug Administration sponsored a scientific workshop to critically examine available data to determine whether alternative GFR-based end points have sufficiently strong relationships with important clinical outcomes of CKD to be used in clinical trials. Based on a series of meta-analyses of cohorts and clinical trials and simulations of trial designs and analytic methods, the workshop concluded that a confirmed decline in estimated GFR of 30% over 2 to 3 years may be an acceptable surrogate end point in some circumstances, but the pattern of treatment effects on GFR must be examined, specifically acute effects on estimated GFR. An estimated GFR decline of 40% may be more broadly acceptable than a 30% decline across a wider range of baseline GFRs and patterns of treatment effects on GFR. However, there are other circumstances in which these end points could lead to a reduction in statistical power or erroneous conclusions regarding benefits or harms of interventions. We encourage careful consideration of these alternative end points in the design of future clinical trials.

  18. Obesity in kidney transplant recipients: association with decline in glomerular filtration rate.

    Science.gov (United States)

    Moreira, Thaís Rodrigues; Bassani, Tayron; de Souza, Gizele; Manfro, Roberto Ceratti; Gonçalves, Luiz Felipe Santos

    2013-10-01

    In this study we aimed to evaluate the influence of obesity in kidney and patient survival and graft function. Retrospective cohort study of kidney transplant recipients performed between 2001 and 2009. The body mass index was calculated at time of transplantation, one and five years after. The main outcomes studied were incidence of delayed graft function, new onset diabetes after transplantation, patient and graft survival, and glomerular filtration rate. The prevalence of obesity and overweight patients were 10.7% and 26.8% respectively, with an increase to 16.9% and 32.5% one year after transplantation. Underweight and obese recipients presented a higher incidence of early graft loss. The incidence of new onset diabetes after transplantation was significantly higher at one and five years in overweight or obese recipients at baseline. Overweight and obese recipients presented significantly lower estimated glomerular filtration rate at five years posttransplantation (p = 0.002). In the Kaplan-Meier analyses no statistically significant differences in patients or grafts survivals were observed. Obese patients have a higher rate of early graft failure and a higher new onset diabetes after transplantation incidence. Also, the finding of decreased glomerular filtration rate is worrisome and perhaps longer follow-up will reveal more graft failures and patients deaths in the group of obese recipients.

  19. Impaired autoregulation of glomerular filtration rate in type 1 (insulin-dependent) diabetic patients with nephropathy

    DEFF Research Database (Denmark)

    Parving, H H; Kastrup, Helge; Smidt, U M

    1984-01-01

    The effect of acute lowering of arterial blood pressure upon kidney function in nephropathy was studied in 13 patients with long-term Type 1 (insulin-dependent) diabetes. Ten normal subjects (six normotensive and four hypertensive) and five short-term Type 1 diabetic patients without nephropathy...... micrograms) or saline (0.154 mmol/l). The arterial blood pressure was similar in the diabetic patients with nephropathy (mean 136 +/- 11 divided by 88 +/- mmHg) and in the non-diabetic control subjects (mean 140 +/- 25 divided by 92 +/- 15 mmHg). The clonidine injection induced similar reductions in mean...... excretion declined from 1707 to 938 micrograms/min (p less than 0.01) in the patients with diabetic nephropathy. Our results suggest that an intrinsic vascular (arteriolar) mechanism underlying the normal autoregulation of glomerular filtration rate, i.e. the relative constancy of glomerular filtration rate...

  20. Assessment of Glomerular Filtration Rate Based on Alterations of Serum Brain-Derived Neurotrophic Factor in Type 2 Diabetic Subjects Treated with Amlodipine/Benazepril or Valsartan/Hydrochlorothiazide

    Directory of Open Access Journals (Sweden)

    I-Te Lee

    2015-01-01

    Full Text Available Background. Brain-derived neurotrophic factor (BDNF is associated with sympathetic activation. However, the effects of BDNF on diabetic nephropathy are unknown. The aim of this study was to assess the estimated glomerular filtration rates (eGFRs and changes in serum BDNF levels in type 2 diabetic subjects treated with antihypertensive medications. Methods. In this randomized, double-blind clinical trial, type 2 diabetic subjects with hypertension were assigned to either the benazepril/amlodipine or valsartan/hydrochlorothiazide treatment groups for a 16-week period. The post hoc analyses were based on increased or decreased serum BDNF levels. Results. Of the 153 enrolled subjects, the changes in eGFR were significantly and inversely correlated with those in BDNF in the 76 subjects treated with valsartan/hydrochlorothiazide (r=-0.264, P=0.021 but not in the 77 subjects treated with benazepril/amlodipine (r=-0.025, P=0.862. The 45 subjects with increased BDNF following valsartan/hydrochlorothiazide treatment exhibited a significantly reduced eGFR (-8.8±14.9 mL/min/1.73 m2; P<0.001. Multivariate regression analysis revealed that increased serum BDNF represents an independent factor for reduced eGFR (95% confidence interval between −0.887 and −0.076, P=0.020. Conclusions. Increased serum BDNF is associated with reduced eGFR in type 2 diabetic subjects treated with valsartan/hydrochlorothiazide but not with amlodipine/benazepril.

  1. Progression of glomerular filtration rate reduction determined in conscious Dahl salt-sensitive hypertensive rats.

    Science.gov (United States)

    Cowley, Allen W; Ryan, Robert P; Kurth, Terry; Skelton, Meredith M; Schock-Kusch, Daniel; Gretz, Norbert

    2013-07-01

    Sequential changes in glomerular filtration rate during development of hypertension in the conscious Dahl salt-sensitive rats were determined using a new method for measurement. Using a miniaturized device, disappearance curves of fluorescein isothiocyanate-sinistrin were measured by transcutaneous excitation and real-time detection of the emitted light through the skin. Rats with implanted femoral venous catheters (dye injection and sampling) and carotid catheters (mean arterial pressure by telemetry) were studied, while maintained on a 0.4% NaCl diet and on days 2, 5, 7, 14, and 21 after switching to 4.0% (high-salt [HS]) diet. A separate group of rats were maintained on 0.4% for 21 days as a time control. Mean arterial pressure rose progressively from the last day of 0.4% (130±2 mm Hg) reaching significance by day 5 of HS and averaged 162±7 mm Hg by day 21. Urine albumin excretion was significantly elevated (×3) by day 7 of HS in Dahl salt-sensitive rats. Glomerular filtration rate reduced on day 14 of HS falling from 1.53±0.06 mL/min per 100 g body weight to 1.27±0.04. By day 21, glomerular filtration rate had fallen 28% to 1.1±0.04 mL/min per 100 g (t(1/2) 28.4±1.1 minute.) No significant reductions of creatinine clearance were observed throughout the study in response to HS demonstrating the insensitivity of creatinine clearance measurements even with creatinine measured using mass spectrometry. We conclude that the observed reduction of glomerular filtration rate was a consequence and not a cause of the hypertension and that this noninvasive approach could be used in these conscious Dahl salt-sensitive rats for a longitudinal assessment of renal function.

  2. Polymorphisms in the non-muscle myosin heavy chain gene (MYH9 are associated with lower glomerular filtration rate in mixed ancestry diabetic subjects from South Africa.

    Directory of Open Access Journals (Sweden)

    Tandi Edith Matsha

    Full Text Available OBJECTIVE: Though single nucleotide polymorphisms (SNPs in the non-muscle myosin gene (MYH9 have been reported to explain most of the excess risk of nondiabetic chronic kidney disease (CKD, in African-Americans, some studies have also shown associations with diabetic end-stage renal disease. We investigated the association of MYH9 SNPs with renal traits in a mixed-ancestry South African population prone to diabetes. RESEARCH DESIGN AND METHODS: Three SNPs known to be associated with CKD (rs4821480, rs5756152 and rs12107 were genotyped using Taqman assay in 716 adults (198 with diabetes from the Bellville-South community, Cape Town. Glomerular filtration rate was estimated (eGFR and urinary albumin/creatinine ratio (ACR assessed. Multivariable regressions were used to relate the SNPs with renal traits. RESULTS: Mean age was 53.6 years, with the expected differences observed in characteristics by diabetic status. Significant associations were found between rs575152 and serum creatinine, and eGFR in the total population, and in diabetic participants (all p≤0.003, but not in non-diabetics (all p≥0.16, with significant interactions by diabetes status (interaction-p≤0.009. The association with ACR was borderline in diabetic participants (p = 0.05 and non-significant in non-diabetics (p = 0.85, with significant interaction (interaction p = 0.02. rs12107 was associated with fasting-, 2-hour glucose and HbA1c in diabetic participants only (interaction-p≤0.003, but not with renal traits. CONCLUSION: MYH9 SNPs were associated with renal traits only in diabetic participants in this population. Our findings and other studies suggest that MYH9 may have a broader genetic risk effect on kidney diseases.

  3. Comparison of predictive accuracy of teicoplanin concentration using creatinine clearance and glomerular filtration rate estimated by serum creatinine or cystatin C.

    Science.gov (United States)

    Kozono, Aki; Hiraki, Yoichi; Adachi, Rui; Nagano, Masahisa; Inoue, Daisuke; Tsuji, Yasuhiro; Kamimura, Hidetoshi; Karube, Yoshiharu

    2016-05-01

    We compared the predictive accuracy of TEIC concentrations (TEIC_conc) calculated using either serum cystatin C (CysC) or serum creatinine (SCr) and the population mean method using the mean population parameter of TEIC_conc for Japan. We also compared the predicted TEIC_conc to measured TEIC_conc. Creatinine clearance (CLCr) predicted using the Cockcroft-Gault (C&G) equation with SCr was 45.23 mL/min (interquartile range [IQR]: 32.12-58.28), and the glomerular filtration rate (GFR) predicted using the Hoek equation with CysC was 45.23 mL/min (IQR: 35.40-53.79). The root mean-squared prediction error (IQR) based on CLCr predicted using the C&G equation with SCr was 6.88 (3.80-9.96) μg/mL, and that based on GFR predicted using the Hoek equation with CysC was 6.72 (3.77-9.68) μg/mL. Predicted TEIC_conc did not differ significantly between the two methods. The predictive accuracy of the TEIC_conc using the Hoek equation with CysC was similar to that of CLCr using the C&G equation with SCr. These findings suggest that the predictive accuracy of the TEIC_conc using CLCr based on the G&G equation and SCr might be sufficient for the initial dose adjustment of TEIC. Given that we were unable to confirm that CysC is the optimal method for predicting TEIC_conc, the expensive measurement of CysC might not be necessary.

  4. The Preliminary Study of Relationship between Donor Glomerular Filtration Rate and Post-Transplant Graft Function in Living Kidney Transplantation%活体肾移植供者肾小球滤过率与受者移植肾功能关系的研究

    Institute of Scientific and Technical Information of China (English)

    赵杰; 宋文利; 莫春柏; 王智平

    2012-01-01

    目的:探讨活体肾移植中供者术前肾小球滤过率(GFR)与受者移植肾功能之间的关系.方法:分析无急性排斥反应、无移植肾功能延迟恢复、随访满2年的活体肾移植患者125例,采用相关分析法分析供者术前肾小球滤过率与受者术后1周、1年、2年肾小球滤过率之间的关系.采用多元线性回归方法分析影响受者术后1年GFR的因素.结果:供者GFR与受者术后1周、1年、2年的GFR相关(r分别为0.217、0.216和0.273,P<0.05).根据多元线性回归分析得出供者GFR和受者体质量是受者术后1年GFR重要的预测因素,线性回归方程为受者术后1年GFR=78.7-0.474×受者体质量+0.239×供者GFR.结论:活体肾移植供者术前GFR为移植肾功能的重要预测因素.%Objective: To investigate the relationship between donor glomerular filtration rate (GFR) and post-transplant graft function in living kidney transplantation. Methods: One hundred and twenty-five cases of living donor kidney transplantation (without acute rejection or delayed graft function, follow-up for 2 years) were retrospectively analyzed. The relationship between donor glomerular filtration rate and recipient glomerular filtration rate was analyzed using the correlation method at 1 -week, 1 -year and 2-year post transplantation. The multiple linear regression method was used to analyze the recipient GFR after one year transplantation. Results: The values of GFR of recipients at lweek, 1-year and 2-year post transplantation were significantly correlated with those of donor GFR (r = 0.217, 0.216, 0.273, P < 0.05). According to the multiple stepwise regression analysis, donor GFR and recipient body weight was an important predictor of graft function at 1 year post transplantation. The linear regression equation, recipient GFR at 1 year post transplantation=78.7-0.474 × recipient body weight+0.239×donor GFR. Conclusion: The donor GFR was the important characteristics for predicting the

  5. GFR normalized to total body water allows comparisons across genders and body sizes.

    Science.gov (United States)

    Eriksen, Bjørn O; Melsom, Toralf; Mathisen, Ulla D; Jenssen, Trond G; Solbu, Marit D; Toft, Ingrid

    2011-08-01

    The normalization of GFR to a standardized body-surface area of 1.73 m(2) impedes comparison of GFR across individuals of different genders, heights, or weights. Ideally, GFR should be normalized to a parameter that best explains variation in GFR. Here, we measured true GFR by iohexol clearance in a representative sample of 1627 individuals from the general population who did not have diabetes, cardiovascular disease, or kidney disease. We also estimated total body water (TBW), extracellular fluid volume, lean body mass, liver volume, metabolic rate, and body-surface area. We compared two methods of normalizing GFR to these physiologic variables: (1) the conventional method of scaling GFR to each physiologic variable by simple division and (2) a method based on regression of the GFR on each variable. TBW explained a higher proportion of the variation in GFR than the other physiologic variables. GFR adjusted for TBW by the regression method exhibited less dependence on gender, height, and weight compared with the other physiologic variables. Thus, adjusting GFR for TBW by the regression method allows direct comparisons between individuals of different genders, weights, and heights. We propose that regression-based normalization of GFR to a standardized TBW of 40 L should replace the current practice of normalizing GFR to 1.73 m(2) of body-surface area.

  6. Relationship between oxygen concentration, respiration and filtration rate in blue mussel Mytilus edulis

    Science.gov (United States)

    Tang, Baojun; Riisgård, Hans Ulrik

    2017-06-01

    The large water-pumping and particle-capturing gills of the filter-feeding blue mussel Mytilus edulis are oversized for respiratory purposes. Consequently, the oxygen uptake rate of the mussel has been suggested to be rather insensitive to decreasing oxygen concentrations in the ambient water, since the diffusion rate of oxygen from water flowing through the mussel determines oxygen uptake. We tested this hypothesis by measuring the oxygen uptake in mussels exposed to various oxygen concentrations. These concentrations were established via N2-bubbling of the water in a respiration chamber with mussels fed algal cells to stimulate fully opening of the valves. It was found that mussels exposed to oxygen concentrations decreasing from 9 to 2 mg O2 /L resulted in a slow but significant reduction in the respiration rate, while the filtration rate remained high and constant. Thus, a decrease of oxygen concentration by 78% only resulted in a 25% decrease in respiration rate. However, at oxygen concentrations below 2 mg O2 /L M. edulis responded by gradually closing its valves, resulting in a rapid decrease of filtration rate, concurrent with a rapid reduction of respiration rate. These observations indicated that M. edulis is no longer able to maintain its normal aerobic metabolism at oxygen concentration below 2 mg O2/L, and there seems to be an energy-saving mechanism in bivalve molluscs to strongly reduce their activity when exposed to low oxygen conditions.

  7. Applicability of Cockcroft-Gault and MDRD equations to estimate the glomerular filtration rates%肾小球滤过率评估公式的适用性

    Institute of Scientific and Technical Information of China (English)

    潘瑞蓉; 袁国跃; 叶菁菁; 杨玲; 王东; 王济芳; 陈霞; 王莹; 孙新艳; 马秋芳

    2011-01-01

    Objective; To investigate the application of Cockcroft-Gault(C-G) and simplified MDRD e-quations in estimating the glomerular filtration rates(GFR) in different stage renal disease. Methods; A total of 143 cases with primary or secondary chronic kidney disease were enrolled in this study. GFR by 99mTc-DTPA clearance rate was used as the reference standard. The patients were divided into four subgroups according to the GFR obtained from Gates. Group A,30 cases, GFR≥90 ml/min;group B,36 cases, 60 ml/min≤ GFR 0.05) ,rB =0.742(P 0. 05 ). The GFR [ ml · min-1· (1. 73m2) -1 ] obtained from Gates methods and MDRD equations: the correlation coefficients of four subgroups were as follows: rA=0.024 (P>0.05) ,rB=0.674 (P 0. 05). Conclusion: Cockcroft-Gault (C-G) and simplified MDRD equations were more suitable for patients with chronic kidney disease in 2,3 stage, by contrast, accuracy of CG formula was slightly better than the MDRD formula in Han nationality. Further research is needed for renal function estimation formulas in Chinese Han population.%目的:以99mTc-DTPA 同位素测定的肾小球滤过率(glomerular filtration rate,GFR)为参考标准,评估美国肾脏病基金会推荐的Cockcroft-Gault(C-G)公式与简化MDRD公式对肾功能进行分期的适用性.方法:以143 例慢性肾脏病患者为研究对象,采用肾动态显像99m Tc标记法测定GFR,根据慢性肾脏病的分期标准,将患者分成4组:A组30例,GFR≥90 ml/min;B组36例,60 ml/min≤GFR<90 ml/min;C组47例,30 ml/min≤GFR<60 ml/min;D组30例GFR<30 ml/min.对各组患者分别采用CG公式、简化MDRD公式估算GFR值并用体表面积(BSA)标准化,分别与不同组BSA标准化的99mTc- DTPA 测得GFR进行比较,并进行相关性分析,评价估算公式的准确性.结果:(1) 采用肾动态显像99m Tc标记法测定的GFR与CG公式估算出的4组GFR值[单位:ml·min-1·(1.73m2)- 1]之间的相关系数为rA=-0.166 (P>0.05) ;rB =0.742(P0.05).(2)

  8. Feasibility and impact of the measurement of extracellular fluid volume simultaneous with GFR by 125I-iothalamate.

    Science.gov (United States)

    Visser, Folkert W; Muntinga, Jaap H J; Dierckx, Rudi A; Navis, Gerjan

    2008-09-01

    The feasibility, validity, and possible applications of the assessment of extracellular fluid volume (ECFV) simultaneous with glomerular filtration rate (GFR) were assessed in a series of validation studies using the constant infusion method of (125)I-iothalamate (IOT). In 48 subjects with a broad range of GFR, distribution volume (V(d)) of IOT corresponded well with V(d) bromide (16.71 +/- 3.0 and 16.73 +/- 3.2 l, respectively, not significant), with a strong correlation (r = 0.933, P IOT during strictly standardized (50 mmol Na(+)/d) sodium intake. An increase in dietary sodium intake (200 mmol Na(+)/d) induced a corresponding rise in V(d) IOT of 1.11 +/- 1.5 l (P IOT. After appropriate validation, also other GFR tracers could be used for such a simultaneous estimation, providing a valuable resource of data on ECFV in renal studies and, moreover, allowing GFR to be indexed to the body fluid compartment it clears: the ECFV.

  9. estimated glomerular filtration rate and risk of survival in acute stroke

    African Journals Online (AJOL)

    2014-03-03

    Mar 3, 2014 ... Subjects: Eighty three acute stroke patients had GFR calculated within 48 hours of admission after basic ... in terms of survival and functional disability (7,8). ... magnetic resonance imaging (MRI) as either cerebral infarct or ...

  10. 武警新兵营养代谢指标特点及其与肾小球滤过率的关系%Characteristics of nutrition metabolism in recruits and relationships between these results and glomerular filtration rate

    Institute of Scientific and Technical Information of China (English)

    肖青; 李德谦; 张建荣; 王芳; 姚立茹; 武福林

    2011-01-01

    Objective To study the characteristics of nutrition metabolism in recruits of the armed police forces , and the relationship with glomerular filtration rate (GFR). Methods We measured the heights, bodyweights, waist circumferences and hip circumferences for 1721 recruits from a province to calculate body mass index( BMI )and waist -to- hip ratio(WHR) ,and determined setum creatinine to estimate GFR, and assayed total cholesterol( TC), triglyceride (TG), low density lipoprotein( LDL - C)and high density lipoprotein ( HDL - C), to carry out statistical analysis. Results 105 persons (6.1% ) were abnormal in blood lipids,in which hypertriglyceridermia was the most commom. 23 ( 1.3% ) subjects had abdominal obesity, and 25 ( 1.5% ) subjects had obesity. There were significant differences between age groups, in bodyweight, waist circumference, hip circumference, BMI, Scr, TC, and LDL - C. There were significant differences between groups from different regions, in height, bodyweight, waist circumference, hip circumference, BMI,Scr,TC ,and GFR. The group of abdominal obesity showed significant difference in creatinine and eGFR from those . Compared with different BMI groups,both the eGFR and the Scr showed significant difference. Conclusions On physical examination of recruits, we should pay attention to the indices which relate to obesity, especial the obesity of abdomen. In evaluating the characteristics of nutrition metabolism in recruits,we should consider the differences in their age and areas they came from.%目的 探讨武警新兵营养代谢指标特点,以及与肾小球滤过率(glomerular filtration rate,eGFR)的关系.方法 对某部1721例新兵进行身高、体重、腰围、臀围的测量,计算体质指数(BMI)及腰臀比(WHR);检测血肌酐(Scr),估算GFR,检测总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C),进行统计分析.结果 受检人群血脂异常105例(占6.1%),

  11. Renal filtration function in patients with gout

    Directory of Open Access Journals (Sweden)

    N. N. Kushnarenko

    2016-01-01

    Full Text Available Aim. To study circadian blood pressure (BP profile in patients with gout depending on the presence of arterial hypertension (HT and their relationship to the renal filtration function.Material and methods. Patients with gout (n=87 were included into the study. All the patients underwent ambulatory BP monitoring (ABPM with the assessment of circadian BP profile, determination of uric acid serum levels, glomerular filtration rate (GFR was evaluated by CKD-EPI method. Depending on GFR level, all the patients were divided into 2 groups - with renal dysfunction or without one.Results. ABPM revealed circadian BP dysregulation in 55% of gout patients both with HT and without HT. Chronic kidney disease (CKD was revealed in 72.4% of male patients, with the prevalence in patients with HT (76.6 vs 61%; p<0.001. Correlations between uric acid levels and some ABPM indicators and GFR were determined.Conclusion. Obtained data suggest the contribution of hyperuricemia in disorders of systemic and renal hemodynamics, leading to the early development of CKD.

  12. Estimated GFR associates with cardiovascular risk factors independently of measured GFR.

    Science.gov (United States)

    Mathisen, Ulla Dorte; Melsom, Toralf; Ingebretsen, Ole C; Jenssen, Trond; Njølstad, Inger; Solbu, Marit D; Toft, Ingrid; Eriksen, Bjørn O

    2011-05-01

    Estimation of the GFR (eGFR) using creatinine- or cystatin C-based equations is imperfect, especially when the true GFR is normal or near-normal. Modest reductions in eGFR from the normal range variably predict cardiovascular morbidity. If eGFR associates not only with measured GFR (mGFR) but also with cardiovascular risk factors, the effects of these non-GFR-related factors might bias the association between eGFR and outcome. To investigate these potential non-GFR-related associations between eGFR and cardiovascular risk factors, we measured GFR by iohexol clearance in a sample from the general population (age 50 to 62 years) without known cardiovascular disease, diabetes, or kidney disease. Even after adjustment for mGFR, eGFR associated with traditional cardiovascular risk factors in multiple regression analyses. More risk factors influenced cystatin C-based eGFR than creatinine-based eGFR, adjusted for mGFR, and some of the risk factors exhibited nonlinear effects in generalized additive models (PGFR. Thus, estimates of cardiovascular risk associated with small changes in eGFR must be interpreted with caution.

  13. Influence of size and density on filtration rate modeling and nutrient uptake by green mussel (Perna viridis).

    Science.gov (United States)

    Tantanasarit, Chayarat; Babel, Sandhya; Englande, Andrew J; Meksumpun, Shettapong

    2013-03-15

    This study investigates green mussel filtration rates based on variation of the mussel size and density, and attempts to correlate these with the amount of Chaetoceros calcitrans consumed by kinetic modeling. The filtration rates were found to be more effective in small mussels and with greater volumes of seawater/mussel which represent low mussel densities in the mussel farms. Under field condition, the first order kinetic model is useful for evaluation of mussel filtration rate. However, the composite exponential kinetic model was determined to better describe filtration rates in a close system. Higher ratios of seawater volume L/g DW mussel tissue, resulted in an increasing filtration rate until a maximum plateau was reached at 10.37 L/h/g DW tissue as determined by first order kinetics. Based on the filtration rate, carbon, nitrogen, and phosphorus uptake by green mussels were found to be 2128.72, 265.41, and 66.67 mg/year/indv, respectively. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. The effect of temperature and body size on filtration rates of Limnoperna fortunei (Bivalvia, Mytilidae under laboratory conditions

    Directory of Open Access Journals (Sweden)

    Débora Pestana

    2009-02-01

    Full Text Available The golden mussel (Limnoperna fortunei, Mollusca: Bivalvia is an invasive species that has been causing considerable environmental and economic problems in South America. In the present study, filtration rates of L. fortunei were determined in the laboratory under different temperatures (10, 15, 20, 25, 28, and 30 ºC and two types of food (Algamac-2000® and the chlorophycean alga Scenedesmus sp.. There was a statistically significant relationship between time and filtration rates in the experiment using Scenedesmus sp., regardless of temperature. However, this pattern was absent in the experiment using Algamac, suggesting that the relationship between filtration rates and temperature might depend on the size of the filtered particles. In addition, there was no correlation between filtration rates and either shell size or condition index (the relationship between the weight and the length of a mussel. The filtration rate measured in the present study (724.94 ml/h was one of the highest rates recorded among invasive bivalves to date. Given that the colonies of the golden mussel could reach hundreds of thousands of individuals per square meter, such filtration levels could severely impact the freshwater environments in its introduced range.

  15. Reduced glomerular filtration rate, inflammation and HDL cholesterol as main determinants of superoxide production in non-dialysis chronic kidney disease patients.

    Science.gov (United States)

    Morena, Marion; Patrier, Laure; Jaussent, Isabelle; Bargnoux, Anne-Sophie; Dupuy, Anne-Marie; Badiou, Stéphanie; Leray-Moragues, Hélène; Klouche, Kada; Canaud, Bernard; Cristol, Jean-Paul

    2011-06-01

    Enhanced oxidative stress partly resulting from an over-production of superoxide anion (O(2)(•-)) represents a novel and particular risk factor in chronic kidney disease (CKD) patients. This study was therefore designed to evaluate O(2)(•-) determinants in this population. O(2)(•-) production was evaluated using chemiluminescence method in 136 CKD patients (79M/57F, median age: 69.5 [27.4-94.6]). Renal function (evaluated by the glomerular filtration rate using modification of diet in renal disease (MDRD)), inflammation, lipids, nutritional and bone mineral as well as clinical parameters were evaluated. Potential relationships between O(2)(•-) and these clinico-biological parameters were investigated to identify main determinants of such a pathological process. Enhanced O(2)(•-) production has been observed at the pre-dialysis phase: stages 4 and 5 of CKD (p = 0.0065). In multivariate analysis, low eGFR (MDRD <30 mL/min/1.73 m(2); p = 0.046), high fibrinogen (≥3.7 g/L; p = 0.044) and abnormal HDL cholesterol (<1.42 mmol/L and ≥ 1.75 mmol/L; p = 0.042) were the main determinants of O(2)(•-) production in CKD patients.

  16. Evaluation of body surface area formulae for scaling GFR of adult renal patients: More between-subjects variability explained by DuBois&DuBois formula.

    Science.gov (United States)

    Hongwei, S; Zhili, L; Chunlei, H; Sijin, L; Zhifang, W

    2014-06-10

    Scaling glomerular filtration rate (GFR) to body surface area (BSA) has been widely accepted, and was debated in recent years. Although the indexation ability of BSA is inferior to other physiological variables, the evaluation of BSA formulae is still meaningful to clinical practice. In this study, to evaluate the indexation ability of BSA formulae, the repeated measures analyses of camerabased scintigraphy (Gates method, gGFR) and plasma-based clearance (pGFR) were used to specially focus on the between-subjects variability that tried to be minimized by GFR normalization. The patients, who were older than 18 y and suffered from renal diseases, were enrolled and grouped according to the Chinese BMI (body mass index) criteria. All patients accepted renal scintigraphy and plasma clearance examinations. The gGFR and pGFR were separately scaled to DuBois&DuBois, Boyd, Stevenson, Gehan, Haycock, Mosteller, Hu and Livingston and Lee's formula. In the repeated measures analyses, the intraclass correlation coefficient (ICC), concordance correlation coefficient (CCC) and the ratio of residual standard deviation to pooled standard deviation (RSD/PSD) were used for the evaluation. During January 2010 and May 2012, 220 patients were enrolled. The evaluated BSA formulae had well correlated results and significant differences among BMI groups. From high to low, the sequence of the correlation between BMI and BSA formula was LL, Haycock, Gehan, Boyd, Mosteller, Stevenson, Hu and DuBois&DuBois formula. Both the scaled indices (ICC and CCC) and RSD/PSD indicated that, the sequence of indexation ability of BSA equations was LivingstonDuBois&DuBois. Among the evaluated BSA formulae, DuBois&DuBois formula correlates to BMI the worst, and has the best indexation ability in scaling GFR of adult renal patients.

  17. Radioactive chromium-ethylenediaminetetraacetic acid for determination of glomerular filtration rate in rabbits

    Energy Technology Data Exchange (ETDEWEB)

    Tvedegaard, E.; Kamstrup, O.

    1981-12-01

    Simultaneous determination of the glomerular filtration rate was made by the insulin clearance technique and by analysis of the plasma disappearance curve of radioactive chromium-ethylenediaminetetraacetic acid (/sup 51/Cr-EDTA) following an intravenous injection in 28 anaesthetized rabbits. In some rabbits, the renal function was reduced by previous surgery. The insulin clearances ranged from 2.7 to 17 ml/minute. By a double-exponential analysis of the plasma disappearance curve, the total plasma clearance of /sup 51/Cr-EDTA was found to exceed the inulin clearance by 12%. By the simpler slope-intercept analysis requiring only two blood samples, this value was 32%. The renal clearance of /sup 51/Cr-EDTA was 97% of inulin clearance. In nephrectomized rabbits, plasma clearance of /sup 51/Cr-EDTA was 0.7 ml/minute. At all levels of renal function, measurement of the plasma clearance rate of /sup 51/Cr-EDTA by the single injection technique allowed a fairly reliable estimate of the glomerular filtration rate.

  18. Is the Chronic Kidney Disease Epidemiology Collaboration creatinine–cystatin C equation useful for glomerular filtration rate estimation in the elderly?

    Directory of Open Access Journals (Sweden)

    Liu X

    2013-10-01

    Full Text Available Xun Liu,1,2,* Huijuan Ma,1,* Hui Huang,3 Cheng Wang,1 Hua Tang,1 Ming Li,1 Yanni Wang,1 Tanqi Lou1 1Division of Nephrology, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-sen University, 2College of Biology Engineering, South China University of Technology, 3Department of Cardiology, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China*These authors contributed equally to the paperBackground: We aimed to evaluate the performance of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI creatinine–cystatin C equation in a cohort of elderly Chinese participants.Materials and methods: Glomerular filtration rate (GFR was measured in 431 elderly Chinese participants by the technetium-99m diethylene-triamine-penta-acetic acid (99mTc-DTPA renal dynamic imaging method, and was calibrated equally to the dual plasma sample 99mTc-DTPA-GFR. Performance of the CKD-EPI creatinine–cystatin C equation was compared with the Cockroft–Gault equation, the re-expressed 4-variable Modification of Diet in Renal Disease (MDRD equation, and the CKD-EPI creatinine equation.Results: Although the bias of the CKD-EPI creatinine–cystatin C equation was greater than with the other equations (median difference, 5.7 mL/minute/1.73 m2 versus a range from 0.4–2.5 mL/minute/1.73 m2; P<0.001 for all, the precision was improved with the CKD-EPI creatinine–cystatin C equation (interquartile range for the difference, 19.5 mL/minute/1.73 m2 versus a range from 23.0–23.6 mL/minute/1.73 m2; P<0.001 for all comparisons, leading to slight improvement in accuracy (median absolute difference, 10.5 mL/minute/1.73 m2 versus 12.2 and 11.4 mL/minute/1.73 m2 for the Cockcroft–Gault equation and the re-expressed 4-variable MDRD equation, P=0.04 for both; 11.6 mL/minute/1.73 m2 for the CKD-EPI creatinine equation, P=0.11, as the optimal scores of performance (6.0 versus a range from 1.0–2.0 for the other

  19. GFRs measured by gates' method according to 5 background sites: comparison with GFR measured by I-125-lothalamate method

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hyun Seok; Chung, Yong An; Kim, Sung Hoon; Kim, Chung Ho; Lee, Sung Young; Sohn, Hyung Seon; Baik, Jun Hyun; Chung, Soo Kyo [School of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2004-08-01

    The aim was to assess how the background site affects the Gates' glomerular filtration rate(GFR) measurement using Tc-99m-DTPA in correlation with GFR by I-125-iothalamate method. The study populations were 63 adults with 39 men and 24 women aged from 20 to 59 yrs (mean = 37.9 yrs). The following five background regions of interest were used in measurement of GFR using Gates' method: 1) lower side of each kidney(subrenal), 2) around each kidney(circumferential), 3) upper side of each kidney(suprarenal), 4) lateral side of each kidney(lateral), 5) between the two kidney(inter-renal). We also measured GFR using I-125-iothalamate in each subject. The two studies were separated by 1 to 3 weeks. The subjects were divided into two groups by renal depth. Group 1 with renal depth{>=}7 cm and group 2 with renal depth < 7 cm. We calculated the means and standard deviations of the GFRs measured by two studies. And we statistically analyzed the correlation and differences among GFRs by Gates' method and the GFR by iothalamate method with correlation analysis. The GFRs Gates' method using suprarenal and inter-renal background correction showed better correlation with the GFR measured by I-125-iothalamate. And GFRs measured by Gates' method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth < 7 cm. But GFRs measured by Gates' method did not show statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth {>=}7 cm. GFRs measured with Gates' method showed higher correlation with the GFR measured by I-125-iothalamate when the regions of interest were placed over the suprarenal and inter-renal backgrounds. And GFRs measured with Gates method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth < 7 cm.

  20. Filtration and respiration rates of the short-necked clam Paphia undulata (Born, 1778 (Mollusca, Pelecypoda: Veneridae under laboratory conditions

    Directory of Open Access Journals (Sweden)

    Laureen Morillo Manalo

    2010-12-01

    Full Text Available The filtration and respiration rates of various size classes (35-39.99, 40-44.99,45-49.99, 50-54.99 and 55-59.99 mm of the short-necked clam Paphia undulata were measured in the laboratory. The effects of three light regimes (0 lux, 172.22 lux and 645.83 lux, three microalgal species (Isochrysis galbana, Tetraselmis tetrahele and Chaetoceros calcitrans and four microalgal concentrations (10, 25, 50 and 100 x 104 cells ml-1 on filtration rates were investigated. Mean filtration rate was highest (0.57 ± 0.04 Lh-1ind.-1 under total darkness. This can be attributed to the natural environment of this species which is characterized by silty substrate and low visibility. Filtration was also highest in the microalga Isochrysis galbana (0.67 ± 0.05. Rates initially increased from low to moderate microalgal concentrations (25 x 104 cells ml-1 and decreased at higher concentrations. Filtration generally decreased with increase in clam size. Light intensity, microalgal species and microalgal concentration showed significant effects on filtration. Respiration of fed clams was higher (0.138 ± 0.026 ml O2h-1ind.-1 than unfed clams (0.053± 0.025 ml O2h-1 nd.-1 and increased with clam size.

  1. Comparison of enhanced CT scanning and SPECT in measurement of glomerular filtration rate in ;living kidney donors%CT增强扫描与SPECT测定活体肾移植供体肾小球滤过率的对照研究

    Institute of Scientific and Technical Information of China (English)

    孙长凤; 赵修义; 孙奔; 田军; 汝艳辉

    2014-01-01

    Objective To investigate the technique for measuring glomerular filtration rate (GFR) in living kidney donors by multi-phase enhanced CT scanning and evaluate the accuracy. Methods 60 living kidney donors were underwent renal CTA.The CT protocol consisted of an unenhanced scan and three contrast-enhanced scans. Glomerular filtration rate was calculated with Patlak equation. As a reference, the exact information of GFR was gained by performing renal SPECT with 99mTc-DTPA.GFR of the two groups were analyzed by linear regression analysis. Results In 60 kidney donors, GFR of the left and right kidney measured by CT was (64.36±5.38) ml·min-1·(1.73 m2)-1 and (65.72±5.73) ml·min-1· (1.73 m2)-1, and the total GFR was (129.48±10.49)ml·min-1·(1.73 m2)-1;GFR measured by SPECT was respectively (41.74±5.49)ml·min-1·(1.73 m2)-1, (43.36±6.31) ml·min-1·(1.73 m2)-1 and (85.09±10.73) ml·min-1·(1.73 m2)-1. Linear regression analysis show that the two groups GFR had well correlation.The correlation coefficient of the left kidney GFR and the right kidney GFR was 0.877 and 0.877, with a regression line of GFR(CT)=28.525+0.859×GFR(SPECT), n=60 and GFR(CT)=31.209+0.785×GFR(SPECT), n=60, the correlation coefficient of the total GFR was 0.867 with a regression line of GFR(CT)=57.337+0.848×GFR(SPECT), n=60. Conclusions GFR measured by enhanced CT scanning has a well correlation with GFR measured by SPECT. It can complete the preoperative evaluation of kidney function and anatomy of living kidney donors simultaneously by using enhanced CT scanning.%目的:研究螺旋CT多期增强扫描测定活体肾移植供体肾小球滤过率(GFR)的方法及其准确性。方法60例健康活体肾移植供体术前均行双肾CTA检查,扫描程序包括平扫、动脉期、静脉期及延迟CTU扫描,应用Patlak方程原理计算双肾GFR,并与SPECT 99mTc-DTPA肾动态显像所测定的GFR对照,并对两组结果进行直线回归与相关分析。结果60例

  2. 过滤方式及压力对速率影响的研究%The Research on the Impact of Filtration Manners and Pressure on Filtration Rate

    Institute of Scientific and Technical Information of China (English)

    杨德武; 王海艳

    2012-01-01

    The advantages and disadvantages of relevant filtrations are introduced.Filtration experiment process is established independently and a corresponding membrane filter is designed to study the horizontal dead-end filtration,vertical dead-end filtration,horizontal cross-flow filtration and vertical cross-flow filtration and operating pressure impacting on the filtration rate.Experimen-tal results show that the filtration rate of vertical cross-flow filtration is larger and the rate attenua-tion is slower than other three filtration manners.After a period of time,the filtration rate tend to a definite value;The filtration rate is improved by increasing pressure,but membrane fouling and the rate attenuation is accelerated.%介绍了相关过滤方式的优缺点,自主建立了过滤实验流程,设计出相应的膜滤器,通过实验,研究了横向终端过滤、竖向终端过滤、横向错流过滤和竖向错流过滤及过滤压力对过滤速率的影响等。结果表明:采用竖向流动错流过滤方式膜过滤速率大于其它方式的过滤速率,衰减最为缓慢,且一段时间后,速率趋于一定值;压力增大可以提高竖向流动错流过滤速率,但也加快了膜污染,使膜速率衰减加快。

  3. Renal blood flow using arterial spin labelling MRI and calculated filtration fraction in healthy adult kidney donors pre-nephrectomy and post-nephrectomy

    Energy Technology Data Exchange (ETDEWEB)

    Cutajar, Marica; Clark, Christopher A.; Gordon, Isky [University College London, Imaging and Biophysics Unit, Institute of Child Health, London (United Kingdom); Hilton, Rachel; Olsburgh, Jonathon [Renal Unit, Guy' s and St Thomas' NHS Foundation Trust, London (United Kingdom); Marks, Stephen D. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Paediatric Nephrology, London (United Kingdom); Thomas, David L. [University College London, Department of Brain Repair and Rehabilitation, Institute of Neurology, London (United Kingdom); Banks, Tina [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom)

    2015-08-15

    Renal plasma flow (RPF) (derived from renal blood flow, RBF) and glomerular filtration rate (GFR) allow the determination of the filtration fraction (FF), which may have a role as a non-invasive renal biomarker. This is a hypothesis-generating pilot study assessing the effect of nephrectomy on renal function in healthy kidney donors. Eight living kidney donors underwent arterial spin labelling (ASL) magnetic resonance imaging (MRI) and GFR measurement prior to and 1 year after nephrectomy. Chromium-51 labelled ethylenediamine tetraacetic acid ({sup 51}Cr-EDTA) with multi-blood sampling was undertaken and GFR calculated. The RBF and GFR obtained were used to calculate FF. All donors showed an increase in single kidney GFR of 24 - 75 %, and all but two showed an increase in FF (-7 to +52 %) after nephrectomy. The increase in RBF, and hence RPF, post-nephrectomy was not as great as the increase in GFR in seven out of eight donors. As with any pilot study, the small number of donors and their relatively narrow age range are potential limiting factors. The ability to measure RBF, and hence RPF, non-invasively, coupled with GFR measurement, allows calculation of FF, a biomarker that might provide a sensitive indicator of loss of renal reserve in potential donors. (orig.)

  4. Clinical significance of determining serum cystatin C for glomerular filtration rate%血清胱蛋白酶抑制剂C测定对肾小球滤过率的临床意义

    Institute of Scientific and Technical Information of China (English)

    郭品娥; 周岳松; 沈茜; 李黎

    2002-01-01

    @@ 肾小球滤过率(glomerular filtration rate,GFR)是反映肾脏功能最重要的指标,由于经济及技术条件方面的限制,目前临床上主要采用内生肌酐清除率及血清肌酐来评价GFR.血清胱蛋白酶抑制剂C(cystatin C,Cys C)是近年发现的一个能反映GFR的指标[1,2].本实验采用乳胶增强的速率散射比浊法检测不同肾病患者血清Cys C、β2微球蛋白(β2-M)和血清肌酐,探讨三者之间的关系,以评价Cys C作为GFR指标的临床价值.

  5. Estimation of glomerular filtration rate by a radial basis function neural network in patients with type-2 diabetes mellitus

    National Research Council Canada - National Science Library

    Liu, Xun; Chen, Yan-Ru; Li, Ning-shan; Wang, Cheng; Lv, Lin-Sheng; Li, Ming; Wu, Xiao-Ming; Lou, Tan-Qi

    2013-01-01

    .... We developed a radial basis function (RBF) network and assessed the performance of this method in the estimation of the GFRs of 207 patients with type-2 diabetes and CKD. Standard GFR (sGFR) was determined by (99m...

  6. Classification of Kidney Transplant Recipients Using a Combination of Estimated GFR and Albuminuria Reflects Risk

    Science.gov (United States)

    White, Christine A.; Akbari, Ayub; Talreja, Hari; Lalani, Neha; Knoll, Greg A.

    2016-01-01

    Background The 2012 Kidney Dialysis Initiative Global Outcomes chronic kidney disease (CKD) classification scheme subdivides stage 3 CKD and incorporates the urinary albumin-to-creatinine ratio (ACR). The aim of this study was to evaluate whether the novel scheme provides graded risk in kidney transplant recipients (KTRs). Methods Prevalent KTRs with available laboratory data were included. The primary outcome was a composite of doubling of serum creatinine, graft failure, or death. Patients were stratified using the CKD-Epidemiolgic Collaboration equation, and ACR and the event rate per 1000 patient-years in each CKD category were calculated. Results There were 269 KTRs with a mean follow-up of 4.5 ± 2.0 years. There was a graded increase in outcomes with increasing ACR and decreasing estimated glomerular filtration rate (eGFR). For the primary outcome, the event rate was 15.3 (95% confidence interval, 4.2-39.2) per 1000 patient-years for those with an eGFR greater than 60 mL/min per 1.73 m2 and an ACR less than 30 mg/g, whereas it was 375 (95% confidence interval, 193.8-655.1) for those with an eGFR less than 30 mL/min per 1.73 m2 and an ACR greater than 300 mg/g. Conclusions The novel Kidney Dialysis Initiative Global Outcomes classification scheme provides graded risk for important clinical events in KTRs. This information can be used to identify high-risk patients and to tailor follow-up and management strategies aimed at improving outcomes.

  7. Measurement of glomerular filtration rate by dynamic contrast-enhanced magnetic resonance imaging using a subject-specific two-compartment model.

    Science.gov (United States)

    Tipirneni-Sajja, Aaryani; Loeffler, Ralf B; Oesingmann, Niels; Bissler, John; Song, Ruitian; McCarville, Beth; Jones, Deborah P; Hudson, Melissa; Spunt, Sheri L; Hillenbrand, Claudia M

    2016-04-01

    Measuring glomerular filtration rate (GFR) by dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) as part of standard of care clinicalMRIexams (e.g., in pediatric solid tumor patients) has the potential to reduce diagnostic burden. However, enthusiasm for this relatively newGFRtest may be curbed by the limited amount of cross-calibration studies with referenceGFRtechniques and the vast variety ofMRtracer model algorithms causing confusion on the choice of model. To advanceMRI-basedGFRquantification via improvedGFRmodeling and comparison with associated(99m)Tc-DTPA-GFR, 29 long-term Wilms' tumor survivors (19.0-43.3 years, [median 32.0 ± 6.0 years]) treated with nephrectomy, nonnephrotoxic chemotherapy ± radiotherapy underwentMRIwith Gd-DTPAadministration and a(99m)Tc-DTPA GFRtest. ForDCE-MRI-basedGFRestimation, a subject-specific two-compartment (SS-2C) model was developed that uses individual hematocrit values, automatically defines subject-specific uptake intervals, and fits tracer-uptake curves by incorporating these measures. The association between reference(99m)Tc-DTPA GFRandMR-GFRs obtained bySS-2C, three published 2C uptake, and inflow-outflow models was investigated via linear regression analysis. Uptake intervals varied from 64 sec to 141 sec [96 sec ± 21 sec] and hematocrit values ranged from 30% to 49% [41% ± 4%]; these parameters can therefore not be assumed as constants in 2C modeling. OurMR-GFRestimates using theSS-2C model showed accordingly the highest correlation with(99m)Tc-DTPA-GFRs (R(2) = 0.76,P < 0.001) compared with other models (R(2)-range: 0.36-0.66). In conclusion,SS-2C modeling ofDCE-MRIdata improved the association betweenGFRobtained by(99m)Tc-DTPAand Gd-DTPA DCE-MRIto such a degree that this approach could turn into a viable, diagnosticGFRassay without radiation exposure to the patient.

  8. 应用99mTc-DTPA肾动态显像测定正常儿童GFR及校正研究%Establishment and calibration of normal reference intervals for GFR of the healthy children with99m Tc-DTPA renal dynamic imaging

    Institute of Scientific and Technical Information of China (English)

    赵晓斐; 赵瑞芳; 阮双岁; 吴哈

    2015-01-01

    目的:肾小球滤过率(GFR)是肾脏功能评估的重要指标之一,本研究以99mTc—DTPA肾动态显像法测定儿童GFR并校正以获得准确结果。方法对99例(8周至12岁)肾功能正常的儿童实施99mTc—DTPA肾动态显像,Gate’s法测得GFR,经核医学侧位影像实测肾脏深度作衰减校正,得出校正GFR(cGFR),并作体表面积标准化。受检者根据年龄分为5组,分别为8周至1岁、1~2岁、2~3岁、3~10岁、10~12岁。结果①第1组:8周至1岁,GFR (70±10)mL/min,cGFR(84±10)mL/min;第2组:1~2岁,GFR (79±6)mL/min,cGFR (94±7)mL/min;第3组:2~3岁,GFR (85±5) mL/min,cGFR (98±4)mL/min;第4组:3~10岁,GFR (84±6)mL/min,cGFR (102±6)mL/min;第5组:10~12岁,GFR (86±7)mL/min,cGFR(105±6)mL/min。②每组GFR和cGFR 比较均有显著差异(P值均<0.05)。③GFR经体表面积标准化,各组值均偏高。④与Schwartz公式估算值eGFR相比,大年龄组的cGFR更与之接近。⑤GFR 95%正常值范围:第1组:8周至1岁,GFR 50~90 mL/min,cG-FR 60~104 mL/min;第2组:1~2岁,GFR 67~91 mL/min,cGFR 80~108 mL/min;第3组:2~3岁, GFR75~95 mL/min,cGFR 90~106 mL/min;第4组:3~10岁,GFR 72~96 mL/min,cGFR 90~114 mL/min;第5组:10~12岁,GFR 72~100 mL/min,cGFR 93~117 mL/min。结论99mTc—DTPA肾动态显像法可获得儿童GFR的正常参考值范围,为临床评估肾功能提供客观量化指标。%Objetive Glomerular filtration rate (GFR)is an important criterion to evaluate renal func-tion.The aim of this study was to measure and calibrate GFR reference intervals for Chinese children by means of 99mTc-DTPA renal dynamic imaging. Methods 99 children(aged 8weeks~12 years)with normal renal function underwent99m Tc-DTPA renal dynamic imaging to measure GFR using Gate’s method

  9. Circulating cathepsin-S levels correlate with GFR decline and sTNFR1 and sTNFR2 levels in mice and humans

    Science.gov (United States)

    Steubl, Dominik; Kumar, Santhosh V.; Tato, Maia; Mulay, Shrikant R.; Larsson, Anders; Lind, Lars; Risérus, Ulf; Renders, Lutz; Heemann, Uwe; Carlsson, Axel C.; Ärnlöv, Johan; Anders, Hans-Joachim

    2017-01-01

    Cardiovascular complications determine morbidity/mortality in chronic kidney disease (CKD). We hypothesized that progressive CKD drives the release of cathepsin-S (Cat-S), a cysteine protease that promotes endothelial dysfunction and cardiovascular complications. Therefore, Cat-S, soluble tumor-necrosis-factor receptor (sTNFR) 1/2 and glomerular filtration rate (GFR) were measured in a CKD mouse model, a German CKD-cohort (MCKD, n = 421) and two Swedish community-based cohorts (ULSAM, n = 764 and PIVUS, n = 804). Association between Cat-S and sTNFR1/2/GFR was assessed using multivariable linear regression. In the mouse model, Cat-S and sTNFR1/2 concentrations were increased following the progressive decline of GFR, showing a strong correlation between Cat-S and GFR (r = −0.746, p < 0.001) and Cat-S and sTNFR1/sTNFR2 (r = 0.837/0.916, p < 0.001, respectively). In the human cohorts, an increase of one standard deviation of estimated GFR was associated with a decrease of 1.008 ng/ml (95%-confidence interval (95%-CI) −1.576–(−0.439), p < 0.001) in Cat-S levels in MCKD; in ULSAM and PIVUS, results were similar. In all three cohorts, Cat-S and sTNFR1/sTNFR2 levels were associated in multivariable linear regression (p < 0.001). In conclusion, as GFR declines Cat-S and markers of inflammation-related endothelial dysfunction increase. The present data indicating that Cat-S activity increases with CKD progression suggest that Cat-S might be a therapeutic target to prevent cardiovascular complications in CKD. PMID:28240259

  10. Quantitative measurement and visualization of biofilm O 2 consumption rates in membrane filtration systems

    KAUST Repository

    Prest, Emmanuelle I E C

    2012-03-01

    There is a strong need for techniques enabling direct assessment of biological activity of biofouling in membrane filtration systems. Here we present a new quantitative and non-destructive method for mapping O 2 dynamics in biofilms during biofouling studies in membrane fouling simulators (MFS). Transparent planar O 2 optodes in combination with a luminescence lifetime imaging system were used to map the two-dimensional distribution of O 2 concentrations and consumption rates inside the MFS. The O 2 distribution was indicative for biofilm development. Biofilm activity was characterized by imaging of O 2 consumption rates, where low and high activity areas could be clearly distinguished. The spatial development of O 2 consumption rates, flow channels and stagnant areas could be determined. This can be used for studies on concentration polarization, i.e. salt accumulation at the membrane surface resulting in increased salt passage and reduced water flux. The new optode-based O 2 imaging technique applied to MFS allows non-destructive and spatially resolved quantitative biological activity measurements (BAM) for on-site biofouling diagnosis and laboratory studies. The following set of complementary tools is now available to study development and control of biofouling in membrane systems: (i) MFS, (ii) sensitive pressure drop measurement, (iii) magnetic resonance imaging, (iv) numerical modelling, and (v) biological activity measurement based on O 2 imaging methodology. © 2011 Elsevier B.V.

  11. Angiopoietin-2 in chronic renal failure patients on hemodialysis: Relationship with glomerular filtration rate in the predialysis stages

    Directory of Open Access Journals (Sweden)

    Fatma A Attia

    2013-01-01

    Conclusion Circulating angiopoietin-2 is a putative marker and potential mediator of atherosclerosis, is inversely related to glomerular filtration rate, and is increased with advanced chronic kidney disease. Normolipidemia in chronic kidney disease patients does not prevent atherosclerotic burden; this is because of the presence of other markers such as angiopoietin-2.

  12. Associations of estimated glomerular filtration rate and albuminuria with mortality and renal failure by sex: a meta-analysis

    NARCIS (Netherlands)

    Nitsch, D.; Grams, M.; Sang, Y.; Black, C.; Cirillo, M.; Djurdjev, O.; Iseki, K.; Jassal, S.K.; Kimm, H.; Kronenberg, F.; Oien, C.M.; Levey, A.S.; Levin, A.; Woodward, M.; Hemmelgarn, B.R.; Wetzels, J.F.

    2013-01-01

    OBJECTIVE: To assess for the presence of a sex interaction in the associations of estimated glomerular filtration rate and albuminuria with all-cause mortality, cardiovascular mortality, and end stage renal disease. DESIGN: Random effects meta-analysis using pooled individual participant data. SETTI

  13. Differential effect of T-type voltage-gated calcium channel disruption on renal plasma flow and glomerular filtration rate in vivo

    DEFF Research Database (Denmark)

    Thuesen, Anne D; Andersen, Henrik; Cardel, Majken

    2014-01-01

    of two T-type Cav knock-out mice strains. Continuous recordings of blood pressure and heart rate, and para-aminohippurate clearance (renal plasma flow) and inulin clearance (GFR) were performed in conscious, chronically catheterized, wild type and Cav 3.1-/- and Cav 3.2-/- mice. Contractility of afferent...

  14. International Collaboration for the Epidemiology of eGFR in Low and Middle Income Populations - Rationale and core protocol for the Disadvantaged Populations eGFR Epidemiology Study (DEGREE).

    Science.gov (United States)

    Caplin, Ben; Jakobsson, Kristina; Glaser, Jason; Nitsch, Dorothea; Jha, Vivekanand; Singh, Ajay; Correa-Rotter, Ricardo; Pearce, Neil

    2017-01-03

    There is an increasing recognition of epidemics of primarily tubular-interstitial chronic kidney disease (CKD) clustering in agricultural communities in low- and middle-income countries (LMICs). Although it is currently unclear whether there is a unified underlying aetiology, these conditions have been collectively termed CKD of undetermined cause (CKDu). CKDu is estimated to have led to the premature deaths of tens to hundreds of thousands of young men and women over the last 2 decades. Thus, there is an urgent need to understand the aetiology and pathophysiology of these condition (s). International comparisons have provided the first steps in understanding many chronic diseases, but such comparisons rely on the availability of standardised tools to estimate disease prevalence. This is a particular problem with CKD, since the disease is asymptomatic until the late stages, and the biases inherent in the methods used to estimate the glomerular filtration rate (GFR) in population studies are highly variable across populations. We therefore propose a simple standardised protocol to estimate the distribution of GFR in LMIC populations - The Disadvantaged Populations eGFR Epidemiology (DEGREE) Study. This involves the quantification of renal function in a representative adult population-based sample and a requirement for standardisation of serum creatinine measurements, along with storage of samples for future measurements of cystatin C and ascertainment of estimates of body composition, in order to obtain valid comparisons of estimated GFR (eGFR) within and between populations. The methodology we present is potentially applicable anywhere, but our particular focus is on disadvantaged populations in LMICs, since these appear to be most susceptible to CKDu. Although the protocol could also be used in specific groups (e.g. occupational groups, thought to be at excess risk of CKDu) the primary aim of the DEGREE project is characterise the population distribution of eGFR

  15. An unusual case of acute kidney injury due to vancomycin lessons learnt from reliance on eGFR.

    Science.gov (United States)

    Barraclough, Katherine; Harris, Marianne; Montessori, Val; Levin, Adeera

    2007-08-01

    We present a case of renal impairment in an emaciated HIV-infected male that initially went unrecognized because of reliance on serum creatinine and estimated glomerular filtration rate (eGFR). Inaccurate vancomycin dosing led to toxic drug levels (66 mg/l), associated with acute and severe worsening of kidney function. This occurred in the context of escalating doses of vancomycin given in the presence of changing kidney function, albeit kidney function that always remained well within the normal range (serum creatinine 29 - 42 mumol/l). In the absence of other plausible explanations, a presumptive diagnosis of vancomycin nephrotoxicity was made. Given the rarity of this diagnosis in the current era, we discuss the pathophysiology of vancomycin nephrotoxicity. We also explore the potential reasons for inaccuracy of GFR prediction equations in the HIV population, and discuss the potential pitfalls associated with application of eGFR or even serum creatinine without appropriate understanding of their limitations. We believe our case highlights a number of important teaching points: Vancomycin nephrotoxitiy is rare but can occur in the setting of kidney dysfunction. Current assessment of kidney function using creatinine and eGFR requires awareness of the clinical caveats in which these measures may be misleading. Acute changes in kidney function, irrespective of the test used, should be contextualized to the individual situation. Persons with HIV and low muscle mass constitute a specific subgroup in whom assessment of kidney function may be problematic using creatinine. We support ongoing efforts to develop or refine equations for specific unique and easily identifiable populations.

  16. Cistatina C e taxa de filtração glomerular em cirurgia cardíaca com circulação extracorpórea Cystatin C and glomerular filtration rate in the cardiac surgery with cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Marcello Laneza Felicio

    2009-09-01

    Full Text Available OBJETIVO: Avaliar a cistatina C como marcador de função renal em pacientes submetidos à cirurgia de cardíaca com circulação extracorpórea, comparando com a dosagem sérica de creatinina. MÉTODOS: Foram analisados 50 pacientes consecutivos submetidos à cirurgia de revascularização do miocárdio. A função renal foi avaliada com a dosagem sérica de cistatina C e de creatinina no pré-operatório, no primeiro e no quinto dia de pós-operatório. Foram utilizadas as fórmulas de Cockcroft-Gault (CG e Modification of Diet in Renal Disease (MDRD para calcular a taxa de filtração glomerular estimada (TFG através da creatinina, e a fórmula de Larsson para a TFG estimada através da cistatina C (TFG-Cis. RESULTADOS: A creatinina e o TFG através das fórmulas de CG e MDRD não mostraram diferença significativa nos momentos estudados. Após a agressão renal pela cirurgia, houve um aumento da cistatina C no 1º e 5º pós-operatório, sendo que no 5º pós-operatório com diferença estatisticamente significativa (P OBJECTIVE: The aim of this study was to compare cystatin C versus creatinine as a marker for acute kidney injury in patients submitted to cardiac surgery with cardiopulmonary bypass. METHODS: Fifty consecutive patients submitted to coronary artery bypass grafting were studied. Renal function was evaluated by serum cystatin C and creatinine. Blood samples were obtained from each patient at three time points: before operation, and on the first and fifth postoperative days. Glomerular filtration rate (GFR was calculated by Cockcroft-Gault (CG, Modification of Diet in Renal Disease (MDRD, and Larsson (Cys-GFR formulas. RESULTS: Creatinine and GFR by CG and MDRD formulas did not show statistical difference between study times. After renal injury from surgery, there was an increase in cystatin C on the 1st and 5th day after surgery, being significantly different on the 5th postoperative (P<0.01. The GFR by Larson formula was higher

  17. Correlation of the glomerular filtration rate by the Gates scintigraphy method and by the creatinine purification in urine of 24 hours; Correlacion de la tasa de filtracion glomerular por el metodo gamagrafico de Gates y por la depuracion de creatinina en orina de 24 horas

    Energy Technology Data Exchange (ETDEWEB)

    Gomez A, E

    2003-07-01

    The kidney is an important organ that makes that exist equilibrium inside the organism. In it' s multiple functions, one that interests us to know is the glomerular filtration rate (GFR). To know this, exist laboratory and scintigraphy studies like the scintigraphy with technique of Gates and the creatinine purification in urine of 24 hours. The files of 44 patients were studied, which were clinically candidates to kidney donors healthy (25 women and 19 men) with ages that varied from the 18 years to the 54 years ( 35.1 years), with a weight of 43 kilograms to 94 kilograms (68.95 Kg) and with a corporal surface of 1.29 to 2.08 m{sup 2} (1.70 m{sup 2}). These patients underwent study protocols with creatinine purification and with renal scintigraphy. The glomerular filtration rate obtained by creatinine purification varied from 51.9 ml/min. to 156 ml/min. and the GFR obtained by scintigraphy varied from 3.6 ml/min. to 155.2 ml/min. Once obtained the gathering of data the test of Student was applied to compare the averages of both distributions and the analysis of lineal regression to determine the coefficients of correlation of the complete group. (Author)

  18. Application of estimated glomerular filtration rate formulae for different stages of chronic kidney disease in diabetes%肾小球滤过率预测公式在糖尿病合并慢性肾脏病不同分期中的适用性

    Institute of Scientific and Technical Information of China (English)

    孙科; 荆春艳; 刘永菊; 王东; 王菊梅; 董林; 姜妍芳; 李素梅

    2015-01-01

    目的 评价肾小球滤过率(glomerular filtration rate,GFR)预测公式在糖尿病肾脏疾病(diabetic kidney disease,DKD)不同分期中的适用性.方法 收集274例住院2型糖尿病患者的临床资料.采用中国改良肾脏病膳食改善实验(modification of diet in renal disease,MDRD)公式、瑞金公式及慢性肾脏病流行病学合作研究(chronic kidney disease epidemiology collaboration,CKD-EPI)公式估算的肾小球滤过率(estimated glomerular filtration rate,eG-FR)与99m锝-二乙烯三胺五乙酸(99mTc-diethylene triamine pentacetic acid,99mTc-DTPA)肾动态显像检查双肾GFR(referred glomerular filtration rate,rGFR)作为参考标准比较.比较上述3公式在GFR正常组(A组)、降低组(B组)、慢性肾脏疾病组(C组)的适用性.结果 在A、B两组,瑞金公式和CKD-EPI公式间eGFR的偏差值及偏差绝对值百分数、30%及50%符合率的差异无统计学意义(均有P>0.05);2者较中国改良MDRD公式eGFR的偏差值、偏差绝对值百分数小,30%、50%符合率高,差异有统计学意义(均有P<0.05).C组,3公式的上述指标两两之间的差异均无统计学意义(均有P >0.05).Bland-Altman作图法显示,瑞金方程eGFR的一致性最好.结论 瑞金方程eGFR可能更适合于评估中国DKD患者的GFR,尤其是早期肾功能损害者.

  19. Plasma NGAL and glomerular filtration rate in cardiac transplant recipients treated with standard or reduced calcineurin inhibitor levels

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Gude, Einar; Sigurdardottir, Vilborg

    2014-01-01

    GFR) at baseline (R(2) = 0.21; p year (median [25-75 % percentiles]: ΔmGFR 5.5 [-0.5-11.5] vs -1 [-7-4] ml/min/1.73 m(2); p = 0.006). Baseline P-NGAL predicted mGFR after 1 year (R(2) = 0.18; p ...: P-NGAL was measured in 88 cardiac transplantation patients (median 5 years post-transplant) with renal dysfunction randomized to continuation of conventional calcineurin inhibitor-based immunosuppression or switching to an everolimus-based regimen. RESULTS: P-NGAL correlated with measured GFR (m...

  20. 肌酐实验室分析变异对估算肾小球滤过率及慢性肾脏病分期的影响%Effects of analytic variations in creatinine measurement on estimated glomerular filtration rate and the classification of CKD

    Institute of Scientific and Technical Information of China (English)

    史德宝; 吕礼应

    2016-01-01

    目的:探讨血清肌酐(sCr)实验室分析变异对估算肾小球滤过率(eGFR)及慢性肾脏病(CKD)分期的影响。方法收集就诊并检测 sCr 者,年龄20~89岁,sCr 介于参考区间上限(URL)±12%×URL 之间的人群共13157例,其中男9886例,女3271例。将 sCr 检测结果分别递增或递减4%、8%、12%及原始结果,共分为7组,观察不同程度 sCr实验室分析变异对 eGFR 及 CKD 分期的影响。结果sCr在 URL ±12%URL 范围内,随着年龄的增加,sCr 呈上升趋势;而 eGFR 随着年龄的增加而逐渐降低(P <0.05)。 eGFR结果较原始结果的平均偏倚随着 sCr 检测结果的实验室变异增大而增大,sCr 检测结果负向偏倚12%时,eGFR 结果的正向偏倚达16.73%。当 sCr 结果正向偏倚达12%时,男性患者 CKD 分期 G3期(eGFR 在30~59 ml/min/1.73 m 2)所占比例可增加20%,而女性患者可增加近30%;当 sCr 负偏倚达12%时,女性 G3期患者所占比例由38.56%减少至10.42%,而男性患者则减少近7%。结论sCr 实验室分析变异在允许范围内的改变,即可引起 eGFR 较大的偏倚,从而导致患者 CKD 分期的改变,eGFR 的正确报告关键在于sCr 的准确检测。%Objective To evaluate the effects of analytic variations in creatintine measurements on estimated glo -merular filtration rate (eGFR) and the classification of chronic kidney disease ( CKD).Methods A total of 13 157 patients, including inpatients, outpatients and health individual , were enrolled, whose creatinine range from upper reference limit (URL) -12% ×URL to URL +12% ×URL.There were 9 886 males and 3 271 fe-males with an age range of 20 ~89 years.The results of sCr incremented or decremented 4%, 8%, 12% and orig-inal results were divided into 7 groups.The effects of different degree of analytic variation in sCr measurement on eGFR and classification of CKD using eGFR were

  1. [New topics regarding equations for GFR estimation based on serum creatinine and cystatin C].

    Science.gov (United States)

    Horio, Masaru

    2014-02-01

    Japanese GFR equations and CKD-EPI equations based on standardized serum creatinine and standardized cystatin C are recommended in recent Japanese CKD guides and KDIGO guidelines for CKD management, respectively. CKD-EPIcreat overestimates GFR in Japanese subjects, probably due to the difference in muscle mass between Japanese and Caucasians. Unlike CKD-EPIcreat, CKD-EPIcys performs well in Japanese subjects, indicating the advantages of using cystatin C as a GFR marker. KDIGO guidelines suggest measuring eGFRcys in adults with eGFRcreat of 45-59 ml/min/1.73 m2 who do not have markers of kidney damage if confirmation of CKD is required. Creatinine is excreted by glomerular filtration, but also secreted by the tubules. Alteration of the tubular secretion of creatinine may influence the performance of GFR equations based on serum creatinine. Multivariate analysis showed that GFR and serum albumin levels were independent parameters affecting the fractional excretion of creatinine (FE-Cr). Alteration of FE-Cr according to the serum albumin levels may be one of the reasons for the bias of GFR equations based on serum creatinine. Low GFR is a risk factor for all-cause and cardiovascular mortality in a general population. However, the relationship between eGFR and the hazard risk of events is different depending on whether cystatin C or creatinine is used to calculate eGFR. The association between eGFRcys and the hazard risk is much stronger compared with eGFRcreat. Cystatin C may be a useful alternative to creatinine for detecting a high risk of complications in a general population and subjects with CKD.

  2. 碳酸锂治疗的躁狂发作患者血锂浓度与肾小球滤过率的关系%The relationship between blood lithium concentration and glomerular filtration rate in patients with manic episode receiving lithium treatment

    Institute of Scientific and Technical Information of China (English)

    汪莉; 徐乐平; 潘圆圆; 纪菊英; 陈琪; 孙剑

    2011-01-01

    Objective To explore the relationship between lithium metabolism and glomerular filtration rates ( GFR ) in manic patients. Methods Fifty two inpatients with manic episode were recruited. The serum creatinine( Scr ),blood urea nitrogen( BUN ),body surface area and plasma sodium concentration were assessed before the administration of lithium. The estimated glomerular filtration rates ( eGFR ) were calculated from the modification of diet in renal disease ( MDRD ) equation. The blood lithium concentration was measured in patients receiving lithium at 1.0 g/d for ahout one week when lithium reached the homeostasis. Correlations between blood lithium concentration and parameters mentioned above were studied. Results The blood lithium concentration was 0.2 ~ 1.0( 0.52±0.18 )mmoL/L. Single factor analysis showed that blood lithium concentration was negatively correlated with body surface area( r=-0.33,P=0.02 )and eGFR ( r=-0.30, P=0.03 ). Multiple stepwise linear regression analysis also revealed a significant inverse relation between blood lithium concentration and hody surface area( β =-0.31,P=0.02 ), eGFR( p =-0.28,P=0.03 ). But no correlations were observed between blood lithium concentration and Scr, BUN( P > 0.05 ). Conclusions Blood lithium concentration is negatively associated with eGFR, suggesting that eGFR may be used as a a predictor to evaluate lithium metabolic ability.%目的 探讨锂盐代谢与肾小球滤过率的关系.方法 收集52例接受碳酸锂治疗的躁狂发作患者,检测治疗前血肌酐、尿素氮、体表面积、血钠浓度等指标,同时根据肾脏病膳食改善(the modification of diet in renal disease,MDRD)方程估算肾小球滤过率(estimated glomerular filtration rates,eGFR);在给予口服碳酸锂1.0 g/d 1周后测定稳态血锂浓度.对上述各项指标与血锂浓度进行相关分析.结果 患者组的稳态血锂浓度为0.2~1.0 mmoL/L,平均(0.52±0.18)mmoL/L.单因素分析显示,血锂浓度与

  3. Hypertension and Prehypertension and Prediction of Development of Decreased Estimated GFR in the General Population: A Meta-analysis of Cohort Studies.

    Science.gov (United States)

    Garofalo, Carlo; Borrelli, Silvio; Pacilio, Mario; Minutolo, Roberto; Chiodini, Paolo; De Nicola, Luca; Conte, Giuseppe

    2016-01-01

    Whether blood pressure (BP) plays an independent predictive role in the onset of decreased glomerular filtration rate (GFR) remains ill-defined because existing meta-analyses have incorporated data from studies that included individuals with low GFRs at baseline. This question is critical to optimize chronic kidney disease prevention in the general population. Systematic review and meta-analysis of longitudinal cohort studies. Adults from general population. We identified in PubMed, EMBASE, and the Cochrane Library database all cohort studies evaluating the role of BP in the incidence of decreased estimated GFR (eGFR; defined as eGFR140/90 mmHg), prehypertension (systolic BP of 120-139 and/or diastolic BP of 80-89 mmHg), and BP as a continuous variable. Risk for decreased eGFR reported as relative risk (RR) and 95% CI. Heterogeneity (I2) was also evaluated. Data from 16 cohorts (315,321 participants) were analyzed. All studies had a Newcastle-Ottawa score in the range of 6 to 8, denoting high quality. During a mean follow-up of 6.5 years, decreased eGFR occurred in 6.6% of participants. The presence of prehypertension and hypertension increased renal risk (RRs of 1.19 [95% CI, 1.07-1.33; I2=23.8%] and 1.76 [95% CI, 1.58-1.97; I2=37.7%], respectively). Similarly, we found that every 10-mm Hg increase in systolic and diastolic BPs associated with higher risk for decreased eGFR (RRs of 1.08 [95% CI, 1.04-1.11; I2=60.0%] and 1.12 [95% CI, 1.04-1.20; I2=51.4%], respectively). Metaregression analysis showed greater risk with older age (P=0.03), whereas other covariates were not significant. No individual patient-level data. Prehypertension and hypertension, as BP levels, are independent predictors of decreased GFR in the general population, with the effect being more pronounced in the elderly. These findings are important for improving risk stratification in the general population. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights

  4. 99mTc-DTPA肾动态显像法测定健康人GFR的研究%Study on 99 mTc-DTPA Renal Dynamic Imaging for Detecting Glomerular Filtration Rate in Healthy People

    Institute of Scientific and Technical Information of China (English)

    杨吉刚; 李春林; 邹兰芳; 张楠

    2011-01-01

    [Objective] To observe the normal value of glomerular filtration rate(GFR) in healthy people detected by 99 mTc-DTPA renal dynamic imaging and its change with the age. [Methods] The case history was inquired. Blood pressure, fasting blood glucose, lipids and serum creatinine were determined. Urine routine test, urine proteins and 24h-urinary protein quantitive test, urinary sediment microscopic examination, renal ultrasound and renal biopsy were performed. The selection and exclusion criteria were strictly formulated. Radionuclide imaging was used to detect the GFR. [Results]The average GFR value in the healthy adults was (87.68±16.74)mL/(min · 1.73 m2). There was no significant difference in GFR of different gender in the same age group. There was no significant difference in GFR in men among different age groups. There was significant different in GFR between women aged more than 50 years old and women aged less than 50 years old[(83.36±10.15)mL/(min · 1.73 m2) , (95.32±13.91)mL/(min · 1.73 m2) , (91.24±16.46)mL/(min · 1.73 m2), (98. 92±11. 35)mL/(min· 1.73 m2)].[Conclusion]The GFR in healthy people detected by 99 mTc-DTPA renal dynamic imaging is different from that in western people. The GFR in women aged over 50 years old has a trend of decline.%[目的]观察99mTc-DTPA肾动态显像法测定健康人肾小球滤过率(GFR)的正常值,以及健康人随着年龄增长GFR值的变化.[方法]通过询问病史,测量血压,测定空腹血糖、血脂、血肌酐、尿常规、尿蛋白4项、24 h尿蛋白定量,尿沉渣镜检,肾脏超声及肾穿刺病理结果,严格制定入选标准及排除标准,并采用放射性核素显像测定GFR.[结果]健康成人的平均GFR值为(87.68±16.74)mL/(min·1.73 m2),142例受试者按年龄段分为20~,30~,40~,50~四组.相同年龄组中不同性别GFR值差异无统计学意义,男性各年龄组的GFR值差异无统计学意义.在>50岁女性的GFR和≤50岁女性各

  5. The influence of blood glucose level on glomerular filtration rate and its estimation equations in type 2 diabetes%血糖水平对2型糖尿病患者肾小球滤过率及其评估方程的影响

    Institute of Scientific and Technical Information of China (English)

    张萌; 黄清梅; 简小金; 方红娟; 杨金奎

    2011-01-01

    目的 探讨不同血糖水平对2型糖尿病患者肾小球滤过率(GFR)及其评估方程的影响方法 选择经同位素99mTc-DTPA测定GFR的2型糖尿病患者495例,HbA1c与99mTc-DTPA测定GFR及CG方程、MDRD方程和MCQ方程GFR估计值之间进行相关性分析;以HbA1c=8%为临界值,比较两组间各评估方程的精确性和准确性.结果:经同位素测定的GFR为(70.11±20.54)ml·min(-1)·(1.73 m2)(-1),HbA1c与同位素测定GFR及CG方程、MDRD方程和MCQ方程GFR估计值呈正相关(γ值分别为0.196、0.201、0.289和0.181,P<0.01).无论血糖水平如何,CG方程的准确性都明显高于其他两个方程.结论 近期高血糖增加同位素测定GFR和方程估算GFR的水平.虽然这些评估方程存在一些不足之处,但由于目前尚缺乏专门针对糖尿病人群的评估方程,在临床实际工作中采用CG方程来评估2型糖尿病患者的GFR不失为一个简便实用的方法.%Objective To discuss the influence of different blood glucose levels on glomerular filtration rate (GFR) and on its estimation equations in type 2 diabetes. Methods 495 type 2 diabetic patients undergoing GFR measurement using 99m Tc-DTPA were enrolled in this study. The correlations were performed between glycosylated hemoglobin (HbA1c) and 99m Tc-DTPA measured GFR and its estimations by CG, MDRD and MCQ equations. The precision and accuracy were compared among these three estimating equations under the threshold of HbA1c 8 %. Results When GFR measured using 99m Tc-DTPA was (70. 11 ± 20. 54 ) ml· min-1 · ( 1.73 m2 )-1, HbA1c was positively correlated with isotopically measured GFR and its estimations by CG, MDRD and MCQ equations (r=0. 196, 0. 201,0. 289 and 0.181, P<0. 01). CG equation was more accurate than the other equations regardless of blood glucose level. Conclusions Acute hyperglycemia increases isotopically measured GFR and its estimations. These equations all have some disadvantages in estimating GFR, but in

  6. Monitoring renal function in children with Fabry disease: comparisons of measured and creatinine-based estimated glomerular filtration rate

    NARCIS (Netherlands)

    C. Tondel; U. Ramaswami; K.M. Aakre; F. Wijburg; M. Bouwman; E. Svarstad

    2010-01-01

    Methods. Eighty-two examinations were done in 42 children (24 boys, 18 girls) with Fabry disease from three different centres. The mean age was 12.3 years. GFR was measured with iohexol, Cr-51-EDTA or iothalamate, and the mean mGFR was 108 ml/min/1.73 m(2). Results. The widely used original Schwartz

  7. Autoregulation of glomerular filtration rate during spironolactone treatment in hypertensive patients with type 1 diabetes: a randomized crossover trial

    DEFF Research Database (Denmark)

    Schjoedt, K.J.; Christensen, P.K.; Jorsal, A.;

    2009-01-01

    BACKGROUND: Autoregulation of GFR, i.e. maintenance of relative constancy of GFR despite variations in mean arterial pressure (MAP) >80 mmHg, is impaired in diabetic kidney disease; furthermore, some antihypertensive drugs may jeopardize autoregulation. The aim of our study was to establish...... if spironolactone affects the ability to autoregulate GFR. METHODS: Sixteen hypertensive type 1 diabetic patients with persistent normoalbuminuria (presumed normal autoregulation) completed this randomized, double-masked, crossover trial. After a 4-week wash-out period, patients received spironolactone 25 mg o...... correlated with diabetes duration (R = 0.67, P hypertension, baseline BP, GFR, HbA1c or to changes in BP. CONCLUSION: Spironolactone did not change the overall ability to autoregulate GFR in 16 hypertensive type 1 diabetic patients with normoalbuminuria. Our data...

  8. Glomerular filtration rate is altered in children with sickle cell disease: a comparison between Hb SS and Hb SC

    Science.gov (United States)

    de Paula, Rafael Pereira; Nascimento, Alana Ferreira; Sousa, Sandra Mara Bispo; Bastos, Paulo Roberto Velasco; Barbosa, Ana Angélica Leal

    2013-01-01

    Background Renal failure is common among older patients with sickle cell disease; this is preceded by subclinical glomerular hyperfiltration. Data about renal function of adults with sickle cell disease have been reported, but data on children is scarce, especially when comparing heterozygotic and homozygotic patients. Objective The goal of this study was to investigate the glomerular filtration rate of heterozygotic and homozygotic children with sickle cell disease. Methods The glomerular filtration rate of 11 children with sickle cell disease [7 homozygotic (SS) and 4 heterozygotic (SC)] with a mean age of 11 years (standard deviation: ± 5 years) was evaluated using standard laboratory techniques. Results are presented as descriptive analysis. Results Our results suggest that glomerular hyperfiltration is present in children with sickle cell disease; this is more evident in homozygotic than heterozygotic children. Conclusion There is evidence of a need to monitor the renal function of children with sickle cell disease when special attention should be paid to homozygotic patients. PMID:24255619

  9. Deferred pre-emptive switch from calcineurin inhibitor to sirolimus leads to improvement in GFR and expansion of T regulatory cell population: a randomized, controlled trial.

    Directory of Open Access Journals (Sweden)

    Dinesh Bansal

    Full Text Available BACKGROUND: Measures to prevent chronic calcineurin inhibitor (CNI toxicity have included limiting exposure by switching to sirolimus (SIR. SIR may favorably influence T regulator cell (T(reg population. This randomized controlled trial compares the effect of switching from CNI to SIR on glomerular filtration rate (GFR and T(reg frequency. METHODS: In this prospective open label randomized trial, primary living donor kidney transplant recipients on CNI-based immunosuppression were randomized to continue CNI or switched to sirolimus 2 months after surgery; 29 were randomized to receive CNI and 31 to SIR. All patients received mycophenolate mofetil and steroids. The main outcome parameter was estimated GFR (eGFR at 180 days. T(reg population was estimated by flowcytometry. RESULTS: Baseline characteristics in the two groups were similar. Forty-eight patients completed the trial. At six months, patients in the SIR group had significantly higher eGFR as compared to those in the CNI group (88.94 ± 11.78 vs 80.59 ± 16.51 mL/min, p = 0.038. Patients on SIR had a 12 mL/min gain of eGFR of at the end of six months. Patients in the SIR group showed significant increase in T(reg population at 30 days, which persisted till day 180. There was no difference in the adverse events in terms of number of acute rejection episodes, death, infections, proteinuria, lipid profile, blood pressure control and hematological parameters between the two groups. Four patients taking SIR developed enthesitis. No patient left the study or switched treatment because of adverse event. CONCLUSIONS: A deferred pre-emptive switch over from CNI to SIR safely improves renal function and T(reg population at 6 months in living donor kidney transplant recipients. Registered in Clinical Trials Registry of India (CTRI/2011/091/000034.

  10. Stent Revascularization Restores Cortical Blood Flow and Reverses Tissue Hypoxia in Atherosclerotic Renal Artery Stenosis, But Fails To Reverse Inflammatory Pathways or GFR

    Science.gov (United States)

    Saad, Ahmed; Herrmann, Sandra M.S.; Crane, John; Glockner, James F; Mckusick, Michael A; Misra, Sanjay; Eirin, Alfonso; Ebrahimi, Behzad; Lerman, Lilach O.; Textor, Stephen C.

    2013-01-01

    Background Atherosclerotic renal artery stenosis (ARAS) is known to reduce renal blood flow (RBF), glomerular filtration rate (GFR) and amplify kidney hypoxia, but the relationships between these factors and tubulo-interstitial injury in the post-stenotic kidney are poorly understood. The purpose of this study was to examine the effect of renal revascularization in ARAS on renal tissue hypoxia and renal injury. Methods and Results Inpatient studies performed in ARAS patients (n = 17), more than 60% occlusion) before and 3 months after stent revascularization, or patients with essential hypertension (EH) (n = 32), during fixed Na+ intake and ACE/ARB Rx. Single-kidney (SK) cortical, medullary perfusion and RBF measured using multidetector CT, and GFR by iothalamate clearance. Tissue deoxyhemoglobin levels (R2*) measured by Blood Oxygen Level Dependent (BOLD) MRI at 3T, as was fractional kidney hypoxia (% of axial area with R2* > 30/s). In addition, we measured renal vein levels of Neutrophil gelatinase-associated lipocalin (NGAL), monocyte chemotactic protein-1 (MCP-1) and Tumor necrosis factor (TNF-α). Pre-stent SK-RBF, perfusion, and GFR were reduced in the post-stenotic kidney. Renal vein NGAL, TNF-α, MCP-1 and fractional hypoxia were higher in untreated ARAS than EH. After stent revascularization, fractional hypoxia fell (p < 0.002) with increased cortical perfusion and blood flow, while GFR and NGAL, MCP-1 and TNF-α remained unchanged. Conclusions These data demonstrate that despite reversal of renal hypoxia and partial restoration of RBF after revascularization, inflammatory cytokines and injury biomarkers remained elevated and GFR failed to recover in ARAS. Restoration of vessel patency alone failed to reverse tubulointerstitial damage and partly explains the limited clinical benefit of renal stenting. These results identify potential therapeutic targets for recovery of kidney function in renovascular disease. PMID:23899868

  11. Correlation between post-transplant glomerular filtration rate in 1 year and long-term graft survival in renal transplant patients%肾移植术后一年时的肾小球滤过率与移植肾长期功能的相关性研究

    Institute of Scientific and Technical Information of China (English)

    任雨; 姚许平; 姜继光; 祁洪刚; 张曙伟; 高文波; 楼江涌; 翁锡君; 翁国斌

    2010-01-01

    目的 探讨肾移植受者术后1年时的肾小球滤过率(GFR)与移植肾长期功能的相关性. 方法 回顾性分析1994年11月至2004年10月间334例肾移植受者的临床资料.根据术后1年时的GFR不同,将受者分成肾功能正常组(≥1.083 ml/s; 267例)和肾功能异常组(GFR<1.083 ml/s;67例))GFR采用Coekeroft-Gault(C-G)公式进行计算.采用Kaplan-Meier方法比较两组受者术后5年时移植肾的长期存活率;分析术后1年与术后5年时GFR的相关性. 结果 肾移植术后移植肾存活率呈现逐年下降趋势,术后1年时的GFR与移植肾存活时间成正比,术后同一时间点(5年、10年),肾功能正常组(不包括或包括肾功能正常的死亡者)移植.肾的长期存活率均高于肾功能异常组,两组比较,差异有统计学意义(P<0.05).与术后1年时GFR比较,术后5年时的GFR变化幅度为(0.080±0.248)ml/s,其下降程度与术后1年时的GFR呈现明显正相关性. 结论 术后1年时的GFR水平影响移植肾的长期功能,术后1年时的GFR越高,术后5年的GFR也越高.%Objective To explore the correlation between post-transplant glomerular filtration rate (GFR) in 1 year and long-term graft survival in renal transplant patients.Methods The clinical data of 334 patients who received their cadaveric kidney transplantations between November 1994 and October 2004 were analyzed retrospectively.According to the GFR at one year after transplant operation, normal GFR group was defined as GFR more than or equal to 1.083 ml/s, while patients whose GFR less than 1.083 ml/s were fallen into abnormal GFR group.Cockeroft-Gault (C-G) formula was used to compare the difference in the renal function between the two groups.Kaplan-Meier assay was used to compare the difference in the allograft survival between the two groups in the functional renal allograft or the non-functional renal allograft.The correlativity of GFR level at the first year and the GFR level at the 5th year was

  12. Use of cystatin C-based estimations of glomerular filtration rate in patients with type 2 diabetes.

    Science.gov (United States)

    Chudleigh, R A; Ollerton, R L; Dunseath, G; Peter, R; Harvey, J N; Luzio, S; Owens, D R

    2009-07-01

    The Modification of Diet in Renal Disease (MDRD) equation has recognised limitations when using estimated GFR in persons at risk of chronic kidney disease. Equations based on cystatin C provide an alternative method. We compared performance of the MDRD equation with a selection of cystatin C-based formulae for estimation of GFR in normoalbuminuric patients with type 2 diabetes. Estimated GFR was calculated using the MDRD equation and the cystatin C formulae proposed by several investigator teams. Isotopic GFR was measured using plasma clearance of (51)Cr-EDTA. We studied 106 participants, of whom 83 (78%) were men with the following characteristics, mean (SD): age 61 (9) years, HbA(1c) 7.10 (1.27)%, creatinine 89.0 (12.7) micromol/l, cystatin C 0.859 (0.234) mg/l and isotopic GFR 104.5 (20.1) ml min(-1) 1.73 m(-2). MDRD estimated GFR was 77.4 (13.6) ml min(-1) 1.73 m(-2) (p < 0.05 for difference from isotopic GFR). Cystatin C-based calculations of estimated GFR were: Perkins 124.5 (31.8), Rule 90.0 (30.0), Stevens (age) 96.0 (30.4) and Stevens (creatinine) 85.6 (19.0) ml min(-1) 1.73 m(-2) (p < 0.05 for difference with isotopic GFR). For Arnal's, MacIsaac's and Tan's formulae cystatin-C estimated GFR were 101.7 (34.8), 102.1 (27.0) and 101.6 (27.8) ml min(-1) 1.73 m(-2), respectively (p = NS for difference with isotopic GFR). Cystatin C-based formulae were less biased and, with the exception of Perkins' formula, more accurate to within 10% of isotopic GFR than MDRD. Performance of cystatin C equations was superior to MDRD in normoalbuminuric patients with type 2 diabetes. These results support further evaluation of cystatin C for estimation of GFR in persons at risk of chronic kidney disease.

  13. Study on the relationship between the serum cystatin C and homocysteine level and glomerular filtration rate in diabetic nephropathy patients%胱抑素C及同型半胱氨酸的血清含量与糖尿病肾病患者肾小球滤过率的相关性研究

    Institute of Scientific and Technical Information of China (English)

    丁波; 张倩; 吴锦丹; 朱余兵; 马建华

    2012-01-01

    目的:通过检测血胱抑素C(Cystatin C,CysC)、同型半胱氨(Homocysteine,Hcy)浓度及尿白蛋白清除率(urine albumin excretion rate,UAER)在糖尿病肾病(diabetic nephropathy,DN)进程中的变化以及与肾小球滤过率(glomerular filtration rate,GFR)的相关性,探讨其在DN诊断中的价值.方法:共47例患者,根据肾小球滤过率将其分为早期糖尿病肾病组(early-DN组,GFR≥60 mL/min)及晚期糖尿病肾病组(end-DN组,GFR<60 mL/min),比较两组间CysC、Hcy的变化以及与肾小球滤过率的相关性.结果:end-DN组CysC、UAER均高于early-DN组(P<0.01).相关分析显示肾小球滤过率与CysC、Hcy、UAER负相关(r=-0.584,P=0.000;r=-0.547,P=0.000;r=-0.507,P=0.000),在慢性肾脏病(chronic kidney disease,CKD)Ⅱ、Ⅲ期,肾小球滤过率与CysC、Hcy负相关(r=-0.617,P=0.000;r=-0.431,P=0.018).结论:糖尿病患者中,伴随慢性肾脏病进程,CysC、Hcy、UAER逐渐升高,尤其在CKD Ⅱ、Ⅲ期,CysC、Hcy联合检测与UAER比较,能更好的反应糖尿病肾病肾小球滤过功能异常.%Objective To demonstrate the diagnostic value of serum cystatin C and homocysteine in diabetic nephropathy patients, and the relationship between the serum cystatin C and homocysteine level and glomerular filtration rate. Methods A total of 47 diabetic patients were divided into two groups based on GFR detection by using isotope 99mTc-DTPA renal dynamic imaging:early stage diabetic nephropathy group (n = 27, GFR ^ 60 mL/min) and end stage diabetic nephropathy group (n = 20, GFR < 60 mL/min). Serum cystatin C , homocysteine and urine albumin excretion rate were detected in all patients. Results The CysC and UAER in the end-DN group were higher than those in the early-DM group. The correlation analysis showed that GFR was negatively correlated with CysC, Hey and UAER (r= -0.584, P= 0.000; r = -0.547, P= 0.000; r = -0.507, P= 0.000), The correlation analysis were also performed in chronic kidney disease at stage II

  14. 血清Cystatin C浓度判定肾小球滤过率的临床意义%Clinical Significance of Serum Cystatin C Concentration for Glomerular Filtration Rate

    Institute of Scientific and Technical Information of China (English)

    邱冬; 张慧; 孙园园; 李亚辉; 李敏霞

    2015-01-01

    目的 探讨血清Cystatin C浓度在临床上判断肾功能早期损害的价值. 方法 对80例肾脏损伤的患者进行99m锝-二乙三胺五醋酸(99mTc-DTPA)清除率和血清Cystatin C浓度的测定,同时测定血清肌酐(Scr)、24小时肌酐清除率(24hCcr)和采用 Cockcroft -Gault 公式计算肌酐清除率(Ccockcroft),以99m锝 -二乙三胺五醋酸( 99m Tc-DTPA)清除率为标准方法,对结果进行相关分析. 结果 以上指标与血清Cystatin C均有相关关系,血清Cystatin C与99m Tc-DTPA清除率有高度相关性,并且血清Cystatin C在Scr正常时已经升高. 结论 Cystatin C浓度检测能够快速、准确和简捷的测定肾小球滤过率,能发现早期肾脏损害和肾功能改变.%Objective To discuss the clinical significance of serum Cystatin C concentration for glo-merular filtration rate(GFR). Method The concentration of Cystatin C, clearance of 99mTc-DTPA,se-rum creatinine(Scr) and 24h creatinine clearance(24hCcr) were evaluated in 80 patients with nephropa-thy. Creatinine clearance was also estimated by Cockcroft-Gault formula(Ccokcroft). The clearance of 99mTc-DTPA was standard. The correlation analysis was performed. Results Tc-GFR, Scr,24hCcr and Ccokcroft were all correlated with Cystatin C concentration significantly. The level of Cystatin C was higher than normal while Scr was normal. Conclusion Serum Cystatin C concentration determination is a rap-id,accurate and simple measurement of GFR and shows early damage clinically.

  15. 静脉肾盂造影未显影的肾脏行99Tcm-喷替酸盐肾动态显像检测GFR价值%Determination of glomerular filtration rate by 99Tcm-DTPA nephro-dynamic imaging in patients with nonvisualization in intravenous pyelography

    Institute of Scientific and Technical Information of China (English)

    孙志勇; 张秉鸿; 王庆旭; 黄之杰; 陈新敏; 孟宪; 陈建中

    2011-01-01

    目的 泌尿系疾病患者行常规的静脉肾盂造影(IVP)检查结果为肾不显影时,进一步行肾动态显像来定量测定肾小球滤过率(glomerular filtration rate,GFR)的意义.方法 将研究对象分为3组:IVP不显影组为76例(37例左肾,39例右肾),其IVP检查为单侧肾脏肾盏肾盂及输尿管不显影,正常对照组为57例肾移植供体,阳性对照组为12例肾功能不全尿毒症期患者,均采用锝-99m-喷替酸盐(99Tcm-DTPA)肾动态显像Gates法计算其GFR,并通过多个独立样本的非参数秩和检验进行统计分析.结果 IVP不显影组中,左肾GFR为:(18.73±9.33)ml/(min·1.73 m2),右肾GFR值为:(16.71±7.02)ml/(min·1.73 m2);正常对照组左肾GFR值为:(43.41±7.40)ml/(min·1.73 m2),右肾GFR值为:(45.37±8.07)ml/(min·1.73 m2);阳性对照组GFR值为:左肾GFR值为:(6.84±3.81)ml/(min·1.73 m2),右肾GFR值为:(7.08±4.75)ml/(min·1.73 m2);3组间存在显著性差异(P<0.01).结论 IVP检查结果为肾不显影时,仍然需要进一步行肾动态显像来定量其单侧GFR,这对临床治疗决策具有指导意义.%Objective To investigate the significance of detection of the glomerular filtration rate( GFR )by 99Tcm_ diethylenetriaminepentaacetic acid( DTPA ) nephro - dynamic imaging in patients with nonvisualization in routine intravenous pyelography( IVP ). Methods Subjects were classified into three groups: IVP - nonvisualization group including 76 patients with unilateral pelvicaliceal and ureteral nonvisualization, normal control group including 57 renal transplant donors, and positive control group including 12 uremic patients with renal inadequacy. GFR was measured by 99Tcm- DTPA nephro - dynamic imaging and statistically analyzed by multiple - independent - sample nonparametric rank test. Results The GFRs of left kidneys and right kidneys in IVP group were( 18.73±9.33 )and( 16.71±7.02 )ml/( min · 1.73 m2 ), respectively. In the normal control group those were ( 43.41±7

  16. Cystatin C, creatinine, estimated glomerular filtration, and long-term mortality in stroke patients.

    Science.gov (United States)

    Hojs Fabjan, Tanja; Penko, Meta; Hojs, Radovan

    2014-02-01

    Renal dysfunction is associated with mortality in patients after ischemic stroke. Cystatin C is a potentially superior marker of renal function compared to creatinine and estimated glomerular filtration rate (GFR). In our observational cohort study, 390 Caucasian patients suffered from acute ischemic stroke (mean age 70.9 years; 183 women and 207 men) were included and prospectively followed up to maximal 56 months. Serum creatinine and cystatin C were measured at admission to the hospital; GFR was estimated according to CKD-EPI creatinine and CKD-EPI creatinine/cystatin equations. According to values of serum creatinine, estimated GFR and serum cystatin C patients were divided into quintiles. In the follow-up period, 191 (49%) patients died. For serum cystatin C and estimated GFR based on creatinine and cystatin C, the mortality and the hazard ratios for long-term mortality increased from the first to the fifth quintile nearly linearly. The associations of serum creatinine and estimated GFR categories based on creatinine with long-term mortality were J-shaped. As compared with lowest quintile of serum cystatin C, the fifth quintile was associated with long-term mortality significantly also after multivariate adjustment (age, gender, initial stroke severity, known risk factors for stroke mortality). In contrast, in adjusted analysis serum creatinine and estimated GFR (CKD-EPI creatinine and CKD-EPI creatinine/cystatin) were not associated with long-term mortality. In summary, serum cystatin C was independently and better associated with the risk of long-term mortality in patients suffering from ischemic stroke than were creatinine and estimated GFR using both CKD-EPI equations.

  17. SUSPENSION-FEEDING IN MARINE SPONGES HALICHONDRIA-PANICEA AND HALICLONA-URCEOLUS - EFFECTS OF TEMPERATURE ON FILTRATION-RATE AND ENERGY-COST OF PUMPING

    DEFF Research Database (Denmark)

    Riisgård, H.U.; Thomassen, S.; Jakobsen, H.

    1993-01-01

    Filtration rate (measured as clearance of algal cells) was measured at different temperatures in the sponge Halichondria panicea. An increase in water temperature from 6 to 12-degrees-C caused the mean filtration rate to increase 4.3 +/- 2.3 times. This value was higher than previously found...... for other marine ciliary suspension-feeding animals. Filtration rate at 12-degrees-C was also measured in Haliclona urceolus by means of an indirect clearance method in addition to a direct technique for measuring pumping rate. It was found that the 2 sponge species had near-identical filtration rates......, with maximum rates of approximately 60 ml min-1 (g dry weight)-1 at 12-degrees-C. The normal pump pressure, or operating point O(p), of a standard sponge (based on our own measurements and calculations from literature data for a 0.1 g dry weight Haliclona sp.) was estimated as the sum of main contributions...

  18. 肾小球滤过功能检查的方法学进展%Advance in methodology on detecting the glomerular filtration rate

    Institute of Scientific and Technical Information of China (English)

    罗侃; 崔有宏; 韩平治

    2005-01-01

    肾小球滤过率(Glomerular filtration rate,GFR)和肾血浆清除率(Clearance)测定是两个在概念上既有联系但又有区别的临床试验。前者表示单位时间(s或min)内从双肾滤过的血浆毫升数,为测定总肾和分肾肾小球滤过功能的重要指标;后者系指双肾于单位时间内,能将若干毫升血浆中所含的某物质全部加以清除,它既可以用来测定肾小球滤过率,

  19. The clinical significance of glomerular filtration rate measured by 99Tcm-diethylentriamine pentaacetic acid renal dynamic imaging in renal cercinoma patients before surgeru%99Tcm-DTPA法肾小球滤过率在肾癌患者术前肾功能评价中的临床意义

    Institute of Scientific and Technical Information of China (English)

    邵小南; 王跃涛; 王小松; 陈海龙

    2011-01-01

    Objective To investigate the clinical significance of glomerular filtration rate(GFR)measured by 99Tcm-diethylenetriamine pentaacetic acid(99Tcm-DTPA)renal dynamic imaging in renal cell carcinoma(RCC)patients before surgery.Methods There were 99 cases of RCC patients,89 patients undergoing radical nephrectomy(RN)and 10 patients undergoing nephron-sparing surgery(NSS).99Tcm-DTPA renal dynamic imaging was performed for determining GFR before surgery.Make a comparison of GFR between RCC group and control group (normal kidney donors),RN group and NSS group.Make a comparison between GFR and serum creatinine in determining preoperative renal dysfunction of RCC patients.All of the data were analyzed by t-test and X2-text.Results Compared with contral group,total GFR of RCC patients was lower,but there was no significant difference[(76.4±20.4)ml/min vs.(80.6±17.4)ml/min,t=0.650,P>0.05)].Nineteen cases(19.2%)of RCC patients had preoperative renal dysfunction(total GFR133μmol/L).There was no significant difference in GFR of neoplastic kidneys between RN group and NSS group[(34.1±11.7)ml/min vs.(37.9±11.9)ml/min,t=0.975,P>0.05].GFR of contralateral kidneys was lower in NSS group than RN group[(32.7±10.3)ml/min vs.(39.6±10.1)ml/min,t=0.044,P0.05).19例(19.2%)RCC患者术前存在肾功能异常(双肾GFR133 μmol/L)者仅4例.RCC患者中,NSS组患侧肾脏GFR与RN组相比,差异无统计学意义[(34.1±11.7)ml/min vs.(37.9±11.9)ml/min,t=0.975,P>0.05],对侧肾脏GFR低于RN组[(32.7±10.3)ml/min vs.(39.6±10.1)ml/min,t=0.044,P<0.05],NSS组术前肾功能异常者比例明显高于RN组(50.0%vs.15.7%,X2=6.808,P<0.01 )结论 99Tcm-DTPA法测定的GFR能获得RCC患者术前双肾和分肾功能的准确信息,对RCC患者的治疗决策有重要意义.

  20. Risk Stratification by 24-Hour Ambulatory Blood Pressure and Estimated Glomerular Filtration Rate in 5322 Subjects From 11 Populations

    DEFF Research Database (Denmark)

    Boggia, José; Thijs, Lutgarde; Li, Yan;

    2013-01-01

    point, and stroke, ABP(24) added 0.35%, 1.17%, and 1.00% to the risk already explained by cohort, sex, age, body mass index, smoking and drinking, previous cardiovascular disease, diabetes mellitus, and antihypertensive drug treatment. Adding eGFR explained an additional 0.13%, 0.09%, and 0.......14%, respectively. Sensitivity analyses stratified for ethnicity, sex, and the presence of hypertension or chronic kidney disease (eGFR...

  1. Effect of Combination of Benazepril,Salvia Miltiorrhiza and Spironolactone on Glomerular Filtration Rate in Patients with Diabetic Nephropathy%贝那普利联合丹参、螺内酯对Ⅳ期糖尿病肾病患者肾功能影响

    Institute of Scientific and Technical Information of China (English)

    赵艳玲; 朱永林; 陈辉乐; 周志宏

    2011-01-01

    OBJECTIVE To illustrate the effect of combination of benazepril, spironolactone and Salvia miltiorrhiza on glomerular filtration rate in patients with diabetic nephropathy. METHODS Eighty patients with diabetic nephropathy were randomly divided into 4 groups: control group, group A(benazepril group), group B(benazepril + Salvia miltiorrhiza group),group C (benazepril+spironolactone+Salvia miltiorrhiza group). All patients were treated with hydrochlorothiazide(25 mg·d-1) orally for 4 weeks respectively. Renal histology was examined and blood pressure, plasma glucose, HbAlc, serum creatinine(Scr),urine protein and glomerular filtration rate(GFR) were measured respectively before and after treatment. RESULTS At the initial levels of blood pressure, urine protein, Scr and GFR did not show significant change in 4 groups. After 4 weeks, the levels of urine protein and Scr were much lower in group A, B and C(P<0.01) and the levels of GFR was significantly higher(P<0.05) than control group. The levels of blood pressure, urine protein and Scr were much lower and the level of GFR after treatment was higher in group B than group A. The levels of blood pressure, urine protein and Scr were decreased(P<0.01) and the levels of GFR was increased(P<0.05) compared to the levels before treatment in groups C. The levels of blood pressure, urine protein and Scr were much lower and the level of GFR after treatment was higher in group C than in group A(P<0.01). After the treatment,the levels of urine protein and Scr were much lower in group C than group B(P<0.05), and the levels of GFR were significantly higher(P<0.05). CONCLUSION Combination of benazepril, spironolactone and Salvia miltrirrhiza could enhance GFR,decrease urine protein and Scr in the patients with diabetic nephropathy and protect kidney function.%目的 探讨贝那普利联合丹参注射液、螺内酯对Ⅳ期糖尿病肾病患者肾功能影响.方法 Ⅳ期糖尿病肾病患者80例,随机分为4组,

  2. Patlak plot analysis CT-GFR for the determination of renal function: comparison of normal dogs with autologous kidney transplant dogs.

    Science.gov (United States)

    Alexander, K; Authier, S; del Castillo, J R E; Arora, V; Qi, S; Guillot, M; Beauchamp, G; Troncy, E

    2010-01-01

    Glomerular filtration rate (GFR) can be determined using Patlak plot analysis with single-slice dynamic computed tomography (CT). Acute autologous graft failure has several causes, all of which induce a measurable decrease in glomerular filtration rate. This study demonstrated in an experimental model of canine autologous renal transplant that CT-derived renal plasma clearance was significantly lower (p = 0.002) in dogs having undergone transplant (0.077 +/- 0.058 ml min(-1) ml renal tissue(-1)) compared with control dogs (0.396 +/- 0.139 ml min(-1) ml renal tissue(-1)). A significant negative curvilinear relationship was seen between serum creatinine and total renal plasma clearance (R(2) = 0.84, p = 0.0001). Alterations in renal time attenuation curve shape in dogs having undergone transplant may have been related to increased renal vascular resistance related to tubular necrosis. CT-GFR may be a useful experimental tool in the evaluation of renal dysfunction in transplant models.

  3. Determination of Glomerular Filtration Rate Using Micro-osmotic Pump in Conscious Rat%采用微渗透泵测定清醒大鼠肾小球滤过率

    Institute of Scientific and Technical Information of China (English)

    王静波; 王海涛; 汪照寒

    2011-01-01

    Objective Two non-radioactive methods for determining glomerular filtration rate ( GFR) in conscious rat using FITC-labeled inulin ( FITC-inulin) and micro-osmotic pumps were evaluated. Methods FITC-inulin (24% ) was dissolved in 0. 9% NaCl and the concentration decreased to 8% after 24 h of dialysis. Two micro-osmotic pumps filled with 200 |xL of 8% FITC-inulin were inserted into the peritoneal cavity of rats. After their complete recovery from anesthesia, the rats were housed individually in metabolic cages. Urine and the residual fluorescence remaining on the cages were collection over 24 h on day 7 after micro-osmotic pump implantation. Blood sample was collected through the saphenous vein at the end of 24-h urine collection. Only blood was sampled using the same method in another group. GFR was evaluated on day 7 after micro-osmotic pump implantation using two methods expressed in microliters per minute, microliters per minute per kilogram body weight and per gram kidney weight. Results Based on the approach measuringurinary inulin clearance with urine collection and without urine collection the estimated GFR was (2. 31 ±0. 33) microliters per minute and ( 2. 53 ± 0. 33) microliters per minute (P = 0. 564) , respectively. These values of GFR in conscious rats were only ca. 70% of that obtained in anesthetized rats determined in other previous studies. It was revealed that anesthesia may significantly influence GFR. Conclusions The results of the present study demonstrate the feasibility of the osmotic micropump approach to monitor GFR in conscious rat using FITC-inulin. Especially, the method without collecting urine is more convenient.%目的 分析以荧光素异硫氰酸酯标记的菊粉(FITC-菊粉)作为标记物,通过微渗透泵,在大鼠清醒状态下,采用菊粉尿排泄率方法测定肾小球滤过率的可行性.方法 将FITC -菊粉溶解在生理盐水中配成浓度为24%的溶液,经滤过后(浓度降至8%)装在微

  4. Association of estimated glomerular filtration rate with SYNTAX score in old patients with coronary heart disease%老年冠心病患者估计肾小球滤过率与SYNTAX积分的相关性

    Institute of Scientific and Technical Information of China (English)

    俞鑫; 孙宇姣; 齐国先

    2016-01-01

    Objective To explore the association between estimated glomerular filtration rate (eGFR) based on creatinine and cystatin C and the SYNTAX score in old patients with coronary heart disease. Methods Two hundred and fifty-six consecutive old patients with coronary heart disease were included in this study. The patients were angiographically diagnosed with coronary heart disease between January 2013 and April 2014 at the Department of Cardiology.eGFR was caculated by using BIS2 equation based on creatinine and cystatin C.SYNTAX score was caculated by SYNTAX score algorithm. Multiple linear regression and ordinal logsitic regreesion was used to analyze the association between eGFR and SYNTAX score. Results In patients with normal of renal function [eGFR≥90 ml/(min·1.73 m2), 110 patients], mild renal insufficiency [60 ml/(min · 1.73 m2) ≤ eGFR<90 ml/(min · 1.73 m2), 98 patients], midrange and severe renal insufficiency[eGFR<60 ml/(min · 1.73 m2), 48 patients], with the decrease in renal function of patients, SYNTAX score increased: (15.42 ± 9.65), (25.24 ± 8.34), (33.73 ± 10.15) scores, P<0.01. eGFR was an independent predictor of SYNTAX score (r=-0.059, P<0.01).eGFR was negatively correlated with SYNTAX score (r=-0.457, P<0.01). Conclusions eGFR is an independent predictor of SYNTAX score and negatively correlated with SYNTAX score in old patients with coronary heart disease. This might be helpful to explain the increased risk of coronary heart disease events and mortality in old patients with renal dysfunction.%目的:探讨在老年冠心病患者中由血清胱抑素C联合血肌酐计算的估计肾小球滤过率(eGFR)与SYNTAX积分的关系。方法连续选取行冠状动脉造影检查的老年冠心病患者256例,通过以血清肌酐和胱抑素C为基础的BIS-2方程计算eGFR,并计算SYNTAX积分。应用多元线性回归分析各临床资料与SYNTAX积分之间的关联,应用有序的Logistic回

  5. Effect of blood flow rate on internal filtration in a high-flux dialyzer with polysulfone membrane.

    Science.gov (United States)

    Sakiyama, Ryoichi; Ishimori, Isamu; Akiba, Takashi; Mineshima, Michio

    2012-09-01

    Internal filtration/backfiltration (IF/BF) of a dialyzer depends on several parameters. This study evaluated the effect of the blood flow rate (Q (B)) on the internal filtration flow rate (Q (IF)) measured using Doppler ultrasonography for a high-flux dialyzer with a polysulfone membrane, APS-15E. In an in vitro study, bovine blood was circulated through the dialyzer, at a Q (B) of 100-350 mL/min. The clearances (CL) of creatinine, β(2)-microglobulin, and α(1)-microglobulin were then investigated. Q (IF) increased with the Q (B) value. A good correlation was obtained between Q (IF) and the pressure difference between the pressures at the inlet of the blood compartment and the pressure at the outlet of the dialysate compartment. The creatinine CL values strongly depended on Q (B) because molecular diffusion was dominant. The β(2)-microglobulin CL also depended on Q (B), because its removal rate seemed to be affected by both diffusive and convective transport caused by the IF/BF. An extremely low CL value was obtained for α(1)-microglobulin because of its low diffusivity and membrane fouling induced by proteins plugging the membrane. In conclusion, the IF/BF in the dialyzer strongly depends on Q (B). Furthermore, the dependence of the solute clearance on Q (B) decreased with increasing molecular size of the solute because of the decrease in diffusivity through the membrane.

  6. Glomerular filtration rate and segmental tubular function in the early phase after transplantation/uninephrectomy in recipients and their living-related kidney donors

    DEFF Research Database (Denmark)

    Kamper, A L; Holstein-Rathlou, N H; Strandgaard, S;

    1994-01-01

    1. Glomerular filtration rate and sequential tubular function were investigated in 18 adult renal transplant recipients and in their matched, adult living-related kidney donors before and 5 days after transplantation/uninephrectomy. At day 54, 13 donors and 11 recipients were re......-investigated. Sixteen of these constituted eight matched pairs. This reduction in the study population was caused by the application of two withdrawal criteria. 2. In the recipients glomerular filtration rate was unchanged at day 5 and had increased to 61 ml/min at day 54 (P glomerular filtration....../min to 2.10 ml/min at day 54 (P glomerular filtration rate, lithium clearance, absolute and fractional proximal...

  7. Effects of anthracene on filtration rates, antioxidant defense system, and redox proteomics in the Mediterranean clam Ruditapes decussatus (Mollusca: Bivalvia).

    Science.gov (United States)

    Sellami, Badreddine; Khazri, Abdelhafidh; Louati, Héla; Dellali, Mohamed; Driss, Mouhamed Ridha; Aïssa, Patricia; Mahmoudi, Ezzeddine; Hamouda, Beyrem; Coelho, Ana Varela; Sheehan, David

    2015-07-01

    This study aimed at analyzing the impact of a toxic polyaromatic hydrocarbon (PAH), anthracene (ANT), on Ruditapes decussatus collected from a Tunisian coastal lagoon (Bizerte Lagoon). Filtration rates, several antioxidant enzymes--superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione reductase (GR), and glutathione transferase (GST)--as well as indices of protein oxidation status were determined in various tissues of this bivalve. Specimens were exposed to 100 μg/L of ANT for 2 days. ANT levels were evaluated using HPLC and were detected in the gill and digestive gland at different amounts. ANT exposure altered the behavior of bivalves by changing the siphon movement and decreasing filtration rate significantly. The enzymatic results indicated that ANT exposure affected the oxidative stress status of the gills of R. decussatus. In addition, modification of proteins was detected in the gills using redox proteomics after ANT treatment. Three protein spots were successfully identified by matrix-assisted laser desorption/ionization tandem time-of-flight mass spectrometry (MALDI-TOF-MS). These proteins can be roughly related to muscle contraction function. In contrast, no significant modification of enzymatic and protein responses was detected in the digestive gland after ANT treatment. These data demonstrate that combined behavioral and biochemical analyses are a powerful tool to provide valuable insights into possible mechanisms of toxicity of anthracene in R. decussatus. Additionally, the results highlight the potential of the gill as a valuable candidate for investigating PAH toxicity.

  8. Determination of glomerular filtration rate in patients with early diabetic nephropathy%早期糖尿病肾病患者肾小球滤过率测定

    Institute of Scientific and Technical Information of China (English)

    朱巧红

    2015-01-01

    Objective To investigate the effect of the determination of glomerular filtration rate in treatment of early diabetic nephropathy.Methods Patients with early diabetic nephropathy and normal in our hospital from January 2012 to January 2014 were selected as a medical study,and divided into an early diabetes group and a normal group,30 cases in each group.The glomerular filtration rate between the two groups were determined and compared. Results GFR average index in normal albuminuria group and microalbuminuria group was higher than that in normal group, and difference in the two group compared with the normal group was significant (P<0.05);A large number of albuminuria GFR index was lower than that in the normal group,with significant difference (P<0.05);With UAER,diabetic patients with elevated BUN,Cr,and only a large number of albuminuria group of patients with BUN,Cr significant difference compared with the normal group (P<0.05). Conclusion Using the determination of glomerular filtration rate for early check in diabetic patients,the result can accurately reflect the status of early diabetic nephropathy in patients with renal damage,so as to provide reference for clinical treatment,is worthy of clinical application.%目的:探讨肾小球滤过率测定对早期糖尿病肾病患者治疗的作用。方法选取2012年1月~2014年1月我院收治的早期糖尿病肾病患者以及在此期间来我院进行体检的正常人为研究对象。分为早期糖尿病组与正常组,每组各30例;同时对两组进行肾小球滤过率测定,比较两组的肾小球滤过率。结果正常白蛋白尿组、微量白蛋白尿组的GFR高于正常组平均指标,且两者与正常组相比差异有统计学意义(P<0.05);大量白蛋白尿组的GFR指标低于正常组,两者相比差异有统计学意义(P<0.05);随UAER的增多,糖尿病患者的BUN、Cr升高,且只有大量白蛋白尿组患者的BUN、Cr与正常组相比

  9. Estimating glomerular filtration rate in oncology patients receiving Cisplatin chemotherapy: Predicted creatinine clearance against 99mTc-DTPA methods

    Science.gov (United States)

    Khaidah Syed Sahab, Sharifah; Manap, Mahayuddin; Hamzah, Fadzilah

    2017-05-01

    The therapeutic potential of cisplatin as the best anticancer treatment for solid tumor is limited by its potential nephrotoxicity. This study analyses the incidence of cisplatin induced nephrotoxicity in oncology patients through GFR estimation using 99mTc-DTPA plasma sampling (reference method) and to compare with predicted creatinine clearance and Tc-99m renal scintigraphy. A prospective study of 33 oncology patients referred for GFR estimation in Penang Hospital. The incidence of cisplatin induced nephrotoxicity was analysed via radionuclide and creatinine based method. Of 33 samples, only 21 selected for the study. The dose of cisplatin given was 75 mg/m2 for each cycle. The mean difference of GFR pre and post chemotherapy (PSC 2) was 13.38 (-4.60, 31.36) ml/min/1.73m2 (p 0.136). Of 21 patients, 3 developed severe nephrotoxicity (GFR < 50ml/min/1.73 m2) contributing 14.3% of incidence. Bland-Altman plot showed only PSC 1 is in agreement with PSC 2 technique. Intraclass Correlation Coefficients (ICC) also showed that PSC 1 has high degree of reliability in comparison to PSC 2 (p < 0.001). The other methods do not show reliability and agreement in comparison to PSC 2 (p < 0.05). 3 of 21 patients (14.3%) developed severe nephrotoxicity post cisplatin chemotherapy. This percentage is much less than the reported 20 - 25% of cases from other studies, probably due to small sample size and biased study population due to strict exclusion criteria. Radionuclide method for evaluating GFR is the most sensitive method for the detection of cisplatin induced nephrotoxicity by showing 3 of 21 patients developing severe nephrotoxicity. PSC 1 was found to be a reliable substitute of PSC 2. The other methods are not reliable for detection of early nephrotoxicity. We will recommend the use of single plasma sampling method (PSC 1) for GFR estimation in monitoring post cisplatin chemotherapy patients.

  10. Diagnostic reference range of κ/λ free light chain ratio to screen for Bence Jones proteinuria is not significantly influenced by GFR.

    Science.gov (United States)

    Schmidt-Hieltjes, Yvonne; Elshof, Clemens; Roovers, Lian; Ruinemans-Koerts, Janneke

    2016-05-01

    The aim of our study was to analyse whether the κ/λ free light chain ratio reference range for screening for Bence Jones proteinuria should be dependent on the estimated glomerular filtration rate (eGFR). The serum κ/λ free light chain ratio, eGFR, serum M-protein and Bence Jones protein were measured in 544 patients for whom Bence Jones protein analysis was ordered. In the population of patients without Bence Jones proteinuria or a M-protein (n = 402), there is no gradual increase in κ/λ free light chain ratio with diminishing eGFR. The κ/λ free light chain ratio in this group was 0.56-1.86 (95% interval). With this diagnostic reference range of the κ/λ ratio, 105 of the 110 patients with Bence Jones protein could be identified correctly. Only five patients with Bence Jones proteinuria (proteinuria. A κ/λ free light chain ratio in serum can be used safely and efficiently to select urine samples which should be analysed for Bence Jones proteinuria with an electrophoresis/immunofixation technique. Using this diagnostic reference range, the number of urine samples which should be analysed by electrophoresis/immunofixation could be reduced by 74%. The diagnostic reference interval can be determined best in a group of patients for whom Bence Jones analysis is indicated. For calculation of this reference range, the eGFR value does not need to be taken into account. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. 代谢综合征与尿微量清蛋白及肾小球滤过率的相关性研究%Associations of Metabolic Syndrome with Urinary Albumin and Glomerular Filtration Rate

    Institute of Scientific and Technical Information of China (English)

    张燕华; 朱义革; 陈蕊华

    2012-01-01

    Objective To investigate the association of the metabolic syndrome with urinary albumin excretion and glomerular filtration rate. Methods From October 2008 to March 2010,452 subjects without diabetes mellitus, glomerular disease and medication intaking was enrolled in this study. (125 female,327 male,mean age was 52±1. 9 years and mean BMI was 23. 8 ±0. 8 kg/m2). Subjects was divided into metabolic syndrome group (n=58,mail/female=44/14) ,and control group (n= 394,mail/female=282/112) according to IDF (International Association of endocrine surgeons) standard. Data of smoking history,waistline,blood pressure,lipids,fasting glucose,serum creatinine,glomerular filtration rate (GFR) and urinary albumin was collect and analyzed. Results Urinary albumin excretion increased significantly ( P<0. 05) and glomerular filtration rate showed insignificant decrease (P<0. 05) in patients with metabolic syndrome. Of all the 5 metabolic syndrome components and other clinical characteristics, systolic blood pressure was the independent determinant for the urinary protein excretion and glomerular filtration rate(OR=l. 13,95% CI:1. 11 — 1. 15,P<0. 01). Conclusion Metabolic syndrome could be a clinical syndrome which is associated with vascular dysfunction. But it showed a negative relationship with glomerular filtration rate in the people without diabetes, glomerular disease and medication consumption.%目的 研究代谢综合征与尿微量清蛋白排泄量及肾小球滤过率的相关性.方法 2008年10月~2010年3月入组452例无糖尿病,无肾小球疾病及不服药的健康体检者(女性125例,男性327例,平均年龄52±1.9岁,平均体重指数23.8±0.8 kg/m2).根据IDF(国际内分泌协会)标准分为代谢综合征组和正常对照组.收集并比较研究对象的吸烟史、腰围、血压、血脂、空腹血糖、血肌酐和尿微量清蛋白情况.结果代谢综合征组的吸烟率、腰围、收缩压、三酰甘油、低密度脂蛋白、空腹

  12. The GFR and GFR decline cannot be accurately estimated in type 2 diabetics.

    Science.gov (United States)

    Gaspari, Flavio; Ruggenenti, Piero; Porrini, Esteban; Motterlini, Nicola; Cannata, Antonio; Carrara, Fabiola; Jiménez Sosa, Alejandro; Cella, Claudia; Ferrari, Silvia; Stucchi, Nadia; Parvanova, Aneliya; Iliev, Ilian; Trevisan, Roberto; Bossi, Antonio; Zaletel, Jelka; Remuzzi, Giuseppe

    2013-07-01

    There are no adequate studies that have formally tested the performance of different estimating formulas in patients with type 2 diabetes both with and without overt nephropathy. Here we evaluated the agreement between baseline GFRs, GFR changes at month 6, and long-term GFR decline measured by iohexol plasma clearance or estimated by 15 creatinine-based formulas in 600 type 2 diabetics followed for a median of 4.0 years. Ninety patients were hyperfiltering. The number of those identified by estimation formulas ranged from 0 to 24:58 were not identified by any formula. Baseline GFR was significantly underestimated and a 6-month GFR reduction was missed in hyperfiltering patients. Long-term GFR decline was also underestimated by all formulas in the whole study group and in hyper-, normo-, and hypofiltering patients considered separately. Five formulas generated positive slopes in hyperfiltering patients. Baseline concordance correlation coefficients and total deviation indexes ranged from 32.1% to 92.6% and from 0.21 to 0.53, respectively. Concordance correlation coefficients between estimated and measured long-term GFR decline ranged from -0.21 to 0.35. The agreement between estimated and measured values was also poor within each subgroup considered separately. Thus, our study questions the use of any estimation formula to identify hyperfiltering patients and monitor renal disease progression and response to treatment in type 2 diabetics without overt nephropathy.

  13. Age, estimated glomerular filtration rate and ejection fraction score predicts contrast-induced acute kidney injury in patients with diabetes and chronic kidney disease: insight from the TRACK-D study

    Institute of Scientific and Technical Information of China (English)

    Li Jing; Li Yi; Wang Xiaozeng; Yang Shuguang; Gao Chuanyu; Zhang Zheng; Yang Chengming

    2014-01-01

    Background The occurrence of contrast induced acute kidney injury (CIAKI) has a pronounced impact on morbidity and mortality.The aim of the present study was to appraise the diagnostic efficacy of age,estimated glomerular filtration rate (eGFR) and ejection fraction (AGEF) score (age/EF(%)+1 (if eGFR was <60 ml·min-1·1.73 m2)) as an predictor of CIAKI in patients with diabetes mellitus (DM) and concomitant chronic kidney disease (CKD).Methods The AGEF score was calculated for 2 998 patients with type 2 DM and concomitant CKD who had undergone coronary/peripheral arterial angiography.CIAKI was defined as an increase in sCr concentration of 0.5 mg/dl (44.2 mmol/L) or 25% above baseline at 72 hours after exposure to the contrast medium.Post hoc analysis was performed by stratifying the rate of CIAKI according to AGEF score tertiles.The diagnostic efficacy of the AGEF score for predicting CIAKI was evaluated with receiver operating characteristic (ROC) analysis.Results The AGEF score ranged from 0.49 to 3.09.The AGEF score tertiles were defined as follows:AGEFlow ≤0.92 (n=1 006); 0.92 <AGEFmid ≤1.16 (n=1 000),and ACEFhigh >1.16 (n=992).The incidence of CIAKI was significantly different in patients with low,middle and high AGEF scores (AGEFlow=1.1%,AGEFmid=2.3% and AGEFhigh=5.8%,P <0.001).By multivariate analysis,AGEF score was an independent predictor of CIAKI (odds ratio=4.96,95% CI:2.32-10.58,P <0.01).ROC analysis showed that the area under the curve was 0.70 (95% CI:0.648-0.753,P <0.001).Conclusion The AGEF score is effective for stratifying risk of CIAKI in patients with DM and CKD undergoing coronary/peripheral arterial angiography.

  14. Filtration Fundamentals.

    Science.gov (United States)

    Ward, Ken; Hunsaker, Scot

    1997-01-01

    Examines how choice of commercial swimming-pool filtration systems is driven by the project-specific needs of the pools. Also highlighted are definitions of specific terms used when discussing filtration systems. Questions that pool designers can answer to make filtration-system purchasing decisions are listed. (GR)

  15. A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension With Acute Kidney Injury.

    Science.gov (United States)

    James, Matthew T; Grams, Morgan E; Woodward, Mark; Elley, C Raina; Green, Jamie A; Wheeler, David C; de Jong, Paul; Gansevoort, Ron T; Levey, Andrew S; Warnock, David G; Sarnak, Mark J

    2015-10-01

    Diabetes mellitus and hypertension are risk factors for acute kidney injury (AKI). Whether estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (ACR) remain risk factors for AKI in the presence and absence of these conditions is uncertain. Meta-analysis of cohort studies. 8 general-population (1,285,045 participants) and 5 chronic kidney disease (CKD; 79,519 participants) cohorts. Cohorts participating in the CKD Prognosis Consortium. Diabetes and hypertension status, eGFR by the 2009 CKD Epidemiology Collaboration creatinine equation, urine ACR, and interactions. Hospitalization with AKI, using Cox proportional hazards models to estimate HRs of AKI and random-effects meta-analysis to pool results. During a mean follow-up of 4 years, there were 16,480 episodes of AKI in the general-population and 2,087 episodes in the CKD cohorts. Low eGFRs and high ACRs were associated with higher risks of AKI in individuals with or without diabetes and with or without hypertension. When compared to a common reference of eGFR of 80mL/min/1.73m(2) in nondiabetic patients, HRs for AKI were generally higher in diabetic patients at any level of eGFR. The same was true for diabetic patients at all levels of ACR compared with nondiabetic patients. The risk gradient for AKI with lower eGFRs was greater in those without diabetes than with diabetes, but similar with higher ACRs in those without versus with diabetes. Those with hypertension had a higher risk of AKI at eGFRs>60mL/min/1.73m(2) than those without hypertension. However, risk gradients for AKI with both lower eGFRs and higher ACRs were greater for those without than with hypertension. AKI identified by diagnostic code. Lower eGFRs and higher ACRs are associated with higher risks of AKI among individuals with or without either diabetes or hypertension. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  16. An orally active adenosine A1 receptor antagonist, FK838, increases renal excretion and maintains glomerular filtration rate in furosemide-resistant rats

    Science.gov (United States)

    Schnackenberg, Christine G; Merz, Emily; Brooks, David P

    2003-01-01

    Loop and thiazide diuretics are common therapeutic agents for the treatment of sodium retention and oedema. However, resistance to diuretics and decreases in renal function can develop during diuretic therapy. Adenosine causes renal vasoconstriction, sodium reabsorption, and participates in the tubuloglomerular feedback mechanism for the regulation of glomerular filtration rate.We tested the hypothesis that the selective adenosine A1 receptor antagonist FK838 is orally active and causes diuresis and natriuresis, but maintains glomerular filtration rate in normal rats or in rats with furosemide resistance.In normal male Sprague – Dawley rats, FK838 dose-dependently increased urine flow and sodium and chloride excretion while sparing potassium. In combination with furosemide, FK838 enhanced the diuretic and natriuretic actions of furosemide to the same extent as hydrochlorothiazide and did not increase the potassium loss in normal rats. In furosemide-resistant rats, FK838 increased urine flow and electrolyte excretion to a greater extent than hydrochlorothiazide. In addition, hydrochlorothiazide significantly decreased glomerular filtration rate, whereas FK838 maintained glomerular filtration rate in furosemide-resistant rats.This study shows that the adenosine A1 receptor antagonist FK838 is orally active and causes potent diuresis and natriuresis and maintains glomerular filtration rate in normal or furosemide-resistant rats. Adenosine A1 receptor antagonists may be novel therapeutics for the treatment of oedema in normal or otherwise diuretic-resistant patients. PMID:12922924

  17. Relationship between Estimated Glomerular Filtration Rate and Cardiovascular Mortality in a Japanese Cohort with Long-Term Follow-Up.

    Directory of Open Access Journals (Sweden)

    Kei Nagai

    Full Text Available Patients with renal impairment are at risk of not only end-stage kidney disease but also cardiovascular disease (CVD. The current definition of CKD stage G3a is eGFR 45-59 ml/min/1.73 m2 and of G3b is 30-44 ml/min/1.73 m2, and subjects in the CKD 3a category are considered to be at lower risk of mortality than are those in CKD 3b.We evaluated the outcome of 97,043 people (33,131 men and 63,912 women living in Ibaraki Prefecture who underwent annual community-based health checkups beginning in 1993 at age 40-80 years and who were followed for a mean of 17.1 years.The number of all-causes deaths was 20,534 (10,375 men and 10,159 women, of which 5,995 (2,695 men and 3,300 women were deaths due to CVD. Multivariable-adjusted hazard ratio for CVD death in the eGFR 45-49 ml/min/1.73 m2 category was significantly increased (1.82; 95% confidential interval, 1.23-2.69 in non-elderly men, whereas all-cause mortality and CVD mortality in elderly men with eGFR 45-49 ml/min/1.73m2 were non significant. In contrast, both in non-elderly women and in elderly women with eGFR 45-49 ml/min/1.73 m2 showed small, but significant, increases in the risks of all-cause mortality and CVD.We demonstrated proportionate increases in mortality with decreasing eGFR in a Japanese CKD population. Like patients in the CKD G3b subgroup, non-elderly men and women with an eGFR of 45-49 ml/min/1.73 m2 (i.e. a part of CKD G3a are at considerable risk of CVD mortality. Age dependent and eGFR dependent finer risk recognition were required for CVD prevention in clinical practice with regard to CKD patients.

  18. Genetic Modifiers of White Blood Cell Count, Albuminuria and Glomerular Filtration Rate in Children with Sickle Cell Anemia

    Science.gov (United States)

    Flanagan, Jonathan M.; Alvarez, Ofelia A.; Nelson, Stephen C.; Aygun, Banu; Nottage, Kerri A.; George, Alex; Roberts, Carla W.; Piccone, Connie M.; Howard, Thad A.; Davis, Barry R.; Ware, Russell E.

    2016-01-01

    Discovery and validation of genetic variants that influence disease severity in children with sickle cell anemia (SCA) could lead to early identification of high-risk patients, better screening strategies, and intervention with targeted and preventive therapy. We hypothesized that newly identified genetic risk factors for the general African American population could also impact laboratory biomarkers known to contribute to the clinical disease expression of SCA, including variants influencing the white blood cell count and the development of albuminuria and abnormal glomerular filtration rate. We first investigated candidate genetic polymorphisms in well-characterized SCA pediatric cohorts from three prospective NHLBI-supported clinical trials: HUSTLE, SWiTCH, and TWiTCH. We also performed whole exome sequencing to identify novel genetic variants, using both a discovery and a validation cohort. Among candidate genes, DARC rs2814778 polymorphism regulating Duffy antigen expression had a clear influence with significantly increased WBC and neutrophil counts, but did not affect the maximum tolerated dose of hydroxyurea therapy. The APOL1 G1 polymorphism, an identified risk factor for non-diabetic renal disease, was associated with albuminuria. Whole exome sequencing discovered several novel variants that maintained significance in the validation cohorts, including ZFHX4 polymorphisms affecting both the leukocyte and neutrophil counts, as well as AGGF1, CYP4B1, CUBN, TOR2A, PKD1L2, and CD163 variants affecting the glomerular filtration rate. The identification of robust, reliable, and reproducible genetic markers for disease severity in SCA remains elusive, but new genetic variants provide avenues for further validation and investigation. PMID:27711207

  19. The prognostic value of estimated glomerular filtration rate, amino-terminal portion of the pro-hormone B-type natriuretic peptide and parameters of cardiopulmonary exercise testing in patients with chronic heart failure

    Directory of Open Access Journals (Sweden)

    G.Aernout Somsen

    2012-06-01

    Full Text Available The aim of this study was to evaluate the prognostic value of renal function in relation to amino-terminal portion of the pro-hormone B-type natriuretic peptide (NT-proBNP and parameters of cardiopulmonary exercise testing in predicting mortality and morbidity in patients with moderate chronic heart failure (CHF. Sixty-one CHF patients were included in the study. Patients’ characteristics were: age 64.3±11.6 years; New York Heart Association class I/II/III: 14/37/10; left ventricular ejection fraction: 0.30±0.13 (%; NT-proBNP: 252.2±348.0 (ng/L; estimated creatinine clearance (e-CC: 73.6±31.4 (mL/min; estimated glomerular filtration rate (e-GFR: 66.1±24.6 (mL/min/1.73 m2; the highest O2 uptake during exercise (VO2-peak: 1.24±0.12 mL/kg/min; VO2/workload: 8.52±1.81 (mL/min/W]. During follow up (59.5±4.0 months there were 15 cardiac deaths and 16 patients were hospitalized due to progression of heart failure. NT-proBNP and VO2/workload were independently associated with cardiac death (P=0.007 and P=0.006, respectively. Hospitalization for progressive CHF was only associated with NT-proBNP (P=0.002. The combined cardiac events (cardiac death and hospitalization were associated with NT-proBNP and VO2/workload (P=0.007 and P=0.005, respectively. The addition of estimates of renal function (neither serum creatinine nor e-GFR did not improve the prognostic value for any of the models. In conclusion, in patients with moderate CHF, increased NT-proBNP and reduced VO2/workload identify those with increased mortality and morbidity, irrespective of estimates of renal function.

  20. The prognostic value of estimated glomerular filtration rate, amino-terminal portion of the pro-hormone B-type natriuretic peptide and parameters of cardiopulmonary exercise testing in patients with chronic heart failure.

    Science.gov (United States)

    Verberne, Hein J; van der Spank, Aukje; Bresser, Paul; Somsen, G Aernout

    2012-06-05

    The aim of this study was to evaluate the prognostic value of renal function in relation to amino-terminal portion of the pro-hormone B-type natriuretic peptide (NT-proBNP) and parameters of cardiopulmonary exercise testing in predicting mortality and morbidity in patients with moderate chronic heart failure (CHF). Sixty-one CHF patients were included in the study. Patients' characteristics were: age 64.3±11.6 years; New York Heart Association class I/II/III: 14/37/10; left ventricular ejection fraction: 0.30±0.13 (%); NT-proBNP: 252.2±348.0 (ng/L); estimated creatinine clearance (e-CC): 73.6±31.4 (mL/min); estimated glomerular filtration rate (e-GFR): 66.1±24.6 (mL/min/1.73 m(2)); the highest O2 uptake during exercise (VO(2-peak)): 1.24±0.12 mL/kg/min; VO(2)/workload: 8.52±1.81 (mL/min/W)]. During follow up (59.5±4.0 months) there were 15 cardiac deaths and 16 patients were hospitalized due to progression of heart failure. NT-proBNP and VO(2)/workload were independently associated with cardiac death (P=0.007 and P=0.006, respectively). Hospitalization for progressive CHF was only associated with NT-proBNP (P=0.002). The combined cardiac events (cardiac death and hospitalization) were associated with NT-proBNP and VO(2)/ workload (P=0.007 and P=0.005, respectively). The addition of estimates of renal function (neither serum creatinine nor e-GFR) did not improve the prognostic value for any of the models.In conclusion, in patients with moderate CHF, increased NT-proBNP and reduced VO(2)/ work-load identify those with increased mortality and morbidity, irrespective of estimates of renal function.

  1. Functional imaging of acute kidney injury at 3 Tesla. Investigating multiple parameters using DCE-MRI and a two-compartment filtration model

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, Frank G.; Zimmer, Fabian; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine; Klotz, Sarah; Hoeger, Simone [Heidelberg Univ., Mannheim (Germany). Dept. of Medicine V

    2015-05-01

    To investigate how MR-based parameters reflect functional changes in kidneys with acute kidney injury (AKI) using dynamic contrast enhanced MRI and a two-compartment renal filtration model. MRI data of eight male Lewis rats were analyzed retrospectively. Five animals were subjected to AKI, three native rats served as control. All animals underwent perfusion imaging by dynamic contrast-enhanced MRI. Renal blood volume, glomerular filtration rate (GFR) as well as plasma and tubular mean transit times were estimated from regions-of-interest drawn in the renal cortex. Differences between healthy kidneys and kidneys subjected to AKI were analyzed using a paired t-test. Significant differences between ischemic and healthy kidneys could only be detected for the glomerular filtration rate. For all other calculated parameters, differences were present, however not significant. In rats with AKI, average single kidney GFR was 0.66 ± 0.37 ml/min for contralateral and 0.26 ± 0.12 ml/ min for diseased kidneys (P = 0.0254). For the healthy control group, the average GFR was 0.39 ± 0.06 ml/min and 0.41 ± 0.11 ml/min, respectively. Differences between diseased kidneys of AKI rats and ipsilateral kidneys of the healthy control group were significant (P=0.0381). Significant differences of functional parameters reflecting damage of the renal tissue of kidneys with AKI compared to the contralateral, healthy kidneys could only be detected by GFR. GFR might be a useful parameter that allows for a spatially resolved detection of abnormal changes of renal tissue by AKI.

  2. Prognostic Significance of Left Ventricular Mass Index and Renal Function Decline Rate in Chronic Kidney Disease G3 and G4

    Science.gov (United States)

    Huang, Jiun-Chi; Chen, Szu-Chia; Tsai, Yi-Chun; Kuo, I-Ching; Chiu, Yi-Wen; Chang, Jer-Ming; Hwang, Shang-Jyh; Chen, Hung-Chun

    2017-01-01

    The effect of left ventricular mass index (LVMI) and estimated glomerular filtration rate (eGFR) decline rate on outcome prediction in patients with chronic kidney disease (CKD) remains unclear. We included 306 CKD G3 and G4 patients with LVMI assessed through echocardiography. Rapid decline in renal function was defined as the eGFR slope <−3 mL/min/1.73 m2/year. Patients were stratified into four groups using sex-specific median values of LVMI and rapid eGFR decline. The composite outcome was progression to maintenance dialysis or death. 32 patients had the composite outcome during a median follow-up of 2.7 years. In multivariate Cox analysis, compared with patients with non-rapid eGFR decline and lower LVMI, those with non-rapid eGFR decline and higher LVMI (hazard ratio [HR]: 5.908, 95% confidence interval [CI] = 1.304–26.780), rapid eGFR decline and lower LVMI (HR: 12.737, 95% CI = 2.297–70.636), and rapid eGFR decline and higher LVMI (HR: 15.249, 95% CI = 3.365–69.097) had an increased risk of progression to adverse outcomes. LVMI and eGFR decline synergistically effect the prognostic implications in CKD G3 and G4 patients. PMID:28195182

  3. Allometric equations for maximum filtration rate in blue mussels Mytilus edulis and importance of condition index

    DEFF Research Database (Denmark)

    Riisgård, Hans Ulrik; Larsen, Poul Scheel; Pleissner, Daniel

    2014-01-01

    rate (F, l h-1), W (g), and L (mm) as described by the equations: FW = aWb and FL = cLd, respectively. This is done by using available and new experimental laboratory data on M. edulis obtained by members of the same research team using different methods and controlled diets of cultivated algal cells...

  4. Comparative study on the determinations of glomerular filtration rate by Gates method using single and double detector%单探头法和双探头Gates法测定肾小球滤过率的比较研究

    Institute of Scientific and Technical Information of China (English)

    邵明哲; 麻广宇; 陈英茂; 徐白萱; 田嘉禾; 陈云爽; 孙雪峰

    2013-01-01

    目的:建立在Gates法基础上的双探头几何均数法使用测量体厚替代估算肾脏深度,理论上应能消除深度估算误差的影响。实验检验双探头几何均数用于Gates法测定GFR的实际可行性。方法:以76名健康者为研究对象,同时采用双血浆法(GFRdt)、Gates单探头法(GFRPOST)及双探头几何均数法(GFRGM)测定肾小球滤过率(GFR)。以GFRdt为参照标准,分析GFRPOST和GFRGM1与GFRdt的一致性。结果:①GFRPOST和GFRGM1与GFRdt的配对t检验均无显著性差异;②GFRPOST和GFRGM1与GFRdt的相关系数分别为0.802和0.722,其相关性GFRPOST高于GFRGM1;③GFRPOST和GFRGM1与GFRdt差值的均值±标准差为(-0.5±12.0)和(3.0±13.9)。结论:双探头几何均数法的准确性不及Gates单探头法,未能实现理论上消除肾脏深度估算误差的目的。%Objective:Glomerular filtration rate(GFR) is determined by the geometric mean method based on Gates method using dual detector with body thickness instead of kidney depth estimation for using single detector, which can eliminate the error of kidney depth estimation theoretically. The feasibility and accuracy of the geometric mean method were investigated by experiments in this study. Methods: Seventy six cases Community Health residents were selected as the research object. The GFRs(GFRdt, GFRPOST and GFRGM) were determined with two-sample method, Gates method using the post single detector and geometric mean method using double detectors respectively. The accuracy of GFRPOST and GFRGM was analysed and compared using GFRdt as the reference. Results:①Paired t test showed no significant differences between GFRPOST, GFRGM and GFRdt. ②Both GFRdt and GFRPOST changed with GFRdt in linear trend. The correlation coefficients were 0.802 and 0.722 for GFRdt and GFRPOST.③The differences between GFRPOST, GFRGM and GFRdt were-0.5±12.0, 3.0±13.9. Conclusion:The accuracy of the geometric mean method using double

  5. Individualizing pharmacotherapy in patients with renal impairment: the validity of the Modification of Diet in Renal Disease formula in specific patient populations with a glomerular filtration rate below 60 ml/min. A systematic review.

    Directory of Open Access Journals (Sweden)

    Willemijn L Eppenga

    Full Text Available The Modification of Diet in Renal Disease (MDRD formula is widely used in clinical practice to assess the correct drug dose. This formula is based on serum creatinine levels which might be influenced by chronic diseases itself or the effects of the chronic diseases. We conducted a systematic review to determine the validity of the MDRD formula in specific patient populations with renal impairment: elderly, hospitalized and obese patients, patients with cardiovascular disease, cancer, chronic respiratory diseases, diabetes mellitus, liver cirrhosis and human immunodeficiency virus.We searched for articles in Pubmed published from January 1999 through January 2014. Selection criteria were (1 patients with a glomerular filtration rate (GFR < 60 ml/min (/1.73 m2, (2 MDRD formula compared with a gold standard and (3 statistical analysis focused on bias, precision and/or accuracy. Data extraction was done by the first author and checked by a second author. A bias of 20% or less, a precision of 30% or less and an accuracy expressed as P30% of 80% or higher were indicators of the validity of the MDRD formula. In total we included 27 studies. The number of patients included ranged from 8 to 1831. The gold standard and measurement method used varied across the studies. For none of the specific patient populations the studies provided sufficient evidence of validity of the MDRD formula regarding the three parameters. For patients with diabetes mellitus and liver cirrhosis, hospitalized patients and elderly with moderate to severe renal impairment we concluded that the MDRD formula is not valid. Limitations of the review are the lack of considering the method of measuring serum creatinine levels and the type of gold standard used.In several specific patient populations with renal impairment the use of the MDRD formula is not valid or has uncertain validity.

  6. A comparison of estimated glomerular filtration rates using Cockcroft-Gault and the Chronic Kidney Disease Epidemiology Collaboration estimating equations in HIV infection

    DEFF Research Database (Denmark)

    Mocroft, A; Nielsen, Lene Ryom; Reiss, P

    2014-01-01

    The aim of this study was to determine whether the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI)- or Cockcroft-Gault (CG)-based estimated glomerular filtration rates (eGFRs) performs better in the cohort setting for predicting moderate/advanced chronic kidney disease (CKD) or end...

  7. Changes in glomerular filtration rate, lithium clearance and plasma protein clearances in the early phase after unilateral nephrectomy in living healthy renal transplant donors

    DEFF Research Database (Denmark)

    Strandgaard, S; Kamper, A; Skaarup, P;

    1988-01-01

    1. Glomerular and tubular function was studied before and 2 months after unilateral nephrectomy in 14 healthy kidney donors by measurement of the clearances of 51Cr-labelled ethylenediaminetetra-acetate, lithium, beta 2-microglobulin, albumin and immunoglobulin G. 2. The glomerular filtration rate...

  8. Influence of filtration and glucose amendment on bacterial growth rate at different tidal conditions in the Minho Estuary River (NW Portugal)

    DEFF Research Database (Denmark)

    Anne, I.; Fidalgo, M. L.; Thosthrup, L.

    2006-01-01

    Bacterioplankton abundance, biomass and growth rates were studied in the Minho Estuary River (NW Portugal). The influence of tidal conditions, glucose amendment, and the filtration process on total bacterial abundance, total and faecal coliforms, as well as faecal streptococci, were evaluated...

  9. Determining true glomerular filtration status in newly presenting type 2 diabetic subjects using age and sex adjustment.

    Science.gov (United States)

    Playle, R; Ollerton, R L; Dunstan, F D; Evans, W D; Burch, A; Luzio, S D; Owens, D R

    1998-11-01

    To determine age- and sex-adjusted reference ranges (ASARRs) for glomerular filtration status using data from nondiabetic subjects and to apply these to newly presenting type 2 diabetic subjects. Glomerular filtration rate corrected for body surface area (cGFR) was determined using a radionuclide (51Cr-EDTA) method in 75 non-diabetic subjects (37 men, 38 women) and 219 type 2 diabetic subjects (157 men, 62 women). The 95% constant reference ranges (CRRs) were calculated as mean nondiabetic cGFR+/-1.96 SD. The 95% ASARRs were calculated by Altman's method from the nondiabetic cGFR versus age regression residuals for both male and female subjects. Using Altman's method, the intercepts, but not the gradients, of the cGFR versus age regressions were significantly different between male and female subjects (intercept difference [95% CI] 8.2 [1.3-15.1], gradient difference -0.4 [-1.1 to 0.3]). Fitting a common gradient, 95% ASARRs for normofiltration were found to be from 123.9 - (0.89 X age) to 181.7 - (0.89 x age) for male subjects, and from 116.0 - (0.89 X age) to 173.2 - (0.89 X age) for female subjects. The 95% CRR for normofiltration was 70.2-138.1 ml x min(-1) x (1.73 m)(-2). When applied to the diabetic cGFRs, the CRRs and ASARRs gave, respectively, 17% (37/219) versus 21% (46/219) hyperfiltrators and 83% (181/219) versus 79% (172/219) normofiltrators. Using the ASARRs, 14 normofiltrators (6 men, 8 women) were reclassified as hyperfiltrators (change [n/total n] [95% CI] 8% [14/181] [4-12]), and 5 hyperfiltrators (5 men, 0 women) were reclassified as normofiltrators (change 14% [5/37] [5-30]). We conclude that age and sex adjustment are essential to assess glomerular filtration status.

  10. The value of radionuclide renal dynamic imaging to evaluate GFR in renal trans-plantation living donors%放射性核素显像法测定肾小球滤过率在活体移植肾供体中的作用

    Institute of Scientific and Technical Information of China (English)

    薛建军; 杨爱民

    2015-01-01

    肾小球滤过率(GFR)是评价肾功能的重要指标,有多种测定方法。菊粉清除率及放射性核素双血浆法是测定GFR的金标准。肾动态显像法测定GFR与菊粉清除率、放射性核素血浆标本法测定GFR等具有良好的相关性,被作为临床上测定GFR的金标准。99m Tc-DTPA放射性核素显像法可以测量分肾GFR ,具有简便、无创及准确等优点,在移植肾活体供体中发挥着重要作用。%Glomerular filtration rate (GFR) is an important index to reflect the renal function .GFR measurement using inulin clearance rate or radionuclide two-sample method ,is highly correlated with the results determined by radionuclide renal dynamic imaging .99m Tc-DTPA renal dynamic imaging method ,which is simple ,noninvasive and accurate ,can provide the split renal GFR ,and plays an important role in renal transplant living donors .

  11. Relationship between carotid intima-media thickness and glomerular filtration rate in type 2 diabetic patients%2型糖尿病患者颈动脉内中膜厚度与肾小球滤过率的相关性分析

    Institute of Scientific and Technical Information of China (English)

    贾艳坤; 韩丽萍; 谢云

    2012-01-01

    Objective To investigate the correlation between carotid intima-media thickness (cIMT) and glomerular filtration rate (GFR) in type 2 diabetic patients. Methods 143 patients whose age is above 45 years were selected and the patients' blood pressure should be controlled below 140/90 mmHg. The patients were divided into two groups: the normal group (cIMT<0. 9 mm) and the thick group (cIMT≥0. 9 mm) by the cut level of cIMT 0. 9 mm. The age. Duration. MAU frequency, GFR and biochemical indexes were compared between them. Results cIMT thick group's age, duration and MAU frequency were much higher than those of cIMT normal group, and the GFR of the thick group was much lower than that of the normal group (P<0. 05). No statistical difference was found in biochemical indexes such as fasting glucose and lipids between two groups. Multiple stepwise regression analysis showed cIMT had a positive correlation with age, duration, and had a negative correlation with eGFR Conclusions With the development of the atherosclerosis, GFR gradually decreases and contributes to the occurance and development of early-stage atherosclerosis.%目的 探讨T2DM患者颈动脉内中膜厚度(cIMT)与肾小球滤过率(GFR)的相关性.方法 随机选取年龄>45岁的血压控制在140/90 mmHg以下的T2DM患者143例,以cIMT 0.9mm为标准将其分为cIMT<0.9 mm(IMT正常组)和cIMT≥0.9mm( IMT增厚组),比较两组间年龄、病程、早期肾病( MAU)所占比例、GFR及各项生化指标的差异. 结果 IMT增厚组的年龄、糖尿病病程、MAU所占比例明显高于IMT正常组,而GFR则明显低于IMT正常组(P<0.05).多元逐步回归分析显示cIMT与年龄、糖尿病病程呈正相关,而与GFR呈负相关. 结论 随着动脉硬化的不断进展,GFR呈不断下降趋势且独立于传统的心血管危险因素参与早期动脉硬化的发生与发展.

  12. Correlation between tricuspid annular plane systolic excursion and glomerular filtration rate in patients with acute decompensated heart failure%急性失代偿型心力衰竭患者三尖瓣收缩期位移与肾小球滤过率的关系

    Institute of Scientific and Technical Information of China (English)

    李邵琳; 张菲斐

    2016-01-01

    目的:探讨急性失代偿型心力衰竭患者三尖瓣收缩期位移(TAPSE)变化及其与肾小球滤过率的关系。方法选取慢性收缩性心力衰竭急性失代偿入院患者102例,经胸超声心动图检测TASPE、左室射血分数(LVEF)及肺动脉收缩压(PASP),静脉采血测定B型氨基端利钠肽原(NT- proBNP)、电解质、血尿素氮(BUN)及血肌酐,采用改良的MDRD方程计算肾小球滤过率(eGFR),将eGFR0.05)。在肾功能不全组中肾小球滤过率分别与TASPE、NT- proBNP、PASP、LVEF进行相关性分析,显示只有TASPE与肾小球滤过率呈显著相关(=0.62,%Objective To explore the change of tricuspid annular plane systolic excursion (TAPSE) and its corre-lation with glomerular filtration rate (GFR) in patients with acute decompensated heart failure (ADHF). Methods One hundred and two consecutive patients with acute decompensated heart failure and left ventricular ejection fraction (LVEF) below 50% on echocardiogram were enrolled. The value of TASPE, LVEF and pulmonary arterial systolic pressure (PASP) were measured by the transthoracic echocardiography. Blood test was conducted to determine NT-proBNP, electrolytes, BUN and creatinine. The estimated GFR (eGFR) was calculated on the basis of simplified Modification of Diet in Renal Disease (MDRD). According to the eGFR, the patients were divided into preserved re-nal function (PRF) group [eGFR≥60 ml/(min·1.73m2), =54] and renal dysfunction (RDSF) group [eGFR﹤60 ml/(min·1.73m2), = 48]. The echocardiographic parameters and serum indexes were compared between the two groups. The correlations between TASPE and echocardiographic parameters, serum indexes in the RDSF group were analyzed. Results TASPE in the PRF group [(16.4 ± 4.0) mm] was significantly lower than that in the RDSF group [(18.9 ± 3.8) mm, ﹤ 0.001], but no significant difference in NT-proBNP, PASP or LVEF was observed between the two groups ( ﹥ 0

  13. A Comparison between Cystatin C and Serum Creatinine Assay in Assessment of Residual Glomerular Filtration Rate in Dialysis Patients%Cystatin C与血肌酐在估算透析患者残余肾功能中的比较研究

    Institute of Scientific and Technical Information of China (English)

    李辉; 陈红; 钟爱民

    2009-01-01

    目的 探讨Cystatin C在评估慢性肾功能衰竭透析患者残余肾功能(RRF)中的应用价值,寻找一种对透析患者较简便、精确的RRF估算指标.方法 收集95例透析患者(其中血液透析患者61例,腹膜透析患者34例)的血、尿标本分别测定血肌酐(Scr)和尿肌酐(Ucr)以及Cystatin C浓度,分析血清Cystatin C能否很好地估算透析患者的RRF,并且将它估算的RRF(eGFR1)同标准的RRF以及肾脏病膳食改良试验(MDRD)公式得出的RRF(eGFR2)进行比较.结果 所有透析患者Cystatin C和Scr浓度均伴随着RRF的降低而上升,但Cystatin C的上升幅度比Scr平稳.血液透析及腹膜透析患者Cystatin C、Scr与RRF均呈负相关(r=-0.53、r=-0.46,P<0.05;r=-0.71、r=-0.63,P<0.05).血液透析及腹膜透析患者分别基于Cystatin C和Scr测得eGFR与 RRF均呈正相关(r=0.69、r=0.63,P<0.05;r=0.74、r=0.58,P<0.05),且Cystatin C测得eGFR与 RRF的相关性更好.结论 Cystatin C估算透析患者RRF准确、简便,在24 h尿标本难于准确收集的情况下,Cystatin C比Scr更适合透析患者RRF的估算.%Objective To exlpore whether Cystatin C assay could be applied to assessing the residual glomerular filtration rate (RRF) in chronic renal failure dialysis patients.Methods Plasma and urine samples from 61 Hemodialysis and 34 peritoneal dialysis patients were subjected to assay of serum creatinine (Scr),urine creatinine (Ucr) and Cystatin C level respectively.A comparison was made between the RRF (eGFR1) derived from the assay of Cystatin C levels and the RRF (eGFR2) derived from the standard RRF or the Modification of Diet in Renal Disease(MDRD) calculation formula.Results Cystatin C and Scr levels rised in all the dialysis patients with RRF descending,but the rise of Cystatin C levels was milder than that of Scr.The levels of Cystatin C and Scr in both hemodialysis and peritoneal dialysis patients were negatively correlated with RRF(r=-0.53,r=-0.46,P<0.05;r=-0.71,r=-0.63,P<0

  14. Association of risk factors for cardiovascular disease and the rate of glomerular filtration: a cross-sectional study in the population from certain areas of Beijing%北京部分地区人群心血管疾病危险因素与慢性肾脏病的相关性分析

    Institute of Scientific and Technical Information of China (English)

    王凡; 叶平; 肖文凯; 骆雷鸣; 吴红梅

    2010-01-01

    Objective Data from several large prospective studies revealed that a low glomerular filtration rate was independently associated with cardiovascular disease (CVD) events and all-cause mortality in high-risk populations. Much on the association was explained by traditional CVD risk factors. However,findings from population-based studies were scarce and inconsistent. We explored the correlation between risks factors of cardiovascular and chronic kidney disease (CKD) in a general population from certain area of Beijing. Methods A population-based cross-sectional survey was conducted during Sep. 2007 to Oct. 2008 in Beijing. Out of 5100 individuals who were selected,4515 met the inclusion criteria and responded to the investigation. By face to face interview,a questionnaire was used to find out the risk factors of cardiovascular disease. Body height,body weight and blood pressures were measured. Serum creatinine and total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) were detected. Glomerular filtration rate through using the Modification of Diet in Renal Disease equation was estimated.Participants were grouped into three:≥90,60-89,<60[ml·min~(-1)·(1.73m~2)~(-1)] by eGFR. Univariate and multivariate logistic regression models were used to identify the associated risk factors. Results Exposure rate of cardiovascular disease risk factors increased along with the decrease of level of eGFR. Data from univariate logistic regression analyses suggested that age,smoking,history of hypertension and diabetes,BMI,SBP,LDL-C and TG were risk factors of CKD while results from multiple logistic regression indicated that age,smoking,hypertension,high level of TG appeared to be independent risk factors of CKD. Conclusion Exposure rate of cardiovascular disease risk factors increased along with the decrease of level of eGFR while age,hypertension,high level of TG and smoking were independent risk factors

  15. Using the developed cross-flow filtration chip for collecting blood plasma under high flow rate condition and applying the immunoglobulin E detection

    Science.gov (United States)

    Yeh, Chia-Hsien; Hung, Chia-Wei; Wu, Chun-Han; Lin, Yu-Cheng

    2014-09-01

    This paper presents a cross-flow filtration chip for separating blood cells (white blood cells, red blood cells, and platelets) and obtaining blood plasma from human blood. Our strategy is to flow the sample solution in parallel to the membrane, which can generate a parallel shear stress to remove the clogging microparticles on the membrane, so the pure sample solution is obtained in the reservoir. The cross-flow filtration chip includes a cross-flow layer, a Ni-Pd alloy micro-porous membrane, and a reservoir layer. The three layers are packaged in a polymethylmethacrylate (PMMA) frame to create the cross-flow filtration chip. Various dilutions of the blood sample (original, 2 × , 3 × , 5 × , and 10×), pore sizes with different diameters (1 µm, 2 µm, 4 µm, 7 µm, and 10 µm), and different flow rates (1 mL/min, 3 mL/min, 5 mL/min, 7 mL/min, and 10 mL/min) are tested to determine their effects on filtration percentage. The best filtration percentage is 96.2% when the dilution of the blood sample is 10 × , the diameter of pore size of a Ni-Pd alloy micro-porous membrane is 2 µm, and the flow rate is 10 mL/min. Finally, for the clinical tests of the immunoglobulin E (IgE) concentration, the cross-flow filtration chip is used to filter the blood of the allergy patients to obtain the blood plasma. This filtered blood plasma is compared with that obtained using the conventional centrifugation based on the enzyme-linked immunosorbent assay. The results reveal that these two blood separation methods have similar detection trends. The proposed filtration chip has the advantages of low cost, short filtration time, and easy operation and thus can be applied to the separation of microparticles, cells, bacteria, and blood.

  16. Estimating glomerular filtration rate using the new CKD-EPI equation and other equations in patients with autosomal dominant polycystic kidney disease

    DEFF Research Database (Denmark)

    Orskov, Bjarne; Strandgaard, Svend; Ørskov, Bjarne;

    2010-01-01

    (CKD-EPI) equation, the Cockcroft-Gault equation adjusted for body surface area and the MDRD equation with cystatin C. Performance was evaluated by mean bias, precision and accuracy. RESULTS: The MDRD equation with cystatin C had 97% of GFR estimates within 30% of measured GFR (accuracy). Both the CKD......-EPI and Cockcroft-Gault equations had an accuracy of 90% whereas the MDRD equation had an accuracy of 83%. This difference of accuracy was especially marked with GFR >60 ml/min/1.73 m(2). CONCLUSION: For estimating GFR in ADPKD patients the MDRD equation with cystatin C incorporated had the best performance...

  17. Effect of Late Revascularization of a Totally Occluded Coronary Artery After Myocardial Infarction on Mortality Rates in Patients with Renal Impairment

    Science.gov (United States)

    Hastings, Ramin; Hochman, Judith S.; Dzavik, Vladimir; Lamas, Gervasio A.; Forman, Sandra A.; Schiele, Francois; Michalis, Lampros K.; Nikas, Dimitris; Jaroch, Joanna; Reynolds, Harmony R.

    2012-01-01

    Renal dysfunction is an independent predictor of cardiovascular events and a negative prognostic indicator after myocardial infarction (MI). Randomized data comparing percutaneous coronary intervention (PCI) to medical therapy in MI patients with renal insufficiency are needed. The Occluded Artery Trial (OAT) compared optimal medical therapy alone to PCI with optimal medical therapy in 2201 high risk patients with an occluded infarct artery >24 hours post-MI with serum creatinine ≤2.5 mg/dl. The primary endpoint was a composite of death, MI, and class IV heart failure (HF). Analyses were carried out utilizing estimated glomerular filtration rates (eGFR) as a continuous variable and by eGFR categories. Long term follow up data (maximum 9 years) were used for this analysis. Lower eGFR (ml/min/1.73m2) was associated with development of the primary outcome (6-year life-table rate 16.9% in eGFR>90; 19.2% in eGFR 60–89; 34.9% in eGFR<60; p-value <0.0001), death, and class IV HF, with no difference in rates of reinfarction. On multivariable analysis, eGFR was an independent predictor of death and HF. There was no effect of treatment assignment on the primary endpoint regardless of eGFR, and there was no significant interaction between eGFR and treatment assignment on any outcome. In conclusion, lower eGFR at enrollment was independently associated with death and HF in OAT participants. Despite this increased risk, the lack of benefit from PCI in the overall trial was also seen in patients with renal dysfunction and persistent occlusion of the infarct artery in the subacute phase post MI. PMID:22728005

  18. Shortening filtrations

    Institute of Scientific and Technical Information of China (English)

    ENOCHS Edgar E.

    2012-01-01

    Let C be a set of modules.We argue that there is an ordinal κ such that if a module has a filtration by modules in C,then it has a filtration of length κ by direct sums of modules in C.As an application we give another way to prove a result of Saorín and (S)(t)oví(c)ek and of (S)(t)oví(c)ek.

  19. Conventional measurements of GFR using {sup 51}Cr-EDTA overestimate true renal clearance by 10 percent

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Amelia E.B.; Park-Holohan, So-Jin; Blake, Glen M.; Fogelman, Ignac [Department of Nuclear Medicine, Guy' s Hospital, St Thomas Street, London, SE1 9RT (United Kingdom)

    2003-01-01

    It is widely believed that measurement of the area under the plasma clearance curve (AUC) following a single intravenous injection of chromium-51 labelled ethylene diamine tetra-acetic acid ({sup 51}Cr-EDTA) is a gold standard method for determining glomerular filtration rate (GFR). However, there are reports that {sup 51}Cr-EDTA may have a significant extrarenal clearance. The aim of this study was to identify the non-renal component of {sup 51}Cr-EDTA plasma clearance contributing to the AUC measurement of GFR. Seventy healthy postmenopausal women (mean age 60 years, range 45-79 years) were injected with 3 MBq {sup 51}Cr-EDTA and 0.25 MBq iodine-125 labelled human serum albumin and 11 blood samples taken between 0 and 4 h through an indwelling venous cannula. For the first 21 subjects, two complete urine collections were made 0-2 h and 2-4 h after injection, and for the final 49 patients, four 1-h urine collections were made. The mean {sup 51}Cr-EDTA total plasma clearance was 84 ml/min (range 50-132 ml/min). The mean ratio (SEM) of urine to total clearance determined from the cumulative 1-, 2-, 3- and 4-h data was 0.903 (0.018), 0.891 (0.013), 0.898 (0.011) and 0.899 (0.010) respectively and remained constant despite the mean urine concentration decreasing from 122% to 15%/litre during this period. A least squares fit to data from the 238 individual urine collections was used to determine the fraction of the total plasma clearance attributable to renal clearance, {alpha}{sub 0}, and the residual urine volume, {delta}V. The results were {alpha}{sub 0}=0.910 (95% CI: 0.889-0.932) and {delta}V=14 ml (95% CI: -4 to +34 ml). The overestimation of the true renal clearance of {sup 51}Cr-EDTA by the AUC method is believed to be due to the failure of the plasma clearance curve to reach the true terminal exponential by 2 h after injection as usually assumed. As a result, conventional measurements of GFR using {sup 51}Cr-EDTA overestimate the true renal clearance of tracer

  20. Measurement of single-kidney glomerular filtration function from magnetic resonance perfusion renography

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Meiying; Cheng, Yingsheng [Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai 200233 (China); Zhao, Binghui, E-mail: binghuizhao@163.com [Department of Radiology, Shanghai Tenth People' s Hospital, Tongji University, Shanghai 200072 (China)

    2015-08-15

    Highlights: • MRPR monitors the transit of contrast material through nephron. • MRPR could reveal renal physiological characteristics in quality and quantity. • This review outlines the basics and future challenges of DCE MRPR. - Abstract: Glomerular filtration rate (GFR) describes the flow rate of filtered fluid through the kidney, and is considered to be the reference standard in the evaluation of renal function. There are many ways to test the GFR clinically, such as serum creatinine concentration, blood urea nitrogen and SPECT renography, however, they’re all not a good standard to evaluate the early damage of renal function. In recent years, the improvement of MRI hardware and software makes it possible to reveal physiological characteristics such as renal blood flow or GFR by dynamic contrast enhancement magnetic resonance perfusion renography (DEC MRPR). MRPR is a method used to monitor the transit of contrast material, typically a gadolinium chelate, through the renal cortex, the medulla, and the collecting system. This review outlines the basics of DCE MRPR included acquisition of dynamic MR perfusion imaging, calculation of the contrast concentration from signal intensity and compartment models, and some challenges of MRPR method faced in prospective clinical application.

  1. Filtration and clearance rates of Anadara grandis juveniles (Pelecypoda, Arcidae with different temperatures and suspended matter concentrations

    Directory of Open Access Journals (Sweden)

    Anselmo Miranda-Baeza

    2006-09-01

    Full Text Available The mangrove cockle Anadara grandis (Broderip and Sowerby, 1829 is a potential candidate for aquaculture and for bioremediation of aquaculture effluents in the tropical and subtropical coastal areas of the eastern Pacific Ocean. Laboratory-produced spat are available, but there is no information on their responses to the range of environmental conditions to which they might be subject during the growth cycle. The aim of this study was to evaluate the filtration and clearance rates of A. grandis spat (shell length 9.50±0.37 mm with a food concentration (7.5 mg∙l-1 at four different temperatures (22, 25, 28 and 31 ºC, with pH = 7.5±0.2 and O2 concentration of 6.4±0.5 mg·l-1; experiment one; and with a temperature (25 °C and five concentrations of suspended matter (from 7.5 to 29 mg·l-1 and pH and O2 values of 7.9±0.2 and 6.8± 0.4 mg·l-1; experiment two. Filtration and clearance rates were highest at 25 ºC and significantly different (p.05. In the second experiment filtration increased according to the amount of food available, but there were no significant differences (p>.05 between 7.5 and 11 mg·l-1 and from 22.4 to 29 mg·l-1. The trend was similar for clearance, and in this case significant differences were found (pLa almeja Anadara grandis (Broderip and Sowerby, 1829 es un candidato potencial para la acuicultura y la biorremediación de efluentes acuícolas en las áreas costeras tropicales y subtropicales del océano Pacífico oriental. Se dispone de semilla producida en laboratorio, sin embargo no hay información sobre sus respuestas a los intervalos de las condiciones ambientales a las cuales puede estar sujeta durante el periodo de crecimiento. El objetivo de este estudio fue evaluar las tasas de filtración y de clarificación de semilla de A. grandis (largo de la concha= 9.50±0.37 mm con una concentración de alimento (7.5 mg∙l-1 y cuatro diferentes temperaturas (22, 25, 28 y 31 °C con pH= 7.5±0.2, concentración de O

  2. Application value of the radionuclide renal dynamic imaging in measuring glomerular filtration rate in patients with cervical cancer chemotherapy%核素肾动态显像测定GFR在宫颈癌患者化疗中的应用价值

    Institute of Scientific and Technical Information of China (English)

    黄清霞; 李春英; 邹金海; 梁育飞; 张庆峰

    2012-01-01

    目的 探讨核素肾动态显像测定肾小球率过滤(GFR)在宫颈癌患者化疗中的应用价值.方法 选择我院2009年1月~2012年4月收治的宫颈癌患者233例,在化疗前及化疗3个周期后应用99锝-二乙三胺五乙酸(99Tcm-DTPA)进行肾动态显像,根据GFR、Tb、C1/2是否超出正常范围为标准,分为异常组70例及正常组163例,分别比较化疗前及化疗3个周期后两组核素肾动态显像结果.结果 异常组70例患者化疗3个周期后与化疗前比较GFR明显下降,差异有高度统计学意义(P < 0.01),肾动态显像主要特点表现为双肾血流灌注峰值下降,Tb及C1/2延长,差异有统计学意义(P < 0.05),而BUN、SCr等指标化疗前后变化均不明显,差异无统计学意义(P > 0.05).结论 99Tcm-DTPA肾动态显像可敏感的监测宫颈癌患者化疗后GFR及早期肾功能损伤.%Objective To investigate the application value of the radionuclide renal dynamic imaging in measuring glomeru-lar filtration rate (GFR) in patients with cervical cancer chemotherapy. Methods 233 patients with cervical cancer in our hospital from January 2009 to April 2012 were collected, 99Tcm-DTPA was used in radionuclide renal dynamic imaging before and 3 periods after chemotherapy. According to the value of GFR, Tb, C1/2, 233 cases were divided into 70 cases of abnormal group and 163 cases of normal group, nuclide renal dynamic imaging results were compared in the two groups before and 3 periods after chemotherapy. Results GFR of 70 cases in abnormal group before and 3 periods after chemotherapy were markedly reduced, the difference were statistically significant (P 0.05). Conclusion The application value of the radionuclide renal dynamic imaging with 99Tcm-DTPA in measuring glomerular filtration rate and early damage of kidney in patients with cervical cancer chemotherapy is sensitive.

  3. The clearance concept with special reference to determination of glomerular filtration rate in patients with fluid retention

    DEFF Research Database (Denmark)

    Henriksen, Ulrik L; Henriksen, Jens H

    2014-01-01

    In subjects without fluid retention, the total plasma clearance of a renal filtration indicator (inulin, (99m) Tc-DTPA, (51) Cr-EDTA) is close to the urinary plasma clearance. Conversely, in patients with fluid retention (oedema, pleural effusions, ascites), there is a substantial discrepancy...

  4. Clinical Commentary: How to Choose Blood Pressure Goals and Treatment: Influence of Estimated Glomerular Filtration Rate and Albuminuria

    Science.gov (United States)

    Weir, Matthew R.

    2008-01-01

    Objective measures of cardiovascular disease are often lacking until patients develop symptoms associated with either coronary, cerebral or peripheral vascular disease. Estimating risk for cardiovascular disease is often based on classic Framingham Heart Study criteria, such as age, gender, blood pressure, cholesterol, glucose levels and family history. Moreover, there is a well described continuous relationship between blood pressure, cholesterol, and glucose and risk for cardiovascular events. Estimating GFR, using simple formulae, and screening quantitatively for albuminuria may provide an important opportunity for identifying patients at increased risk for cardiovascular events. These safe, simple and cost-effective measures of estimating cardiovascular disease risk can be used not only to estimate cardiovascular disease burden, but also to gauge the adequacy of response to cardiovascular risk-reducing therapies. PMID:18596856

  5. 肾小球滤过率的标准化参数%The variables in normalizing glomerular filtration rate

    Institute of Scientific and Technical Information of C