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Sample records for flow glomerular filtration

  1. Captoril suppresses glomerular filtration rate but not blood flow in the affected kidney in renovascular hypertension

    International Nuclear Information System (INIS)

    Fommei, E.; Ghione, S.; Palla, L.; Giaconi, S.; Morraccini, P.; Palombo, C.; Rosa, C.; Gazzetti, P.; Donato, L.

    1985-01-01

    The acute effects of Captopril on glomerular filtration rate and blood flow of the kidney affected by unilateral renal artery stenosis in a patient with renovascular hypertension are reported. The contribution of the stenotic kidney to total glomerular filtration rate and blood flow was assessed by scintigraphic methods, using respectively the glomerular tracer 99m Tc-DTPA and 99m Tc-Albumin microspheres. Captopril induced a marked reduction of glomerular filtration without affecting blood flow. This finding indicates a profound dysruption of Angiotensin II - dependent autoregulation of the glomerular filtration induced by converting enzyme inhibition in renal artery stenosis

  2. Glomerular filtration rate

    Science.gov (United States)

    ... this 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 ...

  3. Assessment of glomerular filtration rate and effective renal plasma flow in cystic fibrosis

    International Nuclear Information System (INIS)

    Spino, M.; Chai, R.P.; Isles, A.F.; Balfe, J.W.; Brown, R.G.; Thiessen, J.J.; MacLeod, S.M.

    1985-01-01

    A study was conducted to examine renal function in 10 healthy control subjects and eight patients with cystic fibrosis in stable condition. Sequential bolus injections of /sup 99m/Tc-DTPA and 125 I-OIH were administered to assess glomerular filtration rate and effective renal plasma flow, respectively. Blood was subsequently collected for 3 hours, and urine for 24 hours. Renal clearances of both radioisotope markers were virtually identical in patients and controls. Inasmuch as neither glomerular filtration rate nor effective renal plasma flow was enhanced in patients with cystic fibrosis, increased clearance of drugs in these patients is unlikely to be the result of enhanced glomerular filtration or tubular secretion

  4. Determination of glomerular filtration rate and renal plasma flow with radioisotopes

    International Nuclear Information System (INIS)

    Duarte, C.G.; Elveback, L.R.; Liedtke, J.R.

    1983-01-01

    The concept of glomerular filtration and the clearance of inulin and creatinine as an index of renal function, advantages in the use of radioisotopes to measure glomerular filtration rate, and the clearance of /sup 125/I-iothalamate in (1) standard clearance and (2) subcutaneous short-clearance studies. The concept of renal plasma flow and clearance of para-aminohippurate, the use of radioisotopes for the measurement of renal plasma flow, and the clearance of /sup 131/I-Hippuran (iodohippurate sodium). Laboratory procedures for standard renal clearances with labeled iothalamate and Hippuran are given in detail, as is the short iothalamate clearance procedure

  5. Autoregulation of renal blood flow and glomerular filtration rate in the pregnant rabbit

    International Nuclear Information System (INIS)

    Woods, L.L.; Mizelle, H.L.; Hall, J.E.

    1987-01-01

    The authors purpose was to determine whether renal autoregulatory capability is retained in pregnancy despite the marked renal vasodilation that occurs at this time. Renal blood flow and glomerular filtration rate (GFR) were measured in anesthetized pregnant (22-27 days gestation) and nonpregnant rabbits during step reductions in renal perfusion pressure from control (100 +/- 3 mmHg) to 50 mmHg. Control renal blood flow and GFR were significantly higher in pregnant animals. Filtration fraction was also significantly elevated in pregnant animals. During step reductions in renal perfusion pressure, renal blood flow was well autoregulated down to ∼70 mmHg in both nonpregnant and pregnant animals. Likewise, GFR was also well autoregulated, falling by 10 +/- 2 and 8 +/- 3% in nonpregnant and pregnant animals, respectively, when perfusion pressure was reduced from 90 to 70 mmHg. These results suggest that renal autoregulation is preserved in pregnancy despite the fact that the renal circulation is already markedly vasodilated

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

    International Nuclear Information System (INIS)

    Lim, Sang Moo; Hong, Sung Woon; Kim, Young Hyun; Hong, Weon Seon; Song, Jae Kwan; Kim, Young Whan; Lee, Jhin Oh; Kang, Tae Woong

    1989-01-01

    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 99m Tc-DTPP and 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 2 with two hour hydration and diuresis method. GFR determined by the use of 99m Tc-DTPA had a good correlation with 24-hour creatinine clearance rate (r=0.77, p 99m Tc-DTPA and 131 I-OIH was a useful tool for the measurement of GFR and ERPF respectively.

  7. Enhancement of glomerular filtration rate and renal plasma flow by oral glucose load in well controlled insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Sandahl Christiansen, J; Christensen, C K; Hermansen, K

    1986-01-01

    Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured in 27 patients with uncomplicated insulin-dependent diabetes (IDDM) before and after an oral glucose load of 1.1 g glucose/kg body wt. In the 18 patients showing near-normoglycaemia (blood glucose less than or equal to 8 m...

  8. Simplified estimation of glomerular filtration rate and effective renal plasma flow

    International Nuclear Information System (INIS)

    Smart, R.; Trew, P.; Burke, J.; Lyons, N.

    1981-01-01

    A method is described for the determination of GFR and ERPF using a combined injection of 51 Cr-EDTA and 125 I-iodohippurate. Plasma samples obtained at 60 min and 150 min after administration were used to determine a flow rate F assuming a monoexponential clearance of the tracers. Empirical relationships were found between F and the true glomerular filtration rate and effective renal plasma flow determined from multiple sampling and multi-exponential analysis of the clearance curves. The method was shown to be superior to previously published methods involving one or two samples. GFR was calculated with a standard deviation (SD) of only 3.3 ml/min when compared to the multiple sample technique (the reference method), whereas the best estimate from a single sample had a SD of 6.3 ml/min. An improvement in accuracy of ERPF estimation was achieved for values of flow of less than 200 ml/min when the SD was only 9.3 ml/min. (orig./MG)

  9. Paradoxical glomerular filtration of carbon nanotubes.

    Science.gov (United States)

    Ruggiero, Alessandro; Villa, Carlos H; Bander, Evan; Rey, Diego A; Bergkvist, Magnus; Batt, Carl A; Manova-Todorova, Katia; Deen, William M; Scheinberg, David A; McDevitt, Michael R

    2010-07-06

    The molecular weight cutoff for glomerular filtration is thought to be 30-50 kDa. Here we report rapid and efficient filtration of molecules 10-20 times that mass and a model for the mechanism of this filtration. We conducted multimodal imaging studies in mice to investigate renal clearance of a single-walled carbon nanotube (SWCNT) construct covalently appended with ligands allowing simultaneous dynamic positron emission tomography, near-infrared fluorescence imaging, and microscopy. These SWCNTs have a length distribution ranging from 100 to 500 nm. The average length was determined to be 200-300 nm, which would yield a functionalized construct with a molecular weight of approximately 350-500 kDa. The construct was rapidly (t(1/2) approximately 6 min) renally cleared intact by glomerular filtration, with partial tubular reabsorption and transient translocation into the proximal tubular cell nuclei. Directional absorption was confirmed in vitro using polarized renal cells. Active secretion via transporters was not involved. Mathematical modeling of the rotational diffusivity showed the tendency of flow to orient SWCNTs of this size to allow clearance via the glomerular pores. Surprisingly, these results raise questions about the rules for renal filtration, given that these large molecules (with aspect ratios ranging from 100:1 to 500:1) were cleared similarly to small molecules. SWCNTs and other novel nanomaterials are being actively investigated for potential biomedical applications, and these observations-that high aspect ratio as well as large molecular size have an impact on glomerular filtration-will allow the design of novel nanoscale-based therapeutics with unusual pharmacologic characteristics.

  10. Measurement of glomerular filtration rate

    International Nuclear Information System (INIS)

    D'haene, E.G.M.

    1987-01-01

    Discussed are various methods for measuring the glomerular filtration rate in men. The unsuitability of the creatinine clearance is again emphasized. Based on comparative studies of Fawdry et al, it is stated that using the single-shot single sample methods by using theoretical distribution volumes is the obvious technique. In Dordrecht a program is developed based on the work of Tauxe et al on the analogy of the program for ERPF determination. Some patient studies are demonstrated. The GFR determination has some disadvantages however there are indications that by using the Captopril test the GFR determination is preferred above the ERPF measurement. 11 refs.; 6 figs.; 4 tabs

  11. Comparative aspects of glomerular filtration in vertebrates.

    Science.gov (United States)

    Yokota, S D; Benyajati, S; Dantzler, W H

    1985-01-01

    Glomerular ultrafiltration of the plasma is a fundamental component of vertebrate renal function. The importance of the glomerulus is reflected by its near-universal presence and great elaboration among the vertebrates. Although the general structural features and functional properties of the glomerulus appear to be largely similar among diverse groups, there exists considerable variation in the magnitude of the rate of filtration. The kidney is the primary vertebrate organ responsible for water and metabolic waste excretion, and glomerular filtration plays an important role in these functions. Therefore, the magnitude of the GFR appears to be influenced primarily by the rates of water influx and metabolism. Major phylogenetic differences in morphological, physiological and metabolic design have a decisive impact on the magnitude of the GFR. The endothermic classes, with more numerous glomeruli, high metabolic rates, and high ultrafiltration pressures, have proportionately higher rates of glomerular filtration than the ectothermic groups. As a group, the reptiles, with presumably the lowest rates of water influx, exhibit the lowest GFRs. Within each class, there are trends toward species with greater access to free water having higher GFRs (e.g. fresh water vs. marine; mesic vs. xeric. The clearest examples exist for the teleosts, with marine forms having lower GFRs than their fresh water relatives. The coupling of the GFR to environmental influences is also demonstrated by the response of the animal to environmentally imposed perturbations, such as dehydration. In terrestrial animals during dehydration, reductions in the rate of glomerular filtration occur reducing the rate of urinary water loss. And increases in GFR appears to be important in the rapid elimination of water loads in nonmammalian vertebrates. This short-term modulation of the GFR occurs by either changing glomerular plasma flow or glomerular capillary hydrostatic pressure, or both. In addition

  12. Enhancement of glomerular filtration rate and renal plasma flow by oral glucose load in well controlled insulin-dependent diabetics

    DEFF Research Database (Denmark)

    Sandahl Christiansen, J; Christensen, C K; Hermansen, K

    1986-01-01

    Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured in 27 patients with uncomplicated insulin-dependent diabetes (IDDM) before and after an oral glucose load of 1.1 g glucose/kg body wt. In the 18 patients showing near-normoglycaemia (blood glucose less than or equal to 8...... mmol/l) before the glucose challenge the increase in blood glucose from 4.2 +/- 1.7 to 15.2 +/- 2.3 mmol/l was accompanied by an enhancement of GFR from 128 +/- 15 to 132 +/- 14 ml/min X 1.73 m2 (2p = 0.030) and of RPF from 534 +/- 116 to 562 +/- 105 ml/min X 1.73 m2 (2p = 0.023). By contrast oral...... GFR response in patients with high initial GFR values (greater than or equal to 130 ml/min X 1.73 m2) as compared to patients with initial values below 130 ml/min X 1.73 m2. It is concluded that the induction of moderate hyperglycaemia in IDDM patients is followed by an enhancement of GFR and RPF...

  13. 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. © The Author(s) 2014.

  14. 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...

  15. Dynamics of intrarenal pressures and glomerular filtration rate after acetazolamide

    DEFF Research Database (Denmark)

    Leyssac, P P; Karlsen, F M; Skøtt, O

    1991-01-01

    The dynamics of intrarenal pressures, early distal tubular fluid conductivity (EDC), and renal flood flow (RBF) were studied in rats given acetazolamide (ACZ), an inhibitor of proximal reabsorption. Glomerular filtration rate (GFR) and end-proximal flow were estimated by clearances of 51Cr......-EDTA and lithium. Proximal tubular pressure (Pprox) increased initially by 1.7 +/- 0.1 mmHg after ACZ, causing a decrease in the hydrostatic pressure difference across the glomerular membrane (delta P). EDC increased, and then RBF, glomerular capillary pressure (Pgc), Pprox, and star vessel pressures (Psv) dropped...

  16. Determination of glomerular filtration rate with radionuclide ...

    African Journals Online (AJOL)

    Mulligan JS, Blue PW, Hasbargen JA. Methods for measuring GFR with technetium-99m-OTPA: an analysis of several common methods. J Nucl Med. 1990; 31: 1211-1219. 4. Jackson JH. Blue PW. Ghaed N. Glomerular filtration rate determined in conjunction with routine renal scanning. Radiology 1985; 154: 203-205. 5.

  17. Update on the glomerular filtration barrier.

    Science.gov (United States)

    Jarad, George; Miner, Jeffrey H

    2009-05-01

    The nephrology community lacks a unified view of protein sieving through the glomerular capillary wall. The glomerular capillary wall consists of three distinct but closely interacting layers: the fenestrated endothelium, with its glycocalyx; the podocytes, with their interdigitated foot processes and slit diaphragms; and the intervening glomerular basement membrane. Proteinuria is associated with abnormalities in any one layer, suggesting that each contributes to the glomerular filtration barrier (GFB). Proteinuria can also be induced in the context of a normal glomerular capillary wall. Here, we review some classic studies as well as some newer concepts and present competing hypotheses about the GFB. Two almost forgotten concepts have recently emerged. One group has challenged the exquisite selectivity of the GFB to albumin and suggested that proteinuria is the result of abnormal tubular uptake. There has also been a reemphasis on diffusion through the glomerular basement membrane as the driving force behind macromolecular filtration. New evidence suggests that the endothelial glycocalyx is an important charge-selective barrier. We suggest viewing the GFB as a dynamic rather than as a rigid barrier, requiring three healthy layers and a hemodynamic steady state. Multiple challenges to studying the endothelium, the tubular handling of albumin, and the role of hemodynamic forces will require new tools, new hypotheses, and open minds.

  18. Simplified method of radionuclide determination of glomerular filtration

    International Nuclear Information System (INIS)

    Butsev, Yu.A.

    1991-01-01

    Glomerular filtration is one of the chief components of renal function. The biochemical methods of its determination (clearance of insulin and endogeneous creatinine) have a number of shortcomings. The use of labelled glomerulotropic agents simplifies methods of the determination of glomerular filtration. A formula and a table of a glomerular filtration value per 1 kg of body mass were calculated

  19. The effect of penbutolol on glomerular filtration

    International Nuclear Information System (INIS)

    Meyer, B.H.; Muller, F.O.; Lotter, M.G.; Iturralde, M.P.; Grigoleit, H.-G.

    1981-01-01

    Penbutolol, a new β-adrenoceptor blocker, was found to increase the glomerular filtration rate (GFR) significantly (16%) relative to placebo when administered orally in a dose of 40 mg daily for 7 consecutive days to healthy males. Measurements were performed after the seventh dose. In contrast, a single acute intravenous dose of penbutolol 4 mg did not influence the GFR, which was determined by means of a gamma counter after intravenous injection of technetium-99m diethylenetriamine-penta-acetic acid. Since penbutolol possesses moderate β-adrenomimetic activity, it is postulated that the observed increase in the GFR after oral penbutolol could be due to increased cardiac output at rest

  20. METHODICAL BASES OF ESTIMATION GLOMERULAR FILTRATION RATE IN UROLOGICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    M. M. Batiushin

    2017-01-01

    Full Text Available The article presents a review of methodological issues of estimation of glomerular filtration rate in urologic practice. Author examine the current international and national recommendations, in particular by KDIGO, the recommendations of the scientific society of nephrologists of Russia, Association of urologists of Russia, the results of comparative analysis of different methods of assessing glomerular filtration rate. It is shown that the currently calculated methods of assessment of glomerular filtration rate have advantages over technique of clearance. The advantages and disadvantages of methods for calculating glomerular filtration rate by the formula of Cockcroft-Gault and MDRD. The author lists the pathological conditions in urological practice, in which there is a need to assess glomerular filtration rate, given nomograms and links to online calculators for quick and easy calculation of glomerular filtration rate.

  1. Diadenosine pentaphosphate modulates glomerular arteriolar tone and glomerular filtration rate.

    Science.gov (United States)

    Patzak, A; Carlström, M; Sendeski, M M; Lai, E Y; Liu, Z Z; Sällström, J; Flöge, J; Heintz, B; Jankowski, J; Jankowski, V

    2015-01-01

    Mechanisms and participating substances involved in the reduction of glomerular filtration (GFR) in contrast-induced acute kidney injury (CI-AKI) are still matter of debate. We hypothesized that diadenosine polyphosphates are released by the action of contrast media on tubular cells and may act on glomerular arterioles and reduce GFR. Freshly isolated rat tubules were treated with the contrast medium iodixanol (47 mg iodine per mL) at 37 °C for 20 min. The content of Apn A (n = 3-6) in the supernatant of treated tubules and in the plasma of healthy persons and patients with AKI was analysed using reversed-phase chromatography, affinity chromatography and mass spectrometry. GFR was obtained in conscious mice by inulin clearance. Concentration response curves for Apn A (n = 3-6, 10(-12) -10(-5)  mol L(-1) ) were measured in isolated perfused glomerular arterioles. Iodixanol treatment of tubules significantly increased the concentration of Apn A (n = 3-5) in the supernatant. Ap6 A was below the detection limit. AKI patient shows higher concentrations of Apn A compared to healthy. Application of Ap5 A significantly reduced the GFR in conscious mice. Ap5 A reduced afferent arteriolar diameters, but did not influence efferent arterioles. The constrictor effect on afferent arterioles was strong immediately after application, but weakened with time. Then, non-selective P2 inhibitor suramin blocked the Ap5 A-induced constriction. The data suggest that Ap5 A plays a role in the pathophysiology of CI-AKI. We show a contrast media-induced release of Ap5 A from tubules, which might increase afferent arteriolar resistance and reduce the GFR. © 2014 Scandinavian Physiological Society. Published by John Wiley & Sons Ltd.

  2. Glomerular Filtration Rate is Unchanged By Ultramarathon.

    Science.gov (United States)

    Wołyniec, Wojciech; Ratkowski, Wojciech; Kasprowicz, Katarzyna; Jastrzębski, Zbigniew; Małgorzewicz, Sylwia; Witek, Konrad; Grzywacz, Tomasz; Żmijewski, Piotr; Renke, Marcin

    2017-12-27

    Acute kidney injury (AKI) is reported as a common complication of marathon and ultramarathon running. In previous studies AKI was diagnosed on the basis of the creatinine level in serum and estimated glomerular filtration rate (eGFR). In the present study we calculated eGFR and also measured creatinine clearance after every 25 km of a 100 km run. 20 healthy, amateur runners (males, mean age 40.75 ± 7.15 years, mean weight 76.87 ± 8.39 kg) took part in a 100 km run on a track. Blood and urine were collected before the run, after every 25 km and 12 hours after the run. 17 runners completed the study. There was increase in creatinine, urea and uric acid observed after 100 km (p AKIN) criteria of AKI. The eGFR according to the MDRD (modification of diet in renal disease), CKD-EPI (chronic kidney disease epidemiology collaboration) and Cockcroft-Gault formulas was significantly decreased after the run (p < 0.05). Otherwise, creatinine clearance calculated from creatinine level in both serum and urine remained stable. In contrast to the majority of previous studies, we did not observe any decrease in the kidney function during an ultramarathon. In this study the creatinine clearance, which is the best routine laboratory method to determine glomerular filtration rate was used. There is no evidence that long running is harmful for kidney.

  3. Impairment in glomerular filtration rate or glomerular filtration barrier and occurrence of stroke.

    Science.gov (United States)

    Ovbiagele, Bruce

    2008-07-01

    Chronic kidney disease (CKD) is associated with substantial burden and is a strong risk factor for cardiovascular disease. However, data on the relationship between CKD and stroke are few and are limited by unreliable or inadequate assessment of renal function. To properly assess the relationship between renal insufficiency and stroke in stroke survivors in the United States by simultaneously examining the effect of guideline-recommended indices of renal disease that measure glomerular filtration rate (creatinine clearance) and glomerular filtration barrier (proteinuria). Cross sectional. Nationally representative survey of the United States. Participants aged 55 or older who participated in the National Health and Nutrition Examination Survey from 1999 to 2004. Indices of renal disease that measure glomerular filtration rate (creatinine clearance) and glomerular filtration barrier (microalbuminuria). Of 6382 adults who met inclusion criteria, 5624 (88%) had full and complete data, of which 414 (6%) reported having had a stroke. Stroke survivors were older and more likely to have CKD, diabetes, hypertension, coronary artery disease, elevated blood pressure, increased glycohemoglobin concentration, and lower hematocrit compared with respondents who did not report stroke. Multivariate models showed that microalbuminuria (odds ratio, 1.51; 95% confidence interval, 1.02-2.24), decreased glomerular filtration rate (odds ratio, 1.93; 95% confidence interval, 1.28-2.91), and stage 3 CKD (odds ratio, 2.09; 95% confidence interval, 1.38-3.16) were significantly associated with stroke. Stroke is independently associated with impairment in structure and function of the glomerulus, which supports the need to consider screening patients with stroke for CKD and to simultaneously assess for both indices of renal disease.

  4. Effects of high- and low-osmolar contrast media on renal plasma flow and glomerular filtration rate in euvolaemic and dehydrated rats

    International Nuclear Information System (INIS)

    Nygren, A.; Ulfendahl, H.R.; Akademiska Sjukhuset, Uppsala

    1989-01-01

    The effects of a slow intravenous injection of contrast media (CM) on renal function and haemodynamics were investigated in euvolaemic and dehydrated rats. Iodine-equivalent doses (1 600 mg I/kg body weight) of ioxithalamate, ioxaglate, iopamidol and iohexol were used. Glomerular filtration rate (GFR) and renal plasma flow (RPF) were assessed with clearance techniques. In euvolaemic rats no statistically significant decrease in GFR or RPF was found after CM injections. In the dehydrated rats the changes in GFR were more pronounced and this was significantly decreased in the ioxithalamate and iopamidol groups while RPF was still not decreased. This study indicates that dehydration potentiates adverse effects of CM on GFR and that there may be differences between the effects of low-osmolar and high-osmolar CM on GFR and also between different low-osmolar CM. (orig.)

  5. Important clinical and laboratory correlates of glomerular filtration ...

    African Journals Online (AJOL)

    Background: Renal impairment is routinely assessed using the estimated glomerular filtration rate (eGFR) and it may be helpful to obtain certain clinical or laboratory markers, which show relationship with glomerular filtration rate (GFR) in sickle cell disease (SCD). Aim: To assess the relationship between important clinical ...

  6. Impact of age on glomerular filtration estimates.

    Science.gov (United States)

    Douville, Pierre; Martel, Ariane R; Talbot, Jean; Desmeules, Simon; Langlois, Serge; Agharazii, Mohsen

    2009-01-01

    Glomerular filtration decreases progressively with age in adults. Predictive equation should have proper modelling to adequately account for normal senescence. Corrected 24-h creatinine clearances (CCLs) were measured in a cohort of 773 outpatients from 18 to 90 years old. Multiple linear regression was used to model the effect of age on glomerular filtration. Comparisons were made with the simplified MDRD and the MAYO equations. Impact of the derived equation was tested in a second cohort of 7551 patients with normal serum creatinine. While all equations show declining function with age, our results suggest that the GFR reduction is progressive after the age of 30 and continue to decline steadily after the age of 60. This leads to a convex curve in the multiple regression analysis that is best fitted by an equation including the quadratic term (age(2)). In contrast, the MDRD equation produces a faster decrease in early adulthood and a flatter curve after the age of 60 while the MAYO equation produces a more linear effect. MDRD results in the normal range are lower than those estimated by the MAYO equation. These equations, as applied on an independent cohort of 7551 normal outpatients from 18 to 102 years, produce different profile of evolution of GFR with age. Inclusion of a quadratic term for age in the formula estimating GFR results in better modelling of the natural decline of renal function associated with ageing. Furthermore, as GFR steadily declines after the age of 30, a single cut-off value of GFR normality for all ages leads to underdiagnosis of young adults and over diagnosis of elderly individuals. Guidelines should take into account the observed reduction of kidney function with age in normal population for optimal evaluation of eGFR.

  7. Normalisation of glomerular filtration rate measurements

    International Nuclear Information System (INIS)

    White, A.J.; Strydom, W.J.

    1991-01-01

    The result of a glomerular filtration rate (GFR) measurement on a particular patient is of limited use to the referring physician since normal GFR values vary widely with the patient's age and build, etc. To overcome this problem, it is usual to normalise the measured GFR by dividing it by the patient's surface area and multiplying the result by the surface area of a 'standard' man. This transforms the measurment onto a scale which applies to all patients, young and old, large and small, where normal values fall within a well-defined range and where the degree of renal impairment can be quantified. We have examined the generally accepted surface area (SA) and the less well-known extracellular volume (ECV) normalisation methods of GFR measurements in a series of 110 patients. The results show that both methods produce essentially the same result; however, ECV normalisation is theoretically more correct, can be found directly without the patient's ECV being measured and does not require the use of empirical formulae. Mathematical justification for ECV normalisation is presented, and a proposed distribution pattern for the normalised measurement is introduced. A simple mathematical model shows that accurate GFR measurements can be made in the presence of an enlarged ECV, but normalisation of these will produce misleading low values. (orig.)

  8. 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.

  9. Glomerular development--shaping the multi-cellular filtration unit.

    Science.gov (United States)

    Schell, C; Wanner, N; Huber, T B

    2014-12-01

    The glomerulus represents a highly structured filtration unit, composed of glomerular endothelial cells, mesangial cells, podocytes and parietal epithelial cells. During glomerulogenesis an intricate network of signaling pathways involving transcription factors, secreted factors and cell-cell communication is required to guarantee accurate evolvement of a functional, complex 3-dimensional glomerular architecture. Here, we want to provide an overview on the critical steps and relevant signaling cascades of glomerular development. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Molecular make-up of the glomerular filtration barrier.

    Science.gov (United States)

    Patrakka, Jaakko; Tryggvason, Karl

    2010-05-21

    The glomerular filtration barrier is composed of glomerular endothelial cells, the glomerulus basement membrane and the podocyte cell layer. The filtration barrier is a target of injury in several systemic and renal diseases, and this often leads to progressive renal disease and kidney failure. Therefore, it is essential to understand the molecular biology of the glomerulus. During the last two decades, a lot of new information about molecular components of the glomerulus filtration barrier has been generated. Many of the key discoveries have been obtained through studies on the genetic background of inherited glomerular diseases. These studies have emphasized the role of podocytes in the filtration barrier function. During the last decade, the use of knockout mouse technology has become more available and given important new insights into the functional significance of glomerular components. Large-scale approaches, such as microarray profiling, have also given data about molecules involved in the biology and pathology of the glomerulus. In the coming decade, the use of global expression profiling platforms, transgenic mouse lines, and other in vivo gene delivery methods will rapidly expand our understanding of biology and pathology of the glomerular filtration barrier, and hopefully expose novel target molecules for therapy in progressive renal diseases. 2010 Elsevier Inc. All rights reserved.

  11. Optical, real-time monitoring of the glomerular filtration rate

    Science.gov (United States)

    Rabito, Carlos A.; Chen, Yang; Schomacker, Kevin T.; Modell, Mark D.

    2005-10-01

    An easy and accurate assessment of the renal function is a critical requirement for detecting the initial functional decline of the kidney induced by acute or chronic renal disease. A method for measuring the glomerular filtration rate is developed with the accuracy of clearance techniques and the convenience of plasma creatinine. The renal function is measured in rats as the rate of clearance determined from time-resolved transcutaneous fluorescence measurements of a new fluorescent glomerular filtration agent. The agent has a large dose-safety coefficient and the same space distribution and clearance characteristics as iothalamate. This new approach is a convenient and accurate way to perform real-time measurements of the glomerular filtration rate to detect early kidney disease before the renal function becomes severely and irreversibly compromised.

  12. Glomerular filtration rate determined in conjunction with routine renal scanning

    International Nuclear Information System (INIS)

    Jackson, J.H.; Blue, P.W.; Ghaed, N.

    1985-01-01

    A method has been developed to estimate glomerular filtration rate using computer evaluation of images obtained during routine renal scanning. The technique requires less than 40 minutes of imaging time, requires only a single blood sample and correlates highly with 24 hour creatinine clearance

  13. 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...

  14. Estimated Glomerular Filtration Rate and Risk of Survival in Acute ...

    African Journals Online (AJOL)

    Objective: To assess the risk of survival in acute stroke using the MDRD equation derived estimated glomerular filtration rate. Design: A prospective observational cross-sectional study. Setting: Medical wards of a tertiary care hospital. Subjects: Eighty three acute stroke patients had GFR calculated within 48 hours of ...

  15. Estimated glomerular filtration rate at initiation of hemodialysis in a ...

    African Journals Online (AJOL)

    Background: Renal replacement therapy is indicated for patients with end-stage renal disease (ESRD). The glomerular filtration rate (GFR) of ESRD patients at initiation of hemodialysis vary depending on several factors including comorbidities, physicians' practice and geographical region amongst others. Aim: We ...

  16. Glomerular filtration rate in steady state children with sickle cell ...

    African Journals Online (AJOL)

    Background: Sickle cell anaemia (SCA) affects mostly people of African origin. It causes kidney problems termed Sickle cell nephropathy (SCN). Increased glomerular filtration rate (GFR) has been documented as one of the functional abnormalities seen in young SCA patients. Objective: To estimate GFR in Nigerian ...

  17. Effect of glycaemic control on glomerular filtration rate in Diabetes ...

    African Journals Online (AJOL)

    Background: Glomerular filtration rate (GFR) is a widely accepted parameter in assessing overall renal function. This study sought to assess the effect of glucose lowering on GFR in diabetic patients admitted for short term therapy at Mulago hospital. Methods: This was a descriptive study where consenting patients were ...

  18. Important clinical and laboratory correlates of glomerular filtration ...

    African Journals Online (AJOL)

    2015-02-03

    Feb 3, 2015 ... associated with laboratory indicators of hemolysis in this group of patients.[6] Progression of sickle nephropathy can. Important clinical and laboratory correlates of glomerular filtration rate in sickle cell anemia. AJ Madu, A Ubesie1, S Ocheni, J Chinawa1, KA Madu2, OG Ibegbulam, C Nlemadim3, A Eze3.

  19. Glomerular basement membrane composition and the filtration barrier.

    Science.gov (United States)

    Miner, Jeffrey H

    2011-09-01

    The glomerular basement membrane (GBM) is an especially thick basement membrane that contributes importantly to the kidney's filtration barrier. The GBM derives from the fusion of separate podocyte and endothelial cell basement membranes during glomerulogenesis and consists primarily of laminin-521 (α5β2γ1), collagen α3α4α5(IV), nidogens-1 and -2, and agrin. Of these nine proteins, mutations in the genes encoding four of them (LAMB2, COL4A3, COL4A4, and COL4A5) cause glomerular disease in humans as well as in mice. Furthermore, mutation of a fifth (Lama5) gene in podocytes in mice causes proteinuria, nephrotic syndrome, and progression to renal failure. These results highlight the importance of the GBM for establishing and maintaining a properly functioning glomerular filtration barrier.

  20. Vibroacustic microvibrations enhance kidney blood supply, glomerular filtration and glutathione peroxidase activity in spontaneously hypertensive rats.

    Science.gov (United States)

    Miloradović, Zoran; Mihailović-Stanojević, Nevena; Jovović, Đurđica; Ivanov, Milan; Vajić, Una J; Karanović, Danijela; Grujić Milanović, Jelica

    2015-01-01

    Limited numbers of studies include research of microvibration therapy in experimental models. We examined effects of chronic vibroacustic-microvibration treatment on haemodynamics and anti-oxidative defense in experimental hypertension. Study was performed on chronically treated hypertensive and normotensive Wistar rats. Mean arterial pressure (MAP), cardiac output (CO), renal blood flow (RBF), glomerular filtration and activity of anti-oxidative enzymes were determined after three weeks treatment. Vibroacustic treatment had no influence on MAP and CO, but RBF was increased in both groups of treated rats. Additionally, vibroacustic treatment enhanced diuresis and increased glomerular filtration in hypertensive rats. Glutathione peroxidase (GSH-Px) activity was elevated in both treated rat strains, but activity of superoxide dismutase was unchanged. We conclude that microvibration treatment doesn't ameliorate hypertension but improves renal blood supply (trough diminished renal vascular resistance), glomerular filtration, diuresis, and enhances glutathione dependent anti-oxidant defense with more important beneficials in hypertensive animals.

  1. 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

  2. Glomerular filtration into the subpodocyte space is highly restricted under physiological perfusion conditions.

    Science.gov (United States)

    Neal, Christopher R; Muston, P Robert; Njegovan, David; Verrill, Rebecca; Harper, Steven J; Deen, William M; Bates, David O

    2007-12-01

    Production of urine is initiated by fluid and solute flux across the glomerular filtration barrier. Recent ultrastructural studies have shown that under extreme conditions of no filtration, or very high filtration, a restriction to flow is predicted in a space underneath the podocyte cell body or its processes, the subpodocyte space (SPS). The SPS covered up to two-thirds of the glomerular filtration barrier (GFB) surface. The magnitude of this restriction to flow suggested that it might be unlikely that filtration into and flow through the SPS would contribute significantly to total flow across the entire GFB under these conditions. To determine whether the SPS has similar properties under normal physiological conditions, we have carried out further three-dimensional reconstruction of rat glomeruli perfused at physiologically normal hydrostatic and colloid osmotic pressures. These reconstructions show that the sub-podocyte space is even more restricted under these conditions, with a mean height of the SPS of 0.34 microm, mean pathlength of 6.7 +/- 1.4 mum, a mean width of the SPS exit pore of 0.15 +/- 0.05 microm, and length of 0.25 +/- 0.05 microm. Mathematical modeling of this SPS based on a circular flow model predicts that the resistance of these dimensions is 2.47 times that of the glomerular filtration barrier and exquisitely sensitive to changes in the dimensions of the SPS exit pore (SEP), indicating that the SEP could be the principal regulator of the extravascular pressure in the SPS. This suggests a physiological role of the podocyte in the regulation of glomerular fluid flux across most of the GFB.

  3. Mechanical challenges to the glomerular filtration barrier: adaptations and pathway to sclerosis.

    Science.gov (United States)

    Kriz, Wilhelm; Lemley, Kevin V

    2017-03-01

    Podocytes are lost as viable cells by detachment from the glomerular basement membrane (GBM), possibly due to factors such as pressure and filtrate flow. Distension of glomerular capillaries in response to increased pressure is limited by the elastic resistance of the GBM. The endothelium and podocytes adapt to changes in GBM area. The slit diaphragm (SD) seems to adjust by shuttling SD components between the SD and the adjacent foot processes (FPs), resulting in changes in SD area that parallel those in perfusion pressure.Filtrate flow tends to drag podocytes towards the urinary orifice by shear forces, which are highest within the filtration slits. The SD represents an atypical adherens junction, mechanically interconnecting the cytoskeleton of opposing FPs and tending to balance the shear forces.If under pathological conditions, increased filtrate flows locally overtax the attachment of FPs, the SDs are replaced by occluding junctions that seal the slits and the attachment of podocytes to the GBM is reinforced by FP effacement. Failure of these temporary adaptive mechanisms results in a steady process of podocyte detachment due to uncontrolled filtrate flows through bare areas of the GBM and, subsequently, the labyrinthine subpodocyte spaces, presenting as pseudocysts. In our view, shear stress due to filtrate flow-not capillary hydrostatic pressure-is the major challenge to the attachment of podocytes to the GBM.

  4. A simple method for the estimation of glomerular filtration rate

    International Nuclear Information System (INIS)

    Groth, T.; Tengstroem, B.

    1977-01-01

    A simple method is presented for indirect estimation of the glomerular filtration rate from two venous blood samples, drawn after a single injection of a small dose of [ 125 I]sodium iothalamate (10 μCi). The method does not require exact dosage, as the first sample, taken after a few minutes (t=5 min) after injection, is used to normilize the value of the second sample, which should be taken in between 2-4 h after injection. The glomerular filtration rate, as measured by standard inulin clearance, may then be predicted from the logarithm of the normalized value and linear regression formulas with a standard error of estimate of the order of 1-2 ml/min/1.73 m 2 . The slope-intercept method for direct estimation of glomerular filtration rate is also evaluated and found to significantly underestimate standard insulin clearance. The normalized 'single-point' method is concluded to be superior to the slope-intercept method and more sophisticated methods using curve fitting technique, with regard to predictive force and clinical applicability. (Auth.)

  5. 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...... of the afferent vasoconstriction for the reduced GFR was tested by addition of a vasodilator during continuous infusion of ACZ. Dopamine caused an increase in renal blood flow (RBF) to pre-ACZ levels. Glomerular capillary pressure (Pgc) and proximal tubular pressure (Pprox) increased in parallel (by 3.1 and 3...

  6. Cross-flow filtration and axial filtration

    International Nuclear Information System (INIS)

    Kraus, K.A.

    1974-01-01

    Two relatively novel alternative solid-liquid-separation techniques of filtration are discussed. In cross-flow filtration, the feed is pumped past the filtering surface. While in axial filtration the filter, mounted on a rotor, is moved with respect to the feed. While large-scale application of the axial filter is still in doubt, it permits with little expenditure of time and money, duplication of many hydrodynamic aspects of cross-flow filtration for fine-particle handling problems. The technique has been applied to municipal wastes, low-level radioactive waste treatment plant, lead removal from industrial wastes, removal of pulp-mill contaminants, textile-mill wastes, and pretreatment of saline waters by lime-soda process in preparation for hyperfiltration. Economics and energy requirements are also discussed

  7. Determination of Glomerular Filtration Rate by Using Gamma camera

    International Nuclear Information System (INIS)

    Amer, M.; Salim, D.

    2007-01-01

    Glomerular filtration rate (GFR) is a commonly accepted standard measure of renal function. It is routinely measured using tracers that are cleared exclusively by glomerular filtration. The aim of this study was to apply new nuclear medicine technique based on direct determination of clearance of a radioactive tracer provided that all the uptake compartments of the radioactive tracer should be included in the field of the view of the gamma camera. A total of 10 men and 7 women range from 27 to 64 years old were studied using dual head gamma camera. The data for clearance calculation comprises : (1) a transmission scan of part of the body using water phantom with a uniform distribution of the radioisotope , (2) the background corrected activity curves in the anterior and posterior views over all uptake compartments following the injection of radioactive tracer, and (3) the activity of radioactive tracer in two blood samples drawn during the examination. The results for GFR above 30 ml min -1 , the regression line of GFR by using simplified multiple sample method versus GFR in gamma camera method were not significantly different from the line of identity. The reliability of the gamma camera method was about 16%, 12 % and 8% for GFR values of 30, 60 and 100 ml min-1. Therefore, the reliability of the gamma camera and the simplified multiple sample method for prediction of GFR were almost the same.

  8. 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...

  9. Glomerular hyperfiltration and increased glomerular filtration surface are associated with renal function decline in normo- and microalbuminuric type 2 diabetes.

    Science.gov (United States)

    Moriya, Tatsumi; Tsuchiya, Akiko; Okizaki, Shin-ichiro; Hayashi, Akinori; Tanaka, Keiji; Shichiri, Masayoshi

    2012-03-01

    The prevalence of glomerular hyperfiltration in type 2 diabetic patients varies widely. Here we studied whether glomerular hyperfiltration in diabetic nephropathy in type 2 patients is related to renal structural changes and predicts the functional development of diabetic nephropathy. Thirty normo- or microalbuminuric type 2 diabetic patients having a renal biopsy were followed every 6 months for a mean of 6.2 years. The glomerular filtration rate (GFR) at the time of biopsy, determined by iohexol clearance, correlated with filtration surface per glomerulus, but no other quantitative microscopic morphometric parameter. The filtration surface was positively associated with the decrease in GFR during the first year but not associated in subsequent years following the renal biopsy. The GFR showed a statistically significant linear decrease in 9 of the 30 patients; however, slopes of the regression lines were almost zero in 11 patients. The GFR increased and decreased in a parabolic manner in two patients. Seven of the nine patients with a statistically significant decline in renal function did not show any appreciable worsening of albuminuria, while two patients developed persistent proteinuria. Thus, in renal biopsy-proven normo- or microalbuminuric type 2 diabetic patients, glomerular hyperfiltration is closely associated with an increased glomerular filtration surface. An elevated GFR predicts its subsequent decline, which may occur without worsening of albuminuria.

  10. Physiology Lab Demonstration: Glomerular Filtration Rate in a Rat.

    Science.gov (United States)

    Hinojosa-Laborde, Carmen; Jespersen, Brian; Shade, Robert

    2015-07-26

    Measurements of glomerular filtration rate (GFR), and the fractional excretion of sodium (Na) and potassium (K) are critical in assessing renal function in health and disease. GFR is measured as the steady state renal clearance of inulin which is filtered at the glomerulus, but not secreted or reabsorbed along the nephron. The fractional excretion of Na and K can be determined from the concentration of Na and K in plasma and urine. The renal clearance of inulin can be demonstrated in an anesthetized animal which has catheters in the femoral artery, femoral vein and bladder. The equipment and supplies used for this procedure are those commonly available in a research core facility, and thus makes this procedure a practical means for measuring renal function. The purpose of this video is to demonstrate the procedures required to perform a lab demonstration in which renal function is assessed before and after a diuretic drug. The presented technique can be utilized to assess renal function in rat models of renal disease.

  11. GLOMERULAR FILTRATION RATE AS INDICATOR OF RENAL FAILURE IN DIABETICS

    Directory of Open Access Journals (Sweden)

    Saša Đurišić

    2007-10-01

    Full Text Available Diabetic nephropathy is a progredient disease which leads to the end stage renal disease and stands for a leading cause of its development in western countries. About one third of patients included in the dialysis program or transplanation program in the USA are diabetics. The aim of the paper was to analyze the degree of renal failure in diabetics by measuring the glomerular filtration rate (GFR and to show the advantages of this method comparing with serum creatinine levels. Total numbers of 23 patients with diabetes mellitus type 1 or type 2 were anlyzed and controlled monthly during 6 months. Average GFR in the examined patients was 53,23±15,48 mL/min/1.73m2. Obtained values for GFR according to CKD Care and ESRD recommendations showed that the great number of diabetics had stage 3 renal failure while stages 1 and 5 were not registered. GFR is an important marker for diagnostics and estimation of renal failure progression in diabetics. Bearing in mind this facts, periodical controls in diabetics must be suplemented by measuring GFR, so as to perform early identification and determination of severity of renal failure. Measuring of lipoprotein levels and determination of glycemic profile must be done according to the National recommendations twice a year. Besides adequate glycoregulation, diabetics need statins therapy and antyhipertensive tratment with ACE inhibitors.

  12. 125I iothalamate an ideal marker for glomerular filtration

    International Nuclear Information System (INIS)

    Odlind, B.; Haellgren, R.S.; Sohtell, M.; Lindstroem, B.

    1985-01-01

    The triiodinated angiographic contrast medium, iothalamate (usually labelled 125 I), has been used extensively as a marker for glomerular filtration. The authors have studied the renal handling of 125 I iothalamate (IOT) in vivo and in vitro in several species. In renal cortical slices from chicken, rabbit, rat, and monkey, the tissue-to-medium ratio of IOT was twice that of 51 Cr-EDTA (EDTA) at 37 degrees C; a difference that was abolished at 0 degree C and markedly reduced by added o-iodohippurate or iodipamide. In five chickens the steady-state renal clearance of IOT (CIOT) was twice that of EDTA (CEDTA) or 3 H inulin (C1); a difference that was abolished by administration of 100 mg/kg/hr of novobiocin, an organic anion transport inhibitor. CEDTA was similar to C1 before as well as after transport inhibition. Utilizing the Sperber technique the mean apparent tubular excretion fraction (ATEF) of IOT was 8%, while that of EDTA was 1%. After novobiocin coinfusion (new steady-state) ATEFIOT was significantly reduced and not different from that of EDTA (-1%). In the same animals the total urinary recovery of IOT was 84 and 57% before and after novobiocin, respectively, while corresponding values for EDTA was unchanged by the inhibitor. In seven rats the renal extraction of IOT was reduced from 29 to 17% by coinfusion of probenecid (5 mg/kg/hr). Corresponding extractions were 82 to 34% and 22% (unchanged) for PAH and EDTA, respectively

  13. Glomerular endothelial surface layer acts as a barrier against albumin filtration

    NARCIS (Netherlands)

    Dane, M.J.; Berg, B.M. van den; Avramut, M.C.; Faas, F.G.; Vlag, J. van der; Rops, A.L.; Ravelli, R.B.; Koster, B.J.; Zonneveld, A.J. van; Vink, H.; Rabelink, T.J.

    2013-01-01

    Glomerular endothelium is highly fenestrated, and its contribution to glomerular barrier function is the subject of debate. In recent years, a polysaccharide-rich endothelial surface layer (ESL) has been postulated to act as a filtration barrier for large molecules, such as albumin. To test this

  14. 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.

  15. /sup 125/I iothalamate an ideal marker for glomerular filtration

    Energy Technology Data Exchange (ETDEWEB)

    Odlind, B.; Haellgren, R.S.; Sohtell, M.; Lindstroem, B.

    1985-01-01

    The triiodinated angiographic contrast medium, iothalamate (usually labelled /sup 125/I), has been used extensively as a marker for glomerular filtration. The authors have studied the renal handling of /sup 125/I iothalamate (IOT) in vivo and in vitro in several species. In renal cortical slices from chicken, rabbit, rat, and monkey, the tissue-to-medium ratio of IOT was twice that of /sup 51/Cr-EDTA (EDTA) at 37 degrees C; a difference that was abolished at 0 degree C and markedly reduced by added o-iodohippurate or iodipamide. In five chickens the steady-state renal clearance of IOT (CIOT) was twice that of EDTA (CEDTA) or /sup 3/H inulin (C1); a difference that was abolished by administration of 100 mg/kg/hr of novobiocin, an organic anion transport inhibitor. CEDTA was similar to C1 before as well as after transport inhibition. Utilizing the Sperber technique the mean apparent tubular excretion fraction (ATEF) of IOT was 8%, while that of EDTA was 1%. After novobiocin coinfusion (new steady-state) ATEFIOT was significantly reduced and not different from that of EDTA (-1%). In the same animals the total urinary recovery of IOT was 84 and 57% before and after novobiocin, respectively, while corresponding values for EDTA was unchanged by the inhibitor. In seven rats the renal extraction of IOT was reduced from 29 to 17% by coinfusion of probenecid (5 mg/kg/hr). Corresponding extractions were 82 to 34% and 22% (unchanged) for PAH and EDTA, respectively.

  16. Persistent decline in estimated but not measured glomerular filtration rate on tenofovir may reflect tubular rather than glomerular toxicity

    NARCIS (Netherlands)

    Vrouenraets, Saskia M. E.; Fux, Christoph A.; Wit, Ferdinand W. N. M.; Garcia, Evian Fernandez; Furrer, Hansjakob; Brinkman, Kees; Hoek, Frans J.; Abeling, Nico G. G. M.; Krediet, Ray T.; Reiss, Peter

    2011-01-01

    Tenofovir disoproxil fumarate (TDF) has been associated with proximal renal tubulopathy and reduction in estimated glomerular filtration rate (eGFR), without accounting for the tubular secretion of creatinine. A substudy was performed among 19 participants of a randomized 48-week trial, comparing

  17. Intraglomerular microcirculation: measurements of single glomerular loop flow in rats.

    Science.gov (United States)

    Steinhausen, M; Zimmerhackl, B; Thederan, H; Dussel, R; Parekh, N; Esslinger, H U; von Hagens, G; Komitowski, D; Dallenbach, F D

    1981-08-01

    With the use of a new fluorescent microscopic technique, we were able to measure the mean intracapillary velocities and pressures of single capillary loops of renal glomeruli of living rats. The technique involved photographing and recording the flow of fluorescent latex particles through the glomerular loops with a television monitor. In 25 rats the single glomerular loop flow velocity was 781 +/- (SD) 271 micrometers . sec-1. The mean diameter of the capillary loops measured 8.4 +/- 1.4 micrometers; their lengths were 72.3 +/- 37.5 micrometers. From the decrease in velocity of flow along the capillary loop, we were able to evaluate the filtration equivalent for the capillary surface. It was possible to measure intracapillary pressures of single glomerular loops continuously under microscopic control. High intracapillary pressures correlated with high intracapillary velocities. From the data we obtained, we were unable to calculate a filtration equilibrium at the ends of the observed capillary loops. For further correlations, we injected the glomeruli we had studied in the living state and examined them with the scanning electron microscope.

  18. 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...

  19. 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...

  20. Resolution of the three dimensional structure of components of the glomerular filtration barrier

    DEFF Research Database (Denmark)

    Arkill, Kenton P; Qvortrup, Klaus; Starborg, Tobias

    2014-01-01

    The human glomerulus is the primary filtration unit of the kidney, and contains the Glomerular Filtration Barrier (GFB). The GFB had been thought to comprise 3 layers - the endothelium, the basement membrane and the podocyte foot processes. However, recent studies have suggested that at least two...

  1. Null mutation of the nicotinamide adenine dinucleotide phosphate-oxidase subunit p67phox protects the Dahl-S rat from salt-induced reductions in medullary blood flow and glomerular filtration rate.

    Science.gov (United States)

    Evans, Louise C; Ryan, Robert P; Broadway, Elizabeth; Skelton, Meredith M; Kurth, Theresa; Cowley, Allen W

    2015-03-01

    Null mutations in the p67(phox) subunit of nicotinamide adenine dinucleotide phosphate-oxidase confer protection from salt sensitivity on Dahl salt-sensitive rats. Here, we track the sequential changes in medullary blood flow (MBF), glomerular filtration rate (GFR), urinary protein, and mean arterial pressure in SSp67(phox) null rats and wild-type littermates during 21 days of 4.0% NaCl high-salt (HS) diet. Optical fibers were implanted in the renal medulla and MBF was measured in conscious rats by laser Doppler flowmetry. Separate groups of rats were prepared with femoral venous catheters and GFR was measured by the transcutaneous assessment of fluorescein isothiocyanate-sinistrin disappearance curves. Mean arterial blood pressure was measured by telemetry. In wild-type rats, HS caused a rapid reduction in MBF, which was significantly lower than control values by HS day-6. Reduced MBF was associated with a progressive increase in mean arterial pressure, averaging 170±5 mm Hg by HS salt day-21. A significant reduction in GFR was evident on day-14 HS, after the onset of hypertension and reduced MBF. In contrast, HS had no significant effect on MBF in SSp67(phox) null rats and the pressor response to sodium was blunted, averaging 150±3 mm Hg on day-21 HS. GFR was maintained throughout the study and proteinuria was reduced. In summary, when p67(phox) is not functional in the salt-sensitive rats, HS does not cause reduced MBF and salt-sensitive hypertension is attenuated, and consequently renal injury is reduced and GFR is maintained. © 2014 American Heart Association, Inc.

  2. Validation of estimated glomerular filtration rate equations for Japanese children.

    Science.gov (United States)

    Gotoh, Yoshimitsu; Uemura, Osamu; Ishikura, Kenji; Sakai, Tomoyuki; Hamasaki, Yuko; Araki, Yoshinori; Hamda, Riku; Honda, Masataka

    2018-01-25

    The gold standard for evaluation of kidney function is renal inulin clearance (Cin). However, the methodology for Cin is complicated and difficult, especially for younger children and/or patients with bladder dysfunction. Therefore, we developed a simple and easier method for obtaining the estimated glomerular filtration rate (eGFR) using equations and values for several biomarkers, i.e., serum creatinine (Cr), serum cystatin C (cystC), serum beta-2 microglobulin (β 2 MG), and creatinine clearance (Ccr). The purpose of the present study was to validate these equations with a new data set. To validate each equation, we used data of 140 patients with CKD with clinical need for Cin, using the measured GFR (mGFR). We compared the results for each eGFR equation with the mGFR using mean error (ME), root mean square error (RMSE), P 30 , and Bland-Altman analysis. The ME of Cr, cystC, β 2 MG, and Ccr based on eGFR was 15.8 ± 13.0, 17.2 ± 16.5, 15.4 ± 14.3, and 10.6 ± 13.0 ml/min/1.73 m 2 , respectively. The RMSE was 29.5, 23.8, 20.9, and 16.7, respectively. The P 30 was 79.4, 71.1, 69.5, and 92.9%, respectively. The Bland-Altman bias analysis showed values of 4.0 ± 18.6, 5.3 ± 16.8, 12.7 ± 17.0, and 2.5 ± 17.2 ml/min/1.73 m 2 , respectively, for these parameters. The bias of each eGFR equation was not large. Therefore, each eGFR equation could be used.

  3. Estimation of glomerular filtration rate by 99mTc-DTPA dynamic renography

    International Nuclear Information System (INIS)

    Qu Wanying

    1989-01-01

    Estimation of glomerular filtration rate (GFR) by 99m Tc-DTPA dynamic renography was performed in 397 adult patients. The entire study requires only 20 minutes but obtained simultaneously the renal blood flow, renogram, renal morphology study and GFR. The GFR was calculated according to Gate's formula. Creatinine clearance values were also determined compared with GFR in 18 of the patients. The author found they correlated well each other (r = 0.93). Normal data of 14 parameters were derived from the blood flow curve. The normal value of GFR was 112.11 +- 19.05 ml/min and no significant difference in GFR of both kidney was revealed. In patients of urinary stones, essential hypertension, chronic glomerulonephritis and chronic pyelonephritis etc., there were significant lowered GFR denoted. The results showed that the estimation of GFR by 99m Tc-DTPA dynamic renography was reliable, safe and conventient method, and suitable to replace creatinine in clinical study

  4. Progress and controversies in unraveling the glomerular filtration mechanism.

    Science.gov (United States)

    Saritas, Turgay; Kuppe, Christoph; Moeller, Marcus J

    2015-05-01

    At first sight, the glomerular filter appears like a problem that should be easily solved. The majority of researchers view the filter like an impermeable wall perforated by specialized and size-selective pores (pore model). However, the fact that this model is in conflict with many of the experimental findings suggests that it may not yet be complete. In the more recent electrokinetic model, we have proposed including electrical effects (streaming potentials). The present review investigates how this can provide a relatively simple mechanistic explanation for the great majority of the so far unexplained characteristics of the filter, for example why the filter never clogs. Understanding how the glomerular filter functions is a prerequisite to investigate the pathogenesis of proteinuric glomerular diseases and the link between glomerular proteinuria and cardiovascular disease.

  5. Size- and charge selectivity of glomerular filtration in Type 1 (insulin-dependent) diabetic patients with and without albuminuria

    DEFF Research Database (Denmark)

    Deckert, T; Kofoed-Enevoldsen, A; Vidal, P

    1993-01-01

    albumin excretion rate was normal in group D1; 30-100 mg/24 h in group D2; 101-300 mg/24 h in group D3 and greater than 300 mg/24 h in groups D4 and D5. Group D5 had elevated serum creatinine (above 110 mumol/l). Glomerular filtration rate and renal plasma flow were determined by constant infusion...

  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. 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

    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...... 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...

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

    DEFF Research Database (Denmark)

    Damkjær, Mads; Wang, T; Brøndum, E

    2015-01-01

    adaption in the giraffe kidney allows normal for size renal haemodynamics and glomerular filtration rate (GFR) despite a MAP double that of other mammals. METHODS: Fourteen anaesthetized giraffes were instrumented with vascular and bladder catheters to measure glomerular filtration rate (GFR) and effective......BACKGROUND: 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...... 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...

  9. Glomerular filtration rate by 51chomium and 113mindium labeled EDTA in horses

    International Nuclear Information System (INIS)

    Maliska, C.; D'Almeida, J.; Pellegrini, P.M.; Schimit, T.S.; Pinho, W.R.; Lima, J.E.T.

    2009-01-01

    The glomerular filtration rate was determined in nine healthy horses, six male and three female, aged two to 12-year-old, by means of 51 Cr and 113m In labeled EDTA single injection technique. The glomerular filtration rate was calculated from the plasma disappearance curve and the volume of distribution of the radiotracer, 51 Cr-EDTA or 113m In-EDTA. The result (mean +- standard deviation) was 148.80 +- 26.42 m L.min -1 .100 kg. It is concluded that the measurement of glomerular filtration rate by 51 Cr-EDTA or 113m In-EDTA by single injection technique eliminates the bladder catheterization, and for its simplicity, convenience, accuracy, and low dose of radiation, can be used in horses as a method of choice in clinical routine. (author)

  10. Glomerular filtration rate: estimation from fractional renal accumulation of 99mTc-DTPA (stannous)

    International Nuclear Information System (INIS)

    Gates, G.F.

    1982-01-01

    99mTc diethylenetriaminepentaacetic acid (stannous) is cleared from the blood by glomerular filtration. However, calculation of the glomerular filtration rate has required analysis of serial blood samples drawn over intervals of several hours in order to determine the radionuclide clearance rate. This lengthy procedure can be circumvented by the direct scintigraphic determination of fractional radionuclide accumulation within each kidney, occurring at a specified time interval after radionuclide administration. This value has been correlated with 24 hr creatinine clearance values in a group of hospitalized patients. From these data, a formula was derived allowing for estimation of total glomerular filtration rate, as well as individually for each kidney, without requiring blood samples. This procedure needs only 6 min of patient time

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

    International Nuclear Information System (INIS)

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

    1988-01-01

    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 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 [de

  12. Mechanisms responsible for decreased glomerular filtration in hibernation and hypothermia

    Science.gov (United States)

    Tempel, G. E.; Musacchia, X. J.; Jones, S. B.

    1977-01-01

    Measurements of blood pressure, heart rate, red blood cell and plasma volumes, and relative distribution of cardiac output were made on hibernating and hypothermic adult male and female golden hamsters weighing 120-140 g to study the mechanisms underlying the elimination or marked depression of renal function in hibernation and hypothermia. The results suggest that the elimination or marked depression in renal function reported in hibernation and hypothermia may partly be explained by alterations in cardiovascular system function. Renal perfusion pressure which decreases nearly 60% in both hibernation and hypothermia and a decrease in plasma volume of roughly 35% in the hypothermic animal might both be expected to markedly alter glomerular function.

  13. Influencing factors of Gate's method to measure of glomerular filtration rate

    International Nuclear Information System (INIS)

    Wu Ha; Shi Hongcheng

    2009-01-01

    Glomerular filtration rate (GFR) is an important criterion to estimate renal function. 99 Tc m - diethylenetrimainepentaacetic acid renal dynamic imaging is one of method to measure GFR that it have the characteristics of simple and accurate. But the Gate's method may be influenced by many factors such as dose of imaging agent, outlined of regions of interest, kidney depth, and so on. (authors)

  14. 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 formulas...

  15. A urinary proteome-based classifier for the early detection of decline in glomerular filtration

    DEFF Research Database (Denmark)

    Pontillo, Claudia; Jacobs, Lotte; Staessen, Jan A

    2017-01-01

    BACKGROUND: Chronic kidney disease (CKD) progression is currently assessed by a decline in estimated glomerular filtration rate (eGFR) and/or an increase in urinary albumin excretion (UAE). However, these markers are considered either to be late-stage markers or to have low sensitivity...

  16. 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...

  17. 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...

  18. 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...

  19. 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

    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...

  20. Sieve plugs in fenestrae of glomerular capillaries--site of the filtration barrier?

    DEFF Research Database (Denmark)

    Rostgaard, Jørgen; Qvortrup, Klaus

    2002-01-01

    The exact location of the filtration barrier of the glomerular capillary wall, which consists of an endothelium, a basement membrane and a visceral epithelium, has not yet been determined. Apparent discrepancies between different investigators in the past could be explained if postmortem artifact...

  1. estimated glomerular filtration rate and risk of survival in acute stroke

    African Journals Online (AJOL)

    2014-03-03

    Mar 3, 2014 ... the risk of survival in acute stroke. INTRODUCTION. Stroke is independently associated with impairment in the structure and function of the glomerulus. (1). Estimated Glomerular Filtration Rate (GFR) as determined by the four-item Modification of diet in renal disease (MDRD) equation is a fairly reliable.

  2. Comparative evaluation of quantitative glomerular filtration rate measured by isotopic and nonisotopic methods

    International Nuclear Information System (INIS)

    Balachandran, S.; Toguri, A.G.; Petrusick, T.W.; Abbott, L.C.

    1981-01-01

    Good correlation of glomerular filtration rate (GFR) measured isotopically from plasma disappearance of Tc-99m-DTPA (Sn) was shown with inulin clearance, creatinine clearance, and graded radionuclide imaging. The isotopic GFR is a simple, urineless technique not requiring continuous infusion that enables one to perform simultaneous renal imaging with one radiotracer

  3. Glomerular filtration rate estimation: performance of serum cystatin C-based prediction equations.

    Science.gov (United States)

    Weinert, Letícia Schwerz; Camargo, Eduardo Guimarães; Soares, Ariana A; Silveiro, Sandra Pinho

    2011-11-01

    Serum creatinine measurement is a mainstay in the routine laboratory evaluation of renal function, despite of having several disadvantages. Cystatin C, on the other hand, suffers less influence of gender and muscle mass and has been proposed as a more sensitive marker for glomerular filtration rate. However, serum endogenous markers should not be used alone to assess glomerular filtration rate. Creatinine-based equations such as the modification of diet in renal disease (MDRD) and Cockcroft-Gault are widely used despite their limitations. A large number of cystatin C-based prediction equations were developed in recent years, in diverse populations, with different laboratory assays and methods. Several studies demonstrated that cystatin C-based equations are reliable markers of glomerular filtration rate and can be used for diagnosis, evaluation and follow-up of kidney disease. They are simpler than creatinine-based equations and have at least the same accuracy and precision for glomerular filtration rate estimation. In conclusion, diabetes mellitus, cystic fibrosis, kidney transplantation, HIV-infection, and cirrhosis are clinical situations where cystatin C-based equations can be useful. Extremes of age such as childhood and advanced age have also been evaluated with favorable results.

  4. A urinary proteome-based classifier for the early detection of decline in glomerular filtration

    NARCIS (Netherlands)

    Pontillo, Claudia; Jacobs, Lotte; Staessen, Jan A.; Schanstra, Joost P.; Rossing, Peter; Heerspink, Hiddo J. L.; Siwy, Justyna; Mullen, William; Vlahou, Antonia; Mischak, Harald; Vanholder, Ray; Zuerbig, Petra; Jankowski, Joachim

    2016-01-01

    BACKGROUND: Chronic kidney disease (CKD) progression is currently assessed by a decline in estimated glomerular filtration rate (eGFR) and/or an increase in urinary albumin excretion (UAE). However, these markers are considered either to be late-stage markers or to have low sensitivity or

  5. Progression of renal injury toward interstitial inflammation and glomerular sclerosis is dependent on abnormal protein filtration.

    Science.gov (United States)

    Zoja, Carlamaria; Abbate, Mauro; Remuzzi, Giuseppe

    2015-05-01

    Chronic proteinuric renal diseases, independent from the type of the initial insult, have in common a loss of selectivity of the glomerular barrier to protein filtration. Glomerular sclerosis is the progressive lesion affecting the glomerular capillary wall, the primary site at which the protein filtration is abnormally enhanced by disease. Dysfunction of podocytes, that serve to maintain the intact barrier, is a central event in lesion development. However, glomerular injury is signalled to tubular and interstitial structures largely in advance of nephron destruction. Glomerular ultrafiltration of excessive amounts of plasma-derived proteins and associated factors incites tubulointerstitial damage and might amplify an inherent susceptibility of the kidney to become dysfunctional in several disease conditions. Thus, noxious substances in the proteinuric ultrafiltrate promote apoptotic responses and multiple changes in the phenotype of tubule cells with generation of inflammatory and fibrogenic mediators. The severity of tubular interstitial damage has long been recognized to be highly correlated to the degree of deterioration of renal failure even better than glomerular lesions. This review focuses on pathways of tubular injury and apoptosis that in turn promote nephron-by-nephron degeneration and interstitial fibrosis during proteinuria contributing to multifaceted processes of kidney scarring and function loss. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  6. Comparative evaluation of iohexol and inulin clearance for glomerular filtration rate determinations

    International Nuclear Information System (INIS)

    Lindblad, H.G.; Berg, U.B.

    1994-01-01

    The authors have evaluated iohexol as a filtration marker in 150 children. The clearance of iohexol was compared with that of inulin or with a formula clearance. The single-sample clearance of iohexol showed a good correlation with the clearance of inulin. The clearance of iohexol correlated well with the formula clearance. The optimal blood sampling time for iohexol clearance determinations appears to be between 120 and 180 min after injection, at least in patient with relatively normal filtration rates. It is concluded that iohexol clearance is an accurate method of determining the glomerular filtration rate in clinical practice. 25 refs., 5 figs

  7. 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.

  8. Glomerular endothelial surface layer acts as a barrier against albumin filtration.

    Science.gov (United States)

    Dane, Martijn J C; van den Berg, Bernard M; Avramut, M Cristina; Faas, Frank G A; van der Vlag, Johan; Rops, Angelique L W M M; Ravelli, Raimond B G; Koster, Bram J; van Zonneveld, Anton Jan; Vink, Hans; Rabelink, Ton J

    2013-05-01

    Glomerular endothelium is highly fenestrated, and its contribution to glomerular barrier function is the subject of debate. In recent years, a polysaccharide-rich endothelial surface layer (ESL) has been postulated to act as a filtration barrier for large molecules, such as albumin. To test this hypothesis, we disturbed the ESL in C57Bl/6 mice using long-term hyaluronidase infusion for 4 weeks and monitored albumin passage using immunolabeling and correlative light-electron microscopy that allows for complete and integral assessment of glomerular albumin passage. ESL ultrastructure was visualized by transmission electron microscopy using cupromeronic blue and by localization of ESL binding lectins using confocal microscopy. We demonstrate that glomerular fenestrae are filled with dense negatively charged polysaccharide structures that are largely removed in the presence of circulating hyaluronidase, leaving the polysaccharide surfaces of other glomerular cells intact. Both retention of native ferritin [corrected] in the glomerular basement membrane and systemic blood pressure were unaltered. Enzyme treatment, however, induced albumin passage across the endothelium in 90% of glomeruli, whereas this could not be observed in controls. Yet, there was no net albuminuria due to binding and uptake of filtered albumin by the podocytes and parietal epithelium. ESL structure and function completely recovered within 4 weeks on cessation of hyaluronidase infusion. Thus, the polyanionic ESL component, hyaluronan, is a key component of the glomerular endothelial protein permeability barrier. Copyright © 2013 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  9. 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.

  10. A microtechnique for radioisotopic determination of glomerular filtration rate in infants and children

    International Nuclear Information System (INIS)

    Braren, V.; Brill, A.B.; Touya, J.; Goddard, J.

    1982-01-01

    Our experience with a microtechnique using 99 mTc-DTPA for determination of glomerular filtraton rate in 172 children is presented. It is a simple finger-stick method carried out in a four-hour time period by trained nuclear medical personnel. The procedure meets all criteria for precise measurement of glomerular filtration rate, and the radiation dose is low. Proof of accuracy was obtained by comparison of this technique with concomitant 24-hour urinary creatinine clearance in a subset of children

  11. Optimization of Gate's technique for measurement of glomerular filtration rate during routine renal scan

    International Nuclear Information System (INIS)

    Zakavi, R.; Momennejad, M.; Soleimani, K.

    2002-01-01

    Using gate's technique for glomerular filtration rate measurement with Gamma camera, the patient is received 5 mCi of Tc-99m-DTPA. By this amount of radioactivity, good quality renal scan is not possible. This study tries to optimize gate's technique for glomerular filtration rate measurement during routing renal scan (with 10-15 mCi). Methods and materials: Scanning was performed for 60 seconds from samples of Tc-99m with activities of 3, 9, 12, 15 and 18 mCi in a small syringe, with a 30 cm distance from the detector. Another sample of mCi of Tc-99m was imaged for 5, 10, 15, 20 and 30 seconds. The same sample was again imaged for 10 seconds in different distances (10, 20, 30 and 40 cm) from the detector. Each image was acquired 10 times. Using rectangular region of interest, total count and maximum count per pixel were recorded for all images. Results: The total count revealed rising in the images form 3 mCi to 15 mCi samples while declining thereafter, suggesting paralysis of the Gamma camera in high activities. Maximum count per pixel was 32767 (2 in 15 power minus one ) in all images except for the 3 mCi sample image, suggesting saturation of the pixels in high activities. Also saturation of the pixels was noted in images of 12 mCi sample for more than 15 seconds. No saturation of pixels was noticed within 20-40 cm distance from the detector. Conclusion: By optimization of the Gate's technique for glomerular filtration rate measurement, glomerular filtration Rate can be calculated during routine renal scan. We suggest using 10-15 mCi of Tc-99 m-DTPA, with 5-15 seconds pre injected syringe count, 30 cm distant from the detector. Comparison of glomerular filtration rate calculation using suggested technique with glomerular filtration rate estimation by creatinine clearance in 9 patients, resulted in a significant and good correlation coefficient. (R=0.883, P=0.005)

  12. Measurement of the plasma clearance of urographic contrast media for the determination of glomerular filtration rate

    International Nuclear Information System (INIS)

    O'Reilly, P.H.; Jones, D.A.; Farah, N.B.

    1988-01-01

    Further experience with a new method to determine glomerular filtration rate is presented. The method depends on measurement by an x-ray fluorescence technique of the plasma disappearance of the injected iodine in standard nonionic radiographic contrast media used during excretory urography. The results of comparison of contrast clearance with /sup 99m/technetium-diethylenetriaminepentaacetic acid clearance in 33 cases showed excellent agreement with a correlation coefficient of 0.95. Reproducibility of the contrast clearance method was confirmed by repeated examination of 10 plasma samples at weekly intervals for 6 weeks, the results of which showed no significant differences. The contrast clearance technique for the measurement of glomerular filtration rate during excretory urography is simple, quick and accurate, and merits further development

  13. Dynamic 99mTc-DTPA renal gammagraphy with glomerular filtration rate determination

    International Nuclear Information System (INIS)

    Vivodova, M.; Hupka, S.; Michalko, J.; Lehotska, V.; Pipa, V.; Hasik, E.; Tomek, D.

    1989-01-01

    Using the method of 99m Tc-DTPA (diethylenetriaminepentaacetic acid) sequential renal gammagraphy with subsequent glomerular filtration rate determination by means of a gamma camera and a computer, a total of 285 patients were examined with suspected renal and urinary tract diseases, subjects after surgery on these organs or those serving as controls after drug therapy. With the help of a modified application computer program, a study was designed to evaluate quantitatively some functional parameters and to determine the total and the separate glomerular filtration rate values by 99m Tc-DTPA according to Gates. The benefits of the method are that it is non-invasive, rapid, atraumatic, with low exposure to radiation while offering a broad range of applications in routine diagnostic practice of nephrology, and especially so in pediatric patients. (author). 7 figs., 3 tabs., 18 refs

  14. Measurement of renal glomerular filtration rate using labelled substances with compartmental analysis

    International Nuclear Information System (INIS)

    Eberstadt, P.L.

    1981-10-01

    Using a model for the two-compartmental open system and experiments on animals (rabbits and dogs) as well as on human healthy volunteers, an attempt was made to study the advantages and limitations of different radionuclide methods for glomerular filtration rate determination. Labelled compounds used in different combinations were: 3 H-inulin, sup(113m)In-EDTA, 131 I-iothalamate, sup(99m)Tc-DTPA and 14 C-creatinine. The results of the study lead to some working hypotheses concerning the value of creatinine and other labelled substances in the measurement of glomerular filtration rate in clinical practice. The advantages and disadvantages of individual methods summarized in the final report are generally in agreement with the present views of many research workers. Also the hypothesis can be justified that the different labelled compounds which have been studied might be handled independently by the membranes involved but at the long run produce similar homeostatic balance

  15. Predictive performance of 12 equations for estimating glomerular filtration rate in severely obese patients

    Directory of Open Access Journals (Sweden)

    Ary Serpa Neto

    2011-09-01

    Full Text Available Objective: Considering that the Cockcroft-Gault formula and theequation of diet modification in renal disease are amply used in clinical practice to estimate the glomerular filtration rate, although they seem to have low accuracy in obese patients, the present study intends to evaluate the predictive performance of 12 equations used to estimate the glomerular filtration rate in obese patients. Methods: This is a cross-sectional retrospective study, conducted between 2007 and 2008 and carried out at a university, of 140 patients with severe obesity (mean body mass index 44 ± 4.4 kg/m2. The glomerular filtration rate was determined by means of 24-hour urine samples. Patients were classified into one or more of the four subgroups: impaired glucose tolerance (n = 43, diabetic (n = 24, metabolic syndrome (n = 76, and/or hypertension (n = 66. We used bias, precision, and accuracy to assess the predictive performance of each equation in the entire group and in the subgroups. Results: In renal disease, Cockcroft-Gault’s formula and the diet modification equation are not precise in severely obese patients (precision: 40.9 and 33.4, respectively. Sobh’s equationshowed no bias in the general group or in two subgroups. Salazar-Corcoran’s and Sobh’s equations showed no bias for the entire group(Bias: -5.2, 95% confidence interval (CI = -11.4, 1.0, and 6. 2; 95%CI = -0.3, 12.7, respectively. All the other equations were imprecise for the entire group. Conclusion: Of the equations studied, those of Sobh and Salazar-Corcoran seem to be the best for estimating the glomerular filtration rate in severely obese patients analyzed in our study.

  16. Glomerular Filtration Rate Estimation by Serum Creatinine or Serum Cystatin C in Preterm (<31 Weeks) Neonates.

    Science.gov (United States)

    Garg, Parvesh; Hidalgo, Guillermo

    2017-06-15

    Glomerular filtration rate (GFR) was estimated by serum creatinine (Schwartz's equation) and serum cystatin C (Filler's equation) in preterm neonates (24-31 weeks of gestation) in a prospective cohort study. Serum creatinine and cystatin C was obtained at birth and then every two weeks during the first month. We found a poor fit between two methods, and a steadier GFR assessment by cystatin C.

  17. 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.

  18. Losartan therapy decreases albuminuria with stable glomerular filtration and permselectivity in sickle cell anemia.

    Science.gov (United States)

    Yee, Marianne E; Lane, Peter A; Archer, David R; Joiner, Clinton H; Eckman, James R; Guasch, Antonio

    2018-03-01

    Sickle cell nephropathy begins with hyperfiltration and microalbuminuria and may progress to renal failure. The aim of this study was to determine the effects of losartan on glomerular function and albumin excretion in sickle cell anemia (SCA). Individuals with SCA on hydroxyurea with persistent albuminuria were enrolled in a 1-year study of losartan. Glomerular filtration rate (GFR) measured by iohexol clearance, albumin excretion rate (AER), and fractional clearance of dextran were assessed at baseline, short-term (1-2month), and long-term (≥12month) intervals. Twelve subjects (6 microalbuminuria, 6 macroalbuminuria) completed short-term studies; 8 completed long-term studies. Baseline GFR was 112ml/min/1.73m 2 (71-147ml/min/1.73m 2 ). AER decreased significantly at the short-term (median decrease -134 mcg/min, p=0.0063). GFR was not significantly-different at short-term or long-term intervals. Dextran clearance improved for diameters smaller than albumin (therapy for ≥1year in sickle nephropathy results in lower albumin excretion with stable GFR. Filtration of neutral molecules ≥36Å was not changed by losartan, suggesting that the effect of losartan is a mechanism other than alteration of glomerular filtration size-selectivity. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Measurement of glomerular filtration rate in connection with renography with 99mTc-DTPA

    International Nuclear Information System (INIS)

    Cappelen, T.; Skretting, A.; Winderen, M.; Aas, M.

    1999-01-01

    Glomerular filtration rate (GFR) was measured in two groups of cancer patients. In 20 patients, glomerular filtration rate was measured simultaneously with 51 Cr-EDTA, 99m Tc-DTPA and the X-ray contrast agent iohexol as markers, and with a complete set of eight blood samples during 24 hours. In a second group of 120 patients, the authors used 99m TC-DTPA only and tested various simplified methods, based on one or two blood samples. Glomerular filtration rate was also calculated from serum creatinine. There was excellent agreement between the values measured with the three markers and in the same group of patients very good agreement with the results of simplified methods. The larger study carried out with 99m Tc-DTPA on the second group of patients confirmed a very good agreement between methods based on the slope of the plasma curve and a method based on one blood sample only. The correlation was worse between the values obtained by any of the radionuclide methods and those calculated from serum creatinine. The latter method should therefore not be used for determination of renal function

  20. Effects of a K+ channel blocker on glomerular filtration rate and electrolyte excretion in conscious rats.

    Science.gov (United States)

    Ludens, J H; Clark, M A; Lawson, J A

    1995-06-01

    Effects of a K+ channel blocker on glomerular filtration rate and electrolyte excretion in conscious rats were observed. Effects of K+ channel modulation on glomerular filtration rate and electrolyte excretion were studied using the adenosine-triphosphate- (ATP)-sensitive K+ channel blocker 4-morpholinecarboximidine-N-1-adamantyl-N'-cyclohexylhydr ochloride (U-37883A) in conscious rats previously equipped with catheters for clearance studies. In saline-loaded rats, i.v. doses of U-37883A of 1.7, 5.0 and 15 mg/kg increased absolute and fractional Na+ excretion dose-dependently without changing K+ excretion. The glomerular filtration rate remained constant during diuresis. In water-loaded (hypotonic dextrose) rats, free-water clearance studies revealed that the ATP-sensitive K+ channel blocker significantly decreased an index of solute reabsorption (free-water clearance adjusted for chloride clearance) in the diluting segment during peak natriuretic activity. In addition, U-37883A significantly decreased the osmolality of renal papillary interstitial fluid, indicative of an effect in the medullary portion of the diluting segment. Together, these findings suggest that ATP-sensitive K+ channels, possibly those located at the apical boarder, play a pivotal role in Na+ reabsorption in the thick ascending limb of the loop of Henle.

  1. 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....

  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. Estimated glomerular filtration rate function in patients with and without metabolic syndrome

    Directory of Open Access Journals (Sweden)

    María E Lizardo

    2016-06-01

    Full Text Available Introduction: Metabolic syndrome (MS is an independent risk factor, which affects the development of chronic kidney disease, so the glomerular filtration rate (GFR as an indicator of glomerular function in patients with and without MS who attended the outpatient clinic “los Grillitos, sector Caña de Azucar”. Materials and Methods: A comparative, correlational, cross-sectional study was conducted in a non-probability sample of convenience consisting of 60 patients with MS diagnosed according to the criteria Panel ATP III, and 60 apparently healthy individuals, whom the GFR was determined by the Cockcroft-Gault as well as clinical and biochemical parameters for the diagnosis of MS. Results: Out of the total patients evaluated, 37 (30.7% showed alterations that put them in grades G2 and G3 system risk stratification of CKD, of these 18 and 19 corresponded to patients with and without MS respectively. Glomerular Hyperfiltration (> 120 mil / min it was found in both groups 28 (46.7% and 24 (40% cases of patients with and without MS respectively. The glomerular function was strongly correlated with abdominal obesity and high levels of stress arterial. As for the number of criteria and its relationship to the level of kidney damage present, not a firm to increase the latter with respect to the first (p=0.385 trend was observed. Conclusion: The change in the glomerular function is not directly related to the MS but with its components, specifically abdominal obesity and hypertension.

  4. The Rho-GTPase binding protein IQGAP2 is required for the glomerular filtration barrier.

    Science.gov (United States)

    Sugano, Yuya; Lindenmeyer, Maja T; Auberger, Ines; Ziegler, Urs; Segerer, Stephan; Cohen, Clemens D; Neuhauss, Stephan C F; Loffing, Johannes

    2015-11-01

    Podocyte dysfunction impairs the size selectivity of the glomerular filter, leading to proteinuria, hypoalbuminuria, and edema, clinically defined as nephrotic syndrome. Hereditary forms of nephrotic syndrome are linked to mutations in podocyte-specific genes. To identify genes contributing to podocyte dysfunction in acquired nephrotic syndrome, we studied human glomerular gene expression data sets for glomerular-enriched gene transcripts differentially regulated between pretransplant biopsy samples and biopsies from patients with nephrotic syndrome. Candidate genes were screened by in situ hybridization for expression in the zebrafish pronephros, an easy-to-use in vivo assay system to assess podocyte function. One glomerulus-enriched product was the Rho-GTPase binding protein, IQGAP2. Immunohistochemistry found a strong presence of IQGAP2 in normal human and zebrafish podocytes. In zebrafish larvae, morpholino-based knockdown of iqgap2 caused a mild foot process effacement of zebrafish podocytes and a cystic dilation of the urinary space of Bowman's capsule upon onset of urinary filtration. Moreover, the glomerulus of zebrafish morphants showed a glomerular permeability for injected high-molecular-weight dextrans, indicating an impaired size selectivity of the glomerular filter. Thus, IQGAP2 is a Rho-GTPase binding protein, highly abundant in human and zebrafish podocytes, which controls normal podocyte structure and function as evidenced in the zebrafish pronephros.

  5. 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....

  6. Podocyte-specific overexpression of metallothionein mitigates diabetic complications in the glomerular filtration barrier and glomerular histoarchitecture: a transmission electron microscopy stereometric analysis.

    Science.gov (United States)

    Carlson, Edward C; Chhoun, Jennifer M; Laturnus, Donna I; Bikash, K C; Berg, Brittany; Zheng, Shirong; Epstein, Paul N

    2013-02-01

    We previously demonstrated that cellular and extracellular components of the blood-urine barrier in renal glomeruli are susceptible to damage in OVE transgenic mice, a valuable model of human diabetic nephropathy that expresses profound albuminuria. To test our hypothesis that glomerular filtration barrier damage in OVE mice may be the result of oxidative insult to podocytes, 150-day-old bi-transgenic OVENmt diabetic mice that overexpress the antioxidant metallothionein specifically in podocytes were examined by enzyme-linked immunosorbent assay for albuminuria mitigation and by unbiased transmission electron microscopy (TEM) stereometry for protection from chronic structural diabetic complications. Although blood glucose and HbA(1c) levels were indistinguishable in OVE and OVENmt animals, albuminuria was significantly reduced (average >7-fold) in OVENmt mice through 8 months of age. Interestingly, the Nmt transgene provided significant glomerular protection against diabetic nephropathic complications outside of the podocyte. Glomerular filtration barrier damage was reduced in OVENmt mice, including significantly increased area occupied by endothelial luminal fenestrations (~13%), significantly reduced glomerular basement membrane (GBM) thickening (~17%) and significantly less podocyte effacement (~18%). In addition, OVENmt mice exhibited significantly reduced glomerular volume (~50%), fewer glomerular endothelial cells (~33%), fewer mesangial cells (~57%) and fewer total glomerular cells (~40%). These results provide evidence of oxidative damage to podocytes induces primary diabetic nephropathic features including severe and sustained albuminuria, specific glomerular filtration barrier damage and alterations in glomerular endothelial and mesangial cell number. Importantly, these diabetic complications are significantly mitigated by podocyte targeted metallothionein overexpression. Copyright © 2012 John Wiley & Sons, Ltd.

  7. The adaptor protein Grb2 is not essential for the establishment of the glomerular filtration barrier.

    Directory of Open Access Journals (Sweden)

    Nicolas Bisson

    Full Text Available The kidney filtration barrier is formed by the combination of endothelial cells, basement membrane and epithelial cells called podocytes. These specialized actin-rich cells form long and dynamic protrusions, the foot processes, which surround glomerular capillaries and are connected by specialized intercellular junctions, the slit diaphragms. Failure to maintain the filtration barrier leads to massive proteinuria and nephrosis. A number of proteins reside in the slit diaphragm, notably the transmembrane proteins Nephrin and Neph1, which are both able to act as tyrosine phosphorylated scaffolds that recruit cytoplasmic effectors to initiate downstream signaling. While association between tyrosine-phosphorylated Neph1 and the SH2/SH3 adaptor Grb2 was shown in vitro to be sufficient to induce actin polymerization, in vivo evidence supporting this finding is still lacking. To test this hypothesis, we generated two independent mouse lines bearing a podocyte-specific constitutive inactivation of the Grb2 locus. Surprisingly, we show that mice lacking Grb2 in podocytes display normal renal ultra-structure and function, thus demonstrating that Grb2 is not required for the establishment of the glomerular filtration barrier in vivo. Moreover, our data indicate that Grb2 is not required to restore podocyte function following kidney injury. Therefore, although in vitro experiments suggested that Grb2 is important for the regulation of actin dynamics, our data clearly shows that its function is not essential in podocytes in vivo, thus suggesting that Grb2 rather plays a secondary role in this process.

  8. Sieve plugs in fenestrae of glomerular capillaries--site of the filtration barrier?

    DEFF Research Database (Denmark)

    Rostgaard, Jørgen; Qvortrup, Klaus

    2002-01-01

    perfusion pressure and a fixative composed of an oxygen-carrying blood substitute fluid containing glutaraldehyde, was employed combined with contrast enhancement. New observations of the glomerular capillary wall revealed that filamentous plugs (about 90 nm in height) filled the capillary fenestrae......The exact location of the filtration barrier of the glomerular capillary wall, which consists of an endothelium, a basement membrane and a visceral epithelium, has not yet been determined. Apparent discrepancies between different investigators in the past could be explained if postmortem...... artifactual tissue changes, due to subnormal blood pressure or anoxia, have taken place in the endothelium before the tissue and tracers have been sufficiently fixed and immobilized by the fixative. To test this supposition, a new method of fixation, which includes a technique to maintain a physiological...

  9. Computation of glomerular filtration rate with Tc-99m DTPA: an in-house computer program

    International Nuclear Information System (INIS)

    Gates, G.F.

    1984-01-01

    The glomerular filtration rate (GFR) can be computed from the scintigraphic determination of Tc-99m DTPA (diethylenetriaminepentaacetic acid) uptake within the kidneys. The required computations are straightforward and can easily be included in the software of various computers, including a hospital's existing data-processing system. This report present a complete operational program based on extensive experience with this method. The program is easy to use, allows for adjustments to be made for unusual clinical conditions, and produces a permanent record that can be issued as part of the final report

  10. Glomerular filtration rate in transplantation patients: estimation of renal function using Tc-99m DTPA

    International Nuclear Information System (INIS)

    Reinig, J.W.; Gordon, L.; Frey, D.; Garrick, E.; Daniel, W.T. III

    1985-01-01

    The clinical assessment of a transplanted kidney is often difficult, especially in the immediate postoperative period. The biochemical parameters used to monitor renal function change slowly and can take several days to reflect the actual renal status. The authors have modified a technique for determining the glomerular filtration rate (GFR) from a Tc-99m DTPA renal scan and have found that it correlates with the actual GFR throughout the postoperative course. In addition, they describe a method for changing dose calibrator measurements into administered counts. This technique for determining the GFR provides a quick and accurate assessment of renal function and is useful to guide therapeutic decisions

  11. Glomerular filtration rate in children: determination from the Tc-99m-DTPA renogram

    International Nuclear Information System (INIS)

    Shore, R.M.; Koff, S.A.; Mentser, M.; Hayes, J.R.; Smith, S.P.; Smith, J.P.; Chesney, R.W.

    1984-01-01

    Analysis of the Tc-99m-DTPA renogram is usually limited to calculating the relative function of each kidney. To develop a method to determine the absolute glomerular filtration rate (GFR), various methods of analyzing the renogram were examined to determine which gave the best correlation with GFR. That regression could then be used to predict GFR without the need for blood samples. Fifty children were studied using Tc-99m-DPTA renograms and GFR measured simultaneously by plasma disappearance. GFR correlated better with the slope of the second phase than with the area under the renogram curve. This method can accurately estimate GFR from the renogram in children

  12. Measurement of glomerular filtration in dogs by 51Cr-EDTA and 113In-DTPA

    International Nuclear Information System (INIS)

    Maliska, C.; Saraiva, J.C.G.

    1977-01-01

    The glomerular filtration rate (GFR) was measured in 15 normal dogs using 51 Cr-EDTA and 113 sup(m) In-DTPA, by a single injection technique. The results of GFR measurements was 3,01 (S.D. + - 0,71) ml/min/kg body weight, and 70,44 (S.D. + - 19,60) ml/min/m 2 surface area. Difference in GFR (means) between the measurement by 51 Cr-EDTA and 113 sup(m) In-DTPA and between the male and female group was not statistically significant (p [pt

  13. Glomerular filtration rate in children with advanced chronic renal failure: methods of determination and clinical applications.

    Science.gov (United States)

    Chan, J C; Sharpe, A R

    1982-01-01

    The rationale, significance and pitfalls of currently available methods for the determination of glomerular filtration rates in children with advanced chronic renal diseases are reviewed. Normal renal clearances in infants and children from birth to adulthood are presented. Methods of serial measurements of renal function, especially by the reciprocals of serum creatinine concentrations, are evaluated. They are applied clinically to monitor the effectiveness of conservative and new modalities of treatment, such as dietary supplementation with essential amino acids plus their keto analogues, and to determine that 1,25-dihydroxyvitamin-D3 treatment of renal osteodystrophy does not accelerate the deterioration of renal function in children with chronic renal insufficiency.

  14. Measurement of glomerular filtration rate in children using technetium-99m diethylenetriamine penta-acetic acid

    International Nuclear Information System (INIS)

    Aaronson, I.A.; Mann, M.D.

    1985-01-01

    During the past 5 years, we have measured the glomerular filtration rate (GFR) by the slope-clearance method using technetium-99m diethylenetriamine penta-acetic acid technetium-99m-DTPA in 130 infants and children. The results in 22 children have been compared with inulin clearance, and a very good correlation between the two methods of measurement of GFR was demonstrated (r = 0,9616; P less than 0,0001). This study provides further evidence that technetium-99m-DTPA is a satisfactory agent for the clinical measurement of GFR in children

  15. 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...

  16. Current status and methodological aspects on the measurement of glomerular filtration rate

    International Nuclear Information System (INIS)

    Froissart, M.; Hignette, C.; Kolar, P.; Prigent, A.; Paillard, M.

    1995-01-01

    Determination of the glomerular filtration rate (GFR) contribute to our understanding of kidney physiology and pathophysiology . Moreover, determination of GFR is of clinical importance in assessing the diagnosis and the progression of renal disease. The purpose of this article is to review the technical performance and results of GFR measurements, including the classical inulin clearance technique and more recent alternative clearance techniques using radioisotope-labelled filtration markers, bolus infusion and spontaneous bladder emptying. Some simplified techniques avoiding urinary collection are also described. We conclude that estimation of GFR from renal and in some cases plasmatic clearances is accurate and more convenient than the classical inulin clearance technique. Such measurements of GFR should be included both in clinical practice and clinical research. (authors). 80 refs., 5 figs., 1 tab

  17. 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.

  18. Resolution of the three dimensional structure of components of the glomerular filtration barrier.

    Science.gov (United States)

    Arkill, Kenton P; Qvortrup, Klaus; Starborg, Tobias; Mantell, Judith M; Knupp, Carlo; Michel, C Charles; Harper, Steve J; Salmon, Andy H J; Squire, John M; Bates, Dave O; Neal, Chris R

    2014-02-01

    The human glomerulus is the primary filtration unit of the kidney, and contains the Glomerular Filtration Barrier (GFB). The GFB had been thought to comprise 3 layers - the endothelium, the basement membrane and the podocyte foot processes. However, recent studies have suggested that at least two additional layers contribute to the function of the GFB, the endothelial glycocalyx on the vascular side, and the sub-podocyte space on the urinary side. To investigate the structure of these additional layers is difficult as it requires three-dimensional reconstruction of delicate sub-microscopic (glomerular volume). Secondly, Focused Ion Beam milling Scanning Electron Microscopy (FIB-SEM) was used to image a filtration region (48 μm3 volume). Lastly Transmission Electron Tomography (Tom-TEM) was performed on a 0.3 μm3 volume to identify the fine structure of the glycocalyx. Tom-TEM clearly showed 20 nm fibre spacing in the glycocalyx, within a limited field of view. FIB-SEM demonstrated, in a far greater field of view, how the glycocalyx structure related to fenestrations and the filtration slits, though without the resolution of TomTEM. SBF-SEM was able to determine the extent of the sub-podocyte space and glycocalyx coverage, without additional heavy metal staining. Neither SBF- nor FIB-SEM suffered the anisotropic shrinkage under the electron beam that is seen with Tom-TEM. These images demonstrate that the three dimensional structure of the GFB can be imaged, and investigated from the whole glomerulus to the fine structure of the glycocalyx using three dimensional electron microscopy techniques. This should allow the identification of structural features regulating physiology, and their disruption in pathological states, aiding the understanding of kidney disease.

  19. Short-term inhibition of prostaglandin synthesis has no effect on the elevated glomerular filtration rate of early insulin-dependent diabetes

    DEFF Research Database (Denmark)

    Christiansen, J S; Feldt-Rasmussen, B; Parving, H H

    1985-01-01

    Glomerular filtration rate and renal plasma flow (constant infusion technique using 125I-iothalamate and 131I-hippuran) were measured twice within a 1-week interval in nine young males with insulin-dependent diabetes of short duration (2-5 years). The study was performed in a randomized double......-blind design, with the patients receiving either indomethacin (150 mg/day) or placebo for 3 days before the study. Measures of metabolic control did not change. No differences were found in glomerular filtration rate (144 +/- 9 versus 144 +/- 9 ml/min X 1.73 m2, mean +/- S.E.M.) or renal plasma flow (579...... +/- 43 versus 560 +/- 52 ml/min X 1.73 m2), when measured during placebo or indomethacin treatment, respectively. It is concluded that the steady-state enhancement of glomerular filtration rate and renal plasma flow found in early insulin-dependent diabetes is not due to an excessive activity...

  20. Urological disorders in chronic kidney disease in children cohort: clinical characteristics and estimation of glomerular filtration rate.

    Science.gov (United States)

    Dodson, Jennifer L; Jerry-Fluker, Judith V; Ng, Derek K; Moxey-Mims, Marva; Schwartz, George J; Dharnidharka, Vikas R; Warady, Bradley A; Furth, Susan L

    2011-10-01

    Urological disorders are the most common cause of pediatric chronic kidney disease. We determined the characteristics of children with urological disorders and assessed the agreement between the newly developed bedside glomerular filtration rate estimating formula with measured glomerular filtration rate in 586 patients in the Chronic Kidney Disease in Children study. The Chronic Kidney Disease in Children study is a prospective, observational cohort of children recruited from 48 sites in the United States and Canada. Eligibility requirements include age 1 to 16 years and estimated glomerular filtration rate by original Schwartz formula 30 to 90 ml/min/1.73 m(2). Baseline demographics, clinical variables and glomerular filtration rate were assessed. Bland-Altman analysis was conducted to assess agreement between estimated and measured glomerular filtration rates. Of the 586 participants with at least 1 glomerular filtration rate measurement 348 (59%) had an underlying urological diagnosis (obstructive uropathy in 118, aplastic/hypoplastic/dysplastic kidneys in 104, reflux in 87 and other condition in 39). Among these patients median age was 9 years, duration of chronic kidney disease was 7 years and age at first visit with a urologist was less than 1 year. Of the patients 67% were male, 67% were white and 21% had a low birth weight. Median height was in the 24th percentile. Median glomerular filtration rate as measured by iohexol plasma disappearance was 44.8 ml/min/1.73 m(2). Median glomerular filtration rate as estimated by the Chronic Kidney Disease in Children bedside equation was 44.3 ml/min/1.73 m(2) (bias = -0.5, 95% CI -1.7 to 0.7, p = 0.44). Underlying urological causes of chronic kidney disease were present in 59% of study participants. These children were diagnosed early in life, and many had low birth weight and growth delay. There is good agreement between the newly developed Chronic Kidney Disease in Children estimating equations and measured

  1. Contrast media and glomerular filtration: dose dependence of clearance for three agents

    International Nuclear Information System (INIS)

    Baeck, S.E.K.; Krutzen, E.; Nilsson-Ehle, P.

    1988-01-01

    Determination of plasma clearance of contrast agents has been advocated as a means to assess glomerular filtration rate. To evaluate the feasibility of different agents for this purpose, we have compared, in healthy volunteers, the dose dependence of plasma clearance for three contrast media (iohexol, a nonionic agent, and iothalamate and metrizoate, which are ionic substances), with special emphasis on the lower dose range (2-20 mL corresponding to 0.9-12.9 g, depending on dose and agent). Iohexol and iothalamate were cleared at constant rates, irrespective of given dose, whereas metrizoate clearance increased significantly at lower doses. In general, the clearances or iothalamate and metrizoate were, respectively, moderately and markedly higher than that of iohexol. The clearance of different doses of metrizoate (2 mL versus a radiographic dose of 40 mL or more) was also compared with the clearance of [ 51 Cr]EDTA in two groups of patients with reduced renal function. When compared with [ 51 Cr]EDTA in patients with renal dysfunction, metrizoate was cleared significantly faster after a 2-mL dose, whereas clearances were identical when the metrizoate dose was 40 mL or more. These findings indicate that tubular secretion plays an active role in the elimination of metrizoate. The pharmacokinetic properties of iohexol, in combination with its low toxicity, make it a suitable agent for determination of glomerular filtration rate in clinical practice

  2. Rhophilin-1 Is a Key Regulator of the Podocyte Cytoskeleton and Is Essential for Glomerular Filtration

    Science.gov (United States)

    Lal, Mark A.; Andersson, Ann-Charlotte; Katayama, Kan; Xiao, Ziejie; Nukui, Masatoshi; Hultenby, Kjell; Wernerson, Annika

    2015-01-01

    Rhophilin-1 is a Rho GTPase-interacting protein, the biologic function of which is largely unknown. Here, we identify and describe the functional role of Rhophilin-1 as a novel podocyte-specific protein of the kidney glomerulus. Rhophilin-1 knockout mice were phenotypically normal at birth but developed albuminuria at about 2 weeks of age. Kidneys from severely albuminuric mice revealed widespread podocyte foot process effacement, thickening of the glomerular basement membrane, and FSGS-like lesions. The absence of any overt changes in the expression of podocyte proteins at the onset of proteinuria suggested that the primary cause of podocyte abnormalities in Rhpn1-null mice was the result of cell-autonomous, Rhophilin-1–dependent signaling events. In culture, Rhophilin-1 was detected at the plasma membrane leading edge of primary podocytes, where it elicited remodeling of the actin cytoskeleton network. This effect of Rhophilin-1 on actin cytoskeleton organization associated with inhibitory effects on Rho-dependent phosphorylation of the myosin regulatory light chain and stress fiber formation. Conversely, phosphorylation of myosin regulatory light chain increased in podocyte foot processes of Rhpn1−/− mice, implicating altered actinomyosin contractility in foot process effacement and compromised filtration capacity. Targeted deletion of RhoA in podocytes of Rhophilin-1 knockout mice exacerbated the renal injury. Taken together, our results indicate that Rhophilin-1 is essential for the integrity of the glomerular filtration barrier and that this protein is a key determinant of podocyte cytoskeleton architecture. PMID:25071083

  3. Three-exponential method for determination of glomerular filtration rate by 169Yb-EDTA

    International Nuclear Information System (INIS)

    Kyuldzhiev, A.; Nikolova, I.; Vitanova, Zh.; Velikov, P.; Stavrev, P.

    1990-01-01

    The method is based on blood clearance curves obtained by external detection over the precordial area of 21 patients after single injection of 2.6 - 3.7 mBq 169 Yb-EDTA. The accuracy of curve preparation is obtained by big number of points measured every minute until the 20th min after injection, at 2 min interval until the 30th min and at 5 min interval until the 240th min. FUMILI microcomputer program (created in JINR, Dubna, and also used in CERN) was applied vor resolving the clearance curves into exponents. The three exponents received prompt to determine the glomerular filtration in a way taking into account the contribution of each of them. For this purpose the authors introduce a formula for calculating the 'efficient period of half-purification', which contain corrections for three-compartment model of distribution and deposition of the radiopharmaceutical. The glomerular filtration determined by this method in 23 patients has higher values compared to one-compartment models which take into account only the third, most slow exponent. 1 fig., 1 tab., 7 refs

  4. Radionuclide measurement of differential glomerular filtration rate in urinary tract obstruction

    International Nuclear Information System (INIS)

    Powers, T.A.; Stone, W.J.; Lowe, B.A.; Patton, J.A.; Bowen, R.D.

    1982-01-01

    In a previous study using dogs whose renal function was rendered asymmetric by unilateral infarction, the efficacy of technetium-99m (/sup 99m/Tc) DTPA and DMSA in measuring differential glomerular filtration rate (GFR) was demonstrated. The present study was undertaken to determine whether the same techniques were applicable to unilateral ureteral obstruction. Five normal dogs and nine dogs with partial unilateral ureteral obstruction had determination of glomerular filtration rate by standard techniques using constant infusions of iothalamate and creatinine after ureteral catheterization. These results were compared with total GFR as measured by single injection of /sup 99m/Tc DTPA and analysis of the plasma disappearance curve. Calculated differential GFR was obtained by multiplying total GFR from double exponential analysis of this curve (DTPA2) by each of three measures of differential function. These included the percent differential uptake of /sup 99m/Tc DTPA and /sup 99m/Tc DMSA in the posterior projection as well as the geometric mean of /sup 99m/Tc DMSA uptake. There were good correlations between differential GFR determined by iothalamate clearances at ureteral catheterization and all noninvasive methods involving radionuclides and DTPA2 ( r . 0.93-0.99). Single exponential analysis of the /sup 99m/Tc DTPA plasma disappearance curve was less satisfactory than double exponential analysis. These results and those reported previously support the use of radionuclides in the determination of differential GFR in a variety of clinical situations

  5. 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.

  6. Glomerular filtration and tubular secretion of MAG-3 in the rat kidney

    International Nuclear Information System (INIS)

    Mueller-Suur, R.M.; Mueller-Suur, C.

    1989-01-01

    Technetium-99m mercaptoacetyltriglycine (MAG-3) has recently been introduced as a new radiopharmaceutical for dynamic renal scintigraphy. To elucidate the mechanism of renal excretion, micropuncture experiments were performed in rat kidneys for direct measurements of glomerular filtration and tubular secretory capacity. Fluid of Bowman space was collected from superficial glomeruli and analyzed for its contents of [99mTc]MAG-3, [125I]hippurate and [3H]inulin during constant infusion of these compounds. The ratio of activity of ultrafiltrate to that of arterial plasma was 0.23 for MAG-3, 0.68 for hippurate and 1.04 for inulin which demonstrates that the filtrated amount of MAG-3 is only 23% of that of inulin, presumably because of higher plasma protein binding which was also measured in vitro and found to be 80 +/- 1.5% for MAG-3 and 32 +/- 2% for [125I]hippurate. Proximal and distal tubules were also micropunctured and their tubular fluid as well as the final urine analyzed for the activity of hippurate and MAG-3. The tubular fluid to plasma ratio values along the nephron and in the final urine were all lower for MAG-3 than for hippurate, indicating a lower secretory capacity. From measurements of whole renal clearance, GFR and plasma protein binding the filtered amount of MAG-3 was 0.26 and of hippurate 0.87 ml/min.g kidney weight (p less than 0.001) and the secreted amount 2.01 and 2.38 ml/min.g kidney weight (p less than 0.05), respectively. We conclude that MAG-3 is predominantly excreted by tubular secretion and that the lower renal clearance of MAG-3 as compared with that of hippurate is a result both of a substantially decreased glomerular filtration and of a lower tubular secretion

  7. Comparing different estimated glomerular filtration rate equations in assessing glomerular function in children based on creatinine and cystatin C.

    Science.gov (United States)

    Conkar, Seçil; Mir, Sevgi; Karaslan, Fatma Nur; Hakverdi, Gülden

    2018-02-27

    Glomerular filtration rate (GFR) is the best marker used to assess renal function. Estimated GFR (eGFR) equations have been developed, and the ideal formula is still under discussion. We wanted to find the most practical and reliable GFR in eGFR formulas. We compared serum creatinine (Scr)- and cystatin C (cysC)-based eGFR formulas in the literature. We also aimed to determine the suitability and the reliability of cysC for practical use in determining GFR in children. We have enrolled 238 children in the study. Measurement of 24-hour creatinine clearance was compared with eGFR equations which are based on Scr, cysC, and creatinine plus cysC. Of the patients (n = 238), 117 were males (49.2%), and 121 (50.8%) were females with a median age of 9.0 years. The areas under the ROC curves of Counahan-Barratt and Bedside Schwartz were equal and 0.89 (with a 95% CI 0.80-0.97). The areas under the ROC curves were not significantly different in all cystatin C-based eGFR equations. The highest AUC values for differentiating normal vs abnormal renal functions according to CrCl 24 were for the CKiD-cysC and CKiD-Scr-cysC equations. In our study, compared with creatinine-based ones, the cystatin C-based formulas did not show much superiority in predicting eGFR. Still, we think Bedside Schwartz is a good formula to provide ease of use because, in this equation, the constant k is same for all age groups. However, the most valuable equations in determining chronic kidney disease are the CKiD-cysC and CKiD-Scr-cysC equations. © 2018 Wiley Periodicals, Inc.

  8. Aberrant glomerular filtration of urokinase-plasminogen activator in nephrotic syndrome leads to amiloride-sensitive plasminogen activation in urine

    DEFF Research Database (Denmark)

    Stæhr, Mette; Buhl, Kristian Bergholt; Andersen, René F

    2015-01-01

    In nephrotic syndrome, aberrant glomerular filtration of plasminogen and conversion to active plasmin in pre-urine is thought to activate proteolytically ENaC and contribute to sodium retention and edema. The ENaC blocker amiloride is an off-target inhibitor of urokinase-type plasminogen activator...... with aberrant filtration of uPA across the injured glomerular barrier. Amiloride inhibits urine uPA activity which attenuates plasminogen activation and urine protease activity in vivo. Urine uPA is a relevant target for amiloride in vivo....

  9. 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 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...

  10. Glomerular filtration rate estimation in renal transplant patients based on serum cystatin-C levels: comparison with other markers of glomerular filtration rate.

    Science.gov (United States)

    Visvardis, G; Griveas, I; Zilidou, R; Papadopoulou, D; Mitsopoulos, E; Kyriklidou, P; Manou, E; Ginikopoulou, E; Meimaridou, D; Pavlitou, A; Sakellariou, G

    2004-01-01

    The assessment of glomerular filtration rate (GFR) is the most commonly used test of renal function. Cystatin-C, a cysteine protease inhibitor, which can be measured by light-scattering immunoassay, possesses many of the attributes required of the ideal GFR marker. Conversely, many endogenous markers that are widely used for the estimation of GFR such as serum creatinine (SCr) are not ideal. The present study was undertaken to evaluate the clinical application of serum cystatin-C (CysC) as a new marker of GFR in renal transplant patients. Eighteen patients (9 men) were enrolled in the study (mean age: 46.35, range: 31-67 years) to measure serum CysC levels and compare them, with SCr, creatinine clearance (CCr), as well as the Cockcroft-Gault equation (CG) or the MDRD as indicator of GFR. Spearman's correlation coefficient was used to determine the relationship between CysC and other markers. There was a significant negative correlation between serum CysC and CCr (r = -0.768). Moreover, the CysC level was negatively correlated with CG (r = -0.854), positively correlated with SCr (r = 0.629), and negatively correlated with MDRD (r = -0.604). These results indicate that measurement of serum cystatin-C was useful and accurate to estimate GFR in renal transplant patients. The recent literature confirms our data although there are concerns about nonrenal influence on this test. Although serum CysC can generally be recommended as a marker for GFR, our study is still in progress seeking to validate the conclusions in a larger number of patients.

  11. 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. Copyright © 2011 S. Karger AG, Basel.

  12. Glomerular filtration in kidney recipients measured by plasma clearance of 169Yb-DTPA

    International Nuclear Information System (INIS)

    Stribrna, J.; Oppelt, A.; Jirickova, E.; Janata, V.; Kocandrle, V.; Sup, I.; Woller, P.; Franke, W.G.

    1986-01-01

    Values of 169 Yb-DTPA clearance (C DTPA ) calculated after a single injection were compared in 26 recipients of kidneys with renal clearance of inulin (C in ), polyfructosan S (C pf ) and creatinine (C cr ). In 21 patients the examinations were made simultaneously, in 5 patients C DTPA was measured within a short interval after the examination of renal clearance. The mean C DTPA values did not significantly differ from C cr but were significantly higher (p in and C pf (by 33% on average). Investigation of changes in C DTPA as compared with C in and C pf showed no significant difference in glomerular filtration (GF). This was measured using inulin and polyfructosan. The results showed that the differing molecular weight of inulin and polyfructosan S had no detectable effect on the GF of kidney recipients. The plasma clearance of 169 Yb-DTPA similarly to C cr overestimates the GF measured by inulin and polyfructosan clearance. (author)

  13. [Estimating glomerular filtration rate in 2012: which adding value for the CKD-EPI equation?].

    Science.gov (United States)

    Delanaye, Pierre; Mariat, Christophe; Moranne, Olivier; Cavalier, Etienne; Flamant, Martin

    2012-07-01

    Measuring or estimating glomerular filtration rate (GFR) is still considered as the best way to apprehend global renal function. In 2009, the new Chronic Kidney Disease Epidemiology (CKD-EPI) equation has been proposed as a better estimator of GFR than the Modification of Diet in Renal Disease (MDRD) study equation. This new equation is supposed to underestimate GFR to a lesser degree in higher GFR levels. In this review, we will present and deeply discuss the performances of this equation. Based on articles published between 2009 and 2012, this review will underline advantages, notably the better knowledge of chronic kidney disease prevalence, but also limitations of this new equation, especially in some specific populations. We eventually insist on the fact that all these equations are estimations and nephrologists should remain cautious in their interpretation. Copyright © 2012 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

  14. Correlation of Cystatin-C with Glomerular Filtration Rate by Inulin Clearance in Pregnancy

    Science.gov (United States)

    Saxena, Aditi R.; Karumanchi, S. Ananth; Fan, Shu-Ling; Horowitz, Gary L.; Seely, Ellen W.

    2012-01-01

    Objective To test utility of cystatin-C as a marker of glomerular filtration rate during pregnancy, we performed serial correlations with inulin clearance during pregnancy and postpartum. Methods Twelve subjects received inulin infusions and serum cystatin-C at three time points. Pearson's correlation coefficient was calculated. Results Cystatin-C levels ranged 0.66 to 1.48 mg/L during pregnancy, and 0.72 to 1.26 mg/L postpartum. Inulin clearance ranged 130 to 188 ml/min during pregnancy, and 110 to 167 ml/min postpartum. Cystatin-C did not correlate with inulin clearance at any time point. Conclusion Serum cystatin-C did not correlate with inulin clearance during pregnancy or postpartum. PMID:22008011

  15. Alternatives for the Bedside Schwartz Equation to Estimate Glomerular Filtration Rate in Children.

    Science.gov (United States)

    Pottel, Hans; Dubourg, Laurence; Goffin, Karolien; Delanaye, Pierre

    2018-01-01

    The bedside Schwartz equation has long been and still is the recommended equation to estimate glomerular filtration rate (GFR) in children. However, this equation is probably best suited to estimate GFR in children with chronic kidney disease (reduced GFR) but is not optimal for children with GFR >75 mL/min/1.73 m 2 . Moreover, the Schwartz equation requires the height of the child, information that is usually not available in the clinical laboratory. This makes automatic reporting of estimated glomerular filtration rate (eGFR) along with serum creatinine impossible. As the majority of children (even children referred to nephrology clinics) have GFR >75 mL/min/1.73 m 2 , it might be interesting to evaluate possible alternatives to the bedside Schwartz equation. The pediatric form of the Full Age Spectrum (FAS) equation offers an alternative to Schwartz, allowing automatic reporting of eGFR since height is not necessary. However, when height is involved in the FAS equation, the equation is essentially equal to the Schwartz equation for children, but there are large differences for adolescents. Combining standardized biomarkers increases the prediction performance of eGFR equations for children, reaching P10 ≈ 45% and P30 ≈ 90%. There are currently good and simple alternatives to the bedside Schwartz equation, but the more complex equations combining serum creatinine, serum cystatin C, and height show the highest accuracy and precision. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  16. Effect of arctiin on glomerular filtration barrier damage in STZ-induced diabetic nephropathy rats.

    Science.gov (United States)

    Ma, Song-Tao; Liu, Dong-lian; Deng, Jing-jing; Niu, Rui; Liu, Rui-bin

    2013-10-01

    Diabetic nephropathy (DN) is the major life-threatening complication of diabetes. Abnormal permeability of glomerular basement membrane plays an important role in DN pathogenesis. This study was performed to assess the effect of arctiin, the lignan constituent from Arctium lappa L., on metabolic profile and aggravation of renal lesions in a rat model of streptozotocin (STZ)-induced DN. STZ-induced diabetic rats were treated with arctiin at the dosage of 60 or 40 mg/kg/day via intraperitoneal injection for 8 weeks. Blood glucose and 24-h urinary albumin content were measured, and kidney histopathological changes were monitored. RT-PCR and immunohistochemistry were used to detect the mRNA and protein levels of nephrin, podocin and heparanase (HPSE) in the kidney cortex of rats, respectively. Treatment with arctiin significantly decreased the levels of 24-h urinary albumin, prevented the sclerosis of glomeruli and effectively restored the glomerular filtration barrier damage by up-regulating the expression of nephrin and podocin and down-regulating HPSE level. Our studies suggest that arctiin might be beneficial for DN. The effects of arctiin on attenuating albuminuria and glomerulosclerosis are possibly mediated by regulating the expression of nephrin and podocin and HPSE in STZ-induced diabetic rats. Copyright © 2012 John Wiley & Sons, Ltd.

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

    Directory of Open Access Journals (Sweden)

    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

  18. 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. Six......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...

  19. 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...

  20. Effect of Calcineurin Inhibitor-Free Everolimus-Based Immunosuppressive Regimen on Albuminuria and Glomerular Filtration Rate after Heart Transplantation

    DEFF Research Database (Denmark)

    Nelson, Laerke M; Andreassen, Arne K; Andersson, Bert

    2017-01-01

    early CNI withdrawal in de novo HTx is unknown. METHODS: We tested if measured glomerular filtration rate (mGFR, by chrome-ethylenediaminetetraacetic acid clearance) was associated with urine albumin/creatinine ratio (UACR) post-HTx in a subgroup of patients included in the Scandinavian Heart Transplant...

  1. 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...

  2. 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...

  3. 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)…

  4. 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

    AIM: Predictors of renal recovery following conversion from calcineurin inhibitor- to proliferation signal inhibitor-based therapy are lacking. We hypothesized that plasma NGAL (P-NGAL) could predict improvement in glomerular filtration rate (GFR) after conversion to everolimus. PATIENTS & METHODS...

  5. Estimating glomerular filtration rate: Cockcroft-Gault and Modification of Diet in Renal Disease formulas compared to renal inulin clearance.

    NARCIS (Netherlands)

    Botev, R.; Mallie, J.P.; Couchoud, C.; Schuck, O.; Fauvel, J.P.; Wetzels, J.F.M.; Lee, N.; Santo, N.G. De; Cirillo, M.

    2009-01-01

    BACKGROUND AND OBJECTIVES: Evaluation of renal function by estimation of the glomerular filtration rate (GFR) is very important for the diagnosis and treatment of patients with chronic kidney disease (CKD). The Cockcroft-Gault (CG) and Modification of Diet in Renal Disease (MDRD) formulas are the

  6. 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…

  7. Monitoring renal function in children with Fabry disease: comparisons of measured and creatinine-based estimated glomerular filtration rate

    NARCIS (Netherlands)

    Tøndel, Camilla; Ramaswami, Uma; Aakre, Kristin Moberg; Wijburg, Frits; Bouwman, Machtelt; Svarstad, Einar

    2010-01-01

    Studies on renal function in children with Fabry disease have mainly been done using estimated creatinine-based glomerular filtration rate (GFR). The aim of this study was to compare estimated creatinine-based GFR (eGFR) with measured GFR (mGFR) in children with Fabry disease and normal renal

  8. The impact of estimated glomerular filtration rate equations on chronic kidney disease staging in pediatric renal or heart transplant recipients

    NARCIS (Netherlands)

    A.B. Vroling (Aram Ben); E.M. Dorresteijn (Eiske); K. Cransberg (Karlien); Y.B. de Rijke (Yolanda)

    2016-01-01

    textabstractBackground: The aim of this study was to evaluate the performance of selected pediatric estimated glomerular filtration rate (eGFR) equations in relation to the clinical management of children after renal or heart transplantation or post-chemotherapy treatment. Methods: This study was a

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

    Directory of Open Access Journals (Sweden)

    Carla Burballa

    2018-03-01

    Full Text Available Introduction: 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. Material and methods: We analyzed the relationship between baseline GFR values measured by Tc-99m-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. Results: 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 Tc99m-DTPA (MDRD4 – 9.4 ± 25 ml/min, P < .05, and CKD-EPI – 4.4 ± 21 ml/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 ± 14 ml/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. Conclusions: In our experience, CKD-EPI is the equation that better correlates with mGFR-Tc99m-DTPA when assessing renal function for donor screening purposes. Resumen: Introducción: El estudio del filtrado glomerular medido (FGm o del estimado (FGe es el eje de la evaluación adecuada de la función renal en la valoración de un potencial donante vivo renal. Nos planteamos estudiar la correlación entre las fórmulas de estimación del FG y los métodos de medición para

  10. Loss of mucin-type O-glycans impairs the integrity of the glomerular filtration barrier in the mouse kidney.

    Science.gov (United States)

    Song, Kai; Fu, Jianxin; Song, Jianhua; Herzog, Brett H; Bergstrom, Kirk; Kondo, Yuji; McDaniel, J Michael; McGee, Samuel; Silasi-Mansat, Robert; Lupu, Florea; Chen, Hong; Bagavant, Harini; Xia, Lijun

    2017-10-06

    The kidney's filtration activity is essential for removing toxins and waste products from the body. The vascular endothelial cells of the glomerulus are fenestrated, flattened, and surrounded by podocytes, specialized cells that support glomerular endothelial cells. Mucin-type core 1-derived O- glycans ( O -glycans) are highly expressed on both glomerular capillary endothelial cells and their supporting podocytes, but their biological role is unclear. Biosynthesis of core 1-derived O -glycans is catalyzed by the glycosyltransferase core 1 β1,3-galactosyltransferase (C1galt1). Here we report that neonatal or adult mice with inducible deletion of C1galt1 ( iC1galt1 -/- ) exhibit spontaneous proteinuria and rapidly progressing glomerulosclerosis. Ultrastructural analysis of the glomerular filtration barrier components revealed that loss of O -glycans results in altered podocyte foot processes. Further analysis indicated that O -glycan is essential for the normal signaling function of podocalyxin, a podocyte foot process-associated glycoprotein. Our results reveal a new function of O -glycosylation in the integrity of the glomerular filtration barrier. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Should physicians always rely on estimated glomerular filtration rate without knowing the equation?

    Directory of Open Access Journals (Sweden)

    Fabbian F

    2017-08-01

    Full Text Available Fabio Fabbian, Dario Priori, Alfredo De Giorgi Department of Medical Sciences, Clinica Medica Unit, University Hospital St Anna, University of Ferrara, Ferrara, ItalyWe read with interest the paper written by Deskur-Smielecka et al1 who investigated the performance of three equations for valuating renal function in 174 patients, aged 78 years, with different cancer diagnosis. They used Cockcroft–Gault (C–G, Modification of Diet in Renal Disease (MDRD, and Berlin Initiative Study1 (BIS1 equations and found that there is a considerable disagreement between renal function estimation formulas. We also performed two studies evaluating different formulas for the calculation of glomerular filtration rate (GFR in patients with eating disorders2 and in those with type 2 diabetes mellitus (DM.3Authors’ replyEwa Deskur-Smielecka1,2 Aleksandra Kotlinska-Lemieszek1,2 Jerzy Chudek3,4 Katarzyna Wieczorowska-Tobis1,2The letter from Fabbian et al, in general, supports our findings concerning the disagreement between currently used equations for the estimation of glomerular filtration rate (GFR. We agree that disagreement in the estimation of kidney function was previously found by a number of authors. However, in our paper1 we describe this aspect in very specific population – geriatric, palliative care patients – with high prevalence of cachexia and substantial muscle mass loss. Our group has shown some similarities (low creatinine generation to the group of patients with anorexia nervosa and bulimia nervosa studied by Fabbian et al.2 However, it has to be stressed that patients with anorexia nervosa and bulimia nervosa were much younger, and therefore had much better, mostly normal kidney function. The second population analyzed by Fabbian et al3 – diabetic patients – also differ from out cohort, as they were better nourished. Regardless of these differences, the conclusions concerning the disagreement of different methods in the estimation of

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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

    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......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...

  15. Single- versus multiple-sample method to measure glomerular filtration rate.

    Science.gov (United States)

    Delanaye, Pierre; Flamant, Martin; Dubourg, Laurence; Vidal-Petiot, Emmanuelle; Lemoine, Sandrine; Cavalier, Etienne; Schaeffner, Elke; Ebert, Natalie; Pottel, Hans

    2018-01-08

    There are many different ways to measure glomerular filtration rate (GFR) using various exogenous filtration markers, each having their own strengths and limitations. However, not only the marker, but also the methodology may vary in many ways, including the use of urinary or plasma clearance, and, in the case of plasma clearance, the number of time points used to calculate the area under the concentration-time curve, ranging from only one (Jacobsson method) to eight (or more) blood samples. We collected the results obtained from 5106 plasma clearances (iohexol or 51Cr-ethylenediaminetetraacetic acid (EDTA)) using three to four time points, allowing GFR calculation using the slope-intercept method and the Bröchner-Mortensen correction. For each time point, the Jacobsson formula was applied to obtain the single-sample GFR. We used Bland-Altman plots to determine the accuracy of the Jacobsson method at each time point. The single-sample method showed within 10% concordances with the multiple-sample method of 66.4%, 83.6%, 91.4% and 96.0% at the time points 120, 180, 240 and ≥300 min, respectively. Concordance was poorer at lower GFR levels, and this trend is in parallel with increasing age. Results were similar in males and females. Some discordance was found in the obese subjects. Single-sample GFR is highly concordant with a multiple-sample strategy, except in the low GFR range (<30 mL/min). © The Author 2018. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  16. Current use of equations for estimating glomerular filtration rate in Spanish laboratories.

    Science.gov (United States)

    Gràcia-Garcia, Sílvia; Montañés-Bermúdez, Rosario; Morales-García, Luis J; Díez-de Los Ríos, M José; Jiménez-García, Juan Á; Macías-Blanco, Carlos; Martínez-López, Rosalina; Ruiz-Altarejos, Joaquín; Ruiz-Martín, Guadalupe; Sanz-Hernández, Sonia; Ventura-Pedret, Salvador

    2012-07-17

    In 2006 the Spanish Society of Clinical Biochemistry and Molecular Pathology (SEQC) and the Spanish Society of Nephrology (S.E.N.) developed a consensus document in order to facilitate the diagnosis and monitoring of chronic kidney disease with the incorporation of equations for estimating glomerular filtration rate (eGFR) into laboratory reports. The current national prevalence of eGFR reporting and the degree of adherence to these recommendations among clinical laboratories is unknown. We administered a national survey in 2010-11 to Spanish clinical laboratories. The survey was through e-mail or telephone to laboratories that participated in the SEQC’s Programme for External Quality Assurance, included in the National Hospitals Catalogue 2010, including both primary care and private laboratories. A total of 281 laboratories answered to the survey. Of these, 88.2% reported on the eGFR, with 61.9% reporting on the MDRD equation and 31.6% using the MDRD-IDMS equation. A total of 42.5% of laboratories always reported serum creatinine values, and other variables only when specifically requested. Regarding the way results were presented, 46.2% of laboratories reported the exact numerical value only when the filtration rate was below 60mL/min/1.73m2, while 50.6% reported all values regardless. In 56.3% of the cases reporting eGFR, an interpretive commentary of it was enclosed. Although a high percentage of Spanish laboratories have added eGFR in their reports, this metric is not universally used. Moreover, some aspects, such as the equation used and the correct expression of eGFR results, should be improved.

  17. Radioisotopic measurement of glomerular filtration rate in severe chronic renal failure

    International Nuclear Information System (INIS)

    LaFrance, N.D.; Drew, H.H.; Walser, M.

    1988-01-01

    In order to determine the best method for routine measurement of glomerular filtration rate (GFR) in severe renal failure, we compared simultaneously the urinary clearances of [/sup 99m/Tc] diethylenetriaminepentaacetic acid (DTPA) (UD), [ 125 I]iothalamate (UI), 24-hr creatinine clearance (UC) and plasma clearance of [/sup 99m/Tc]DTPA (PD), based on three plasma samples. In 60 studies in 22 patients with serum creatinine values of 2 to 8 mg/dl, UD and UI were almost identical: UD = 0.358 +/- 0.976 UI +/- 0.87 ml/min, r = 0.990. However, PD overestimated UD by a large and variable extent: PD = 11.3 +/- 0.843 UD +/- 5.5 ml/min, r = 0.694, and was inconsistent in sequential measurements in individual patients. UC also overestimated urinary isotope clearance: UC = 4.2 + 0.95 UI +/- 3.9 ml/min, r = 0.865. Sequential measurements of GFR in five patients with severe but stable renal failure (mean GFR 5.9 ml/min) showed an average standard deviation of only 0.83 ml/min. Thus both UD and UI appear to be reliable and precise measures of GFR in severe renal failure

  18. Improving precision of glomerular filtration rate estimating model by ensemble learning

    Directory of Open Access Journals (Sweden)

    Xun Liu

    2017-11-01

    Full Text Available Abstract Background Accurate assessment of kidney function is clinically important, but estimates of glomerular filtration rate (GFR by regression are imprecise. Methods We hypothesized that ensemble learning could improve precision. A total of 1419 participants were enrolled, with 1002 in the development dataset and 417 in the external validation dataset. GFR was independently estimated from age, sex and serum creatinine using an artificial neural network (ANN, support vector machine (SVM, regression, and ensemble learning. GFR was measured by 99mTc-DTPA renal dynamic imaging calibrated with dual plasma sample 99mTc-DTPA GFR. Results Mean measured GFRs were 70.0 ml/min/1.73 m2 in the developmental and 53.4 ml/min/1.73 m2 in the external validation cohorts. In the external validation cohort, precision was better in the ensemble model of the ANN, SVM and regression equation (IQR = 13.5 ml/min/1.73 m2 than in the new regression model (IQR = 14.0 ml/min/1.73 m2, P  0.05 for all comparisons of the new regression equation and the other new models. Conclusions An ensemble learning model including three variables, the average ANN, SVM, and regression equation values, was more precise than the new regression model. A more complex ensemble learning strategy may further improve GFR estimates.

  19. [Change in glomerular filtration rate in hypertensive patients in Vitória-ES].

    Science.gov (United States)

    Passigatti, Cynthia Perin; Molina, Maria Del Carmen; Cade, Nágela Valadão

    2014-01-01

    As monitoring of renal function, it is used the estimation of glomerular filtration rate (GFR). This study aimed to estimate the GFR by means of the Cockcroft-Gault equation in hypertensive patients in the Municipality of Vitoria-ES. It is a transversal study of secondary data with 754 hypertensive patients attended in health facilities in 2009. For statistical analysis, there has been used the chi-square test. The female sex, overweight and uncontrolled blood pressure predominated. The average age was 58.18 years (± 13.52) and the serum creatinine (SCr) 0.81 mg / dl (± 0.28). The prevalence of reduced GFR was 19% when from 30 to 59 ml/min and 1.6% when from 29 to 15 ml/min. The prevalence of reduced GFR was 15 times higher in the elderly, 4.93 times higher in those with elevated SCr, 2.19 times in low-weight hypertensives and 1.6 times more prevalent in men. The study showed the importance of monitoring renal function with a view to early intervention and postponement of kidney function loss in hypertensive patients.

  20. Glomerular filtration rate and functional decline in an acute geriatric unit

    Directory of Open Access Journals (Sweden)

    Ocampo Chaparro, José Mauricio

    2018-01-01

    Full Text Available Introduction: Low estimated Glomerular filtration rate (eGFR is associated with functional decline. Little is known on that association in hospitalized elderly. Objective: Determine if low eGFR is associated with functional decline. Methods: Prospective cohort study that included 1826 patients 60 years and older hospitalized in a Geriatric Acute Unit, admitted between January 2012 and August 2015. The outcome was functional status assessed four times by the Barthel Index (BI. Kidney function was estimated by MDRD-4 IDMS and was grouped into four categories according to eGFR (normal ≥90, mild 60-89, moderate 59-30, severe <30. Multivariate logistic regression models and GLIMMIX procedure for longitudinal analyzes were used. Results: Mean age was 82.3±7.2 years, 51 % were women. In multivariate logistic regression, a BI≤60 at admission was associated with age ≥80, female gender, high comorbidity, social deterioration, hypoalbuminemia, anemia, MMSE<19, while the presence of mild or moderate renal failure reduced this risk. In the longitudinal analysis, lower total BI at follow-up was associated with age ≥80, female gender, social deterioration, hospital stay ≥15 days, high comorbidity, hypoalbuminemia, MMSE<19. The presence of mild, moderate or severe renal impairment was associated with higher BI over time. Conclusions: A low eGFR was associated with lower risk for functional decline at admission and overtime. These findings differ from previous reports in the literature.

  1. 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.

  2. 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. © 2014 Asian Pacific Society of Nephrology.

  3. Chronic changes of hematocrit value alter blood pressure and glomerular filtration in spontaneously hypertensive rats

    Directory of Open Access Journals (Sweden)

    Milanović S.

    2012-01-01

    Full Text Available Many studies in hypertensive humans and animals have shown that increased blood viscosity is in direct relation with essential hypertension. The aim of our studies was to investigate the effects of chronic hematocrit value changes on arterial blood pressure and kidney function in genetically induced hypertension. To this end, we studied the effects of several interventions, designed to increase/decrease hematocrit, on hemodynamic parameters, vascular reactivity, glomerular filtration and renal function curve in spontaneously hypertensive rats (SHR. Results of our study show that chronic hematocrit value elevation increases blood pressure and peripheral vascular resistance in SHR. On the other hand, chronic hematocrit lowering elucidates blood pressure and peripheral vascular resistance decrease followed by cardiac output rising. Both hematocrit value changes significantly reduce vasodilatory vascular response. Hematocrit lowering induces acute renal failure. Sodium excretion is shifted to higher blood pressure values in high hematocrit value animals and opposite - lower blood pressure values in low hematocrit value animals. Repeated transfusions develop salt sensitive malignant hypertension in SHR. Further studies are necessary to evaluate the degree of kidney damage after chronic hematocrit value changes in SHR.

  4. 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.

  5. Albuminuria and reduced glomerular filtration rate for predicting the renal outcomes in type 2 diabetic patients.

    Science.gov (United States)

    Tanaka, Nobue; Babazono, Tetsuya; Takagi, Michino; Yoshida, Naoshi; Toya, Kiwako; Nyumura, Izumi; Hanai, Ko; Uchigata, Yasuko

    2015-08-01

    The first clinical manifestation of diabetic kidney disease is usually the development of microalbuminuria. However, recent studies have focused on diabetic patients with reduced glomerular filtration rate (GFR) without albuminuria. To evaluate the association of albuminuria and GFR with renal outcomes, we performed an observational study. A total of 3231 type 2 diabetic patients were included in this study between 2003 and 2005. There were 1249 women and the mean age was 59 ± 12 years. The renal endpoints were defined as the initiation of renal replacement therapy (RRT) or 50% reduction from the baseline of estimated GFR (eGFR). At baseline, 669 (20.7%) patients had eGFR albuminuria. During the mean follow-up period of 5.9 ± 1.6 years, 107 patients initiated RRT. A 50% reduction of eGFR from the baseline value was found in 279 patients. None of the normoalbuminuric subjects with or without reduced eGFR required RRT during the observational period (P Albuminuria was a significant predictor for the evaluated renal endpoints, but the impact of eGFR is likely to be less than that of albuminuria. © 2015 Asian Pacific Society of Nephrology.

  6. Age-dependent reference intervals for estimated and measured glomerular filtration rate.

    Science.gov (United States)

    Pottel, Hans; Delanaye, Pierre; Weekers, Laurent; Selistre, Luciano; Goffin, Karolien; Gheysens, Olivier; Dubourg, Laurence

    2017-08-01

    Defining mean and reference intervals for glomerular filtration rate (GFR) has been the subject of only a limited number of studies and review articles, with contradicting statements about the mean. Normal measured GFR (mGFR) values of ∼120-130 mL/min/1.73 m 2 have long been the referenced values for young adults but seem to be too high according to recent studies. Reference intervals are difficult to define because of the age decline of GFR, which is also observed in healthy subjects. Little data are available for subjects >70 years of age. Based on the reference intervals for serum creatinine (SCr) and the recently published full-age spectrum (FAS) equation, we define simple age-dependent equations for the reference limits of GFR. The mGFR of 633 living potential kidney donors was used to validate the new formulae that define the reference interval. The reference limits for estimated GFR (eGFR), calculated by entering the reference limits for SCr into the FAS equation closely correspond with published reference limits for mGFR. Of the mGFRs of potential living kidney donors, 97.2% lie between the newly defined reference limits for GFR. SCr reference limits may serve to define age-dependent reference limits for eGFR and mGFR.

  7. Association of Glomerular Filtration Rate with Inflammation in Polycystic Ovary Syndrome

    Directory of Open Access Journals (Sweden)

    Ilay Ozturk Gozukara

    2015-07-01

    Full Text Available Background: We aimed to estimate the glomerular filtration rate (GFR in women with polycystic ovary syndrome (PCOS and to determine the relationship between GFR with C-reactive protein (CRP and uric acid. Materials and Methods: In this cross-sectional study, one-hundred and forty PCOS women and 60 healthy subjects were evaluated. The study was carried out at Endocrinology Outpatient Clinic, Erzurum Training and Research Hospital, Erzurum, Turkey, from December 2010 to January 2011. GFRs were estimated by Modification of Diet in Renal Disease (MDRD formula. CRP, urinary albumin excretion (UAE and uric acid levels were also measured. Results: GFRs were significantly higher in PCOS group than control (135.24 ± 25.62 vs. 114.92 ± 24.07 ml/min per 1.73 m2. CRP levels were significantly higher in PCOS patients (4.4 ± 3.4 vs. 2.12 ± 1.5 mg/l. The PCOS group had significantly higher serum uric acid levels (4.36 ± 1.3 mg/dl vs. 3.2 ± 0.73 mg/dl. There was also significantly higher proteinuria level in PCOS patients. Conclusion: Even though PCOS patients had higher GFR, serum uric acid and UAE values than control patients, the renal function was within normal limits. Increased GFR in PCOS women positively correlates with elevated serum CRP and uric acid.

  8. Clinician’s use of automated reports of estimated glomerular filtration rate: A qualitative study

    Directory of Open Access Journals (Sweden)

    Smith David H

    2012-11-01

    Full Text Available Background There is a growing awareness in primary care of the importance of identifying patients with chronic kidney disease (CKD so that they can receive appropriate clinical care; one method that has been widely embraced is the use of automated reporting of estimated glomerular filtration rate (eGFR by clinical laboratories. We undertook a qualitative study to examine how clinicians use eGFR in clinical decision making, patient communication issues, barriers to use of eGFR, and suggestions to improve the clinical usefulness of eGFR reports. Methods Our study used qualitative methods with structured interviews among primary care clinicians including both physicians and allied health providers, recruited from Kaiser Permanente Northwest, a non-profit health maintenance organization. Results We found that clinicians generally held favorable views toward eGFR reporting but did not use eGFR to replace serum creatinine in their clinical decision-making. Clinicians used eGFR as a tool to help identify CKD, educate patients about their kidney function and make treatment decisions. Barriers noted by several clinicians included a desire for greater education regarding care for patients with CKD and tools to facilitate discussion of eGFR findings with patients. Conclusions The manner in which clinicians use eGFRs appears to be more complex than previously understood, and our study illustrates some of the efforts that might be usefully undertaken (e.g. specific clinician education when encouraging further promulgation of eGFR reporting and usage.

  9. Correlation of Serum Cystatin C with Glomerular Filtration Rate in Patients Receiving Platinum-Based Chemotherapy.

    Science.gov (United States)

    Cavalcanti, Ernesta; Barchiesi, Vittoria; Cerasuolo, Dionigio; Di Paola, Flaviano; Cantile, Monica; Cecere, Sabrina Chiara; Pignata, Sandro; Morabito, Alessandro; Costanzo, Raffaele; Di Maio, Massimo; Perrone, Francesco

    2016-01-01

    Objectives . Serum cystatin C seems to be an accurate marker of glomerular filtration rate (GFR) compared to serum creatinine. The aim of this work was to explore the possibility of using serum cystatin C instead of serum creatinine to early predict renal failure in cancer patients who received platinum based chemotherapy. Design and Methods . Serum creatinine, serum cystatin C concentrations, and GFR were determined simultaneously in 52 cancer patients received carboplatin-based or cisplatin-based chemotherapy. Serum creatinine was assayed on Cobas C6000-Roche, serum cystatin C assay was performed on AIA 360-Tosoh, and GFR was determined in all patients, before the first cycle of chemotherapy and before the subsequent administrations. Results . In the overall series, for the prediction of a fall of GFR cystatin C was 0,667 and the best threshold was 1.135 mg/L (sensitivity 90.5%, specificity 61.1%). For a GFR fall cystatin C was 74.3% and the best threshold was 1.415 mg/L (sensitivity 66.7%, specificity 73.2%). Conclusions . Baseline cystatin C values were not able to predict renal failure during subsequent treatment. In conclusion, serum cystatin C is not a reliable early marker to efficiently predict renal failure in patients receiving chemotherapy.

  10. Cystatin C as a parameter of glomerular filtration rate in patients with ovarian cancer.

    Science.gov (United States)

    Bodnar, Lubomir; Wcislo, Gabriel Benedykt; Smoter, Marta; Gasowska-Bodnar, Agnieszka; Stec, Rafał; Synowiec, Agnieszka; Szczylik, Cezary

    2010-01-01

    To evaluate the potential role of serum cystatin C as a marker of renal function in patients with ovarian cancer. Treatment of consecutive ovarian cancer patients who were eligible for chemotherapy with paclitaxel (135 mg/m²/24 h) and cisplatin (75 mg/m²) every 3 weeks in 6 cycles. Glomerular filtration rate (GFR) markers, i.e. serum levels of creatinine and cystatin C, estimated by the Cockcroft-Gault and Modification of Diet in Renal Disease formulas, were recorded before each cycle and 3 weeks after the 6th course. The median age of 34 patients was 54 years. In the initial stage of treatment, we did not observe any correlation between cystatin C and other GFR markers. We noted a significant association between cystatin C and tumor extent on spiral CT scans (diameter: >1 cm) performed at baseline (p = 0.004), and after the 1st (p = 0.03) and 2nd cycle (p = 0.026). We observed a correlation between cystatin C and CA-125 level before chemotherapy (R = 0.4; p = 0.02) and after the 1st cycle (R = 0.43; p = 0.04). The results of our study suggest that cystatin C is not a reliable marker of the GFR in ovarian cancer patients, probably due to its nature as a cysteine protease inhibitor. Copyright © 2010 S. Karger AG, Basel.

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

    Science.gov (United States)

    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 Psepsis. © The Korean Society for Laboratory Medicine

  12. Acute caloric restriction improves glomerular filtration rate in patients with morbid obesity and type 2 diabetes.

    Science.gov (United States)

    Giordani, I; Malandrucco, I; Donno, S; Picconi, F; Di Giacinto, P; Di Flaviani, A; Chioma, L; Frontoni, S

    2014-04-01

    The role of caloric restriction in the improvement of renal function following bariatric surgery is still unclear; with some evidence showing that calorie restriction can reduce proteinuria. However, data on the impact of caloric restriction on renal function are still lacking. Renal function, as measured by glomerular filtration rate (GFR), was evaluated in 14 patients with type 2 diabetes mellitus, morbid obesity and stage 2 chronic kidney disease before and after a 7-day very low-calory diet (VLCD). After the VLCD, both GFR and overall glucose disposal (M value) significantly increased from 72.6 ± 3.8 mL/min/1.73 m(-2) BSA to 86.9 ± 6.1 mL/min/1.73 m(-2) BSA (P=0.026) and from 979 ± 107 μmol/min(1)/m(2) BSA to 1205 ± 94 μmol/min(1)/m(2) BSA (P=0.008), respectively. A significant correlation was observed between the increase in GFR and the rise in M value (r=0.625, P=0.017). Our observation of improved renal function following acute caloric restriction before weight loss became relevant suggesting that calory restriction per se is able to affect renal function. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  13. Renal shear wave velocity and estimated glomerular filtration rate in children with chronic kidney disease.

    Science.gov (United States)

    Bruno, Costanza; Brugnara, Milena; Micciolo, Rocco; Cecchetto, Mariangela; Zuffante, Michele; Bucci, Alessandra; Zaffanello, Marco

    2016-01-01

    A shear wave velocity (SWV) value obtained by the acoustic radiation force impulse technique depends on tissue elasticity. We investigated the relationship between SWV values and the estimated glomerular filtration rate (eGFR) in children with chronic kidney disease. A total of 29 patients were enrolled in the study. There were 18 primary and 11 secondary cases of vesicoureteral reflux. eGFR was calculated using Schwartz's formulas (2012). Partial eGFR for each kidney was assessed by multiplying the eGFR by the percentage of renal function measured by means of renal (99m)Tc-dimercaptosuccinic acid scintigraphy. All ultrasound tests were done by a single qualified technician using a convex probe (frequency 4 MHz) on an S-2000 system. The mean SWV values of the two kidneys were significantly and negatively correlated with eGFR calculated with both univariate (cystatin C [Cys C] and multivariate (creatinine, Cys C, and nitrogen) equations. Of all the formulae, the strongest correlation was obtained with eGFR (Cys C). SWV of the renal cortex correlates with the eGFR of patients affected by malformative uropathies. Nevertheless, this technique needs standardization and validation.

  14. 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.)

  15. Aging and decreased glomerular filtration rate: An elderly population-based study.

    Science.gov (United States)

    Abdulkader, Regina C R M; Burdmann, Emmanuel A; Lebrão, Maria Lúcia; Duarte, Yeda A O; Zanetta, Dirce M T

    2017-01-01

    Although a reduced glomerular filtration rate (GFR) in old people has been attributed to physiologic aging, it may be associated with kidney disease or superimposed comorbidities. This study aims to assess the prevalence of decreased GFR in a geriatric population in a developing country and its prevalence in the absence of simultaneous diseases. This is a cross-sectional study of data from the Saúde, Bem-Estar e Envelhecimento cohort study (SABE study[Health, Well-Being and Aging]), a multiple cohorts study. A multistage cluster sample composed of 1,253 individuals representative of 1,249,388 inhabitants of São Paulo city aged ≥60 years in 2010 was analyzed. The participants answered a survey on socio-demographic factors and health, had blood pressure measured and urine and blood samples collected. GFR was estimated and defined as decreased when 0.20 g/g. The prevalence of GFR cardiovascular disease (43 versus 24%, pcardiovascular disease and hypertension were associated with GFR<60 mL/min/1.73m2. Decreased GFR was highly prevalent among the geriatric population in a megalopolis of a developing country. It was rarely present without simultaneous chronic comorbidities or kidney damage.

  16. Over-estimation of glomerular filtration rate by single injection [51Cr] EDTA plasma clearance determination in patients with ascites

    International Nuclear Information System (INIS)

    Henriksen, J.H.; Broechner-Mortensen, J.; Malchow-Moeller, A.; Schlichting, P.

    1980-01-01

    The total plasma (Clsub(t)) and the renal plasma (Clsub(r)) clearances of [ 51 Cr]EDTA were determined simultaneously in nine patients with ascites due to liver cirrhosis. Clsub(t) (mean 78 ml/min, range 34-115 ml/min) was significantly higher than Clsub(r) (mean 52 ml/min, range 13-96 ml/min, P 51 Cr]EDTA increased throughout the investigation period (5 h). The results suggested that [ 51 Cr]EDTA equilibrates slowly with the peritoneal space which indicates that Clsub(t) will over-estimate the glomerular filtration rate by approximately 20 ml/min in patients with ascites. To assess glomerular filtration rate in presence of ascites, the renal plasma clearance of [ 51 Cr]EDTA should be used instead of the total plasma clearance. (author)

  17. 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)....

  18. Comparison of single point normalized and modified Gate's method for measurement of glomerular filtration rate by nuclear medicine

    International Nuclear Information System (INIS)

    Fonseca, L.M.B. da; Fonseca, N.M.; Martins, E.; Pereira, E.

    1992-01-01

    Glomerular filtration rate was measured in 22 patients (mean age 30 years) using a noninvasive modified Gates method and the results were compared to the one point normalized technique. The values obtained were 74-11.7 and 82-11.09 ml/min., respectively. The advantages of the method are its reliability, easy adaptation to small laboratories and the avoidance of blood and urine sampling. (author)

  19. Research on the influencing factors of measuring glomerular filtration rate through 99Tcm-DTPA renal dynamic imaging

    International Nuclear Information System (INIS)

    Huang Jianmin; Tang Zidu; Pan Liping; Liu Xiaomei; Xie Peng; Gao Jianqing

    2011-01-01

    Glomerular filtration rate (GFR) is an important criterion to estimate renal function. The most common way to measure GFR clinically is 99 Tc m -DTPA Renal Dynamic Imaging. However, the result may be influenced by many factors such as plasma protein binding, delineation of kidney and background region of interest, kidney depth, age and renal function and preparation of patient, nurse's operative technique, etc. The article analyzed each factor above respectively for clinical reference. (authors)

  20. 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).

  1. Amikacin maturation model as a marker of renal maturation to predict glomerular filtration rate and vancomycin clearance in neonates.

    Science.gov (United States)

    Zhao, Wei; Biran, Valérie; Jacqz-Aigrain, Evelyne

    2013-12-01

    Amikacin clearance has recently been proposed as a marker of renal maturation in neonates. However, the predictive value of this marker is still unknown. The objective of the present exploratory study was to evaluate the predictive performance of renal maturation model derived from amikacin to predict the glomerular filtration rate (GFR) and vancomycin clearance in neonates. The GFR and vancomycin clearance in neonates were predicted using a maturation model derived from amikacin via estimation and simulation in a cohort of 116 neonates using non-linear mixed-effects modeling NONMEM® software. Our results demonstrate good correlations between predicted and observed GFR and vancomycin clearance in neonates. The square of the correlation coefficient, and means of the prediction error (2.5th-97.5th percentiles) and absolute prediction error (2.5th-97.5th percentiles) are 0.96, 1.2 % (-39.7 to 30.0 %) and 12.3 % (0.4-39.7 %), respectively, for GFR, and 0.97, -11.3 % (-38.2 to 15.4 %) and 14.0 % (0.5-38.2 %), respectively, for vancomycin. The prediction error is not significantly correlated with age. An amikacin maturation model can precisely reflect maturation of glomerular filtration and thus predict the dosage regimens of other renally excreted drugs by glomerular filtration in neonates.

  2. 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

  3. Methods for characterizing differences in longitudinal glomerular filtration rate changes between children with glomerular chronic kidney disease and those with nonglomerular chronic kidney disease.

    Science.gov (United States)

    Pierce, Christopher B; Cox, Christopher; Saland, Jeffrey M; Furth, Susan L; Muñoz, Alvaro

    2011-09-01

    The rate of decline of glomerular filtration rate (GFR) in children with chronic kidney disease (CKD) can vary, even among those with similar diagnoses. Classic regression methods applied to the log-transformed GFR (i.e., lognormal) quantify only rigid shifts in a given outcome. The generalized gamma distribution offers an alternative approach for characterizing the heterogeneity of effect of an exposure on a positive, continuous outcome. Using directly measured GFR longitudinally assessed between 2005 and 2010 in 529 children enrolled in the Chronic Kidney Disease in Children Study, the authors characterized the effect of glomerular CKD versus nonglomerular CKD diagnoses on the outcome, measured as the annualized GFR ratio. Relative percentiles were used to characterize the heterogeneity of effect of CKD diagnosis across the distribution of the outcome. The rigid shift assumed by the classic mixed models failed to capture the fact that the greatest difference between the glomerular and nonglomerular diagnosis' annualized GFR ratios was in children who exhibited the fastest GFR declines. Although this difference was enhanced in children with an initial GFR level of 45 mL/minute/1.73 m(2) or less, the effect of diagnosis on outcome was not significantly modified by level. Generalized gamma models captured heterogeneity of effect more richly and provided a better fit to the data than did conventional lognormal models.

  4. 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...... APR and a fall in FPR. The proximal tubules thus initially handle the increased filtrate load by passing it on to more distal nephron segments.(ABSTRACT TRUNCATED AT 250 WORDS)...

  5. Association of estimated glomerular filtration rate with muscle function in older persons who have fallen.

    Science.gov (United States)

    Tap, Lisanne; Boyé, Nicole D A; Hartholt, Klaas A; van der Cammen, Tischa J M; Mattace-Raso, Francesco U S

    2018-03-01

    studies suggest that estimated glomerular filtration rate (eGFR) is less reliable in older persons and that a low serum-creatinine might reflect reduced muscle mass rather than high kidney function. This study investigates the possible relationship between eGFR and multiple elements of physical performance in older fallers. baseline data of the IMPROveFALL-study were examined in participants ≥65 years. Serum-creatinine based eGFR was classified as normal (≥90 ml/min), mildly reduced (60-89 ml/min) or moderately-severely reduced (<60 ml/min). Timed-Up-and-Go-test and Five-Times-Sit-to-Stand-test were used to assess mobility; calf circumference and handgrip strength to assess muscle status. Ancova models adjusted for age, sex, Charlson comorbidity index and body mass index were performed. a total of 578 participants were included. Participants with a normal eGFR had lower handgrip strength than those with a mildly reduced eGFR (-9.5%, P < 0.001) and those with a moderately-severely reduced eGFR (-6.3%, P = 0.033) with mean strengths of 23.4, 25.8 and 24.9 kg, respectively. Participants with a normal eGFR had a smaller calf circumference than those with a mildly reduced eGFR (35.5 versus 36.5 cm, P = 0.006). Mean time to complete the mobility tests did not differ. in this study we found that older fallers with an eGFR ≥ 90 ml/min had smaller calf circumference and up to 10% lower handgrip strength than those with a reduced eGFR. This lower muscle mass is likely to lead to an overestimation of kidney function. This outcome therefore supports the search for biomarkers independent of muscle mass to estimate kidney function in older persons.

  6. Use of glomerular filtration rate estimating equations for drug dosing in HIV-positive patients

    Science.gov (United States)

    Okparavero, Aghogho A; Tighiouart, Hocine; Krishnasami, Zipporah; Wyatt, Christina M; Graham, Hiba; Hellinger, James; Inker, Lesley A

    2014-01-01

    Background Current HIV treatment guidelines recommend using the Cockcroft-Gault equation for drug dosing adjustments. The use of newer glomerular filtration rate (GFR) estimating equations for drug dosing and the appropriateness of physician antiretroviral dosing based on estimated kidney function have not been studied in an HIV-positive population. Methods We evaluated concordance between measured and estimated GFR for the assignment of kidney function categories designated by the Food and Drug Administration (FDA) Guidance for Industry for pharmacokinetic studies, and appropriateness of physician antiretroviral drug dosing for level of kidney function in 200 HIV-positive patients on stable antiretroviral therapy. Estimated kidney function was determined using the Chronic Kidney Disease-Epidemiology collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD) Study and Cockcroft-Gault equations. Results For assignment of FDA-designated kidney function categories, concordance rates between measured and estimated GFR using the CKD-EPI, MDRD Study and Cockcroft-Gault equations were 79%, 71% and 77%, respectively. This pattern was consistent across most subgroups. When actual prescribed dosages were compared to recommended dosages based on the level of estimated kidney function, 3% to 19% of study participants were prescribed higher than recommended dosages. The largest discordance between prescribed and recommended dosages was observed for the Cockcroft-Gault equation. Conclusions The CKD-EPI equation has the highest concordance with measured GFR for the assignment of FDA-designated kidney function categories. Its use may lead to lower dosing related errors in HIV-infected US adults on stable antiretroviral therapy. More education is required with respect to dose adjustment for level of kidney function. PMID:23963249

  7. Cardiac resynchronization therapy improves renal function in human heart failure with reduced glomerular filtration rate.

    Science.gov (United States)

    Boerrigter, Guido; Costello-Boerrigter, Lisa C; Abraham, William T; Sutton, Martin G St John; Heublein, Denise M; Kruger, Kristin M; Hill, Michael R S; McCullough, Peter A; Burnett, John C

    2008-09-01

    Renal dysfunction is an important independent prognostic factor in heart failure (HF). Cardiac resynchronization therapy (CRT) improves functional status and left ventricular (LV) function in HF patients with ventricular dyssynchrony, but the impact of CRT on renal function is less defined. We hypothesized that CRT would improve glomerular filtration rate as estimated by the abbreviated Modification of Diet in Renal Disease equation (eGFR). The Multicenter InSync Randomized Clinical Evaluation (MIRACLE) study evaluated CRT in HF patients with NYHA Class III-IV, ejection fraction or=130 ms. Patients were evaluated before and 6 months after randomization to control (n = 225) or CRT (n = 228). Patients were categorized according to their baseline eGFR: >or=90 (category A), 60

  8. Transcutaneous glomerular filtration rate measurement in a canine animal model of chronic kidney disease.

    Science.gov (United States)

    Mondritzki, Thomas; Steinbach, Sarah M L; Boehme, Philip; Hoffmann, Jessica; Kullmann, Maximilian; Schock-Kusch, Daniel; Vogel, Julia; Kolkhof, Peter; Sandner, Peter; Bischoff, Erwin; Hüser, Jörg; Dinh, Wilfried; Truebel, Hubert

    Quantitative assessment of renal function by measurement of glomerular filtration rate (GFR) is an important part of safety and efficacy evaluation in preclinical drug development. Existing methods are often time consuming, imprecise and associated with animal burden. Here we describe the comparison between GFR determinations with sinistrin (PS-GFR) and fluorescence-labelled sinistrin-application and its transcutaneous detection (TD-GFR) in a large animal model of chronic kidney disease (CKD). TD-GFR measurements compared to a standard method using i.v. sinistrin were performed in a canine model. Animals were treated with one-sided renal wrapping (RW) followed by renal artery occlusion (RO). Biomarker and remote hemodynamic measurements were performed. Plasma sinistrin in comparison to transcutaneous derived GFR data were determined during healthy conditions, after RW and RW+RO. RW alone did not led to any significant changes in renal function, neither with PS-GFR nor TD-GFR. Additional RO showed a rise in blood pressure (+68.0mmHg), plasma urea (+28.8mmol/l), creatinine (+224,4μmol/l) and symmetric dimethylarginine (SDMA™; +12.6μg/dl). Plasma sinistrin derived data confirmed the expected drop (-44.7%, p<0.0001) in GFR. The calculated transcutaneous determined Fluorescein Isothiocyanate (FITC)-sinistrin GFR showed no differences to plasma sinistrin GFR at all times. Both methods were equaly sensitive to diagnose renal dysfunction in the affected animals. Renal function assessment using TD-GFR is a valid method to improve preclinical drug discovery and development. Furthermore, TD-GFR method offers advantages in terms of reduced need for blood sampling and thus decreasing animal burden compared to standard procedures. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. The Mayo Clinic quadratic equation improves the prediction of glomerular filtration rate in diabetic subjects.

    Science.gov (United States)

    Rigalleau, Vincent; Lasseur, Catherine; Raffaitin, Christelle; Perlemoine, Caroline; Barthe, Nicole; Chauveau, Philippe; Combe, Christian; Gin, Henri

    2007-03-01

    Although recommended, both the Cockcroft and Gault formula (CG) and the modification of diet in renal disease (MDRD) equation are not ideally predictive of glomerular filtration rate (GFR) in diabetic subjects; we tested whether the new Mayo Clinic Quadratic (MCQ) equation performed better. In 200 diabetic subjects with a wide range of renal function, GFR was measured by 51Cr-EDTA clearance, and compared with the results of the three predictive equations by regression analysis and Bland and Altman procedures. The correlations with body mass index, age and albumin excretion rates were tested. The precisions (absolute difference as percentage), diagnostic accuracies [receiver operating characteristic (ROC) curves for the diagnosis of moderate and severe chronic kidney disease (CKD)], and the results of stratification according to the KDOQ classification were compared. The CG and MCQ overestimated mean GFR, whereas the MDRD underestimated it. Correlation coefficients and areas under the ROC curves were better for the MDRD and the MCQ as compared with the CG, which was biased by body weight (+30% overestimation in obese diabetic subjects). The absolute differences with true GFR were slightly lower for the MDRD than the MCQ, and both better than the CG. Both the MDRD and MCQ correctly stratified 65% of the subjects (CG: 55%, P<0.05). In contrast with the MDRD, the MCQ did not underestimate normal GFR, and its performance for stratification was uniformly good over a wide GFR range. In diabetic subjects, the MCQ has a similar diagnostic performance to the MDRD, but it does not underestimate normal GFR, which is an important advantage.

  10. Water-soluble vitamins in people with low glomerular filtration rate or on dialysis: a review.

    Science.gov (United States)

    Clase, Catherine M; Ki, Vincent; Holden, Rachel M

    2013-01-01

    People with low glomerular filtration rate and people on dialysis are spontaneously at risk for vitamin deficiency because of the potential for problems with decreased appetite and decreased sense of smell and taste, leading to decreased intake, and because decreased energy or decreased cognitive ability results in difficulties in shopping and cooking. Imposed dietary restrictions because of their renal dysfunction and because of comorbidities such as hypertension and diabetes exacerbate this problem. Finally, particularly for water-soluble vitamins, loss may occur into the dialysate. We did not identify any randomized trials of administering daily doses close to the recommended daily allowances of these vitamins. In people who are eating at all, deficiencies of B5 and B7 seem unlikely. It is unclear whether supplements of B2 and B3 are necessary. Because of dialyzability and documented evidence of insufficiency in dialysis patients, B1 supplementation is likely to be helpful. B6, B9, and B12 are implicated in the hyperhomocysteinemia observed in patients on dialysis. These vitamins have been studied in combinations, in high doses, with the hope of reducing cardiovascular outcomes. No reductions in patient-important outcomes were seen in adequately powered randomized trials. Because of their involvement in the homocysteine pathway, however, supplementation with lower doses, close to the recommended daily allowances, may be helpful. Vitamin C deficiency is common in patients on dialysis who are not taking supplements: low-dose supplements are warranted. Vitamins for dialysis patients contain most or all of the B vitamins and low-dose vitamin C. We are not aware of any medical reasons to choose one over another. © 2013. The Authors. Seminars in Dialysis published by Wiley Periodicals, Inc.

  11. 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.

  12. Clinical predictors of the estimated glomerular filtration rate 1 year after radical nephrectomy in Japanese patients

    Directory of Open Access Journals (Sweden)

    Shuichi Shimada

    2017-07-01

    Full Text Available Purpose: To evaluate renal function 1 year after radical nephrectomy (RN for renal cell carcinoma, the preoperative predictors of postnephrectomy renal function were investigated by sex, and equations to predict the estimated glomerular filtration rate (eGFR 1 year after RN were developed. Materials and Methods: A total of 525 patients who underwent RN between May 2007 and August 2011 at Tohoku University Hospital and its affiliated hospitals were prospectively evaluated. Overall, 422 patients were analyzed in this study. Results: Independent preoperative factors associated with postnephrectomy renal function were different in males and females. Preoperative eGFR, age, tumor size, and body mass index (BMI were independent factors in males, while tumor size and BMI were not independent factors in females. The equations developed to predict eGFR 1 year after RN were: Predicted eGFR in males (mL/min/1.73 m2 =27.99-(0.196×age+(0.497×eGFR+(0.744×tumor size-(0.339×BMI; and predicted eGFR in females=44.57- (0.275×age+(0.298×eGFR. The equations were validated in the validation dataset (R2 =0.63, p<0.0001 and R2 =0.31, p<0.0001, respectively. Conclusions: The developed equations by sex enable better prediction of eGFR 1 year after RN. The equations will be useful for preoperative patient counseling and selection of the type of surgical procedure in elective partial or RN cases.

  13. Derivation of new equations to estimate glomerular filtration rate in pediatric oncology patients.

    Science.gov (United States)

    Millisor, Vanessa E; Roberts, Jessica K; Sun, Yilun; Tang, Li; Daryani, Vinay M; Gregornik, David; Cross, Shane J; Ward, Deborah; Pauley, Jennifer L; Molinelli, Alejandro; Brennan, Rachel C; Stewart, Clinton F

    2017-06-02

    Monitoring renal function is critical in treating pediatric patients, especially when dosing nephrotoxic agents. We evaluated the validity of the bedside Schwartz and Brandt equations in pediatric oncology patients and developed new equations for estimated glomerular filtration rate (eGFR) in these patients. A retrospective analysis was conducted comparing eGFR using the bedside Schwartz and Brandt equations to measured GFR (mGFR) from technetium-99m diethylenetriamine pentaacetic acid ( 99m Tc-DTPA) between January 2007 and August 2013. An improved equation to estimate GFR was developed, simplified, and externally validated in a cohort of patients studied from September 2013 to June 2015. Carboplatin doses calculated from 99m Tc-DTPA were compared with doses calculated by GFR-estimating equations. Overall, the bedside Schwartz and Brandt equations did not precisely or accurately predict measured GFR (mGFR). Using a data subset, we developed a five-covariate equation, which included height, serum creatinine, age, blood urea nitrogen (BUN), and gender, and a simplified version (two-covariates), which contained height and serum creatinine. These equations were used to estimate GFR in 2036 studies, resulting in precise and accurate predictors of mGFR values. Equations were validated in an external cohort of 570 studies; both new equations were more accurate in calculating carboplatin doses than either the bedside Schwartz or Brandt equation. Two new equations were developed to estimate GFR in pediatric oncology patients, both of which did a better job at estimating mGFR than published equations.

  14. Cystatin C in assessment of glomerular filtration rate in children and young adults suffering from cancer.

    Science.gov (United States)

    Barnfield, Mark C; Burniston, Maria T; Reid, Una; Graham, Alastair M; Henderson, Mick; Picton, Susan V

    2013-06-01

    The study objective was to establish the diagnostic efficacy of cystatin C in the assessment of glomerular filtration rate (GFR) in paediatric oncology patients by investigating the relationships between serum cystatin C, serum creatinine and isotope clearance and determining whether these relationships are different from those seen in a group of patients of similar age with renal disease. This was a cohort study in which patients were divided into two groups: group A comprised renal patients and group B comprised oncology patients. All patients were referred for isotopic GFR assessment as part of routine clinical management and concurrently also had assessments made of their serum creatinine and cystatin C levels, together with height and weight measurements. Reciprocals of cystatin C correlate well with isotopic GFR; correlation coefficients from linear regression were 0.83 and 0.66 for the renal and oncology groups, respectively. However, when GFR was assessed from serum creatinine and cystatin C, levels of agreement were still very high (95% levels of agreement: -33 and 31 ml/min/1.73 m for cystatin C and -46 and 30 ml/min/1.73 m for the Counahan serum creatinine estimate). Receiver-operator characteristic curve analysis demonstrated that cystatin C has improved diagnostic utility for identifying patients with GFRs both below normal (90 ml/min/1.73 m) and below the point at which chemotherapy dose reduction may be considered (60 ml/min/1.73 m). Levels of intrapatient variability were similar for both tracers. Cystatin C was shown to be a better indicator of renal function compared with serum creatinine in oncology patients as demonstrated by receiver-operator characteristic curve and Bland-Altman analyses; however, sensitivity of the tracer to mild reductions in GFR is still low.

  15. Correlation of Serum Cystatin C with Glomerular Filtration Rate in Patients Receiving Platinum-Based Chemotherapy

    Directory of Open Access Journals (Sweden)

    Ernesta Cavalcanti

    2016-01-01

    Full Text Available Objectives. Serum cystatin C seems to be an accurate marker of glomerular filtration rate (GFR compared to serum creatinine. The aim of this work was to explore the possibility of using serum cystatin C instead of serum creatinine to early predict renal failure in cancer patients who received platinum based chemotherapy. Design and Methods. Serum creatinine, serum cystatin C concentrations, and GFR were determined simultaneously in 52 cancer patients received carboplatin-based or cisplatin-based chemotherapy. Serum creatinine was assayed on Cobas C6000-Roche, serum cystatin C assay was performed on AIA 360-Tosoh, and GFR was determined in all patients, before the first cycle of chemotherapy and before the subsequent administrations. Results. In the overall series, for the prediction of a fall of GFR < 80 mL/min/1.73 m2, the AUC of the ROC curve for cystatin C was 0,667 and the best threshold was 1.135 mg/L (sensitivity 90.5%, specificity 61.1%. For a GFR fall < 60 mL/min/1.73 m2, the AUC of ROC curve for cystatin C was 74.3% and the best threshold was 1.415 mg/L (sensitivity 66.7%, specificity 73.2%. Conclusions. Baseline cystatin C values were not able to predict renal failure during subsequent treatment. In conclusion, serum cystatin C is not a reliable early marker to efficiently predict renal failure in patients receiving chemotherapy.

  16. [Cystatin C as a marker of glomerular filtration rate in patients with ovarian cancer].

    Science.gov (United States)

    Bodnar, Lubomir; Wcisło, Gabriel B; elichowski, Grzegorz; Raczka, Anna; Wańkowicz, Zofia; Szczylik, Cezary

    2008-04-01

    Cystatin C, a cysteine protease inhibitor, has been recommended as a new marker of glomerular filtration rate (GFR). THE AIM OF STUDY We investigated significance of cystatin C in assessment of GFR and its influence on overall survival (OS) in patients with ovarian cancer (OC). We prospectively included consecutive patients with OC, who after surgery were qualified to first line chemotherapy according to the following protocol: cisplatin 75 mg/m2 and 24-hour infusion of paclitaxel 135 mg/m2 every three weeks. We assessed: serum levels of creatinine (Cr), cystatin C (Cys C), creatinine clearance (ClCr) calculated from 24-hour urine collection, GFR estimated according to Cocroft-Gault (CG) and Modification Diet of Renal Disease (MDRD) formulas. Age median of 37 patients enrolled into this study was 54 years (range from 28 to 68). We noted correlation between cystatin C and CrCl (R Spearman= -0.36; p = 0.03). We did not state any correlation between Cys C and another markers of GFR as: serum creatinine, CG, MDRD. However, we observed correlation between Cys C and measured tumor mass seeing in spiral CT-scan (diameter more than 1 cm) after surgery (R Spearman = 0.4; p = 0.01) and serum level of marker CA 125 (R Spearman= 0.4; p = 0.03). We didn't find any statistical correlation between values of serum Cys C (using median's as cutoff values) in overall survival of our patients (log-rank test, p = 0.9). Serum cystatin C level in patient with ovarian cancer is both the poor marker of GFR and has not prognostic value in the course of cancer after surgery with further primary chemotherapy. The explanation of this phenomenon could rely on the presence of residual ovarian cancer.

  17. The relationship of serum and urinary laminin and glomerular filtration rate in diabetes mellitus

    International Nuclear Information System (INIS)

    Li Jianlin

    2002-01-01

    Objective: To observe the relationship of serum and urinary laminin and glomerular filtration rate (GFR) in diabetes mellitus. Methods: The level of serum and urinary laminin was measured by radioimmunoassay, GFR acquired by 99m Tc diethylenetriamine pentaacetic acid ( 99m Tc-DTPA), renal dynamic imaging in 75 diabetes mellitus and 42 normal subjects. Results: (1) The level of serum LN (136.30 ± 11.20 ng/ml) and urinary LN (31.76 ± 5.77 ng/ml) in diabetic nephropathy was significantly higher than that in diabetes without nephrosis group (P<0.05) and control group (P<0.01), the level of serum LN (126.54 ± 6.98 ng/ml) and urinary LN (26.27 ± 3.81 ng/ml) in diabetes without nephrosis group was significantly higher than that in control group (P<0.05); the GFR of diabetic nephropathy (78.84 ± 10.79 ng/ml) was significantly lower than that in diabetes without nephrosis group (P<0.05) and control group (P<0.01); the level of serum (131.49 ± 10.74 ng/ml) and urinary LN (29.05 ± 5.60 ng/ml) in diabetes mellitus was significantly higher than that in control group (P<0.05), but GFR was significantly lower than that in control group (P<0.05). (2) The value of GFR in diabetes mellitus lasted less than 1 year was higher than that of control group (P<0.05), but inverse in diabetes mellitus more than 10 years (P<0.05). (3) The level of serum and urinary LN had significantly negative correlation with GFR (P<0.01). Conclusion: LN may accelerates the alteration of GFR and causes microangiopathy of diabetic nephropathy. It may be an important indicator in the diagnosis of the early diabetic nephropathy

  18. Serum C-reactive protein and thioredoxin levels in subjects with mildly reduced glomerular filtration rate

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    Ishimura Eiji

    2010-04-01

    Full Text Available Abstract Background Chronic kidney disease (CKD is a newly recognized high-risk condition for cardiovascular disease (CVD, and previous studies reported the changes in inflammation and oxidative stress in advanced stages of CKD. We compared the levels of serum biomarkers for inflammation and oxidative stress between subjects with normal and mildly reduced glomerular filtration rate (GFR. Methods The subjects were 182 participants of a health check-up program including those with normal (≥ 90 mL/min/1.73 m2, N = 79 and mildly reduced eGFR (60-89 mL/min/1.73 m2, N = 103 which was calculated based on serum creatinine, age and sex. We excluded those with reduced eGFR 2. No one had proteinuria. We measured serum levels of C-reactive protein (CRP and thioredoxin (TRX as the markers of inflammation and oxidative stress, respectively. Results As compared with subjects with normal eGFR, those with mildly reduced eGFR had increased levels of both CRP and TRX. Also, eGFR was inversely correlated with these biomarkers. The associations of eGFR with these biomarkers remained significant after adjustment for age and sex. When adjustment was done for eight possible confounders, CRP showed significant association with systolic blood pressure, high density lipoprotein cholesterol (HDL-C and non-HDL-C, whereas TRX was associated with sex significantly, and with eGFR and systolic blood pressure at borderline significance. Conclusions We showed the increased levels of CRP and TRX in subjects with mildly reduced eGFR. The eGFR-CRP link and the eGFR-TRX link appeared to be mediated, at least partly, by the alterations in blood pressure and plasma lipids in these subjects.

  19. Adjusted Anion Gap Is Associated with Glomerular Filtration Rate Decline in Chronic Kidney Disease.

    Science.gov (United States)

    Togawa, Akashi; Uyama, Satoko; Takanohashi, Seiko; Shimasaki, Megumi; Miyaji, Takehiko; Endo, Hiroyuki; Fujigaki, Yoshihide

    2013-01-01

    Metabolic acidosis is known to accelerate the progression of chronic kidney disease (CKD). However, whether undetermined anions as indicated by the adjusted anion gap (aAG) are associated with estimated glomerular filtration rate (eGFR) decline in patients with CKD is unclear. Data from 42 patients with CKD (baseline eGFR, 7.1-52.0 ml/min/ 1.73 m 2 ) without massive proteinuria (urinary protein-creatinine ratio, UPCR <3.5) were retrospectively analyzed. aAG was calculated from serum sodium, serum chloride, serum bicarbonate, serum albumin, serum potassium, serum calcium and serum phosphate. The association between the percentage of the 6-month change of eGFR (%ΔeGFR/6m) and aAG was examined. The mean baseline eGFR was 27.5 ± 11.1 ml/min/1.73 m 2 and the mean %ΔeGFR/6m was 13.8 ± 10.3. UPCR and aAG were 1.13 ± 0.93 and 9.48 ± 1.88, respectively. %ΔeGFR/6m was associated with aAG (r = 0.438, p < 0.005), but not with UPCR (r = 0.194, p = 0.218). In multivariate linear regression analyses, aAG remained significantly associated with %ΔeGFR/6m (β = 0.45, p < 0.01) after controlling for age, baseline eGFR, UPCR and HCO 3 - concentration. These data suggest that aAG appears to be associated with the progression of CKD. aAG might be an independent predictor of CKD progression.

  20. 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.

  1. Tubular and glomerular proteinuria in HIV-infected adults with estimated glomerular filtration rate ≥ 60 ml/min per 1.73 m2.

    Science.gov (United States)

    Reynes, Jacques; Cournil, Amandine; Peyriere, Hélène; Psomas, Christina; Guiller, Elsa; Chatron, Marlène; Cristol, Jean-Paul; Badiou, Stéphanie

    2013-05-15

    To assess the frequency of glomerular and tubular proteinuria in a cohort of HIV-infected patients, and to determine the factors associated with each type of injury. Cross-sectional study of 1210 consecutive HIV-infected adults followed in HIV outpatient unit (Montpellier/France). Spot urine protein to creatinine (uPCR), albumin to creatinine (uACR) and albumin to protein (uAPR) ratios were assessed. Glomerular injury was defined as uACR at least 30 mg/g or uPCR at least 200 mg/g with uAPR at least 0.4. Tubular injury was defined as uPCR 200 mg/g or more with uAPR less than 0.4. Multivariate logistic regression identified independent factors of each type of proteinuria, in the 1158 patients with estimated glomerular filtration rate (eGFR) at least 60 ml/min per 1.73 m, using re-expressed modification of diet in renal disease equation. Frequency of proteinuria was 18.2% among patients with eGFR at least 60 ml/min per 1.73 m consisting in tubular proteinuria for 50.7% of them. Factors associated with glomerular proteinuria were age [OR 1.34/10-year increment (95%CI: 1.08-1.66)], diabetes [OR 3.37 (95%CI: 1.53-7.44)], and arterial hypertension [OR 2.52 (95%CI: 1.36-4.66)]. Factors associated with tubular proteinuria were age [OR 1.43 (95%CI: 1.14-1.79)], current tenofovir use [OR 3.52 (95%CI: 1.86-6.65)], hepatitis C co-infection [OR 1.62 (95%CI: 1.00-2.65)], AIDS stage [OR 1.83 (95%CI: 1.18-2.82)], CD4 cell count less than 200 per μl [OR 2.48 (95%CI: 1.31-4.70)]. This study distinguished risk factors for tubular injury, mainly related to HIV disease and its treatment (tenofovir), and glomerular injury, linked to non HIV-related variables (age, diabetes, hypertension). Measuring uPCR, uACR and uAPR may help with the detection and specific management of early chronic kidney disease in HIV-infected patients having normal or sub-normal eGFR.

  2. Measured glomerular filtration rate at dialysis initiation and clinical outcomes of Indian peritoneal dialysis patients

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    N Prasad

    2017-01-01

    Full Text Available The optimal time for dialysis initiation remains controversial. Studies have failed to show better outcomes with early initiation of hemodialysis; even a few had shown increased adverse outcomes including poorer survival. Few studies have examined the same in patients on peritoneal dialysis (PD. Measured glomerular filtration rate (mGFR not creatinine-based estimated GFR is recommended as the measure of kidney function in end-stage renal disease (ESRD patients. The objective of this observational study was to compare the outcomes of Indian patients initiated on PD with different residual renal function (RRF as measured by 24-h urinary clearance method. A total of 352 incident patients starting on chronic ambulatory PD as the first modality of renal replacement therapy were followed prospectively. Patients were categorized into three groups as per mGFR at the initiation of PD (≤5, >5–10, and> 10 ml/min/1.73 m2. Patient survival and technique survival were compared among the three groups. Patients with GFR of ≤5 ml/min/1.73 m2 (hazard ratio [HR] - 3.42, 95% confidence interval [CI] - 1.85–6.30, P = 0.000 and> 5–10 ml/min/1.73 m2 (HR - 2.16, 95% CI - 1.26–3.71, P = 0.005 had higher risk of mortality as compared to those with GFR of> 10 ml/min/1.73 m2. Each increment of 1 ml/min/1.73 m2 in baseline GFR was associated with 10% reduced risk of death (HR - 0.90, 95% CI - 0.85–0.96, P = 0.002. Technique survival was poor in those with an initial mGFR of ≤5 ml/min/1.73 m2 as compared to other categories. RRF at the initiation was also an important factor predicting nutritional status at 1 year of follow-up. To conclude, initiation of PD at a lower baseline mGFR is associated with poorer patient and technique survival in Indian ESRD patients.

  3. Cystatin C Is a Gender-Neutral Glomerular Filtration Rate Biomarker in Patients with Cirrhosis.

    Science.gov (United States)

    Mindikoglu, Ayse L; Opekun, Antone R; Mitch, William E; Magder, Laurence S; Christenson, Robert H; Dowling, Thomas C; Weir, Matthew R; Seliger, Stephen L; Howell, Charles D; Raufman, Jean-Pierre; Rana, Abbas; Goss, John A; Khaderi, Saira A; Vierling, John M

    2018-03-01

    Lower serum Cr levels in women as compared to men result in underestimation of renal dysfunction and lower model for end-stage liver disease-sodium scores leading to reduced access to liver transplantation in women compared to men with comparable hepatic dysfunction. The aim of this study was to determine the gender differences in serum Cr, cystatin C, and other endogenous glomerular filtration rate (GFR) biomarkers, measured and estimated GFR, Cr clearance, and Cr production rates. We measured GFR by iothalamate plasma clearance in 103 patients with cirrhosis and assessed gender differences in GFR, Cr clearance and production rate, serum Cr, cystatin C and other endogenous GFR biomarkers including beta-trace protein, beta-2 microglobulin, and dimethylarginines. Comparison of men and women showed significantly lower values for mean serum Cr (0.97 vs. 0.82 mg/dl, P = 0.023), and Cr production rate (13.37 vs. 11.02 mg/kg/day, P = 0.022). In contrast to the serum Cr and Cr production rate, men and women exhibited no significant differences in the means of serum cystatin C and other GFR biomarkers, measured GFR, GFR estimated using Cr-cystatin C GFR equation for cirrhosis, measured and estimated Cr clearances. After controlling for age, race, weight, height, and GFR, female gender remained associated with lower serum Cr levels (P = 0.003). Serum cystatin C levels were not associated with gender, age, race, weight, height, C-reactive protein, and history of hypothyroidism. Our results suggest that cystatin C and endogenous GFR biomarkers other than Cr, measured GFR, GFR estimated by Cr-cystatin C GFR equation for cirrhosis, measured and estimated Cr clearance minimized between-gender biases in accounting for renal function in patients with cirrhosis. Therefore, serum cystatin C should be measured as a complementary test to serum Cr when renal function is assessed in patients with cirrhosis, particularly in women and those with sarcopenia.

  4. Aging and decreased glomerular filtration rate: An elderly population-based study.

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    Regina C R M Abdulkader

    Full Text Available Although a reduced glomerular filtration rate (GFR in old people has been attributed to physiologic aging, it may be associated with kidney disease or superimposed comorbidities. This study aims to assess the prevalence of decreased GFR in a geriatric population in a developing country and its prevalence in the absence of simultaneous diseases.This is a cross-sectional study of data from the Saúde, Bem-Estar e Envelhecimento cohort study (SABE study[Health, Well-Being and Aging], a multiple cohorts study. A multistage cluster sample composed of 1,253 individuals representative of 1,249,388 inhabitants of São Paulo city aged ≥60 years in 2010 was analyzed. The participants answered a survey on socio-demographic factors and health, had blood pressure measured and urine and blood samples collected. GFR was estimated and defined as decreased when 0.20 g/g.The prevalence of GFR <60 mL/min/1.73m2 was 19.3%. Individuals with GFR <60 mL/min/1.73m2 were older (75±1 versus 69±1 years, p<0.001, had lower schooling (18 versus 30% with complete 8-year basic cycle, p = 0.010, and higher prevalence of hypertension (82 versus 63%, p<0.001, diabetes (34 versus 26%, p = 0.021, cardiovascular disease (43 versus 24%, p<0.001 and kidney damage (35% versus 15%, p<0.001. Only 0.7% of the entire studied population had GFR <60 mL/min/1.73m2 without simultaneous diseases or kidney damage. Among the individuals with GFR <60 mL/min/1.73m2, 3.5% had neither renal damage nor associated comorbidities, whereas among those with GFR ≥60 mL/min/1.73m2, 11.0% had none of these conditions. Logistic regression showed that older age, cardiovascular disease and hypertension were associated with GFR<60 mL/min/1.73m2.Decreased GFR was highly prevalent among the geriatric population in a megalopolis of a developing country. It was rarely present without simultaneous chronic comorbidities or kidney damage.

  5. 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

  6. Existing creatinine-based equations overestimate glomerular filtration rate in Indians.

    Science.gov (United States)

    Kumar, Vivek; Yadav, Ashok Kumar; Yasuda, Yoshinari; Horio, Masaru; Kumar, Vinod; Sahni, Nancy; Gupta, Krishan L; Matsuo, Seiichi; Kohli, Harbir Singh; Jha, Vivekanand

    2018-02-01

    Accurate estimation of glomerular filtration rate (GFR) is important for diagnosis and risk stratification in chronic kidney disease and for selection of living donors. Ethnic differences have required correction factors in the originally developed creatinine-based GFR estimation equations for populations around the world. Existing equations have not been validated in the vegetarian Indian population. We examined the performance of creatinine and cystatin-based GFR estimating equations in Indians. GFR was measured by urinary clearance of inulin. Serum creatinine was measured using IDMS-traceable Jaffe's and enzymatic assays, and cystatin C by colloidal gold immunoassay. Dietary protein intake was calculated by measuring urinary nitrogen appearance. Bias, precision and accuracy were calculated for the eGFR equations. A total of 130 participants (63 healthy kidney donors and 67 with CKD) were studied. About 50% were vegetarians, and the remainder ate meat 3.8 times every month. The average creatinine excretion were 14.7 mg/kg/day (95% CI: 13.5 to 15.9 mg/kg/day) and 12.4 mg/kg/day (95% CI: 11.2 to 13.6 mg/kg/day) in males and females, respectively. The average daily protein intake was 46.1 g/day (95% CI: 43.2 to 48.8 g/day). The mean mGFR in the study population was 51.66 ± 31.68 ml/min/1.73m 2 . All creatinine-based eGFR equations overestimated GFR (p < 0.01 for each creatinine based eGFR equation). However, eGFR by CKD-EPI Cys was not significantly different from mGFR (p = 0.38). The CKD-EPI Cys exhibited lowest bias [mean bias: -3.53 ± 14.70 ml/min/1.73m 2 (95% CI: -0.608 to -0.98)] and highest accuracy (P 30 : 74.6%). The GFR in the healthy population was 79.44 ± 20.19 (range: 41.90-134.50) ml/min/1.73m 2 . Existing creatinine-based GFR estimating equations overestimate GFR in Indians. An appropriately powered study is needed to develop either a correction factor or a new equation for accurate assessment of kidney function in the

  7. Predictors of estimated glomerular filtration rate progression, stabilization or improvement after chronic renal impairment in HIV-positive individuals

    DEFF Research Database (Denmark)

    Ryom, Lene; Mocroft, Amanda; Kirk, Ole

    2017-01-01

    GFR defining CRI, and changes were grouped into improvement (>+10 ml/min per 1.73 m), stabilization (-10 to +10 ml/min per 1.73 m) and progression (polynomial regression models assessed odds of better eGFR outcomes after CRI, assuming that eGFR improvement is better than......OBJECTIVES: The objectives of this analysis were to investigate predictors of progression, stabilization or improvement in estimated glomerular filtration rate (eGFR) after development of chronic renal impairment (CRI) in HIV-positive individuals. DESIGN: Prospective observational study. METHODS...

  8. Transcutaneous measurement of glomerular filtration rate in conscious laboratory animals: state of the art and future perspectives

    Science.gov (United States)

    Friedemann, Jochen; Schock-Kusch, Daniel; Shulhevich, Yury

    2017-02-01

    Transcutaneous measurement of Glomerular Filtration Rate (tGFR) is now frequently used in preclinical in vivo animal studies. tGFR allows consecutive measurements on the same animal, including multiple measurements on a daily basis. A description of the measurement device and its many applications, along with examples from the recent literature will be given. We will highlight the fields of interest in which the system is used and give an overview about its performance versus endogenous and other exogenous methods of GFR measurement. A special focus will be put on the precision of tGFR compared to standard measurements employed in the research setting.

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

    International Nuclear Information System (INIS)

    Kamper, A.L.; Thomsen, H.S.; Nielsen, S.L.; Strandgaard, S.; Herlev Hospital

    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 51 Cr-EDTA plasma clearance fell by 14% (P 99m Tc-DMSA increased by 10% (P<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. (orig.)

  10. 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

    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...... 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...

  11. 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......No previous study addressed whether in the general population estimated glomerular filtration rate (eGFR [Chronic Kidney Disease Epidemiology Collaboration formula]) adds to the prediction of cardiovascular outcome over and beyond ambulatory blood pressure. We recorded health outcomes in 5322...

  12. 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.

  13. Comparison of inulin, iothalamate, and /sup 99m/Tc-DTPA for measurement of glomerular filtration rate

    International Nuclear Information System (INIS)

    Barbour, G.L.; Crumb, C.K.; Boyd, C.M.; Reeves, R.D.; Rastogi, S.P.; Patterson, R.M.

    1976-01-01

    Clearances of inulin, 125 I-iothalamate, and /sup 99m/Tc-Sn-DTPA were measured simultaneously in five mongrel dogs exhibiting a wide range of glomerular filtration rates (GFR). Standard constant-infusion inulin clearance was compared to radionuclide clearances after subcutaneous injection of the emitters mixed with aqueous epinephrine. All three substances were found to have virtually identical clearances. The accuracy, accessibility, low cost, low radiation hazard, and short half-life of /sup 99m/Tc-Sn-DTPA make it an excellent substance for measuring GFR. The subcutaneous technique offers an accuracy comparable to the more difficult constant-infusion method

  14. Dynamic, size-selective effects of protamine sulfate and hyaluronidase on the rat glomerular filtration barrier in vivo.

    Science.gov (United States)

    Sverrisson, Kristinn; Axelsson, Josefin; Rippe, Anna; Asgeirsson, Daniel; Rippe, Bengt

    2014-11-15

    The proteinuric actions of protamine sulfate (PS) have classically been, at least partly, attributed to alterations of the negatively charged glomerular endothelial glycocalyx. To investigate whether the charge-selective properties of the glomerular filtration barrier (GFB) would be altered by PS, we assessed the glomerular sieving of conventional, uncharged, polydispersed Ficoll (n-Ficoll) compared with charge modified, conformationally intact, anionic (carboxymethylated) Ficoll (a-Ficoll) before and after systemic infusions of PS in rats. For comparison, we also investigated the impact of hyaluronidase (hyase), which partially degrades the glycocalyx, on GFB permeability. In anaesthetized Wistar rats, blood access was achieved, and the left ureter was cannulated for urine collection. Rats were infused with either n-Ficoll or a-Ficoll before and during systemic infusions with either PS or hyase. Plasma and urine samples were taken repeatedly and analyzed by high-performance size exclusion chromatography to assess glomerular sieving coefficients (θ) for Ficoll (radius 10-80 Å). The GFB showed a significant glomerular charge selectivity for Ficoll molecules of radius 20-35 Å. PS and hyase infusions reversibly increased θ for large Ficoll molecules (Ficoll molecules of radius 50-80 Å). Thus, for PS, θ for a-Ficoll molecules of radius 70 Å increased from 2.47 × 10(-5) ± 1.1(-5) to 7.25 × 10(-5) ± 1.1(-5) (P < 0.05) at 15 min. For hyase, changes in a-Ficoll molecules of radius 50-80 Å were, however, not statistically significant. Neither PS nor hyase had any effect on θ for n-Ficoll molecules of radius 20-45 Å or a-Ficoll molecules of radius 20-45 Å. It is concluded that systemically administered PS and hyase in moderate doses dynamically decreased the size selectivity of the rat GFB without affecting its charge selective properties. Copyright © 2014 the American Physiological Society.

  15. Glomerular filtration rate by {sup 51}chomium and {sup 113m}indium labeled EDTA in horses; Taxa de filtracao glomerular pelo EDTA marcado com {sup 51}cromo e com {sup 113m}indio em equinos

    Energy Technology Data Exchange (ETDEWEB)

    Maliska, C.; D' Almeida, J.; Pellegrini, P.M.; Schimit, T.S. [Hospital Central do Exercito (HCE), Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear; Pinho, W.R. [Centro de Ensino Superior, Valenca, RJ (Brazil). Fac. de Medicina Veterinaria; Lima, J.E.T. [Instituto Nacional do Cancer (INCa), Rio de Janeiro, RJ (Brazil). Servico de Medicina Nuclear

    2009-07-01

    The glomerular filtration rate was determined in nine healthy horses, six male and three female, aged two to 12-year-old, by means of {sup 51}Cr and {sup 113m}In labeled EDTA single injection technique. The glomerular filtration rate was calculated from the plasma disappearance curve and the volume of distribution of the radiotracer, {sup 51}Cr-EDTA or {sup 113m}In-EDTA. The result (mean +- standard deviation) was 148.80 +- 26.42 m L.min{sup -1}.100 kg. It is concluded that the measurement of glomerular filtration rate by {sup 51}Cr-EDTA or {sup 113m}In-EDTA by single injection technique eliminates the bladder catheterization, and for its simplicity, convenience, accuracy, and low dose of radiation, can be used in horses as a method of choice in clinical routine. (author)

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

    Directory of Open Access Journals (Sweden)

    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

  17. Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C.

    Science.gov (United States)

    Pottel, Hans; Delanaye, Pierre; Schaeffner, Elke; Dubourg, Laurence; Eriksen, Bjørn Odvar; Melsom, Toralf; Lamb, Edmund J; Rule, Andrew D; Turner, Stephen T; Glassock, Richard J; De Souza, Vandréa; Selistre, Luciano; Goffin, Karolien; Pauwels, Steven; Mariat, Christophe; Flamant, Martin; Ebert, Natalie

    2017-03-01

    We recently published and validated the new serum creatinine (Scr)-based full-age-spectrum equation (FAS crea ) for estimating the glomerular filtration rate (GFR) for healthy and kidney-diseased subjects of all ages. The equation was based on the concept of normalized Scr and shows equivalent to superior prediction performance to the currently recommended equations for children, adolescents, adults and older adults. Based on an evaluation of the serum cystatin C (ScysC) distribution, we defined normalization constants for ScysC ( Q cysC  =   0.82 mg/L for ages <70 years and Q cysC  =   0.95 mg/L for ages ≥70 years). By replacing Scr/ Q crea in the FAS crea equation with ScysC/ Q cysC , or with the average of both normalized biomarkers, we obtained new ScysC-based (FAS cysC ) and combined Scr-/ScysC-based FAS equations (FAS combi ). To validate the new FAS cysC and FAS combi we collected data on measured GFR, Scr, ScysC, age, gender, height and weight from 11 different cohorts including n  = 6132 unique white subjects (368 children, aged ≤18 years, 4295 adults and 1469 older adults, aged ≥70 years). In children and adolescents, the new FAS cysC equation showed significantly better performance [percentage of patients within 30% of mGFR (P30) = 86.1%] than the Caucasian Asian Paediatric Adult Cohort equation (P30 = 76.6%; P < 0.0001), or the ScysC-based Schwartz equation (P30 = 68.8%; P < 0.0001) and the FAS combi equation outperformed all equations with P30 = 92.1% (P < 0.0001). In adults, the FAS cysC equation (P30 = 82.6%) performed equally as well as the Chronic Kidney Disease Epidemiology Collaboration equation (CKD-EPI cysC ) (P30 = 80.4%) and the FAS combi equation (P30 = 89.9%) was also equal to the combined CKD-EPI equation (P30 = 88.2%). In older adults, FAS cysC was superior (P30 = 88.2%) to CKD-EPI cysC (P30 = 84.4%; P < 0.0001) and the FAS combi equation (P30 = 91

  18. Is the new Mayo Clinic Quadratic equation useful for the estimation of glomerular filtration rate in type 2 diabetic patients?

    Science.gov (United States)

    Fontseré, Néstor; Bonal, Jordi; Salinas, Isabel; de Arellano, Manel Ramírez; Rios, Jose; Torres, Ferran; Sanmartí, Anna; Romero, Ramón

    2008-12-01

    To test the Mayo Clinic Quadratic (MCQ) equation against isotopic glomerular filtration rate, compared with the Modification of Diet in Renal Disease (MDRD) and the Cockcroft-Gault formulas, in type 2 diabetes. Based on values obtained with iothalamate, 118 type 2 diabetic patients were divided into three groups according to renal function: hyperfiltration (26), normal function (56), or chronic kidney disease (CKD) stages 3-4 (36). ANOVA, the Bland-Altman procedure, and Lins coefficient (Rc) were performed to study accuracy. In the hyperfiltration and normal function groups, all prediction equations significantly underestimated the value obtained with isotopic glomerular filtration rate (P equations also presented significant differences with the isotopic method. However, MDRD had a bias of -5.3 (Rc 0.452), Cockcroft-Gault formula -0.2 (Rc 0.471), and the MCQ -4.5 (Rc 0.526). The MCQ and prediction equations proved inaccurate (excessive underestimation) in type 2 diabetic patients with hyperfiltration or normal renal function. With regard to CKD, the results obtained provided no evidence of superiority of the MCQ over the MDRD or the Cockcroft-Gault formula.

  19. 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. Six......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...

  20. Adjustment of serum HE4 to reduced glomerular filtration and its use in biomarker-based prediction of deep myometrial invasion in endometrial cancer

    DEFF Research Database (Denmark)

    Chovanec, Josef; Serlingerova, Iveta; Greplova, Kristina

    2017-01-01

    Background: We investigated the efficacy of circulating biomarkers together with histological grade and age to predict deep myometrial invasion (dMI) in endometrial cancer patients. Methods: HE4ren was developed adjusting HE4 serum levels towards decreased glomerular filtration rate as quantified...... based on single-institution data from 120 EC patients and validated against multicentric data from 379 EC patients. Results: In non-cancer individuals, serum HE4 levels increase log-linearly with reduced glomerular filtration of eGFR = 90 ml/min/1.73 m2. HE4ren, adjusting HE4 serum levels to decreased e...

  1. Normal values of glomerular filtration rate in geriatrics in Bandung and its correlation with serum cystatin-C levels

    International Nuclear Information System (INIS)

    Resnaldi, A.; Yuliani, A.; Hidayat, B.; Kartamihardja, A.H.S.

    2007-01-01

    Full text: Determination of the normal values of glomerular filtration rate (GFR) is an essential part of the evaluation of patient with kidney disease. GFR almost linearly decreases with age at a mean annual rate of 0.8 ml/min/1.73 m2 over the age of 30 years old. According to NHANES III mean GFR for population with age > 60 years was 80 mL/min/1.73 m2. It is recommended for each centre to determine their own normal values of GFR for different age groups particularly in geriatric population. Recently, serum cystatin-C has been proposed as a new endogenous marker of glomerular filtration rate. Aim of the study was to determination of normal values of glomerular filtration rate (GFR) in geriatrics in Bandung and its correlation with serum Cystatin-C levels. Subjects were 24 males and 36 females (mean age 66.71 ± 6.7 years; range 60-87 yrs), without any renal and/or systemic disease. Creatinine clearance was estimated by using Cockroft-Gault formula and serum cystatin-C level were determined by using particle enhanced immunonephelometric method, while GFR values were determined by external body counting methods using Tc-99m DTPA ( Gates' methods ). Pearson correlation was used to determine correlation between variables and a P value < 0.05 is considered significant. Results and Discussion. Mean total GFR was 67.57 ml/min/1.73 m2 (SD ± 16.02), range from 45 to 100 ml/min/1.73 m2. Mean total GFR for male was 69.46 ml/min/1.73 m2, and female was 66.31 ml/min/1.73 m2, the difference was statistically significant (p < 0.05). The results were lower than NHANES III values. There was a better correlation between total GFR and cystatin-C level (r = -0.522 and p < 0.001) compared to total GFR and creatinine clearance (r 0.306 and p < 0.005). Mean creatinine clearance was 57.93 ml/min and serum cystatin-C was 0.97 mg/dl, the correlation was statistically significant (r -0.414 and p < 0.005). Conclusions: The normal values of GFR in geriatric population in Bandung were 69

  2. 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

    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......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...... up by the tubular cells from the peritubular capillaries since the uptake was unaffected by the acute decrease in GFR....

  3. Beneficial Effect of Conversion to Belatacept in Kidney-Transplant Patients with a Low Glomerular-Filtration Rate

    Directory of Open Access Journals (Sweden)

    Julie Belliere

    2014-01-01

    Full Text Available Belatacept has been found to be efficient at preserving good kidney function in maintenance kidney-transplant patients. Herein, we report on the use of belatacept as a rescue therapy for two kidney-transplant patients presenting with severe adverse events after treatment with calcineurin inhibitors (CNIs and mammalian target-of-rapamycin (mTOR inhibitors. Two kidney-transplant patients developed severely impaired kidney function after receiving CNIs. The use of everolimus was associated with severe angioedema. Belatacept was then successfully used to improve kidney function in both cases, even though estimated glomerular-filtration rate before conversion was <20 mL/min. These case reports show that belatacept can be used as a rescue therapy, even if kidney function is very low in kidney-transplant patients who cannot tolerate CNIs and/or mTOR inhibitors.

  4. Comparison of methods for estimating glomerular filtration rate in head and neck cancer patients treated with cisplatin

    DEFF Research Database (Denmark)

    Lindberg, Lotte; Brødbæk, Kasper; Hägerström, Erik G

    2017-01-01

    Cisplatin is a chemotherapeutic agent widely used in the treatment of various solid tumors. Cisplatin induces nephrotoxicity and may lead to long-term reduction of kidney function. Consequently, determination of glomerular filtration rate (GFR) is used to monitor potential kidney damage. This study...... aimed to compare two commonly used algorithms for estimating GFR (eGFR) from plasma creatinine (PCr) with 51Cr-EDTA clearance (CrCl) as a reference method. This was a retrospective single center study of 94 head and neck cancer patients treated with cisplatin. CrCl was performed once before, during......, and after treatment, and PCr was measured concurrently. eGFR was assessed from PCr applying the Cockcroft-Gault (CG) and the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations. Agreement was assessed applying the statistical methods of Bland and Altman. A predefined limit of clinically...

  5. Comparison of glomerular filtration as determined by renal plasma clearance of 51Cr-EDTA and by biochemical methods

    International Nuclear Information System (INIS)

    Pontuch, P.; Srbecky, M.; Sedlak, T.; Mikulecky, M.

    1989-01-01

    In 22 patients (age 19 to 73 years) glomerular filtration was examined by assessing the renal clearance of 51 Cr-EDTA, in addition to the plasma method with several blood samples, by methods with a smaller number of blood samples and external assessment of the radioactivity, and also by estimation of creatinine clearance using biochemical methods. As a reference method, the assessment was used of renal plasma clearance of 51 Cr-EDTA by means of a one-compartment model from the radioactivity of blood samples collected during the 60th, 120th and 180th minutes. It was revealed that for the normal value of glomerular filtration (GF=1.8 ml/s) and for its reduced value (GF=0.5 ml/s), as compared with the reference method RP, the highest external and internal accuracy, i.e., the best agreement with the reference method and the closest interval estimates, were obtained by the single sample method RE (blood sample during the 120th minute) supplemented by three external assessments of radioactivity during the 50th-70th, 110th-130th and 170th-190th minutes. The regression relationship of these methods is expressed by the following equations: RE=-8.9+1.06xRP; RP=8.47+0.94xRE. The biochemical methods were less accurate as compared with the radionuclide ones. Their accuracy declined from the calculated creatinine clearance according to Cockcroft and Gault via the inverse value of the serum creatinine concentration towards the 24-hour creatinine clearance. (author). 2 figs., 1 tab., 16 refs

  6. Genetic Modifiers of White Blood Cell Count, Albuminuria and Glomerular Filtration Rate in Children with Sickle Cell Anemia.

    Directory of Open Access Journals (Sweden)

    Beverly A Schaefer

    Full Text Available 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.

  7. Tumor necrosis factor-alpha-induced reduction of glomerular filtration rate in rats with fulminant hepatic failure.

    Science.gov (United States)

    Wang, Jing-Bo; Wang, Dong-Lei; Wang, Hai-Tao; Wang, Zhao-Han; Wen, Ying; Sun, Cui-Ming; Zhao, Yi-Tong; Wu, Jian; Liu, Pei

    2014-07-01

    The mechanism of renal failure during fulminant hepatic failure (FHF) or end-stage of liver disease is not fully understood. The present study aims to delineate the mechanisms of decreased glomerular filtration rate (GFR) in acute hepatic failure. A rat model of renal insufficiency in severe liver injury was established by lipopolysaccharide (LPS) plus D-galactosamine (GalN) exposure. GFR was evaluated by continuous infusion of fluorescein isothiocyanate-inulin with implanted micro-osmotic pumps. GalN/LPS intoxication resulted in severe hepatocyte toxicity as evidenced by liver histology and biochemical tests, whereas renal morphology remained normal. GFR was reduced by 33% of the controls 12 h after GalN/LPS exposure, accompanied with a decreased serum sodium levels, a marked increase in serum TNF-α and ET-1 levels as well as significantly upregulated renal type 1 inositol 1,4,5-trisphosphate receptor (IP3R1) expression. The upregulated IP3R1 expression was abrogated by the treatment of anti-TNF-α antibodies, but not by 2-aminoethoxydiphenylborate (2-APB), which blocks the inositol 1,4,5-trisphosphate signaling pathway. Treatments with either TNF-α antibodies or 2-APB also significantly improved the compromised GFR, elevated serum urea nitrogen and creatinine levels, and reversed the decrease in glomerular inulin space and the increase in glomerular calcium content in GalN/LPS-exposed rats. The extent of acute liver injury as reflected by serum ALT levels was much more attenuated by anti-TNF-α antibodies than by 2-APB. Liver histology further confirmed that anti-TNF-α antibodies conferred better protection than 2-APB in GalN/LPS-exposed rats. LPS-elicited TNF-α over-production is responsible for decreased GFR through IP3R1 overexpression, and the compromised GFR resulted in the development of acute renal failure in rats with FHF.

  8. 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; Borresen, Malene L; Feldt-Rasmussen, Bo

    2010-01-01

    BACKGROUND: No studies have compared the performance of equations for estimating glomerular filtration rate (GFR) in patients with autosomal dominant polycystic kidney disease (ADPKD), where the declining GFR typically is followed for many years or even decades. This was the purpose of the present...

  9. 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...

  10. Improved metabolic control does not alter the charge-dependent glomerular filtration of albumin in uncomplicated type 1 (insulin-dependent) diabetes

    DEFF Research Database (Denmark)

    Kverneland, A; Welinder, B; Feldt-Rasmussen, B

    1988-01-01

    . It was, however, unaffected by 12 weeks of improved metabolic control with a mean decline in HbA1c of 1.9% in seven patients. We conclude that the increased electronegative charge of the glomerular filtration barrier observed in uncomplicated diabetes is related to long term metabolic control...

  11. 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...

  12. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease. A collaborative meta-analysis of kidney disease population cohorts

    DEFF Research Database (Denmark)

    Astor, Brad C; Matsushita, Kunihiro; Gansevoort, Ron T

    2011-01-01

    We studied here the independent associations of estimated glomerular filtration rate (eGFR) and albuminuria with mortality and end-stage renal disease (ESRD) in individuals with chronic kidney disease (CKD). We performed a collaborative meta-analysis of 13 studies totaling 21,688 patients selected...

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

    NARCIS (Netherlands)

    Holtkamp, Frank A.; de Zeeuw, Dick; Thomas, Merlin C.; Cooper, Mark E.; de Graeff, Pieter A.; Hillege, Hans J. L.; Parving, Hans-Henrik; Brenner, Barry M.; Shahinfar, Shahnaz; Lambers Heerspink, Hiddo J.

    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

  14. 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

    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

  15. 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.

    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).

  16. Overexpression of TGF-β Inducible microRNA-143 in Zebrafish Leads to Impairment of the Glomerular Filtration Barrier by Targeting Proteoglycans.

    Science.gov (United States)

    Müller-Deile, Janina; Gellrich, Finn; Schenk, Heiko; Schroder, Patricia; Nyström, Jenny; Lorenzen, Johan; Haller, Hermann; Schiffer, Mario

    2016-01-01

    TGF-β is known as an important stress factor of podocytes in glomerular diseases. Apart from activation of direct pro-apoptotic pathways we wanted to analyze micro-RNA (miRs) driven regulation of components involved in the integrity of the glomerular filtration barrier induced by TGF-β. Since miR-143-3p (miR-143) is described as a TGF-β inducible miR in other cell types, we examined this specific miR and its ability to induce glomerular pathology. We analyzed miR-143 expression in cultured human podocytes after stimulation with TGF-β. We also microinjected zebrafish eggs with a miR-143 mimic or with morpholinos specific for its targets syndecan and versican and compared phenotype and proteinuria development. We detected a time dependent, TGF-β inducible expression of miR-143 in human podocytes. Targets of miR-143 relevant in glomerular biology are syndecans and versican, which are known components of the glycocalyx. We found that syndecan 1 and 4 were predominantly expressed in podocytes while syndecan 3 was largely expressed in glomerular endothelial cells. Versican could be detected in both cell types. After injection of a miR-143 mimic in zebrafish larvae, syndecan 3, 4 and versican were significantly downregulated. Moreover, miR-143 overexpression or versican knockdown by morpholino caused loss of plasma proteins, edema, podocyte effacement and endothelial damage. In contrast, knockdown of syndecan 3 and syndecan 4 had no effects on glomerular filtration barrier. Expression of versican and syndecan isoforms is indispensable for proper barrier function. Podocyte-derived miR-143 is a mediator for paracrine and autocrine cross talk between podocytes and glomerular endothelial cells and can alter expression of glomerular glycocalyx proteins. © 2016 The Author(s) Published by S. Karger AG, Basel.

  17. RENAL HEMODYNAMICS AND GLOMERULAR FILTRATION RATE IN MEN AND WOMEN WITH ARTERIAL HYPERTENSION AT THE AGE OF 40-60 YEARS

    Directory of Open Access Journals (Sweden)

    I. G. Fomina

    2015-12-01

    Full Text Available Aim. To study parameters of a renal hemodynamic and the general glomerular filtration rate (GGFR and their correlations with cardiovascular risk factors (RF in patient with arterial hypertension (AH.Material and methods. 102 patients with AH (35 men and 67 women of 40-60 y.o. were involved in the study. 20 persons (10 men and 10 women with normal blood pressure (BP were included in control group. Dynamic renal angioscintigraphy was used for an estimation of a renal hemodynamic and GGFR.Results. Hypertensive women had lower renal blood flow and GGFR than these in men (p<0,000. Renal hemodynamics and GGFR in men and women did not differ in control group. Positive correlation  r=0,61; p<0,05 between GGFR and a tobacco smoking was found in hypertensive men as well as negative correlation (r=-0,41; p<0,005 between GGFR and body mass index (BMI in women.Conclusion. Renal blood flow and GGFR are lower in hypertensive women than these in men. Positive correlation between GGFR and tobacco smoking and negative correlation between GGFR and BMI were found in men and women respectively.

  18. Cystatin C and asymptomatic coronary artery disease in patients with metabolic syndrome and normal glomerular filtration rate

    Directory of Open Access Journals (Sweden)

    Qing Xie

    2012-09-01

    Full Text Available Abstract Background All of the components of Metabolic syndrome (MetS have been regarded as risk factors for coronary artery disease (CAD. Early detection of CAD in asymptomatic patients with MetS remains a challenge. Cystatin C,which has been proposed as a novel marker of renal dysfunction,is correlated with mortality in CAD, The purpose of the study was to evaluate whether cystatin C is a potential marker of asymptomatic CAD in MetS patients with normal kidney function. Methods A total of 211asymptomatic MetS patients without prior history of CAD patients were included in a cross-sectional study. Patients were divided into MetS with asymptomatic CAD (n = 136 and MetS without CAD (n = 75 groups according to coronary angiograph results. Serum cystatin C levels were measured using particle enhanced immunonephelometric assays. We first assessed whether there is an independent association of cystatin C with the presence and severity of asymptomatic CAD. Then, we investigated the association between cystatin C and other biochemical risk factors for atherosclerosis. Results Serum cystatin C levels in patients with asymptomatic CAD were significantly higher than those without CAD (P = 0.004. A multiple logistic regression analysis demonstrated cystatin C was independently associated with the presence of asymptomatic CAD (OR = 1.326, 95%CI: 1.086-1.619. On receiver operating characteristics (ROC analysis, the area under the curve (AUC was 0.622 (95 % CI: 0543–0.701, P = 0.003, and cystatin C showed a moderate predictive value. Furthermore, cystatin C was independently correlated with Gensini score (standardized β = 0.183, P = 0.007, and serum cystatin C levels increased with the increasing of number of disease vessels (P = 0.005. In a multiple stepwise regression analysis, uric acid (UA(P P = 0.002, triglyceride(TG(P = 0.03, estimated glomerular filtration rate (eGFR(P (P = 0.001 were independently

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

    Directory of Open Access Journals (Sweden)

    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

  20. Metabolic alkalosis in the rat. Evidence that reduced glomerular filtration rather than enhanced tubular bicarbonate reabsorption is responsible for maintaining the alkalotic state.

    Science.gov (United States)

    Cogan, M G; Liu, F Y

    1983-01-01

    Maintenance of chronic metabolic alkalosis might occur by a reduction in glomerular filtration rate (GFR) without increased bicarbonate reabsorption or, alternatively, by augmentation of bicarbonate reabsorption with a normal GFR. To differentiate these possibilities, free-flow micropuncture was performed in alkalotic Munich-Wistar rats with a glomerular ultrafiltrate total CO2 concentration of 46.5 +/- 0.9 mM (vs. 27.7 +/- 0.9 mM in controls). Alkalotic animals had a markedly reduced single nephron GFR compared with controls (27.4 +/- 1.5 vs. 51.6 +/- 1.6 nl/min) and consequently unchanged filtered load of bicarbonate. Absolute proximal bicarbonate reabsorption in alkalotic animals was similar to controls (981 +/- 49 vs. 1,081 +/- 57 pmol/min), despite a higher luminal bicarbonate concentration, contracted extracellular volume, and potassium depletion. When single nephron GFR during alkalosis was increased toward normal by isohydric volume expansion or in another group by isotonic bicarbonate loading, absolute proximal bicarbonate reabsorption was not substantially augmented and bicarbonaturia developed. To confirm that a fall in GFR occurs during metabolic alkalosis, additional clearance studies were performed. Awake rats were studied before and after induction of metabolic alkalosis associated with varying amounts of potassium and chloride depletion. In all cases, the rise in blood bicarbonate concentration was inversely proportional to a reduction in GFR; filtered bicarbonate load remained normal. In conclusion, a reduction in GFR is proposed as being critical for maintaining chronic metabolic alkalosis in the rat. Constancy of the filtered bicarbonate load allows normal rates of renal bicarbonate reabsorption to maintain the alkalotic state. Images PMID:6853706

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

    International Nuclear Information System (INIS)

    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 ( 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 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 ( 51 Cr-EDTA) and 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 2 in the group with renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m 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 2 , p=0.001) and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m 2 , p=0.68). Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA) did not show

  2. 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

  3. 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

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

    Directory of Open Access Journals (Sweden)

    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

  5. Improvement in estimated glomerular filtration rate in patients with chronic kidney disease undergoing catheter ablation for atrial fibrillation.

    Science.gov (United States)

    Navaravong, Leenhapong; Barakat, Michel; Burgon, Nathan; Mahnkopf, Christian; Koopmann, Matthias; Ranjan, Ravi; Kholmovski, Eugene; Marrouche, Nassir; Akoum, Nazem

    2015-01-01

    Chronic kidney disease (CKD) and atrial fibrillation (AF) often coexist. We studied the association of CKD with atrial fibrosis and the effect of AF ablation on kidney function. AF patients who had a pre- and postablation serum creatinine and who completed a late gadolinium enhancement cardiac magnetic resonance imaging (MRI; LGE-MRI) prior to ablation were included. Estimated glomerular filtration rate (eGFR) was calculated and CKD was staged using the National Kidney Foundation guidelines. Patients with eGFR disease. Atrial fibrosis was not significant different between included CKD stages: 15.8 ± 8.8%, 16.6 ± 12.1%, 17.1 ± 10.4%, and 16.5 ± 8.4% for CKD stage 1, 2, 3A, and 3B, respectively (P = 0.476). At a median of 115 days following ablation, eGFR increased significantly in CKD stage 2 (74 ± 9 to 80 ± 23; P = 0.04), 3A (53 ± 5 to 69 ± 24; P chronic kidney disease. © 2014 Wiley Periodicals, Inc.

  6. Prevalence of hypothyroidism in nondiabetic chronic kidney disease and effect of thyroxine replacement on estimated glomerular filtration rate

    Directory of Open Access Journals (Sweden)

    S Bajaj

    2017-01-01

    Full Text Available Reduced T3 and free T4, elevated thyroid stimulating hormone, and hyporesponsiveness to thyrotropin releasing hormone raise questions about the presence of hypothyroidism in chronic kidney disease (CKD and raise the possibility of benefit from thyroxine supplementation. A prospective cohort study was conducted on 73 nondiabetic CKD cases. Hypothyroid patients were started on levothyroxine and were reviewed after 3 and 6 months. The mean age of study population was 42.3 ± 16.8 years. Of the total population, 32 (43.8% cases had hypothyroidism, among whom 2 (2.7% had overt hypothyroidism and 30 (41.1% had subclinical hypothyroidism. Prevalence of hypothyroidism increased with increasing severity of CKD. There were 1 (3.1% case with hypothyroidism in stage 3b, 8 (25% cases in stage 4, and 23 (71.9% cases in stage 5. The mean estimated glomerular filtration rate (ml/min/1.73 m2 at baseline was 13.7 ± 8.9 which increased to 17.5 ± 6.8 and 22.4 ± 9.3 after 3 and 6 months of thyroid hormone replacement therapy (THRT, respectively (P < 0.001. Hypothyroidism is commonly associated with nondiabetic CKD and its prevalence increases with declining renal function. THRT significantly improves renal function in nondiabetic CKD with hypothyroidism.

  7. 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.

  8. Prediction of Human Glomerular Filtration Rate from Preterm Neonates to Adults: Evaluation of Predictive Performance of Several Empirical Models.

    Science.gov (United States)

    Mahmood, Iftekhar; Staschen, Carl-Michael

    2016-03-01

    The objective of this study was to evaluate the predictive performance of several allometric empirical models (body weight dependent, age dependent, fixed exponent 0.75, a data-dependent single exponent, and maturation models) to predict glomerular filtration rate (GFR) in preterm and term neonates, infants, children, and adults without any renal disease. In this analysis, the models were developed from GFR data obtained from inulin clearance (preterm neonates to adults; n = 93) and the predictive performance of these models were evaluated in 335 subjects (preterm neonates to adults). The primary end point was the prediction of GFR from the empirical allometric models and the comparison of the predicted GFR with measured GFR. A prediction error within ±30% was considered acceptable. Overall, the predictive performance of the four models (BDE, ADE, and two maturation models) for the prediction of mean GFR was good across all age groups but the prediction of GFR in individual healthy subjects especially in neonates and infants was erratic and may be clinically unacceptable.

  9. 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.

  10. Reliability of a 99sp(m)Tc-DTPA gamma camera technique for determination of single kidney glomerular filtration rate

    International Nuclear Information System (INIS)

    Rehling, M.; Moeller, M.L.; Thamdrup, B.; Lund, J.O.; Trap-Jensen, J.

    1986-01-01

    In a recent paper we described a method for calculation of single kidney glomerular filtration rate (SKGFR) from the 99 sp(m)Tc-DTPA renogram obtained by gamma camera. In this paper the reliability of the method was compared to other methods for estimation of GFR in 20 unilaterally nephrectomized patients. The values for SKGFR obtained from the renograms and from the estimated endogenous creatinine clearances according to serum creatinine concentration and a nomogram were both accurate. The reliability of the renography method was significantly better judged by less variance in the estimates. SKGFR calculated from the plasma clearance of 51 Cr-EDTA overestimated the renal clearance of inulin on an average by 11.3%. No difference was found in the variance of the values obtained from the renograms and from the plasma clearances of 51 Cr-EDTA compared to the renal clearance of inulin. Apart from the inaccuracy in the GFR values calculated from the plasma clearance of 51 Cr-EDTA, the reliability of these two methods was equal. (author)

  11. Significance of estimated glomerular filtration rate in predicting brain or heart attacks in obese and non-obese populations.

    Science.gov (United States)

    Sato, Yuji; Fujimoto, Shouichi; Konta, Tsuneo; Iseki, Kunitoshi; Moriyama, Toshiki; Yamagata, Kunihiro; Tsuruya, Kazuhiko; Kimura, Kenjiro; Narita, Ichiei; Kondo, Masahide; Asahi, Koichi; Kurahashi, Issei; Ohashi, Yasuo; Watanabe, Tsuyoshi

    2015-10-01

    The Japanese Specific Health Checkup mainly focuses on metabolic syndrome for preventing cardiovascular events. Subjects are stratified by measuring waist circumference, body mass index, blood pressure, triglycerides, and fasting plasma glucose. However, estimated glomerular filtration rate (eGFR) is not considered essential. A longitudinal cohort study assessed the association of eGFR with new-onset brain or heart attacks in a large Japanese nationwide Specific Health Checkup database. A total of 109,349 Japanese subjects (mean age 63.2 years, 39.5 % men) were examined for the events 2 years later. The odds ratios were calculated for new events in the total and subgroup populations divided by BMI proteinuria (dipstick test ≥1+), lower eGFR, and higher systolic and diastolic BP, fasting plasma glucose, hemoglobin A1c, and triglycerides (TG). Rates of new-onset brain or heart attacks were 3.1 and 4.0 % in the groups of non-obese and obese subjects, respectively. In the total population, eGFR as well as higher BMI (≥25 kg/m(2)), higher BP (high-normal hypertension or greater), higher TG (≥150 mg/dl), and proteinuria were significant risk factors for developing brain or heart attacks. The eGFR was significant in non-obese subjects, but not in the obese. As the ultimate aim of 'Specific Health Checkup' is to prevent cardiovascular events, our study suggests that eGFR should be evaluated in non-obese subjects.

  12. Assessment of glomerular filtration rate in diabetic nephropathy using the plasma clearance of 51Cr-EDTA

    DEFF Research Database (Denmark)

    Hansen, H P; Rossing, P; Mathiesen, E R

    1998-01-01

    Plasma clearance of 51Cr-EDTA is widely used to assess the glomerular filtration rate (GFR) in diabetic nephropathy. Originally, the ratio between the intravenously injected amount of tracer and the total area under the plasma concentration curve was used for the calculation of total 51Cr......-EDTA plasma clearance (C(T)). Simplified methods, using the final mono-exponential part of the plasma curve, have been suggested, e.g. four samples, taken 180 to 240 min after injection (C(IV)), or using one sample taken at 240 min (C(I)). Our aim was to evaluate the agreement between measurements of GFR......-EDTA by determining the radioactivity in venous blood samples taken 5, 7, 10, 15, 30, 45, 60, 90, 120, 150, 180, 200, 220, and 240 min after the injection. Rate of decline in GFR was assessed using 12 (6-17) determinations of GFR over a period of time of 8 (4-10) years. Mean (SD) GFRT was 123 (21) ml x min(-1...

  13. Reliability of single kidney glomerular filtration rate measured by a 99mTc-DTPA gamma camera technique

    International Nuclear Information System (INIS)

    Rehling, M.; Moller, M.L.; Jensen, J.J.; Thamdrup, B.; Lund, J.O.; Trap-Jensen, J.

    1986-01-01

    The reliability of a previously published method for determination of single kidney glomerular filtration rate (SKGFR) by means of technetium-99m-diethylenetriaminepenta-acetate (99mTc-DTPA) gamma camera renography was evaluated. The day-to-day variation in the calculated SKGFR values was earlier found to be 8.8%. The technique was compared to the simultaneously measured renal clearance of inulin in 19 unilaterally nephrectomized patients with GFR varying from 11 to 76 ml/min. The regression line (y = 1.04 X -2.5) did not differ significantly from the line of identity. The standard error of estimate was 4.3 ml/min. In 17 patients the inter- and intraobserver variation of the calculated SKGFR values was 1.2 ml/min and 1.3 ml/min, respectively. In 21 of 25 healthy subjects studied (age range 27-29 years), total GFR calculated from the renograms was within an established age-dependent normal range of GFR

  14. Comparison of methods for estimating glomerular filtration rate in head and neck cancer patients treated with cisplatin.

    Science.gov (United States)

    Lindberg, Lotte; Brødbæk, Kasper; Hägerström, Erik G; Bentzen, Jens; Kristensen, Bent; Zerahn, Bo

    2017-07-01

    Cisplatin is a chemotherapeutic agent widely used in the treatment of various solid tumors. Cisplatin induces nephrotoxicity and may lead to long-term reduction of kidney function. Consequently, determination of glomerular filtration rate (GFR) is used to monitor potential kidney damage. This study aimed to compare two commonly used algorithms for estimating GFR (eGFR) from plasma creatinine (PCr) with 51 Cr-EDTA clearance (CrCl) as a reference method. This was a retrospective single center study of 94 head and neck cancer patients treated with cisplatin. CrCl was performed once before, during, and after treatment, and PCr was measured concurrently. eGFR was assessed from PCr applying the Cockcroft-Gault (CG) and the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations. Agreement was assessed applying the statistical methods of Bland and Altman. A predefined limit of clinically acceptable variation between CrCl and eGFR of 14% was applied. Comparison of CrCl and eGFR CKD revealed a positive slope of the linear regression line, suggesting proportional bias (p cisplatin due to systematic bias. Consequently, if CrCl is unavailable, then the CG equation is the better choice provided proper attention is paid to the large variation between methods.

  15. Glomerular Filtration Rate and Urine Albumin to Creatinine Ratio Associated With Hearing Impairment Among Korean Adults With Diabetes

    Science.gov (United States)

    Cho, Yunji; Kim, Do Hoon; Choi, June; Lee, Joo Kyung; Roh, Yong-Kyun; Nam, Hyo-Yun; Nam, Ga-Eun; Kim, Dong-Won; Lee, Seung-Hyun; Lee, Chung-Woo; Han, Kyungdo; Park, Yong-Gyu

    2016-01-01

    Abstract The objective of this study was to examine the association of estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR) with hearing impairment among diabetic adults in Korea. The study was based on data from Korea National Health and Nutrition Examination Survey 2011 to 2012. Participants were 1206 diabetic adults, aged over 19 years, who completed audiometric testing supervised by nationally certified clinicians. Hearing impairment was defined in three grades: no hearing impairment (pure-tone average 0–25 dB), slight hearing impairment (26–40 dB), and disabling hearing impairment (>40 dB) in the better ear at frequencies 0.5, 1, 2, 3, 4 and 6 kHz. Using logistic regression, risk of hearing impairment was assessed after having controlled for confounding factors. Higher levels of ACR and lower levels of eGFR correlated with an increase in percentage of disabling hearing impairment both unilaterally and bilaterally (P metabolic syndrome. PMID:27124027

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

    International Nuclear Information System (INIS)

    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

  17. Factors Related to Significant Improvement of Estimated Glomerular Filtration Rates in Chronic Hepatitis B Patients Receiving Telbivudine Therapy

    Directory of Open Access Journals (Sweden)

    Te-Fu Lin

    2017-01-01

    Full Text Available Background and Aim. The improvement of estimated glomerular filtration rates (eGFRs in chronic hepatitis B (CHB patients receiving telbivudine therapy is well known. The aim of this study was to clarify the kinetics of eGFRs and to identify the significant factors related to the improvement of eGFRs in telbivudine-treated CHB patients in a real-world setting. Methods. Serial eGFRs were calculated every 3 months using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI equation. The patients were classified as CKD-1, -2, or -3 according to a baseline eGFR of ≥90, 60–89, or <60 mL/min/1.73 m2, respectively. A significant improvement of eGFR was defined as a more than 10% increase from the baseline. Results. A total of 129 patients were enrolled, of whom 36% had significantly improved eGFRs. According to a multivariate analysis, diabetes mellitus (DM (p=0.028 and CKD-3 (p=0.043 were both significantly related to such improvement. The rates of significant improvement of eGFR were about 73% and 77% in patients with DM and CKD-3, respectively. Conclusions. Telbivudine is an alternative drug of choice for the treatment of hepatitis B patients for whom renal safety is a concern, especially patients with DM and CKD-3.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. The clinical value of glomerular filtration rate with 99Tcm-DTPA on living kidney transplantation donor

    International Nuclear Information System (INIS)

    Xue Jianjun; Yang Aimin; Deng Huixing; Ran Hongde; Cheng Hu

    2010-01-01

    Objective: To determine the normal reference range of glomerular filtration rate (GFR) in different ages with 99 Tc m -DTPA renal dynamic imaging on living kidney transplantation donor, and to evaluate the clinical value of GFR in living kidney transplantation. Methods: 99 Tc m -DTPA renal dynamic imaging was performed in 300 patients on living kidney transplantation donor. The image was processed according to Gates' method to obtain GFR. The normal reference range of GFR was obtained in different ages and the relationship between GFR and gender, age and body mass index was also analyzed. Results: The left, right and total renal GFR of 300 living kidney transplantation donors were 49.25±10.34 ml/min. 49.27±9.69 ml/min and 98.52±19.03 ml/min, respectively. The GFR in the group of age 4 0 was higher significantly than that of age ≥50 (P 0.05). The study of logistic regression showed that the age was the only important impact factor on GFR. Conclusions: GFR obtained by 99 Tc m -DTPA is simple and reliable, which can be used to accurately assess the individual renal filterability and the urinary drainage function, This affords an useful method on screening the living relative kidney transplantation donor. (authors)

  20. Recombinant human erythropoietin in humans down-regulates proximal renal tubular reabsorption and causes a fall in glomerular filtration rate

    DEFF Research Database (Denmark)

    Olsen, Niels Vidiendal; Aachmann-Andersen, Niels Jacob; Oturai, Peter

    2010-01-01

    rHuEPO elevates hemoglobin concentration both by increasing red blood cell volume and by a decrease in plasma volume. This study delineates the association of rHuEPO-induced changes in blood volumes with changes in the renin-aldosterone system and renal function. 16 healthy males were given r......HuEPO for 28 days in doses raising the hematocrit to 48.3 (4.1) %. Renal clearance studies with urine collections (N = 8) were done at baseline and at days 4, 11, 29, and 42. Glomerular filtration rate (GFR) was measured by (51)Cr-EDTA. Renal clearance of lithium (C(Li)) was used as an index of proximal...... tubular outflow and to assess segmental renal tubular handling of sodium and water. rHuEPO-induced increases in hematocrit occurred from day 10 onwards and was caused by both an increase in red cell volume and a fall in plasma volume. Well before that (from day 2 and throughout the treatment time), r...

  1. β2-microglobulin and a test with 169Yb-DTPA in the evaluation of glomerular filtration and protein reabsorption in gynecological cancer patients

    International Nuclear Information System (INIS)

    Modnikov, O.P.

    1989-01-01

    Radionuclide investigation (a test with 169 Yb-DTPA) and radioimmunoassay determination of the concentration of β 2 -MG in the blood serum and urine were performed to study glomerular filtration and protein reabsorption in patients with myoma (57) and uterine body cancer (51) before operation, on the 1st. 3rd, 5th and 14th days of the postoperative period, and 6-12 mos. after operation. At the same time 24 healthy women (controls) were investigated. The greatest changes of glomerular filtration and protein reabsorption in the patients of the study group were shown to develop on the 5th day after operation. There was parallelism of the results of radionuclide investigation and the radioimmunoassay with β 2 -MG therefore the latter can be recommended for the diagnosis of renal dysfunction in the early postoperative period

  2. Wtip- and gadd45a-interacting protein dendrin is not crucial for the development or maintenance of the glomerular filtration barrier.

    Science.gov (United States)

    Xiao, Zhijie; Rodriguez, Patricia Q; He, Liqun; Betsholtz, Christer; Tryggvason, Karl; Patrakka, Jaakko

    2013-01-01

    Glomerular podocyte cells are critical for the function of the renal ultrafiltration barrier. Especially, the highly specialized cell-cell junction of podocytes, the slit diaphragm, has a central role in the filtration barrier. This is highlighted by the fact that mutations in molecular components of the slit diaphragm, including nephrin and Cd2-associated protein (Cd2ap), result in proteinuric diseases in man. Dendrin is a poorly characterized cytosolic component of the slit diaphragm in where it interacts with nephrin and Cd2ap. Dendrin is highly specific for the podocyte slit diaphragm, suggesting that it has a dedicated role in the glomerular filtration barrier. In this study, we have generated a dendrin knockout mouse line and explored the molecular interactions of dendrin. Dendrin-deficient mice were viable, fertile, and had a normal life span. Morphologically, the glomerulogenesis proceeded normally and adult dendrin-deficient mice showed normal glomerular histology. No significant proteinuria was observed. Following glomerular injury, lack of dendrin did not affect the severity of the damage or the recovery process. Yeast two-hybrid screen and co-immunoprecipitation experiments showed that dendrin binds to Wt1-interacting protein (Wtip) and growth arrest and DNA-damage-inducible 45 alpha (Gadd45a). Wtip and Gadd45a mediate gene transcription in the nucleus, suggesting that dendrin may have similar functions in podocytes. In line with this, we observed the relocation of dendrin to nucleus in adriamycin nephropathy model. Our results indicate that dendrin is dispensable for the function of the normal glomerular filtration barrier and that dendrin interacts with Wtip and Gadd45a.

  3. Wtip- and gadd45a-interacting protein dendrin is not crucial for the development or maintenance of the glomerular filtration barrier.

    Directory of Open Access Journals (Sweden)

    Zhijie Xiao

    Full Text Available Glomerular podocyte cells are critical for the function of the renal ultrafiltration barrier. Especially, the highly specialized cell-cell junction of podocytes, the slit diaphragm, has a central role in the filtration barrier. This is highlighted by the fact that mutations in molecular components of the slit diaphragm, including nephrin and Cd2-associated protein (Cd2ap, result in proteinuric diseases in man. Dendrin is a poorly characterized cytosolic component of the slit diaphragm in where it interacts with nephrin and Cd2ap. Dendrin is highly specific for the podocyte slit diaphragm, suggesting that it has a dedicated role in the glomerular filtration barrier. In this study, we have generated a dendrin knockout mouse line and explored the molecular interactions of dendrin. Dendrin-deficient mice were viable, fertile, and had a normal life span. Morphologically, the glomerulogenesis proceeded normally and adult dendrin-deficient mice showed normal glomerular histology. No significant proteinuria was observed. Following glomerular injury, lack of dendrin did not affect the severity of the damage or the recovery process. Yeast two-hybrid screen and co-immunoprecipitation experiments showed that dendrin binds to Wt1-interacting protein (Wtip and growth arrest and DNA-damage-inducible 45 alpha (Gadd45a. Wtip and Gadd45a mediate gene transcription in the nucleus, suggesting that dendrin may have similar functions in podocytes. In line with this, we observed the relocation of dendrin to nucleus in adriamycin nephropathy model. Our results indicate that dendrin is dispensable for the function of the normal glomerular filtration barrier and that dendrin interacts with Wtip and Gadd45a.

  4. Mercaptoacetyltriglycine-3 renogram is not superior to estimated glomerular filtration rate measurement for the prediction of long-term renal function after nephrectomy

    International Nuclear Information System (INIS)

    Kanamaru, Hiroshi; Yamamoto, Masakazu; Nagahama, Kanji

    2011-01-01

    The objective of this study was to evaluate the clinical usefulness of effective renal plasma flow (ERPF) measured using preoperative mercaptoacetyltriglycine-3 (MAG3) renogram for the prediction of chronic renal insufficiency after nephrectomy. A total of 47 patients underwent preoperative MAG3 renal scintigraphy and subsequent unilateral nephrectomy. Correlations between the 5-year postoperative estimated glomerular filtration rate (eGFR) and the preoperative ERPF of the contralateral kidney (cERPF), ERPF of the diseased kidney (dERPF), total ERPF (tERPF), cERPF to dERPF ratio, serum creatinine (sCr) level, eGFR, as well as the influence of preoperative comorbidities (diabetes, hypertension) on the postoperative eGFR, were evaluated with both univariate and multivariate analyses. Multiple linear regression analysis showed that preoperative cERPF significantly correlated with postoperative eGFR. However, a much stronger correlation was observed between the preoperative and postoperative eGFR. Multiple logistic regression analysis showed that only preoperative eGFR was a significant predicator of the development of advanced-stage chronic kidney disease (CKD). Preoperative MAG3 renogram is not superior to eGFR measurement as a prognostic indicator of long-term renal function after unilateral nephrectomy. (author)

  5. A dose-attenuation shield for use in glomerular filtration rate computations. A method for combined renal scintiangiography and functional quantification

    International Nuclear Information System (INIS)

    Gates, G.F.

    1991-01-01

    Renal perfusion and function can be determined by renography using Tc-99m DTPA. However, the high dose of tracer necessary for scintiangiography may result in inaccurate syringe-count determinations when measured by the gamma camera necessary for calculating the glomerular filtration rate by a camera technique. This report describes a syringe shield, constructed at minimal cost, which allows for suitable count attenuation and use of high doses of tracer for assessment of both renal perfusion and function

  6. Estimated Glomerular Filtration Rate, Proteinuria, and Risk of Cardiovascular Diseases and All-cause Mortality in Diabetic Population: a Community-based Cohort Study

    OpenAIRE

    Wang, Anxin; Chen, Guojuan; Cao, Yibin; Liu, Xiaoxue; Su, Zhaoping; Luo, Yanxia; Zhao, Zhan; Li, Xia; Chen, Shuohua; Wu, Shouling; Guo, Xiuhua

    2017-01-01

    Data about associations between estimated glomerular filtration rate (eGFR) and proteinuria with cardiovascular diseases (CVDs) and all-cause mortality among diabetic population is less described. We aimed to describe these associations in Chinese diabetic population, and investigate the difference between sexes. The study was based on 8,301 diabetic participants in the Kailuan study, who was free of CVDs at baseline. We used Cox proportional hazard models to examine the associations of eGFR ...

  7. The relation of Complementary-Alternative Medicine use with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage.

    Science.gov (United States)

    Esen, Bennur; Atay, Ahmet Engin; Gokmen, Emel Saglam; Karakoc, Ayten; Sari, Hakan; Sarisakal, Samprie; Kahvecioglu, Serdar; Kayabasi, Hasan; Sit, Dede

    2015-05-08

    Complementary and alternative medicine is a broad field of health including all health care practices and methods; and their accompanying theories and beliefs. In the present study, we aimed to examine the frequency of complementary-alternative medicine use, and its relation with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage. A total of 1053 predialysis patients; 518 female and 535 male, that were followed up with chronic kidney disease for at least 3 months were enrolled into the study. Demographic features, biochemical parameters and findings of physical examination were recorded. Their compliance to diet, and knowledge about disease were questioned. Beck depression inventory and questionnaire regarding to complementary-alternative medicine use were performed. The overall frequency of complementary-alternative medicine use was 40.3% . Total ratio of herbal products was 46%. Complementary-alternative medicine use was significantly more frequent in female or single patients, and patients that informed about chronic kidney disease or under strict diet (p:0.007, p:0.016, p:0.02, p:0.016; respectively). When glomerular filtration rate of participants were considered, complementary-alternative medicine use was similar in different stages of kidney disease. Depression was observed in 41.9% of patients and significantly frequent in patients with alternative method use (p:0.002). Depression score was higher as creatinine increases and glomerular filtration rate decreases (p:0.002; r: 0,093). We determined that complementary-alternative medicine use gradually increases at predialysis stage as glomerular filtration rate decreases and there is a strict relation between complementary-alternative medicine use and depression or female gender. Disorder related stressors may lead to seeking of alternative methods. This article is protected by copyright. All rights reserved.

  8. Proteomic analysis of formalin-fixed paraffin-embedded glomeruli suggests depletion of glomerular filtration barrier proteins in two-kidney, one-clip hypertensive rats.

    Science.gov (United States)

    Finne, Kenneth; Vethe, Heidrun; Skogstrand, Trude; Leh, Sabine; Dahl, Tone D; Tenstad, Olav; Berven, Frode S; Reed, Rolf K; Vikse, Bjørn Egil

    2014-12-01

    It is well known that hypertension may cause glomerular damage, but the molecular mechanisms involved are still incompletely understood. In the present study, we used formalin-fixed paraffin-embedded (FFPE) tissue to investigate changes in the glomerular proteome in the non-clipped kidney of two-kidney one-clip (2K1C) hypertensive rats, with special emphasis on the glomerular filtration barrier. 2K1C hypertension was induced in 6-week-old Wistar Hannover rats (n = 6) that were sacrificed 23 weeks later and compared with age-matched sham-operated controls (n = 6). Tissue was stored in FFPE tissue blocks and later prepared on tissue slides for laser microdissection. Glomeruli without severe morphological damage were isolated, and the proteomes were analysed using liquid chromatography-tandem mass spectrometry. 2K1C glomeruli showed reduced abundance of proteins important for slit diaphragm complex, such as nephrin, podocin and neph1. The podocyte foot process had a pattern of reduced abundance of transmembrane proteins but unchanged abundances of the podocyte cytoskeletal proteins synaptopodin and α-actinin-4. Lower abundance of important glomerular basement membrane proteins was seen. Possible glomerular markers of damage with increased abundance in 2K1C were transgelin, desmin and acyl-coenzyme A thioesterase 1. Microdissection and tandem mass spectrometry could be used to investigate the proteome of isolated glomeruli from FFPE tissue. Glomerular filtration barrier proteins had reduced abundance in the non-clipped kidney of 2K1C hypertensive rats. © The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA.

  9. Quantification of single-kidney glomerular filtration rate with electron-beam computed tomography

    Science.gov (United States)

    Lerman, Lilach O.; Ritman, Erik L.; Pelaez, Laura I.; Sheedy, Patrick F., II; Krier, James D.

    2000-04-01

    The ability to accurately and noninvasively quantify single- kidney GFR could be invaluable for assessment of renal function. We developed a model that enables this measurement with EBCT. To examine the reliability of this method, EBCT renal flow and volume studies after contrast media administration were performed in pigs with unilateral renal artery stenosis (Group 1), controls (Group 2), and simultaneously with inulin clearance (Group 3). Renal flow curves, obtained from the bilateral renal cortex and medulla, depicted transit of the contrast through the vascular and tubular compartments, and were fitted using extended gamma- variate functions. Renal blood flow was calculated as the sum of products of cortical and medullary perfusions and volumes. Normalized GFR (mL/min/cc) was calculated using the rate (maximal slope) of proximal tubular contrast accumulation, and EBCT-GFR as normalized GFR* cortical volume. In Group 1, the decreased GFR of the stenotic kidney correlated well with its decreased volume and RBF, and with the degree of stenosis (r equals -0.99). In Group 3, EBCT-GFR correlated well with inulin clearance (slope 1.1, r equals 0.81). This novel approach can be very useful for quantification of concurrent regional hemodynamics and function in the intact kidneys, in a manner potentially applicable to humans.

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

    Directory of Open Access Journals (Sweden)

    Ian Ford

    2009-01-01

    Full Text Available BACKGROUND: 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. METHODS AND FINDINGS: Glomerular filtration rate was estimated (eGFR using the Modification of Diet in Renal Disease equation and was categorized in the ranges ([20-40], [40-50], [50-60] >or= 60 ml/min/1.73 m(2. Baseline risk factors were analysed by category of eGFR, with and without adjustment for other risk factors. The associations between baseline eGFR and morbidity and mortality outcomes, accrued after an average of 3.2 y, were investigated using Cox proportional hazard models adjusting for traditional risk factors. We tested for evidence of an interaction between the benefit of statin treatment and baseline eGFR status. Age, low-density lipoprotein (LDL and high-density lipoprotein (HDL cholesterol, C-reactive protein (CRP, body mass index, fasting glucose, female sex, histories of hypertension and vascular disease were associated with eGFR (p = 0.001 or less after adjustment for other risk factors. Low eGFR was independently associated with risk of all cause mortality, vascular mortality, and other noncancer mortality and with fatal and nonfatal coronary and heart failure events (hazard ratios adjusted for CRP and other risk factors (95% confidence intervals [CIs] for eGFR or= 60 ml/min/1.73m(2 respectively 2.04 (1.48-2.80, 2.37 (1.53-3.67, 3.52 (1.78-6.96, 1.64 (1.18-2.27, 3.31 (2.03-5.41. There were no nominally statistically significant interactions (p < 0.05 between randomized treatment allocation and eGFR for clinical outcomes, with the exception of the outcome of coronary heart disease death or

  11. The Rac-specific exchange factors Dock1 and Dock5 are dispensable for the establishment of the glomerular filtration barrier in vivo.

    Science.gov (United States)

    Laurin, Mélanie; Dumouchel, Annie; Fukui, Yoshinori; Côté, Jean-François

    2013-01-01

    Podocytes are specialized kidney cells that form the kidney filtration barrier through the connection of their foot processes. Nephrin and Neph family transmembrane molecules at the surface of podocytes interconnect to form a unique type of cell-cell junction, the slit diaphragm, which acts as a molecular sieve. The cytoplasmic tails of Nephrin and Neph mediate cytoskeletal rearrangement that contributes to the maintenance of the filtration barrier. Nephrin and Neph1 orthologs are essential to regulate cell-cell adhesion and Rac-dependent actin rearrangement during Drosophila myoblast fusion. We hypothesized here that molecules regulating myoblast fusion in Drosophila could contribute to signaling downstream of Nephrin and Neph1 in podocytes. We found that Nephrin engagement promoted recruitment of the Rac exchange factor Dock1 to the membrane. Furthermore, Nephrin overexpression led to lamellipodia formation that could be blocked by inhibiting Rac1 activity. We generated in vivo mouse models to investigate whether Dock1 and Dock5 contribute to the formation and maintenance of the kidney filtration barrier. Our results indicate that while Dock1 and Dock5 are expressed in podocytes, their functions are not essential for the development of the glomerular filtration barrier. Furthermore, mice lacking Dock1 were not protected from LPS-induced podocyte effacement. Our data suggest that Dock1 and Dock5 are not the important exchange factors regulating Rac activity during the establishment and maintenance of the glomerular barrier.

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

    International Nuclear Information System (INIS)

    Kim, Hye Ok; Chae, Sun Young; Back, Sora; Moon, Dae Hyuk

    2010-01-01

    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 (β=-0.3, P<0.005). In the disease nephrectomy group, HTN, preoperative creatinine level, and age were significantly associated with change in GFR (β=-6.2, p<0.005; β=-10.9, p<0.01; β=-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.

  13. 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.)

  14. 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.

  15. Changes in glomerular filtration rate after donation in living kidney donors: a single-center cohort study.

    Science.gov (United States)

    Saito, Takako; Uchida, Keiko; Ishida, Hideki; Tanabe, Kazunari; Nitta, Kosaku

    2015-02-01

    A number of studies have reported on decline in glomerular filtration rate (GFR) after donation in Japanese living kidney donors. The purpose of the present study was to examine the clinicopathological factors associated with changes in GFR after donation in living kidney donors. We reviewed the charts of living kidney donors (n = 294) and monitored estimated GFR (eGFR) values from the time of 0-h kidney biopsy until 3 years after donation. We assessed donor age, gender, body mass index, blood pressure, urinalysis, and several other clinical parameters including the severity of glomerulosclerosis and arteriosclerosis. The grade of arteriosclerosis in 0-h biopsy specimens was higher in the older donor group (57-76 years) than in the younger donor group (30-56 years). Mean donor eGFR at the time of the donation was 80.1 ± 13.6 ml/min/1.73 m(2). Most of the living kidney donors in this study developed stage 3 chronic kidney disease (CKD). The mean changes in eGFR at 1-3 years after donation showed a steady state that was distinct from the generally accepted notion that GFR declines with age. Multivariate regression analyses showed that the changes in eGFR were negatively associated with age (r = -0.21, P < 0.001) and preoperative eGFR (r = -0.18, P < 0.001), but not associated with the grade of glomerulosclerosis and arteriosclerosis. Donor age and pre-GFR at the time of nephrectomy were associated with decline in kidney function in living kidney donors after donation. Most of the donors developed stage 3 CKD within 3 years after donation but without subsequent progression, at least for several years.

  16. Estimation of the glomerular filtration rate in infants and children using iohexol and X-ray fluorescence technique

    International Nuclear Information System (INIS)

    Stake, G.

    1992-01-01

    The aim of the present study was to establish methods for the estimation of the glomerular filtration rate (GFR) in children. The conclusions and clinical implications of the study are as follows: Urography with iohexol in children had no significant influence on the GFR. Valid GFR estimates were calculated from the plasma disappearance rate obtained from two plasma samples taken three and four hour after the injection of iohexol. Both iohexol and metrizoate caused a transitory, increased renal excretion of alkaline phosphatase. GFR as well as the excretion of albumin and β 2 -microglobulin were unchanged. Using the weight-related empirical distribution volume for determination of GFR from the plasma sample taken three hour after the injection of iohexol, a high degree of agreement was found between the preliminary single sample GFR estimate and the reference, two plasma sample GFR. However, the relationship was curvilinear, and in order to obtain a value for the final three hour single sample GFR equal to the reference GFR, the preliminary value had to be corrected by a second degree correction factor. The day-to-day variations of GFRs estimated with the iohexol methods were similar to those obtained with other standard methods. In another group of infants and children, independent, but otherwise comparable to the patients who formed the basis for the single sample iohexol method, it was confirmed that valid GFR estimates were obtained from the three hour single plasma sample. GFR determinations from one hour, two hour, and four hour single samples further supported that the optimal sampling time in patients with GFR down to 20 ml per minute -1 1.73 m -2 was three hours. 53 refs., 5 figs

  17. Prevalence of augmented renal clearance and performance of glomerular filtration estimates in Indigenous Australian patients requiring intensive care admission.

    Science.gov (United States)

    Tsai, D; Udy, A A; Stewart, P C; Gourley, S; Morick, N M; Lipman, J; Roberts, J A

    2018-01-01

    Augmented renal clearance (ARC) refers to the enhanced renal excretion of circulating solute commonly demonstrated in numerous critically ill subgroups. This study aimed to describe the prevalence of ARC in critically ill Indigenous Australian patients and explore the accuracy of commonly employed mathematical estimates of glomerular filtration. We completed a single-centre, prospective, observational study in the intensive care unit (ICU), Alice Springs Hospital, Central Australia. Participants were critically ill adult Indigenous and non-Indigenous Australian patients with a urinary catheter in situ. Exclusion criteria were anuria, pregnancy or the requirement for renal replacement therapy. Daily eight-hour measured creatinine clearances (CrCLm) were collected throughout the ICU stay. ARC was defined by a CrCLm ≥130 ml/min/1.73 m2. The Cockcroft-Gault and Chronic Kidney Disease Epidemiology Collaboration equations were also used to calculate mathematical estimates for comparison. In total, 131 patients were recruited (97 Indigenous, 34 non-Indigenous) and 445 samples were collected. The median (range) CrCLm was 93.0 (5.14 to 205.2) and 90.4 (18.7 to 206.8) ml/min/1.73 m2 in Indigenous and non-Indigenous patients, respectively. Thirty-one of 97 (32%) Indigenous patients manifested ARC, compared to 7 of 34 (21%) non-Indigenous patients (P=0.21). Younger age, major surgery, higher baseline renal function and an absence of diabetes were all associated with ARC. Both mathematical estimates manifest limited accuracy. ARC was prevalent in critically ill Indigenous patients, which places them at significant risk of underdosing with renally excreted drugs. CrCLm should be obtained wherever possible to ensure accurate dosing.

  18. [Prevalence of low glomerular filtration rate in the elderly population of Spain. The PREV-ICTUS study].

    Science.gov (United States)

    Cea-Calvo, Luis; Redón, Josep; Martí-Canales, Juan C; Lozano, José V; Llisterri, José L; Fernández-Pérez, Cristina; Aznar, José; González-Esteban, Jorge

    2007-11-17

    To assess the prevalence of low glomerular filtration rate (GFR ICTUS, a population-based study carried out in a sample of subjects aged 60 years or more, randomly selected and stratified by Autonomic Communities according to the census of inhabitants and the habitat in each Community. Demographic data, cardiovascular risk factors and diseases were collected. GFR was calculated using the MDRD (Modification of Diet in Renal Disease) equation. In 6,799 subjects (age 71.9 years-old; 53.6% women; 72.9% with arterial hypertension [HT]; 27.0% with diabetes mellitus [DM]; 24.3% with cardiovascular disease), 25.9% had low GFR (95% confidence interval, 24.8-26.9). The prevalence increased linearly, from 16.5% in subjects aged 60-64 years to 46.5% in those aged 85 or more (p < 0.001), and was higher in women (36.1% vs 14.1% in men, p < 0.001). In the multivariate analysis, low GFR was independently related to advanced age (odds ratio [OR] between 1.30 y 4.20), female gender (OR = 5.82), HT older than 7 years (OR = 1.23), uric acid (OR = 1.52 for each increment of 1 mg/dl) and cardiovascular disease (OR = 1.68). The association with DM did not reach statistical significance. In a model without cardiovascular disease, related factors remained the same, increasing the significance of HT older than 7 years (OR = 1.31) and of DM (OR = 1.19). One out or 4 subjects of this sample showed low GFR. The variables directly associated with low GFR were advanced age, female gender, HT of longer evolution, cardiovascular disease, increased uric acid, and, in one model, DM.

  19. Effect of Calcineurin Inhibitor-Free, Everolimus-Based Immunosuppressive Regimen on Albuminuria and Glomerular Filtration Rate After Heart Transplantation.

    Science.gov (United States)

    Nelson, Lærke Marie; Andreassen, Arne Kristian; Andersson, Bert; Gude, Einar; Eiskjær, Hans; Rådegran, Göran; Dellgren, Göran; Gullestad, Lars; Gustafsson, Finn

    2017-11-01

    Albuminuria in maintenance heart transplantation (HTx) is associated with poor renal response when switching to a calcineurin inhibitor (CNI)-lowered or CNI-free immunosuppressive regimen using everolimus (EVR), but the significance of albuminuria associated with EVR treatment after early CNI withdrawal in de novo HTx is unknown. We tested if measured glomerular filtration rate (mGFR, by chrome-ethylenediaminetetraacetic acid clearance) was associated with urine albumin/creatinine ratio (UACR) post-HTx in a subgroup of patients included in the Scandinavian Heart Transplant Everolimus De Novo Study With Early Calcineurin Inhibitor Avoidance trial, where de novo HTx patients (n = 115) were randomized to EVR with complete CNI elimination 7 to 11 weeks post-HTx or standard CNI immunosuppression. In 66 patients, UACR measures were available at 1 year. In 7 patients in the EVR group, a CNI was reintroduced within 12 months. Median mGFR was significantly higher in the EVR group both 1 and 3 years post-HTx (P = 0.0004 and P = 0.03, respectively). Median UACR at 1 year was significantly higher in the EVR group (P = 0.002). There was no correlation between log(UACR) at 1 year and mGFR at 1 or 3 years (r = -0.01, P = 0.9 and r = 0.15, P = 0.26, respectively) and in the EVR group between log(UACR) at 1 year and change in mGFR (Δ1-3 years) (r = 0.27, P = 0.14). Excluding patients in the EVR group in whom a CNI was reintroduced did not significantly change the results. The effects of EVR with early CNI withdrawal after HTx on albuminuria and renal function seem dissociated; hence, the clinical significance of albuminuria in this setting is uncertain and should not necessarily rule out EVR-based immunosuppression.

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Pediatric reference values for serum creatinine and estimated glomerular filtration rate in Iranians: Tehran Lipid and Glucose Study.

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    Ghasemi, Asghar; Azimzadeh, Iraj; Afghan, Marjan; Momenan, Amir Abbas; Bagheripour, Fatemeh; Azizi, Fereidoun

    2015-11-01

    Serum creatinine is the most widely used marker for estimating glomerular filtration rate (GFR). The aim of this study was to determine pediatric reference values for serum creatinine levels and eGFR values using data from a population-based study in Iran. Serum creatinine of 1594 subjects, aged 3 - 18 years, participating in phase 4 of the Tehran Lipid and Glucose Study (2008 - 2011) was measured using the conventional Jaffe method. The non-parametric method of Schwartz and Counahan-Barratt equations were used to calculate eGFR. CLSI/IFCC guidelines were used to determine reference values. In both genders, serum creatinine concentration was significantly increased with age and had a positive correlation with age (boys (r = 0.786, n = 778, P serum creatinine concentration was significantly higher in boys, compared to girls (0.86 ± 0.01 vs. 0.80 ± 0.01 mg/dL, P serum creatinine (mg/dL) = k × age (year) + 0.5, where k was 0.03 for boys and 0.02 for girls. This study presents pediatric reference values in Iranian boys and girls for serum creatinine levels to be 0.6 - 1.20 mg/dL and 0.6 - 1.00 mg/dL and for eGFR values to be 81 - 154 mL/min/1.73 m(2) and 80 - 129 mL/min/1.73 m(2), respectively. These values can be used for diagnostic and therapeutic purposes.

  2. Effect of a cooked meat meal on serum creatinine and estimated glomerular filtration rate in diabetes-related kidney disease.

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    Nair, Sunil; O'Brien, Sarah V; Hayden, Katharine; Pandya, Bhavna; Lisboa, Paulo J G; Hardy, Kevin J; Wilding, John P H

    2014-02-01

    Fasting is not routinely recommended for renal function tests, despite the known effects of cooked meat on creatinine. We therefore studied variation in creatinine and estimated glomerular filtration rate (eGFR) after a standardized cooked meat meal in 80 subjects: healthy volunteers and diabetic patients with chronic kidney disease (CKD) stages 1 and 2, 3a, 3b, and 4 (n = 16/group). The interventions were a standardized cooked meat and a nonmeat meal, each providing ∼54 g protein, together with 250 mL water, on separate days. Fasting and postprandial blood samples at 1, 2, and 4 h were drawn for creatinine measurement using a kinetic alkaline picrate assay on an Olympus AU640 analyzer. The modified four-variable Modification of Diet in Renal Disease equation traceable to isotope dilution mass spectrometry creatinine was used to calculate eGFR. Consumption of a standardized cooked meat meal significantly increased serum creatinine and resulted in significant fall in eGFR in all stages of CKD studied; 6 of 16 CKD 3a patients were misclassified as CKD 3b. This effect of cooked meat on serum creatinine disappears after 12 h of fasting in all study participants. Creatine in meat is converted to creatinine on cooking, which is absorbed, causing significant increases in serum creatinine. This could impact management, as threshold for commencing and withdrawing certain medications and expensive investigations is defined by eGFR. eGFR calculated using fasting serum creatinine would be a better reflection of kidney function in these patients.

  3. First Report on the Percentiles of the Glomerular Filtration Rate in Iranian Children Using the 2009 Schwartz Equations

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    Peyman Roomizadeh

    2018-03-01

    Full Text Available The glomerular filtration rate (GFR is widely considered the best overall index of renal function. The Schwartz equations are designed for measuring the GFR in children between 1 and 16 years of age. In the present study, we investigated the percentiles of the GFR in a general population of Iranian children with no known renal disease via the 2009 Schwartz equations (updated and combined equations. Between 2010 and 2011, we selected 687 children aged 7–16 years from the Iranian province of Isfahan. Blood samples were analyzed for blood urea nitrogen, creatinine, and cystatin C. For each child, we calculated the GFR using 2 Schwartz equations. The Wilcoxon test was applied to examine the differences in the estimated GFRs between the equations. To determine the correlation between the GFRs obtained via the updated and combined Schwartz equations in the boys and the girls and also for the correlation between age and the GFR, we performed the Pearson or Spearman correlation coefficients. The statistical analyses were conducted using MedCalc, version 12.1.4.0 (MedCalc Software, Mariakerke, Belgium. The mean GFR was 100.06±19.80 mL/min/1.73 m2 based on the updated equation and 96.10±18.44 mL/min/1.73 m2 according to the combined equation. No significant differences were observed between these equations in estimating the GFRs. The correlation analysis for determining the association between age and the GFR estimated by the updated (r=0.05, P=0.1 and combined (r=0.06, P=0.09 Schwartz equations was not statistically significant. In conclusion, in the current study we showed that the updated and combined Schwartz equations exhibited high concordance in estimating GFR values in this age group.

  4. Albuminuria and neck circumference are determinate factors of successful accurate estimation of glomerular filtration rate in high cardiovascular risk patients.

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    Po-Jen Hsiao

    Full Text Available Estimated glomerular filtration rate (eGFR is used for diagnosis of chronic kidney disease (CKD. The eGFR models based on serum creatinine or cystatin C are used more in clinical practice. Albuminuria and neck circumference are associated with CKD and may have correlations with eGFR.We explored the correlations and modelling formulates among various indicators such as serum creatinine, cystatin C, albuminuria, and neck circumference for eGFR.Cross-sectional study.We reviewed the records of patients with high cardiovascular risk from 2010 to 2011 in Taiwan. 24-hour urine creatinine clearance was used as the standard. We utilized a decision tree to select for variables and adopted a stepwise regression method to generate five models. Model 1 was based on only serum creatinine and was adjusted for age and gender. Model 2 added serum cystatin C, models 3 and 4 added albuminuria and neck circumference, respectively. Model 5 simultaneously added both albuminuria and neck circumference.Total 177 patients were recruited in this study. In model 1, the bias was 2.01 and its precision was 14.04. In model 2, the bias was reduced to 1.86 with a precision of 13.48. The bias of model 3 was 1.49 with a precision of 12.89, and the bias for model 4 was 1.74 with a precision of 12.97. In model 5, the bias could be lower to 1.40 with a precision of 12.53.In this study, the predicting ability of eGFR was improved after the addition of serum cystatin C compared to serum creatinine alone. The bias was more significantly reduced by the calculation of albuminuria. Furthermore, the model generated by combined albuminuria and neck circumference could provide the best eGFR predictions among these five eGFR models. Neck circumference can be investigated potentially in the further studies.

  5. Cystatin C - a fast and reliable biomarker for glomerular filtration rate in head and neck cancer patients.

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    Bölke, Edwin; Schieren, Gisela; Gripp, Stephan; Steinbach, Gerald; Peiper, Matthias; Orth, Klaus; Matuschek, Christiane; Pelzer, Maximilian; Lammering, Guido; Houben, Ruud; Antke, Christina; Rump, Lars Christian; Mota, Rodrigo; Gerber, Peter Arne; Schuler, Patrick; Hoffmann, Thomas K; Rusnak, Ethelyn; Hermsen, Derik; Budach, Wilfried

    2011-03-01

    Determination of renal function is a prerequisite for planning therapy in cancer patients. Limitations of creatinine as marker for the glomerular filtration rate (GFR) led to the proposal of cystatin C as a more accurate biomarker especially in mild renal insufficiency or in patients with low muscle mass. We compared the accuracy of cystatin C- and creatinine-based equations to estimate GFR in head and neck cancer (HNC) patients receiving platinum-based radiochemotherapy. The study population consisted of 52 HNC patients (GFR range, 37-105 mL/min/1.73 m(2) complemented by 17 patients with known renal insufficiency (GFR range, 10-60 mL/min/1.73 m(2)). Intraclass correlation coefficients were calculated between the reference method (51)Cr-EDTA clearance and estimated GFR by creatinine clearance and equations based on creatinine (Cockroft-Gault, modification of diet in renal disease (MDRD), Wright) or cystatin C (Larsson, Dade-Behring, Hoek). In addition, sensitivity and specificity to discriminate GFR > 60 mL/min/1.73 m(2) were evaluated by receiver operating characteristic curve (ROC). The highest correlation coefficients were found for the cystatin C-based estimates in comparison with creatinine-based estimates or creatinine clearance, even though Bland-Altman plots revealed GFR overestimation for all equations tested. The cystatin C-based Hoek formula exhibited the highest overall precision and accuracy. GFR of 60 mL/min/1.73 m(2) for the creatinine-based Wright formula, closely followed by the MDRD formula and cystatin C-based equations of Larsson, Dade-Behring, and Hoek. Cystatin C-based GFR estimates showed the overall strongest correlation to the reference method. Thus, we recommend cystatin C for GFR estimation in HNC patients as an alternative method to the estimated creatinine clearance in clinical practice.

  6. The effects of protein intake on albuminuria in different estimated glomerular filtration rate: A population-based study.

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    Liu, Yan; Tan, Rong-Shao; Zhou, Dao-Yuan; Xiao, Xiao; Ran, Jian-Min; Qin, Dan-Ping; Zhong, Xiao-Shi; Hu, Jian-Guang; Liu, Yun; Zheng, Yuan-Yuan

    2018-02-01

    Chronic kidney disease (CKD) is a serious condition associated with early mortality, decreased quality of life, and increased health-care expenditures. Data from the National Health and Nutrition Examination Survey (NHANES) collected from 1999 to 2012 were used. Subjects were divided into 4 estimated glomerular filtration rate (eGFR) categories: stage 1: eGFR≥90mL/min/1.73m 2 , stage 2: eGFR 60-89, stage 3: eGFR 30-59, and stage 4/5: eGFRprotein intake and albuminuria were determined. A total of 45,259 subjects were included. Despite decreasing protein intake, there was a significant increase in the prevalence of albuminuria with decreasing levels of eGFR. Multivariable analysis showed that albuminuria was associated with daily protein intake in patients ≥65years old with stage 1 disease, and that diabetes was associated with albuminuria in patients ≥65years old with stage 2 and 3 diseases. Overall, albuminuria in patients with stage 1 disease was associated with hours of sitting per day and blood glucose level. Albuminuria was associated with daily protein intake in patients of 45-64years old with stage 1 CKD disease, and was associated with hours of sitting per day and blood glucose level. These data further support the importance of lifestyle changes in the management of CKD, especially in patients with early-stage disease. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  7. [Concordance of glomerular filtration rate with creatinine clearance in 24-hour urine and Schwartz and Schwartz updated].

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    Salazar-Gutiérrez, María Luisa; Ochoa-Ponce, Cristina; Lona-Reyes, Juan Carlos; Gutiérrez-Íñiguez, Sara Ivonne

    Reference methods for the quantification of the glomerular filtration rate (GFR) are difficult to use in clinical practice; formulas for evaluating GFR based on serum creatinine (SCr) and/or creatinine clearance are used. The aim of this study was to quantify the correlation and concordance of GFR with creatinine clearance in 24-hour urine (GFR24) and Schwartz and Schwartz updated formulas. Cross-sectional study involving healthy pediatric patients and with chronic kidney disease (CKD) from 5 to 16.9 years. Linear correlation between GFR 24 and two formulas was evaluated with the Pearson correlation coefficient (r) and intraclass correlation coefficient (ICC). We studied 134 patients, of which 59.7% were male. Mean age was 10.8 years. The average GFR24 was 140.34ml/min/1.73m 2 ; 34.3% (n=46) had GFR Schwartz (r= 0.63) and Schwartz updated (r= 0.65) formulas was observed. There was good concordance between the GFR24 and Schwartz (ICC= 0.77) and updated Schwartz (ICC= 0.77) formulas. Schwartz classical formula in patients with GFR24 ≥ 90ml/min/1.73m 2 estimated higher values, while Schwartz updated underestimated values. There is moderate correlation and good concordance between the GFR24 and Schwartz and Schwartz updated formulas. The concordance was better in patients with obesity and lower in women, patients with hyperfiltration and normal weight. Copyright © 2016 Hospital Infantil de México Federico Gómez. Publicado por Masson Doyma México S.A. All rights reserved.

  8. Estimation of the glomerular filtration rate – comparison between serum creatinine, cystatin c and calculated creatinine clearance

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    Radovan Hojs

    2006-08-01

    Full Text Available Background: With increasing emphasis on the earlier detection and management of chronic kidney disease (CKD, estimation of the glomerular filtration rate (GFR has assumed greater importance. GFR is often estimated from serum creatinine, recently also from serum cystatin C and by Cockcroft-Gault (C&G and Modification of diet in renal disease (MDRD formulas. In our study different markers of GFR were compared with gold standard 51CrEDTA clearance.Patients and methods: We included 468 patients with CKD stages 2–5 (216 women and 252 men, average age 60.4 ± 14.3 years, who performed 51CrEDTA clearance. In each patient, serum creatinine and cystatin C were determined, creatinine clearance was calculated using C&G and MDRD formulas.Results: We found significant correlation between 51CrEDTA clearance with serum creatinine (r = –0.889, reciprocal of serum creatinine (r = 0.866, serum cystatin C (r = –0.902, reciprocal of serum cystatin C (r = 0.901 and with calculated creatinine clearance from C&G (r = 0.808 and MDRD formulas (r = 0.901. The ROC curve analysis (cut–off for GFR 60 ml/min/1.73m2 showed that serum cystatin C had higher diagnostic accuracy than serum creatinine (P = 0.006 and calculated creatinine clearance from C&G formula (P = 0.004. No difference in diagnostic accuracy was found between serum cystatin C and creatinine clearance calculated from the MDRD formula.Conclusions: Serum cystatin C is a better marker of GFR and has a higher diagnostic accuracy than serum creatinine and calculated creatinine clearance from C&G formula. No difference in diagnostic accuracy was found between serum cystatin C and creatinine clearance calculated from the MDRD formula.

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

    International Nuclear Information System (INIS)

    Toyoshima, S.; Noguchi, K.; Seto, H.; Shimizu, M.; Watanabe, N.

    2000-01-01

    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 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 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 -3 ±0.18x10 -3 mm 2 /s; moderate renal dysfunction, 1.38x10 -3 ±0.10x10 -3 mm2/s) were significantly lower than that of the normal functioning hydronephrotic kidneys (1.63x10 -3 ±0.12±10 -3 mm 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

  10. Role of the VEGF--a signaling pathway in the glomerulus: evidence for crosstalk between components of the glomerular filtration barrier.

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    Eremina, Vera; Baelde, Hans J; Quaggin, Susan E

    2007-01-01

    Vascular endothelial growth factor is a major regulator of angiogenesis and vascular permeability [Carmeliet et al.: Nature 1996;380:435-439]. The podocyte, the outermost layer of the glomerular filtration barrier, produces large amounts of VEGF-A. The observation that levels of VEGF-A are altered in glomerular diseases, the identification of a link between pre-eclampsia and elevated levels of a circulating soluble VEGF receptor, and the entry of anti-VEGF therapies into the clinical arena have generated intense interest in the functional role of VEGF-A in the glomerulus. A variety of studies have been performed to address the role of VEGF-A signaling in the glomerulus. These include descriptions of expression patterns in human renal biopsies, cell culture studies to dissect paracrine versus autocrine signaling roles, and manipulation of VEGF-A expression in animal models using pharmacologic, biologic or genetic approaches. Exquisite dosage sensitivity to VEGF-A exists in the developing glomerulus as small reductions in the expression of VEGF-A lead to profound changes in glomerular structure and function in mice. The use of VEGF inhibitors is associated with damage to the glomerular endothelium in animal models and proteinuria in patients, suggesting that local VEGF-A production is also required for maintenance of this specialized vascular bed. Tight regulation of VEGF-A signaling is required for development and maintenance of the glomerular filtration barrier (GFB) and emphasizes the role of podocyte-endothelial crosstalk in the glomerulus. The relative contributions of various VEGF-A isoforms, the role of autocrine signaling in vivo and identification of factors and mechanisms that regulate constitutive expression, storage and delivery of VEGF-A in the glomerulus are still under investigation. Copyright 2007 S. Karger AG, Basel.

  11. Long-term lithium treatment in bipolar disorder: effects on glomerular filtration rate and other metabolic parameters.

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    Tondo, Leonardo; Abramowicz, Maria; Alda, Martin; Bauer, Michael; Bocchetta, Alberto; Bolzani, Lorenza; Calkin, Cynthia V; Chillotti, Caterina; Hidalgo-Mazzei, Diego; Manchia, Mirko; Müller-Oerlinghausen, Bruno; Murru, Andrea; Perugi, Giulio; Pinna, Marco; Quaranta, Giuseppe; Reginaldi, Daniela; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K; Saiger, David; Sani, Gabriele; Selle, Valerio; Stamm, Thomas; Vázquez, Gustavo H; Veeh, Julia; Vieta, Eduard; Baldessarini, Ross J

    2017-12-01

    Concerns about potential adverse effects of long-term exposure to lithium as a mood-stabilizing treatment notably include altered renal function. However, the incidence of severe renal dysfunction; rate of decline over time; effects of lithium dose, serum concentration, and duration of treatment; relative effects of lithium exposure vs. aging; and contributions of sex and other factors all remain unclear. Accordingly, we acquired data from 12 collaborating international sites and 312 bipolar disorder patients (6142 person-years, 2669 assays) treated with lithium carbonate for 8-48 (mean 18) years and aged 20-89 (mean 56) years. We evaluated changes of estimated glomerular filtration rate (eGFR) as well as serum creatinine, urea-nitrogen, and glucose concentrations, white blood cell count, and body-mass index, and tested associations of eGFR with selected factors, using standard bivariate contrasts and regression modeling. Overall, 29.5% of subjects experienced at least one low value of eGFR ( 55; risk of ≥2 low values was 18.1%; none experienced end-stage renal failure. eGFR declined by 0.71%/year of age and 0.92%/year of treatment, both by 19% more among women than men. Mean serum creatinine increased from 0.87 to 1.17 mg/dL, BUN from 23.7 to 33.1 mg/dL, glucose from 88 to 122 mg/dL, and BMI from 25.9 to 26.6 kg/m 2 . By multivariate regression, risk factors for declining eGFR ranked: longer lithium treatment, lower lithium dose, higher serum lithium concentration, older age, and medical comorbidity. Later low eGFR was also predicted by lower initial eGFR, and starting lithium at age ≥ 40 years. Control data for age-matched subjects not exposed to lithium were lacking. Long-term lithium treatment was associated with gradual decline of renal functioning (eGFR) by about 30% more than that was associated with aging alone. Risk of subnormal eGFR was from 18.1% (≥2 low values) to 29.5% (≥1 low value), requiring about 30 years of exposure. Additional

  12. 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

  13. Estimated Glomerular Filtration Rate, Cardiovascular Events and Mortality Across Age Groups Among Individuals Older Than 60 Years in Southern Europe.

    Science.gov (United States)

    Salvador-González, Betlem; Gil-Terrón, Neus; Cerain-Herrero, M Jesús; Subirana, Isaac; Güell-Miró, Roser; Rodríguez-Latre, Luisa M; Cunillera-Puértolas, Oriol; Elosua, Roberto; Grau, Maria; Vila, Joan; Pascual-Benito, Luisa; Mestre-Ferrer, Jordi; Ramos, Rafel; Baena-Díez, José Miguel; Soler-Vila, Maria; Alonso-Bes, Eva; Ruipérez-Guijarro, Laura; Álvarez-Funes, Virtudes; Freixes-Villaró, Esther; Rodríguez-Pascual, Mercedes; Martínez-Castelao, Alberto

    2017-10-28

    Individuals with a decreased estimated glomerular filtration rate (eGFR) are at increased risk of all-cause (ACM) and cardiovascular mortality; there is ongoing debate about whether older individuals with eGFR 45 to 59mL/min/1.73 m 2 are also at increased risk. We evaluated the association between eGFR and ACM and cardiovascular events (CVE) in people aged 60 to 74 and ≥ 75 years in a population with a low coronary disease incidence. We conducted a retrospective cohort study by using primary care and hospital electronic records. We included 130 233 individuals aged ≥ 60 years with creatinine measurement between January 1, 2010 and December 31, 2011; eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. The independent association between eGFR and the risk of ACM and hospital admission due to CVE were determined with Cox and Fine-Gray regressions, respectively. The median was age 70 years, and 56.1% were women; 13.5% had eGFR < 60 (69.7% eGFR 45-59). During a median follow-up of 38.2 months, 6474 participants died and 3746 had a CVE. For ACM and CVE, the HR in older individuals became significant at eGFR < 60. Fully adjusted HR for ACM in the eGFR 45 to 59 category were 1.61; 95%CI, 1.37-1.89 and 1.19; 95%CI, 1.10-1.28 in 60- to 74-year-olds and ≥ 75-year-olds, respectively; for CVE HR were 1.28; 95%CI, 1.08-1.51 and 1.12; 95%CI, 0.99-1.26. In a region with low coronary disease incidence, the risk of death and CVE increased with decreasing eGFR. In ≥ 75-year-olds, the eGFR 45 to 59 category, which had borderline risk for CVE, included many individuals without significant additional risk. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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

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    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 (<60 mL/min/1.73 m), and 556 patients had a normal eGFR (≥90 mL/min/1.73 m). A total of 694 patients suffered from cerebral artery stenosis, in which 293 patients only had intracranial artery stenosis (ICAS), 110 only with extracranial carotid atherosclerotic stenosis (ECAS), and 301 with both ICAS and ECAS. The patients with eGFR <60 mL/min/1.73m had a higher proportion of death and newly ischemic events compared with those with a relatively normal eGFR. Multivariate analysis revealed that a baseline eGFR <60 mL/min/1.73 m increased the risk of mortality by 3.089-fold and newly ischemic events by 4.067-fold. In further analysis, a reduced eGFR was associated with increased rates of mortality and newly events both in ICAS patients and ECAS patients. However, only an increased risk of newly events was found as the degree of renal function deteriorated in ICAS patients (odds ratio = 8.169, 95% confidence interval = 2.445-14.127).A low baseline eGFR predicted a high mortality and newly ischemic events at 3 months in ischemic stroke patients. A low baseline eGFR was also a strong independent predictor for newly

  15. No Impact of the Analytical Method Used for Determining Cystatin C on Estimating Glomerular Filtration Rate in Children.

    Science.gov (United States)

    Alberer, Martin; Hoefele, Julia; Benz, Marcus R; Bökenkamp, Arend; Weber, Lutz T

    2017-01-01

    Measurement of inulin clearance is considered to be the gold standard for determining kidney function in children, but this method is time consuming and expensive. The glomerular filtration rate (GFR) is on the other hand easier to calculate by using various creatinine- and/or cystatin C (Cys C)-based formulas. However, for the determination of serum creatinine (Scr) and Cys C, different and non-interchangeable analytical methods exist. Given the fact that different analytical methods for the determination of creatinine and Cys C were used in order to validate existing GFR formulas, clinicians should be aware of the type used in their local laboratory. In this study, we compared GFR results calculated on the basis of different GFR formulas and either used Scr and Cys C values as determined by the analytical method originally employed for validation or values obtained by an alternative analytical method to evaluate any possible effects on the performance. Cys C values determined by means of an immunoturbidimetric assay were used for calculating the GFR using equations in which this analytical method had originally been used for validation. Additionally, these same values were then used in other GFR formulas that had originally been validated using a nephelometric immunoassay for determining Cys C. The effect of using either the compatible or the possibly incompatible analytical method for determining Cys C in the calculation of GFR was assessed in comparison with the GFR measured by creatinine clearance (CrCl). Unexpectedly, using GFR equations that employed Cys C values derived from a possibly incompatible analytical method did not result in a significant difference concerning the classification of patients as having normal or reduced GFR compared to the classification obtained on the basis of CrCl. Sensitivity and specificity were adequate. On the other hand, formulas using Cys C values derived from a compatible analytical method partly showed insufficient

  16. Development of formulas for the estimation of renal depth and application in the measurement of glomerular filtration rate in Koreans

    International Nuclear Information System (INIS)

    Yoo, Ie Ryung; Kim, Sung Hoon; Chung, Yong An

    2000-01-01

    There is no established formula for estimating renal depths in Korean. As a result, we undertook this study to develop a new formula, and to apply this formula in the calculation of glomerular filtration rate (GFR). We measured the renal depth (RD) on the abdominal CT obtained in 300 adults (M:F=167:133, mean age 50.9 years) without known renal diseases. The RDs measured by CT were compared with the estimated RDs based on the Tonnesen and Taylor equations. New formulas were derived from the measured RDs in 200 out of 300 patients based on several variables such as sex, age, weight, and height by multiple regression analysis. The RDs estimated from the new formulas were compared with the measured RDs in the remaining 100 patients as a control. In 48 patients who underwent Tc-99m DTPA renal scintigraphy, GFR was measured with three equations (new formula, Tonnesen and Taylor equations), respectively, and compared with each other. The mean values of the RDs measured from CT were 6.9 cm for right kidney of the men (MRK), 6.7 cm for left kidney of the men (MLK), 6.7 cm for right kidney of the women (WRK), and 6.6 cm for left kidney of the men (WLK). The RDs estimated from Tonnesen equation were shorter than the ones measured from CT significantly. The newly derived formulas were 12.813 (weight/height) +0.002 (age) +2.264 for MRK, 15.344 (weight/height)+0.011 (age)+0.557 for for MLK,12.936 (weight/height)+0.014 (age)+1.462 for WRK and 13.488 (weight/height)+0.019 (age)+0.762 for WLK. The correlation coefficients of the RD measured from CT and estimated from the new formula were 0.529 in MRK, 0.729 in MLK, 0.601 in WRK, and 0.724 in WLK, respectively. The GFRs from the new formula were significantly higher than those from the Tonnesen equation significantly, which was the most similar to normal GFR values. We generated new formulas for estimating RD in Korean from the data by CT. By adopting these formulas, we expect that GFR can be measured by the Gates method accurately

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Evaluation of glomerular filtration rate in cats with reduced renal mass and administered meloxicam and acetylsalicylic acid.

    Science.gov (United States)

    Surdyk, Kathryn K; Brown, Cathy A; Brown, Scott A

    2013-04-01

    To determine whether administration of meloxicam or acetylsalicylic acid alters glomerular filtration rate (GFR) in cats with renal azotemia. 6 young adult cats. 3 sexually intact male cats and 3 sexually intact female cats had surgically reduced renal mass and azotemia comparable to International Renal Interest Society chronic kidney disease stages 2 and 3. Renal function was evaluated by measurement of serum creatinine concentration, urinary clearance of exogenously administered creatinine, and the urine protein-to-creatinine concentration ratio (UP:C). Measurements taken in cats receiving placebo at the beginning and end of the study were compared with results obtained at the end of 7 days of treatment with either meloxicam (0.2 mg/kg, SC, on day 1; 0.1 mg/kg, SC, on days 2 to 7) or acetylsalicylic acid (20 mg/kg, PO, on days 1, 4, and 7). No significant treatment effects on urinary clearance of exogenously administered creatinine, serum creatinine concentration, or UP:C were detected. Mean ± SEM serum creatinine concentration and urinary clearance of exogenously administered creatinine measurements following 7 days of treatment with meloxicam (serum creatinine concentration, 2.67 ± 0.17 mg/dL; urinary clearance of exogenously administered creatinine, 1.34 ± 0.08 mL/min/kg) and acetylsalicylic acid (serum creatinine concentration, 2.62 ± 0.12 mg/dL; urinary clearance of exogenously administered creatinine, 1.35 ± 0.07 mL/min/kg) were not significantly different from the mean baseline values for these variables (serum creatinine concentration, 2.77 ± 0.14 mg/dL; urinary clearance of exogenously administered creatinine, 1.36 ± 0.07 mL/min/kg). Neither meloxicam nor acetylsalicylic acid had a measurable effect on urinary clearance of exogenously administered creatinine, serum creatinine concentration, or UP:C. These results are consistent with the hypothesis that GFR of euvolemic cats with normal or reduced renal function is not dependent on cyclooxygenase

  19. Glomerular filtration values obtained with 99mTc-DTPA v/s measurements of creatinine Clearance and calculation of the filtered glomerular using the Schwartz formula in a pediatric population

    International Nuclear Information System (INIS)

    Opazo, Claudio; Gutierrez, Elisa; Zamorano, Julio; Troncoso, TM

    2005-01-01

    We compare glomerular filtration rate by DTPA Renogram (DTPA-GFR) with creatinine clearance (CC) and Glomerular filtration rate from Schwartz formula (Schwartz-GFR). The need for using (DTPA-GFR) method raised from the practical difficulties in getting an accurate (CC) in pediatric population. From Sep-2001 to May-2005, 48 patients aged 1month to 18 years, underwent (DTPA-GFR) and (Schwartz-GFR). 18 had also (CC). Comparison were made among these measurements also accounting for age groups. We found a better correlation between (DTPA-GFR) and (CC) Pearson = 0,895. (Schwartz)/(CC) comparison showed a slightly lower correlation Pearson = 0,857. The worst correlation was found comparing (DTPA-GFR)/(Schwartz-GFR) in children < 3 yr Pearson = 0,560. As we found a better correlation between (DTPA-GFR)/(CC) than (DTPA-GFR)/(Schwartz-GFR), DTPA-GFR could be considered reliable method in evaluating renal function in children having difficulties to get a Creatinine Clearance (au)

  20. Impact of proteinuria and glomerular filtration rate on risk of ischaemic and intracerebral hemorrhagic stroke: a result from the Kailuan study.

    Science.gov (United States)

    Li, Z; Wang, A; Cai, J; Gao, X; Zhou, Y; Luo, Y; Wu, S; Zhao, X

    2015-02-01

    Persons with chronic kidney disease, defined by a reduced estimated glomerular filtration rate and proteinuria, have an increased risk of cardiovascular disease including stroke. However, data from developing countries are limited. Our aim was to assess the relationship between chronic kidney disease and risk of stroke and its subtypes in a community-based population in China. The study was based on 92,013 participants (18-98 years old; 73,248 men and 18,765 women) of the Kailuan study who at baseline were free from stroke and myocardial infarction and had undergone tests for serum creatinine or proteinuria. Glomerular filtration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration formula and proteinuria by the urine dipstick result in laboratory databases. The primary outcome was the first occurrence of stroke. Data were analyzed using Cox proportional hazards models adjusted for relevant confounders and results are presented as hazard ratios (HRs) with 95% confidence intervals (CIs). During a follow-up of 4 years, 1575 stroke events (1128 ischaemic, 406 intracerebral hemorrhagic and 41 subarachnoid hemorrhagic strokes) occurred. After adjustment for variable confounders, patients with proteinuria were found to have increased HRs for the total and subtypes of stroke events (HR 1.61; 95% CI 1.35-1.92 for total stroke; HR 1.53; 95% CI 1.24-1.89 for ischaemic stroke; and HR 1.90; 95% CI 1.35-2.67 for hemorrhagic stroke). However, estimated glomerular filtration rate was not associated with incident stroke after adjustment for established cardiovascular risk factors. Proteinuria increased the risk of stroke in a general Chinese population. © 2014 EAN.

  1. Compare serum creatinine versus Renal 99mTc-DTPA scan determined glomerular filtration rates in veterans with traumatic spinal cord injury and meurogenic bladder.

    Science.gov (United States)

    Rabadi, Meheroz H; Aston, Christopher E

    2016-11-01

    This observational study: (a) compared serum creatinine (estimated glomerular filtration rate (EGFR)) to renal isotope 99m Tc-DTPA (GFR) determined glomerular filtration rate, and evaluated whether either method (b) better determined the state of renal function, and (c) predict urinary tract infection (UTI), renal and urological structural lesions or mortality in veterans with traumatic spinal cord injury (SCI) and neurogenic bladder (NGB). Observational study. VA Medical Center affiliated with Oklahoma University. Veterans with SCI and regularly followed in SCI clinic. Demographic and clinical data, as well as, EGFR, GFR, blood urea nitrogen (BUN) and serum creatinine levels, and presence of UTI, renal and urinary bladder lesions on renal nuclear scan, renal ultrasound, and cystoscopy studies were recorded. None. Urological lesions, UTI, and Mortality. For 161 patients with SCI and NGB the mean ± SD for EGFR was 104 ± 36 and 84 ± 32 for GFR. EGFR and GFR were positively correlated (r = 0.34, P = 0.015). GFR was significantly (P < 0.05) more sensitive and specific in determining renal functional state. Neither measures were significant indicator for UTI, renal or urological lesions; GFR was a significant predictor of risk of death (1.2 times increase in risk per 10 unit drop in GFR) even after adjusting for age (P = 0.040). While GFR and EGFR are comparable measures of glomerular filtration, GFR was a more informative measure of renal functional state and risk of mortality than EGFR. Neither method predicted the presence of UTI related renal or urological lesions.

  2. {sup 99m}Tc-N, N'-bis(aminoethyl)propanediamine hexaacetic acid (BPHA): a glomerular filtration agent similar to {sup 99m}Tc-DTPA

    Energy Technology Data Exchange (ETDEWEB)

    Liu Guozheng E-mail: Guozheng.Liu@umassmed.edu; Zhang Chunli; Liu Fei; Wang Rongfu; Fu Zhanli; Li Guiqun; Miao Zengxing

    2002-05-01

    Investigations on the biodistribution of {sup 99m}Tc-BPHA in normal and probenecid treated mice and a comparison with {sup 99m}Tc-DTPA injected mice suggested that {sup 99m}Tc-BPHA is also a glomerular filtration agent. Whole body radioactivity measurements in mice and rabbits after administration of {sup 99m}Tc-BPHA showed negligible whole body radioactivity at 24 h. Excellent kidney images both in rabbits and a human volunteer were obtained. The significance of higher GFR estimates using {sup 99m}Tc-BPHA compared to {sup 99m}Tc-DTPA is discussed.

  3. Over-estimation of glomerular filtration rate by single injection [51Cr]EDTA plasma clearance determination in patients with ascites

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Brøchner-Mortensen, J; Malchow-Møller, A

    1980-01-01

    The total plasma (Clt) and the renal plasma (Clr) clearances of [51Cr]EDTA were determined simultaneously in nine patients with ascites due to liver cirrhosis. Clt (mean 78 ml/min, range 34-115 ml/min) was significantly higher than Clr (mean 52 ml/min, range 13-96 ml/min, P ... fluid-plasma activity ratio of [51Cr]EDTA increased throughout the investigation period (5h). The results suggest that [51Cr]EDTA equilibrates slowly with the peritoneal space which indicates that Clt will over-estimate the glomerular filtration rate by approximately 20 ml/min in patients with ascites...

  4. Detection of Chronic Kidney Disease by Using Different Equations of Glomerular Filtration Rate in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Analysis

    OpenAIRE

    Zaman, Sojib Bin

    2017-01-01

    Introduction Chronic kidney disease (CKD) is a global threat due to its high mortality. It is essential to know the actual magnitude of diabetic CKD to design a specific management program. However, there is limited knowledge regarding the most suitable equation to measure CKD in patients with Type 2 diabetes mellitus (T2DM). This paper aimed to analyze estimated glomerular filtration rate (eGFR) based on different equations to detect the CKD among T2DM.? Methods A hospital-based cross-sectio...

  5. 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

    Besides bone marrow, the kidneys are often dose-limiting organs in internal radiotherapy. The effects of high-linear energy transfer (LET) radiation on the kidneys after alpha-radioimmunotherapy (alpha-RIT) with the alpha-particle emitter, (211)At, were studied in nude mice by serial measurements...... 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...

  6. Cross-flow micro-filtration using ceramic membranes

    International Nuclear Information System (INIS)

    Thern, Gerardo G.; Marajofsky, Adolfo; Rossi, Federico; La Gamma, Ana M.; Chocron, Mauricio

    2004-01-01

    Pressurized Heavy Water Reactors have a system devoted to the purification and upgrading of the collected heavy water leaks. The purification train is fed with different degradation ratios (D 2 O/H 2 O), activities and impurities. The water is distilled in a packed bed column filled with a mesh type packing. With the purpose of minimizing the column stack corrosion, the water is pre-treated in a train consisting on an activated charcoal bed-strong cationic-anionic resin and a final polishing anionic bed resin. Traces of oils are retained by the charcoal bed but some of them pass through and could be responsible for the resins fouling. The process of micro filtration using ceramic materials is particularly applied to the treatment of waters with oil micro droplets. We describe the development stages of single and double layer filtration ceramic tubes, their characterization and the adaptation to test equipment. The efficiency was evaluated by means of tangential ('cross-flow') filtration of aqueous solutions containing dodecane at the micrograms per ml concentration level. This compound simulates the properties of a typical oil contaminant. A 100-fold reduction in the amount of dodecane in water was observed after the filtration treatment. (author)

  7. Performance of glomerular filtration rate estimation equations in Congolese healthy adults: The inopportunity of the ethnic correction.

    Science.gov (United States)

    Bukabau, Justine B; Sumaili, Ernest K; Cavalier, Etienne; Pottel, Hans; Kifakiou, Bejos; Nkodila, Aliocha; Makulo, Jean Robert R; Mokoli, Vieux M; Zinga, Chantal V; Longo, Augustin L; Engole, Yannick M; Nlandu, Yannick M; Lepira, François B; Nseka, Nazaire M; Krzesinski, Jean Marie; Delanaye, Pierre

    2018-01-01

    In the estimation of glomerular filtration rate (GFR), ethnicity is an important determinant. However, all existing equations have been built solely from Caucasian and Afro-American populations and they are potentially inaccurate for estimating GFR in African populations. We therefore evaluated the performance of different estimated GFR (eGFR) equations in predicting measured GFR (mGFR). In a cross-sectional study, 93 healthy adults were randomly selected in the general population of Kinshasa, Democratic Republic of the Congo, between June 2015 and April 2016. We compared mGFR by plasma clearance of iohexol with eGFR obtained with the Modified Diet in Renal Disease (MDRD) equation with and without ethnic factor, the Chronic Kidney Disease Epidemiology (CKD-EPI) serum creatinine (SCr)-based equation, with and without ethnic factor, the cystatin C-based CKD-EPI equation (CKD-EPI SCys) and with the combined equation (CKD-EPI SCrCys) with and without ethnic factor. The performance of the equations was studied by calculating bias, precision and accuracy within 30% (P30) of mGFR. There were 48 women and 45 men. Their mean age was 45.0±15.7 years and the average body surface area was 1.68±0.16m2. Mean mGFR was 92.0±17.2 mL/min/1.73m2 (range of 57 to 141 mL/min/1.73m2). Mean eGFRs with the different equations were 105.5±30.1 and 87.2±24.8 mL/min/1.73m2 for MDRD with and without ethnic factor, respectively; 108.8±24.1 and 94.3x20.9 mL/min/1.73m2 for CKD-EPI SCr with and without ethnic factor, respectively, 93.5±18.6 mL/min/1.73m2 for CKD-EPI SCys; 93.5±18.0 and 101±19.6 mL/min/ 1.73m2 for CKD-EPI SCrCys with and without ethnic factor, respectively. All equations slightly overestimated mGFR except MDRD without ethnic factor which underestimated by -3.8±23.0 mL/min /1.73m2. Both CKD-EPI SCr and MDRD with ethnic factors highly overestimated mGFR with a bias of 17.9±19.2 and 14.5±27.1 mL/min/1.73m2, respectively. There was a trend for better P30 for MDRD and CKD

  8. sup(99m)Tc-DTPA gamma-camera renography: Normal values and rapid determination of single-kidney glomerular filtration rate

    International Nuclear Information System (INIS)

    Rehling, M.; Moller, M.L.; Lund, J.O.; Trap-Jensen, J.; Jensen, K.B.; Thamdrup, B.

    1985-01-01

    A method for sup(99m)Tc-diethylenetriaminepentaacetate (DTPA) gamma-camera renography is presented. From each renogram an uptake index (UI) proportional to the single-kidney glomerular filtration rate (SKGFR) is defined. If the proportionality factor between UI and SKGFR is the same in all patients, UI can be used as an accurate measure of SKGFR. In order to test this, sup(99m)Tc-DTPA renography was performed in 101 patients with glomerular filtration rates (GFR) varying between 4 and 172 ml/min. The sum of the right- and left-kidney UIs correlated well with the total GFR calculated from the simultaneously measured plasma clearance of sup(99m)Tc-DTPA after a single injection. The correlation coefficient was 0.97. The method was tested in a prospective study of 57 patients. The total GFR estimated from the renograms was not significantly different from the GFR calculated from the plasma clearance of sup(99m)Tc-DTPA. The coefficient of variation -a combination of inaccuracy and imprecision in the estimates as well as in the reference values - was 11.8% at a GFR of 100 ml/min. It is concluded that, in adults, the SKGFR can be calculated as part of the clinical routine from sup(99m)Tc-DTPA gamma-camera renography without determining the injected dose or collecting urine or blood samples. Normal values for some parameters of the renogram obtained in 25 normal subjects are given. (orig.)

  9. Correlation of the glomerular filtration rate by the Gates scintigraphy method and by the creatinine purification in urine of 24 hours

    International Nuclear Information System (INIS)

    Gomez A, E.

    2003-01-01

    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 2 (1.70 m 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)

  10. A meta-analysis on diagnostic value of serum cystatin C and creatinine for the evaluation of glomerular filtration function in renal transplant patients.

    Science.gov (United States)

    Pan, Pan; Binjie, Hu; Min, Li; Lipei, Fan; Yanli, Ni; Junwen, Zhou; Xianghua, Shi

    2014-12-01

    This meta-analysis aimed to perform a systematic review on comparing the diagnostic value of serum cystatin C and creatinine for glomerular filtration rate in renal transplant patients. The data was extracted into 2×2 table after the articles were assessed by the tool of QUADAS and heterogeneity analysis. The SROC curve and meta-analysis were performed by MetaDisc1.4. Meta-analysis showed that the serum cystatin C had no heterogeneity (P=0.418, I2=2.2%, DOR=25.03), while creatinine heterogeneity was high (P=0.109, I2=37.5%, DOR=9.11). The values of SEN, SPE and SAUC were calculated as 0.86, 0.70 and 0.9015 for cystatin C, and 0.78, 0.73 and 0.8285 for creatinine individually. This study utilized GFR detection and subgroups analysis by cutoff. The PLR was 6.13 and the NLR was 0.12 for cystatin C, compared to SCr (3.72, 0.32). There was homogeneity among these studies using PENIA testing for cystatin C (χ2=2.61, P=0.4560, I2=0.0%. There were significant correlations among cystatin C , creatinine and glomerular filtration rate (GFR). Cystatin C had more sensitivity but less specificity than creatinine for evaluation of GFR. Cystatin C had strong ability in diagnosing renal function after renal transplant and ruling out diagnostic efficacy.

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

  12. Differences between nisoldipine and lisinopril on glomerular filtration rates and albuminuria in hypertensive IDDM patients with diabetic nephropathy during the first year of treatment

    DEFF Research Database (Denmark)

    Rossing, P; Tarnow, L; Boelskifte, S

    1997-01-01

    Our objective was to compare the effect of a long-acting calcium antagonist (nisoldipine) versus an ACE inhibitor (lisinopril) on albuminuria, arterial blood pressure, and glomerular filtration rate (GFR) in hypertensive IDDM patients with diabetic nephropathy. We performed a 1-year, double......-blind, double-dummy, randomized, controlled study comparing nisoldipine (20-40 mg once daily) with lisinopril (10-20 mg once daily) in 52 hypertensive IDDM subjects with diabetic nephropathy. Three patients dropped out, and results for the remaining 49 (25 nisoldipine, 24 lisinopril) are presented. Diuretics...... were required in 10 nisoldipine- and 8 lisinopril-treated patients. Every 3 months, 24-h ambulatory blood pressure (TM2420, A&D, Tokyo, Japan) and albuminuria in three 24-h samples (enzyme immunoassay) were measured; GFR (51Cr-EDTA plasma clearance) was recorded every 6 months. Mean arterial blood...

  13. 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

    initial fall in eGFR had a significant lower long-term eGFR slope compared to those with a moderate fall or rise. This relationship was independent of other risk markers or change in risk markers for progression of renal disease such as blood pressure and albuminuria. Thus, the greater the acute fall in e......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...... a significantly greater acute fall in estimated (eGFR) during the first 3 months compared to patients assigned to placebo, but a significantly slower long-term mean decline of eGFR thereafter. A large interindividual difference, however, was noticed in the acute eGFR change. When patients were divided...

  14. A precise evaluation of glomerular filtration rate (GFR) in two plasma samples following a single administration of 57Co-B12 vitamin

    International Nuclear Information System (INIS)

    Camargo, E.E.; Rockmann, R.L.; Barreto, T.M.; Eston, T.E.; Papaleo Netto, M.; Carvalho, N.

    1974-01-01

    Through a logarithmic regression performed with the contings of 4 plasma samples withdrawn at 20,40,60 and 80 minutes after a venous injection of vitamin B 12 - 57 Co, the glomerular filtration-rate(GFR) in 11 patients, performing simultaneously the same study with EDTA- 51 Cr in 3 of them, is evaluated. The values obtained through the regression straight line are compared with those given by only 2 points, in the 6 possible combinations: 20 and 40 minutes, 20 and 60 minutes, 20 and 80 minutes, 40 and 60 minutes, 40 and 80 minutes, 60 and 80 minutes. The pair of points obtained at 20 and 80 minutes determined the straight line most similar to the logarithmic regression and as a simplification of the method, the withdraw of only 2 plasma samples, at and 80 minutes after a single injection of vitamin B 12 -57 Co is proposed [pt

  15. 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

    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...... in GFR. These results suggest that a mean absorbed dose to the kidneys of approximately 10 Gy is acceptable, and that the kidneys would not be the primary dose-limiting organ in systemic alpha-RIT when using (211)At-MX35-F(ab')(2) Udgivelsesdato: 2009/12...

  16. Drug dosing in patients with renal insufficiency in a hospital setting using electronic prescribing and automated reporting of estimated glomerular filtration rate

    DEFF Research Database (Denmark)

    Nielsen, Anita L; Henriksen, Daniel P; Marinakis, Christianna

    2014-01-01

    the clinical support system Renbase(®) as reference, we investigated the use and dosing of drugs in patients with impaired renal function in a university hospital setting using electronic prescription and automatic reporting of estimated glomerular filtration rate (eGFR). In all, 232 patients with an e......In patients with impaired renal function, drug dose adjustment is often required. Non-adherence to clinical prescribing recommendations may result in severe adverse events. In previous studies, the prevalence rate of non-adherence to recommended dosing has been reported to be 19-67%. Using......GFR in the range of 10-49 ml/min/1.73m(2) were included. We identified 436 episodes with administration of renal risk drugs (prescribed to 183 patients): 410 drugs required dose adjustment according to the eGFR and 26 should be avoided. In total, the use or dosing of 66 (15%) of the 436 renal risk drugs...

  17. Reduced adenosine A2a receptor-mediated efferent arteriolar vasodilation contributes to diabetes-induced glomerular hyperfiltration.

    Science.gov (United States)

    Persson, Patrik; Hansell, Peter; Palm, Fredrik

    2015-01-01

    Diabetes is associated with increased risk for development of kidney disease, and an increased glomerular filtration rate is an early indication of altered kidney function. Here we determine whether reduced adenosine A2a receptor-mediated vasodilation of the efferent arteriole contributes to the increased glomerular filtration rate in diabetes. The glomerular filtration rate, renal blood flow, and proximal tubular stop flow pressure were investigated in control and streptozotocin-diabetic rats during baseline and after administration of the adenosine A2a receptor antagonist ZM241385 or the adenosine A2a receptor agonist CGS21680. The diabetes-induced glomerular hyperfiltration was reduced by 24% following A2a receptor stimulation but was unaffected by A2a receptor inhibition. Contrarily, glomerular filtration rate in controls increased by 22% after A2a receptor inhibition and was unaffected by A2a stimulation. The increased glomerular filtration rate after A2a receptor inhibition in controls and decreased glomerular filtration rate after A2a receptor activation in diabetics were caused by increased and decreased stop flow pressure, respectively. None of the interventions affected renal blood flow. Thus, the normal adenosine A2a receptor-mediated tonic vasodilation of efferent arterioles is abolished in the diabetic kidney. This causes increased efferent arteriolar resistance resulting in increased filtration fraction and hyperfiltration.

  18. Induction of an experimental Fanconi syndrome in mice: Its effect on the glomerular filtration function studied by 99mTc-DTPA

    International Nuclear Information System (INIS)

    Sawas-Dimopoulou, C.; Sigalas, I.; Margaritis, L.

    1996-01-01

    An experimental mice model of maleate (MAL)-induced Fanconi syndrome has been used to test 99m Tc-DTPA ability to detect hampered glomerular filtration rate (GFR) early in drug-induced Fanconi syndrome. In fact, declining GFR has been reported both in idiopathic and acquired Fanconi syndrome. The above MAL model shows urine biochemistry changes similar to those reported in patients suffering from Fanconi syndrome. Moreover, biodistribution study and whole-body autoradiographies performed after IV injection of 99m Tc-DTPA in MAL and control mice show significantly delayed pharmacokinetics of the above radiopharmaceutical in a MAL dose-dependent effect. After administration of a MAL dose of 6 mM/kg BW, the 5-min biodistribution of 99m Tc-DTPA, a radiopharmaceutical freely excreted by glomerular filtration, is significantly changed in all organs. In blood of MAL mice, 27.62 ± 2.86% of the injected dose is still circulating compared to 13.67 ± 1.22% of the injected dose in control mice, and only 1.37 ± 0.31% of the injected dose has been excreted in urine of MAL mice compared to 24.66 ± 4.12% of the injected dose in urine of control mice. The obtained results suggest that 99m Tc-DTPA may be efficient both in the early detection of abnormal GFR in acquired Fanconi syndrome after application of a nephrotoxic treatment, and in the follow-up of patients in recovery phase after discontinuation of the therapy

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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...

  1. Interfering RNA against PKC-α Inhibits TNF-α-induced IP3R1 Expression and Improves Glomerular Filtration Rate in Rats with Fulminant Hepatic Failure.

    Science.gov (United States)

    Wang, Dong-Lei; Dai, Wen-Ying; Wang, Wen; Wen, Ying; Zhou, Ying; Zhao, Yi-Tong; Wu, Jian; Liu, Pei

    2018-01-10

    We have reported that tumor necrosis factor- (TNF-α) is critical for reduction of glomerular filtration rate (GFR) in rats with fulminant hepatic failure (FHF). The present study aims to evaluate the underlying mechanisms of decreased GFR during acute hepatic failure. Rats with FHF induced by D-galactosamine plus lipopolysaccharide (GalN/LPS) were injected intravenously with recombinant lentivirus harboring shRNA against the protein kinase C-α (PKC-α) gene (Lenti-shRNA-PKC-α). GFR, serum levels of aminotransferases, creatinine, urea nitrogen, potassium, sodium, chloride, TNF-α and endothelin-1 (ET-1), as well as type 1 inositol 1,4,5-trisphosphate receptor (IP3R1) expression in renal tissue were assessed. The effects of PKC-α silencing on TNF-α-induced IP3R1, specificity protein 1 (SP-1) and c-Jun N-terminal kinase (JNK) expression, as well as cytosolic calcium content were determined in glomerular mesangial cell (GMCs) with RNAi against PKC-α. Renal IP3R1 overexpression was abrogated by pre-treatment with Lenti-shRNA-PKC-α. The PKC- silence significantly improved the compromised GFR, reduced Cr levels, and reversed the decrease in glomerular inulin space and the increase in glomerular calcium content in GalN/LPS-exposed rats. TNF-α treatment increased expression of PKC-α, IP3R1, specificity protein 1 (SP-1), JNK and p-JNK in GMCs, and increased Ca2+ release and binding activity of SP-1 to the IP3R1 promoter. These effects were blocked by transfection of siRNA against the PKC-α gene, and the PKC-α gene silence also restored cytosolic [Ca2+]i. RNAi targeting PKC-α inhibited TNF-α-induced IP3R1 overexpression, and in turn improved compromised GFR in the development of acute kidney injury during FHF in rats.

  2. Decreased arterial elasticity in children with nondialysis chronic kidney disease is related to blood pressure and not to glomerular filtration rate.

    Science.gov (United States)

    Sinha, Manish D; Keehn, Louise; Milne, Laura; Sofocleous, Paula; Chowienczyk, Phil J

    2015-10-01

    We compared large artery mechanical properties in children with nondialysis stages of chronic kidney disease with those in children with normal renal function, examining the potential effect of blood pressure (BP) components and level of renal dysfunction. Common carotid artery mechanical properties, carotid-femoral pulse wave velocity, and carotid and peripheral BP were measured in children (n=226) with nondialysis chronic kidney disease (n=188; 11.9±3.7 years; 26%, 25%, 30%, 16%, and 3% in stages 1, 2, 3, 4 and 5, respectively) and healthy controls (n=38; 11.5±3.3 years). In children with nondialysis chronic kidney disease when compared with healthy controls, at similar levels of peripheral and carotid BP, carotid artery diastolic diameter and wall thickness were similar. In those with suboptimal BP (≥75th percentile), indices of arterial elasticity indicated greater stiffness than in healthy normotensive controls (distensibility: 92±31 versus 114±33 kPa(-1)×10(-3), P=0.03; compliance: 2.1±0.7 versus 2.6±0.7 m(2) kPa(-1)×10(-6), P=0.02; Young elastic modulus: 0.151±0.068 versus 0.109±0.049 kPa×10(3), P=0.02; and wall stress: 83.6±23.5 versus 68.7±14.9 kPa, P=0.02). In all children, mechanical properties were independently related to carotid and peripheral BP components but not to estimated glomerular filtration rate. In children with nondialysis chronic kidney disease, changes in elastic properties of the carotid artery are primarily related to BP and not to glomerular renal function. © 2015 American Heart Association, Inc.

  3. Quantification of glomerular filtration rate by measurement of gadobutrol clearance from the extracellular fluid volume: comparison of a TurboFLASH and a TrueFISP approach

    Science.gov (United States)

    Boss, Andreas; Martirosian, Petros; Artunc, Ferruh; Risler, Teut; Claussen, Claus D.; Schlemmer, Heinz-Peter; Schick, Fritz

    2007-03-01

    Purpose: As the MR contrast-medium gadobutrol is completely eliminated via glomerular filtration, the glomerular filtration rate (GFR) can be quantified after bolus-injection of gadobutrol and complete mixing in the extracellular fluid volume (ECFV) by measuring the signal decrease within the liver parenchyma. Two different navigator-gated single-shot saturation-recovery sequences have been tested for suitability of GFR quantification: a TurboFLASH and a TrueFISP readout technique. Materials and Methods: Ten healthy volunteers (mean age 26.1+/-3.6) were equally devided in two subgroups. After bolus-injection of 0.05 mmol/kg gadobutrol, coronal single-slice images of the liver were recorded every 4-5 seconds during free breathing using either the TurboFLASH or the TrueFISP technique. Time-intensity curves were determined from manually drawn regions-of-interest over the liver parenchyma. Both sequences were subsequently evaluated regarding signal to noise ratio (SNR) and the behaviour of signal intensity curves. The calculated GFR values were compared to an iopromide clearance gold standard. Results: The TrueFISP sequence exhibited a 3.4-fold higher SNR as compared to the TurboFLASH sequence and markedly lower variability of the recorded time-intensity curves. The calculated mean GFR values were 107.0+/-16.1 ml/min/1.73m2 (iopromide: 92.1+/-14.5 ml/min/1.73m2) for the TrueFISP technique and 125.6+/-24.1 ml/min/1.73m2 (iopromide: 97.7+/-6.3 ml/min/1.73m2) for the TurboFLASH approach. The mean paired differences with TrueFISP was lower (15.0 ml/min/1.73m2) than in the TurboFLASH method (27.9 ml/min/1.73m2). Conclusion: The global GFR can be quantified via measurement of gadobutrol clearance from the ECFV. A saturation-recovery TrueFISP sequence allows for more reliable GFR quantification as a saturation recovery TurboFLASH technique.

  4. 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.

  5. Tangential Flow Filtration Technique: an Overview on Nanomedicine Applications.

    Science.gov (United States)

    Musumeci, Teresa; Leonardi, Antonio; Bonaccorso, Angela; Pignatello, Rosario; Puglisi, Giovanni

    2018-03-06

    Purification is a key step for different type of approaches, ranging from food, biotechnology to pharmaceutical fields. In biotechnology tangential flow filtration (TFF) allows to obtain the separation of different components of cells without instability phenomena. In food industry, TFF ensures the removal of contaminants or other substances that negatively affect visual appearance, organoleptic attributes, nutritional value and/or safety of aliments. Purification is an important and necessary step controlling the quality of final product also in the pharmaceutical area. In the field of research and development of nanomedicines, several techniques are used to purify and/or to concentrate the batches for in vitro and in vivo application. Despite many approaches exist; current data reveals continued unsatisfactory results. Between them, TFF showed promising results, even if, currently, its use is uncommon if compared with the other purification techniques usually reported in "materials and methods" sections. This review represents an overview of the different applications of TFF from protein purification to food application, with particular attention to the field of nanomedicine from polymeric to metallic nanoparticles, highlighting advantages and dis-advantages in the use of this technique. Theoretical aspect of the process has been examined. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Prognostic value of proteinuria and glomerular filtration rate on Taiwanese patients with diabetes mellitus and advanced chronic kidney disease: a single center experience.

    Science.gov (United States)

    Chen, Ping-Min; Wada, Takashi; Chiang, Chih-Kang

    2017-04-01

    Several risk factors were associated with poor outcomes in diabetic patients with chronic kidney disease (CKD). However, few studies addressed the prognostic implications of these factors in advanced CKD. Our study aimed to provide more evidence for risk factor stratification of diabetic patients with advanced CKD. A total of 447 diabetic patients with advanced CKD, age of 18-80, who visited the nephrology out-patient clinic were enrolled. All patients were in stage 3B-5 CKD. The primary outcomes included long-term renal replacement therapy and mortality. The occurrence of cardiovascular events was also analyzed as secondary outcome. Multivariate Cox regression models were used to address each risk factor in this cohort. We also used this cohort to evaluate the validity of the modified diabetic nephropathy score. Patients with lower estimated glomerular filtration rate (eGFR) were associated with higher degree of proteinuria. In the multivariate Cox regression model, eGFR and the degree of proteinuria were both strong outcome predictors. The effects of glycosylated hemoglobin and blood pressure in this advanced CKD cohort were minimal. Elder patients with advanced CKD had a higher mortality rate, but commenced less renal replacement therapy. Applying these indicator analyses, we proposed a modified diabetic nephropathy score for outcome prediction. Our analysis demonstrated the impact of eGFR and proteinuria in the advanced CKD group. Indicators in early CKD possessed a different prognostic profile in this advanced CKD cohort, therefore, necessitating a modified scoring system.

  7. The effect of improved modelling of plasma clearance in paediatric patients with expanded body spaces on estimation of the glomerular filtration rate

    International Nuclear Information System (INIS)

    Perkinson, A S; Evans, C J; Burniston, M T; Smye, S W

    2010-01-01

    The glomerular filtration rate (GFR) is used clinically to assess renal function. The most accurate estimation technique is tracer clearance where deterministic compartment pharmacokinetic models are most widely used. The aim of this study was to assess the viability of alternative pharmacokinetic models to describe tracer clearance, and in turn, measure GFR. This study was carried out on 126 clearance datasets obtained from 44 patients with large solid tumours; these were fitted to four pharmacokinetic models with superiority of model determined by Akaike Information Criteria. A fractal model was found to be superior to the best deterministic compartment model (70% of datasets, P < 0.0020) as was a gamma-distributed residence time model (93% of datasets, P < 0.0020); both models also gave greater mean weighted coefficients of determination than deterministic compartment models. These results suggest that gamma-distributed residence time and fractal models better describe tracer clearance than deterministic compartment models and therefore should allow more accurate estimation of GFR

  8. Results of the first-in-human clinical trial for MB-102, a novel fluorescent tracer agent for real-time measurement of glomerular filtration rate

    Science.gov (United States)

    Dorshow, Richard B.; Debreczeny, Martin P.; Dowling, Thomas C.

    2015-03-01

    The fluorescent tracer agent 2,5-bis[N-(1-carboxy-2-hydroxy)]carbamoyl-3,6-diaminopyrazine, designated MB-102, has been developed with properties and attributes necessary for use as a direct measure of glomerular filtration rate (GFR). Comparison to known standard exogenous GFR agents in animal models has demonstrated an excellent correlation. A clinical trial to demonstrate this same correlation in humans is in progress. This clinical trial is the first in a series of trials necessary to obtain regulatory clearance from the FDA. We report herein the comparison of plasma pharmacokinetics between MB-102 and the known standard exogenous GFR agent Iohexol in healthy subjects with normal renal function. Post simultaneous administration of both agents, blood samples over a period of 12 hours were collected from each subject to assess pharmacokinetic parameters including GFR. Urine samples were collected over this same period to assess percent injected dose recovered in the urine. Results indicate MB-102 is a GFR agent in humans from the comparison to the standard agent.

  9. High glucose increases glomerular filtration barrier permeability by activating protein kinase G type Iα subunits in a Nox4-dependent manner.

    Science.gov (United States)

    Piwkowska, Agnieszka; Rogacka, Dorota; Audzeyenka, Irena; Angielski, Stefan; Jankowski, Maciej

    2014-01-01

    Hyperglycemia is a primary factor that disturbs podocyte function in the glomerular filtration process; this disturbance leads to the development of diabetic nephropathy, and ultimately, renal failure. Podocyte function may also be altered by biological agents that modify protein kinase activity, including the cGMP-activated protein kinase type Iα (PKGIα). We hypothesized that hyperglycemia-induced podocyte protein hyperpermeability was dependent on PKGIα activation, and that PKGIα was activated via dimerization induced by reactive oxygen species. This hypothesis was investigated in rat podocytes cultured in high glucose (HG, 30 mM). Protein expression was measured with Western blot and immunofluorescence. Podocyte permeability was measured with a transmembrane albumin flux assay. We found that HG increased podocyte permeability in long-term incubations (1, 3, and 5 days); permeability was increased by 66% on day 5. This effect was abolished with apocynin, a NAD(P)H inhibitor, and Rp-8-Br-cGMPS, a PKG inhibitor. It was also abolished by introducing small interfering RNAs (siRNAs) against Nox4 and PKGIα into cultured podocytes. Furthermore, HG increased PKGIα dimerization by 138% (0.23 ± 0.04 vs. 0.54 ± 0.09; Pfiltration barrier via Nox4-dependent PKGIα dimerization. © 2013 Published by Elsevier Inc.

  10. Association between polyvascular atherosclerosis and estimated glomerular filtration rate in patients with ischaemic stroke: data analysis of the patients in the Chinese National Stroke Registry.

    Science.gov (United States)

    Meng, Xia; Chen, Yu; Jing, Jing; Zhao, Xingquan; Wang, Chunxue; Liu, Liping; Wang, Anxin; Pan, Yuesong; Li, Chao; Wang, Yilong

    2015-05-01

    This study evaluated the prevalence of chronic kidney disease (CKD) in ischemic stroke (IS) patients with polyvascular disease (PolyVD) and analysed the relationship between PolyVD and estimated glomerular filtration rate (eGFR) in IS patients. Data from 9152 consecutive IS patients from the China National Stroke Registry were analysed. PolyVD was defined as patients with IS and coronary artery disease (CAD) and/or peripheral arterial disease (PAD). Chronic kidney disease was defined as eGFR stroke, and National Institutes of Health Stroke Scale scores. PolyVD was observed in 1387 of 9152 patients (15.16%). Among these patients, 1351 (14.76%) had CAD, 56 (0.61%) had PAD, and 20 (0.22%) had CAD and PAD in addition to IS. The prevalence of CKD in IS patients with PolyVD and IS alone was 29.56 and 16.28%, respectively (P < 0.0001). The PolyVD group had a significantly higher risk of lower eGFR (OR: 1.414, 95% CI: 1.202-1.665, P < 0.0001) compared with patients with IS alone. IS patients with PolyVD had a high prevalence of CKD, and PolyVD was independently associated with a low eGFR.

  11. 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.

  12. Demystifying ethnic/sex differences in kidney function: is the difference in (estimating) glomerular filtration rate or in serum creatinine concentration?

    Science.gov (United States)

    Pottel, Hans; Hoste, Liesbeth; Delanaye, Pierre; Cavalier, Etienne; Martens, Frank

    2012-10-09

    The recent evaluation of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation for estimating the glomerular filtration rate (GFR) in multiple ethnicities has raised the question on how well this equation performs for African-American and Asian subjects. There is no doubt that serum creatinine (Scr) concentration differs between ethnicities and sexes. We show that creatinine-based equations for white populations may be inaccurate for estimating GFR in other ethnic/gender groups, especially in populations from Asia. This study presents a mathematical analysis of the CKD-EPI-equation complemented with a literature review of median and reference values for IDMS-standardized Scr-concentrations for multiple ethnicities. The study shows that at equal eGFR-CKD-EPI-values, the ratio of Scr between females and males equals 0.79 and between other ethnicities/sexes and white males is constant too. From this information, it is possible to calculate mean Scr-values that correspond very well with literature values directly obtained from Scr-distributions in healthy white males and females and in black males, but the discrepancy is larger for other populations. Our results confirm the criticism that has been raised for using the CKD-EPI-equation for these ethnicities. An alternative eGFR-model is proposed based on a population-normalized Scr that needs further validation. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Plasma creatinine levels, estimated glomerular filtration rate and carotid intima media thickness in middle-aged women: a population based cohort study.

    Science.gov (United States)

    Gentile, M; Panico, S; Mattiello, A; de Michele, M; Iannuzzi, A; Jossa, F; Marotta, G; Rubba, P

    2014-06-01

    The relationships between high Creatinine (Cr) levels or low estimated Glomerular Filtration Rate (eGFR) and common carotid Intima Media thickness (IMT) have been evaluated in a population-based cohort study in women, aged 30-69 (Progetto ATENA). Serum Cr and eGFR were measured in 310 women, as a part of 5.062. In this group carotid ultrasound examination (B-Mode imaging) was performed and mean max IMT was calculated. Women were classified by Cr levels >1 mg/dL or eGFR Women with Cr > 1 mg/dL (90th percentile of creatinine distribution) or eGFR less than 56 ml/min (5th percentile of eGFR distribution) had relatively more carotid plaques as compared to the rest of the cohort. Multivariate logistic analysis, after adjustment for age, demonstrated a significant association between Cr (>1 mg/dL) and IMT (≥1.2 mm): OR 4.12 (C.I 1.22-13.86), p = 0.022; or eGFR (women, independently of age, suggest the value of screening for early carotid disease in asymptomatic middle aged-women with mild renal insufficiency, in order to predict those at relatively higher risk for future cardiovascular events. Copyright © 2013 Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki; Awai, Kazuo; Funama, Yoshinori

    2011-01-01

    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 m 2 ) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 2 at baseline was high in patients with advanced age, CVD and DM and in patients without oncologic disease

  15. Retrospective study of renal distribution volume with DTPA-99mTc: performance of single plasma method for glomerular filtration rate estimation

    International Nuclear Information System (INIS)

    Legendre, J.M.; Cledes, J.; Morin, J.F.; Morin, P.P.

    1997-01-01

    169 glomerular filtration rate (GFR) measurements, performed in clinical practice, were analysed for estimation of GFR by several common methods. In one half of patients, we observed that early (2-3-4 hours) and tardive (3-4-5 hours three point plasma methods were highly correlated, r = 0,998 (n = 82). Even if regression line significantly differed from identify, differences between methods were low (-6, 1 to + 4,4 mL/min/1,73 m 2 ). Method with urinary collection was also correlated to plasma methods (r = 0,920 in both cases). Plasma based mean values were higher than that for urinary by 3,6 mL/min/1,73 m 2 (2-3-4 hours) and 3, 1 (3-4-5 hours). Using plasma GFR values and distribution volume, linear and quadratic regressions were tested for GFR = f (V) and GFR = f (In (V). The lowest observed standard deviation (3,6 mL/min; n = 82) was for GFR 234 = f (V 4h ) using a quadratic equation. This was applied to the second patient group for GFR estimation with 4 hours single point plasma method. Estimations were compared to GFR plasma values. For comparison, GFR estimations were also obtained using the Christensen's equation. (authors)

  16. Association Between Contrast Media Volume-Glomerular Filtration Rate Ratio and Contrast-Induced Acute Kidney Injury After Primary Percutaneous Coronary Intervention.

    Science.gov (United States)

    Celik, Omer; Ozturk, Derya; Akin, Fatih; Ayca, Burak; Yalcın, Ahmet Arif; Erturk, Mehmet; Bıyık, Ismail; Ayaz, Ahmet; Akturk, Ibrahim Faruk; Enhos, Asım; Aslan, Serkan

    2015-07-01

    We hypothesized that contrast media volume-estimated glomerular filtration rate (CV-e-GFR) ratio may be a predictor of contrast media-induced acute kidney injury (CI-AKI). We investigated the associations between CV-e-GFR ratio and CI-AKI in 597 patients undergoing primary percutaneous coronary intervention (pPCI). An absolute ≥0.3 mg/dL increase in serum creatinine compared with baseline levels within 48 hours after the procedure was considered as CI-AKI; 78 (13.1%) of the 597 patients experienced CI-AKI. The amount of contrast during procedure was higher in the CI-AKI group than in those without CI-AKI (153 vs 135 mL, P = .003). The CV-e-GFR ratio was significantly higher in patients with CI-AKI than without (2.3 vs 1.5, P 2 (P < .001, OR = 5.917). In conclusion, CV-e-GFR ratio is significantly associated with CI-AKI after pPCI. © The Author(s) 2014.

  17. Positive linear dose-response relationships, but no J-shaped relationship, between drinking habits and estimated glomerular filtration rate in middle-aged Japanese men.

    Science.gov (United States)

    Shirai, Yoshiro; Kuriki, Kiyonori; Endoh, Kaori; Miyauchi, Rie; Kasezawa, Nobuhiko; Tohyama, Kazushige; Goda, Toshinao

    2016-03-01

    The relationship between drinking frequency and amount of alcohol consumption (i.e., drinking habits) and the risk of chronic kidney disease (CKD) remains unclear. We aimed to clarify either a linear or J-shaped dose-response relationship between drinking habits and estimated glomerular filtration rate (eGFR) as a biomarker for identifying individuals at high risk of CKD. In a large-scale cross-sectional study, 403 men and 121 women with an eGFR of 30-60 mL/min per 1.73 m(2) were defined as cases, and 1209 men and 363 women with ≥60 mL/min/1.73 m(2) were randomly extracted as controls (one case subject was matched with three control subjects, matched according to age and season of data collection). We calculated multivariate-adjusted CKD risk and the corresponding mean eGFR according to drinking habits. In men, negative and positive linear relationships with drinking habits were found for CKD risk and mean eGFR (p alcohol consumption, respectively). In women, no association was found. Regarding each drinking habit, we found a positive linear dose-response relationship to eGFR in middle-aged men with an eGFR ≥30 mL/min/1.73 m(2). Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Comparison of glomerular filtration rate estimating equations derived from creatinine and cystatin C: validation in the Age, Gene/Environment Susceptibility-Reykjavik elderly cohort.

    Science.gov (United States)

    Björk, Jonas; Grubb, Anders; Gudnason, Vilmundur; Indridason, Olafur S; Levey, Andrew S; Palsson, Runolfur; Nyman, Ulf

    2017-10-05

    Validation studies comparing glomerular filtration rate (GFR) equations based on standardized creatinine and cystatin C assays in the elderly are needed. The Icelandic Age, Gene/Environment Susceptibility-Kidney cohort was used to compare two pairs of recently developed GFR equations, the revised Lund-Malmö creatinine equation (LMRCr) and the arithmetic mean of the LMRCr and Caucasian, Asian, Paediatric and Adult cystatin C equations (MEANLMR+CAPA), as well as the Full Age Spectrum creatinine equation (FASCr) and its combination with cystatin C (FASCr+Cys), with the corresponding pair of Chronic Kidney Disease Epidemiology Collaboration equations (CKD-EPICr and CKD-EPICr+Cys). A total of 805 individuals, 74-93 years of age, underwent measurement of GFR (mGFR) using plasma clearance of iohexol. Four metrics were used to compare the performance of the GFR equations: bias, precision, accuracy [including the percentage of participants with estimated GFR (eGFR) within 30% of mGFR (P30)] and the ability to detect mGFR equations had a P30 >90%. LMRCr and FASCr yielded significantly higher precision and P30 than CKD-EPICr, while bias was significantly worse. LMRCr, FASCr and CKD-EPICr showed similar ability to detect mGFR equations. None of the creatinine-based equations was clearly superior overall in this community-dwelling elderly cohort. The addition of cystatin C improved all of the creatinine-based equations.

  19. Glomerular Filtration Rate and Urine Albumin to Creatinine Ratio Associated With Hearing Impairment Among Korean Adults With Diabetes: A Nationwide Population-Based Study.

    Science.gov (United States)

    Cho, Yunji; Kim, Do Hoon; Choi, June; Lee, Joo Kyung; Roh, Yong-Kyun; Nam, Hyo-Yun; Nam, Ga-Eun; Kim, Dong-Won; Lee, Seung-Hyun; Lee, Chung-Woo; Han, Kyungdo; Park, Yong-Gyu

    2016-04-01

    The objective of this study was to examine the association of estimated glomerular filtration rate (eGFR) and urine albumin to creatinine ratio (ACR) with hearing impairment among diabetic adults in Korea. The study was based on data from Korea National Health and Nutrition Examination Survey 2011 to 2012. Participants were 1206 diabetic adults, aged over 19 years, who completed audiometric testing supervised by nationally certified clinicians. Hearing impairment was defined in three grades: no hearing impairment (pure-tone average 0-25 dB), slight hearing impairment (26-40 dB), and disabling hearing impairment (>40 dB) in the better ear at frequencies 0.5, 1, 2, 3, 4 and 6 kHz. Using logistic regression, risk of hearing impairment was assessed after having controlled for confounding factors. Higher levels of ACR and lower levels of eGFR correlated with an increase in percentage of disabling hearing impairment both unilaterally and bilaterally (P metabolic syndrome.

  20. The Association Between the Metabolic Syndrome and Metabolic Syndrome Score and Urine Microalbumin/Urine Creatinine Ratio and Glomerular Filtration Rate in Korean Adults With Obesity.

    Science.gov (United States)

    Yoon, Hyun; Moon, Ae Eun; Kim, Yu Jeong; Kim, Min Cheol; Jung, Eun Young

    2017-07-01

    This study assessed the association between metabolic syndrome (MetS) and metabolic syndrome score (MSS) and the levels of urine microalbumin-urine creatinine ratio (uACR) and glomerular filtration rate (GFR) in Korean adults with obesity. Analyses of data obtained during the 2012 Korean National Health and Nutrition Examination Survey were restricted to that obtained from 1,612 adults aged ≥20 years with obesity. After adjusting for relevant variables (excluding age), uACR levels were positively associated with MetS (P < .001) and MSS (P < .001), and GFR levels were inversely associated with MetS (P < .001) and MSS (P < .001). However, when further adjusting for age, uACR levels were positively associated with MetS (P < .001) and MSS (P < .001) levels, but GFR levels were not associated with MetS (P = .632) and MSS (P = .275) levels. MetS and MSS were positively associated with uACR levels in Korean adults with obesity, but were not associated with GFR levels. Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  1. Metabolic syndrome components and estimated glomerular filtration rate based on creatinine and/or cystatin C in young adults: A gender issue?

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    Medeiros, Thalia; do Rosário, Natalia Fonseca; Gama, Nycole Abreu; Mérida, Lyris Anunciata Demétrio; Storch, Amanda Sampaio; Ferraz, Leda; de Fátima Lopes, Patricia; da Silva, Andrea Alice; Almeida, Jorge Reis

    2017-11-01

    This work aims to identify correlations between estimated glomerular filtration rate (eGFR) based on creatinine and/or cystatin C (Cr, CysC) with metabolic syndrome (MS) components in young adults, according to gender. This is a cross sectional study, where young adults aged between 18 and 30 were matched by gender, age and body mass index. All subjects underwent clinical evaluation and blood sampling for laboratory measurements. MS was determined according to the JIS criteria. The eGFR was estimated using CKD-EPI equations (eGFR Cr ; eGFR CysC ; eGFR Cr-CysC ). We evaluated 78 subjects with a mean age of 24.5 years. 10.2% had MS, with higher incidence among males (15.4% ♂ vs. 5.1% ♀). Elevated waist circumference was the MS component most observed. Significant correlations (Pearson; pmetabolic markers were observed only in males. In addition, we observed a significant association between the increase of MS components and the decay of eGFR Cr and eGFR Cr-CysC (zero vs. two or more components, ANOVA, p<0.05) only among males. eGFR decay associated with components of MS and insulin resistance in young male adults could represent a worrying specific risk and indicate that further studies are needed to better understand these findings. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  2. A Limited Sampling, Simple, and Useful Method for Determination of Glomerular Filtration Rate in Cats by Using a New Accurate HPLC Method to Measure Iohexol Plasmatic Concentrations

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    Meucci Valentina

    2013-01-01

    Full Text Available Glomerular filtration rate (GFR is still a highly underutilized tool in cats because available methods are not easy to be performed in clinical practice. Iohexol (IOX has been shown to be a useful and reliable marker of GFR both in animals and in humans. The aim of the present study was to develop a rapid and reliable method for measuring IOX in feline plasma and to evaluate the accuracy of limited sampling models to establish a low-cost and clinically suitable GFR test. IOX concentrations were determined by using a new HPLC-UV method. GFR was assessed as plasma clearance of IOX, which was calculated by dividing dose administered by area under the curve of plasmatic concentration versus time (AUC, and indexed to body weight (BW. Correlation and agreement analysis between the GFR values obtained by a seven-point clearance method and the GFR values determined by the application of simplified sample combinations indicated that the 3-blood sample clearance model (5, 30, and 60 min was the best simplified method because it provided an accurate GFR value in only one hour. The reported method is a simple and accurate way of GFR determination, which may be easily used in a clinical setting.

  3. Comparison of serum cystatin C and creatinine levels in determining glomerular filtration rate in children with stage I to III chronic renal disease.

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    Dönmez, Osman; Korkmaz, Hüseyin Anıl; Yıldız, Nalan; Ediz, Bülent

    2015-06-01

    Pediatric studies are relatively scarce on the superiority of cystatin C over creatinine in estimation of glomerular filtration rate (GFR). This study measured cystatin C and serum creatinine levels, and compared GFR estimated from these two parameters in patients with chronic renal disease. This prospective, observational, controlled study included 166 patients aged 1-18 years diagnosed with stage I to III chronic renal disease, and 29 age- and sex-matched control subjects. In all patients, GFR was estimated via creatinine clearance, Schwartz formula, Zappitelli 1 and Zappitelli 2 formula and the results were compared using Bland-Altman analysis. Patients and controls did not differ with regard to height, body weight, BMI, serum creatinine and serum cystatin levels, and Schwartz formula-based GFR (p > 0.05). There was a significant relationship between creatinine and cystatin C levels. However, although creatinine levels showed a significant association with age, height, and BMI, cystatin C levels showed no such association. ROC analysis showed that cystatin C performed better than creatinine in detecting low GFR. Cystatin C is a more sensitive and feasible indicator than creatinine for the diagnosis of stage I to III chronic renal disease.

  4. The role of pneumoperitoneum in the glomerular filtration in an experimental model with 2/3 reduction of the renal mass

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    Marco Aurélio Valadão

    2017-05-01

    Full Text Available Objective: To evaluate the influence of the CO2 pneumoperitoneum in the glomerular filtration in a rat model with a 2/3 reduction of renal parenchyma. Methods: Adult Wistar male rats (n = 50 were subjected to right nephrectomy and a 2/3 ligature of the renal left vascular branch. Animals were randomly distributed as follows: GI (n = 10 - simulated, GII (n = 20 –8 mm Hg pneumoperitoneum, and GIII (n = 20 –15 mm Hg pneumoperitoneum. After two (GIIA and GIIIA and three (GIIB and GIIIB hours of insufflation, and one hour of disinsufflation, they were evaluated for the following aspects: mean blood pressure (MBP, microhematocrit, urinary volume and inulin clearance. Results: The microscopic aspects showed signs of glomerulosclerosis that caused proteinuria. Renal function with8 mm Hg pneumoperitoneum after two hours of disinsufflation (Δ% = 202.68 was better than after three hours (Δ% = 10.89. With15 mm Hg pneumoperitoneum, the renal function was damaged by both procedures, that is, two (Δ% = -3.57 and three hours (Δ% = -3.25. Conclusion: Inulin clearance evidenced renal insufficiency in the model with a 2/3 reduction of renal mass, and depending on both the increase of the exposure time and the pressure intensity, it can be more intensified.

  5. [Prevalence of chronic renal insufficiency in diabetic type 2 diabetes patients based on the estimated glomerular filtration rate and relation with cardiovascular risk].

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    Mur Martí, Teresa; Villaró Gabarrós, Mercè; Porta Martínez, Nuria; Jaén Manzanera, Angels

    2013-05-04

    The aim of this study was: to estimate the prevalence of chronic renal insufficiency (CRI) in diabetic type 2 (DM2) patients treated in Primary Care based on the estimated glomerular filtration rate (GFe); to determine associated factors with CRI, and to evaluate the relationship of GF rate and risk of cardiovascular disease. This was a descriptive cross-sectional study. We included 500 medical histories randomly selected in a total of 2,950 DM2 patients. We registered sociodemographic data, comorbidities, cardiovascular risk factors and laboratory data. CRI definition was based on GFe rate and classified according to the K/DOQI Clinical Practice Guidelines for Chronic Kidney Disease. The prevalence of CRI was 23.2%. There were 51.6% females and the mean age was 66.2 years; 70,4% had hypertension and 67% dyslipidemia. The presence of CRI was related with older age, females, smoking habit, plasma creatinine value, microalbuminuria, and history of hypertension, dyslipidemia and cardiovascular disease. After analysing the data according to the category of GF rate, only the significant relationship with smoking habit disappeared. Multivariate statistic analysis supports a relation with older age, female gender, dyslipidemia and heart disease. We confirm a high prevalence of CRI in DM2 patients and their relationship with the presence of cardiovascular disease. Copyright © 2011 Elsevier España, S.L. All rights reserved.

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

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    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.

  7. Tamm-Horsfall Protein Regulates Circulating and Renal Cytokines by Affecting Glomerular Filtration Rate and Acting as a Urinary Cytokine Trap*

    Science.gov (United States)

    Liu, Yan; El-Achkar, Tarek M.; Wu, Xue-Ru

    2012-01-01

    Although few organ systems play a more important role than the kidneys in cytokine catabolism, the mechanism(s) regulating this pivotal physiological function and how its deficiency affects systemic cytokine homeostasis remain unclear. Here we show that elimination of Tamm-Horsfall protein (THP) expression from mouse kidneys caused a marked elevation of circulating IFN-γ, IL1α, TNF-α, IL6, CXCL1, and IL13. Accompanying this were enlarged spleens with prominent white-pulp macrophage infiltration. Lipopolysaccharide (LPS) exacerbated the increase of serum cytokines without a corresponding increase in their urinary excretion in THP knock-out (KO) mice. This, along with the rise of serum cystatin C and the reduced inulin and creatinine clearance from the circulation, suggested that diminished glomerular filtration may contribute to reduced cytokine clearance in THP KO mice both at the baseline and under stress. Unlike wild-type mice where renal and urinary cytokines formed specific in vivo complexes with THP, this “trapping” effect was absent in THP KO mice, thus explaining why cytokine signaling pathways were activated in renal epithelial cells in such mice. Our study provides new evidence implicating an important role of THP in influencing cytokine clearance and acting as a decoy receptor for urinary cytokines. Based on these and other data, we present a unifying model that underscores the role of THP as a major regulator of renal and systemic immunity. PMID:22451664

  8. Clinical benefits of using inulin clearance and cystatin C for determining glomerular filtration rate in HIV-1-infected individuals treated with dolutegravir.

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    Yukawa, Satomi; Watanabe, Dai; Uehira, Tomoko; Shirasaka, Takuma

    2018-03-01

    Dolutegravir may inhibit creatinine transporters in renal tubules and elevate serum creatinine levels. We investigated the usefulness of glomerular filtration rate (GFR) measured using inulin clearance (Cin), creatinine clearance (Ccr), and estimated GFR based on both serum creatinine (eGFRcre) and serum cystatin C (eGFRcys). HIV-1-infected Japanese patients with suppressed viremia and whose antiretroviral drug was switched to dolutegravir from other drugs were included (n = 108, Study 1). We compared eGFRcre and eGFRcys at the start and after 48 weeks of dolutegravir administration. For the patients providing consent, we measured Cin and Ccr (n = 15, Study 2). We assessed biases and accuracy and compared Cin with eGFRcre, eGFRcys, and Ccr. There were no differences in serum cystatin C and eGFRcys between baseline and at 48 weeks. Moreover, eGFRcre was significantly less accurate (within 30% of measured GFR) than both eGFRcys and Ccr (40% accuracy compared to 93% and 93%, respectively). eGFRcys was significantly less biased than eGFRcre and Ccr (p inulin clearance and eGFRcys. This is the first study performing inulin clearance for HIV-1-infected individuals and to show data for eGFRcys from a large cohort following a switch to dolutegravir from other antiretroviral agents. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Comparative Performance of Creatinine-Based Estimated Glomerular Filtration Rate Equations in the Malays: A Pilot Study in Tertiary Hospital in Malaysia

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    Maisarah Jalalonmuhali

    2017-01-01

    Full Text Available Aim. To validate the accuracy of estimated glomerular filtration rate (eGFR equations in Malay population attending our hospital in comparison with radiolabeled measured GFR. Methods. A cross-sectional study recruiting volunteered patients in the outpatient setting. Chromium EDTA (51Cr-EDTA was used as measured GFR. The predictive capabilities of Cockcroft-Gault equation corrected for body surface area (CGBSA, four-variable Modification of Diet in Renal Disease (4-MDRD, and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI equations were calculated. Results. A total of 51 subjects were recruited with mean measured GFR 42.04 (17.70–111.10 ml/min/1.73 m2. Estimated GFR based on CGBSA, 4-MDRD, and CKD-EPI were 40.47 (16.52–115.52, 35.90 (14.00–98.00, and 37.24 (14.00–121.00, respectively. Higher accuracy was noted in 4-MDRD equations throughout all GFR groups except for subgroup of GFR ≥ 60 ml/min/1.73 m2 where CGBSA was better. Conclusions. The 4-MDRD equation seems to perform better in estimating GFR in Malay CKD patients generally and specifically in the subgroup of GFR < 60 ml/min/1.73 m2 and both BMI subgroups.

  10. Janus kinase 2/signal transducer and activator of transcription 3 inhibitors attenuate the effect of cardiotrophin-like cytokine factor 1 and human focal segmental glomerulosclerosis serum on glomerular filtration barrier.

    Science.gov (United States)

    Sharma, Mukut; Zhou, Jianping; Gauchat, Jean-François; Sharma, Ram; McCarthy, Ellen T; Srivastava, Tarak; Savin, Virginia J

    2015-10-01

    Recurrence of idiopathic focal segmental glomerulosclerosis (FSGS) after renal transplantation is believed to be caused by a circulating factor(s). We detected cardiotrophin-like cytokine factor 1 (CLCF1), a member of the interleukin 6 family, in the plasma from patients with recurrent FSGS. We hypothesized that CLCF1 contributes to the effect of FSGS serum on the glomerular filtration barrier in vitro. Presently, we studied the effect of CLCF1 on isolated rat glomeruli using an in vitro assay of albumin permeability (P(alb)). CLCF1 (0.05-100 ng/mL) increased P(alb) and caused maximal effect at 5-10 ng/mL (P glomerular filtration barrier. We speculate that albuminuria in FSGS is related to qualitative or quantitative changes in the CLCF1-CRLF1 complex, and that JAK2 or STAT3 inhibitors may be novel therapeutic agents to treat FSGS. Published by Elsevier Inc.

  11. Is the Chronic Kidney Disease Epidemiology Collaboration creatinine–cystatin C equation useful for glomerular filtration rate estimation in the elderly?

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    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

  12. Extracellular fluid volume and glomerular filtration rate in 1878 healthy potential renal transplant donors: effects of age, gender, obesity and scaling.

    Science.gov (United States)

    Peters, A Michael; Perry, Laura; Hooker, Claire A; Howard, Bethany; Neilly, Mark D J; Seshadri, Nagabhushan; Sobnack, Ravin; Irwin, Andrew; Snelling, Hayley; Gruning, Thomas; Patel, Neva H; Lawson, Richard S; Shabo, Gregory; Williams, Nigel; Dave, Surendra; Barnfield, Mark C

    2012-04-01

    Aim. The aim of this study was to investigate the influence of age, gender, obesity and scaling on glomerular filtration rate (GFR) and extracellular fluid volume (ECV) in healthy subjects. This is a retrospective multi-centre study of 1878 healthy prospective kidney transplant donors (819 men) from 15 centres. Age and body mass index (BMI) were not significantly different between men and women. Slope-intercept GFR was measured (using Cr-51-EDTA in 14 centres; Tc-99m-DTPA in one) and scaled to body surface area (BSA) and lean body mass (LBM), both estimated from height and weight. GFR was also expressed as the slope rate constant, with one-compartment correction (GFR/ECV). ECV was measured as the ratio, GFR to GFR/ECV. ECV was age independent but GFR declined with age, at a significantly faster rate in women than men. GFR/BSA was higher in men but GFR/ECV and GFR/LBM were higher in women. Young women (65 years). There was no difference in GFR between obese (BMI>30 kg/m2) and non-obese men. Obese women, however, had lower GFR than non-obese women and negative correlations were observed between GFR and both BMI and %fat. The decline in GFR with age was no faster in obese versus non-obese subjects. ECV/BSA was higher in men but ECV/LBM was higher in women. ECV/weight was almost gender independent, suggesting that fat-free mass in women contains more extracellular water. BSA is therefore a misleading scaling variable. There are several significant differences in GFR and ECV between healthy men and women.

  13. Impact of interferon-free regimens on the glomerular filtration rate during treatment of chronic hepatitis C in a real-life cohort.

    Science.gov (United States)

    Álvarez-Ossorio, M J; Sarmento E Castro, R; Granados, R; Macías, J; Morano-Amado, L E; Ríos, M J; Merino, D; Álvarez, E N; Collado, A; Pérez-Pérez, M; Téllez, F; Martín, J M; Méndez, J; Pineda, J A; Neukam, K

    2018-01-28

    Little data are available on renal toxicity exerted by direct-acting antivirals (DAAs) in real life. The aim of this study was to assess the impact of direct-acting antivirals against hepatitis C virus infection currently used in Spain and Portugal on the estimated glomerular filtration rate (eGFR) in clinical practise. From an international, prospective multicohort study, patients treated with DAAs for at least 12 weeks and with eGFR ≥30 mL/min per 1.73 m 2 at baseline were selected. eGFR was determined using the CKD-EPI formula. A total of 1131 patients were included; 658 (58%) were HIV/HCV-coinfected patients. Among the 901 patients treated for 12 weeks, median (interquartile range) eGFR was 100 (87-107) at baseline vs 97 (85-105) mL/min per 1.73 m 2 at week 12 of follow-up (FU12) post-treatment (P 60 mL/min per 1.73 m 2 at baseline, 22 (2%) had eGFR <60 mL/min per 1.73 m 2 at FU12, but none presented with eGFR <30 mL/min per 1.73 m 2 . In conclusion, eGFR slightly declines during therapy with all-oral DAAs and this effect persists up to 12 weeks after stopping treatment in subjects with normal to moderately impaired renal function, regardless of HIV status. Concomitant use of tenofovir plus PI/r does not seem to have an impact on eGFR. © 2018 John Wiley & Sons Ltd.

  14. 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. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. The Association between Glomerular Filtration Rate Estimated Using Different Equations and Mortality in the Japanese Community-Based Population: The Yamagata (Takahata Study

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    Asami Kabasawa

    2018-01-01

    Full Text Available Background. To evaluate renal function, the indices of estimated glomerular filtration rate (eGFR obtained using several equations, including the Japanese versions of the serum creatinine-based MDRD equation (eGFRcreat, Chronic Kidney Disease Epidemiology Collaboration equation (eGFR-EPI, and serum cystatin C-based equation (eGFRcys, are utilized. This study prospectively examined the association between these eGFR values and all-cause mortality during a 12-year observational period in a community-based population. Methods and Results. The subjects of this study were 1312 participants undergoing a health checkup, aged ≥40 years. In the total population, the mean eGFR values (mL·min−1·1.73 m−2 were 81.5 for eGFRcreat, 78.1 for eGFR-EPI, and 76.6 for eGFRcys. There were 141 deaths during the observation period, and the area under the receiver operating characteristic curve for predicting mortality was 0.59 for eGFRcreat, 0.67 for eGFR-EPI, and 0.70 for eGFRcys (all P<0.01. In the Cox proportional analysis adjusted for age and sex, eGFRcys, but not eGFRcreat and eGFR-EPI, showed a significant association with all-cause mortality (per 15 mL·min−1·1.73 m−2 decrease: hazard ratio 1.40, 95% confidence interval 1.18–1.67. Conclusions. This study revealed that eGFRcys showed lower values than eGFRcreat and eGFR-EPI and was significantly associated with all-cause mortality in the Japanese community-based population.

  16. Effects of changes in analytic variables and contrast medium on estimation of glomerular filtration rates by computed tomography in healthy dogs.

    Science.gov (United States)

    Matsuda, Yuri; Kishimoto, Miori; Kushida, Kazuya; Yamada, Kazutaka; Shimizu, Miki; Itoh, Hiroshi

    2017-09-01

    OBJECTIVE To investigate effects of changes in analytic variables and contrast medium osmolality on glomerular filtration rate estimated by CT (CT-GFR) in dogs. ANIMALS 4 healthy anesthetized Beagles. PROCEDURES GFR was estimated by inulin clearance, and dogs underwent CT-GFR with iodinated contrast medium (iohexol or iodixanol) in a crossover-design study. Dynamic renal CT scanning was performed. Patlak plot analysis was used to calculate GFR with the renal cortex or whole kidney selected as the region of interest. The renal cortex was analyzed just prior to time of the second cortical attenuation peak. The whole kidney was analyzed 60, 80, 100, and 120 seconds after the appearance of contrast medium. Automated GFR calculations were performed with preinstalled perfusion software including 2 noise reduction levels (medium and strong). The CT-GFRs were compared with GFR estimated by inulin clearance. RESULTS There was no significant difference in CT-GFR with iohexol versus iodixanol in any analyses. The CT-GFR at the renal cortex, CT-GFR for the whole kidney 60 seconds after appearance of contrast medium, and CT-GFR calculated by perfusion software with medium noise reduction did not differ significantly from GFR estimated by inulin clearance. The CT-GFR was underestimated at ≥ 80 seconds after contrast medium appearance (whole kidney) and when strong noise reduction was used with perfusion CT software. CONCLUSIONS AND CLINICAL RELEVANCE Selection of the renal cortex as region of interest or use of the 60-second time point for whole-kidney evaluation yielded the best CT-GFR results. The perfusion software used produced good results with appropriate noise reduction. IMPACT FOR HUMAN MEDICINE The finding that excessive noise reduction caused underestimation of CT-GFR suggests that this factor should also be considered in CT-GFR examination of human patients.

  17. Glomerular filtration rate equations overestimate creatinine clearance in older individuals enrolled in the Baltimore Longitudinal Study on Aging: impact on renal drug dosing.

    Science.gov (United States)

    Dowling, Thomas C; Wang, En-Shih; Ferrucci, Luigi; Sorkin, John D

    2013-09-01

    To evaluate the performance of kidney function estimation equations and to determine the frequency of drug dose discordance in an older population. Cross-sectional analysis of data from community-dwelling volunteers randomly selected from the Baltimore Longitudinal Study of Aging from January 1, 2005, to December 31, 2010. A total of 269 men and women with a mean ± SD age of 81 ± 6 years, mean serum creatinine concentration (Scr ) of 1.1 ± 0.4 mg/dl, and mean 24-hour measured creatinine clearance (mClcr ) of 53 ± 13 ml/minute. Kidney function was estimated by using the following equations: Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The performance of each equation was assessed by measuring bias and precision relative to mClcr . Dose calculation errors (discordance) were determined for 10 drugs requiring renal dosage adjustments to avoid toxicity when compared with the dosages approved by the Food and Drug Administration. The CG equation was the least biased estimate of mClcr . The MDRD and CKD-EPI equations were significantly positively biased compared with CG (mean ± SD 34 ± 20% and 22 ± 15%, respectively, prenal impairment. Thus equations estimating glomerular filtration rate should not be substituted in place of the CG equation in older adults for the purpose of renal dosage adjustments. In addition, the common practice of rounding or replacing low Scr values with an arbitrary value of 1.0 mg/dl for use in the CG equation should be avoided. Additional studies that evaluate alternative eGFR equations in the older populations that incorporate pharmacokinetic and pharmacodynamic outcomes measures are needed. © 2013 Pharmacotherapy Publications, Inc.

  18. Prevalence of diabetic retinopathy and its relationship with glomerular filtration rate and other risk factors in patients with type 2 diabetes mellitus in Spain. DM2 HOPE study.

    Science.gov (United States)

    López, Maribel; Cos, Francesc Xavier; Álvarez-Guisasola, Fernando; Fuster, Eva

    2017-09-01

    Diabetic retinopathy (DR) is the leading cause of blindness in working age population in developed countries. Albuminuria and estimated glomerular filtration rate (eGFR) have been considered biomarkers for DR. This study aimed to investigate the prevalence of DR and its relationship with eGFR and other risk factors in type 2 diabetic patients (T2DM) in Spain. A cross-sectional and descriptive study has been performed in 14,266 patients. Clinical records were reviewed. Demographic data, clinical diagnoses, clinical variables, and results from laboratory tests were recorded. Prevalence rates of DR were calculated. Logistic regression analysis was applied to assess predictors of the DR presence/absence. DR prevalence was 14.9%, being more prevalent in women (p = 0.0087) and in older patients (p < 0.0001). Duration of disease (OR = 5.3, IC95% = 3.8-7.4; p < 0.0001), eGFR < 60 ml/min/1.73 m 2 (OR = 2.0, IC95% 1.6-2.4; p < 0.0001), levels of HbA1c ≥ 7% (OR = 1.9, IC95% = 1.5-2.3; p < 0.0001) and high blood pressure (OR = 1.6, IC95% = 1.2-2.1; p = 0.0032) were associated with higher risk of DR. DR was also more frequent in patients taking insulin (32,6% vs. 10,2%; p < 0.0001). Around one in seven patients with T2DM has DR after nine years since diagnosis. Time since diagnosis, insulin therapy, cardiovascular profile, and renal dysfunction are associated with DR in patients with T2DM in Spain.

  19. CKD-EPI creatinine-cystatin C glomerular filtration rate estimation equation seems more suitable for Chinese patients with chronic kidney disease than other equations.

    Science.gov (United States)

    Chi, Xiao-Hua; Li, Gui-Ping; Wang, Quan-Shi; Qi, Yong-Shuai; Huang, Kai; Zhang, Qian; Xue, Yao-Ming

    2017-07-10

    The aim of this study was to identify the optimal equation that accurately estimates the glomerular filtration rate (GFR) and the chronic kidney disease (CKD) stage in the Chinese population. A total of 1296 Chinese patients aged 18-65 years old were enrolled in this study. The estimated GFRs (eGFRs) calculated separately by three Diet in Renal Disease (MDRD) equations and three Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were compared with the reference GFR (rGFR) measured by the 99 Tc m -DTPA renal dynamic imaging method. By Bland-Altman analysis, eGFR cys and eGFR scr_cys performed similarly, showing the tightest limits of agreement among the six equations. They also achieved the first and second highest 30% and 50% accuracies. Using a combination of the serum creatinine and cystatin C levels (eGFR scr_cys ) could improve the bias (-0.3 for eGFR scr_cys ) of the equation and achieve the highest diagnostic accuracy for renal insufficiency (AUC 60 , 0.953; P equations predicted stage 3 CKD with moderate accuracy (49.7-51.4%) and stage 5 CKD with good accuracy (90.2-96.4%). For stage 1 CKD, eGFR cys showed a higher percentage of misclassification than the other equations. All equations seemed to perform poorly at predicting stage 2 and 4 CKD, as compared to the other CKD stages. eGFR scr_cys was the best-performing equation in terms of accurate classification of the CKD stage based on the overall performance (kappa value, 0.423). For a Chinese population, the CKD-EPI scr_cys equation seems more suitable for estimating the GFR than the other equations. Each equation had its own advantages in predicting different CKD stages.

  20. Prospective Comparison of Equations Based on Creatinine and Cystatin C for the Glomerular Filtration Rate Estimation in Chinese Renal Transplant Recipients.

    Science.gov (United States)

    Tang, Z; Tao, J; Sun, L; Han, Z; Chen, H; Huang, Z; Zhou, W; Zhao, C; Fei, S; Que, H; Li, Y; Tan, R; Gu, M

    Currently, there is no dedicated equation to estimate glomerular filtration rate (GFR) for transplanted kidneys. This study aimed to compare the performance of serum creatinine (Scr)- and cystatin C (CysC)-based equations in Chinese renal transplant recipients. A total of 252 stable renal transplant recipients were enrolled in this study. The plasma clearance of 99m Tc-DTPA (rGFR) was used as a reference standard. The Scr, CysC, and rGFR of the patients were measured on the same day. The bias, precision, accuracy (percentage of estimates within 10%, 30%, and 50% of rGFR), and agreements of 8 Scr and 5 CysC eGFR equations were assessed. The factors affecting the accuracy were also evaluated. Among the Scr-based equations, the Japanese Society of Nephrology-Chronic Kidney Disease Initiatives (JSN-CKDI) equation had the best overall performance with a bias of -6.2 mL/min/1.73 m 2 , and 96.1% of its estimates were within 30% of the rGFR. For the CysC-based equations, the Filler equation had the best performance with a bias of -3.9 mL/min/1.73 m 2 , and 93.7% of its estimates were within 30% of the rGFR. Overall, the CysC-based equations showed better performance than the Scr-based equations. In addition, significant differences were observed between bias and gender and between bias and rGFR value in some equations, whereas transplantation time and immunosuppressive regimens were not correlated with the bias. The JSN-CKDI equation provides the best estimation of the GFR equations, and the CysC-based equations performed better than the Scr-based equations in this population. Copyright © 2017. Published by Elsevier Inc.

  1. Correlation of glomerular filtration rate measurement using Tc-99m DTPA with cystatin-C levels and creatinine clearance for staging of chronic kidney disease

    International Nuclear Information System (INIS)

    Elliyanti, A.; Iskandar, Azmi S.

    2007-01-01

    Full text: The presence of Chronic Kidney Disease (CKD) was established based on kidney damage presence and the level of kidney function through Glomerular filtration rate (GFR). It was also recognized that renal scintigraphy (renogram) using TC-99m DTPA (diethylenetriamine pentacetic acid) has advantages in the measurement of GFR. Recently, serum Cystatin-C is proposed as the new marker of GFR. The aim of this study is to find out the correlation of GFR, derived from renogram, with Cystatin- C levels and Creatinine Clearance (CC) in CKD. Material and Methods: A total of 30 subjects (age mean is 60.8 years, 21 males and 9 females) were enrolled in this study with diagnosis stage 2 of CKD. CKD staging was determined by Cockroft-Gault (CG) equation, taking into account the serum creatinine. Renogram was performed using a single head camera with IV administration of 5 mCi DTPA. Cystatin-C and creatinine clearance (24-hours urine samples) were include in this study. Results: The mean GFR of renogram, Cystatin-C, CC and CG are 64.96 ml/min/1.73m2 (SD 28.047), 53.37 ml/min/1.73m2 (SD 21.29), 58.09 ml/min/1.73m2 (SD 35.45), 46.00 ml/min/1.73m2 (SD 12.06) respectively. There is better correlation between renogram and Cystatin-C (r=0.585, p0.0007) compared renogram and CC (r=0.388, p=0.03) or renogram and CG (r=-0.029, p=0.87). Conclusion: Cystatin-C shows better indicator of GFR than CC and CG. Serum creatinine concentration alone should not be used to assess the level of kidney function in the staging of CKD. (author)

  2. The modified CKD-EPI equation may be not more accurate than CKD-EPI equation in determining glomerular filtration rate in Chinese patients with chronic kidney disease.

    Science.gov (United States)

    Xie, Peng; Huang, Jian-Min; Li, Ying; Liu, Huai-Jun; Qu, Yan

    2017-06-01

    To investigate the application of the new modified Chronic Kidney Disease Epidemiology Collaboration (mCKD-EPI) equation developed by Liu for the measurement of glomerular filtration rate (GFR) in Chinese patients with chronic kidney disease (CKD) and to evaluate whether this modified form is more accurate than the original one in clinical practice. GFR was determined simultaneously by 3 methods: (a) 99m Tc-diethylene triamine pentaacetic acid ( 99m Tc-DTPA) dual plasma sample clearance method (mGFR), which was used as the reference standard; (b) CKD-EPI equation (eGFRckdepi); (c) modified CKD-EPI equation (eGFRmodified). Concordance correlation and Passing-Bablok regression were used to compare the validity of eGFRckdepi and eGFRmodified. Bias, precision and accuracy were compared to identify which equation showed the better performance in determining GFR. A total of 170 patients were enrolled. Both eGFRckdepi and eGFRmodified correlated well with mGFR (concordance correlation coefficient 0.90 and 0.74, respectively) and the Passing-Bablok regression equation of eGFRckdepi and eGFRmodified against mGFR was mGFR = 0.37 + 1.04 eGFRckdepi and -49.25 + 1.74 eGFRmodified, respectively. In terms of bias, precision and 30 % accuracy, eGFRmodified showed a worse performance compared to eGFRckdepi, in the whole cohort. The new modified CKD-EPI equation cannot replace the original CKD-EPI equation in determining GFR in Chinese patients with CKD.

  3. Prevalence of Reduced Kidney Function by Estimated Glomerular Filtration Rate Using an Equation Based on Creatinine and Cystatin C in Metabolic Syndrome and Its Components in Korean Adults.

    Science.gov (United States)

    Kang, Yang Ho; Jeong, Dong Wook; Son, Seok Man

    2016-09-01

    It is known that metabolic syndrome (MetS) is associated with chronic kidney disease. We evaluated and compared the prevalence of reduced kidney function in MetS and its components by estimated glomerular filtration rate (eGFR) using an equation based on creatinine (eGFRcr), cystatin C (eGFRcys), and combined creatinine-cystatin C (eGFRcr-cys) in Korean adults. We analyzed data from 3,649 adults who participated in a comprehensive health examination. Mean values of eGFRcys were higher compared with mean values of eGFRcr (96.1±18.2 mL/min/1.73 m² vs. 91.2±13.6 mL/min/1.73 m²) in total subjects. The prevalence of reduced kidney function increased with age (9.6% for eGFRcys vs. 5.8% for eGFRcr-cys vs. 4.9% for eGFRcr, in subjects aged ≥60 years), and significantly increased with MetS, abdominal obesity, hypertension, high triglyceride, low high density lipoprotein (HDL), and high insulin resistance. The prevalence of MetS, abdominal obesity, hypertension, high insulin resistance, low HDL, and hepatic steatosis was significantly increased in subjects with reduced kidney function. This increased prevalence and the odds ratio of reduced kidney function for prevalence of MetS was highest for eGFRcys, followed by those of eGFRcr-cys, and eGFRcr. The prevalence of reduced kidney function by eGFR was significantly increased in subjects with MetS and its related components. eGFRcys and eGFRcr-cys were superior to eGFRcr in detecting reduced kidney function.

  4. Association of Metabolic Syndrome with Chronic Kidney Disease in Elderly Japanese Women: Comparison by Estimation of Glomerular Filtration Rate from Creatinine, Cystatin C, and Both.

    Science.gov (United States)

    Kurata, Miki; Tsuboi, Ayaka; Takeuchi, Mika; Fukuo, Keisuke; Kazumi, Tsutomu

    2016-02-01

    Associations between metabolic syndrome (MetS) and chronic kidney disease (CKD) has not been extensively studied in elderly Asians, who in general have lower body mass index (BMI) than European populations. A cross-sectional analysis was conducted including 159 community-living elderly Japanese women. MetS was defined by the modified National Cholesterol Education Program Adult Treatment Panel III criteria, but using a BMI ≥25 kg/m(2) instead of waist circumference and renal function was assessed according to the Kidney Disease Outcomes Quality Initiative CKD classification. Creatinine-based and cystatin C-based estimated glomerular filtration rate (eGFR) and the average of the two eGFRS were used. Prevalence of CKD was much higher when creatinine-based eGFR was used than the prevalence obtained when cystatin-C based equations were used (46.5% vs. 12.6%, P creatinine-based (P = 0.86) and cystatin C-based (P = 0.12) eGFR alone. Lower average eGFR and higher prevalence of CKD using average eGFR were evident in even women with only one MetS component, 89% of whom had elevated blood pressure. Prevalence of CKD varied substantially depending on the used equation. In nonobese, elderly Japanese women, both the presence of MetS and the number of MetS components were associated with higher prevalence of CKD and elevated blood pressure may play an important role in these associations. These findings should be confirmed in studies employing more participants with MetS diagnosed using standard criteria (waist circumference instead of BMI).

  5. Prevalence of Reduced Kidney Function by Estimated Glomerular Filtration Rate Using an Equation Based on Creatinine and Cystatin C in Metabolic Syndrome and Its Components in Korean Adults

    Directory of Open Access Journals (Sweden)

    Yang Ho Kang

    2016-09-01

    Full Text Available BackgroundIt is known that metabolic syndrome (MetS is associated with chronic kidney disease. We evaluated and compared the prevalence of reduced kidney function in MetS and its components by estimated glomerular filtration rate (eGFR using an equation based on creatinine (eGFRcr, cystatin C (eGFRcys, and combined creatinine-cystatin C (eGFRcr-cys in Korean adults.MethodsWe analyzed data from 3,649 adults who participated in a comprehensive health examination.ResultsMean values of eGFRcys were higher compared with mean values of eGFRcr (96.1±18.2 mL/min/1.73 m2 vs. 91.2±13.6 mL/min/1.73 m2 in total subjects. The prevalence of reduced kidney function increased with age (9.6% for eGFRcys vs. 5.8% for eGFRcr-cys vs. 4.9% for eGFRcr, in subjects aged ≥60 years, and significantly increased with MetS, abdominal obesity, hypertension, high triglyceride, low high density lipoprotein (HDL, and high insulin resistance. The prevalence of MetS, abdominal obesity, hypertension, high insulin resistance, low HDL, and hepatic steatosis was significantly increased in subjects with reduced kidney function. This increased prevalence and the odds ratio of reduced kidney function for prevalence of MetS was highest for eGFRcys, followed by those of eGFRcr-cys, and eGFRcr.ConclusionThe prevalence of reduced kidney function by eGFR was significantly increased in subjects with MetS and its related components. eGFRcys and eGFRcr-cys were superior to eGFRcr in detecting reduced kidney function.

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

    International Nuclear Information System (INIS)

    Weaver, Virginia M.; Vargas, Gonzalo García; Silbergeld, Ellen K.; Rothenberg, Stephen J.; Fadrowski, Jeffrey J.; Rubio-Andrade, Marisela; Parsons, Patrick J.; Steuerwald, Amy J.

    2014-01-01

    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 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

  7. 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. Copyright © 2016 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  8. Estimated glomerular filtration rate better predicts 30-day mortality after non-cardiac surgery than serum creatinine: a retrospective analysis of 92,888 patients.

    Science.gov (United States)

    Cywinski, Jacek B; Mascha, Edward J; Kurz, Andrea; Sessler, Daniel I

    2015-07-01

    Serum creatinine is the most commonly used indicator of renal function, but its derivative, estimated glomerular filtration rate (eGFR), has been shown to be superior in non-surgical settings. It remains unknown if eGFR better predicts postoperative mortality in non-cardiac surgical patients. We thus tested the hypothesis that eGFR predicts 30-day mortality after non-cardiac surgery better than serum creatinine. We evaluated patients who had inpatient non-cardiac surgery of at least one hour duration during January 2006 to December 2011 at the Cleveland Clinic Main Campus and whose preoperative serum creatinine was measured within 30 days before surgery. The eGFR was calculated using the Chronic Kidney Disease-Epidemiology Collaboration equation. Preoperative eGFR was compared in a multivariable analysis with preoperative serum creatinine (both assessed as continuous variables) on the ability to predict 30-day mortality in all patients. Secondarily, the comparison was made within subgroups based on amount of blood loss, blood transfusion, and sex. There were 92,888 patients included in the final analysis. The eGFR was a modestly better discriminator of 30-day mortality than serum creatinine, with an estimated c-statistic (95% confidence interval) of 0.67 (0.65 to 0.68) for eGFR vs 0.61 (0.59 to 0.63) for serum creatinine (P serum creatinine. Nevertheless, a multivariable combination of baseline characteristics of American Society of Anesthesiologists physical status, age, and body mass index (all P serum creatinine did not change the c-statistic. The eGFR is a modestly better predictor of 30-day mortality than serum creatinine in patients having inpatient non-cardiac surgery. Given that eGFR is often reported by clinical laboratories and is otherwise easy to calculate, it should generally be used in preference to creatinine alone.

  9. Correlation between glomerular filtration rate with gamma camera and estimated serum creatinine clearance from Cockcroft and Gault's formula

    International Nuclear Information System (INIS)

    Bhushan, Shivanand; Kumar, Rajesh

    2012-01-01

    The purpose of the present study is to find out the correlation between the glomerular filtration rate (GFR by Gates gamma camera method) and serum creatinine clearance (SCrCl by Cockcroft and Gault's method) within ± 3 weeks’ time difference. Study design retrospectively in 59 patients with serum creatinine value calculated for SCrCl with Cockcroft and Gault's formula as an index parameter for kidney function underwent the 99m-Technitium labeled Di-ethyl Triamine Penta Acetic Acid (99mTc-DTPA) renogram with ECIL planar gamma camera. All data of 59 patients has been divided into Group- I, II, and III based on the time difference of serum creatinine test from 99mTc-DTPA renal GFR tests performed on the same subjects. Serum Creatinine test was carried out within ± 3 days, between ± 4 days and ± 7 days, and between ± 8 days and ± 21 days from the DTPA GFR Test performed in the Group-I, II, and III respectively. Correlation coefficient of Group-I (n = 15) patients showed 0.8198 and P value < 0.001 for GFR and S. Creatinine within ± 3 days. Group-II (n = 17) and Group-III (n = 27) patients having correlation coefficient 0.6194 and 0.589 and P value <0.01 respectively, within ± 21 days. The two methods gave almost identical estimate of GFR even at 3 weeks interval. Study concludes that SCrCl using Cockcroft and Gault's formula could serve as an instant, easy, and reliable method for assessing kidney function. SCrCl with Cockcroft and Gault's formula is more useful for rapid estimation of global GFR for those patients who are not accessible to DTPA renogram with gamma camera. Correlation can be established further with the prospective study in various renal pathophysiological conditions

  10. 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.

  11. 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.

  12. Correlation of Cystatin-C and radionuclidic measurement method of glomerular filtration rate in patients with lung cancer receiving cisplatin treatment.

    Science.gov (United States)

    Oc, Murat Alper; Demir, Hakan; Cekmen, Mustafa Baki; Isgoren, Serkan; Gorur, Gozde Daglioz; Bilgili, Umit

    2014-08-01

    Cisplatin is a chemotherapeutic agent which affects renal functions adversely. The best indicator of renal functions is glomerular filtration rate (GFR) measurement. Cystatin-C appears to be a good alternative to existing methods of measuring GFR. However, it is controversial whether Cystatin-C demonstrates GFR correctly for patients receiving chemotherapy. This study aimed to investigate the correlation between GFR values calculated by Cystatin-C based formulas, radionuclidic method (multiple blood sampling) and blood Cystatin-C values in patients with lung cancer, receiving cisplatin treatment in both pre-treatment and post-treatment periods. Thirty-six patients with lung cancer who were going to receive cisplatin treatment were included in this study. However, the evaluation was performed with 20 patients since 16 of them could not complete the treatment. Blood Cystatin-C values, GFR values calculated via Cystatin-C based formulas, and radionuclidic method were investigated before and after the cisplatin treatment. After treatment significant decreases were detected in GFR values, obtained via radionuclidic measuring method. However, there was no significant difference in Cystatin-C values between pre-treatment and post-treatment periods. Also GFR values obtained by Cystatin-C based formulas were not significantly different in pre-treatment and post-treatment periods. There were meaningful correlations between radionuclidic method and Cystatin-C values and Cystatin-C based formulas before treatment. However, all correlations disappeared after the treatment. GFR values, calculated by Cystatin-C may not be reliable in following renal functions in patients receiving chemotherapy. When reliable monitoring of the renal functions is necessary radionuclidic method may be preferred in these patients.

  13. Cystatin C Based Equation Accurately Estimates Glomerular Filtration Rate in Children With Solid and Central Nervous System Tumours: Enough Evidence to Change Practice?

    Science.gov (United States)

    Dodgshun, Andrew J; Quinlan, Catherine; Sullivan, Michael J

    2016-09-01

    Assessing the glomerular filtration rate (GFR) of paediatric patients receiving nephrotoxic chemotherapy is a vital element of clinical practice. Isotopically measured GFR is the gold standard in terms of accuracy but requires injection of tracer followed by several hours of blood tests. Estimation of GFR using creatinine is widely used but inaccurate, and there is increasing concern regarding its usage for paediatric oncology patients. Cystatin C (CysC) based equations are increasingly used in other paediatric specialities to estimate GFR, and their usefulness in paediatric oncology practice is becoming evident. We assessed the renal function of children with solid tumours and CNS tumours receiving nephrotoxic chemotherapy over a 1-year period using paired CysC and isotopic GFR. Fifty-six sets of measurements were reviewed with estimated GFR predicted using CysC-based and creatinine-based equations. The best performing equation was the 'new CKiD' equation, which estimated GFR within 30% of the measured GFR on 86% of occasions, outperforming the Schwartz equation. If estimated GFR using this equation was >100 ml/min/1.73 m(2) , all values of measured GFR were normal at >90 ml/min/1.73 m(2) , a category containing two-thirds of all measurements. The new CKiD equation predicts GFR in paediatric oncology patients with more accuracy than creatinine-based equations. When the estimated GFR is >100 ml/min/1.73 m(2) , isotopic GFR can be safely omitted. © 2016 Wiley Periodicals, Inc.

  14. Metabolic syndrome but not obesity measures are risk factors for accelerated age-related glomerular filtration rate decline in the general population.

    Science.gov (United States)

    Stefansson, Vidar T N; Schei, Jørgen; Solbu, Marit D; Jenssen, Trond G; Melsom, Toralf; Eriksen, Bjørn O

    2018-01-22

    Rapid age-related glomerular filtration rate (GFR) decline increases the risk of end-stage renal disease, and a low GFR increases the risk of mortality and cardiovascular disease. High body mass index and the metabolic syndrome are well-known risk factors for patients with advanced chronic kidney disease, but their role in accelerating age-related GFR decline independent of cardiovascular disease, hypertension and diabetes is not adequately understood. We studied body mass index, waist circumference, waist-hip ratio and metabolic syndrome as risk factors for accelerated GFR decline in 1261 middle-aged people representative of the general population without diabetes, cardiovascular disease or kidney disease. GFR was measured as iohexol clearance at baseline and repeated after a median of 5.6 years. Metabolic syndrome was defined as fulfilling three out of five criteria, based on waist circumference, blood pressure, glucose, high-density lipoprotein cholesterol and triglycerides. The mean GFR decline rate was 0.95 ml/min/year. Neither the body mass index, waist circumference nor waist-hip ratio predicted statistically significant changes in age-related GFR decline, but individuals with baseline metabolic syndrome had a significant mean of 0.30 ml/min/year faster decline than individuals without metabolic syndrome in a multivariable adjusted linear regression model. This association was mainly driven by the triglyceride criterion of metabolic syndrome, which was associated with a significant 0.36 ml/min/year faster decline when analyzed separately. Results differed significantly when GFR was estimated using creatinine and/or cystatin C. Thus, metabolic syndrome, but not the body mass index, waist circumference or waist-hip ratio, is an independent risk factor for accelerated age-related GFR decline in the general population. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  15. 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.

  16. Significant differences when using creatinine, modification of diet in renal disease, or cystatin C for estimating glomerular filtration rate in ICU patients.

    Science.gov (United States)

    Lipcsey, Miklós; Furebring, Mia; Rubertsson, Sten; Larsson, Anders

    2011-03-01

    Renal dysfunction is associated with increased morbidity and mortality in intensive care patients. In most cases the glomerular filtration rate (GFR) is estimated based on serum creatinine and the Modification of Diet in Renal Disease (MDRD) formula, but cystatin C-estimated GFR is being used increasingly. The aim of this study was to compare creatinine and MDRD and cystatin C-estimated GFR in intensive care patients. Retrospective observational study was performed, on patients treated within the general intensive care unit (ICU) during 2004-2006, in a Swedish university hospital. GFR markers are frequently ordered in the ICU; 92% of the patient test results had cystatin C-estimated GFR (eGFR(cystatinC)) ≤ 80 mL/min/1.73 m(2), 75% had eGFR ≤ 50 mL/min/1.73 m(2), and 30% had eGFR ≤ 20 mL/min/1.73 m(2). In contrast, only 46% of the patients had reduced renal function assessed by plasma creatinine alone, and only 47% had eGFR(MDRD) ≤ 80 mL/min/1.73 m(2). The mean difference between eGFR(MDRD) and eGFR(cystatinC) was 39 mL/min/1.73 m(2) for eGFR(cystatinC) values ≤ 60 mL/min/1.73 m(2). GFR is commonly assessed in the ICU. Cystatin C-estimated GFR yields markedly lower GFR results than plasma creatinine and eGFR(MDRD). Many pharmaceuticals are eliminated by the kidney, and their dosage is adjusted for kidney function. Thus, the differences in GFR estimates by the methods used indicate that the GFR method used in the intensive care unit may influence the treatment.

  17. Validity of Serum Cystatin C as an Early and Accurate Marker of Glomerular Filtration Rate in type 1 Diabetes Mellitus Patients

    International Nuclear Information System (INIS)

    Fathy, H.A.; Fathy, M.A.

    2017-01-01

    The present study aims at exploring the clinical validity of measuring cystatin C for the early and accurate assessment of GFR (as compared to measuring serum creatinine or β2 microglobulin) in patients suffering from type 1 diabetes mellitus who are at risk of developing diabetic nephropathy as well as those who have already developed the condition. This study included 80 subjects who were further subdivided into two groups: Control group (1) which comprised 20 healthy age and sex matched children. Patient group (2) comprised 60 patients of both sexes properly diagnosed with type 1 diabetes. The patients were further subdivided into 3 subgroups according albumin levels in their 24 hour urine : Group 2a: 20 patients who were considered normo-albumin uric. Group 2b: 20 patients who were considered micro-albumin uric. Group 2c: 20 patients who were considered macro - albumin uric. All subjects were subjected to the estimation of serum creatinine level as well as serum β2 microglobulin and serum cystatin C levels. They were also subjected to Isotope renogram using 99m Tc- diethylene triamine pentaacetic acid (DTPA) single injection technique for accurate measurement of glomerular filtration rate (GFR). A positive correlation was observed between each of serum creatinine, β2 microglobulin, cystatin C with albumin in 24 hr urine in all the patient subgroups and this correlation was highly significant. However, the correlation between serum cystatin C levels in the diabetic patients and albumin in 24 hr urine was higher than that observed for either serum creatinine or serum β2 microglobulin. Cystatin C had the highest negative correlation with GFR (as measured by 99m Tc-DTPA clearance) compared to either serum creatinine or serum β 2 microglobulin in group II patients. It can be concluded that cystatin C could act as an early and accurate marker of GFR and renal function in patients with type 1 diabetes mellitus at risk of developing or who have already developed

  18. Role of lean body mass for estimation of glomerular filtration rate in patients with chronic kidney disease with various body mass indices.

    Science.gov (United States)

    Ozmen, Sehmus; Kaplan, Mehmet Ali; Kaya, Halil; Akin, Davut; Danis, Ramazan; Kizilkan, Berfin; Yazanel, Orhan

    2009-01-01

    Glomerular filtration rate (GFR) is the main tool used to diagnose, treat and follow up renal diseases. Age, gender, ethnicity and obesity all affect the relationship between serum creatinine, muscle mass/body weight and GFR. This study aimed to investigate the role of lean body mass for GFR estimation in patients with chronic kidney disease (CKD) with various body mass indices. In total, 110 Caucasian adult subjects with CKD referred for GFR measurement by (99m)Tc-DTPA renography were enrolled in the study. The patients were categorized according to body mass index values: 30 kg/m(2) (obese). Lean body mass (LBM) and fat mass were measured by leg-to-leg bioimpedance. Predictive factors were identified by linear regression analysis in each group. GFR measured by DTPA, creatinine clearance, Cockcroft and Gault, and Modification of Diet in Renal Disease (four-variable) equations was 37+/-27, 42+/-30, 42+/-27, and 49+/-35 ml/min/1.73 m(2), respectively. The predictive role of 1/SCr, age, serum albumin, amount of proteinuria, LBM and fat mass was investigated all groups. None of the factors was significant in underweight and healthy weight groups except for 1/serum creatinine (SCr). LBM/SCr was an independent predictive factor for both overweight and obese groups. 1/SCr accounted for 96.2% of the variability in measured GFR for underweight subjects but only 58.1% of the variability in GFR of obese subjects. The formulae derived from SCr should be used cautiously in overweight and obese subjects. LBM measured by bioimpedance was an independent predictive factor of GFR in obese/overweight subjects and added clinically important diagnostic value to 1/SCr. It needs to be investigated as a parameter in further studies attempting to develop formulae for estimating GFR in larger obese and overweight populations.

  19. Routine reporting of estimated glomerular filtration rate (eGFR) in African laboratories and the need for its increased utilisation in clinical practice.

    Science.gov (United States)

    Adebisi, Simeon A

    2013-03-01

    Chronic Kidney Disease (CKD) is defined as the presence of markers of kidney damage or of estimated glomerular filtration rate (eGFR)clinical practice. Current guidelines advocate the use of prediction equations, such as the Cockcroft-Gault (CG) formula and the Modification of Diet in Renal Disease (MDRD) study-derived equations. Laboratories in African should commence routine reporting of eGFR for a number of reasons; 1. The sensitivity of serum creatinine (Scr) in identifying CKD is low.2. In Nigeria, a representative country; screening for Chronic Kidney Disease (CKD) is hardly considered in the routine practice of the primary and secondary care medical officers.3 Studies have shown that routine reporting of eGFR improved the documentation and identification of CKD by almost 50%.4 There is the possibility of reversing CKD if picked earlier.5. The high cost of treating CKD patients in advanced stages and the low per capital income status of the populace in Sub-Saharan Africa.6. Poor health infrastructure to manage advanced CKD patients in the continent.7. Several studies, now show lack of awareness of CKD among non-nephrologists that is related, at least in part, to difficulty in interpreting serum creatinine concentrations (the reciprocal, non-linear relationship between GFR and serum creatinine).8 Mathematical estimates of GFR [ as in eGFR] that incorporate creatinine concentration, as well as factors affecting creatinine production rates, such as size, gender, age and ethnic background, are more sensitive to changes in renal function than serum creatinine value alone.9 Recent guidelines define "action plans" for CKD according to the GFR, including referral to nephrologists at GFRs<30 mL.min(-1).(1.73 m2).

  20. Prevalence and determinants of differences in cystatin C and creatinine-based estimated glomerular filtration rate in community-dwelling older adults: a cross-sectional study.

    Science.gov (United States)

    Legrand, Helen; Werner, Karin; Christensson, Anders; Pihlsgård, Mats; Elmståhl, Sölve

    2017-12-04

    Differences in cystatin C and creatinine-based estimated glomerular filtration rate (eGFR) can lead to clinical uncertainty. Existing eGFR equations perform poorly in a subset of individuals. This study aims to describe the prevalence of differences between cystatin C-based (eGFR cys ) and creatinine-based (eGFR creat ) eGFR in older adults and to explore which subsets of individuals may be most affected by differing estimations. In this cross-sectional study, participants from a cohort of community-dwelling older adults were examined at a baseline visit in 2001-2004 as part of the larger "Good Aging in Skåne" study. Exposure variables were obtained from questionnaires, interviews, examinations, and medical records. Blood samples were taken during the baseline visit, cryopreserved, and analyzed at a later time for biomarkers. The CKD-EPI equations were used to estimate GFR. Initial descriptive analyses were performed on 2931 individuals. A total of 2532 participants were included in the final multiple linear regression. Nearly two-thirds of participants had eGFR differences exceeding 10%, with nearly 20 % of participants having eGFR differences exceeding 30%. Smoking, age, body mass index (BMI), C-reactive protein (CRP), glucocorticoid use, and mean eGFR were correlated with differences between eGFR creat and eGFR cys . Differences between eGFR creat and eGFR cys are common and often of large magnitude in this community-dwelling population of older adults. The finding of multiple non-GFR determinants correlated to differences in GFR estimations can help direct future research to improve eGFR equations for subgroups prone to conflicting GFR estimations or to guide choice of biomarker for GFR estimation in these subgroups.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. Filtração glomerular e fatores associados em hipertensos atendidos na atenção básica Glomerular filtration and associated factors in hypertensive individuals treated at primary care level

    Directory of Open Access Journals (Sweden)

    Ana Karina Teixeira da Cunha França

    2010-06-01

    Full Text Available FUNDAMENTO: No Brasil, a hipertensão arterial (HA constitui-se um dos principais fatores de risco para doença renal crônica (DRC. Recomenda-se o monitoramento da filtração glomerular (FG para avaliação da função renal em hipertensos, posto que sua redução precede o aparecimento de sintomas. OBJETIVO: Avaliar a FG e fatores associados em hipertensos. MÉTODOS: Realizou-se estudo transversal no período de janeiro a junho de 2008, com 297 hipertensos com ou sem diabete melito (DM tratados em uma unidade básica de saúde em São Luís-MA. Foram incluídos pacientes >20 anos e de ambos os sexos. Avaliaram-se dados sociodemográficos, estado nutricional, FG e microalbuminúria em urina de 24h, controle pressórico e glicêmico, creatinina sérica e lipidograma. RESULTADOS: A idade média foi 60,6 × 11,5 anos com predomínio do sexo feminino (75,1%, sobrepeso/obesidade (65,0% e circunferência da cintura elevada (60,6%. A prevalência de FG 65 anos, que permaneceu após ajustamento. Para o grupo HA com DM houve associação da redução da FG com idade > 65 anos, tabagismo e obesidade, porém, após ajustamento, permaneceram idade e tabagismo. CONCLUSÃO: Nestes pacientes, a prevalência de FG 65 anos e tabagismo apresentaram-se como fatores associados à FG. Isto reforça a necessidade da avaliação sistemática da FG em hipertensos visando a prevenção secundária da doença renal crônica.BACKGROUND: In Brazil, arterial hypertension (AH constitutes one of the main risk factors for chronic kidney disease (CKD. The monitoring of glomerular filtration (GF is recommended for the assessment of kidney function in hypertensive individuals, as GF decrease precedes symptom onset. OBJECTIVE: To assess GF and its associated factors in hypertensive individuals. METHODS: A cross-sectional study was carried out from January to June 2008 in 297 individuals with arterial hypertension (AH with or without diabetes mellitus (DM, treated at a primary

  3. Investigation of cadmium-induced alterations in renal glomerular function

    International Nuclear Information System (INIS)

    Long, T.J.

    1982-01-01

    This research was designed to test the hypothesis that certain aspects of cadmium-induced renal dysfunction are the result of glomerular, rather than classic tubular, injury. To determine whether cadmium-induced proteinuria was due to altered glomerular function, cadmium was administered chronically at a concentration of 185 ppm in the drinking water. This protocol resulted in the production of proteinuria which when analyzed by high pressure liquid chromatography and radioimmunoassay was indistinguishable from that occurring in control rats. Glomerular filtration rate, renal blood flow, and filtration fraction were all significantly depressed after 20-30 weeks of exposure. In order to further investigate these alterations in glomerular function, an acute exposure model was developed. It was found that a single i.p. injection of cadmium in mercaptoethanol resulted in the onset of acute renal failure. The clinical picture was characterized by a reduction in glomerular filtrate rate of 50-90% within 24 hours, with partial to total recovery occurring by day 7 post-exposure. Histological evidence indicated that to a large extent the reduction in GFR was due to tubular blockade and/or backleak of filtrate across damaged tubules

  4. Flux Enhancement in Crossflow Membrane Filtration: Fouling and It's Minimization by Flow Reversal. Final Report

    International Nuclear Information System (INIS)

    Shamsuddin Ilias

    2005-01-01

    Fouling problems are perhaps the single most important reason for relatively slow acceptance of ultrafiltration in many areas of chemical and biological processing. To overcome the losses in permeate flux associated with concentration polarization and fouling in cross flow membrane filtration, we investigated the concept of flow reversal as a method to enhance membrane flux in ultrafiltration. Conceptually, flow reversal prevents the formation of stable hydrodynamic and concentration boundary layers at or near the membrane surface. Further more, periodic reversal of the flow direction of the feed stream at the membrane surface results in prevention and mitigation of membrane fouling. Consequently, these advantages are expected to enhance membrane flux significantly. A crossflow membrane filtration unit was designed and built to test the concept of periodic flow reversal for flux enhancement. The essential elements of the system include a crossflow hollow fiber membrane module integrated with a two-way valve to direct the feed flow directions. The two-way valve is controlled by a controller-timer for periodic reversal of flow of feed stream. Another important feature of the system is that with changing feed flow direction, the permeate flow direction is also changed to maintain countercurrent feed and permeate flows for enhanced mass transfer driving force (concentration difference). Three feed solutions (Bovine serum albumin (BSA), apple juice and citrus fruit pectin) were studied in crossflow membrane filtration. These solutes are well-known in membrane filtration for their fouling and concentration polarization potentials. Laboratory-scale tests on a hollow-fiber ultrafiltration membrane module using each of the feed solutes show that under flow reversal conditions, the permeate flux is significantly enhanced when compared with the conventional unidirectional flow. The flux enhancement is dramatic (by an order of magnitude) with increased feed concentration and

  5. Flux Enhancement in Crossflow Membrane Filtration: Fouling and It's Minimization by Flow Reversal

    Energy Technology Data Exchange (ETDEWEB)

    Shamsuddin Ilias

    2005-08-04

    Fouling problems are perhaps the single most important reason for relatively slow acceptance of ultrafiltration in many areas of chemical and biological processing. To overcome the losses in permeate flux associated with concentration polarization and fouling in cross flow membrane filtration, we investigated the concept of flow reversal as a method to enhance membrane flux in ultrafiltration. Conceptually, flow reversal prevents the formation of stable hydrodynamic and concentration boundary layers at or near the membrane surface. Further more, periodic reversal of the flow direction of the feed stream at the membrane surface results in prevention and mitigation of membrane fouling. Consequently, these advantages are expected to enhance membrane flux significantly. A crossflow membrane filtration unit was designed and built to test the concept of periodic flow reversal for flux enhancement. The essential elements of the system include a crossflow hollow fiber membrane module integrated with a two-way valve to direct the feed flow directions. The two-way valve is controlled by a controller-timer for periodic reversal of flow of feed stream. Another important feature of the system is that with changing feed flow direction, the permeate flow direction is also changed to maintain countercurrent feed and permeate flows for enhanced mass transfer driving force (concentration difference). Three feed solutions (Bovine serum albumin (BSA), apple juice and citrus fruit pectin) were studied in crossflow membrane filtration. These solutes are well-known in membrane filtration for their fouling and concentration polarization potentials. Laboratory-scale tests on a hollow-fiber ultrafiltration membrane module using each of the feed solutes show that under flow reversal conditions, the permeate flux is significantly enhanced when compared with the conventional unidirectional flow. The flux enhancement is dramatic (by an order of magnitude) with increased feed concentration and

  6. Copepod feeding currents : flow patterns, filtration rates and energetics

    NARCIS (Netherlands)

    van Duren, L.A; Stamhuis, E.J; Videler, J.J

    Particle image velocimetry was used to construct a quasi 3-dimensional image of the flow generated by the feeding appendages of the calanoid copepod Temora longicornis. By scanning layers of flow, detailed information was obtained on flow velocity and velocity gradients. The flow around feeding T.

  7. Determination of filtration velocity and direction of groundwater flow using tracer technique, Port Dickson, Negeri Sembilan

    International Nuclear Information System (INIS)

    Md Shahid Ayub; Roslan Mohd Ali; Kamarudin Samuding

    1996-01-01

    The filtration velocity of the groundwater was determine by introducing I mCi Br-82 into a borehole. Br-82 was in the form of potassium bromide. The result showed that the filtration velocity varies from 2.3 to 4.5 cm/day depending on the soil matrix with the clayey layer posting more resistance to flow. Au-198 in the form of aurium chloride was introduce into two other boreholes to determine the direction of flow. The general trend of flow was in the direction between N140E and N160E

  8. Separation of spermatozoa with a combination of pinched flow fraction and tangential filtration

    NARCIS (Netherlands)

    Berendsen, Johanna Theodora Wilhelmina; Eijkel, Jan C.T.; Segerink, Loes Irene

    2016-01-01

    We demonstrate a pinched flow tangential filtration method to sort spermatozoa from larger particles with a spermatozoa collection efficiency of 94±2% and a separation efficiency of 100%. In conventional pinched flow fractionation (PFF), an observed tumbling-like rotation of spermatozoa complicates

  9. Decrease in glomerular filtration rate by plasma low-density lipoprotein cholesterol in subjects with normal kidney function assessed by urinalysis and plasma creatinine.

    Science.gov (United States)

    Morita, Yasuko; Homma, Yasuhiko; Igarashi, Mihoko; Miyano, Ryuusuke; Yamaguchi, Hiroshi; Matsuda, Momoo; Tanigaki, Toshimori; Shiina, Yutaka; Homma, Koichiro

    2010-06-01

    It has not been well defined whether plasma low-density lipoprotein cholesterol (LDL-C) progresses arteriolosclerosis (arteriosclerosis of small arteries) or not. Estimated glomerular filtration rate (e-GFR) is an indicator of the function of renal arterioles and capillaries of glomeruli. The relationship between e-GFR and plasma LDL-C was studied to estimate the effect of plasma LDL-C on the function of renal arterioles and capillaries of glomeruli to speculate the effect of plasma LDL-C on arteriolosclerosis. Major coronary risk factors; blood pressure, plasma lipids, and fasting plasma glucose were compared among 4 groups of examinees of a health evaluation and promotion center separated by e-GFR, namely, Control group, Group 1, 2, 3 from highest e-GFR to lowest e-GFR. Numbers of total male and female subjects were 4602 and 2920, respectively. Plasma LDL-C levels were significantly high in Group 2 and 3 in all male subjects and high in Group 1, 2, and 3 in male subjects with age of fifties, compared with Control group. Plasma LDL-C levels were significantly high in Group 1, 2, and 3 in all female subjects and high in Group 2 and 3 in female subjects with age of fifties, compared with Control group. Plasma levels of LDL-C were not significantly different at each years of age in subjects with age of fifties in both sex. BMI and waist circumference were higher in male subjects with low e-GFR but not in female subjects. Blood pressure and fasting plasma glucose were not high in subjects in Group 1, 2, and 3, compared with Control group in all subjects and subjects with age of fifties in both sex. We concluded that the high plasma level of LDL-C was the major risk factor among coronary risk factors to reduce GFR probably due to impairing the function of renal arterioles and capillaries of glomeruli in subjects with normal kidney function assessed by urinalysis and plasma creatinine. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. 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, poverweight subjects (r = 0.86, poverweight children with a kidney disorder. The CKiD bedside GFR estimations were not significantly different compared with 24-hour urine Clcr values for the overweight group with kidney disorder (p=0.85). The Schwartz 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

  13. Relationship between Kidney Dysfunction and Ischemic Stroke Outcomes: Albuminuria, but Not Estimated Glomerular Filtration Rate, Is Associated with the Risk of Further Vascular Events and Mortality after Stroke.

    Science.gov (United States)

    Lee, Seung-Jae; Lee, Dong-Geun

    2016-01-01

    Estimated glomerular filtration rate (eGFR) and albuminuria are known to be associated with ischemic stroke outcomes. In this study, we investigated the longitudinal relationships of the two markers with mortality, vascular events and functional outcomes in a stroke cohort. A total of 295 patients with acute ischemic stroke were prospectively recruited in a single center between May 2012 and February 2015. Renal dysfunction was defined as a decreased eGFR (albuminuria (urine albumin-to-creatinine ratio ≥ 30 mg/g). Good functional outcome at 6 months was defined as a modified Rankin scale score ≤ 2, and the occurrence of major vascular events (stroke, acute coronary syndrome or peripheral artery occlusion) or death was monitored. The associations between renal dysfunction and mortality, major vascular events, and 6-month functional outcome were evaluated by the Cox proportional hazards model and logistic regression analysis. Unadjusted and adjusted hazards ratios (HRs), odds ratios (ORs), and 95% confidence intervals (CIs) were obtained. A Kaplan-Meier survival curve for composite adverse events (major vascular events or death) was also computed according to the presence or absence of albuminuria. Albuminuria, not eGFR, was significantly associated with mortality (P = 0.028; HR 2.15; 95% CI 1.09-4.25) and major vascular events (P = 0.044; HR 2.24; 95% CI 1.02-4.94) in the multivariate Cox proportional hazards models adjusting for age, sex, diabetes, hypertension, current smoking, atrial fibrillation, previous stroke, alcohol history, initial National Institutes of Health Stroke Scale (NIHSS) score and eGFR. In addition, albuminuria was negatively associated with 6-month functional outcome in the multivariate logistic regression analysis adjusting for age, sex, diabetes, hypertension, current smoking, atrial fibrillation, previous stroke, alcohol history and eGFR (P = 0.001; OR 0.36; 95% CI 0.20-0.65), but the association disappeared when NIHSS score was

  14. Accuracy and precision of the CKD-EPI and MDRD predictive equations compared with glomerular filtration rate measured by inulin clearance in a Saudi population.

    Science.gov (United States)

    Al-Wakeel, Jamal Saleh

    2016-01-01

    Predictive equations for estimating glomerular filtration rate (GFR) in different clinical conditions should be validated by comparing with the measurement of GFR using inulin clearance, a highly accurate measure of GFR. Our aim was to validate the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD) equations by comparing it to the GFR measured using inulin clearance in chronic kidney disease (CKD) patients. Cross-sectional study performed in adult Saudi patients with CKD. King Saud University Affiliated Hospital, Riyadh, Saudi Arabia in 2014. We compared GFR measured by inulin clearance with the estimated GFR calculated using CKD-EPI and MDRD predictive formulas. Correlation, bias, precision and accuracy between the estimated GFR and inulin clearance. Comparisons were made in 31 participants (23 CKD and 8 transplanted), including 19 males (mean age 42.2 [15] years and weight 68.7 [18] kg). GFR using inulin was 51.54 (33.8) mL/min/1.73 m2 in comparison to inulin clearance, the GFR by the predictive equations was: CKD-EPI creatinine 52.6 (34.4) mL/ min/1.73 m2 (P=.490), CKD-EPI cystatin C 41.39 (30.30) mL/min/1.73 m2 (P=.002), CKD creatinine-cystatin C 45.03 (30.9) mL/min/1.73 m2 (P=.004) and MDRD GFR 48.35 (31.5) mL/min/1.73 m2 (P=.028) (statistical comparisons vs inulin). Bland-Altman plots demonstrated that GFR estimated by the CKD-EPI creatinine was the most accurate compared with inulin clearance, having a mean difference (estimated bias) and limits of agreement of -1.1 (15.6,-17.7). By comparison the mean differences for predictive equations were: CKD-EPI cystatin C 10.2 (43.7,-23.4), CKD creatinine-cystatin C 6.5 (29.3,-16.3) and MDRD 3.2 (18.3,-11.9). except for CKD-EPI creatinine, all of the equations underestimated GFR in comparison with inulin clearance. When compared with inulin clearance, the CKD-EPI creatinine equation is the most accurate, precise and least biased equation for estimation of GFR

  15. A prospective study of estimated glomerular filtration rate and outcomes in patients with atrial fibrillation: the Loire Valley Atrial Fibrillation Project.

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    Banerjee, Amitava; Fauchier, Laurent; Vourc'h, Patrick; Andres, Christian R; Taillandier, Sophie; Halimi, Jean Michel; Lip, Gregory Y H

    2014-06-01

    Atrial fibrillation (AF) is more likely to develop in patients with chronic kidney disease (CKD) than in individuals with normal renal function, and patients with CKD are more likely to suffer ischemic stroke (IS)/thromboembolism (TE). To our knowledge, no prior study has considered the impact of estimated glomerular filtration rate (eGFR) on bleeding. We investigated the relationship of eGFR to IS/TE, mortality, and bleeding in an AF population unrestricted by age or comorbidity. Patients with nonvalvular AF (NVAF) were stratified into five categories according to eGFR (≥ 90, 60-89, 30-59, 15-29, and < 15 mL/min/1.73 m2), analyzing risk factors, all-cause mortality, bleeding, and IS/TE. Of 8,962 eligible individuals, 5,912 had NVAF and available serum creatinine data, with 14,499 patient-years of follow-up. The incidence rates of IS/TE were 7.4 and 7.2 per 1,000 person-years in individuals not receiving and receiving anticoagulation therapy, respectively. Rates of all-cause mortality were 13.4 and 9.4 per 1,000 person-years, respectively, and of major bleeding, 6.2 and 9.0 per 1,000 person-years, respectively. Rates increased with decreasing eGFR, with IS/TE rates being lower in individuals receiving oral anticoagulation (OAC) therapy. eGFR was not an independent predictor of IS/TE on multivariate analyses. When the benefit of IS reduction is balanced against the increased risk of hemorrhagic stroke, the net clinical benefit (NCB) was clearly positive in favor of OAC use. Incidence rates of IS/TE, mortality, and bleeding increased with reducing eGFR across the whole range of renal function. OAC use was associated with a lower incidence of IS/TE and mortality at 1 year compared with individuals not receiving anticoagulants in all categories of renal function as measured by eGFR. The NCB balancing IS against serious bleeding was positive in favor of OAC use among patients with renal impairment.

  16. 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 equations were found. Bland-Altman analysis for the same cut-off showed that CKD-EPI creatinine-cystatin 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. © 2017 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  17. Creatinine-or cystatin C-based equations to estimate glomerular filtration in the general population: impact on the epidemiology of chronic kidney disease

    Science.gov (United States)

    2013-01-01

    Background Chronic kidney disease (CKD) is a major issue in public health. Its prevalence has been calculated using estimation of glomerular filtration rate (GFR) by the creatinine-based equations developed in the Modified Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) study. Recently, new equations based either on cystatin C (CKD-EPI Cys) or both cystatin and creatinine (CKD-EPI mix) have been proposed by the CKD-EPI consortium. The aim of this study was to measure the difference in the prevalence of stage 3 CKD, defined as an estimated GFR less than 60 mL/min/1.73 m2, in a population using these four equations. Methods CKD screening was performed in the Province of Liège, Belgium. On a voluntary basis, people aged over 50 years have been screened. GFR was estimated by the four equations. Stage 3 CKD was defined as a GFR less than 60 mL/min/1.73 m2. Results The population screened consisted of 4189 people (47% were men, mean age 63 ± 7y). Their mean serum creatinine and plasma cystatin C levels were 0.88 ± 0.21 mg/dL and 0.85 ± 0.17 mg/L, respectively. The prevalence of CKD in this population using the MDRD, the CKD-EPI, the CKD-EPI Cys and the CKD-EPI mix equations was 13%, 9.8%, 4.7% and 5%, respectively. The prevalence of CKD was significantly higher with the creatinine-based (MDRD and the CKD-EPI) equations compared to the new cystatin C-based equations. Conclusions Prevalence of CKD varies strongly depending on the method used to estimate GFR. Such discrepancies are of importance and must be confirmed and explained by additional studies, notably by studies using GFR measured with a reference method. Trial registration B70720071509 PMID:23496839

  18. Impact of chronic renal insufficiency on the early and late clinical outcomes of carotid artery stenting using serum creatinine vs glomerular filtration rate.

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    AbuRahma, Ali F; Alhalbouni, Saadi; Abu-Halimah, Shadi; Dean, L Scott; Stone, Patrick A

    2014-04-01

    This study analyzed the impact of chronic renal insufficiency (CRI) on early and late clinical outcomes of carotid artery stenting (CAS) using serum creatinine and glomerular filtration rate (GFR). There were 313 CAS patients classified into 3 groups: normal (serum creatinine serum creatinine ≥ 3 or GFR serum creatinine, perioperative stroke rates for normal, moderate, and severe CRI were: 5%, 0%, and 25%, respectively, (p = 0.05) vs 4.6%, 3.7%, and 11.1%, respectively, (p = 0.44) using GFR. The perioperative MAE rates for symptomatic patients were 9.3% and 0% (p = 0.355) and 2% and 5.9% (p = 0.223) for asymptomatic patients for normal and moderate/severe CRI, respectively, using serum creatinine vs 8.1% and 7.8%, respectively, for symptomatic patients and 2.5% and 3%, respectively, for asymptomatic patients using GFR. At a mean follow-up of 21 months, late MAE rates in normal vs moderate/severe CRI patients were 8.2% and 14%, respectively, (p = 0.247) using serum creatinine vs 6.6% and 13.3%, respectively, (p = 0.05) using GFR. Late MAE rates for symptomatic patients in normal vs moderate/severe CRI were: 8.7% vs 27%, respectively, (p = 0.061) using serum creatinine and 5.7% vs 18.8%, respectively, (p = 0.026) using GFR. Late death rate was 0.55% in normal vs 7.6% (p = 0.002) for moderate/severe CRI. Freedom from MAE at 3 years in symptomatic patients was 81% in normal and 46% in moderate/severe CRI (p = 0.0198). A multivariate Cox regression analysis showed that a GFR of < 60 mL/min/1.73 m(2) had an odds ratio of 1.6 (p = 0.222) of having a MAE after CAS. The GFR was more sensitive in detecting late MAE after CAS. Carotid artery stenting in moderate CRI patients can be done with a satisfactory perioperative outcome; however, late death was significant. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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

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    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

  20. Comparison of equations for estimating glomerular filtration rate in screening for chronic kidney disease in asymptomatic black Africans: a cross sectional study.

    Science.gov (United States)

    Omuse, Geoffrey; Maina, Daniel; Mwangi, Jane; Wambua, Caroline; Kanyua, Alice; Kagotho, Elizabeth; Amayo, Angela; Ojwang, Peter; Erasmus, Rajiv

    2017-12-20

    Several equations have been developed to estimate glomerular filtration rate (eGFR). The common equations used were derived from populations predominantly comprised of Caucasians with chronic kidney disease (CKD). Some of the equations provide a correction factor for African-Americans due to their relatively increased muscle mass and this has been extrapolated to black Africans. Studies carried out in Africa in patients with CKD suggest that using this correction factor for the black African race may not be appropriate. However, these studies were not carried out in healthy individuals and as such the extrapolation of the findings to an asymptomatic black African population is questionable. We sought to compare the proportion of asymptomatic black Africans reported as having reduced eGFR using various eGFR equations. We further compared the association between known risk factors for CKD with eGFR determined using the different equations. We used participant and laboratory data collected as part of a global reference interval study conducted by the Committee of Reference Intervals and Decision Limits (C-RIDL) under the International Federation of Clinical Chemistry (IFCC). Serum creatinine values were used to calculate eGFR using the Cockcroft-Gault (CG), re-expressed 4 variable modified diet in renal disease (4v-MDRD), full age spectrum (FAS) and chronic kidney disease epidemiology collaboration equations (CKD-EPI). CKD classification based on eGFR was determined for every participant. A total of 533 participants were included comprising 273 (51.2%) females. The 4v-MDRD equation without correction for race classified the least number of participants (61.7%) as having an eGFR equivalent to CKD stage G1 compared to 93.6% for CKD-EPI with correction for race. Only age had a statistically significant linear association with eGFR across all equations after performing multiple regression analysis. The multiple correlation coefficients for CKD risk factors were higher for

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

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    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

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

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    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 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 associated with reduced GFR in SSc. These medications should be therefore

  3. FLUX ENHANCEMENT IN CROSSFLOW MEMBRANE FILTRATION: FOULING AND IT'S MINIMIZATION BY FLOW REVERSAL

    International Nuclear Information System (INIS)

    Shamsuddin Ilias

    2005-01-01

    Fouling problems are perhaps the single most important reason for relatively slow acceptance of ultrafiltration in many areas of chemical and biological processing. To overcome the losses in permeate flux associated with concentration polarization and fouling in cross flow membrane filtration, we investigated the concept of flow reversal as a method to enhance membrane flux in ultrafiltration. Conceptually, flow reversal prevents the formation of stable hydrodynamic and concentration boundary layers at or near the membrane surface. Further more, periodic reversal of the flow direction of the feed stream at the membrane surface results in prevention and mitigation of membrane fouling. Consequently, these advantages are expected to enhance membrane flux significantly. A crossflow membrane filtration unit was designed and built to test the concept of periodic flow reversal for flux enhancement. The essential elements of the system include a crossflow hollow fiber membrane module integrated with a two-way valve to direct the feed flow directions. The two-way valve is controlled by a controller-timer for periodic reversal of flow of feed stream. Another important feature of the system is that with changing feed flow direction, the permeate flow direction is also changed to maintain countercurrent feed and permeate flows for enhanced mass transfer driving force (concentration difference). In this report, we report our application of Flow Reversal technique in clarification of apple juice containing pectin. The presence of pectin in apple juice makes the clarification process difficult and is believed to cause membrane fouling. Of all compounds found in apple juice, pectin is most often identified as the major hindrance to filtration performance. Based on our ultrafiltration experiments with apple juice, we conclude that under flow reversal conditions, the permeate flux is significantly enhanced when compared with the conventional unidirectional flow. Thus, flow reversal

  4. Change in glomerular volume and its clinicopathological impact after kidney transplantation.

    Science.gov (United States)

    Kobayashi, Akimitsu; Yamamoto, Izumi; Katsumata, Haruki; Yamakawa, Takafumi; Mafune, Aki; Nakada, Yasuyuki; Koike, Kentaro; Mitome, Jun; Miki, Jun; Yamada, Hiroki; Tanno, Yudo; Ohkido, Ichiro; Tsuboi, Nobuo; Yokoyama, Keitaro; Yamamoto, Hiroyasu; Yokoo, Takashi

    2015-07-01

    Both immunological and non-immunological etiologies affect graft function after kidney transplantation, including acute rejection, calcineurin inhibitor toxicity, and a recurrence of glomerulonephritis. Glomerular enlargement or glomerular sclerosis due to glomerular hyperfiltration related to increased renal blood flow is another cause. Although the glomerular volume in baseline biopsies predicts late allograft function, the relationship between allograft function and the annual changes in glomerular volume after kidney transplantation are unclear. We investigated changes in glomerular volume after kidney transplantation and their clinicopathological relationship. We enrolled 23 patients with stable kidney function without an episode of rejection or any complication resulting in a functional decrease in the graft. We measured glomerular volume (GV) using the Weibel-Gomez method and glomerular density (GD) using 0,1 h biopsy samples as baseline controls and 1 yr biopsy samples and investigated the association between the changes in them and clinical parameters, including graft function, proteinuria, and renal hemodynamic markers, including effective renal plasma flow (ERPF) and filtration fraction (FF). The ERPF was calculated from a 99mTc-mercaptoacetyltriglycine (MAG3) renogram. The GV and ERPF increased significantly 1 yr after kidney transplantation. In contrast, proteinuria decreased significantly and Δproteinuria (1 yr - 1 month after transplantation) was correlated with ΔGV (P Glomerular enlargement 1 yr after transplantation may be related to improved proteinuria. It is possible that glomerular enlargement serves as a renal adaptation after kidney transplantation. © 2015 Asian Pacific Society of Nephrology.

  5. Self Cleaning High Efficiency Particulate Air (HEPA) Filtration without Interrupting Process Flow - 59347

    International Nuclear Information System (INIS)

    Chadwick, Chris

    2012-01-01

    The strategy of protecting the traditional glass fibre HEPA filtration train from it's blinding contamination and the recovery of dust by the means of self cleaning, pre-filtration is a proven means in the reduction of ultimate disposal volumes and has been used within the Fuel Production Industry. However, there is an increasing demand in nuclear applications requiring elevated operating temperatures, fire resistance, moisture resistance and chemical composition that the existing glass fibre HEPA filtration cannot accommodate, which can be remedied by the use of a metallic HEPA filter media. Previous research suggests that the then costs to the Department of Energy (DOE), based on a five year life cycle, was $29.5 million for the installation, testing, removal and disposal of glass fibre HEPA filtration trains. Within these costs, $300 was the value given to the filter and $4, 450 was given to the peripheral activity. Development of a low cost, cleanable, metallic, direct replacement of the traditional filter train will the clear solution. The Bergman et al work has suggested that a 1000 ft 3 /min, cleanable, stainless HEPA could be commercially available for $5, 000 each, whereas the industry has determined that the truer cost of such an item in isolation would be closer to $15, 000. This results in a conflict within the requirement between 'low cost' and 'stainless HEPA'. By proposing a system that combines metallic HEPA filtration with the ability to self clean without interrupting the process flow, the need for a tradition HEPA filtration train will be eliminated and this dramatically reduces the resources required for cleaning or disposal, thus presenting a route to reducing ultimate costs. The paper will examine the performance characteristics, filtration efficiency, flow verses differential pressure and cleanability of a self cleaning HEPA grade sintered metal filter element, together with data to prove the contention. (authors)

  6. Prevalence of chronic kidney diseases in patients with chronic obstructive pulmonary disease: assessment based on glomerular filtration rate estimated from creatinine and cystatin C levels

    Directory of Open Access Journals (Sweden)

    Yoshizawa T

    2015-07-01

    Full Text Available Takayuki Yoshizawa,1,2 Kazuyoshi Okada,3 Sachiko Furuichi,1,2 Toshihiko Ishiguro,1 Akitaka Yoshizawa,1 Toshiki Akahoshi,2 Yasuhiro Gon,2 Tsuneto Akashiba,2 Yoshifumi Hosokawa,1,2 Shu Hashimoto2 1Department of Internal Medicine, Kanamecho Hospital, Toshima-ku, 2Division of Respiratory Medicine, Department of Internal Medicine, 3Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan Background: Cardiovascular diseases, osteoporosis, and depression are identified comorbidities of chronic obstructive pulmonary disease (COPD, but there have been few reports of chronic kidney disease (CKD as a comorbidity of COPD. The objective of this study was to investigate the prevalence of CKD in COPD patients using estimated glomerular filtration rate (eGFR based on creatinine (Cr and cystatin C (Cys levels. Methods: The prevalence of CKD and the values of various CKD-related parameters were compared between 108 stable COPD outpatients (COPD group and a non-COPD control group consisting of 73 patients aged 60 years or more without a history of COPD or kidney disease. CKD was defined as an eGFR less than 60 mL/min/1.73 m2. Results: The Cr level was significantly higher in the COPD group, but eGFR based on serum Cr (eGFRCr was not significantly different between the two groups (73.3±25.3 vs 79.7±15.5 mL/min/1.73 m2. The Cys level was significantly higher and eGFR based on serum Cys (eGFRCys was significantly lower in the COPD group (60.0±19.4 vs 74.0±13.5 mL/min/1.73 m2, P<0.0001. The prevalence of CKD evaluated based on eGFRCr was 31% in the COPD group and 8% in the non-COPD group with an odds ratio of 4.91 (95% confidence interval, 1.94–12.46, P=0.0008, whereas the evaluated prevalence based on eGFRCys was 53% in the COPD group and 15% in the non-COPD group with an odds ratio of 6.30 (95% confidence interval, 2.99–13.26, P<0.0001, demonstrating a higher prevalence of

  7. Contribution of non-traditional lipid profiles to reduced glomerular filtration rate in H-type hypertension population of rural China.

    Science.gov (United States)

    Wang, Haoyu; Li, Zhao; Guo, Xiaofan; Chen, Yintao; Chen, Shuang; Tian, Yichen; Sun, Yingxian

    2018-05-01

    Despite current interest in the unfavourable impact of non-traditional lipid profiles on cardiovascular disease, information regarding its relations to reduced glomerular filtration rate (GFR) in H-type hypertension population has not been systemically elucidated. Analyses were based upon a cross-sectional study of 3259 participants with H-type hypertension who underwent assessment of biochemical, anthropometric and blood pressure values. Reduced GFR was considered if meeting estimated GFR <60 ml/min/1.73 m 2 . A stepwise multivariate regression analysis indicated that non-traditional lipid parameters remained as independent determinants of estimated GFR (all p < .001). In multivariable models, we observed a 50%, 51%, 31%, and 24% higher risk for decreased GFR with each SD increment in TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C levels, respectively. The highest quartile of TC/HDL-C, TG/HDL-C and LDL-C/HDL-C ratios carried reduced GFR odds (confidence intervals) of 5.50 (2.50 to 12.09), 6.63 (2.58 to 17.05) and 2.22 (1.15 to 4.29), respectively. The relative independent contribution of non-traditional lipid profiles, as indexed by TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C, towards reduced GFR putting research evidence at the very heart of lipoprotein-mediated renal injury set a vital example for applying a clinical and public health recommendation for reducing the burden of chronic kidney disease. KEY MESSAGES Non-traditional lipid profiles has been linked with the occurrence of cardiovascular disease, but none of the studies that address the effect of non-traditional lipid profiles on reduced GFR risk in H-type hypertension population has been specifically established. A greater emphasis of this study resided in the intrinsic value of TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios and non-HDL-C that integrate atherogenic and anti-atherogenic lipid molecules to predict the risk of reduced GFR among H-type hypertension population and provide

  8. 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

  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

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    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. 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

  11. Tangential Flow Filtration of Colloidal Silver Nanoparticles: A "Green" Laboratory Experiment for Chemistry and Engineering Students

    Science.gov (United States)

    Dorney, Kevin M.; Baker, Joshua D.; Edwards, Michelle L.; Kanel, Sushil R.; O'Malley, Matthew; Pavel Sizemore, Ioana E.

    2014-01-01

    Numerous nanoparticle (NP) fabrication methodologies employ "bottom-up" syntheses, which may result in heterogeneous mixtures of NPs or may require toxic capping agents to reduce NP polydispersity. Tangential flow filtration (TFF) is an alternative "green" technique for the purification, concentration, and size-selection of…

  12. Semi-continuous protein fractionating using affinity cross-flow filtration

    NARCIS (Netherlands)

    Borneman, Zandrie; Zhang, W.; van den Boomgaard, Anthonie; Smolders, C.A.

    2002-01-01

    Protein purification by means of downstream processing is increasingly important. At the University of Twente a semi-continuous process is developed for the isolation of BSA out of crude protein mixtures. For this purpose an automated Affinity Cross-Flow Filtration, ACFF, process is developed. This

  13. Efectos de la circulación extracorpórea sobre el filtrado glomerular en la cirugía cardiovascular pediátrica Effects of extracorporeal circulation on glomerular filtration in pediatric cardiovascular surgery

    OpenAIRE

    Abel Facenda; Antolín Romero; Junior M Lima; Cruz M Contreras; Heilyn del Valle Montero; Manuel G Lima Montero

    2011-01-01

    Objetivo: conocer como afecta la circulación extracorpórea la función renal tomando como marcador la alteración del filtrado glomerular. Material y método: se realizó un estudio prospectivo, analítico y observacional en 63 pacientes pediátricos sometidos a cirugía cardiaca electiva con circulación extracorpórea en el Cardiocentro Pediátrico «William Soler» entre octubre de 2009 y abril de 2010. Se calcularon las variaciones del filtrado glomerular durante la circulación extracorpórea por el m...

  14. Visualization and evaluation of flow during water filtration: Parameterization and sensitivity analysis

    Directory of Open Access Journals (Sweden)

    Bílek Petr

    2016-01-01

    Full Text Available This paper deals with visualization and evaluation of flow during filtration of water seeded by artificial microscopic particles. Planar laser induced fluorescence (PLIF is a wide spread method for visualization and non-invasive characterization of flow. However the method uses fluorescent dyes or fluorescent particles in special cases. In this article the flow is seeded by non-fluorescent monodisperse polystyrene particles with the diameter smaller than one micrometer. The monodisperse sub-micron particles are very suitable for testing of textile filtration materials. Nevertheless non-fluorescent particles are not useful for PLIF method. A water filtration setup with an optical access to the place, were a tested filter is mounted, was built and used for the experiments. Concentration of particles in front of and behind the tested filter in a laser light sheet measured is and the local filtration efficiency expressed is. The article describes further progress in the measurement. It was carried out sensitivity analysis, parameterization and performance of the method during several simulations and experiments.

  15. Baleen Hydrodynamics and Morphology of Cross-Flow Filtration in Balaenid Whale Suspension Feeding.

    Directory of Open Access Journals (Sweden)

    Alexander J Werth

    Full Text Available The traditional view of mysticete feeding involves static baleen directly sieving particles from seawater using a simple, dead-end flow-through filtration mechanism. Flow tank experiments on bowhead (Balaena mysticetus baleen indicate the long-standing model of dead-end filtration, at least in balaenid (bowhead and right whales, is not merely simplistic but wrong. To recreate continuous intraoral flow, sections of baleen were tested in a flume through which water and buoyant particles circulated with variable flow velocity. Kinematic sequences were analyzed to investigate movement and capture of particles by baleen plates and fringes. Results indicate that very few particles flow directly through the baleen rack; instead much water flows anteroposteriorly along the interior (lingual side of the rack, allowing items to be carried posteriorly and accumulate at the posterior of the mouth where they might readily be swallowed. Since water flows mainly parallel to rather than directly through the filter, the cross-flow mechanism significantly reduces entrapment and tangling of minute items in baleen fringes, obviating the need to clean the filter. The absence of copepods or other prey found trapped in the baleen of necropsied right and bowhead whales supports this hypothesis. Reduced through-baleen flow was observed with and without boundaries modeling the tongue and lips, indicating that baleen itself is the main if not sole agent of crossflow. Preliminary investigation of baleen from balaenopterid whales that use intermittent filter feeding suggests that although the biomechanics and hydrodynamics of oral flow differ, cross-flow filtration may occur to some degree in all mysticetes.

  16. 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)

  17. 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.)

  18. Renal blood flow using arterial spin labelling MRI and calculated filtration fraction in healthy adult kidney donors pre-nephrectomy and post-nephrectomy

    International Nuclear Information System (INIS)

    Cutajar, Marica; Clark, Christopher A.; Gordon, Isky; Hilton, Rachel; Olsburgh, Jonathon; Marks, Stephen D.; Thomas, David L.; Banks, Tina

    2015-01-01

    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 ( 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.)

  19. Glomerular nephrotoxicity of aminoglycosides

    International Nuclear Information System (INIS)

    Martinez-Salgado, Carlos; Lopez-Hernandez, Francisco J.; Lopez-Novoa, Jose M.

    2007-01-01

    Aminoglycoside antibiotics are the most commonly used antibiotics worldwide in the treatment of Gram-negative bacterial infections. However, aminoglycosides induce nephrotoxicity in 10-20% of therapeutic courses. Aminoglycoside-induced nephrotoxicity is characterized by slow rises in serum creatinine, tubular necrosis and marked decreases in glomerular filtration rate and in the ultrafiltration coefficient. Regulation of the ultrafiltration coefficient depends on the activity of intraglomerular mesangial cells. The mechanisms responsible for tubular nephrotoxicity of aminoglycosides have been intensively reviewed previously, but glomerular toxicity has received less attention. The purpose of this review is to critically assess the published literature regarding the toxic mechanisms of action of aminoglycosides on renal glomeruli and mesangial cells. The main goal of this review is to provide an actualized and mechanistic vision of pathways involved in glomerular toxic effects of aminoglycosides

  20. 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.

    Directory of Open Access Journals (Sweden)

    Holly Kramer

    Full Text Available 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.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.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.

  1. Prevalence of decreased glomerular filtration rate in patients seeking non-nephrological medical care--an evaluation using IDMS-traceable creatinine based MDRD as well as Mayo Clinic quadratic equation estimates.

    Science.gov (United States)

    Risch, Lorenz; Saely, Christoph H; Neyer, Ulrich; Hoefle, Guenter; Gouya, Ghazaleh; Zerlauth, Manfred; Risch, Gerhard M; Risch, Martin; Drexel, Heinz

    2007-03-01

    Data on the prevalence of decreased glomerular filtration rate in Europe are limited. Most of the available studies did not employ laboratory methods providing creatinine concentrations traceable to the reference method, i.e. isotope dilution mass spectrometry (IDMS). We therefore conducted a cross-sectional study in the principality of Liechtenstein consecutively enrolling adult patients seeking non-nephrological medical care from whom serum samples were referred for renal function assessment. All measurements were done in one central laboratory. The estimated glomerular filtration rate (eGFR) was calculated based on the determination of IDMS-traceable creatinine by a kinetic Jaffe method (Roche Diagnostics, Switzerland) by means of the MDRD and Mayo Clinic quadratic equations. We further estimated the incidence of end stage renal disease during the next 5 years. For 43% (n=9378) of the entire population>or=25 years renal function assessment was available. An eGFR indicating chronic kidney disease (CKD) stages 3-5 was found in 4.93% when using the MDRD equation and in 3.98 % when using the Mayo Clinic quadratic equation. The two equations had a very good agreement in classifying patients to have an eGFR consistent with CKD stages 3-5 (Cohen's kappa 0.887). Further calculations suggested that among patients aged 80 or younger, annually 42 per 100,000 are going to develop an eGFR<15 ml/min/1.73 m2 over the next 5 years. 4-5% of patients seeking non-nephrological medical advice have an eGFR consistent with CKD stages 3-5, and a considerable number of subjects is expected to develop end stage renal disease over a 5 year period. In order to obtain comparable kidney function estimates among different institutions it is not only important to use standardized methods to measure creatinine but rather to employ standardized methods to calculate a GFR estimate.

  2. PERFORMANCE IMPROVEMENT OF CROSS-FLOW FILTRATION FOR HIGH LEVEL WASTE TREATMENT

    Energy Technology Data Exchange (ETDEWEB)

    Duignan, M.; Nash, C.; Poirier, M.

    2011-01-12

    In the interest of accelerating waste treatment processing, the DOE has funded studies to better understand filtration with the goal of improving filter fluxes in existing cross-flow equipment. The Savannah River National Laboratory (SRNL) was included in those studies, with a focus on start-up techniques, filter cake development, the application of filter aids (cake forming solid precoats), and body feeds (flux enhancing polymers). This paper discusses the progress of those filter studies. Cross-flow filtration is a key process step in many operating and planned waste treatment facilities to separate undissolved solids from supernate slurries. This separation technology generally has the advantage of self-cleaning through the action of wall shear stress created by the flow of waste slurry through the filter tubes. However, the ability of filter wall self-cleaning depends on the slurry being filtered. Many of the alkaline radioactive wastes are extremely challenging to filtration, e.g., those containing compounds of aluminum and iron, which have particles whose size and morphology reduce permeability. Unfortunately, low filter flux can be a bottleneck in waste processing facilities such as the Savannah River Modular Caustic Side Solvent Extraction Unit and the Hanford Waste Treatment Plant. Any improvement to the filtration rate would lead directly to increased throughput of the entire process. To date increased rates are generally realized by either increasing the cross-flow filter axial flowrate, limited by pump capacity, or by increasing filter surface area, limited by space and increasing the required pump load. SRNL set up both dead-end and cross-flow filter tests to better understand filter performance based on filter media structure, flow conditions, filter cleaning, and several different types of filter aids and body feeds. Using non-radioactive simulated wastes, both chemically and physically similar to the actual radioactive wastes, the authors performed

  3. 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

    International Nuclear Information System (INIS)

    Kim, Yangho; Lee, Byung-Kook

    2012-01-01

    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 m² (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 m² (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 μg/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.

  4. 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.

  5. Hemodinâmica glomerular renal no roedor Calomys callosus

    Directory of Open Access Journals (Sweden)

    Mirian A. Boim

    1989-03-01

    . This rodent presented a significant number of superficial glomeruli, allowing to evaluate glomerular hemodynamics and renal microcirculation parameters. Despite mean arterial pressure similar to the Munich- Wistar (MW rats, mean glomerular capillary hydraulic pressure was lower in Calomys callosum due to a lower post glomerular resistance in this rodent when compared to MW rats. The mean glomerular plasma flow rate was relatively elevated when compared with single nephron glomerular filtration rate, which in turn blunted the lower intraglomerular hydraulic pressure, and thus increased the single nephron glomerular filtration rate per g/kidney. The present work suggests that despite of the technical difficulties imposed by the reduced size of the Calomys callosus, the study of the renal function and glomerular hemodynamics is possible, establishing therefore, a model for the study such renal function.

  6. Flow fraction in charged rectangular microchannel to optimally design hydrodynamic filtration chip for cell sorting

    Science.gov (United States)

    Chun, Myung-Suk; Jeong, Sohyun; Kim, Jae Hun; Lee, Tae Seok

    2015-11-01

    Among the passive separations, hydrodynamic filtration (HDF) can perform the fractionation of cells or particles by selective extraction of streamlines controlled by the flow fraction at each branch. Only the stream near the sidewall enters the branches as the focusing, with the amount of fluid leaving the main channel being determined by the flow distribution related to the hydraulic flow resistances. Its understanding is important, but in-depth consideration has not been treated until now. The virtual boundary of the fluid layer should be first specified, and the parabolic velocity profile starts to form from the steady state flow with high Péclet numbers. We computed the 3-dimensional flow profile at the rectangular cross-section with any aspect ratios, by considering electrokinetic transport coupled with the Poisson-Boltzmann and Navier-Stokes equations. The chip was designed with the parameters rigorously determined by the complete analysis of laminar flow for flow fraction and complicated networks of main and multi-branched channels for cell sorting into the finite number of subpopulations. For potential applications to the precise sorting, our designed microfluidic chip can be validated by applying model cells consisting of heterogeneous subpopulations. Supported by the KIST Institutional Program (No. 2E25382).

  7. Glomerular Diseases

    Science.gov (United States)

    ... is called a glomerulus , which comes from the Greek word meaning filter. The plural form of the ... primary indicator of Alport syndrome is a family history of chronic glomerular disease, although it may also ...

  8. Agreement between Chronic Kidney Disease Epidemiological Collaboration and Berlin Initiative Study equations for estimating glomerular filtration rate in older people: The Invecchiare in Chianti (Aging in Chianti Region) study.

    Science.gov (United States)

    Corsonello, Andrea; Pedone, Claudio; Bandinelli, Stefania; Ferrucci, Luigi; Antonelli Incalzi, Raffaele

    2017-10-01

    The aim was to investigate to what extent chronic kidney disease (CKD) can be staged interchangeably by Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) and by Berlin Initiative Study (BIS) equations, and to verify whether cystatin C can improve concordance between formulas. Our series consisted of 828 community-dwelling individuals aged 65 years or older enrolled in the Invecchiare in Chianti Study ("Aging in the Chianti Region"). Estimated glomerular filtration rate was calculated using the creatinine-based CKD-EPI, creatinine/cystatin C-based CKD-EPI, creatinine-based BIS and creatinine/cystatin C-based BIS equations. Agreement and sources of discrepancy between equations in identifying people with different degrees of kidney dysfunction was investigated by κ statistic and Bland-Altman plots. Overall, CKD-EPI values were higher than that obtained with BIS equations, especially for eGFR = 30-60 mL/min/1.73 m 2 . A total of 191 out of 828 participants were classified in stage 2 by the creatinine-based CKD-EPI and in stage 3a by the creatinine-based BIS equation, whereas 123 participants were classified in stage 2 by creatinine/cystatin C-based CKD-EPI and in stage 3a by the creatinine/cystatin C-based BIS equation. A total of 27 participants were classified in stage 3a by creatinine-based CKD-EPI and in stage 3b by creatinine-based BIS equation, whereas 18 were classified as stage 3a by creatinine/cystatin C-based CKD-EPI and stage 3b by the creatinine/cystatin C-based BIS equation. Despite a fair overall concordance, the CKD-EPI and BIS equations cannot be considered interchangeable to assess estimated glomerular filtration rate in older people, and using creatinine/cystatin C-based rather than creatinine-based equations only marginally improves the concordance between CKD-EPI and BIS. Disagreement between equations might significantly impact the applications of stage-specific measures for managing CKD among older people

  9. Continuous enrichment of circulating tumor cells using a microfluidic lateral flow filtration chip.

    Science.gov (United States)

    Lee, Sung-Woo; Hyun, Kyung-A; Kim, Seung-Il; Kang, Ji-Yoon; Jung, Hyo-Il

    2015-01-16

    The isolation and characterization of circulating tumor cells (CTC) is of great importance in cancer diagnosis and prognosis. Highly sensitive detection of CTCs can be very difficult because they are extremely rare (i.e., 1-5 CTCs per 10(9) erythrocytes) in blood. Recently, various devices have been developed that exploit biochemical (affinity-based) and physical (size or density) methods. Antibody-based isolation has its own limitations, as the expression level of the epitopes for an antibody varies due to the heterogeneity of cancer cells. Harsh conditions associated with physical methods can cause the deformation and damage of CTCs during the isolation process. Here, we propose a microfluidic lateral flow filtration (μ-LaFF) chip in which lateral flow was combined with vertical flow into the filter to capture the CTCs gently. The CTCs experienced weak shear flow owing to the lateral flow and traveled alongside the filter channel until finally being captured. The vertical flow in the filter held the captured cells tightly and served as an exit for uncaptured hematological cells (white and red blood cells). From our μ-LaFF chip we obtained a high capture efficiency (95%) and purity (99%), minimizing any damage to the CTCs. Our μ-LaFF technology is expected to be useful in the diagnosis and prognosis of various cancers. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Determination and clinical significance of renal filtration fraction in nephrogenic hypertension

    International Nuclear Information System (INIS)

    Karaev, M.Eh.; Figarov, I.G.; Samedov, R.N.; Grigor'ev, O.N.

    1989-01-01

    The effective renal plasma flow (ERPF), the rate of glomerular filtration and filtration fraction were investigated in 48 patients with nephrogenic hypertension (NH) using the method of dynamic renoscintigraphy with a double label ( 131 I-hippuran and 99m Tc-DTPA). The proposed method of noninvasive combined assessment of renal function was shown to be simple to perform and permitted the determination of a degree of involvement of the glomerular and tubular apparatus of the kidneys in NH. The comparison of renoscintigraphic and histomorphological results made it possible to determine renoscintigraphic criteria of glomerulo- and nephrosclerosis

  11. Decreased glomerular filtration rate and markers of kidney damage persisting for more than three months in a sample of biochemistry students of the Universidad Nacional del Litoral (Santa Fe, Argentine. 2014-2015

    Directory of Open Access Journals (Sweden)

    Cecilia Brissón

    2016-06-01

    Full Text Available Introduction: Early stages of chronic kidney disease (CKD are asymptomatic and patients may ignore their condition or discover it in a routine medical consultation or because of the consultation about other disease. CKD high global prevalence is accepted. Reliable data is needed to provide evidence and knowledge about the disease in the region. Methods: Descriptive study. 81 students. Period May 2014 to December 2015. Glomerular Filtration Rate, GFR, was estimated by CKD-EPI and creatinine clearance. Kidney damage was determined in 1st morning urine: test strip and urinary sediment and proteinuria. Students with GFR 150 mg/24 h; 8.6% hematuria and 1.2% cylindruria, isolated or combined with GFR<60 ml/min/1.73m2 and 1.2% had GFR <60 ml/min/1.73m2. At 3 months reevaluation persistent findings were seen in 11.2% of the subjects studied. Conclusions: The high proportion of apparently healthy young people with persistent impaired renal function or markers of renal damage in a follow-up greater than 3 months provides an evidence of the magnitude of the CKD problem.

  12. Combined heart-kidney transplant improves post-transplant survival compared with isolated heart transplant in recipients with reduced glomerular filtration rate: Analysis of 593 combined heart-kidney transplants from the United Network Organ Sharing Database.

    Science.gov (United States)

    Karamlou, Tara; Welke, Karl F; McMullan, D Michael; Cohen, Gordon A; Gelow, Jill; Tibayan, Frederick A; Mudd, James M; Slater, Matthew S; Song, Howard K

    2014-01-01

    Criteria for simultaneous heart-kidney transplant (HKTx) recipients are unclear. We characterized the evolution of combined HKTx in the United States over time compared with isolated heart transplantation (HTx) and determined factors maximizing post-transplant survival. We focused on whether a threshold estimated glomerular filtration rate (eGFR) could be identified that justified combined transplantation. A supplemented United Network Organ Sharing Dataset identified HTx and HKTx recipients from 2000 to 2010. eGFR was calculated for HTx and recipients were grouped into eGFR quintiles. Time-related mortality was compared among recipients, with multivariable factors sought using Cox proportional hazard regression models. We identified 26,183 HTx recipients, of whom 593 were HKTx recipients. HTx increased modestly over time (3.6%), whereas prevalence of HKTx increased dramatically (147%). Risk-unadjusted survival was similar among HTx recipients (8.4 ± 0.04 years) and HKTx recipients (7.7 ± 0.2 years) (P = .76). Isolated HTx recipients in the lowest eGFR quintile had decreased survival (P transplant survival in patients with eGFR <37 mL/minute and can be recommended in this subgroup. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  13. The Comparative Study of the Measurement of Serum Cystatin C and 99mTc-DTPA for the Measurement of Glomerular Filtration Rate (GFR) in Type 2 Diabetic Nephropathy

    International Nuclear Information System (INIS)

    Kong Linghua; Wu Junyuan; Gao Bin; Wang Xueqin; Gu Kaikai

    2010-01-01

    To explore the clinical value between measurement of serum cystatin C (Cys C) and determination of plasma with 99m Tc-DTPA glomerular filtration rate (GFR) clearance for type 2 diabetes (T2DM) in early detection of renal damage, the serum cystatin C levels in 87 patients with type 2 diabetes were determined by immune turbidimetry Cys C. The patients were also carried out dynamic imaging to measure renal GFR. The result showed that the serum levels of Cys C in patients with Type 2 diabetic was 1.68 ± 0.52 mg / L, the normal group was 0.72±0.26 mg/L; The GFR in patients with T2DM was 93.8 ± 30.2 ml/min/1.73m 2 , the control group was 107.48±15.23 ml/min/1.73m 2 , there was significant difference between patients and controls (P 99m Tc-DTPA renal dynamic imaging. The serum Cys C could reflect the damage in early diabetic patients. The method is simple, accurate and easy to spread. The renal dynamic imaging method of GFR determination is slightly complex and requires specialized equipment. It can reflect the sub-renal function. The combined measurement of serum Cys C and GFR are very important in the early detection of type 2 diabetic patients with early renal function. (authors)

  14. Performance in adolescents of the two Japanese serum creatinine based estimated glomerular filtration rate equations, for adults and paediatric patients: A study of the Japan Renal Biopsy Registry and Japan Kidney Disease Registry from 2007 to 2013.

    Science.gov (United States)

    Uemura, Osamu; Yokoyama, Hitoshi; Ishikura, Kenji; Gotoh, Yoshimitsu; Sato, Hiroshi; Sugiyama, Hitoshi; Honda, Masataka; Matsuo, Seiichi

    2017-06-01

    There are two different Japanese serum creatinine-based equations for estimated glomerular filtration rate (eGFR), for adults and paediatric patients, with both equations deemed applicable to 18-year-old subjects. This study assessed the relative accuracy of the two equations in assessing eGFR in patients aged 18 years with chronic kidney disease. A total of 3042 patients (1679 males and 1363 females), aged 2-20 years, who were registered in the Japan Renal Biopsy Registry or the Japan Kidney Disease Registry between 2007 and 2013 were evaluated. eGFR values derived from formulas for children (Uemura's formula) and adults (the 3-variable Japanese formula) were calculated and compared, especially in patients aged 18 years. At all ages, but especially at younger ages, eGFR was significantly higher when calculated with the adult than the paediatric formula. This finding was also observed in 18-year-old adolescents with eGFR creatinine-based equations used to calculate eGFR rate in Japanese children and adults with chronic kidney disease could be used to determine eGFR in 18-year-old subjects, with the difference between the two within permissible levels for clinical use. © 2017 Asian Pacific Society of Nephrology.

  15. Detection of circulating microparticles by flow cytometry: influence of centrifugation, filtration of buffer, and freezing.

    Science.gov (United States)

    Dey-Hazra, Emily; Hertel, Barbara; Kirsch, Torsten; Woywodt, Alexander; Lovric, Svjetlana; Haller, Hermann; Haubitz, Marion; Erdbruegger, Uta

    2010-12-06

    The clinical importance of microparticles resulting from vesiculation of platelets and other blood cells is increasingly recognized, although no standardized method exists for their measurement. Only a few studies have examined the analytical and preanalytical steps and variables affecting microparticle detection. We focused our analysis on microparticle detection by flow cytometry. The goal of our study was to analyze the effects of different centrifugation protocols looking at different durations of high and low centrifugation speeds. We also analyzed the effect of filtration of buffer and long-term freezing on microparticle quantification, as well as the role of Annexin V in the detection of microparticles. Absolute and platelet-derived microparticles were 10- to 15-fold higher using initial lower centrifugation speeds at 1500 × g compared with protocols using centrifugation speeds at 5000 × g (P centrifugation speeds. Filtration of buffer with a 0.2 μm filter reduced a significant amount of background noise. Storing samples for microparticle detection at -80°C decreased microparticle levels at days 28, 42, and 56 (P centrifugation speeds should be used to minimize contamination by smaller size platelets.

  16. Application of Cross-Flow Filtration Technique in Purification and Concentration of Juice from Vietnamese Fruits

    Directory of Open Access Journals (Sweden)

    Huynh Cang Mai

    2017-09-01

    Full Text Available This study is to offer a 1st insight in the use of membrane process for the purification and concentration of Vietnamese fruit juices: cashew apple (Anacardium occidentale Line., dragon fruit (Cactus hémiépiphytes, pineapple (Ananas comosus, pomelo (Citrus grandis L., and gac aril oil (Momordica cochinchinensis Spreng.. On a laboratory scale, the effect of different operating parameters such as trans-membrane pressures (TMP, temperature and membrane pore sizes on permeate flux was determined in order to optimize process conditions that would ensure acceptable flux with adequate juice quality. The quality of the samples coming from the ultrafiltration (UF process was evaluated in terms of: total soluble solids (TSS, suspended solids (SS, and vitamin C. For example, the purification process of cashew apple juice by cross-flow filtration was optimized at 0.5 μm membrane pore size, 2.5 bars TMP, and 60 min filtration time. Besides, this technique was applied to enhance carotenoids concentration from gac oil. Optimum conditions for a high permeate flux and a good carotenoids retention are 5 nm, 2 bars, and 40 °C of membrane pore size, TMP, and temperature, respectively. Carotenoids were concentrated higher than that in feeding oil.

  17. Detection of circulating microparticles by flow cytometry: influence of centrifugation, filtration of buffer, and freezing

    Science.gov (United States)

    Dey-Hazra, Emily; Hertel, Barbara; Kirsch, Torsten; Woywodt, Alexander; Lovric, Svjetlana; Haller, Hermann; Haubitz, Marion; Erdbruegger, Uta

    2010-01-01

    The clinical importance of microparticles resulting from vesiculation of platelets and other blood cells is increasingly recognized, although no standardized method exists for their measurement. Only a few studies have examined the analytical and preanalytical steps and variables affecting microparticle detection. We focused our analysis on microparticle detection by flow cytometry. The goal of our study was to analyze the effects of different centrifugation protocols looking at different durations of high and low centrifugation speeds. We also analyzed the effect of filtration of buffer and long-term freezing on microparticle quantification, as well as the role of Annexin V in the detection of microparticles. Absolute and platelet-derived microparticles were 10- to 15-fold higher using initial lower centrifugation speeds at 1500 × g compared with protocols using centrifugation speeds at 5000 × g (P centrifugation speeds. Filtration of buffer with a 0.2 μm filter reduced a significant amount of background noise. Storing samples for microparticle detection at −80°C decreased microparticle levels at days 28, 42, and 56 (P centrifugation speeds should be used to minimize contamination by smaller size platelets. PMID:21191433

  18. Mathematical models of membrane fouling in cross-flow micro-filtration

    Directory of Open Access Journals (Sweden)

    Mónica Jimena Ortíz Jerez

    2008-01-01

    Full Text Available The greatest difficulty arising during cross-flow micro-filtration is the formation of a cake layer on the membrane sur-face (also called fouling, thereby affecting system performance. Fouling has been related to permeate flux decay re-sulting from changes in operating variables. Many articles have been published in an attempt to explain this phe-nomenon but it has not yet been fully understood because it depends on specific solution/membrane interactions and differing parameters. This work was aimed at presenting an analytical review of recently published mathematical models to explain fouling. Although the reviewed models can be adjusted to any type of application, a simple “con-centration polarisation” model is advisable in the particular case of tropical fruit juices for describing the insoluble solids being deposited on membrane surface.

  19. Combination of electroflotation process and down-flow granular filtration to treat wastewater contaminated with oil.

    Science.gov (United States)

    Nonato, Thyara Campos Martins; Schöntag, Juliana Marques; Burgardt, Tiago; Alves, Alcione Aparecida de Almeida; Broock, William Flores; Dalsasso, Ramon Lucas; Sens, Maurício Luiz

    2018-03-01

    One of the main problems faced by the oil industry is related to the amount of produced water generated during the oil extraction process. For proper disposal of this effluent, treatment processes should be applied to meet the requirements established by environmental agencies. Thus, the present study aimed to evaluate the efficiency of the combination of electroflotation process and down-flow granular filtration in the treatment of wastewater contaminated with oil. To this end, they were studied in a pilot system, to optimize the electroflotation process and combination of processes. The performance of the pilot system was determined by removal of oil and grease content (OG) in the treated effluent. According to the results, the electroflotation process had the best performance with an effluent input rate of 62 m 3  m -2  d -1 , current density of 80 A m -2 and NaCl concentration of 7900 mg L -1 . Under these conditions, the mean removal of OG from synthesized solution after 720 minutes of treatment was 86.64% (59.51 mg L -1 ) for the electroflotation process and 61.52% (12.91 mg L -1 ) after down-flow granular filtration. By combining the processes studied, we obtained an initial OG removal (470.55 mg L -1 ) of over 98% (6.42 mg L -1 ) in 720 minutes of treatment, with an energy consumption of the electrochemical reactor of 1.47 kWh m -3 . ANOVA: analysis of variance; CCRD: Central Composite Rotational Delineation; DOC: dissolved organic carbon; DSA: dimensionally stable anodes; LAPOA: Laboratory of Water Potabilization; OG: oil and grease; OPER: operating parameters of the electrochemical reactor; TDS: total dissolved solids; UFSC: Federal University of Santa Catarina.

  20. Short-term resistance training with blood flow restriction enhances microvascular filtration capacity of human calf muscles.

    Science.gov (United States)

    Evans, Colin; Vance, Steven; Brown, Maggie

    2010-07-01

    Resistance training increases muscle strength and endurance but may require high intensity and long duration to enhance capillarity. Vascular occlusion during low-load resistance training augments the strength and endurance gains compared with low-load resistance training alone, but in this study we investigated whether it also promotes microvascular filtration capacity, an index of capillarity. Nine healthy males performed short-term low-intensity resistance training of the calf muscles (four sets of 50 heel raises, three times a week for 4 weeks) under restricted (thigh cuff inflated to 150 mmHg on the non-dominant leg) or unrestricted (dominant leg without thigh cuff) blood flow conditions. Before and after resistance training, calf filtration capacity and resting blood flow were assessed by strain gauge plethysmography, and calf muscle strength and fatigue were assessed respectively by maximal voluntary contraction and force decline during electrically evoked ischaemic contractions in both legs. Calf filtration capacity increased by 26% in the restricted leg but did not increase significantly in the unrestricted leg. Calf muscle strength was 18% greater in the restricted leg but unchanged in the unrestricted leg. Calf muscle fatigue and resting blood flow did not change in either leg. Resistance training promoted microvascular filtration capacity, an effect that was somewhat enhanced by blood flow restriction, and could be due to increased capillarization.

  1. Fast response filter module with plug flow of filtrate for on-line sampling from submerged cultures of filamentous fungi

    NARCIS (Netherlands)

    Poulsen, B.R.; Ruijter, G.J.G.; Panneman, H.; Iversen, J.J.L.; Visser, J.

    2004-01-01

    Automatic and accurate sampling is both convenient and sometimes necessary to obtain detailed information about cell cultures. We developed an autoclavable sampling system in which culture broth was pumped through an ultrafiltration cross-flow module with a novel filtrate collecting principle and a

  2. Soil and Waste Matrix Affects Spatial Heterogeneity of Bacteria Filtration during Unsaturated Flow

    Directory of Open Access Journals (Sweden)

    Adrian Unc

    2015-02-01

    Full Text Available Discontinuous flows resulting from discrete natural rain events induce temporal and spatial variability in the transport of bacteria from organic waste through soils in which the degree of saturation varies. Transport and continuity of associated pathways are dependent on structure and stability of the soil under conditions of variable moisture and ionic strength of the soil solution. Lysimeters containing undisturbed monoliths of clay, clay loam or sandy loam soils were used to investigate transport and pathway continuity for bacteria and hydrophobic fluorescent microspheres. Biosolids, to which the microspheres were added, were surface applied and followed by serial irrigation events. Microspheres, Escherichia coli, Enterococcus spp., Salmonella spp. and Clostridium perfringens were enumerated in drainage collected from 64 distinct collection areas through funnels installed in a grid pattern at the lower boundary of the monoliths. Bacteria-dependent filtration coefficients along pathways of increasing water flux were independent of flow volume, suggesting: (1 tracer or colloid dependent retention; and (2 transport depended on the total volume of contiguous pores accessible for bacteria transport. Management decisions, in this case resulting from the form of organic waste, induced changes in tortuosity and continuity of pores and modified the effective capacity of soil to retain bacteria. Surface application of liquid municipal biosolids had a negative impact on transport pathway continuity, relative to the solid municipal biosolids, enhancing retention under less favourable electrostatic conditions consistent with an initial increase in straining within inactive pores and subsequent by limited re-suspension from reactivated pores.

  3. Initial formal toxicity evaluation of APC-2, a novel fluorescent tracer agent for real-time measurement of glomerular filtration rate in preparation for a first-in-man clinical trial

    Science.gov (United States)

    Bugaj, Joseph E.; Dorshow, Richard B.

    2014-03-01

    The fluorescent tracer agent 2,5-bis[N-(1-carboxy-2-hydroxy)]carbamoyl-3,6-diaminopyrazine, designated APC-2, has been developed with properties and attributes necessary for use as a direct measure of glomerular filtration rate (GFR). Comparison to known standard exogenous GFR agents in animal models has demonstrated an excellent correlation. A clinical trial to demonstrate this same correlation in humans is in preparation. A battery of formal toxicity tests necessary for regulatory clearance to proceed with a clinical trial has been recently completed on this new fluorescent tracer agent. These include single dose toxicity studies in rats and dogs to determine overall toxicity and toxicokinetics of the compound. Blood compatibility, mutation assay, chromosomal aberration assay, and several other assays were also completed. Toxicity assessments were based on mortality, clinical signs, body weight, food consumption and anatomical pathology. Blood samples were collected to assess pharmacokinetic parameters including half-life, area under the curve, and clearance. Urine samples were collected to assess distribution. Doses of up to 200-300 times the estimated human dose were administered. No test-article related effects were noted on body weight, food consumption, ophthalmic observations and no abnormal pathology was seen in either macroscopic or microscopic evaluations of any organs or tissues. All animals survived to scheduled sacrifice. Transient discoloration of skin and urine was noted at the higher dose levels in both species as expected from a highly fluorescent compound and was not considered pathological. Thus initial toxicology studies of this new fluorescent tracer agent APC-2 have resulted in no demonstrable pathological test article concerns.

  4. 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.

  5. Prognostic comparison between creatinine-based glomerular filtration rate formulas for the prediction of 10-year outcome in patients with non-ST elevation acute coronary syndrome treated by percutaneous coronary intervention.

    Science.gov (United States)

    Ballo, Piercarlo; Chechi, Tania; Spaziani, Gaia; Fibbi, Veronica; Conti, Duccio; Ferro, Giuseppe; Nigrelli, Santi; Dattolo, Pietro; Fazi, Antonio; Santoro, Giovanni Maria; Zuppiroli, Alfredo; Pizzarelli, Francesco

    2017-03-01

    Estimated glomerular filtration rate (eGFR) is a predictor of outcome among patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), but which estimation formula provides the best long-term risk stratification in this setting is still unclear. We compared the prognostic performance of four creatinine-based formulas for the prediction of 10-year outcome in a NSTE-ACS population treated by percutaneous coronary intervention. In 222 NSTE-ACS patients submitted to percutaneous coronary intervention, eGFR was calculated using four formulas: Cockcroft-Gault, re-expressed modification of diet in renal disease (MDRD), chronic kidney disease epidemiology collaboration (CKD-Epi), and Mayo-quadratic. Predefined endpoints were all-cause death and a composite of cardiovascular death, non-fatal reinfarction, clinically driven repeat revascularisation, and heart failure hospitalisation. The different eGFR values showed poor agreement, with prevalences of renal dysfunction ranging from 14% to 35%. Over a median follow-up of 10.2 years, eGFR calculated by the CKD-Epi and Mayo-quadratic formulas independently predicted outcome, with an increase in the risk of death and events by up to 17% and 11%, respectively, for each decrement of 10 ml/min/1.73 m 2 . The Cockcroft-Gault and MDRD equations showed a borderline association with mortality and did not predict events. When compared in terms of goodness of fit, discrimination and calibration, the Mayo-quadratic outperformed the other formulas for the prediction of death and the CKD-Epi showed the best performance for the prediction of events (net reclassification improvement values 0.33-0.35). eGFR is an independent predictor of long-term outcome in patients with NSTE-ACS treated by percutaneous coronary intervention. The Mayo-quadratic and CKD-Epi equations might be superior to classic eGFR formulas for risk stratification in these patients.

  6. 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.

  7. Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease Epidemiology Collaboration equations for estimating glomerular filtration rates in cancer patients receiving cisplatin-based chemotherapy.

    Science.gov (United States)

    Rhee, Jiyoung; Kwon, Jung Mi; Han, Sang Hoon; Kim, Sun Hyung; Park, Chang Hyun; Jeon, Ji Hyeon; Cho, Jong Tae; Lee, Eun Kyoung; Kim, So Mi

    2017-12-01

    Although the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has been recommended for accurate estimates of glomerular filtration rate (eGFR), there is little information regarding differences in GFR estimates obtained using the Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) equations in East Asian cancer patients. We investigated discrepancies in GFR and toxicities in patients treated with cisplatin-based chemotherapy using three equations equations. A total of 229 patients were retrospectively recruited. We calculated eGFR using the three equations and separated patients into three categories based on GFR 50 (group C) mL/min/1.73m 2 . We analyzed chemotherapy toxicities. The mean eGFR calculated using the CG was the lowest of the values derived using the three equations. Estimates using the MDRD and CKD-EPI equations resulted in reclassifying 32 (71.1%) and 33 (73.3%) of 45 patients, originally placed in group B using the CG into group C. However, only 1 (7.7%) of 13 patients placed in group B using the MDRD were reclassified into group C using the CKD-EPI. Twenty-eight of 45 patients classified into group B using the CG equation were treated with reduced doses of cisplatin. However, these patients did not show significant differences in toxicities compared with other patients taking full doses of cisplatin. The CG equations underestimated GFR compared to the MDRD and CKD-EPI equations. Therefore, when GFR is estimated using CG equations, East Asian cancer patients may receive insufficient doses of chemotherapeutic agents, including cisplatin.

  8. 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.

  9. 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- (eGFR cystatin C ) and a creatinine-based (eGFR creatinine ) 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 eGFR cystatin C and eGFR creatinine plays a pivotal role in the diagnosis of Shrunken Pore Syndrome, where low eGFR cystatin C compared to eGFR creatinine 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 eGFR cystatin C and a eGFR creatinine 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 eGFR cystatin and eGFR creatinine may help identify pediatric patients with Shrunken Pore Syndrome.

  10. 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.

  11. Relationship between renal volume calculated by using multislice computed tomography and glomerular filtration rate calculated by using the Cockcroft-Gault and modification of diet in renal disease equations in living kidney donors.

    Science.gov (United States)

    Adibi, Atoosa; Mortazavi, Mojgan; Shayganfar, Azin; Kamal, Sima; Azad, Roya; Aalinezhad, Marzieh

    2016-01-01

    It is essential to ascertain the state of health and renal function of potential kidney donors before organ removal. In this regard, one of the primary steps is to estimate the donor's glomerular filtration rate (GFR). For this purpose, the modification of diet in renal disease (MDRD) and the Cockcroft-Gault (CG) formulas has been used. However, these two formulas produce different results and finding new techniques with greater accuracy is required. Measuring the renal volume from computed tomography (CT) scan may be a valuable index to assess the renal function. This study was conducted to investigate the correlation between renal volume and the GFR values in potential living kidney donors referred to the multislice imaging center at Alzahra Hospital during 2014. The study comprised 66 subjects whose GFR was calculated using the two aforementioned formulas. Their kidney volumes were measured by using 64-slice CT angiography and the correlation between renal volume and GFR values were analyzed using the Statistical Package for the Social Science software. There was no correlation between the volume of the left and right kidneys and the MDRD-based estimates of GFR (P = 0.772, r = 0.036, P = 0.251, r = 0.143, respectively). A direct linear correlation was found between the volume of the left and right kidneys and the CG-based GFR values (P = 0.001, r = 0.397, P kidney volume derived from multislice CT scan can help predict the GFR value in kidney donors with normal renal function. The limitations of our study include the small sample size and the medium resolution of 64-slice multislice scanners. Further studies with larger sample size and using higher resolution scanners are warranted to determine the accuracy of this method in potential kidney donors.

  12. 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.

  13. Using the developed cross-flow filtration chip for collecting blood plasma under high flow rate condition and applying the immunoglobulin E detection

    International Nuclear Information System (INIS)

    Yeh, Chia-Hsien; Hung, Chia-Wei; Lin, Yu-Cheng; Wu, Chun-Han

    2014-01-01

    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. (paper)

  14. Systematic analysis of silver nanoparticle ionic dissolution by tangential flow filtration: toxicological implications.

    Science.gov (United States)

    Maurer, Elizabeth I; Sharma, Monita; Schlager, John J; Hussain, Saber M

    2014-11-01

    In the field of toxicology of nanomaterials, scientists have not clearly determined if the observed toxicological events are due to the nanoparticles (NPs) themselves or the dissolution of ions released into the biophysiological environment or both phenomenon participate in combination based upon their bioregional and temporal occurrence during exposure conditions. Consequently, research involving the toxicological analysis of silver NPs (Ag-NPs) has shifted towards assessment of 'nanosized' silver in comparison to its solvated 'ionic' counterpart. Current literature suggests that dissolution of ions from Ag-NPs may play a key role in toxicity; however, the present assessment methodology to separate ions from NPs still requires improvement before a definitive cause of toxicity can be determined. Recently, centrifugation-based techniques have been employed to obtain solvated ions from the NP solution, but this approach leads to NP agglomeration, making further toxicological analysis difficult to assess. Additionally, extremely small NPs are retained in the supernatant even after ultracentrifugation, leading to incomplete separation of ions from their respective NPs. To address these complex toxicology issues we applied enhanced separation techniques with the aim to study levels of ions originating from the Ag-NP using separation by a recirculating tangential flow filtration system. This system uses a unique diffusion-driven filtration method that retains large particles within the continuous flow path, while allowing the solution (ions) to pass through molecular filters by lateral diffusion separation. Use of this technique provides reproducible NP separation from their solvated ions which permits for further quantification using an inductively coupled plasma mass spectrometry or comparison use in bioassay exposures to biological systems. In this study, we thoroughly characterised NPs in biologically relevant solutions to understand the dissolution of Ag-NPs (10 and

  15. Rheological Influence Upon the Glomerular Podocyte and Resultant Mechanotransduction

    Directory of Open Access Journals (Sweden)

    Simona Pichler Sekulic

    2015-03-01

    Full Text Available The glomerular podocyte is exposed to numerous mechanical forces as a constituent of the glomerular filtration apparatus. This includes fluid shear stress (FSS displaced upon the podocytic foot process's apical, lateral, and basal surfaces. Even in the face of continuous flow the podocyte is capable of contributing to physiologic filtration, however with pathologic levels of hyperfiltration there is increased FSS placed upon the cell. The mechanisms by which the podocyte detects and responds to FSS are topics of recent investigations, with the aim to clarify the way these cells are injured and/or adapt in times of hyperfiltration and disease states. As the pathogenesis of numerous glomerulopathies is contingent on the status of the podocyte, understanding the manner that these cells can be modified by FSS is essential. Likewise, determination of the effect of such mechanical forces upon other resident cells of the renal corpuscle would reveal the contribution of FSS in the progression of glomerular diseases. The biochemical manner in which podocytes sense and respond to FSS, that is mechanotransduction, will be discussed.

  16. Purification of infectious adenovirus in two hours by ultracentrifugation and tangential flow filtration

    International Nuclear Information System (INIS)

    Ugai, Hideyo; Yamasaki, Takahito; Hirose, Megumi; Inabe, Kumiko; Kujime, Yukari; Terashima, Miho; Liu, Bingbing; Tang, Hong; Zhao, Mujun; Murata, Takehide; Kimura, Makoto; Pan, Jianzhi; Obata, Yuichi; Hamada, Hirofumi; Yokoyama, Kazunari K.

    2005-01-01

    Adenoviruses are excellent vectors for gene transfer and are used extensively for high-level expression of the products of transgenes in living cells. The development of simple and rapid methods for the purification of stable infectious recombinant adenoviruses (rAds) remains a challenge. We report here a method for the purification of infectious adenovirus type 5 (Ad5) that involves ultracentrifugation on a cesium chloride gradient at 604,000g for 15 min at 4 deg C and tangential flow filtration. The entire procedure requires less than two hours and infectious Ad5 can be recovered at levels higher than 64% of the number of plaque-forming units (pfu) in the initial crude preparation of viruses. We have obtained titers of infectious purified Ad5 of 1.35 x 10 10 pfu/ml and a ratio of particle titer to infectious titer of seven. The method described here allows the rapid purification of rAds for studies of gene function in vivo and in vitro, as well as the rapid purification of Ad5

  17. Retrospective study of renal distribution volume with DTPA-{sup 99m}Tc: performance of single plasma method for glomerular filtration rate estimation; Etude retrospective du volume de distribution du traceur renal DTPA-{sup 99m}Tc: performance d`une methode a un prelevement sanguin pour l`estimation du debit de filtration glomerulaire

    Energy Technology Data Exchange (ETDEWEB)

    Legendre, J.M.; Cledes, J.; Morin, J.F.; Morin, P.P. [Centre Hospitalier Regional Augustin-Morvan, 29 - Brest (France)

    1997-08-01

    169 glomerular filtration rate (GFR) measurements, performed in clinical practice, were analysed for estimation of GFR by several common methods. In one half of patients, we observed that early (2-3-4 hours) and tardive (3-4-5 hours) three point plasma methods were highly correlated, r = 0,998 (n = 82). Even if regression line significantly differed from identify, differences between methods were low (-6, 1 to + 4,4 mL/min/1,73 m{sup 2}). Method with urinary collection was also correlated to plasma methods (r = 0,920 in both cases). Plasma based mean values were higher than that for urinary by 3,6 mL/min/1,73 m{sup 2} (2-3-4 hours) and 3, 1 (3-4-5 hours). Using plasma GFR values and distribution volume, linear and quadratic regressions were tested for GFR = f (V) and GFR = f (In (V)). The lowest observed standard deviation (3,6 mL/min; n = 82) was for GFR{sub 234} = f (V{sub 4h}) using a quadratic equation. This was applied to the second patient group for GFR estimation with 4 hours single point plasma method. Estimations were compared to GFR plasma values. For comparison, GFR estimations were also obtained using the Christensen`s equation. (authors). 17 refs.

  18. Determination of glomerular filtration rate with radionuclide ...

    African Journals Online (AJOL)

    Direct urinary activity quantitation was done in patients scheduled for routine radionuclide renography and compared to standard multiple-blood-sample techniques by means of Cr-51-EDTA and Tc-99m-DTPA. Setting. Academic Medical Complex, Department of Nuclear Medicine, Universitas Hospital, Bloemfontein.

  19. The Modification of Diet in Renal Disease 4-calculated glomerular filtration rate is a better prognostic factor of cardiovascular events than classical cardiovascular risk factors in patients with peripheral arterial disease.

    Science.gov (United States)

    Romero, Jose-María; Bover, Jordi; Fite, Joan; Bellmunt, Sergi; Dilmé, Jaime-Félix; Camacho, Mercedes; Vila, Luis; Escudero, Jose-Román

    2012-11-01

    Risk prediction is important in medical management, especially to optimize patient management before surgical intervention. No quantitative risk scores or predictors are available for patients with peripheral arterial disease (PAD). Surgical risk and prognosis are usually based on anesthetic scores or clinical evaluation. We suggest that renal function is a better predictor of risk than other cardiovascular parameters. This study used the four-variable Modification of Diet in Renal Disease (MDRD-4)-calculated glomerular filtration rate (GFR) to compare classical cardiovascular risk factors with prognosis and cardiovascular events of hospitalized PAD patients. The study evaluated 204 patients who were admitted for vascular intervention and diagnosed with grade IIb, III, or IV PAD or with carotid or renal stenosis. Those with carotid or renal stenosis were excluded, leaving 188 patients who were randomized from 2004 to 2005 and monitored until 2010. We performed a life-table analysis with a 6-year follow-up period and one final checkpoint. The following risk factors were evaluated: age, sex, ischemic heart disease, ictus (as a manifestation of cerebrovascular disease related to systemic arterial disease), diabetes, arterial hypertension, dyslipidemia, smoking, chronic obstructive pulmonary disease, type of vascular intervention, and urea and creatinine plasma levels. The GFR was calculated using the MDRD-4 equation. Death, major cardiovascular events, and reintervention for arterial disease were recorded during the follow-up. Patients (73% men) were a mean age of 71.38 ± 11.43 (standard deviation) years. PAD grade IIb was diagnosed in 41 (20%) and grade III-IV in 147 (72%). Forty-two minor amputations (20.6%), 21 major amputations (10.3%), and 102 revascularizations (50%) were performed. A major cardiovascular event occurred in 60 patients (29.4%), and 71 (34.8%) died. Multivariate logistic regression analysis showed that the MDRD-4 GFR, age, and male sex were

  20. Changes in serum creatinine, uric acid, creatine kinase, and glomerular filtration rate in street runners. http://dx.doi.org/10.5007/1980-0037.2013v15n1p71

    Directory of Open Access Journals (Sweden)

    Anderson Pontes Morales

    2013-01-01

    Full Text Available The strategies adopted by street runners during races are influenced by the distance of the race as well as the technical and physical condition levels of the runners. The objective of this study was to examine the biochemical effects of Creatinine (C, Uric Acid (UA, Creatine Kinase (CK, and of the Glomerular Filtration Rate (GFR caused by a 6-kilometer street race. The participants (n=15 were all male athletes (40.53±8.65 years and were divided into 3 groups: Group 1 Best Times (G1MT n=5, Group 2 Intermediate Times (G2TI n=5, Group 3 Worst Times (G3PT n=5. Blood samples were collected 30 minutes before and immediately after the race. The data was analyzed by Two-Way ANOVA, Wilcoxon, and Mann Whitney. Significant levels were considered as (p<0.05. The results showed that there were significant intragroup increases in serum activities of (C in G1MT pre: 1.18±0.04 mg.dL-¹ post: 1.60±0.15 mg.dL-¹; G2TI pre: 1.04±0.15 mg.dL-¹ post: 1.56±0.21 mg.dL-¹; G3PT pre 1.08±0.13 mg.dL-¹ post 1.52±0.32 mg.dL-¹, and in (AU G1MT pre: 3.80±0.75 mg.dL-¹ post 4.56±0.94 mg.dL-¹; G2TI pre 4.36±1.62 mg.dL-¹ post 5.0±1.69 mg.dL-¹; G3PT pre 4.62±1.08 mg.dL-¹ post: 5.42±0.86 mg.dL-¹, while CK and GFR did not show any significant difference.

  1. Protein Diet Restriction Slows Chronic Kidney Disease Progression in Non-Diabetic and in Type 1 Diabetic Patients, but Not in Type 2 Diabetic Patients: A Meta-Analysis of Randomized Controlled Trials Using Glomerular Filtration Rate as a Surrogate.

    Science.gov (United States)

    Rughooputh, Mahesh Shumsher; Zeng, Rui; Yao, Ying

    2015-01-01

    Studies, including various meta-analyses, on the effect of Protein Diet Restriction on Glomerular Filtration Rate (GFR) in Chronic Kidney Disease (CKD) have reported conflicting results. In this paper, we have provided an update on the evidence available on this topic. We have investigated the reasons why the effect has been inconsistent across studies. We have also compared the effect on GFR in various subgroups including type 1 diabetics, type 2 diabetics and non-diabetics. We searched for Randomized Controlled Trials on this intervention from MEDLINE, EMBASE, and other information sources. The PRISMA guidelines, as well as recommended meta-analysis practices were followed in the selection process, analysis and reporting of our findings. The effect estimate used was the change in mean GFR. Heterogeneity across the considered studies was explored using both subgroup analyses and meta-regression. Quality assessment was done using the Cochrane risk of bias tool and sensitivity analyses. 15 randomized controlled trials, including 1965 subjects, were analyzed. The pooled effect size, as assessed using random-effects model, for all the 15 studies was -0.95 ml/min/1.73m2/year (95% CI: -1.79, -0.11), with a significant p value of 0.03. The combined effect estimate for the non-diabetic and type 1 diabetic studies was -1.50 ml/min/1.73m2/year (95% CI: -2.73, -0.26) with p value of 0.02. The effect estimate for the type 2 diabetic group was -0.17 ml/min/1.73m2/year (95% CI: -1.88, 1.55) with p value of 0.85. There was significant heterogeneity across the included studies (I2 = 74%, p value for Q diabetic subjects, the number of subjects and overall compliance level to diet prescribed. Our findings suggest that protein diet restriction slows chronic renal disease progression in non-diabetic and in type 1 diabetic patients, but not in type 2 diabetic patients.

  2. Glomerular filtration rate measured by (99m) Tc-DTPA renal dynamic imaging is significantly lower than that estimated by the CKD-EPI equation in horseshoe kidney patients.

    Science.gov (United States)

    Qi, Yan; Hu, Panpan; Xie, Yuansheng; Wei, Kai; Jin, Meiling; Ma, Guangyu; Li, Qinggang; Xu, Baixuan; Chen, Xiangmei

    2016-06-01

    Gate's glomerular filtration rate (gGFR) measured by (99m) Tc-DTPA renal dynamic imaging and estimated GFR (eGFR) estimated by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation are two indexes used to evaluate renal function. However, little is known about whether gGFR can be used to accurately assess renal function in horseshoe kidney (HSK) patients with renal fusion anomalies. Nineteen HSK patients (HSK group) diagnosed by renal imaging and 38 CKD patients with "normal kidney shape" (non-HSK group) matched to the HSK patients in terms of gender, age and biochemical indicators at Chinese PLA General Hospital were enrolled in this study. Gender, age, serum total protein (TP), albumin (ALB), blood urea nitrogen (BUN), serum creatinine (Scr), gGFR and eGFR were recorded and analyzed using χ(2) test, t-test, and Wilcoxon test which was presented as median(IQR). (1) There were no significant differences in gender, age, TP, ALB, BUN, Scr, or eGFR between these two groups. (2) In HSK patients, the renogram showed abnormal renal axis with the lower poles orientated medially. The timed uptake curve showed that the isotope excretion in the HSK group was slower than that in the non-HSK group. (3) For all HSK patients, gGFR was significantly lower than eGFR (range -12.52 mL/min per 1.73m(2) to -93.18 mL/min per 1.73m(2) ). There was no significant difference in eGFR between the HSK [96.42 (36.02) mL/min per 1.73 m(2) ] and non-HSK groups [94.46 (33.00) mL/min per 1.73 m(2) ]. The gGFR of the HSK group [41.18 (16.60) mL/min per 1.73m(2) ] was much lower than that of the non-HSK group [86.42(26.40) mL/min per 1.73m(2) , P renal dynamic imaging is significantly lower than eGFR estimated by the CKD-EPI equation, which indicates that isotope renogram cannot accurately evaluate the GFR of HSK patients. © 2015 The Authors Nephrology published by Wiley Publishing Asia Pty Ltd on behalf of Asian Pacific Society of Nephrology.

  3. Design of combination biofilter and subsurface constructed wetland-multilayer filtration with vertical flow type using Vetiveria zizanioides (akar wangi)

    Science.gov (United States)

    Astuti, A. D.; Lindu, M.; Yanidar, R.; Faruq, M.

    2018-01-01

    As environmental regulation has become stricter in recent years, there is an increasing concern about the issue of wastewater treatment in urban areas. Senior High School as center of student activity has a potential source to generated domestic wastewater from toilet, bathroom and canteen. Canteen wastewater contains high-organic content that to be treated before discharged. Based on previous research the subsurface constructed wetland-multilayer filtration with vertical flow is an attractive alternative to provide efficient treatment of canteen wastewater. The effluent concentration complied with regulation according to [9]. Due to limited land, addition of preliminary treatment such as the presence of biofilter was found to improve the performance. The aim of this study was to design combination biofilter and subsurface constructed wetland-multilayer filtration with vertical flow type using vetiveria zizanioides (akar wangi) treating canteen wastewater. Vetiveria zizanioides (akar wangi) is used because from previous research, subsurface constructed wetland-multilayer filtration (SCW-MLF) with vertical flow type using vetiveria zizanioides (akar wangi) can be an alternative canteen wastewater treatment that is uncomplicated in technology, low cost in operational and have a beautiful landscape view, besides no odors or insects were presented during the operation.

  4. Glomerular disease and acute kidney injury in Sudan ...

    African Journals Online (AJOL)

    Age at presentation but not baseline renal function by estimated glomerular filtration rate (eGFR), was associated with the likelihood of having residual chronic kidney disease following an episode of AKI. Conclusions. The data suggested differences in the pattern of intrinsic renal/glomerular disease leading to AKI to those ...

  5. Short-term anti-proteinuric effect of tacrolimus is not related to preservation of the glomerular filtration rate in IgA nephropathy: A 5-year follow-up study.

    Science.gov (United States)

    Yu, Mi-Yeon; Kim, Yong-Chul; Koo, Ho Suk; Chin, Ho Jun

    2017-01-01

    The immunosuppressive drug tacrolimus has the short-term effect of reducing proteinuria in patients with immunoglobulin A nephropathy (IgAN). Our study investigated the effects on proteinuria and kidney function after discontinuation of tacrolimus. Patients with biopsy-proven IgAN were included in the study and randomly divided into two treatment groups. There was a corresponding control group for each treatment group. The first group included patients treated with tacrolimus (Tac vs non-Tac group) and the second group included patients with a renin angiotensin system blocker (RASi vs non-RASi group). The Tac group received treatment for up to 16 weeks, with the administration of tacrolimus being ceased at the final visit (trial phase). We tracked the patients at 12, 24, 52, and 240 weeks (observational phase). The primary outcomes examined were the percentage change (from the trial phase to the observational phase) of time-averaged proteinuria (TA-proteinuria; g/g creatinine [cr]) and the estimated glomerular filtration rate (eGFR). Time-averaged proteinuria was defined as the average of urine protein to creatinine ratio (UPCR), measured every 3 months during both the trial and observational phases of the study. A significant reduction in UPCR was observed in the Tac group compared to non-Tac group at the 4 and 8 week visits during the trial phase (p = 0.023 and p = 0.003, respectively). However, the difference between the Tac group and non-Tac group was not evident in the other review periods, estimated by linear mixed effect model. The percentage change in TA-proteinuria was greater in the Tac group than that in the corresponding control group (116 ± 96% vs. 63 ± 239%, p = 0.004). Therefore, during the observational phase, TA-proteinuria was not significantly different between the Tac group and the non-Tac group (1.150 ± 0.733 g/g cr vs. 1.455 ± 2.017 g/g cr, p = 0.775). The levels of eGFR throughout the observational phase were not significantly different

  6. Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs.

    Science.gov (United States)

    Halsøy, Kathrine; Kondratiev, Timofey; Tveita, Torkjel; Bjertnaes, Lars J

    2016-01-01

    Victims of severe accidental hypothermia are prone to fluid extravasation but rarely develop lung edema. We hypothesize that combined hypothermia-induced increase in pulmonary vascular resistance (PVR) and a concomitant fall in cardiac output protect the lungs against edema development. Our aim was to explore in hypothermic-isolated blood-perfused rat lungs whether perfusion at constant pressure influences fluid filtration differently from perfusion at constant flow. Isolated blood-perfused rat lungs were hanging freely in a weight transducer for measuring weight changes (ΔW). Fluid filtration coefficient (Kfc), was determined by transiently elevating left atrial pressure (Pla) by 5.8 mmHg two times each during normothermia (37°C) and during hypothermia (15°C). The lung preparations were randomized to two groups. One group was perfused with constant flow (Constant flow group) and the other group with constant pulmonary artery pressure (Constant PPA group). Microvascular pressure (Pmv) was determined before and during elevation of Pla (ΔPmv) by means of the double occlusion technique. Kfc was calculated with the formula Kfc = ΔW/ΔPmv/min. All Kfc values were normalized to predicted lung weight (P LW ), which was based on body weight (BW) according to the formula: P LW  = 0.0053 BW - 0.48 and presented as Kfc PLW in mg/min/mmHg/g. At cessation, bronchoalveolar lavage (BAL) fluid/perfusate protein concentration (B/P) ratio was determined photometrically. Data were analyzed with parametric or non-parametric tests as appropriate. p  < 0.05 considered as significant. Perfusate flow remained constant in the Constant flow group, but was more than halved during hypothermia in the Constant PPA group concomitant with a more fold increase in PVR. In the Constant flow group, Kfc PLW and B/P ratio increased significantly by more than 10-fold during hypothermia concerted by visible signs of edema in the trachea. Hemoglobin and hematocrit increased within

  7. Final Report: Pilot-Scale X-Flow Filtration Test - Env C Plus Entrained Solids Plus Sr/TRU

    Energy Technology Data Exchange (ETDEWEB)

    Duignan, M.R.

    2000-07-27

    This report discusses the results of the operation of a cross-flow filter in a pilot-scale experimental facility that was designed, built, and run by the Experimental Thermal Fluids Laboratory of the Savannah River Technology Center of the Westinghouse Savannah River Company. This filtration technology was evaluated for its inclusion in the pretreatment section of the nuclear waste stabilization plant being designed by BNFL, Inc. The plant will be built at the U.S. Department of Energy's Hanford Site as part of the River Protection Project.

  8. The cell biology of renal filtration

    Science.gov (United States)

    Quaggin, Susan E.

    2015-01-01

    The function of the kidney, filtering blood and concentrating metabolic waste into urine, takes place in an intricate and functionally elegant structure called the renal glomerulus. Normal glomerular function retains circulating cells and valuable macromolecular components of plasma in blood, resulting in urine with just trace amounts of proteins. Endothelial cells of glomerular capillaries, the podocytes wrapped around them, and the fused extracellular matrix these cells form altogether comprise the glomerular filtration barrier, a dynamic and highly selective filter that sieves on the basis of molecular size and electrical charge. Current understanding of the structural organization and the cellular and molecular basis of renal filtration draws from studies of human glomerular diseases and animal models of glomerular dysfunction. PMID:25918223

  9. Large-scale purification of pharmaceutical-grade plasmid DNA using tangential flow filtration and multi-step chromatography.

    Science.gov (United States)

    Sun, Bo; Yu, XiangHui; Yin, Yuhe; Liu, Xintao; Wu, Yongge; Chen, Yan; Zhang, Xizhen; Jiang, Chunlai; Kong, Wei

    2013-09-01

    The demand for pharmaceutical-grade plasmid DNA in vaccine applications and gene therapy has been increasing in recent years. In the present study, a process consisting of alkaline lysis, tangential flow filtration, purification by anion exchange chromatography, hydrophobic interaction chromatography and size exclusion chromatography was developed. The final product met the requirements for pharmaceutical-grade plasmid DNA. The chromosomal DNA content was RNA was not detectable by agarose gel electrophoresis. Moreover, the protein content was bacterial cell paste. The overall yield of the final plasmid DNA reached 48%. Therefore, we have established a rapid and efficient production process for pharmaceutical-grade plasmid DNA. Copyright © 2013 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

  10. Documentation of renal glomerular and tubular impairment and glomerular hyperfiltration in multitransfused patients with beta thalassemia.

    Science.gov (United States)

    Deveci, Burak; Kurtoglu, Aysegul; Kurtoglu, Erdal; Salim, Ozan; Toptas, Tayfur

    2016-02-01

    Urinary albumin to creatinine (ACR) and beta2 microglobulin to creatinine ratios (BCR) are the surrogate and robust markers of renal glomerulopathy and tubulopathy, respectively. These markers predict short-term renal deterioration and mortality in various conditions. We aimed to assess the frequency and predictors of glomerular and tubular defects, renal impairment, and hyperfiltration in 96 adult patients with beta thalassemia intermedia and major. ACR > 300 mg/g creatinine and BCR > 300 μg/g creatinine were used to define the renal glomerular and tubular damages, respectively. Glomerular filtration rate (eGFRcreat) was estimated according to 2009 the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Decreased eGFRcreat was defined as less than 60 mL/min per 1.73 m(2). Renal glomerular and/or tubular defects were observed in about 68.8 % of all patients. Forty percent of patients had glomerular hyperfiltration. None of the patients had a decreased eGFRcreat. T2* value ≤20 msec on cardiac magnetic resonance (cMR) was the only independent predictor of glomerular damage (p = 0.013). Use of alendronate was associated with less renal tubular damage (p = 0.007). Female gender and previous history of splenectomy were the independent predictors of glomerular hyperfiltration in multivariate analysis (p glomerular damage is frequent in adult patients with thalassemia intermedia and major. T2* value on cMR was the only independent predictor of glomerular damage. However, since we did not explore all the parameters of iron, it is not possible to draw a definite conclusion about the association of cMR and glomerular damage. There is no association with cardiac iron overload/accumulation and tubular damage or hyperfiltration.

  11. New collector efficiency equation for colloid filtration in both natural and engineered flow conditions

    Science.gov (United States)

    Nelson, Kirk E.; Ginn, Timothy R.

    2011-05-01

    A new equation for the collector efficiency (η) of the colloid filtration theory (CFT) is developed via nonlinear regression on the numerical data generated by a large number of Lagrangian simulations conducted in Happel's sphere-in-cell porous media model over a wide range of environmentally relevant conditions. The new equation expands the range of CFT's applicability in the natural subsurface primarily by accommodating departures from power law dependence of η on the Peclet and gravity numbers, a necessary but as of yet unavailable feature for applying CFT to large-scale field transport (e.g., of nanoparticles, radionuclides, or genetically modified organisms) under low groundwater velocity conditions. The new equation also departs from prior equations for colloids in the nanoparticle size range at all fluid velocities. These departures are particularly relevant to subsurface colloid and colloid-facilitated transport where low permeabilities and/or hydraulic gradients lead to low groundwater velocities and/or to nanoparticle fate and transport in porous media in general. We also note the importance of consistency in the conceptualization of particle flux through the single collector model on which most η equations are based for the purpose of attaining a mechanistic understanding of the transport and attachment steps of deposition. A lack of sufficient data for small particles and low velocities warrants further experiments to draw more definitive and comprehensive conclusions regarding the most significant discrepancies between the available equations.

  12. Glomerular Disease in Women

    Directory of Open Access Journals (Sweden)

    Kate Wiles

    2018-03-01

    Full Text Available Gender differences exist in the prevalence of glomerular diseases. Data based on histological diagnosis underestimate the prevalence of preeclampsia, which is almost certainly the commonest glomerular disease in the world, and uniquely gender-specific. Glomerular disease affects fertility via disease activity, the therapeutic use of cyclophosphamide, and underlying chronic kidney disease. Techniques to preserve fertility during chemotherapy and risk minimization of artificial reproductive techniques are considered. The risks, benefits, and effectiveness of different contraceptive methods for women with glomerular disease are outlined. Glomerular disease increases the risk of adverse outcomes in pregnancy, including preeclampsia; yet, diagnosis of preeclampsia is complicated by the presence of hypertension and proteinuria that precede pregnancy. The role of renal biopsy in pregnancy is examined, in addition to the use of emerging angiogenic biomarkers. The safety of drugs prescribed for glomerular disease in relation to reproductive health is detailed. The impact of both gender and pregnancy on long-term prognosis is discussed.

  13. Oil recovery in the presence of microbubbles in the filtration flow

    Science.gov (United States)

    Mikhailov, D. N.

    2012-05-01

    This paper presents mathematical models for oil-gas flow taking into account the various processes due to the formation of gas micronuclei (microbubbles) in oil: slip of oil relative to the walls of the pore channels (gas lubrication), changes in oil viscosity, and motion of microbubles with respect to oil. We consider examples of oil flow in the near-wellbore zone for the case where a reduction in pressure to the saturation pressure leads to the formation of gas microbubbles and micronuclei and examples of the action of a water-gas mixture in the case where oil foams in the contact area with the injected gas, i.e., a finely dispersed mixture of oil and microbubbles is formed. The behavior of indicator curves for an oil well with the formation of microbubbles is simulated, and the effect of microbubbles on the oil recovery factor in a water-alternating-gas injection process is studied.

  14. Form, Function and Flow in the Plankton: Jet Propulsion and Filtration by Pelagic Tunicates

    Science.gov (United States)

    2010-02-01

    1998). Each individual broods a single embryo, or in a few species several embryos, which becomes a solitary budding individual. Salps are most...insect wing 14 and a bird wing) can be explained by the tendency of systems to evolve in such a way that flow through the system is optimized and...behavior. Limnol. Oceanogr. 20, 907-917. Harbison, G. R. (1998). The parasites and predators of Thaliacea. In: Bone Q (ed) The biology of pelagic

  15. Final Report: Pilot-scale Cross-flow Filtration Test - Envelope A + Entrained Solids

    Energy Technology Data Exchange (ETDEWEB)

    Duignan, M.R.

    2000-06-27

    This report discusses the results of the operation of a cross-flow filter in a pilot-scale experimental facility that was designed, built, and run by the Experimental Thermal Fluids Laboratory of the Savannah River Technology Center of the Westinghouse Savannah River Company.This filter technology was evaluated for its inclusion in the pretreatment section of the nuclear waste stabilization plant being designed by BNFL, Inc. This plant will be built at the U.S. Department of Energy's Hanford Site as part of the River Protection Project.

  16. 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.

  17. Synthesis of inorganic materials in a supercritical carbon dioxide medium. Application to ceramic cross-flow filtration membranes preparation

    International Nuclear Information System (INIS)

    Papet, Sebastien

    2000-01-01

    Membrane separations, using cross-flow