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Sample records for included serum creatinine

  1. Serum Creatinine: Not So Simple!

    OpenAIRE

    DELANAYE, Pierre; Cavalier, Etienne; Pottel, Hans

    2017-01-01

    Measuring serum creatinine is cheap and commonly done in daily practice. However, interpretation of serum creatinine results is not always easy. In this review, we will briefly remind the physiological limitations of serum creatinine due notably to its tubular secretion and the influence of muscular mass or protein intake on its concentration. We mainly focus on the analytical limitations of serum creatinine, insisting on important concept such as reference intervals, standardization (and IDM...

  2. Modeling Serum Creatinine in Septic ICU Patients

    DEFF Research Database (Denmark)

    De Gaetano, Andrea; Cortese, Giuliana; Pedersen, Morten Gram

    2004-01-01

    Serum creatinine is a metabolite assumed to be constantly produced by the normally functioning muscle mass and is a good measure for monitoring daily renal function in the intensive care unit (ICU). High serum creatinine levels or an abnormal departure from normal pre-disease basal levels....... The present work details the structure of a model describing observed creatinine serum concentration (CSC) variations, depending on the time-varying septic insult to renal function in ICU patients, as well as the estimation of its parameters. CSC determinations were routinely obtained from 12 patients...

  3. Prevalence of elevated serum creatinine among treated ...

    African Journals Online (AJOL)

    A cut off mark of 1.5mg/dl was used to evaluate elevated serum creatinine levels. Results: There were 826patients with a male/female ratio of 1:1.32. Males were 356 (43.1%) and females 470 (56.9%). Among these patients, 118 (14.3%) had a serum creatinine value of over 1.5mg/dl, signifying renal disease. Conclusion: A ...

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Routine serum creatinine measurements: how well do we perform?

    Science.gov (United States)

    Hoste, Liesbeth; Deiteren, Kathleen; Pottel, Hans; Callewaert, Nico; Martens, Frank

    2015-02-14

    The first aim of the study was to investigate the accuracy and intra-laboratory variation of serum creatinine measurements in clinical laboratories in Flanders. The second purpose was to check the effect of this variation in serum creatinine concentration results on the calculated estimated glomerular filtration rate (eGFR) and the impact on classification of patients into a chronic kidney disease (CKD) stage. 26 routine instruments were included, representing 13 different types of analyzers from 6 manufacturers and covering all current methodologies (Jaffe, compensated Jaffe, enzymatic liquid and dry chemistry methods). Target values of five serum pools (creatinine concentrations ranging from 35 to 934 μmol/L) were assigned by the gold standard method (ID-GC/MS). Intra-run CV (%) (n = 5) and bias (%) from the target values were higher for low creatinine concentrations. Especially Jaffe and enzymatic dry chemistry methods showed a higher error. The calculated eGFR values corresponding with the reported creatinine concentration ranges resulted in a different CKD classification in 47% of cases. Although most creatinine assays claim to be traceable to the gold standard (ID-GC/MS), large inter-assay differences still exist. The inaccuracy in the lower concentration range is of particular concern and may lead to clinical misinterpretation when the creatinine-based eGFR of the patient is used for CKD staging. Further research to improve harmonization between methods is required.

  6. A comparison of definitions of contrast-induced nephropathy in patients with normal serum creatinine.

    Science.gov (United States)

    Khatami, Mohammad Reza; Nikravan, Nasrin; Salari-Far, Mojtaba; Davoudi, Safieh; Pahlavan-Sabbagh, Mohammad Reza

    2016-01-01

    Contrast-induced nephropathy (CIN) is the third leading cause of acute kidney injury in hospitalized patients. The prevalence of CIN is reported to range from 0% to 50%, depending not only on patient condition and the procedure used but also the definition of CIN applied. We aimed to determine the best diagnostic indicator of CIN in patients with normal serum creatinine. This study included 206 patients with normal serum creatinine who underwent coronary angiography/angioplasty. Serum creatinine level and glomerular filtration rate (GFR) were measured before and on the second and fifth days after contrast administration. The incidence of CIN based on a 25% increase in serum creatinine was calculated and compared with the incidence based on a 25% decrease in GFR or an increase of at least 0.5 mg/dL in serum creatinine. Of 206 patients, 127 were male (61.7%) and 79 were female (38.3%); the mean age was 59.56±10.3 years. The prevalence of CIN was 30% based on a 25% increase in serum creatinine, 23% based on a 25% decrease in GFR (Pserum creatinine increase of at least 0.5 mg/dL (Pserum creatinine levels remained within the normal range in the majority of patients with CIN based on the different definitions. In patients with normal serum creatinine, the absolute increase in serum creatinine may describe the prevalence of CIN more accurately than the relative increase in serum creatinine or relative decrease in GFR.

  7. An exploratory study of serum creatinine levels in patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Chen, Xueping; Guo, Xiaoyan; Huang, Rui; Zheng, Zhenzhen; Chen, Yongping; Shang, Hui-Fang

    2014-10-01

    The etiology of amyotrophic lateral sclerosis (ALS) remains unknown, but existing data argue for a role of creatinine in ALS pathophysiology. Our aim is to clarify the correlation between serum creatinine and ALS in Chinese population. A total of 512 sporadic ALS (SALS) patients and 501 age- and gender-matched healthy controls were included. Revised ALS Functional Rating Scale (ALS-FRS-R) was used to assess the motor functional status of SALS patients. Survival analysis was performed using Kaplan-Meier method. Serum creatinine levels were significantly lower in SALS patients than in controls (p creatinine levels had a significantly lower presence of ALS compared to those with the lowest quartile (p for trend serum creatinine levels, but underweight patients presented lower levels of serum creatinine. Patients with low serum creatinine levels are more likely to have severe motor impairment and low body mass index (BMI) values. This study demonstrates that SALS patients have lower serum creatinine levels than well-matched controls. Higher levels of serum creatinine are less likely to be associated with the presence of ALS in Chinese populations. Low serum creatinine levels may be related to severe motor impairment in SALS patients, after adjusting the confounding factor-BMI. However, serum creatinine has no deleterious impact on survival in ALS.

  8. Stable cystatin C serum levels confirm normal renal function in patients with dronedarone-associated increase in serum creatinine.

    Science.gov (United States)

    Duncker, David; Oswald, Hanno; Gardiwal, Ajmal; Lüsebrink, Ulrich; König, Thorben; Schreyer, Hendrik; Klein, Gunnar

    2013-03-01

    Dronedarone is a new antiarrhythmic drug for patients with nonpermanent atrial fibrillation (AF). A relatively consistent finding in all trials studying dronedarone was a moderate but significant elevation of serum creatinine. Since dronedarone competes for the same organic cation transporter in the distal renal tubule with creatinine, serum creatinine and its derived estimated glomerular filtration rate might not reflect true renal function in patients on dronedarone. We therefore investigated alternative markers for renal function in these patients. We prospectively included 20 patients with nonpermanent AF in whom dronedarone 400 mg twice daily was started. Patients had normal renal function and serum creatinine; serum cystatin C and creatinine clearance were measured before treatment and 10 and 90 days after treatment started. Mean serum creatinine level for all 20 patients at baseline (day 0) was 84.55 ± 12.14 and 87.8 ± 17.59 µmol/L on day 10. This slight increase in all patients was not significant. Patients were now divided into the predefined groups of "increased creatinine" (increase in serum creatinine level > 1 standard deviation) and "not increased creatinine." Patients with increased creatinine levels (n = 5) showed a significant elevation of serum creatinine levels from day 0 to day 10 (82.4 ± 9.18 to 104.4 ± 12.74 µmol/L; P = .003), whereas change in serum creatinine levels in the not increased creatinine group (n = 15) was not significant. Serum cystatin C levels remained stable in both of these groups (increased creatinine group: 0.76 ± 0.08 to 0.78 ± 0.08 mg/L; P = .65; not increased creatinine group: 0.77 ± 0.108 to 0.77 ± 0.107 mg/L; P = .906). In conclusion, cystatin C represents an easily available and reliable biomarker for estimation of true renal function in patients on dronedarone treatment.

  9. Salivary Creatinine Estimation as an Alternative to Serum Creatinine in Chronic Kidney Disease Patients

    OpenAIRE

    Venkatapathy, Ramesh; Govindarajan, Vasupradha; Oza, Nirima; Parameswaran, Sreejith; Pennagaram Dhanasekaran, Balamurali; Prashad, Karthikshree V.

    2014-01-01

    Context. Sampling blood for serum analysis is an invasive procedure. A noninvasive alternative would be beneficial to patients and health care professionals. Aim. To correlate serum and salivary creatinine levels and evaluate the role of saliva as a noninvasive alternative to serum for creatinine estimation in chronic kidney disease patients. Study Design. Case-control study. Methods. Blood and saliva samples were collected from 37 healthy individuals and 105 chronic kidney disease patients...

  10. Association of serum uric acid with blood urea and serum creatinine

    International Nuclear Information System (INIS)

    Haq, A.U.; Ahmad, Z.; Rehman, J.U.

    2010-01-01

    Background: Hyperuricemia can cause serious health problems including renal insufficiency. Hyperuricemia is associated with many diseases including Hypertension, Diabetes Mellitus, Hypertriglyceridemia and Obesity. Objective of the present study was to study the Association of Serum Uric Acid with Blood Urea and Serum Creatinine. Methods: Eighty subjects, aged above 40, having blood urea more than 40 mg/dl and serum Creatinine more than 1.3 mg/dl were selected. 52.5 % subjects were male. Eighty subjects were selected as control group matching the age and sex with study group with normal blood urea and serum Creatinine. Results: Serum Uric Acid was found to be raised in 33 patients. Mean Serum Uric Acid value was 6.98+-2.021 in males (p<0.05) and 5.054+-2.324 in females (p<0.05). Conclusion: Serum Uric Acid is raised in patients with impaired renal function (p<0.05). Levels of increased Serum Uric Acid were not significantly associated with the cause of renal disease. (author)

  11. Lower serum albumin level is associated with higher fractional excretion of creatinine.

    Science.gov (United States)

    Horio, Masaru; Imai, Enyu; Yasuda, Yoshinari; Watanabe, Tsuyoshi; Matsuo, Seiichi

    2014-06-01

    Creatinine clearance (Ccr) overestimates glomerular filtration rate (GFR) due to the tubular secretion of creatinine. It is known that fractional excretion of creatinine (FE-Cr) increases with decreasing GFR. Association of serum albumin level with the tubular secretion of creatinine was also reported previously. Alteration of FE-Cr may affect the performance of GFR estimating equations based on serum creatinine. Therefore, we analyzed the factors influencing FE-Cr and compared the performance of GFR equations in subjects stratified by serum albumin levels. Seven hundred and fifty-seven Japanese subjects were included. GFR was measured by inulin renal clearance. GFR and Ccr were measured simultaneously. FE-Cr was calculated as the ratio of Ccr to GFR. Multivariate analysis was performed to evaluate the factors influencing FE-Cr. Age, gender, GFR, body mass index (BMI), body weight, height and serum albumin level were analyzed as the parameters. Estimated GFR was calculated by Japanese GFR equations based on serum creatinine (Eq-cr), serum cystatin C (Eq-cys) and 5 variables including serum albumin (Eq-5var). FE-Cr in subjects with serum albumin serum albumin serum albumin ≥4.0 g/dl. Multivariate analysis showed that GFR (p serum albumin level (p = 0.004) were independent parameters affecting FE-Cr. Biases of Eq-cr, Eq-cys and Eq-5var in subjects with serum albumin serum albumin ≥4.0 g/dl were 6.4 ± 18.8, 2.0 ± 18.1 and 3.0 ± 18.3 ml/min/1.73 m(2), respectively. Eq-cr significantly underestimated GFR compared with Eq-cys or Eq-5var. GFR and serum albumin level were independent parameters affecting FE-Cr. Alteration of FE-Cr according to the serum albumin levels may be one of the reasons of the bias of GFR equation based on serum creatinine.

  12. A comparison of definitions of contrast-induced nephropathy in patients with normal serum creatinine

    OpenAIRE

    Mohammad Reza Khatami; Nasrin Nikravan; Mojtaba Salari-Far; Safieh Davoudi; Mohammad Reza Pahlavan-Sabbagh

    2016-01-01

    Contrast-induced nephropathy (CIN) is the third leading cause of acute kidney injury in hospitalized patients. The prevalence of CIN is reported to range from 0% to 50%, depending not only on patient condition and the procedure used but also the definition of CIN applied. We aimed to determine the best diagnostic indicator of CIN in patients with normal serum creatinine. This study included 206 patients with normal serum creatinine who underwent coronary angiography/angioplasty. Serum creatin...

  13. Changes in Serum Proteins and Creatinine levels in HIV Infected ...

    African Journals Online (AJOL)

    This study examined the level of total serum proteins and globulins in HIV infected Nigerians. 64 patients with HIV infection and 10 apparently healthy subjects were recruited from 3 hospitals in Lagos Metropolis. They were examined for the presence of TB and malaria. Serum total protein, albumin and creatinine levels ...

  14. Reference intervals for serum cystatin C and creatinine of an ...

    African Journals Online (AJOL)

    2014-09-25

    Sep 25, 2014 ... Background and Aim: Estimation of the glomerular filtration rate (GFR) is important for the evaluation of patients with kidney disease. Some studies suggest that GFR estimated from serum cystatin C (Cys C) is more accurate than that from serum creatinine (SCr). For Cys C to be used for this purpose, normal ...

  15. serum albumin, creatinine, uric acid and hypertensive disorders of ...

    African Journals Online (AJOL)

    hi-tech

    2003-08-08

    Aug 8, 2003 ... pregnancy using single estimation of serum protein, creatinine and uric in serum samples of healthy primigravidae with singleton pregnancy. ... developing the disease early in pregnancy. This is because ... as hypertension, diabetes mellitus or renal disease and drug use. This was followed by a complete ...

  16. Reference intervals for serum cystatin C and creatinine of an ...

    African Journals Online (AJOL)

    Background and Aim: Estimation of the glomerular filtration rate (GFR) is important for the evaluation of patients with kidney disease. Some studies suggest that GFR estimated from serum cystatin C (Cys C) is more accurate than that from serum creatinine (SCr). For Cys C to be used for this purpose, normal values need to ...

  17. The relative role of serum albumin and urinary creatinine as ...

    African Journals Online (AJOL)

    Their weight, Body mass index, serum albumin and 24-hour urinary creatinine were determined before treatment, at the end of the 1st, 2nd, 4th and 6th month of treatment. Using ANOVA, the mean values of the weight, BIM and serum albumin were analysed with further analysis paired student T- test of the pre-treatment ...

  18. Choice of Reference Serum Creatinine in Defining AKI

    Science.gov (United States)

    Siew, Edward D.; Matheny, Michael E.

    2015-01-01

    Background/Aims The study of acute kidney injury (AKI) has expanded with the increasing availability of electronic health records and the use of standardized definitions. Understanding the impact of AKI between settings is limited by heterogeneity in the selection of reference creatinine to anchor the definition of AKI. In this mini-review, we discuss different approaches used to select reference creatinine and their relative merits and limitations. Methods We reviewed the literature to obtain representative examples of published baseline creatinine definitions when pre-hospital data were not available, as well as literature evaluating estimation of baseline renal function, using Pubmed and reference back-tracing within known works. Results 1) Prehospital creatinine values are useful in determining reference creatinine, and in high-risk populations, the mean outpatient serum creatinine value 7-365 days before hospitalization closely approximates nephrology adjudication, 2) in patients without pre-hospital data, the eGFR 75 approach does not reliably estimate true AKI incidence in most at-risk populations 3) using the lowest inpatient serum creatinine may be reasonable, especially in those with preserved kidney function, but may generously estimate AKI incidence and severity and miss community-acquired AKI that does not fully resolve, 4) using more specific definitions of AKI (e.g. KIDGO Stage 2 and 3) may help to reduce the effects of misclassification when using surrogate values, and 5) leveraging available clinical data may help refine the estimate of reference creatinine. Conclusions Choosing reference creatinine for AKI calculation is important for AKI classification and study interpretation. We recommend obtaining data on pre-hospital kidney function, wherever possible. In studies where surrogate estimates are used, transparency in how they are applied and discussion that informs the reader of potential biases should be provided. Further work to refine the

  19. Serum urea and creatinine levels in Nigerian human malaria patients

    African Journals Online (AJOL)

    Serum urea and creatinine levels were determined in malaria patients infected with P. falciparum. Serum urea levels decreased significantly (P<0.05) in both mild (4.10 ±1.10 mmol/L) and moderate (4.40 ±1.40 mmol/L) parasitaemia when compared to control subjects (5.50 ±1.40 mmol/L). On the other hand, serum ...

  20. Classifying AKI by Urine Output versus Serum Creatinine Level.

    Science.gov (United States)

    Kellum, John A; Sileanu, Florentina E; Murugan, Raghavan; Lucko, Nicole; Shaw, Andrew D; Clermont, Gilles

    2015-09-01

    Severity of AKI is determined by the magnitude of increase in serum creatinine level or decrease in urine output. However, patients manifesting both oliguria and azotemia and those in which these impairments are persistent are more likely to have worse disease. Thus, we investigated the relationship of AKI severity and duration across creatinine and urine output domains with the risk for RRT and likelihood of renal recovery and survival using a large, academic medical center database of critically ill patients. We analyzed electronic records from 32,045 patients treated between 2000 and 2008, of which 23,866 (74.5%) developed AKI. We classified patients by levels of serum creatinine and/or urine output according to Kidney Disease Improving Global Outcomes staging criteria for AKI. In-hospital mortality and RRT rates increased from 4.3% and 0%, respectively, for no AKI to 51.1% and 55.3%, respectively, when serum creatinine level and urine output both indicated stage 3 AKI. Both short- and long-term outcomes were worse when patients had any stage of AKI defined by both criteria. Duration of AKI was also a significant predictor of long-term outcomes irrespective of severity. We conclude that short- and long-term risk of death or RRT is greatest when patients meet both the serum creatinine level and urine output criteria for AKI and when these abnormalities persist. Copyright © 2015 by the American Society of Nephrology.

  1. Increased serum urea and creatinine levels correlate with decreased retinal nerve fibre layer thickness in diabetic retinopathy.

    Science.gov (United States)

    Srivastav, Khushboo; Saxena, Sandeep; Mahdi, Abbas A; Kruzliak, Peter; Khanna, Vinay K

    2015-01-01

    Correlation of increased levels of serum urea and creatinine with retinal nerve fibre layer (RNFL) thinning on spectral domain optical coherence tomography (SD-OCT) was studied in diabetic retinopathy (DR). Sixty consecutive cases and 20 healthy controls were included. Cases were divided into three groups: without DR, non-proliferative DR with macular oedema and proliferative DR with oedema. Serum urea and creatinine were measured using a standard protocol. Average (RNFL) was measured using SD-OCT. Increased severity of DR was associated with decrease in levels of serum urea and serum creatinine levels. RNFL thinning correlated positively with increase in serum urea and creatinine levels.

  2. Relation between serum creatinine and postoperative results of open-heart surgery.

    Science.gov (United States)

    Ezeldin, Tamer H

    2013-10-01

    To determine the impact of preoperative serum creatinine level in non-dialyzable patients on postoperative morbidity and mortality. This is a prospective study, where serum creatinine was used to give primary assessment on renal function status preoperatively. This study includes 1,033 patients, who underwent coronary artery bypass grafting, or valve(s) operations. The study took place at Al-Hada Military Hospital, Taif, Kingdom of Saudi between May 2008 and January 2012. Data were statistically analyzed using Chi square (x2) test and multivariable logistic regression, to evaluate the postoperative morbidity and mortality risks associated with low serum creatinine levels. Postoperative mortality increased with high serum creatinine level >1.8 mg/dL (pcreatinine level of more than 1.8 mg/dL was associated with increased risk of re-operation for bleeding, postoperative renal failure, prolonged ventilatory support, ICU stay, and total hospital stay. Perioperative serum creatinine is strongly related to post operative morbidity and mortality in open heart surgery. High serum creatinine in non-dialyzable patients can predict the increased morbidity and mortality after cardiac operations.

  3. Differences in urine cadmium associations with kidney outcomes based on serum creatinine and cystatin C

    Energy Technology Data Exchange (ETDEWEB)

    Weaver, Virginia M., E-mail: vweaver@jhsph.edu [Division of Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, 615N. Wolfe St., Rm. 7041, Baltimore, MD 21205 (United States); Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (United States); Kim, Nam-Soo; Lee, Byung-Kook [Institute of Industrial Medicine, SoonChunHyang University, Asan (Korea, Republic of); 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); Spector, June [Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA (United States); Fadrowski, Jeffrey [Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (United States); Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD (United States); Jaar, Bernard G. [Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD (United States); Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD (United States); Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (United States); Steuerwald, Amy 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); Todd, Andrew C. [Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY (United States); and others

    2011-11-15

    Cadmium is a well-known nephrotoxicant; chronic exposure increases risk for chronic kidney disease. Recently, however, associations between urine cadmium and higher creatinine-based estimated glomerular filtration rate (eGFR) have been reported. Analyses utilizing alternate biomarkers of kidney function allow evaluation of potential mechanisms for these observations. We compared associations of urine cadmium with kidney function measures based on serum cystatin C to those with serum creatinine in 712 lead workers. Mean (standard deviation) molybdenum-corrected urine cadmium, Modification of Diet in Renal Disease (MDRD) eGFR and multi-variable cystatin C eGFR were 1.02 (0.65) {mu}g/g creatinine, and 97.4 (19.2) and 112.0 (17.7) mL/min/1.73 m{sup 2}, respectively. The eGFR measures were moderately correlated (r{sub s}=0.5; p<0.001). After adjustment, ln (urine cadmium) was not associated with serum cystatin-C-based measures. However, higher ln (urine cadmium) was associated with higher creatinine-based eGFRs including the MDRD and an equation incorporating serum cystatin C and creatinine (beta-coefficient=4.1 mL/min/1.73 m{sup 2}; 95% confidence interval=1.6, 6.6). Urine creatinine was associated with serum creatinine-based but not cystatin-C-based eGFRs. These results support a biomarker-specific, rather than a kidney function, effect underlying the associations observed between higher urine cadmium and creatinine-based kidney function measures. Given the routine use of serum and urine creatinine in kidney and biomarker research, additional research to elucidate the mechanism(s) for these associations is essential.

  4. Quality of serum creatinine measurement in light of EQA programs.

    Science.gov (United States)

    Friedecky, Bedrich; Kratochvila, Josef; Budina, Marek; Jabor, Antonin

    2007-01-01

    The aim of our study was to identify the role of External Quality Assessment (EQA) programs in improving the quality of serum creatinine measurement and glomerular filtration rate (GFR) estimation. Comparison of results achieved during EQA with National Kidney Disease Education Program and College of American Pathologists guidelines identified an urgent need for an improvement in measurement quality. We compared actual results for serum creatinine measurement within the Czech Republic EQA with the requirements of EC Directive 98/79. We used the results for 2005-2006 EQA programs. There were seven surveys involved with two samples each, and a 2006 questionnaire on the post-analytical phase survey. Bias depended strongly on the creatinine concentration. However, this dependence varied for different in vitro diagnostic manufacturers, although they should all follow the same directive. We chose biological variation as the significance rate for bias and a resulting overall error of 6.9%. The proportion of results with total error EQA programs in improving the quality of creatinine measurement results and GFR calculation should be in monitoring the quality of IVD products, enabling users to adapt their use of these products accordingly. EQA programs can also educate on performing GFR estimation in a unified way. Highly commutable control materials with certified creatinine values or, alternatively, lyophilized materials with sufficient commutability proved by comparison with native frozen human sera, should become an important EQA tool.

  5. Can salivary creatinine and urea levels be used to diagnose chronic kidney disease in children as accurately as serum creatinine and urea levels? A case-control study.

    Science.gov (United States)

    Renda, Rahime

    2017-11-01

    Children with chronic kidney disease (CKD) develop many metabolic changes in blood that often necessitate frequent biochemical analysis. Serum analysis is an invasive and painful procedure. It would be highly beneficial if a noninvasive alternative process to serum analysis in children were identified. Saliva can be collected noninvasively, repeatedly, and without the use of healthcare personnel. The aims of this study were to compare serum and salivary urea and creatinine levels in children with CKD and healthy controls, and to determine if salivary creatinine and urea levels can be used to diagnose CKD in children as accurately as serum creatinine and urea levels. This case-control study included 35 children with CKD and 28 healthy children as controls. Saliva and blood samples were collected for measurement of urea and creatinine levels. The urea and creatinine levels in serum and saliva in the CKD and control groups were compared using the independent samples Mann-Whitney U test. Correlations between the serum and salivary urea and creatinine levels were determined using Pearson's correlation coefficient. Receiver operating characteristic analysis was used to assess the diagnostic performance of salivary creatinine and cutoff values were identified. In the CKD group, the mean salivary creatinine level was 0.45 mg/dL and the mean salivary urea level was 0.11 mg/dL, versus 28.83 mg/dL and 21.78 mg/dL, respectively, in the control group. Stage 4 and 5 CKD patients had a mean salivary urea level of 31.35 mg/dL, as compared to 17.78 mg/dL in the control group. Serum urea and creatinine, and salivary creatinine were significantly higher in the CKD patients (regardless of disease stage) than in the controls (p serum and salivary creatinine. The area under the curve for salivary creatinine was 0.805. The cutoff value for salivary creatinine was 0.125 mg/dL, with a sensitivity of 82.9% and specificity of 78.6%. Based on the positive correlation between

  6. Kidney transplantation from deceased donors with elevated serum creatinine.

    Science.gov (United States)

    Gallinat, Anja; Leerhoff, Sabine; Paul, Andreas; Molmenti, Ernesto P; Schulze, Maren; Witzke, Oliver; Sotiropoulos, Georgios C

    2016-12-01

    Elevated donor serum creatinine has been associated with inferior graft survival in kidney transplantation (KT). The aim of this study was to evaluate the impact of elevated donor serum creatinine on short and long-term outcomes and to determine possible ways to optimize the use of these organs. All kidney transplants from 01-2000 to 12-2012 with donor creatinine ≥ 2 mg/dl were considered. Risk factors for delayed graft function (DGF) were explored with uni- and multivariate regression analyses. Donor and recipient data were analyzed with uni- and multivariate cox proportional hazard analyses. Graft and patient survival were calculated using the Kaplan-Meier method. Seventy-eight patients were considered. Median recipient age and waiting time on dialysis were 53 years and 5.1 years, respectively. After a median follow-up of 6.2 years, 63 patients are alive. 1, 3, and 5-year graft and patient survival rates were 92, 89, and 89 % and 96, 93, and 89 %, respectively. Serum creatinine level at procurement and recipient's dialysis time prior to KT were predictors of DGF in multivariate analysis (p = 0.0164 and p = 0.0101, respectively). Charlson comorbidity score retained statistical significance by multivariate regression analysis for graft survival (p = 0.0321). Recipient age (p = 0.0035) was predictive of patient survival by multivariate analysis. Satisfactory long-term kidney transplant outcomes in the setting of elevated donor serum creatinine ≥2 mg/dl can be achieved when donor creatinine is <3.5 mg/dl, and the recipient has low comorbidities, is under 56 years of age, and remains in dialysis prior to KT for <6.8 years.

  7. Blood pressure and serum creatinine in obese female.

    Science.gov (United States)

    Asrin, M; Nessa, A; Hasan, M I; Das, R K

    2015-01-01

    Obesity is increasing in developed as well as in developing countries. This analytical cross sectional study was carried out to document the relation between blood pressure, serum creatinine and body mass index in female and to assess potential health differences among obese female and normal weight female. This study was done in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2012 to June 2013. Seventy female persons volunteered as subjects. Among them 35 were within normal weight (BMI 18.5-24.9kg/m²) and 35 were obese (BMI≥30kg/m²). Non probability purposive type of sampling technique was used to select the subjects. Measurement of body mass index and blood pressure were done as per procedure. Serum creatinine level was estimated by enzymatic colorimetric method. The results were calculated and analyzed by using SPSS (statistical package for social science, version 17.0), scientific electronic calculator and simultaneously with a computer assisted program like Microsoft excel. Unpaired 't' test was applied to find the significance of difference regarding serum creatinine and blood pressure levels in obese female. The value of p was 1% to indicate highly significant and 5% to indicate simply significant or statistically significant. The mean±SE of systolic blood pressure, diastolic blood pressure and serum creatinine levels were 135.71±1.58mmHg, 88.74±0.95mmHg and 1.03±0.01mg/dl respectively; significant at 1% level for obese group of BMI (pserum creatinine & blood pressure in obese female which indicate the obese subjects are prone to cardiovascular & metabolic risk.

  8. Contribution of the organic anion transporter OAT2 to the renal active tubular secretion of creatinine and mechanism for serum creatinine elevations caused by cobicistat

    Science.gov (United States)

    Lepist, Eve-Irene; Zhang, Xuexiang; Hao, Jia; Huang, Jane; Kosaka, Alan; Birkus, Gabriel; Murray, Bernard P; Bannister, Roy; Cihlar, Tomas; Huang, Yong; Ray, Adrian S

    2014-01-01

    Many xenobiotics including the pharmacoenhancer cobicistat increase serum creatinine by inhibiting its renal active tubular secretion without affecting the glomerular filtration rate. This study aimed to define the transporters involved in creatinine secretion, applying that knowledge to establish the mechanism for xenobiotic-induced effects. The basolateral uptake transporters organic anion transporter OAT2 and organic cation transporters OCT2 and OCT3 were found to transport creatinine. At physiologic creatinine concentrations, the specific activity of OAT2 transport was over twofold higher than OCT2 or OCT3, establishing OAT2 as a likely relevant creatinine transporter and further challenging the traditional view that creatinine is solely transported by a cationic pathway. The apical multidrug and toxin extrusion transporters MATE1 and MATE2-K demonstrated low-affinity and high-capacity transport. All drugs known to affect creatinine inhibited OCT2 and MATE1. Similar to cimetidine and ritonavir, cobicistat had the greatest effect on MATE1 with a 50% inhibition constant of 0.99 μM for creatinine transport. Trimethoprim potently inhibited MATE2-K, whereas dolutegravir preferentially inhibited OCT2. Cimetidine was unique, inhibiting all transporters that interact with creatinine. Thus, the clinical observation of elevated serum creatinine in patients taking cobicistat is likely a result of OCT2 transport, facilitating intracellular accumulation, and MATE1 inhibition. PMID:24646860

  9. Inverse association between serum creatinine and mortality in acute kidney injury.

    Science.gov (United States)

    de Souza, Sergio Pinto; Matos, Rodrigo Santos; Barros, Luisa Leite; Rocha, Paulo Novis

    2014-01-01

    Sepsis is a leading precipitant of Acute Kidney Injury (AKI) in intensive care unit (ICU) patients, and is associated with a high mortality rate. We aimed to evaluate the risk factors for dialysis and mortality in a cohort of AKI patients of predominantly septic etiology. Adult patients from an ICU for whom nephrology consultation was requested were included. End-stage chronic renal failure and kidney transplant patients were excluded. 114 patients were followed. Most had sepsis (84%), AKIN stage 3 (69%) and oliguria (62%) at first consultation. Dialysis was performed in 66% and overall mortality was 70%. Median serum creatinine in survivors and non-survivors was 3.95 mg/dl (2.63 - 5.28) and 2.75 mg/dl (1.81 - 3.69), respectively. In the multivariable models, oliguria and serum urea were positively associated with dialysis; otherwise, a lower serum creatinine at first consultation was independently associated with higher mortality. In a cohort of septic AKI, oliguria and serum urea were the main indications for dialysis. We also described an inverse association between serum creatinine and mortality. Potential explanations for this finding include: delay in diagnosis, fluid overload with hemodilution of serum creatinine or poor nutritional status. This finding may also help to explain the low discriminative power of general severity scores - that assign higher risks to higher creatinine levels - in septic AKI patients.

  10. How to use… serum creatinine, cystatin C and GFR.

    Science.gov (United States)

    Pasala, Swetha; Carmody, J Bryan

    2017-02-01

    Glomerular filtration rate (GFR) is the best overall measure of kidney function. The GFR is relatively low at birth but increases through infancy and early childhood to reach adult levels of approximately 120 mL/min/1.73 m 2 by age 2. While GFR can be measured most accurately by the urinary clearance of an exogenous ideal filtration marker such as inulin, it is more clinically useful to estimate GFR using a single serum measurement of an endogenous biomarker such as creatinine or cystatin C. When in steady state, there is an inverse relationship between creatinine/cystatin C and GFR, allowing GFR to be estimated from either using simple equations. Because of the non-linear relationship between creatinine/cystatin C and GFR, relatively small initial increases in these markers represent significant decreases in GFR. While cystatin C is produced by all nucleated cells, creatinine is a waste product of muscle metabolism and is therefore influenced by diet and muscle mass/body habitus. Decreased GFR is used to diagnose and stage chronic kidney disease (CKD) using the Kidney Disease: Improving Global Outcomes system. A diagnosis of CKD requires GFR serum creatinine and urine output are used to diagnose acute kidney injury. It is possible to calculate a kinetic GFR when the creatinine is changing rapidly, though more complex calculations are required. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. 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.

  12. Spectrophotometric assay of creatinine in human serum sample

    Directory of Open Access Journals (Sweden)

    Avinash Krishnegowda

    2017-05-01

    Full Text Available A new spectrophotometric method for the analysis of creatinine concentration in human serum samples is developed. The method explores the oxidation of p-methylamino phenol sulfate (Metol in the presence of copper sulfate and creatinine which yields an intense violet colored species with maximum absorbance at 530 nm. The calibration graph of creatinine by fixed time assay ranged from 4.4 to 620 μM. Recovery of creatinine in human serum samples varied from 101% to 106%. Limit of detection and limit of quantification were 0.145 μM and 0.487 μM respectively. Sandell’s sensitivity was 0.112 μg cm−2 and molar absorptivity was 0.101 × 104 L mol−1 cm−1. Within day precision was 2.5–4.8% and day-to-day precision range was 3.2–7.8%. The robustness and ruggedness of the method expressed in RSD values ranged from 0.78% to 2.12% and 1.32% to 3.46% respectively, suggesting that the developed method was rugged. This method provides good sensitivity and is comparable to standard Jaffe’s method with comparatively less interference from foreign substances.

  13. Can urine dipstick predict an elevated serum creatinine?

    Science.gov (United States)

    Shah, Kaushal; Kilian, Barbara; Hsieh, Wei-Jen; Kyrillou, Emily; Hedge, Vishal; Newman, David H

    2010-06-01

    Chart review studies have suggested that point-of-care urine dipstick testing may accurately predict an elevation in serum creatinine (Cr). We aimed to prospectively evaluate the test characteristics of proteinuria/hematuria in predicting elevated serum Cr. A prospective, observational study was conducted between March 2007 and June 2008 at 2 affiliated, urban hospitals with an annual emergency department census of 150,000. Patients undergoing laboratory urinalysis, point-of-care urine dipstick, and a serum chemistry panel were enrolled. Trained research assistants collected data on consecutive patients 18 hours per day using preformatted data forms and entry into an anonymized Access (Microsoft, Seattle, Wash) database. Demographic baseline variables including age, sex, chief complaint, vital signs, and source of sample (catheter vs "clean catch") were also collected. An elevated Cr level was defined as greater than 1.3 based on the laboratory reference range. Standard statistical methods were used to calculate diagnostic test operating characteristics of proteinuria or hematuria as a predictor of elevated serum Cr. Five thousand four hundred sixteen subjects were enrolled with 28.3% male and a mean age of 50.2 years. Elevated serum Cr greater than 1.3 mg/dL was found in 13.9% (755/5416) of subjects. The sensitivity of either proteinuria or hematuria for elevated Cr was 82.5% (95% confidence interval [CI], 80%-85%) and specificity was 34.4% (95% CI, 33%-36%). Positive predictive value was 16.9% (95% CI, 16%-18%) and negative predictive value was 92.4% (95% CI, 91-94%). The likelihood ratio for a positive test was 1.3 (95% CI, 1.1-1.5), and the likelihood ratio for a negative test was 0.5 (95% CI, 0.3-0.8). Although negative predictive value was high, the presence of proteinuria/hematuria was only moderately predictive of elevated serum Cr level. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  14. Serum albumin and creatinine clearance rate among smear positive pulmonary tuberculosis patients in Bangladesh.

    Science.gov (United States)

    Hoque, M R; Chakraborty, P K; Paul, U K; Sarkar, S; Akhter, S; Shahidullah, S M; Gautam, B; Sultana, S; Ferdous, N; Samsunnahar, M

    2014-07-01

    This case control study was carried out in the Department of Biochemistry, Mymensingh Medical College in cooperation with the Outpatient Department and Medicine Units of Mymensingh Medical College Hospital, Fulbaria Upazilla Health Complex, Mymensingh and some DOTS centers of BRAC, a non-government organization during the period of July 2006 to June 2007. The aim of the study was to explore the status of serum albumin & creatinine clearance levels in smear positive Bangladeshi pulmonary tuberculosis patients as a means to monitor the possibility of management of these patients as these levels decrease significantly. Serum albumin level was investigated in TB patients for monitoring the nutritional status of TB patients and also for the adjustment of serum calcium level. Creatinine clearance rate was investigated in TB patients for monitoring the impairment of renal function and nutritional depletion in tuberculosis patients. A total of 120 people of different age groups were included in this study. Subjects were divided into two groups- Group I (Control; n=60) - apparently healthy people selected matching by age, sex and socioeconomic status with the cases and Group II (Case; n=60) - people with smear positive pulmonary tuberculosis. Serum albumin was estimated by colorimetric principle. Serum creatinine was also estimated by colorimetric principle & creatinine clearance rate was estimated from serum creatinine by Cockcroft- Gault equation. Statistical analysis was done by using SPSS windows package. Among the groups, mean±SD of serum albumin in Group II (3.74±0.44gm/dl) was significantly lower (pcreatinine clearance rate in Group II (35.36±8.29ml/min) was also significantly lower than that in Group I (84.16±20.20ml/min). It is evident from the study that serum albumin & creatinine clearance rate levels significantly decrease in smear positive Bangladeshi pulmonary tuberculosis patients.

  15. Serum Creatinine Trajectories for Community- versus Hospital-Acquired Acute Kidney Injury.

    Science.gov (United States)

    Warnock, David G; Powell, T Clark; Siew, Edward D; Donnelly, John P; Wang, Henry E; Mehta, Ravindra L

    2016-01-01

    Patterns of acute kidney injury (AKI) can be distinguished by the rate of changes in the serum creation concentrations during hospitalizations. We hypothesized that the timing and values of minimum and maximum serum creatinine (sCr) could be used to distinguish between transient hospital-associated AKI (THA-AKI) and hospital-acquired AKI (HA-AKI). We evaluated adults admitted to 2 regionally distinct academic medical centers. Peak sCr during the hospitalization was used to define AKI, using absolute changes and timing from the minimum sCr. sCr trajectories were derived based on the rate of change between the minimum and peak creatinine concentrations. Peak creatinine followed the minimum creatinine for HA-AKI, while the peak creatinine preceded the minimum creatinine for THA-AKI. There were 82,403 patients included in the analyses, and 53,882 (65%) did not have AKI during the index hospitalization. There were 2,611 inpatient deaths; HA-AKI had a 4.8-fold increased risk relative to those without AKI (p Creatinine trajectories can be used to describe the rate of development as well as recovery from inpatient AKI. The 24- and 48-hour interval slopes may be early indicators of developing AKI. © 2016 S. Karger AG, Basel.

  16. Is Doubling of Serum Creatinine a Valid Clinical 'Hard' Endpoint in Clinical Nephrology Trials?

    NARCIS (Netherlands)

    Lambers Heerspink, H. J.; Perkovic, V.; de Zeeuw, D.

    2011-01-01

    The composite of end stage renal disease (ESRD), doubling of serum creatinine and (renal) death, is a frequently used endpoint in randomized clinical trials in nephrology. Doubling of serum creatinine is a well-accepted part of this endpoint because a doubling of serum creatinine reflects a large

  17. Role of serum creatinine for screening renal diseases

    International Nuclear Information System (INIS)

    Younas, M.; Khan, F.A.; Sattar, A.; Kazmi, A.

    2011-01-01

    Chronic kidney disease (CKD) is a public Heath problem with increasing prevalence in Pakistan. Early identification of mild renal disease can delay its progression. Glomerular filtration rate (GFR) is the best overall index of renal function, but it is difficult to measure, so mostly clinicians rely on. serum creatinine (SCr) concentration which its own limitations. On the other hand 24 hours (h) urinary creatinine clearance (CICl) is a more sensitive marker of renal dysfunction. Presently SCr is being used in our clinical practice to screen the renal diseases which can miss mild renal dysfunctions, so this study was designed to calculate frequency of individuals having reduced GFR as determined by CrCI having normal SCr levels. (author)

  18. Serum creatinine is associated with the prevalence but not disease progression of multiple system atrophy in Chinese population.

    Science.gov (United States)

    Cao, Bei; Guo, XiaoYan; Chen, Ke; Song, Wei; Huang, Rui; Wei, QianQian; Zhao, Bi; Shang, Hui-Fang

    2016-03-01

    Oxidative stress is involved in the pathogenesis of multiple system atrophy (MSA). Creatine, which is converted to creatinine, has an anti-oxidative effect. Our aim is to clarify the correlations between creatinine and the occurrence as well as the progression of MSA. A total of 115 patients with probable MSA and 115 age- and gender-matched healthy controls were included in the study. The serum creatinine level of all patients and controls were evaluated and compared. The mean age of MSA patients was 58.18 ± 8.67 years and the mean disease duration was 2.85 ± 1.71 years. The creatinine level of MSA patients was significantly lower than that of healthy controls (P creatinine quartiles compared with the lowest creatinine quartiles. In a gender-specific analysis, patients with the highest quartiles and second quartiles of creatinine level had decreased occurrence than patients with the lowest quartile in females, but not in males. The serum level of creatinine was not found correlated with the mean rate of annualised changes, neither with other independent factors, such as age, body mass index (BMI), sex, Unified MSA Rating Scale (UMSARS) scores and disease duration at the initial visit in patients with MSA. High level of serum creatinine may be associated with a low occurrence of MSA in Chinese population, especially in female. However, serum creatinine does not deteriorate or ameliorate the progression of MSA.

  19. Low antioxidant status of serum bilirubin, uric acid, albumin and creatinine in patients with myasthenia gravis.

    Science.gov (United States)

    Yang, Dehao; Su, Zhongqian; Wu, Shengjie; Bi, Yong; Li, Xiang; Li, Jia; Lou, Kangliang; Zhang, Hongyu; Zhang, Xu

    2016-12-01

    Oxidative stress and low antioxidant status play a major role in the pathogenesis of inflammatory and autoimmune diseases. Myasthenia gravis (MG) is an autoimmune condition targeting the neuromuscular junction, and its antioxidant status is still controversial. Our study aimed to investigate the correlation between the clinical characteristics of MG and the serum antioxidant status of bilirubin (Tbil, Dbil and Ibil), uric acid, albumin and creatinine. We measured serum antioxidant molecule levels of bilirubin (Tbil, Dbil and Ibil), uric acid, albumin and creatinine in 380 individuals, including 166 MG and 214 healthy controls. We found that MG patients had significantly lower serum levels of bilirubin (Tbil, Dbil and Ibil), uric acid, albumin and creatinine than healthy controls, whether male or female. Moreover, it was also shown in our study that uric acid, albumin and creatinine levels in patients with MG were correlated with disease activity and classifications performed by the Myasthenia Gravis Foundation of America. Our findings demonstrated that serum levels of bilirubin (Tbil, Dbil and Ibil), uric acid, albumin and creatinine were reduced in patients with MG. This suggested an active oxidative process in MG patients who had low antioxidant status.

  20. Urinary creatinine to serum creatinine ratio and renal failure index in dogs infected with Babesia canis.

    Science.gov (United States)

    Zygner, Wojciech; Gójska-Zygner, Olga; Wesołowska, Agnieszka; Wędrychowicz, Halina

    2013-09-01

    Urinary creatinine to serum creatinine (UCr/SCr) ratio and renal failure index (RFI) are useful indices of renal damage. Both UCr/SCr ratio and RFI are used in differentiation between prerenal azotaemia and acute tubular necrosis. In this work the authors calculated the UCr/SCr ratio and RFI in dogs infected with Babesia canis and the values of these indices in azotaemic dogs infected with the parasite. The results of this study showed significantly lower UCr/SCr ratio in dogs infected with B. canis than in healthy dogs. Moreover, in azotaemic dogs infected with B. canis the UCr/SCr ratio was significantly lower and the RFI was significantly higher than in non-azotaemic dogs infected with B. canis. The calculated correlation between RFI and duration of the disease before diagnosis and treatment was high, positive and statistically significant (r = 0.89, p < 0.001). The results of this study showed that during the course of canine babesiosis caused by B. canis in Poland acute tubular necrosis may develop.

  1. Serum cystatin C as a marker of renal function in critically ill patients with normal serum creatinine.

    Science.gov (United States)

    Sagheb, Mohammad Mahdi; Namazi, Soha; Geramizadeh, Bita; Karimzadeh, Amin; Oghazian, Mohammad Bagher; Karimzadeh, Iman

    2014-03-01

    Serum creatinine as a classic marker of renal function has several limitations in the detection of renal dysfunction. This study assessed the validity of serum cystatin C as a marker of renal function in critically ill patients with normal serum creatinine. Eighty adult patients referred to intensive care units with serum creatinine levels < 1.5 mg/dL and without hemodynamic instability were chosen and their serum creatinine and cystatin C levels were measured. A 24-hour urine sample was collected to calculate creatinine clearance (Ccr). Renal dysfunction was defined as Ccr < 80 mL/min/1.73 m(2). There were significant correlations between measured Ccr and 1/serum creatinine (R = 0.51, P < 0.001) and 1/serum cystatin C (R = 0.25, P = 0.028). The difference between false negative rates of serum creatinine (93.33%) and cystatin C (80%) in the detection of renal dysfunction was significant (P = 0.032). Receiver operating characteristic curve analysis illustrated that area under the curve of serum creatinine and cystatin C for detecting renal dysfunction were 0.711 and 0.607, respectively; however, this difference was not significant (P = 0.222). Our data demonstrated that serum cystatin C is not superior to serum creatinine in the early detection of renal dysfunction in critically ill patients.

  2. Reference values for serum creatinine in children younger than 1 year of age

    OpenAIRE

    Boer, Dirk P.; de Rijke, Yolanda B.; Hop, Wim C.; Cransberg, Karlien; Dorresteijn, Eiske M.

    2010-01-01

    textabstractReliable reference values of enzymatically assayed serum creatinine categorized in small age intervals are lacking in young children. The aim of this study was to determine reference values for serum creatinine during the first year of life and study the influence of gender, weight and height on these values. Serum creatinine determinations between 2003 and 2008 were retrieved from the hospital database. Strict exclusion criteria ensured the selection of patients without kidney da...

  3. Creatinine

    Science.gov (United States)

    ... Culture Blood Gases Blood Ketones Blood Smear Blood Typing Blood Urea Nitrogen (BUN) BNP and NT-proBNP ... Luteinizing Hormone (LH) Lyme Disease Tests Magnesium Maternal Serum Screening, Second Trimester Measles and Mumps Tests Mercury ...

  4. The urinary excretion of metformin, ceftizoxime and ofloxacin in high serum creatinine rats: Can creatinine predict renal tubular elimination?

    Science.gov (United States)

    Ma, Yan-Rong; Zhou, Yan; Huang, Jing; Qin, Hong-Yan; Wang, Pei; Wu, Xin-An

    2018-03-01

    The renal excretion of creatinine and most drugs are the net result of glomerular filtration and tubular secretion, and their tubular secretions are mediated by individual transporters. Thus, we hypothesized that the increase of serum creatinine (SCr) levels attributing to inhibiting tubular transporters but not glomerular filtration rate (GFR) could be used to evaluate the tubular excretion of drugs mediated by identical or partial overlap transporter with creatinine. In this work, we firstly developed the creatinine excretion inhibition model with normal GFR by competitively inhibiting tubular transporters, and investigated the renal excretion of metformin, ceftizoxime and ofloxacin in vivo and in vitro. The results showed that the 24-hour urinary excretion of metformin and ceftizoxime in model rats were decreased by 25% and 17% compared to that in control rats, respectively. The uptake amount and urinary excretion of metformin and ceftizoxime could be inhibited by creatinine in renal cortical slices and isolated kidney perfusion. However, the urinary excretion of ofloxacin was not affected by high SCr. These results showed that the inhibition of tubular creatinine transporters by high SCr resulted to the decrease of urinary excretion of metformin and ceftizoxime, but not ofloxacin, which implied that the increase of SCr could also be used to evaluate the tubular excretion of drugs mediated by identical or partial overlap transporter with creatinine in normal GFR rats. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Reference values for serum creatinine in children younger than 1 year of age

    NARCIS (Netherlands)

    D. Boer (Dirk); Y.B. de Rijke (Yolanda); W.C.J. Hop (Wim); K. Cransberg (Karlien); E.M. Dorresteijn (Eiske)

    2010-01-01

    textabstractReliable reference values of enzymatically assayed serum creatinine categorized in small age intervals are lacking in young children. The aim of this study was to determine reference values for serum creatinine during the first year of life and study the influence of gender, weight and

  6. Prognostic Importance of Low Admission Serum Creatinine Concentration for Mortality in Hospitalized Patients.

    Science.gov (United States)

    Thongprayoon, Charat; Cheungpasitporn, Wisit; Kittanamongkolchai, Wonngarm; Harrison, Andrew M; Kashani, Kianoush

    2017-05-01

    The study objective was to assess the association between low serum creatinine value at admission and in-hospital mortality in hospitalized patients. This was a retrospective single-center cohort study conducted at a tertiary referral hospital. All hospitalized adult patients between 2011 and 2013 who had an admission creatinine value available were identified for inclusion in this study. Admission creatinine value was categorized into 7 groups: ≤0.4, 0.5 to 0.6, 0.7 to 0.8, 0.9 to 1.0, 1.1 to 1.2, 1.3 to 1.4, and ≥1.5 mg/dL. The primary outcome was in-hospital mortality. Logistic regression analysis was performed to obtain the odds ratio of in-hospital mortality for the various admission creatinine levels, using a creatinine value of 0.7 to 0.8 mg/dL as the reference group in the analysis of all patients and female patients and of 0.9 to 1.0 mg/dL in the analysis of male patients because it was associated with the lowest in-hospital mortality. Of 73,994 included patients, 973 (1.3%) died in the hospital. The association between different categories of admission creatinine value and in-hospital mortality assumed a U-shaped distribution, with both low and high creatinine values associated with higher in-hospital mortality. After adjustment for age, sex, ethnicity, principal diagnosis, and comorbid conditions, very low creatinine value (≤0.4 mg/dL) was significantly associated with increased mortality (odds ratio, 3.29; 95% confidence interval, 2.08-5.00), exceeding the risk related to a markedly increased creatinine value of ≥1.5 mg/dL (odds ratio, 2.56; 95% confidence interval, 2.07-3.17). The association remained significant in the subgroup analysis of male and female patients. Low creatinine value at admission is independently associated with increased in-hospital mortality in hospitalized patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Relationship between serum creatinine and obesity in children in Xinjiang, China.

    Science.gov (United States)

    Li, X-M; Ma, Y-T; Xie, X; Yang, Y-N; Li, X M; Zheng, Y-Y

    2014-04-03

    This study was designed to analyze the relationship between serum creatinine and body mass index in children in Xinjiang, China. We used a stratified sampling method to select 5222 children aged 6-17 years in 3 areas in Xinjiang and then measured serum creatinine with an enzymatic method. Our analysis showed that the mean serum creatinine of the various age groups differed, and the reference value increased gradually with age. In the groups with subjects older than 10 years, the serum creatinine values had a positive correlation with body mass index (r = 0.016, 10- and 11-year-olds; r = 0.177, 12- and 13-year-olds; r = 0.314, 14- and 15-year-olds; r = 0.380, 16- and 17-year-olds; P serum creatinine levels in children aged more than 10 years. Weight control is important in the protection of renal function.

  8. Serum creatinine and alkaline phosphatase levels are associated with severe chronic periodontitis.

    Science.gov (United States)

    Caúla, A L; Lira-Junior, R; Tinoco, E M B; Fischer, R G

    2015-12-01

    Periodontitis may alter systemic homeostasis and influence creatinine and alkaline phosphatase levels. Therefore, the aim of this study was to evaluate the relationship between severe chronic periodontitis and serum creatinine and alkaline phosphatase levels. One hundred patients were evaluated, 66 with severe chronic periodontitis (test group) and 34 periodontally healthy controls (control group). Medical, demographic and periodontal parameters were registered. Blood sample was collected after an overnight fast and serum creatinine and alkaline phosphatase levels were determined. There were significant differences between test and control groups in ethnicity, gender and educational level (p creatinine level (p serum creatinine and alkaline phosphatase levels. Severe chronic periodontitis was associated to lower creatinine and higher alkaline phosphatase levels. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. KEY COMPARISON: CCQM-K12: The determination of creatinine in serum

    Science.gov (United States)

    Welch, Michael J.; Phinney, Curtis P.; Parris, Reenie M.; May, Willie E.; Heo, Gwi Suk; Henrion, Andre; O'Conner, Gavin; Schimmel, Heinz

    2003-01-01

    A Key Comparison on the determination of creatinine in human serum organized by the Consultative Committee on Amount of Substance (CCQM) was carried out in 2001. To address the measurement traceability needs of the clinical chemistry community, the CCQM is undertaking Key Comparisons to document the capabilities of national metrology institutes (NMIs) that provide measurement services in this area. This Key Comparison, along with two others recently completed, CCQM-K6 and CCQM-K11, determination of total cholesterol and glucose, respectively, in serum, will provide a basis for evaluating the capabilities of NMIs for the determination of well-defined, organic substances of similar molecular weights and concentrations in human serum. Participants in CCQM-K12 included: National Institute of Standards and Technology (NIST) [USA], Coordinating Laboratory; Institute for Reference Materials and Measurements (IRMM) [EU]; Korea Research Institute of Standards and Science (KRISS) [S Korea]; Laboratory of the Government Chemist, (LGC) [UK]; and Physikalisch-Technische Bundesanstalt (PTB) [Germany]. Two frozen human serum materials were analyzed by each of the participants using either ID-GC/MS-based methods (three laboratories) or ID-LC/MS-based methods (two laboratories). Agreement of results among the participants was excellent, in accordance with the agreement found in a pilot study (CCQM-P9) for creatinine in serum. The resulting Key Comparison Reference Values had expanded uncertainties of less than 1% for both materials. In conclusion, five NMIs have demonstrated their ability to make reference measurements of creatinine in serum using isotope dilution-based methods that, when executed properly, provide measurements that are precise, accurate and SI traceable. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer

  10. Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials.

    Science.gov (United States)

    Coca, Steven G; Zabetian, Azadeh; Ferket, Bart S; Zhou, Jing; Testani, Jeffrey M; Garg, Amit X; Parikh, Chirag R

    2016-08-01

    Observational studies have shown that acute change in kidney function (specifically, AKI) is a strong risk factor for poor outcomes. Thus, the outcome of acute change in serum creatinine level, regardless of underlying biology or etiology, is frequently used in clinical trials as both efficacy and safety end points. We performed a meta-analysis of clinical trials to quantify the relationship between positive or negative short-term effects of interventions on change in serum creatinine level and more meaningful clinical outcomes. After a thorough literature search, we included 14 randomized trials of interventions that altered risk for an acute increase in serum creatinine level and had reported between-group differences in CKD and/or mortality rate ≥3 months after randomization. Seven trials assessed interventions that, compared with placebo, increased risk of acute elevation in serum creatinine level (pooled relative risk, 1.52; 95% confidence interval, 1.22 to 1.89), and seven trials assessed interventions that, compared with placebo, reduced risk of acute elevation in serum creatinine level (pooled relative risk, 0.57; 95% confidence interval, 0.44 to 0.74). However, pooled risks for CKD and mortality associated with interventions did not differ from those with placebo in either group. In conclusion, several interventions that affect risk of acute, mild to moderate, often temporary elevation in serum creatinine level in placebo-controlled randomized trials showed no appreciable effect on CKD or mortality months later, raising questions about the value of using small to moderate changes in serum creatinine level as end points in clinical trials. Copyright © 2016 by the American Society of Nephrology.

  11. Serum Creatinine Versus Plasma Methotrexate Levels to Predict Toxicities in Children Receiving High-dose Methotrexate.

    Science.gov (United States)

    Tiwari, Priya; Thomas, M K; Pathania, Subha; Dhawan, Deepa; Gupta, Y K; Vishnubhatla, Sreenivas; Bakhshi, Sameer

    2015-01-01

    Facilities for measuring methotrexate (MTX) levels are not available everywhere, potentially limiting administration of high-dose methotrexate (HDMTX). We hypothesized that serum creatinine alteration after HDMTX administration predicts MTX clearance. Overall, 122 cycles in 50 patients of non-Hodgkin lymphoma or acute lymphoblastic leukemia aged ≤18 years receiving HDMTX were enrolled prospectively. Plasma MTX levels were measured at 12, 24, 36, 48, 60, and 72 hours; serum creatinine was measured at baseline, 24, 48, and 72 hours. Correlation of plasma MTX levels with creatinine levels and changes in creatinine from baseline (Δ creatinine) were evaluated. Plasma MTX levels at 72 hours showed positive correlation with serum creatinine at 48 hours (P = .011) and 72 hours (P = .013) as also Δ creatinine at 48 hours (P = .042) and 72 hours (P = .045). However, cut-off value of either creatinine or Δ creatinine could not be established to reliably predict delayed MTX clearance. Greater than 50% Δ creatinine at 48 and 72 hours significantly predicted grade 3/4 leucopenia (P = .036 and P = .001, respectively) and thrombocytopenia (P = .012 and P = .009, respectively) but not mucositis (P = .827 and P = .910, respectively). Delayed MTX elimination did not predict any grade 3/4 toxicity. In spite of demonstration of significant correlation between serum creatinine and Δ creatinine with plasma MTX levels at 72 hours, cut-off value of either variable to predict MTX delay could not be established. Thus, either of these cannot be used as a surrogate for plasma MTX estimation. Interestingly, Δ creatinine effectively predicted hematological toxicities, which were not predicted by delayed MTX clearance.

  12. Metabolic risk factors associated with serum creatinine in a non-diabetic population.

    Science.gov (United States)

    Kronborg, Jens; Jenssen, Trond; Njølstad, Inger; Toft, Ingrid; Eriksen, Bjørn O

    2007-01-01

    Insulin resistance, low HDL-cholesterol and microalbuminuria are important components of the metabolic syndrome as defined by WHO. Insulin resistance and low HDL-cholesterol are also common in chronic kidney disease (CKD), but it is not clear whether they are early or late phenomenons in the development of renal failure. This study examined whether low-grade albuminuria (microalbuminuria), lipoprotein fractions, and the insulin/glucose ratio (IGR)-a surrogate marker of insulin resistance-were related to renal function (expressed as serum creatinine) in persons without diabetes and with apparently normal renal function. The study included 4,131 men and women aged 55-75 years from the cross-sectional Tromsø IV survey (1994-1995). Lifestyle factors, waist circumference and blood pressure were included in the analyses. Gender stratified multivariate analysis was used to assess the relationship between serum creatinine and microalbuminuria, lipoprotein fractions and IGR. Serum creatinine was positively associated with microalbuminuria in men (beta = 2.50, 95% confidence interval (CI) 0.66-4.34), but not in women. HDL-cholesterol and IGR were strongly associated with creatinine in both genders (HDL-cholesterol: Men: beta = -4.82, 95% CI -6.27 to -3.37; women: beta = -2.12, 95% CI -3.28 to -0.96. IGR: Second, third and fourth quartile compared with first quartile, men: beta = 0.94, 95% CI -0.63 to 2.51; 2.10, 95% CI 0.52-3.69 and 2.40, 95% CI 0.75-4.04; women: beta = 1.91, 95% CI 0.59-3.22; 2.61, 95% CI 1.28-3.95 and 3.20, 95% CI 1.80-4.60). These findings suggest that even early impairment of renal function may be associated with insulin resistance and dyslipidemia, regardless of renal albumin leakage.

  13. Serum Concentrations of Symmetric Dimethylarginine and Creatinine in Dogs with Naturally Occurring Chronic Kidney Disease.

    Science.gov (United States)

    Hall, J A; Yerramilli, M; Obare, E; Yerramilli, M; Almes, K; Jewell, D E

    2016-05-01

    Serum concentrations of symmetric dimethylarginine (SDMA) detected chronic kidney disease (CKD) in cats an average of 17.0 months before serum creatinine (Cr) concentrations increased above the reference interval. To report on the utility of measuring serum SDMA concentrations in dogs for detection of CKD before diagnosis by measurement of serum Cr. CKD dogs (n = 19) included those persistently azotemic for ≥3 months (n = 5), dogs that were azotemic at the time of death (n = 4), and nonazotemic dogs (n = 10). CKD dogs were compared with healthy control dogs (n = 20). Retrospective study, whereby serum Cr concentrations were determined by enzymatic colorimetry and serum SDMA concentrations were determined by liquid chromatography-mass spectrometry in dogs with necropsy confirmed CKD. Serum SDMA increased before serum Cr in 17 of 19 dogs (mean, 9.8 months; range, 2.2-27.0 months). Duration of elevations in serum SDMA concentrations before the dog developed azotemia (N = 1) or before the dog died (N = 1) was not determined. Serum SDMA and Cr concentrations were linearly related (r = 0.84; P Serum SDMA (r = -0.80) and serum Cr (r = -0.89) concentrations were significantly related to glomerular filtration rate (both P serum SDMA as a biomarker for CKD allows earlier detection of kidney dysfunction in dogs than does measurement of serum Cr. Earlier detection might be desirable for initiating renoprotective interventions that slow progression of kidney disease. Copyright © 2016 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  14. Relationship between normal serum creatinine concentration and periodontal disease in Japanese middle-aged males.

    Science.gov (United States)

    Shimazaki, Yoshihiro; Kushiyama, Mitoshi; Murakami, Masatoshi; Yamashita, Yoshihisa

    2013-01-01

    Periodontitis has been shown to be closely related to diabetes, which was recently found to be associated with lower serum creatinine. Conversely, several studies have suggested a positive relationship between periodontitis and abnormally high concentrations of serum creatinine associated with renal dysfunction, seemingly contradicting the above. This study evaluates periodontal status and serum levels of creatinine within the normal range to resolve this apparent contradiction. A comprehensive health examination of 907 Japanese males, 49 to 59 years old, was performed from 2000 to 2002. A blood sample was collected from the antecubital vein after an overnight fast. The periodontal parameters were periodontal probing depth (PD) and clinical attachment loss (AL). We examined the association between serum creatinine concentration within the normal range and periodontal parameters. Serum creatinine concentration within the normal range was inversely correlated with mean PD and mean AL. In multivariate linear regression analyses, every 0.1-mg/dL increment in serum creatinine concentration was associated with a 0.064-mm decrease in both mean PD and mean AL (P serum creatinine concentration and periodontal disease.

  15. Genome-Wide Association Study of Serum Creatinine Levels during Vancomycin Therapy

    Science.gov (United States)

    Van Driest, Sara L.; McGregor, Tracy L.; Velez Edwards, Digna R.; Saville, Ben R.; Kitchner, Terrie E.; Hebbring, Scott J.; Brilliant, Murray; Jouni, Hayan; Kullo, Iftikhar J.; Creech, C. Buddy; Kannankeril, Prince J.; Vear, Susan I.; Brothers, Kyle B.; Bowton, Erica A.; Shaffer, Christian M.; Patel, Neelam; Delaney, Jessica T.; Bradford, Yuki; Wilson, Sarah; Olson, Lana M.; Crawford, Dana C.; Potts, Amy L.; Ho, Richard H.; Roden, Dan M.; Denny, Josh C.

    2015-01-01

    Vancomycin, a commonly used antibiotic, can be nephrotoxic. Known risk factors such as age, creatinine clearance, vancomycin dose / dosing interval, and concurrent nephrotoxic medications fail to accurately predict nephrotoxicity. To identify potential genomic risk factors, we performed a genome-wide association study (GWAS) of serum creatinine levels while on vancomycin in 489 European American individuals and validated findings in three independent cohorts totaling 439 European American individuals. In primary analyses, the chromosome 6q22.31 locus was associated with increased serum creatinine levels while on vancomycin therapy (most significant variant rs2789047, risk allele A, β = -0.06, p = 1.1 x 10-7). SNPs in this region had consistent directions of effect in the validation cohorts, with a meta-p of 1.1 x 10-7. Variation in this region on chromosome 6, which includes the genes TBC1D32/C6orf170 and GJA1 (encoding connexin43), may modulate risk of vancomycin-induced kidney injury. PMID:26030142

  16. Prognosis and serum creatinine levels in acute renal failure at the time of nephrology consultation: an observational cohort study

    Directory of Open Access Journals (Sweden)

    de Irala Jokin

    2007-09-01

    Full Text Available Abstract Background The aim of this study is to evaluate the association between acute serum creatinine changes in acute renal failure (ARF, before specialized treatment begins, and in-hospital mortality, recovery of renal function, and overall mortality at 6 months, on an equal degree of ARF severity, using the RIFLE criteria, and comorbid illnesses. Methods Prospective cohort study of 1008 consecutive patients who had been diagnosed as having ARF, and had been admitted in an university-affiliated hospital over 10 years. Demographic, clinical information and outcomes were measured. After that, 646 patients who had presented enough increment in serum creatinine to qualify for the RIFLE criteria were included for subsequent analysis. The population was divided into two groups using the median serum creatinine change (101% as the cut-off value. Multivariate non-conditional logistic and linear regression models were used. Results A ≥ 101% increment of creatinine respect to its baseline before nephrology consultation was associated with significant increase of in-hospital mortality (35.6% vs. 22.6%, p Conclusion In this cohort, patients who had presented an increment in serum level of creatinine of ≥ 101% with respect to basal values, at the time of nephrology consultation, had increased mortality rates and were discharged from hospital with a more deteriorated renal function than those with similar Liano scoring and the same RIFLE classes, but with a

  17. Elevated Urinary Methylmalonic Acid/creatinine ratio and Serum Sterol levels in Patients with Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Sivrikaya Abdullah

    2018-01-01

    Full Text Available Introduction: Sitosterolemia, defined as phytosterolemia, is a rare autosomal recessive disease characterized by elevated blood sterol levels. Our aim was to investigate serum plant sterols, methylmalonic acid, vitamin B12, oxidized-LDL and homocysteine levels in ischemic and hemorrhagic stroke patients and healthy subjects. Material and Methods: 50 healthy subjects (without a family history of coronary artery disease and 89 patients hospitalized in the Selcuk University neurology clinic or intensive care unit with a diagnosis of stroke were included in this study. Serum plant sterols, homocysteine and methylmalonic acid, oxidized-LDL, total cholesterol, triglycerides, HDL-Cholesterol and vitamin B12 levels were analyzed by gas chromatography-mass spectrometry, liquid-chromatography tandem mass spectrometry, commercially available ELISA kit, spectrophotometry and chemiluminescence methods, respectively. Results: Urinary methylmalonic acid/creatinine ratio (p< 0.05, serum β-sitosterol levels and β-sitosterol/ cholesterol ratio were significantly higher (p <0.01 in patients compared to the control group. There was a significant positive correlation between the serum OxLDL- methylmalonic acid, serum homocysteine- urinary methylmalonic acid /creatinine ratio, serum methylmalonic acid - Urinary methylmalonic acid (p<0.05, serum homocysteine- urinary methylmalonic acid, urinary methylmalonic acid-methylmalonic acid/creatinine ratio, serum methylmalonic acid- methylmalonic acid/creatinine ratio, serum beta-sitosterol- beta-sitosterol /cholesterol, total cholesterol-HDL, total cholesterol-LDL (p <0.01 levels and negative correlation between vitamin B12- serum methylmalonic acid (p<0.05, cholesterol-stigmasterol/cholesterol, LDL- stigmasterol/cholesterol (p <0.01 levels in the patient group. Conclusion: Our findings presented that the serum sitosterol levels were significantly higher in stroke patients compared to controls.

  18. Differences in urine cadmium associations with kidney outcomes based on serum creatinine and cystatin C

    International Nuclear Information System (INIS)

    Weaver, Virginia M.; Kim, Nam-Soo; Lee, Byung-Kook; Parsons, Patrick J.; Spector, June; Fadrowski, Jeffrey; Jaar, Bernard G.; Steuerwald, Amy J.; Todd, Andrew C.

    2011-01-01

    Cadmium is a well-known nephrotoxicant; chronic exposure increases risk for chronic kidney disease. Recently, however, associations between urine cadmium and higher creatinine-based estimated glomerular filtration rate (eGFR) have been reported. Analyses utilizing alternate biomarkers of kidney function allow evaluation of potential mechanisms for these observations. We compared associations of urine cadmium with kidney function measures based on serum cystatin C to those with serum creatinine in 712 lead workers. Mean (standard deviation) molybdenum-corrected urine cadmium, Modification of Diet in Renal Disease (MDRD) eGFR and multi-variable cystatin C eGFR were 1.02 (0.65) μg/g creatinine, and 97.4 (19.2) and 112.0 (17.7) mL/min/1.73 m 2 , respectively. The eGFR measures were moderately correlated (r s =0.5; p 2 ; 95% confidence interval=1.6, 6.6). Urine creatinine was associated with serum creatinine-based but not cystatin-C-based eGFRs. These results support a biomarker-specific, rather than a kidney function, effect underlying the associations observed between higher urine cadmium and creatinine-based kidney function measures. Given the routine use of serum and urine creatinine in kidney and biomarker research, additional research to elucidate the mechanism(s) for these associations is essential.

  19. Lower Serum Creatinine Is Associated with Low Bone Mineral Density in Subjects without Overt Nephropathy.

    Science.gov (United States)

    Huh, Ji Hye; Choi, Soo In; Lim, Jung Soo; Chung, Choon Hee; Shin, Jang Yel; Lee, Mi Young

    2015-01-01

    Low skeletal muscle mass is associated with deterioration of bone mineral density. Because serum creatinine can serve as a marker of muscle mass, we evaluated the relationship between serum creatinine and bone mineral density in an older population with normal renal function. Data from a total of 8,648 participants (4,573 men and 4,075 postmenopausal women) aged 45-95 years with an estimated glomerular filtration rate >60 ml/min/1.73 m2 were analyzed from the Fourth Korea National Health and Nutrition Examination Survey (2008-2010). Bone mineral density (BMD) and appendicular muscle mass (ASM) were measured using dual-energy X-ray absorptiometry. Receiver operating characteristic curve analysis revealed that the cut points of serum creatinine for sarcopenia were below 0.88 mg/dl in men and 0.75 mg/dl in women. Subjects were divided into two groups: low creatinine and upper normal creatinine according to the cut point value of serum creatinine for sarcopenia. In partial correlation analysis adjusted for age, serum creatinine was positively associated with both BMD and ASM. Subjects with low serum creatinine were at a higher risk for low BMD (T-score ≤ -1.0) at the femur neck, total hip and lumbar spine in men, and at the total hip and lumbar spine in women after adjustment for confounding factors. Each standard deviation increase in serum creatinine was significantly associated with reduction in the likelihood of low BMD at the total hip and lumbar spine in both sexes (men: odds ratio (OR) = 0.84 [95% CI = 0.74-0.96] at the total hip, OR = 0.8 [95% CI = 0.68-0.96] at the lumbar spine; women: OR = 0.83 [95% CI = 0.73-0.95] at the total hip, OR=0.81 [95% CI = 0.67-0.99] at the lumbar spine). Serum creatinine reflected muscle mass, and low serum creatinine was independently associated with low bone mineral density in subjects with normal kidney function.

  20. Trends in the levels of urine and serum creatinine: data from NHANES 2001-2014.

    Science.gov (United States)

    Jain, Ram B

    2017-04-01

    Data from the National Health and Nutrition Examination Survey were used to study trends for urine and serum creatinine over 2001-2014 for those aged ≥20 years. In the absence of chronic kidney disease, levels of urine creatinine decreased for the total population, for those aged 20-29, 50-59, and ≥70 years, for males, and for Mexican Americans and other race/ethnicities. Levels of serum cotinine also exhibited a decreasing trend over 2001-2014 for the total population, for those aged 20-29 and 40-49 years, for females, and for non-Hispanic whites and Mexican Americans. In general, levels of serum creatinine and urine creatinine were positively correlated for chronic kidney disease stages 1-3 and negatively correlated for chronic kidney disease stages 4 and 5.

  1. 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.

  2. Relationship between levels of serum creatinine and perirenal hyperintensity on heavily T2-weighted MR images

    Energy Technology Data Exchange (ETDEWEB)

    Erden, Ayse, E-mail: ayse.erden@medicine.ankara.edu.tr [Ankara University, School of Medicine, Department of Radiology, Talatpasa Bulvari, Sihhiye, 06100 Ankara (Turkey); Sahin, Burcu Savran, E-mail: bsavrans@hotmail.com [Ankara University, School of Medicine, Department of Radiology, Talatpasa Bulvari, Sihhiye, 06100 Ankara (Turkey); Orgodol, Horolsuren, E-mail: hoogii99@yahoo.com [Ankara University, School of Medicine, Department of Radiology, Talatpasa Bulvari, Sihhiye, 06100 Ankara (Turkey); Erden, Ilhan, E-mail: erden@medicine.ankara.edu.tr [Ankara University, School of Medicine, Department of Radiology, Talatpasa Bulvari, Sihhiye, 06100 Ankara (Turkey); Biyikli, Zeynep, E-mail: zeynep.biyikli@gmail.com [Ankara University, School of Medicine, Department of Biostatistics, Talatpasa Bulvari, Sihhiye, 06100 Ankara (Turkey)

    2011-11-15

    Objective: To determine the frequency of perirenal hyperintensity on heavily T2-weighted images and to evaluate its relationship with serum creatinine levels. Subjects and methods: Axial and coronal single-shot fast spin-echo images which have been originally obtained for MR cholangiopancreatography in 150 subjects were examined by two observers individually for the presence of perirenal hyperintensity. The morphologic properties of perirenal hyperintensity (peripheral rim-like, discontinuous, polar) were recorded. Chi square test was used to test whether the frequencies of bilateral perirenal hyperintensity differ significantly in subjects with high serum creatinine levels and those with normal creatinine levels. This test was also used to compare the frequencies of perirenal hyperintensity in patients with and without renal cysts and in patients with and without corticomedullary differentiation. A p value of less than 0.05 was considered to be statistically significant. Results: The perirenal hyperintensity was identified in 40 of 150 cases (26.6%) on heavily T2-weighted image. Serum creatinine levels were high in 18 of 150 cases (12%). The perirenal hyperintensity was present in 11 of 18 subjects (61%) with high serum creatinine levels and 26 of 132 subjects (19.7%) with normal creatinine levels. The difference of rates in two groups was statistically significant. Odds ratio was 6407 (95% confidence interval 2264-18,129). The frequency of perirenal hyperintensity was also significantly higher in subjects with renal cyst or cysts in whom serum creatinine levels were normal (p < 0.05) (37.5% vs. 11.8%). Conclusion: Perirenal hyperintensities are more frequent in patients with high serum creatinine levels. They are also more common in patients with simple renal cysts.

  3. Relationship between levels of serum creatinine and perirenal hyperintensity on heavily T2-weighted MR images

    International Nuclear Information System (INIS)

    Erden, Ayse; Sahin, Burcu Savran; Orgodol, Horolsuren; Erden, Ilhan; Biyikli, Zeynep

    2011-01-01

    Objective: To determine the frequency of perirenal hyperintensity on heavily T2-weighted images and to evaluate its relationship with serum creatinine levels. Subjects and methods: Axial and coronal single-shot fast spin-echo images which have been originally obtained for MR cholangiopancreatography in 150 subjects were examined by two observers individually for the presence of perirenal hyperintensity. The morphologic properties of perirenal hyperintensity (peripheral rim-like, discontinuous, polar) were recorded. Chi square test was used to test whether the frequencies of bilateral perirenal hyperintensity differ significantly in subjects with high serum creatinine levels and those with normal creatinine levels. This test was also used to compare the frequencies of perirenal hyperintensity in patients with and without renal cysts and in patients with and without corticomedullary differentiation. A p value of less than 0.05 was considered to be statistically significant. Results: The perirenal hyperintensity was identified in 40 of 150 cases (26.6%) on heavily T2-weighted image. Serum creatinine levels were high in 18 of 150 cases (12%). The perirenal hyperintensity was present in 11 of 18 subjects (61%) with high serum creatinine levels and 26 of 132 subjects (19.7%) with normal creatinine levels. The difference of rates in two groups was statistically significant. Odds ratio was 6407 (95% confidence interval 2264-18,129). The frequency of perirenal hyperintensity was also significantly higher in subjects with renal cyst or cysts in whom serum creatinine levels were normal (p < 0.05) (37.5% vs. 11.8%). Conclusion: Perirenal hyperintensities are more frequent in patients with high serum creatinine levels. They are also more common in patients with simple renal cysts.

  4. Serum creatinine changes associated with critical illness and detection of persistent renal dysfunction after AKI.

    Science.gov (United States)

    Prowle, John R; Kolic, Ivana; Purdell-Lewis, Jeremy; Taylor, Rachelle; Pearse, Rupert M; Kirwan, Christopher J

    2014-06-06

    AKI is a risk factor for development or worsening of CKD. However, diagnosis of renal dysfunction by serum creatinine could be confounded by loss of muscle mass and creatinine generation after critical illness. A retrospective, single center analysis of serum in patients surviving to hospital discharge with an intensive care unit admission of 5 or more days between 2009 and 2011 was performed. In total, 700 cases were identified, with a 66% incidence of AKI. In 241 patients without AKI, creatinine was significantly lower (Pcreatinine was significantly lower than baseline in all patients except those patients with severe AKI (Kidney Disease Improving Global Outcomes category 3), who had no significant difference. In a multivariable regression model, median duration of hospitalization was associated with a predicted 30% decrease (95% confidence interval, 8% to 45%) in creatinine from baseline in the absence of AKI; after allowing for this effect, AKI was associated with a 29% (95% confidence interval, 10% to 51%) increase in predicted hospital discharge creatinine. Using a similar model to exclude the confounding effect of prolonged major illness on creatinine, 148 of 700 patients (95% confidence interval, 143 to 161) would have eGFRcreatinine (a 135% increase in potential CKD diagnoses; Pserum creatinine that persist to hospital discharge, potentially causing inaccurate assessment of renal function at discharge, particularly in survivors of AKI. Prospective measurements of GFR and creatinine generation are required to confirm the significance of these findings. Copyright © 2014 by the American Society of Nephrology.

  5. [New topics regarding equations for GFR estimation based on serum creatinine and cystatin C].

    Science.gov (United States)

    Horio, Masaru

    2014-02-01

    Japanese GFR equations and CKD-EPI equations based on standardized serum creatinine and standardized cystatin C are recommended in recent Japanese CKD guides and KDIGO guidelines for CKD management, respectively. CKD-EPIcreat overestimates GFR in Japanese subjects, probably due to the difference in muscle mass between Japanese and Caucasians. Unlike CKD-EPIcreat, CKD-EPIcys performs well in Japanese subjects, indicating the advantages of using cystatin C as a GFR marker. KDIGO guidelines suggest measuring eGFRcys in adults with eGFRcreat of 45-59 ml/min/1.73 m2 who do not have markers of kidney damage if confirmation of CKD is required. Creatinine is excreted by glomerular filtration, but also secreted by the tubules. Alteration of the tubular secretion of creatinine may influence the performance of GFR equations based on serum creatinine. Multivariate analysis showed that GFR and serum albumin levels were independent parameters affecting the fractional excretion of creatinine (FE-Cr). Alteration of FE-Cr according to the serum albumin levels may be one of the reasons for the bias of GFR equations based on serum creatinine. Low GFR is a risk factor for all-cause and cardiovascular mortality in a general population. However, the relationship between eGFR and the hazard risk of events is different depending on whether cystatin C or creatinine is used to calculate eGFR. The association between eGFRcys and the hazard risk is much stronger compared with eGFRcreat. Cystatin C may be a useful alternative to creatinine for detecting a high risk of complications in a general population and subjects with CKD.

  6. Serum creatinine is associated with coronary disease risk even in the absence of metabolic disorders.

    Science.gov (United States)

    Onat, Altan; Yüksel, Hüsniye; Can, Günay; Köroğlu, Bayram; Kaya, Ayşem; Altay, Servet

    2013-10-01

    In view of recent evidence that serum creatinine and dysfunctional apolipoprotein (apo)A-I may serve as inflammation mediators in people with enhanced inflammation, we studied whether or not these molecules were interrelated and associated with coronary heart disease (CHD) likelihood even in subjects without metabolic syndrome (MetS) or type-2 diabetes. Among unselected middle-aged Turkish adults with available serum apo A-I, lipoprotein(a) and creatinine measurements, 697 participants (designated as 'healthy') were enrolled, after exclusion of the stated metabolic disorders. CHD was identified in 87 subjects, roughly half during 3.1 years' follow-up. 'Healthy' individuals were overweight and had partly impaired fasting glucose but otherwise normal serum creatinine and other biochemical measurements. Being consistent with lacking anti-inflammatory activity, apoA-I was linearly and positively associated with apoB, in women further with creatinine. Logistic regression analyses showed that, beyond age, not non-HDL-cholesterol, systolic blood pressure and smoking status, but serum creatinine in each sex (OR in men 1.63 [95% CI 1.14; 2.31]) and CRP in women were significantly associated with CHD likelihood. The combined highest and lowest creatinine quartiles in women displayed an OR 2.14 (1.02; 4.51) compared with the intermediate quartiles, after similar adjustments. Elevated creatinine levels within normal range, linked to apoA-I dysfunctionality, are independently associated with CHD likelihood even in non-diabetic subjects without MetS. In such women the lowest creatinine quartile is also linked to CHD risk.

  7. Gender-Specific Differences in Baseline, Peak, and Delta Serum Creatinine: The NACSELD Experience.

    Science.gov (United States)

    O'Leary, Jacqueline G; Wong, Florence; Reddy, K Rajender; Garcia-Tsao, Guadalupe; Kamath, Patrick S; Biggins, Scott W; Fallon, Michael B; Subramanian, Ram M; Maliakkal, B; Thacker, Leroy; Bajaj, Jasmohan S

    2017-03-01

    Women have lower serum creatinine values than men for similar renal function. We aimed to determine the differential effect of baseline, peak, and delta creatinine between genders on outcomes in infected hospitalized cirrhotic patients. North American Consortium for the Study of End-Stage Liver Disease is a 15-center consortium of tertiary care hepatology centers prospectively enrolling infected cirrhotic inpatients. Baseline, peak, and delta creatinine during hospitalization were compared between genders, and their impact on overall survival, transplant-free survival, probability of transplantation, and need for renal replacement therapy (RRT) was analyzed. In total, 532 patients with cirrhosis (males = 59% median admission MELD = 20) had significantly lower median baseline (1.07 vs. 1.30 mg/dL, p creatinine (1.47 vs. 1.59 mg/dL, p = 0.024) in women than men during hospitalization for an infection, but both genders had similar delta creatinine levels (0.30 vs. 0.30 mg/dL, p = 0.957). Thirty-day mortality was similar between genders. RRT was not used more often in women (19 vs. 12%, p = 0.050), and women were 1.8 times more likely than men to receive RRT at the same creatinine (p = 0.028). Both peak and delta creatinine significantly predicted 6-month overall and transplant-free survival (p creatinine. Infected hospitalized cirrhotic women are significantly more likely than men to receive RRT at similar creatinine levels. Gender-specific differences in baseline, peak, and delta creatinine need further investigation to determine whether women need acute kidney injury treatment at lower creatinine thresholds than men.

  8. Clusterin in kidney transplantation: novel biomarkers versus serum creatinine for early prediction of delayed graft function.

    Science.gov (United States)

    Pianta, Timothy J; Peake, Philip W; Pickering, John W; Kelleher, Michaela; Buckley, Nicholas A; Endre, Zoltan H

    2015-01-01

    Current methods for rapid detection of delayed graft function (DGF) after kidney transplantation are unreliable. Urinary clusterin is a biomarker of kidney injury but its utility for prediction of graft dysfunction is unknown. In a single-center, prospective cohort study of renal transplant recipients (N=81), urinary clusterin was measured serially between 4 hr and 7 days after transplantation. The utility of clusterin for prediction of DGF (hemodialysis within 7 days of transplantation) was compared with urinary interleukin (IL)-18, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1, serum creatinine, and clinical variables. At 4 hr after reperfusion, anuria was highly specific, but of low sensitivity for detection of DGF. At 4 hr, receiver operating characteristic analysis suggested that urinary clusterin, IL-18, kidney injury molecule-1, and NGAL concentration were predictive of DGF. After adjusting for preoperative clinical variables and anuria, clusterin and IL-18 independently enhanced the clinical model for prediction of DGF. Kidney injury molecule-1 only modestly improved the prediction of DGF, whereas NGAL, serum creatinine, and the creatinine reduction ratio did not improve on the clinical model. At 12 hr, the creatinine reduction ratio independently predicted DGF. Both urinary clusterin and IL-18 are useful biomarkers and may allow triaging of patients with DGF within 4 hr of transplantation. Relative performance of biomarkers for prediction of graft function is time-dependant. Early and frequent measurements of serum creatinine and calculation of the creatinine reduction ratio also predict DGF within 12 hr of reperfusion.

  9. 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.

  10. Effect of management on serum electrolytes, urea and creatinine in ...

    African Journals Online (AJOL)

    Primary nephrotic syndrome (NS) and acute glomerulonephritis (AGN) are known to cause varying degrees of renal insufficiency depending on the severity. Certain drugs and management strategies used in these two disorders also have profound effect on the serum electrolyte and urea profiles. This study determines the ...

  11. Serum total proteins and creatinine levels in experimental gambian ...

    African Journals Online (AJOL)

    Attempt was therefore made to evaluate the effect of two strains of Trypanosoma brucei gambiense on total proteins and other serum biochemical parameters using vervet monkeys as a model. The outcome of both strains in vervet monkeys was traumatic as the monkeys died from infection 12 – 15 weeks post infection while ...

  12. Concurrence of Serum Creatinine and Albumin With Lower Risk for Death in Twice-Weekly Hemodialysis Patients.

    Science.gov (United States)

    Wang, Jialin; Streja, Elani; Soohoo, Melissa; Chen, Joline L T; Rhee, Connie M; Kim, Taehee; Molnar, Miklos Z; Kovesdy, Csaba P; Mehrotra, Rajnish; Kalantar-Zadeh, Kamyar

    2017-01-01

    Markers of better nutritional status including both higher levels of serum albumin (as a measure of visceral proteins) and creatinine (as a measure of the muscle mass) are associated with lower mortality in conventional (thrice weekly) hemodialysis patients. However, data for these associations in twice-weekly hemodialysis patients, in whom less frequent hemodialysis may confound nutritional predictors, are lacking. We identified 1,113 twice-weekly and matched 4,448 thrice-weekly hemodialysis patients from a large national dialysis cohort of incident hemodialysis patients over 5 years (2007-2011). Mortality risk, adjusted for potential confounders, was examined across two-by-two combinations of serum creatinine (creatinine ≥ 6 mg/dL and albumin ≥ 3.5 g/dL as reference, patients with creatinine creatinine mortality associations between twice-weekly and thrice-weekly hemodialysis patients (P-for-interaction = .7667). Surrogate markers of higher visceral protein and muscle mass combined may confer greatest survival in both twice-weekly and thrice-weekly hemodialysis patients. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  13. Creatinine clearance test

    Science.gov (United States)

    Serum creatinine clearance; Kidney function - creatinine clearance; Renal function - creatinine clearance ... Chernecky CC, Berger BJ. Creatinine clearance - serum and urine. ... Diagnostic Procedures . 6th ed. St Louis, MO: Elsevier Saunders; ...

  14. Effects of serum creatinine calibration on estimated renal function in african americans: the Jackson heart study.

    Science.gov (United States)

    Wang, Wei; Young, Bessie A; Fülöp, Tibor; de Boer, Ian H; Boulware, L Ebony; Katz, Ronit; Correa, Adolfo; Griswold, Michael E

    2015-05-01

    The calibration to isotope dilution mass spectrometry-traceable creatinine is essential for valid use of the new Chronic Kidney Disease Epidemiology Collaboration equation to estimate the glomerular filtration rate. For 5,210 participants in the Jackson Heart Study (JHS), serum creatinine was measured with a multipoint enzymatic spectrophotometric assay at the baseline visit (2000-2004) and remeasured using the Roche enzymatic method, traceable to isotope dilution mass spectrometry in a subset of 206 subjects. The 200 eligible samples (6 were excluded, 1 for failure of the remeasurement and 5 for outliers) were divided into 3 disjoint sets-training, validation and test-to select a calibration model, estimate true errors and assess performance of the final calibration equation. The calibration equation was applied to serum creatinine measurements of 5,210 participants to estimate glomerular filtration rate and the prevalence of chronic kidney disease (CKD). The selected Deming regression model provided a slope of 0.968 (95% confidence interval [CI], 0.904-1.053) and intercept of -0.0248 (95% CI, -0.0862 to 0.0366) with R value of 0.9527. Calibrated serum creatinine showed high agreement with actual measurements when applying to the unused test set (concordance correlation coefficient 0.934, 95% CI, 0.894-0.960). The baseline prevalence of CKD in the JHS (2000-2004) was 6.30% using calibrated values compared with 8.29% using noncalibrated serum creatinine with the Chronic Kidney Disease Epidemiology Collaboration equation (P serum creatinine measurements in the JHS, and the calibrated values provide a lower CKD prevalence estimate.

  15. In which patients should serum creatinine be measured before iodinated contrast medium administration?

    International Nuclear Information System (INIS)

    Thomsen, Henrik S.

    2005-01-01

    Routine measurement of serum creatinine before injection of intravascular iodinated contrast material in all patients would be cumbersome and have an associated cost. There is doubt about whether serum creatinine should be measured routinely in all patients or selectively. The Contrast Media Safety Committee of the European Society of Urogenital Radiology decided to review the literature and draw up guidelines on this important practical issue. A literature search was carried out and summarized in a report. Based on the available information and discussions amongst the members of the Committee, guidelines were produced. The report and guidelines were discussed at the 11th European Symposium on Urogenital Radiology in Santiago de Compostela, Spain. The practice for identifying patients at risk of contrast medium induced nephropathy varies considerably from one institution to another. Patients at risk constitute only a small percentage of all cases referred for contrast enhanced imaging examination. However, it is important to identify them and take the necessary precautions. Recent serum creatinine level should be available in patients with an increased probability of a raised serum creatinine level (renal disease, renal surgery, proteinuria, diabetes mellitus, hypertension, gout, current intake of nephrotoxic drugs). A simple guideline has been produced. (orig.)

  16. Clinical evaluation of analytical variations in serum creatinine measurements : why laboratories should abandon Jaffe techniques

    NARCIS (Netherlands)

    Drion, Iefke; Cobbaert, Christa; Groenier, Klaas H.; Weykamp, Cas; Bilo, Henk J. G.; Wetzels, Jack F. M.; Kleefstra, Nanne

    2012-01-01

    Background: Non-equivalence in serum creatinine (SCr) measurements across Dutch laboratories and the consequences hereof on chronic kidney disease (CKD) staging were examined. Methods: National data from the Dutch annual external quality organization of 2009 were used. 144 participating laboratories

  17. Reference ranges for serum creatinine and urea in elderly coastal Melanesians.

    Science.gov (United States)

    Erasmus, R T; Ray, U; Nathaniel, K; Dowse, G

    1997-06-01

    Mean values and reference ranges are presented for serum creatinine and serum urea in Melanesian men and women aged over 50 years from coastal Papua. The values are presented separately for three age groups, 51-60, 61-70 and 71-85 years, but there was no significant difference between them. The values for women were lower than for men in all age groups.

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

    Science.gov (United States)

    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.

  19. Serum cystatin C predicts vancomycin trough levels better than serum creatinine in hospitalized patients: a cohort study.

    Science.gov (United States)

    Frazee, Erin N; Rule, Andrew D; Herrmann, Sandra M; Kashani, Kianoush B; Leung, Nelson; Virk, Abinash; Voskoboev, Nikolay; Lieske, John C

    2014-05-29

    Serum cystatin C can improve glomerular filtration rate (GFR) estimation over creatinine alone, but whether this translates into clinically relevant improvements in drug dosing is unclear. This prospective cohort study enrolled adults receiving scheduled intravenous vancomycin while hospitalized at the Mayo Clinic in 2012. Vancomycin dosing was based on weight, serum creatinine with the Cockcroft-Gault equation, and clinical judgment. Cystatin C was later assayed from the stored serum used for the creatinine-based dosing. Vancomycin trough prediction models were developed by using factors available at therapy initiation. Residuals from each model were used to predict the proportion of patients who would have achieved the target trough with the model compared with that observed with usual care. Of 173 patients enrolled, only 35 (20%) had a trough vancomycin level within their target range (10 to 15 mg/L or 15 to 20 mg/L). Cystatin C-inclusive models better predicted vancomycin troughs than models based upon serum creatinine alone, although both were an improvement over usual care. The optimal model used estimated GFR by the Chronic Kidney Disease Epidemiology Collaborative (CKD-EPI) creatinine-cystatin C equation (R(2) = 0.580). This model is expected to yield 54% (95% confidence interval 45% to 61%) target trough attainment (P creatinine clearance yielded poor trough achievement. The developed dosing model with estimated GFR from CKD-EPIcreatinine-cystatin C could yield a 2.5-fold increase in target trough achievement compared with current clinical practice. Although this study is promising, prospective validation of this or similar cystatin C-inclusive dosing models is warranted.

  20. Serum creatinine levels and reactive nitrogen intermediates in children with cerebral malaria in Papua New Guinea.

    Science.gov (United States)

    al-Yaman, F; Awburn, M M; Clark, I A

    1997-01-01

    Serum from 41 of 92 children admitted to Madang Hospital, Papua New Guinea, with cerebral malaria, previously assessed for serum levels of reactive nitrogen intermediates (RNI: nitrate plus nitrite), were re-assessed for creatinine levels on the day of admission. Further analysis of RNI levels on day 21 compared to day 0 was carried out. Children with the highest RNI levels on admission, and with the longest duration of coma, did not have elevated creatinine levels. The highest levels of creatinine occurred among those with the lightest coma and creatinine levels were similar in those with short ( 48 h) duration of coma. Between days 0 and 21, RNI decreased in 30 of 57 children, increased in 23, and did not change in 4. There was a significant relationship between the decrease in RNI relative to the level of RNI on admission and the duration of coma. For children with a coma duration RNI level, but 6 of the 9 children with coma duration > 48 h showed a decrease in RNI greater than 50% of the RNI levels on admission. None of these 9 children had elevated creatinine levels. Elevated RNI levels in severe cases were thus not associated with renal function in these children in Papua New Guinea.

  1. 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…

  2. Comparison of serum cystatin C and creatinine changes after cardiopulmonary bypass in patients with normal preoperative kidney function.

    Science.gov (United States)

    Svensson, Anders S; Kovesdy, Csaba P; Kvitting, John-Peder Escobar; Rosén, Magnus; Cederholm, Ingemar; Szabó, Zoltán

    2013-12-01

    Serum creatinine is used ubiquitously to estimate glomerular filtration rate and to diagnose acute kidney injury after cardiac surgery. Serum cystatin C is a novel biomarker that has emerged as a possible diagnostic alternative to serum creatinine. It is unclear if the dynamic changes in serum cystatin C immediately following cardiopulmonary bypass (CPB) differ from those of serum creatinine in patients with normal preoperative kidney function. We compared changes in serum levels of creatinine and cystatin C by measuring them serially in 19 patients undergoing CPB. Within-patient differences for serum creatinine and serum cystatin C were compared by repeated measures ANOVA. Serum creatinine and cystatin C levels showed significant correlation with each other. Both biomarkers showed a significant decrease after CPB, but their serum concentrations reverted to pre-CPB levels within 12 h. Serum levels of serum creatinine remained unchanged from baseline levels throughout 72-h post-CPB. In contrast, serum cystatin C levels rose further and became significantly higher compared to baseline within 48 h. Serum cystatin C remained significantly elevated at 48- and 72-h post-CPB. Processes that determine the serum concentrations of serum creatinine and cystatin C in the post-CPB period affect the two biomarkers differently, suggesting that the two are not interchangeable as diagnostic markers of glomerular filtration rate. Future studies are needed to examine if these discrepancies are related to differences in their production rates, in their ability to detect small changes in glomerular filtration rate, or to a combination of these, and to determine the effect of such differences on the diagnostic and prognostic accuracy of the two biomarkers.

  3. Sigma metric analysis for performance of creatinine with fresh frozen serum.

    Science.gov (United States)

    Kang, Fengfeng; Zhang, Chuanbao; Wang, Wei; Wang, Zhiguo

    2016-01-01

    Six sigma provides an objective and quantitative methodology to describe the laboratory testing performance. In this study, we conducted a national trueness verification scheme with fresh frozen serum (FFS) for serum creatinine to evaluate its performance in China. Two different concentration levels of FFS, targeted with reference method, were sent to 98 laboratories in China. Imprecision and bias of the measurement procedure were calculated for each participant to further evaluate the sigma value. Quality goal index (QGI) analysis was used to investigate the reason of unacceptable performance for laboratories with σ creatinine had preferable sigma values. For the enzymatic method, 7.0% (5/71) to 45.1% (32/71) of the laboratories need to improve their measurement procedures (σ 1.2). Only 3.1-5.3% of the laboratories should improve both of the precision and trueness. Sigma metric analysis of the serum creatinine assays is disappointing, which was mainly due to the unacceptable analytical bias according to the QGI analysis. Further effort is needed to enhance the trueness of the creatinine measurement.

  4. Do acute elevations of serum creatinine in primary care engender an increased mortality risk?

    Science.gov (United States)

    Hobbs, Helen; Bassett, Paul; Wheeler, Toby; Bedford, Michael; Irving, Jean; Stevens, Paul E; Farmer, Christopher K T

    2014-12-22

    The significant impact Acute Kidney Injury (AKI) has on patient morbidity and mortality emphasizes the need for early recognition and effective treatment. AKI presenting to or occurring during hospitalisation has been widely studied but little is known about the incidence and outcomes of patients experiencing acute elevations in serum creatinine in the primary care setting where people are not subsequently admitted to hospital. The aim of this study was to define this incidence and explore its impact on mortality. The study cohort was identified by using hospital data bases over a six month period. People with a serum creatinine request during the study period, 18 or over and not on renal replacement therapy.The patients were stratified by a rise in serum creatinine corresponding to the Acute Kidney Injury Network (AKIN) criteria for comparison purposes. Descriptive and survival data were then analysed.Ethical approval was granted from National Research Ethics Service (NRES) Committee South East Coast and from the National Information Governance Board. The total study population was 61,432. 57,300 subjects with 'no AKI', mean age 64.The number (mean age) of acute serum creatinine rises overall were, 'AKI 1' 3,798 (72), 'AKI 2' 232 (73), and 'AKI 3' 102 (68) which equates to an overall incidence of 14,192 pmp/year (adult). Unadjusted 30 day survival was 99.9% in subjects with 'no AKI', compared to 98.6%, 90.1% and 82.3% in those with 'AKI 1', 'AKI 2' and 'AKI 3' respectively. After multivariable analysis adjusting for age, gender, baseline kidney function and co-morbidity the odds ratio of 30 day mortality was 5.3 (95% CI 3.6, 7.7), 36.8 (95% CI 21.6, 62.7) and 123 (95% CI 64.8, 235) respectively, compared to those without acute serum creatinine rises as defined. People who develop acute elevations of serum creatinine in primary care without being admitted to hospital have significantly worse outcomes than those with stable kidney function.

  5. Serum concentrations of symmetric dimethylarginine and creatinine in cats with kidney stones.

    Science.gov (United States)

    Hall, Jean A; Yerramilli, Maha; Obare, Edward; Li, Jun; Yerramilli, Murthy; Jewell, Dennis E

    2017-01-01

    Serum concentrations of symmetric dimethylarginine (SDMA) correlate with renal function in cats and SDMA has been shown to be a more reliable and earlier marker for chronic kidney disease (CKD) compared with serum creatinine (Cr). Calcium oxalate uroliths tend to develop in mid-to-older aged cats and kidney stones may cause a reduction in renal function with increased SDMA, but normal serum Cr. The purpose of this retrospective study was to determine if cats with kidney stones had increased serum SDMA concentrations, and whether SDMA increased earlier than serum creatinine concentrations. Cats in the colony with kidney stones diagnosed between August 2010 and December 2015 (n = 43) were compared with healthy geriatric cats (n = 21) without kidney stones. Serum SDMA concentrations were determined by liquid chromatography-mass spectrometry and serum Cr concentrations were determined by enzymatic colorimetry. Cats with kidney stones were diagnosed antemortem by radiographic imaging (n = 12) or by postmortem necropsy (n = 31). Retrospectively, serum SDMA was found to be increased above the upper reference limit in 39 of 43 cats with kidney stones. Serum Cr was increased above the upper reference limit in 18 of 43 cats; 6 of these 18 cats had terminal azotemia only. The mean time that serum SDMA was increased before serum Cr was increased was 26.9 months (range 0 to 60 months). Kidney stones were composed of calcium oxalate in 30 of 34 cats. The lifespan for cats with kidney stones (mean, 12.5 years; range, 6.1 to 18.1 years) was shorter (P < 0.001) than for control cats (mean, 15.2 years; range, 13.0 to 17.2 years), suggesting that non-obstructive kidney stones have an effect on mortality rate or rate of CKD progression. In conclusion, if SDMA concentrations are elevated in mid-to-older aged cats, further imaging studies are warranted to check for the presence of kidney stones.

  6. Reference values for serum creatinine with Jaffe-compensated assay in adult Iranian subjects: Tehran Lipid and Glucose Study.

    Science.gov (United States)

    Ghasemi, Asghar; Azimzadeh, Iraj; Zahediasl, Saleh; Azizi, Fereidoun

    2014-06-01

    Chronic kidney disease is a worldwide public health problem and glomerular filtration rate (GFR), the best overall index of renal function, is most commonly estimated from serum creatinine concentrations. The aim of this study was to determine reference values for serum creatinine concentrations using data from a population-based study in Iran. Serum creatinine was measured using the Jaffe method in 5247 men and women, aged 20-88 years, participants of the Tehran Lipid and Glucose Study. For calculating Jaffe compensated creatinine values in 382 samples, serum creatinine was measured using both the Jaffe and the enzymatic p-aminophenazone (PAP) methods. Linear regression analysis yielded a regression line equation of Jaffe-creatinine=0.863 × PAP-creatinine + 38.9 μmol/L (r = 0.973, n = 382, P creatinine reference values. Reference values for serum creatinine ranged between 47-98 μmol/L (0.53-1.11 mg/dL), 37-68 μmol/L (0.42-0.77 mg/dL), and 37-78 μmol/L (0.42-0.88 mg/dL) in men, non-menopausal women, and menopausal women, respectively. Mean serum creatinine concentration was significantly higher in men compared to women for both age ≤ 50 years [70 ± 11 vs. 50 ± 10 μmol/L (0.79 ± 0.12 vs. 0.57 ± 0.11 mg/dL), P 50 years [73 ± 12 vs. 55 ± 12 μmol/L (0.83 ± 0.14 vs. 0.62 ± 0.14 mg/dL), P serum creatinine using the compensated Jaffe method are presented in Iranian subjects, values that could help assessment of kidney function.

  7. Persistent serum creatinine increase following contrast-induced acute kidney injury.

    Science.gov (United States)

    Briguori, Carlo; Quintavalle, Cristina; De Micco, Francesca; Visconti, Gabriella; Di Palma, Vito; Napolitano, Giovanni; Focaccio, Amelia; Condorelli, Gerolama

    2017-08-11

    Contrast-induced acute kidney injury (CI-AKI) may led to both a transient and a persistent serum creatinine (sCr) increase. To assess whether serum cystatin C (sCyC) and urine and serum neutrophil gelatinase-associated lipocalin (uNGAL, sNGAL) are useful in the early identification of persistent sCr increase following CI-AKI. One hundred and eighteen patients who developed CI-AKI were included into the study. Persistent sCr elevation was defined as a persistent increase ≥0.3 mg dL -1 at 1 month after contrast media (CM) administration. sCr levels recovered in 87 patients (74%; Transient group), whereas a persistent elevation of sCr was observed in the remaining 31 patients (26%; Persistent group). By multivariable logistic regression analysis, independent predictors of persistent sCr increase were insulin therapy, uNGAL at 48 hr and absolute sCr difference between 48 and 72 hr. On the contrary, sCyC assessment did not help in the early identification of this subset of patients. By receiver operating curve analysis, the best cutoff values for predicting persistent sCr increase were uNGAL ≥0.50 ng dL -1 at 48 hr, and the absolute sCr increase ≥0.20 mg dL -1 between 48 and 72 hr. uNGAL ≥0.50 ng dL -1 at 48 hr and absolute sCr increase ≥0.20 mg dL -1 between 48 and 72 hr but not sCyC are useful in the early identification of patients developing persistent sCr increase after CM administration. © 2017 Wiley Periodicals, Inc.

  8. Early serum creatinine accurately predicts acute kidney injury post cardiac surgery.

    Science.gov (United States)

    Grynberg, Keren; Polkinghorne, Kevan R; Ford, Sharon; Stenning, Fiona; Lew, Thomas E; Barrett, Jonathan A; Summers, Shaun A

    2017-03-16

    Acute Kidney Injury (AKI) is a well recognized complication of cardiac surgery. It is associated with significant morbidity and mortality. The aims of our study are twofold; 1. To define the incidence of AKI post cardiac surgery. 2. To identify pre-morbid and operative risk factors for developing AKI and to determine if immediate post operative serum creatinine (IPOsCr) accurately predicts the development of AKI. We prospectively studied 196 consecutive patients undergoing elective (on-pump) cardiac surgery. Baseline patient characteristics, including medical co-morbidities, proteinuria, procedural data and kidney function (serum creatinine (sCr) were collected. Internationally standardised criteria for AKI were used (sCr >1.5 times baseline, elevation in sCr >26.4 μmmol/L (0.3 mg/dl). Measurements were collected pre-operatively, within 2 h of surgical completion (IPOsCr) and daily for two days. Logistic regression was used to assess predictive factors for AKI including IPOsCr. Model discrimination was assessed using ROC AUC curves. Forty (20.4%) patients developed AKI postoperatively. Hypertension (OR 2.64, p = 0.02), diabetes (OR 2.25, p = 0.04), proteinuria (OR 2.48, p = 0.02) and a lower baseline eGFR (OR 0.74, p = 0.002) were associated with AKI in univariate analysis. A multivariate logistic model with preoperative and surgical factors (age, gender, eGFR, proteinuria, hypertension, diabetes and type of cardiac surgery) demonstrated moderate discrimination for AKI (ROC AUC 0.76). The addition of IPOsCr improved model discrimination for AKI (AUC 0.82, p = 0.07 versus baseline AUC) and was independently associated with AKI (OR 7.17; 95% CI 1.27-40.32; p = 0.025). One in 5 patients developed AKI post cardiac surgery. These patients have significantly increased morbidity and mortality. IPOsCr is significantly associated with the development of AKI, providing a cheap readily available prognostic marker.

  9. Four-week effects of allopurinol and febuxostat treatments on blood pressure and serum creatinine level in gouty men.

    Science.gov (United States)

    Kim, Hyun Ah; Seo, Young-Il; Song, Yeong W

    2014-08-01

    The aim of this study was to observe the effects of uric acid lowering therapy (UALT), febuxostat and allopurinol, on blood pressure (BP) and serum creatinine level. Post-hoc data were derived from a phase-III, randomised, double-blind, 4-week trial of male gouty patients that compared the safety and efficacy of febuxostat and allopurinol in adults with gout. The subjects were randomly assigned to one of five groups, 35-37 in each group (febuxostat: 40, 80, 120 mg/d; allopurinol: 300 mg/d; control group: placebo). Blood pressure and serum creatinine level were measured at baseline and at weeks 2 and 4. Diastolic BP and creatinine level had decreased significantly in the UALT groups compared to the control group at week 4. Diastolic BP had decreased significantly in the allopurinol group and serum creatinine level had decreased significantly in the febuxostat groups at week 4. After adjusting for confounding variables, serum uric acid changes were found to be significantly correlated with changes in serum creatinine level but were not associated with changes in systolic or diastolic BP. UALT in gouty subjects significantly decreased diastolic BP and serum creatinine level. Changes in uric acid were significantly correlated with those in serum creatinine level, suggesting the feasibility of renal function improvement through UALT in gouty men.

  10. GFR, serum creatinine and 24-hour urine protein in evaluating renal function of patients with diabetes mellitus

    International Nuclear Information System (INIS)

    Chi Xiaohua; Li Guiping; Liu Feng; Wang Bing; Du Li; Deng Zhifang; Li Wei

    2013-01-01

    Background: Diabetes nephropathy is a common complication of diabetes mellitus patients. Early detection of renal impairment can improve the quality of life of patients. Purpose: The value of total GFR, serum creatinine, 24-hour urine protein excretion in diabetes mellitus patients with renal impairment were evaluated. Methods: A retrospective analysis of 147 patients with diabetes undergoing routine renal dynamic imaging was undertaken. The cases were divided into three groups according to the illness duration: group I of not more than five years, group 2 of five to ten years, Gr.3: more than ten years. The 22 renal transplant donors were selected as the normal control group, The total GFR, serum creatinine and 24-hour urinary protein excretion of all patients were measured before the treatments, and the data were statistically analyzed. Results: There was no significant differences in renal function between the two kidneys of in the diabetes mellitus patients (P=0.536). Serum creatinine and total GFR had significant correlation (R 2 =0.762), but no significant relationship between the 24-hour urine protein and the total GFR or serum creatinine. In the early and middle times of renal function impairment, the total GFR and serum creatinine have significant difference in different time periods (P<0.05). During the mid-late times of renal function impairment, total GFR and serum creatinine have no statistically significant differences (P value is 0.781, 0.297). 24-hour urine protein quality had no statistical differences in each stage. However: the total GFR is more sensitive than the serum creatinine in evaluation of early impairing of renal function. Conclusions: There is significant correlation between serum creatinine and total GFR. Both of them can reflect the degree of diabetic renal injury, but the total GFR is more sensitive than serum creatinine in early degree. 24-hour urine protein quantitative can not evaluate the degree of impaired renal function alone

  11. Elevated serum creatinine and low albumin are associated with poor outcomes in patients with liposarcoma.

    Science.gov (United States)

    Panotopoulos, Joannis; Posch, Florian; Funovics, Philipp T; Willegger, Madeleine; Scharrer, Anke; Lamm, Wolfgang; Brodowicz, Thomas; Windhager, Reinhard; Ay, Cihan

    2016-03-01

    Low serum albumin levels and impaired kidney function have been associated with decreased survival in patients with a variety of cancer types. In a retrospective cohort study, we analyzed 84 patients with liposarcoma treated at from May 1994 to October 2011. Uni- and multivariable Cox proportional hazard models and competing risk analyses were performed to evaluate the association between putative biomarkers with disease-specific and overall survival. The median age of the study population was 51.7 (range 19.6-83.8) years. In multivariable analysis adjusted for AJCC tumor stage, serum creatinine was highly associated with disease-specific survival (Subdistribution Hazard ratio (SHR) per 1 mg/dl increase = 2.94; 95%CI 1.39-6.23; p = 0.005). High albumin was associated with improved overall and disease-specific survival (Hazard Ratio (HR) per 10 units increase = 0.50; 95%CI 0.26-0.95; p = 0.033 and SHR = 0.64; 95%CI 0.42-1.00; p = 0.049). The serum albumin-creatinine-ratio emerged to be associated with both overall and disease-specific survival after adjusting for AJCC tumor stage (HR = 0.95; 95%CI 0.92-0.99; p = 0.011 and SHR = 0.96; 95%CI 0.93-0.99; p = 0.08). Our study provides evidence for a tumor-stage-independent association between higher creatinine and lower albumin with worse disease-specific survival. Low albumin and a high albumin-creatinine-ratio independently predict poor overall survival. Our work identified novel prognostic biomarkers for prognosis of patients with liposarcoma. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  12. Use of cystatin C and serum creatinine for the diagnosis of contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography at an oncology centre.

    Science.gov (United States)

    Fortalesa Melo, Joao Italo; Chojniak, Rubens; Costa Silva, Debora Helena; Oliveira Junior, Jose Carlos; Vieira Bitencourt, Almir Galvão; Holanda Silva, Diego; Guimarães, Marcos Duarte; Silva, Hernandes Cerqueira Souza; Dias, Denis Guilherme Teixeira; Rodrigues, Winglison Carli; Brancucci, Ellen Luzia; Cruz, Barbara Martins Soares; Schiavon, Beatriz Nunes; Argenton, Juliana Luz Passos; Camporini, Margareth Arrivabene; Zocchio, Adriana

    2015-01-01

    Our aim was to assess renal function using as laboratory measurements serum creatinine and cystatin C concentrations before and after administration of low-osmolarity (nonionic) iodinated contrast medium in patients with cancer undergoing computed tomography (CT). This prospective study included 400 oncologic outpatients. Serum creatinine and cystatin C concentrations were measured before and 72 h after contrast administration. Glomerular filtration rates (GFRs) were estimated using serum creatinine-based [Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault and cystatin C based (Larsson) equations. Exploratory data analysis was performed. The nonparametric Wilcoxon test was used to compare pre and post contrast of test results and estimated clearance. The confidence interval used in the analysis was 95%. Compared with the pre-contrast values, the mean serum creatinine concentration was significantly higher and average GFRs estimated using MDRD and Cockcroft-Gault equations were significantly lower after the administration of contrast (p serum creatinine and cystatin C concentrations showed changes in renal function among patients with cancer undergoing contrast-enhanced CT examination in this study. No significant renal damage related to the use of low-osmolarity iodinated contrast medium of the type and dosage employed in this study was observed. This contrast medium is thus safe for use in patients with cancer.

  13. INCREASED SERUM LEVELS OF UREA AND CREATININE ARE SURROGATE MARKERS FOR DISRUPTION OF RETINAL PHOTORECEPTOR EXTERNAL LIMITING MEMBRANE AND INNER SEGMENT ELLIPSOID ZONE IN TYPE 2 DIABETES MELLITUS.

    Science.gov (United States)

    Saxena, Sandeep; Ruia, Surabhi; Prasad, Senthamizh; Jain, Astha; Mishra, Nibha; Natu, Shankar M; Meyer, Carsten H; Gilhotra, Jagjit S; Kruzliak, Peter; Akduman, Levent

    2017-02-01

    To evaluate the role of serum urea and creatinine as surrogate markers for disruption of retinal photoreceptor external limiting membrane (ELM) and inner segment ellipsoid zone (EZ) in Type 2 diabetic retinopathy (DR) using spectral-domain optical coherence tomography, for the first time. One hundred and seventeen consecutive cases of Type 2 diabetes mellitus (diabetes without retinopathy [No DR; n = 39], nonproliferative diabetic retinopathy [NPDR; n = 39], proliferative diabetic retinopathy [PDR; n = 39]) and 40 healthy control subjects were included. Serum levels of urea and creatinine were assessed using standard protocol. Spectral-domain optical coherence tomography was used to grade the disruption of ELM and EZ as follows: Grade 0, no disruption of ELM and EZ; Grade 1, ELM disrupted, EZ intact; Grade 2, ELM and EZ disrupted. Data were analyzed statistically. Increase in serum levels of urea (F = 22.93) and creatinine (F = 15.82) and increased grades of disruption of ELM and EZ (γ = 116.3) were observed with increased severity of DR (P serum levels of urea (F = 10.45) and creatinine (F = 6.89) was observed with increased grades of disruption of ELM and EZ (P = 0.001). Serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor ELM and EZ on spectral-domain optical coherence tomography in DR.

  14. Serum albumin, but not glycated albumin was a potent factor affecting the performance of GFR equation based on serum creatinine.

    Science.gov (United States)

    Horio, Masaru; Imai, Enyu; Yasuda, Yoshinari; Watanabe, Tsuyoshi; Yokoyama, Hitoshi; Makino, Hirofumi; Matsuo, Seiichi

    2015-04-01

    Recently, Tsuda et al. reported that high HbA1C or high glycated albumin (GA) level is a major factor in overestimation of GFR by Japanese GFR equation based on serum creatinine (Eq-cr). They developed a modified equation of Eq-cr (M-Eq-cr) using GA or HbA1c. Therefore, effect of GA levels on the estimated GFR (eGFR) by Eq-cr was evaluated in Japanese subjects. We validated the accuracy of the modified equation using GA by Tsuda et al. (M-Eq-cr) and new equations that we developed in the present study. Seven hundred and fifteen Japanese subjects were included. GFR was measured by inulin renal clearance (Cin). The subjects were divided into two groups by upper limit of the GA reference range (GA-1: GA 16.4 %). Factors affecting the ratio of eGFR to Cin (eGFR/Cin) were evaluated using multivariate analysis. New equations based on creatinine and albumin (Eq-cr-alb) and based on creatinine, albumin and GA were developed from development dataset (382 subjects). Performances of the equations were validated in validation dataset (333 subjects). Correlation coefficients between eGFR by Eq-cr and Cin were 0.839 and 0.914 in GA-1 and GA-2, respectively. Slopes (95 % confidential interval) of the regression lines with zero intercepts were 1.013 (0.991 to 1.036) and 0.997 (0.951 to 1.043), respectively. Both slopes were not significantly different from 1.0. Biases were -2.3 ± 19.0 and 0.2 ± 11.7 ml/min/1.73 m(2), respectively. Accuracy (p30; percentage of subjects within 30 % of Cin) (95 % CI) were 78 % (75, 81) and 71 % (62, 78), respectively. There was no significant difference in bias and accuracy between the two groups, indicating a reasonable accuracy of Eq-cr in GA-1 and GA-2. Multiple regression analysis showed that lower serum albumin and higher GA were associated with higher eGFR/Cin. Albumin was a more potent factor affecting eGFR/Cin than GA. M-Eq-cr significantly underestimated GFR and had significantly larger bias compared with Eq-cr in subjects with GA > 20

  15. Effect of combined treatment of angiotensin converting enzyme inhibitors and diuretics on serum creatinine levels among elderly patients

    International Nuclear Information System (INIS)

    Sweileh, Waleed M.

    2006-01-01

    The adverse effects of angiotensin converting enzyme inhibitors (ACE-I) and diuretics when given together need extensive research and attention. We performed a cross-sectional study of patients admitted to the internal department of a general medical hospital to investigate the effect of drug combinations on serum creatinine level and creatinine clearance upon admission. Age, sex, disease, status and prior consumption of the target drugs: diuretics and ACE-I were correlated with creatnine and creatinine clearance on admission. The levels of serum creatinine for groups receiving the target combination in both sexes were significantly higher than groups who were not receiving the target combination. Computing an estimate of creatinine clearance based on Cockroft equation yields similar results to that for serum level creatinine. The levels of creatinine clearance in both sexes were significantly higher in the control group compared to those receiving the target combinations. Low dose aspirin seems to have a synergistic negative effect on renal function when given in combination with the target medications. Taking ACE-I/diuretic combination was associated with significant changes in creatinine levels and creatinine clearance. Attention should be made to balance positive effects of theses medications against their negative effect on renal function. (author)

  16. In vitro interference by acetaminophen, aspirin, and metamizole in serum measurements of glucose, urea, and creatinine.

    Science.gov (United States)

    Luna-Záizar, Hilda; Virgen-Montelongo, María; Cortez-Álvarez, Cesar R; Ruiz-Quezada, Sandra L; Escutia-Gutiérrez, Raymundo; García-Lemus, Cuauhtémoc R; Mendizabal-Ruiz, Adriana P

    2015-05-01

    Here we aimed to investigate the in vitro effects of three analgesic-antipyretic drugs frequently used in clinical practice in Mexico - acetaminophen (AAP), aspirin (ASA) and metamizole (MMZ) - on serum measurements of glucose, urea, and creatinine. Each analyte was measured in a base-serum pool spiked with the drugs at subtherapeutic, therapeutic, and toxic doses. Serum glucose and urea were measured using the hexokinase/G-6PDH and urease/GLDH kinetic assays, respectively. Serum creatinine (SCr) was measured with a Jaffe procedure based on the alkaline-picrate reaction and with an enzymatic dry-chemistry system. Measurements were carried out in IL-Monarch and Vitros DT60-II analyzers, respectively. Data were analyzed by the difference-paired interference test and by ANOVA. By the kinetic Jaffe/Monarch procedure, we found positive interference by the drugs on the SCr measurements and by only ASA for urea measurement. For creatinine measurements, the total errors (TEs) were 22-51%, 18-105%, and 15-26% for AAP, ASA, and MMZ respectively, while for urea measurement the TE was 16-21% for ASA. A negative interference by MMZ on SCr (TE=-47%), but no-interference for AAP or ASA, were found via the enzymatic/DT60-II system. In vitro positive interference induced by AAP, ASA, and MMZ (via the alkaline-picrate reaction), or negative interference by MMZ (via a dry-chemistry system), on the SCr measurements highlights the importance of investigating all possible sources of variation that may alter the accuracy of the laboratory tests, in order to provide useful results for making medical decisions for optimal patient care. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  17. Serum neopterin/creatinine values correlate with severity of symptoms caused by cytomegalovirus infection in renal transplant recipients

    NARCIS (Netherlands)

    Raasveld, M. H.; Bloemena, E.; Wertheim-van Dillen, P.; Surachno, J.; Wilmink, J. M.; ten Berge, I. J.

    1993-01-01

    Serum neopterin/creatinine ratios were longitudinally measured in 86 renal transplant recipients from the day before transplantation until 4 months after transplantation, and the relationship to the clinical symptoms of cytomegalovirus (CMV) infection was studied. Infection with cytomegalovirus

  18. THE PATTERN OF LONGITUDINAL CHANGE IN SERUM CREATININE AND NINETY-DAY MORTALITY AFTER MAJOR SURGERY

    Science.gov (United States)

    Hobson, Charles E; Pardalos, Panos

    2016-01-01

    Objective Calculate mortality risk that accounts for both severity and recovery of postoperative kidney dysfunction using the pattern of longitudinal change in creatinine. Summary Background Data Although the importance of renal recovery after acute kidney injury (AKI) is increasingly recognized, the complex association that accounts for longitudinal creatinine changes and mortality is not fully described. Methods We used routinely collected clinical information for 46,299 adult patients undergoing major surgery to develop a multivariable probabilistic model optimized for non-linearity of serum creatinine time series that calculates the risk function for ninety-day mortality. We performed a 70/30 cross validation analysis to assess the accuracy of the model. Results All creatinine time series exhibited nonlinear risk function in relation to ninety-day mortality and their addition to other clinical factors improved the model discrimination. For any given severity of AKI, patients with complete renal recovery, as manifested by the return of the discharge creatinine to the baseline value, experienced a significant decrease in the odds of dying within ninety days of admission compared to patients with partial recovery. Yet, for any severity of AKI even complete renal recovery did not entirely mitigate the increased odds of dying as patients with mild AKI and complete renal recovery still had significantly increased odds for dying compared to patients without AKI (odds ratio 1,48 (95% confidence interval 1.30-1.68). Conclusions We demonstrate the nonlinear relationship between both severity and recovery of renal dysfunction and ninety-day mortality after major surgery. We have developed an easily applicable computer algorithm that calculates this complex relationship. PMID:26181482

  19. The Pattern of Longitudinal Change in Serum Creatinine and 90-Day Mortality After Major Surgery.

    Science.gov (United States)

    Korenkevych, Dmytro; Ozrazgat-Baslanti, Tezcan; Thottakkara, Paul; Hobson, Charles E; Pardalos, Panos; Momcilovic, Petar; Bihorac, Azra

    2016-06-01

    Calculate mortality risk that accounts for both severity and recovery of postoperative kidney dysfunction using the pattern of longitudinal change in creatinine. Although the importance of renal recovery after acute kidney injury (AKI) is increasingly recognized, the complex association that accounts for longitudinal creatinine changes and mortality is not fully described. We used routinely collected clinical information for 46,299 adult patients undergoing major surgery to develop a multivariable probabilistic model optimized for nonlinearity of serum creatinine time series that calculates the risk function for 90-day mortality. We performed a 70/30 cross validation analysis to assess the accuracy of the model. All creatinine time series exhibited nonlinear risk function in relation to 90-day mortality and their addition to other clinical factors improved the model discrimination. For any given severity of AKI, patients with complete renal recovery, as manifested by the return of the discharge creatinine to the baseline value, experienced a significant decrease in the odds of dying within 90 days of admission compared with patients with partial recovery. Yet, for any severity of AKI, even complete renal recovery did not entirely mitigate the increased odds of dying, as patients with mild AKI and complete renal recovery still had significantly increased odds for dying compared with patients without AKI [odds ratio: 1.48 (95% confidence interval: 1.30-1.68)]. We demonstrate the nonlinear relationship between both severity and recovery of renal dysfunction and 90-day mortality after major surgery. We have developed an easily applicable computer algorithm that calculates this complex relationship.

  20. Low Body Mass Index, Serum Creatinine, and Cause of Death in Patients Undergoing Percutaneous Coronary Intervention.

    Science.gov (United States)

    Goel, Kashish; Gulati, Rajiv; Reeder, Guy S; Lennon, Ryan J; Lewis, Bradley R; Behfar, Atta; Sandhu, Gurpreet S; Rihal, Charanjit S; Singh, Mandeep

    2016-10-31

    Low body mass index (BMI) and serum creatinine are surrogate markers of frailty and sarcopenia. Their relationship with cause-specific mortality in elderly patients undergoing percutaneous coronary intervention is not well studied. We determined long-term cardiovascular and noncardiovascular mortality in 9394 consecutive patients aged ≥65 years who underwent percutaneous coronary intervention from 2000 to 2011. BMI and serum creatinine were divided into 4 categories. During a median follow-up of 4.2 years (interquartile range 1.8-7.3 years), 3243 patients (33.4%) died. In the multivariable model, compared with patients with normal BMI, patients with low BMI had significantly increased all-cause mortality (hazard ratio [HR] 1.4, 95% CI 1.1-1.7), which was related to both cardiovascular causes (HR 1.4, 95% CI 1.0-1.8) and noncardiovascular causes (HR 1.4, 95% CI 1.06-1.9). Compared with normal BMI, significant reduction was noted in patients who were overweight and obese in terms of cardiovascular mortality (overweight: HR 0.77, 95% CI 0.67-0.88; obese: HR 0.80, 95% CI 0.70-0.93) and noncardiovascular mortality (overweight: HR 0.85, 95% CI 0.74-0.97; obese: HR 0.82, 95% CI 0.72-0.95). In a multivariable model, in patients with normal BMI, low creatinine (≤0.70 mg/dL) was significantly associated with increased all-cause mortality (HR 1.8, 95% CI 1.3-2.5) and cardiovascular mortality (HR 2.3, 95% CI 1.4-3.8) compared with patients with normal creatinine (0.71-1.0 mg/dL); however, this was not observed in other BMI categories. We identified a new subgroup of patients with low serum creatinine and normal BMI that was associated with increased all-cause mortality and cardiovascular mortality in elderly patients undergoing percutaneous coronary intervention. Low BMI was associated with increased cardiovascular and noncardiovascular mortality. Nutritional support, resistance training, and weight-gain strategies may have potential roles for these patients undergoing

  1. The role of the uncertainty of measurement of serum creatinine concentrations in the diagnosis of acute kidney injury.

    Science.gov (United States)

    Kin Tekce, Buket; Tekce, Hikmet; Aktas, Gulali; Uyeturk, Ugur

    2016-01-01

    Uncertainty of measurement is the numeric expression of the errors associated with all measurements taken in clinical laboratories. Serum creatinine concentration is the most common diagnostic marker for acute kidney injury. The goal of this study was to determine the effect of the uncertainty of measurement of serum creatinine concentrations on the diagnosis of acute kidney injury. We calculated the uncertainty of measurement of serum creatinine according to the Nordtest Guide. Retrospectively, we identified 289 patients who were evaluated for acute kidney injury. Of the total patient pool, 233 were diagnosed with acute kidney injury using the AKIN classification scheme and then were compared using statistical analysis. We determined nine probabilities of the uncertainty of measurement of serum creatinine concentrations. There was a statistically significant difference in the number of patients diagnosed with acute kidney injury when uncertainty of measurement was taken into consideration (first probability compared to the fifth p = 0.023 and first probability compared to the ninth p = 0.012). We found that the uncertainty of measurement for serum creatinine concentrations was an important factor for correctly diagnosing acute kidney injury. In addition, based on the AKIN classification scheme, minimizing the total allowable error levels for serum creatinine concentrations is necessary for the accurate diagnosis of acute kidney injury by clinicians.

  2. Development of an isotope dilution GC-MS procedure for the routine determination of creatinine in complex serum samples.

    Science.gov (United States)

    Fernández-Fernández, Mario; González-Antuña, Ana; Rodríguez-González, Pablo; Añón Álvarez, M Elena; Álvarez, Francisco V; García Alonso, J Ignacio

    2014-04-20

    The accurate determination of creatinine in serum is essential for the diagnosis and treatment of kidney diseases. The determination of serum creatinine in clinical laboratories is routinely carried out by the Jaffe method or by enzymatic methods that may suffer from interferences. So, the development of reliable, fast and interference-free routine methods for complex serum samples is required. A fast method using isotope dilution mass spectrometry (IDMS) and gas chromatography mass spectrometry (GC-MS) was developed using minimally (13)C labeled creatinine analogs, multiple linear regression and rapid derivatization of creatinine with acetylacetone in 2 min by using focused microwave technology. The proposed method was validated with the analyses of two Certified Reference Materials (ERM-DA252a and ERM-DA253a) and compared with the Jaffe and enzymatic methods when analyzing real serum samples containing variable levels of bilirubin The proposed method is capable of providing accurate serum creatinine concentrations in less than 45 min from sample arrival to full data treatment and can be an alternative routine procedure for creatinine determinations in complex serum samples. Copyright © 2014 Elsevier B.V. All rights reserved.

  3.  Is serum cystatin C a better marker of kidney function than serum creatinine in septic newborns?

    Science.gov (United States)

    Maruniak-Chudek, Iwona; Owsianka-Podleśny, Teresa; Wróblewska, Jolanta; Jadamus-Niebrój, Danuta

    2012-04-02

    Several studies have claimed that the estimation of serum cystatin C could be a better marker of kidney excretory function than serum creatinine. However, its role in the diagnosis of reduced kidney function was not unquestionably confirmed. The aim of this study was to analyze the concentrations of serum cystatin C in neonates with sepsis. Thirty-two neonates (gestational age from 34 to 40 weeks) admitted to the NICU during the first 14 days of life were enrolled. Serum cystatin C concentrations were estimated by ELISA during three successive days in neonates treated for infection. The study group consisted of 9 newborns with sepsis, 14 with severe sepsis and 9 with septic shock. At the beginning of the observational period the mean serum concentration of cystatin C in the study group was 1.35 mg/L (95% CI 1.20-1.49). Surprisingly, the lowest concentration of cystatin was observed in patients with septic shock (1.23 mg/L; 95%CI 0.92-1.54) within the observation period. Higher concentrations were found in neonates with sepsis (1.47 mg/L; 95%CI 1.04-1.90) and severe sepsis (1.50; 1.12-1.87). There was no correlation between serum cystatin C concentration and serum creatinine or gestational age. A significant correlation was discovered between chronological age and cystatin C (R=-0.439, p=0.01). There was a tendency for cystatin C to decline during the second observational day in patients with sepsis (to 1.53 mg/L; 95%CI: 1.19-1.86) and severe sepsis (to 1.32 mg/L; 95%CI: 1.07-1.57), while a slight insignificant increase in patient with septic shock (to 1.28 mg/L; 95%CI: 0.88-1.68) was revealed. The interrelation between age and cystatin C concentration disappeared in the following days of stay in the NICU. Even in patients who died in the course of septic shock the observed changes in cystatin C levels were small and did not exceed those of serum creatinine. Cystatin C is not a useful marker of kidney function in neonates with sepsis.

  4. Serum Cystatin C– Versus Creatinine-Based Definitions of Acute Kidney Injury Following Cardiac Surgery: A Prospective Cohort Study

    Science.gov (United States)

    Spahillari, Aferdita; Parikh, Chirag R.; Sint, Kyaw; Koyner, Jay L.; Patel, Uptal D.; Edelstein, Charles L.; Passik, Cary S.; Thiessen-Philbrook, Heather; Swaminathan, Madhav; Shlipak, Michael G.

    2012-01-01

    Background The primary aim of this study was to compare the sensitivity and rapidity of AKI detection by cystatin C relative to creatinine following cardiac surgery. Study Design Prospective cohort study Settings and Participants 1,150 high-risk, adult cardiac surgery patients in the TRIBE-AKI (Translational Research Investigating Biomarker Endpoints for Acute Kidney Injury) Consortium. Predictor Changes in serum creatinine and cystatin C Outcome Post-surgical incidence of AKI Measurements Serum creatinine and cystatin C were measured at the preoperative visit and daily on postoperative days 1–5. To allow comparisons between changes in creatinine and cystatin C, AKI endpoints were defined by the relative increases in each marker from baseline (25, 50 and 100%) and the incidence of AKI was compared based upon each marker. Secondary aims were to compare clinical outcomes among patients defined as having AKI by cystatin C and/or creatinine. Results Overall, serum creatinine detected more cases of AKI than cystatin C: 35% developed a ≥25% increase in serum creatinine, whereas only 23% had ≥25% increase in cystatin C (p Creatinine also had higher proportions meeting the 50% (14% and 8%, pcreatinine or cystatin C. However, for each AKI threshold, patients with AKI confirmed by both markers had significantly higher risk of the combined mortality/dialysis outcome compared with patients with AKI detected by creatinine alone (p=0.002). Limitations There were few adverse clinical outcomes, limiting our ability to detect differences in outcomes between subgroups of patients based upon their definitions of AKI. Conclusion In this large multicenter study, we found that cystatin C was less sensitive for AKI detection compared with creatinine. However, confirmation by cystatin C appeared to identify a subset of AKI patients with substantially higher risk of adverse outcomes. PMID:22809763

  5. Adjusting the loading dose of Magnesium sulfate in preeclampsia according to BMI, serum level of creatinin and albumin

    Directory of Open Access Journals (Sweden)

    Hantoosh Zadeh S

    2001-11-01

    Full Text Available To determine the therapeutic dose of Mg according to BMI, serum level of calcium, creatinin and albumin a cross sectional study were carried on 150 cases of preeclampsia (100 mild, 50 sever type in Valei-Asr Hospital through the years 1378-79. All of eligible patients had given a single dose of 4 gr Mg, sulfate intravenously, then had continued with 20 gr/lit, 28 drop/min through IV infusion. Mild and sever preeclampsia cases were similar about the mean serum level of calcium and Mg. Before beginning of treatment, but were significantly different about the mean of serum level of creatinin and albumin (P=0.0001. In univariat analysis there was significant direct correlation between serum level of Mg 6 hours after beginning of treatment with serum level of creatinine and albumin, and significant association with BMI (P<0.05. So the serum level of Mg in end of treatment, (P<0.05 in multivariate regression analysis, the serum level of Mg in 6 hours after and end of treatment was correlated positively with serum level of creatinine and albumin and negatively with BMI. Serum level of Mg 6 hours after=-0.2+0.8 (Alb. Level +2.99 (creat level –0.22 (BMI. Serum level of Mg in end of treatment=-0.2+0.8 (Alb. Level +3.3 (creat level –0.24 (BMI.

  6. Imatinib Increases Serum Creatinine by Inhibiting Its Tubular Secretion in a Reversible Fashion in Chronic Myeloid Leukemia.

    Science.gov (United States)

    Vidal-Petiot, Emmanuelle; Rea, Delphine; Serrano, Fidéline; Stehlé, Thomas; Gardin, Claude; Rousselot, Philippe; Peraldi, Marie-Noëlle; Flamant, Martin

    2016-03-01

    Monitoring renal function is important in imatinib-treated patients with chronic myeloid leukemia because serum creatinine may increase during the course of therapy. The mechanism of this increase and its reversibility on treatment cessation have never been investigated. We retrospectively analyzed data from imatinib-treated patients explored in our renal physiology unit with measurement of glomerular filtration rate (urinary clearance of (51)CrEDTA) and of urinary clearance and tubular secretion of creatinine. Results were compared with those of controls matched for measured glomerular filtration rate, age, gender, and ethnicity. We also analyzed variations of serum creatinine before and during imatinib cessation and after imatinib resumption in patients enrolled in imatinib discontinuation studies. In 4 imatinib-treated patients who underwent thorough renal exploration, the part of creatinine clearance due to tubular secretion was negligible (2.4, 3.1, -1.3, and 2.8 mL/min) and significantly lower than that measured in their respective controls (17.7 ± 5.6, 43.0 ± 18.0, 23.1 ± 6.7, and 18.6 ± 5.6 mL/min, P creatinine tubular secretion (20.3 vs. 17.9 ± 5.2 mL/min in the control population, P = .2). In 15 patients of imatinib discontinuation studies, a median decrease in serum creatinine of 17.9% was observed after imatinib cessation. Resumption of treatment in 6 patients led to a median increase in serum creatinine of 18.8%. Imatinib completely blunts tubular secretion of creatinine, a previously unreported pharmacologic property. This inhibition increases serum creatinine independently of any glomerular dysfunction and is fully reversible on imatinib cessation. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Evaluation of formulas using the serum creatinine level to calculate the optimal dosage of carboplatin.

    Science.gov (United States)

    van Warmerdam, L J; Rodenhuis, S; ten Bokkel Huinink, W W; Maes, R A; Beijnen, J H

    1996-01-01

    Carboplatin is a chemotherapeutic agent frequently used in the treatment of various malignancies. An individual dosing strategy has been recommended to yield the most optimal exposure, expressed as the area under the concentration-time curve (AUC). The formula developed by Calvert et al. (dose = target-AUC x [GFR + 25]) can be used to achieve this. However, due to the inconvenient [51Cr]-ethylenediamine-tetraacetic acid ([51Cr]-EDTA)-based measurement of the glomerular filtration rate (GFR), its application in the clinic has thus far been limited. Chatelut and co-workers have recently proposed a formula to estimate carboplatin clearance using the serum creatinine concentration. We retrospectively tested the Chatelut equation and the Calvert formula using either the creatinine clearance based on 24-h urine collection or the creatinine clearance based on the formula of Cockcroft and Gault. The latter equations were shown to predict the carboplatin clearance reasonably well, although systematic overprediction and underprediction occurred. However, the formula proposed by Chatelut and co-workers had no significant bias and was precise. It is proposed that this formula be used to calculate the optimal carboplatin dosage after prospective validation has been performed.

  8. How the use of creatine supplements can elevate serum creatinine in the absence of underlying kidney pathology

    Science.gov (United States)

    Williamson, Lydia; New, David

    2014-01-01

    Serum creatinine is a widely used marker in the assessment of renal function. Elevated creatinine levels suggest kidney dysfunction, prompting the need for further investigation. This report describes a case in which the consumption of the bodybuilding supplement creatine ethyl ester resulted in raised serum creatinine in the absence of true underlying kidney pathology. The abnormalities reversed after discontinuation of the supplement. A case of pseudo renal failure was recognised and kidney function was concluded to be normal. This report aims to address the mechanisms by which the ingestion of creatine ethyl ester can mimic the blood results expected in advanced renal failure, and confronts the problems faced when relying on serum creatinine as a diagnostic tool. PMID:25239988

  9. Serum creatinine elevation after renin-angiotensin system blockade and long term cardiorenal risks: cohort study.

    Science.gov (United States)

    Schmidt, Morten; Mansfield, Kathryn E; Bhaskaran, Krishnan; Nitsch, Dorothea; Sørensen, Henrik Toft; Smeeth, Liam; Tomlinson, Laurie A

    2017-03-09

    Objective  To examine long term cardiorenal outcomes associated with increased concentrations of creatinine after the start of angiotensin converting enzyme inhibitor/angiotensin receptor blocker treatment. Design  Population based cohort study using electronic health records from the Clinical Practice Research Datalink and Hospital Episode Statistics. Setting  UK primary care, 1997-2014. Participants  Patients starting treatment with angiotensin converting enzyme inhibitors or angiotensin receptor blockers (n=122 363). Main outcome measures  Poisson regression was used to compare rates of end stage renal disease, myocardial infarction, heart failure, and death among patients with creatinine increases of 30% or more after starting treatment against those without such increases, and for each 10% increase in creatinine. Analyses were adjusted for age, sex, calendar period, socioeconomic status, lifestyle factors, chronic kidney disease, diabetes, cardiovascular comorbidities, and use of other antihypertensive drugs and non-steroidal anti-inflammatory drugs. Results  Among the 2078 (1.7%) patients with creatinine increases of 30% or more, a higher proportion were female, were elderly, had cardiorenal comorbidity, and used non-steroidal anti-inflammatory drugs, loop diuretics, or potassium sparing diuretics. Creatinine increases of 30% or more were associated with an increased adjusted incidence rate ratio for all outcomes, compared with increases of less than 30%: 3.43 (95% confidence interval 2.40 to 4.91) for end stage renal disease, 1.46 (1.16 to 1.84) for myocardial infarction, 1.37 (1.14 to 1.65) for heart failure, and 1.84 (1.65 to 2.05) for death. The detailed categorisation of increases in creatinine concentrations (creatinine increases of less than 30% were also associated with increased incidence rate ratios for all outcomes, including death (1.15 (1.09 to 1.22) for increases of 10-19% and 1.35 (1.23 to 1.49) for increases of 20-29%, using creatinine

  10. Blood urea nitrogen to serum creatinine ratio is an accurate predictor of outcome in diarrhea-associated hemolytic uremic syndrome, a preliminary study.

    Science.gov (United States)

    Keenswijk, Werner; Vanmassenhove, Jill; Raes, Ann; Dhont, Evelyn; Vande Walle, Johan

    2017-03-01

    Diarrhea-associated hemolytic uremic syndrome (D+HUS) is a common thrombotic microangiopathy during childhood and early identification of parameters predicting poor outcome could enable timely intervention. This study aims to establish the accuracy of BUN-to-serum creatinine ratio at admission, in addition to other parameters in predicting the clinical course and outcome. Records were searched for children between 1 January 2008 and 1 January 2015 admitted with D+HUS. A complicated course was defined as developing one or more of the following: neurological dysfunction, pancreatitis, cardiac or pulmonary involvement, hemodynamic instability, and hematologic complications while poor outcome was defined by death or development of chronic kidney disease. Thirty-four children were included from which 11 with a complicated disease course/poor outcome. Risk of a complicated course/poor outcome was strongly associated with oliguria (p = 0.000006) and hypertension (p = 0.00003) at presentation. In addition, higher serum creatinine (p = 0.000006) and sLDH (p = 0.02) with lower BUN-to-serum creatinine ratio (p = 0.000007) were significantly associated with development of complications. A BUN-to-sCreatinine ratio ≤40 at admission was a sensitive and highly specific predictor of a complicated disease course/poor outcome. A BUN-to-serum Creatinine ratio can accurately identify children with D+HUS at risk for a complicated course and poor outcome. What is Known: • Oliguria is a predictor of poor long-term outcome in D+HUS What is New: • BUN-to-serum Creatinine ratio at admission is an entirely novel and accurate predictor of poor outcome and complicated clinical outcome in D+HUS • Early detection of the high risk group in D+HUS enabling early treatment and adequate monitoring.

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

    Science.gov (United States)

    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.

  12. Creatinine Index as a Surrogate of Lean Body Mass Derived from Urea Kt/V, Pre-Dialysis Serum Levels and Anthropometric Characteristics of Haemodialysis Patients

    Science.gov (United States)

    Canaud, Bernard; Granger Vallée, Alexandre; Molinari, Nicolas; Chenine, Leila; Leray-Moragues, Hélène; Rodriguez, Annie; Chalabi, Lotfi; Morena, Marion; Cristol, Jean-Paul

    2014-01-01

    Background and Objectives Protein-energy wasting is common in long-term haemodialysis (HD) patients with chronic kidney disease and is associated with increased morbidity and mortality. The creatinine index (CI) is a simple and useful nutritional parameter reflecting the dietary skeletal muscle protein intake and skeletal muscle mass of the patient. Because of the complexity of creatinine kinetic modeling (CKM) to derive CI, we developed a more simplified formula to estimate CI in HD patients. Design, Setting, Participants & Measurements A large database of 549 HD patients followed over more than 20 years including monthly CKM-derived CI values was used to develop a simple equation based on patient demographics, predialysis serum creatinine values and dialysis dose (spKt/V) using mixed regression models. Results The equation to estimate CI was developed based on age, gender, pre-dialysis serum creatinine concentrations and spKt/V urea. The equation-derived CI correlated strongly with the measured CI using CKM (correlation coefficient  = 0.79, p-value serum creatinine concentrations and dialysis dose is a simple and accurate surrogate measure for muscle mass estimation. However, the predictive value of the simplified CI assessment method on mortality deserves further evaluation in large cohorts of HD patients. PMID:24671212

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

    Science.gov (United States)

    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.

  14. Serum creatinine levels during and after long-term treatment with cyclosporine A in patients with severe atopic dermatitis.

    Science.gov (United States)

    van der Schaft, Jorien; van Zuilen, Arjan D; Deinum, Joukje; Bruijnzeel-Koomen, Carla A F M; de Bruin-Weller, Marjolein S

    2015-11-01

    Safety data with respect to kidney function during long-term treatment with cyclosporine A (CsA) in patients with atopic dermatitis is limited. Data on serum creatinine levels before, during and after CsA treatment were collected in a retrospective cohort of adult patients with atopic dermatitis. The median duration of treatment of 150 patients was 280 days (interquartile range 203-528 days). There was a significant, but not clinically relevant, increase in serum creatinine compared with the baseline level after 3 weeks of treatment with CsA and stabilization during the maintenance phase at the group level. Twenty-two (14.7%) patients had a greater than 30% increase in serum creatinine (cut-off point for clinically relevant change) compared with baseline. These patients were significantly older than the patients without a 30% increase (mean ± standard deviation age 41.4 ± 15.6 vs. 33.8 ± 11.7 years (p = 0.01)). During follow-up, all patients had a less than 30% increase in serum creatinine levels compared with baseline levels. At the group level serum creatinine levels during follow-up were not significantly different from baseline.

  15. Positive Impact of Nutritional Interventions on Serum Symmetric Dimethylarginine and Creatinine Concentrations in Client-Owned Geriatric Cats.

    Directory of Open Access Journals (Sweden)

    Jean A Hall

    Full Text Available A prospective study was conducted in client-owned geriatric cats to evaluate the short- term effects of a test food on serum symmetric dimethylarginine (SDMA and creatinine (Cr concentrations. Test food contained functional lipids (fish oil, antioxidants (vitamins C and E, L-carnitine, botanicals (vegetables, highly bioavailable protein, and amino acid supplements. Cats (n = 80 were fed either test food or owner's-choice foods (non-nutritionally controlled cohort. Cats were included based on age (≥ 9 years, indoor only, neutered, and free of chronic disease. At baseline, all cats had serum Cr concentrations within the reference interval. Renal function biomarkers and urinalysis results at baseline and after consuming test food or owner's-choice foods for 3 and 6 months were evaluated. Cats consuming test food showed significant decreases in serum Cr and BUN concentrations across time. Overall, cats consuming owner's-choice foods showed significant increases in serum SDMA concentrations at 3 and 6 months compared with baseline (P ≤ 0.05, whereas in cats consuming test food serum SDMA concentrations did not change. At baseline or during the 6-month feeding trial, 23 (28.8% cats had increased serum SDMA, but normal serum Cr consistent with IRIS Stage 1 chronic kidney disease. This included 6 cats fed test food and 17 cats fed owner's-choice foods. In the 6 cats fed test food, serum SDMA decreased in 3 cats and remained stable in 1 cat, whereas in the 17 cats fed owner's-choice foods, serum SDMA increased in 13 cats and decreased or remained stable in 4 cats. The increase in serum SDMA concentration was significant (P = 0.02 only for cats fed owner's-choice foods. These results suggest that nonazotemic cats with elevated serum SDMA (early renal insufficiency when fed a food designed to promote healthy aging are more likely to demonstrate stable renal function compared with cats fed owner's-choice foods. Cats fed owner's-choice foods were more

  16. Positive Impact of Nutritional Interventions on Serum Symmetric Dimethylarginine and Creatinine Concentrations in Client-Owned Geriatric Cats.

    Science.gov (United States)

    Hall, Jean A; MacLeay, Jennifer; Yerramilli, Maha; Obare, Edward; Yerramilli, Murthy; Schiefelbein, Heidi; Paetau-Robinson, Inke; Jewell, Dennis E

    2016-01-01

    A prospective study was conducted in client-owned geriatric cats to evaluate the short- term effects of a test food on serum symmetric dimethylarginine (SDMA) and creatinine (Cr) concentrations. Test food contained functional lipids (fish oil), antioxidants (vitamins C and E), L-carnitine, botanicals (vegetables), highly bioavailable protein, and amino acid supplements. Cats (n = 80) were fed either test food or owner's-choice foods (non-nutritionally controlled cohort). Cats were included based on age (≥ 9 years), indoor only, neutered, and free of chronic disease. At baseline, all cats had serum Cr concentrations within the reference interval. Renal function biomarkers and urinalysis results at baseline and after consuming test food or owner's-choice foods for 3 and 6 months were evaluated. Cats consuming test food showed significant decreases in serum Cr and BUN concentrations across time. Overall, cats consuming owner's-choice foods showed significant increases in serum SDMA concentrations at 3 and 6 months compared with baseline (P ≤ 0.05), whereas in cats consuming test food serum SDMA concentrations did not change. At baseline or during the 6-month feeding trial, 23 (28.8%) cats had increased serum SDMA, but normal serum Cr consistent with IRIS Stage 1 chronic kidney disease. This included 6 cats fed test food and 17 cats fed owner's-choice foods. In the 6 cats fed test food, serum SDMA decreased in 3 cats and remained stable in 1 cat, whereas in the 17 cats fed owner's-choice foods, serum SDMA increased in 13 cats and decreased or remained stable in 4 cats. The increase in serum SDMA concentration was significant (P = 0.02) only for cats fed owner's-choice foods. These results suggest that nonazotemic cats with elevated serum SDMA (early renal insufficiency) when fed a food designed to promote healthy aging are more likely to demonstrate stable renal function compared with cats fed owner's-choice foods. Cats fed owner's-choice foods were more likely to

  17. The Effect of Hibiscus Sabdariffa on Lipid Profile, Creatinine, and Serum Electrolytes: A Randomized Clinical Trial

    Science.gov (United States)

    Mohagheghi, Abbas; Maghsoud, Shirin; Khashayar, Patricia; Ghazi-Khansari, Mohammad

    2011-01-01

    Background. Hibiscus Sabdariffa L. (HS), a member of malvaceae family, is a medicinal plant with a worldwide fame. Its effect on reducing serum lipids is mentioned in several studies. The purpose of this study was to assess the efficacy of this plant in reducing the serum's lipids in hypertensive patients. Materials and Methods. Ninety hypertensive patients were randomly assigned to receive Hibiscus Sabdariffa (HS) tea or black tea for 15 days. The patients were asked to drink the tea within 20 minutes following its preparation. This process had to be repeated two times, daily. Patient's FBS and lipid profile were collected at the first visit day (day 0) and on the day 30. Results. There was no significant differences between pre and post experiment values within the two groups. An upward trend in total cholesterol, HDL, and LDL cholesterol was evident in both groups. The increase in total and HDL cholesterol in both groups relative to their initial values were significant. Conclusion. Hibiscus Sabdariffa is probably a safe medicinal plant. No significant harmful changes in cholesterol, triglyceride, BUN, serum creatinine, Na and K levels were observed within 15 days after the discontinuation of the medication. PMID:21991538

  18. Use of cystatin C and serum creatinine for the diagnosis of contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography at an oncology centre.

    Directory of Open Access Journals (Sweden)

    Joao Italo Fortalesa Melo

    Full Text Available Our aim was to assess renal function using as laboratory measurements serum creatinine and cystatin C concentrations before and after administration of low-osmolarity (nonionic iodinated contrast medium in patients with cancer undergoing computed tomography (CT.This prospective study included 400 oncologic outpatients. Serum creatinine and cystatin C concentrations were measured before and 72 h after contrast administration. Glomerular filtration rates (GFRs were estimated using serum creatinine-based [Modification of Diet in Renal Disease (MDRD and Cockroft-Gault and cystatin C based (Larsson equations. Exploratory data analysis was performed. The nonparametric Wilcoxon test was used to compare pre and post contrast of test results and estimated clearance. The confidence interval used in the analysis was 95%.Compared with the pre-contrast values, the mean serum creatinine concentration was significantly higher and average GFRs estimated using MDRD and Cockcroft-Gault equations were significantly lower after the administration of contrast (p <0.001. It was also observed a significant increase after contrast in the concentration of Cystatin C (p = 0.015. In addition, a decrease in GFR estimated using the average Larsson (p = 0.021 was observed between time points. However, none of the patients presented clinically significant nephropathy.Assessment using serum creatinine and cystatin C concentrations showed changes in renal function among patients with cancer undergoing contrast-enhanced CT examination in this study. No significant renal damage related to the use of low-osmolarity iodinated contrast medium of the type and dosage employed in this study was observed. This contrast medium is thus safe for use in patients with cancer.

  19. Superiority of Serum Cystatin C Over Creatinine in Prediction of Long-Term Prognosis at Discharge From ICU.

    Science.gov (United States)

    Ravn, Bo; Prowle, John R; Mårtensson, Johan; Martling, Claes-Roland; Bell, Max

    2017-09-01

    Renal outcomes after critical illness are seldom assessed despite strong correlation between chronic kidney disease and survival. Outside hospital, renal dysfunction is more strongly associated with mortality when assessed by serum cystatin C than by creatinine. The relationship between creatinine and longer term mortality might be particularly weak in survivors of critical illness. Retrospective observational cohort study. In 3,077 adult ICU survivors, we compared ICU discharge cystatin C and creatinine and their association with 1-year mortality. Exclusions were death within 72 hours of ICU discharge, ICU stay less than 24 hours, and end-stage renal disease. None. During ICU admission, serum cystatin C and creatinine diverged, so that by ICU discharge, almost twice as many patients had glomerular filtration rate less than 60 mL/min/1.73 m when estimated from cystatin C compared with glomerular filtration rate estimated from creatinine, 44% versus 26%. In 743 patients without acute kidney injury, where ICU discharge renal function should reflect ongoing baseline, discharge glomerular filtration rate estimated from creatinine consistently overestimated follow-up glomerular filtration rate estimated from creatinine, whereas ICU discharge glomerular filtration rate estimated from cystatin C well matched follow-up chronic kidney disease status. By 1 year, 535 (17.4%) had died. In survival analysis adjusted for age, sex, and comorbidity, cystatin C was near-linearly associated with increased mortality, hazard ratio equals to 1.78 (95% CI, 1.46-2.18), 75th versus 25th centile. Conversely, creatinine demonstrated a J-shaped relationship with mortality, so that in the majority of patients, there was no significant association with survival, hazard ratio equals to 1.03 (0.87-1.2), 75th versus 25th centile. After adjustment for both creatinine and cystatin C levels, higher discharge creatinine was then associated with lower long-term mortality. In contrast to creatinine

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  1. Serum uric acid to creatinine ratio: A predictor of incident chronic kidney disease in type 2 diabetes mellitus patients with preserved kidney function.

    Science.gov (United States)

    Gu, Liubao; Huang, Liji; Wu, Haidi; Lou, Qinglin; Bian, Rongwen

    2017-05-01

    Serum uric acid has shown to be a predictor of renal disease progression in most but not all studies. This study aims to test whether renal function-normalized serum uric acid is superior to serum uric acid as the predictor of incident chronic kidney disease in type 2 diabetes mellitus patients. In this study, 1339 type 2 diabetes mellitus patients with estimated glomerular filtration rate ⩾60 mL/min/1.73 m 2 and normouricemia were included. Renal function-normalized serum uric acid was calculated using serum uric acid/creatinine. Cox regression analysis was used to estimate the association between serum uric acid, renal function-normalized serum uric acid and incident chronic kidney disease. In total, 74 (5.53%) patients developed to chronic kidney disease 3 or greater during a median follow-up of 4 years, with older ages, longer diabetes duration and lower estimated glomerular filtration rate at baseline. The decline rate of estimated glomerular filtration rate was positively correlated with serum uric acid/creatinine ( r = 0.219, p type 2 diabetes mellitus patients.

  2. 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

  3. Positive Impact of Nutritional Interventions on Serum Symmetric Dimethylarginine and Creatinine Concentrations in Client-Owned Geriatric Dogs.

    Science.gov (United States)

    Hall, Jean A; MacLeay, Jennifer; Yerramilli, Maha; Obare, Edward; Yerramilli, Murthy; Schiefelbein, Heidi; Paetau-Robinson, Inke; Jewell, Dennis E

    2016-01-01

    A prospective study was conducted in client-owned geriatric dogs to evaluate the short-term effects of a test food on serum symmetric dimethylarginine (SDMA) and creatinine (Cr) concentrations. Test food contained functional lipids (fish oil), antioxidants (lipoic acid, vitamins C and E), L-carnitine, botanicals (fruits and vegetables), controlled sodium concentration, and high quality protein sources (high bioavailability and an ideal amino acid composition). Dogs (n = 210) were fed either test food or owner's-choice foods (non-nutritionally controlled cohort). Dogs were included based on age and body weight: small (6.8 to 11.4 kg) and medium dogs (11.5 to 22.7 kg) were ≥ 9 years, whereas dogs >22.7 kg were ≥ 7 years at baseline. At baseline, all dogs had to have serum Cr concentrations within the reference interval and be free of chronic disease. Renal function biomarkers and urinalysis results at baseline, and after consuming test food or owner's-choice foods for 3 and 6 months, were evaluated. Only dogs consuming test food showed significant decreases in serum SDMA and Cr concentrations (both P ≤ 0.05) across time. At baseline or during the 6-month feeding trial, 18 dogs (8.6%) had increased serum SDMA, but normal serum Cr, consistent with IRIS Stage 1 chronic kidney disease. This included 9 dogs fed test food and 9 dogs fed owner's-choice foods. Compared with baseline, after feeding 9 dogs test food for 6 months, serum SDMA decreased in 8 dogs and increased in 1 dog. After feeding 9 dogs owner's-choice foods for 6 months, serum SDMA decreased in 4 dogs and increased in 4 dogs (remained stable in 1 dog). The decreases in serum SDMA and Cr concentrations were significant (both P = 0.03) only for dogs fed test food. These results suggest that nonazotemic dogs with elevated serum SDMA (early renal insufficiency) when fed a test food designed to promote healthy aging are more likely to demonstrate improved renal function compared with dogs fed owner

  4. Positive Impact of Nutritional Interventions on Serum Symmetric Dimethylarginine and Creatinine Concentrations in Client-Owned Geriatric Dogs.

    Directory of Open Access Journals (Sweden)

    Jean A Hall

    Full Text Available A prospective study was conducted in client-owned geriatric dogs to evaluate the short-term effects of a test food on serum symmetric dimethylarginine (SDMA and creatinine (Cr concentrations. Test food contained functional lipids (fish oil, antioxidants (lipoic acid, vitamins C and E, L-carnitine, botanicals (fruits and vegetables, controlled sodium concentration, and high quality protein sources (high bioavailability and an ideal amino acid composition. Dogs (n = 210 were fed either test food or owner's-choice foods (non-nutritionally controlled cohort. Dogs were included based on age and body weight: small (6.8 to 11.4 kg and medium dogs (11.5 to 22.7 kg were ≥ 9 years, whereas dogs >22.7 kg were ≥ 7 years at baseline. At baseline, all dogs had to have serum Cr concentrations within the reference interval and be free of chronic disease. Renal function biomarkers and urinalysis results at baseline, and after consuming test food or owner's-choice foods for 3 and 6 months, were evaluated. Only dogs consuming test food showed significant decreases in serum SDMA and Cr concentrations (both P ≤ 0.05 across time. At baseline or during the 6-month feeding trial, 18 dogs (8.6% had increased serum SDMA, but normal serum Cr, consistent with IRIS Stage 1 chronic kidney disease. This included 9 dogs fed test food and 9 dogs fed owner's-choice foods. Compared with baseline, after feeding 9 dogs test food for 6 months, serum SDMA decreased in 8 dogs and increased in 1 dog. After feeding 9 dogs owner's-choice foods for 6 months, serum SDMA decreased in 4 dogs and increased in 4 dogs (remained stable in 1 dog. The decreases in serum SDMA and Cr concentrations were significant (both P = 0.03 only for dogs fed test food. These results suggest that nonazotemic dogs with elevated serum SDMA (early renal insufficiency when fed a test food designed to promote healthy aging are more likely to demonstrate improved renal function compared with dogs fed owner

  5. Positive Impact of Nutritional Interventions on Serum Symmetric Dimethylarginine and Creatinine Concentrations in Client-Owned Geriatric Dogs

    Science.gov (United States)

    Hall, Jean A.; MacLeay, Jennifer; Yerramilli, Maha; Obare, Edward; Yerramilli, Murthy; Schiefelbein, Heidi; Paetau-Robinson, Inke; Jewell, Dennis E.

    2016-01-01

    A prospective study was conducted in client-owned geriatric dogs to evaluate the short-term effects of a test food on serum symmetric dimethylarginine (SDMA) and creatinine (Cr) concentrations. Test food contained functional lipids (fish oil), antioxidants (lipoic acid, vitamins C and E), L-carnitine, botanicals (fruits and vegetables), controlled sodium concentration, and high quality protein sources (high bioavailability and an ideal amino acid composition). Dogs (n = 210) were fed either test food or owner’s-choice foods (non-nutritionally controlled cohort). Dogs were included based on age and body weight: small (6.8 to 11.4 kg) and medium dogs (11.5 to 22.7 kg) were ≥ 9 years, whereas dogs >22.7 kg were ≥ 7 years at baseline. At baseline, all dogs had to have serum Cr concentrations within the reference interval and be free of chronic disease. Renal function biomarkers and urinalysis results at baseline, and after consuming test food or owner’s-choice foods for 3 and 6 months, were evaluated. Only dogs consuming test food showed significant decreases in serum SDMA and Cr concentrations (both P ≤ 0.05) across time. At baseline or during the 6-month feeding trial, 18 dogs (8.6%) had increased serum SDMA, but normal serum Cr, consistent with IRIS Stage 1 chronic kidney disease. This included 9 dogs fed test food and 9 dogs fed owner’s-choice foods. Compared with baseline, after feeding 9 dogs test food for 6 months, serum SDMA decreased in 8 dogs and increased in 1 dog. After feeding 9 dogs owner’s-choice foods for 6 months, serum SDMA decreased in 4 dogs and increased in 4 dogs (remained stable in 1 dog). The decreases in serum SDMA and Cr concentrations were significant (both P = 0.03) only for dogs fed test food. These results suggest that nonazotemic dogs with elevated serum SDMA (early renal insufficiency) when fed a test food designed to promote healthy aging are more likely to demonstrate improved renal function compared with dogs fed owner

  6. Effect of Intravenous Administration of Contrast Media on Serum Creatinine Levels in Neonates.

    Science.gov (United States)

    Bedoya, Maria A; White, Ammie M; Edgar, J Christopher; Pradhan, Madhura; Raab, Elisabeth L; Meyer, James S

    2017-08-01

    Purpose To assess the effect of intravenous contrast media on renal function in neonates. Materials and Methods Institutional review board approval was obtained with waiver of consent. Electronic health records from January 2011 to April 2013 were reviewed retrospectively. Measures of renal function were obtained in inpatient neonates who underwent magnetic resonance (MR) imaging or computed tomography (CT) and for whom serum creatinine (Cr) levels were obtained within 72 hours before imaging and at least one time after imaging (>1 day after administration of contrast material). A total of 140 neonates who received contrast material (59 who underwent CT with iohexol or iodixanol and 81 who underwent MR imaging with gadopentetate dimeglumine) were identified. These neonates were frequency matched according to sex, gestational and postnatal age, and preimaging serum Cr levels with neonates who underwent unenhanced MR imaging or CT. Cr levels and glomerular filtration rates (GFRs) were grouped according to when they were obtained (before imaging, 1-2 days after imaging, 3-5 days after imaging, 6-9 days after imaging, 10-45 days after imaging, and more than 45 days after imaging). Serum Cr levels and GFRs for each time period were compared between groups by using hierarchic regressions or χ 2 or Fisher exact tests and with repeated-measures analysis of variance to compare groups on the rate of change in serum Cr levels and GFRs from before to after imaging. Results Cr levels decreased and GFRs increased in both groups from before to after imaging (CT group, P ≤ .01; MR imaging group, P ≤ .01). The neonates who underwent contrast material-enhanced imaging and the neonates who underwent unenhanced imaging showed similar serum Cr levels at all examined time periods. Groups also did not differ in the proportion of neonates with serum Cr levels higher than the reference range (>0.4 mg/dL) at any time point (iodine- [P > .12] or gadolinium-based [P > .13] contrast

  7. Serum Creatinine Levels During and After Long-term Treatment with Cyclosporine A in Patients with Severe Atopic Dermatitis

    NARCIS (Netherlands)

    van der Schaft, Jorien; van Zuilen, Arjan D.; Deinum, Joukje; Bruijnzeel-Koomen, Carla A F M; de Bruin-Weller, Marjolein S

    2015-01-01

    Safety data with respect to kidney function during long-term treatment with cyclosporine A (CsA) in patients with atopic dermatitis is limited. Data on serum creatinine levels before, during and after CsA treatment were collected in a retrospective cohort of adult patients with atopic dermatitis.

  8. Does serum albumin and creatinine predict survival of inpatient palliative care patients?

    Science.gov (United States)

    Aung, Aye; Alqudihy, Shukri; Rybicki, Lisa; Platt, Alexandra; Davis, Mellar P

    2014-12-01

    Low creatinine and albumin are found among the chronically ill patients. This study retrospectively reviewed albumin and creatinine levels for survival in patients upon admission. Records of patients admitted over 2 months were reviewed. Recursive partitioning analysis (RPA) identified cutpoints in albumin and creatinine that predicted survival. Kaplan-Meier survival, Cox proportional hazards, and stepwise Cox analyses identified prognostic factors. Of 83 patients, 81 were assessable. Variables for worse survival were albumin creatinine >0.93 mg/dL, and male gender. Albumin by continuous, median, RPA, and tertiles was significant; creatinine by RPA. Hazard ratio for albumin >3.1 was 0.28 (P creatinine >0.91 mg/dL was 1.8 (P = .046). Albumin and creatinine are prognostically important. © The Author(s) 2013.

  9. Early Acute Kidney Injury based on Serum Creatinine or Cystatin C in Intensive Care Unit after Major Trauma

    Directory of Open Access Journals (Sweden)

    Farid Zand

    2015-11-01

    Full Text Available Background: Acute kidney injury (AKI is a common problem in critically ill patients and is independently associated with increased morbidity and mortality. Recently, serum cystatin C has been shown to be superior to creatinine in early detection of renal function impairment. We compared estimated GFR based on serum cystatin C with estimated GFR based on serum creatinine for early detection of renal dysfunction according to the RIFLE criteria. Methods: During 9 months, three hundred post trauma patients that were referred to the intensive care unit of a referral trauma hospital were recruited. Serum creatinine and serum cystatin C were measured and the estimated GFR within 24 hours of ICU admission was calculated. The primary outcome was the incidence of AKI according to the RIFLE criteria within 2nd to 7th day of admission. Results: During the first week of ICU admission,21% of patients experienced AKI. After adjusting for major confounders, only the patients with first day's serum cystatin level higher than 0.78 mg/l were at higher risk of first week AKI (OR=6.14, 95% CI: 2.5-14.7, P<0.001. First day’s serum cystatin C and injury severity score were the major risk factors for ICU mortality (OR=3.54, 95% CI: 1.7-7.4, P=0.001 and (OR=4.6, 95% CI: 1.5-14, P=0.007, respectively. Conclusion: Within 24 hours after admission in ICU due to multiple trauma, high serum cystatin C level may have prognostic value in predicting early AKI and mortality during ICU admission. However, such correlation was not seen neither with creatinine nor cystatin C based GFR.

  10. Prevalence of Elevated Serum Creatinine Concentration in Dogs Presenting to a Veterinary Academic Medical Center (2010-2014).

    Science.gov (United States)

    Babyak, J M; Weiner, D E; Noubary, F; Sharp, C R

    2017-11-01

    The epidemiology of kidney disease is not extensively described in dogs. To better understand the prevalence of elevated serum creatinine concentration in dogs. Client-owned dogs. A retrospective, observational cross-sectional study design was used. We made a dataset of 115,631 hospital visits of all dogs presenting from October 2010 to October 2014. We estimated the prevalence and risk of elevated serum creatinine, defined as >1.6 mg/dL, in evaluated dogs. Of 115,631 visits, 98,693 were outpatient visits and 16,938 were hospital admissions. Among outpatient visits, 9,983 (10.1%) had serum creatinine assessment (4,423 [44.3%] visits were first visits), whereas, among hospital admissions, 12,228 (60.0%) had at least 1 serum creatinine (7,731 [75.6%] admissions were first admissions). The prevalence of elevated serum creatinine concentration in all evaluated dogs was 11.5% (95% CI: 11.0%, 11.9%); 10.2% (95% CI: 9.6%, 10.8%) of inpatients and 12.9% (95% CI: 12.1%, 13.8%) of outpatients had elevated serum creatinine concentration. The relative risk (RR) of elevated serum creatinine concentration was significantly higher in geriatric dogs (outpatient RR 1.45 [95% CI: 1.23, 1.70], inpatient RR 1.43 [95% CI: 1.16, 1.76]) and lower in young dogs (outpatient RR 0.39 [95% CI: 0.26, 0.59], inpatient RR 0.44 [95% CI: 0.32, 0.62]) when compared to the measured population risk. When selected for laboratory evaluation, the proportion of dogs presenting to an academic medical center with evidence of kidney injury is high compared to previous reports and might reflect a population of sicker dogs. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  11. Serum creatinine may indicate risk of symptomatic intracranial hemorrhage after intravenous tissue plasminogen activator (IV tPA).

    Science.gov (United States)

    Marsh, Elisabeth B; Gottesman, Rebecca F; Hillis, Argye E; Urrutia, Victor C; Llinas, Rafael H

    2013-11-01

    Symptomatic intracranial hemorrhage (sICH) is a known complication following administration of intravenous tissue plasminogen activator (IV tPA) for acute ischemic stroke. sICH results in high rates of death or long-term disability. Our ability to predict its occurrence is important in clinical decision making and when counseling families. The initial National Institute of Neurological Disorders and Stroke (NINDS) investigators developed a list of relative contraindications to IV tPA meant to decrease the risk of subsequent sICH. To date, the impact of renal impairment has not been well studied. In the current study we evaluate the potential association between renal impairment and post-tPA intracranial hemorrhage (ICH). Admission serum creatinine and estimated glomerular filtration rate (eGFR) were recorded in 224 patients presenting within 4.5 hours from symptom onset and treated with IV tPA based on NINDS criteria. Neuroimaging was obtained 1 day post-tPA and for any change in neurologic status to evaluate for ICH. Images were retrospectively evaluated for hemorrhage by a board-certified neuroradiologist and 2 reviewers blinded to the patient's neurologic status. Medical records were reviewed retrospectively for evidence of neurologic decline indicating a "symptomatic" hemorrhage. sICH was defined as subjective clinical deterioration (documented by the primary neurology team) and hemorrhage on neuroimaging that was felt to be the most likely cause. Renal impairment was evaluated using both serum creatinine and eGFR in a number of ways: 1) continuous creatinine; 2) any renal impairment by creatinine (serum creatinine >1.0 mg/dL); 3) continuous eGFR; and 4) any renal impairment by eGFR (eGFR serum creatinine >1.0 mg/dL) was not associated with combined symptomatic and asymptomatic intracranial bleeding (p = 0.359); however, there was an adjusted 5.5-fold increased odds of sICH when creatinine was >1.0 mg/dL (95% confidence interval, 1.08-28.39), and the frequency

  12. Application of an artificial neural network model to predict delayed decrease of serum creatinine in pediatric patients after kidney transplantation.

    Science.gov (United States)

    Santori, G; Fontana, I; Valente, U

    2007-01-01

    Artificial neural network, a computer-based technology that uses nonlinear statistics to recognize the relationship between input variables and an output variable, has been previously applied to outcome prediction in adult kidney recipients. In this study, we evaluated the effectiveness of a neural network model to predict a delayed decrease of serum creatinine in pediatric kidney recipients. The neural network was constructed with a training set of pediatric kidney recipients (n = 107) by using 20 input variables and assuming for the output variable, the time after 3 days to reach a serum creatinine level 50% below that before kidney transplantation. In the final model, the following input variables showing higher predictive values were retained: serum creatinine on day 1 post transplant, urine volume in the first 24 hours, diagnostic category, pretransplant dialysis mode, patient sex, donor sex, body weight on day 1 posttransplant, and patient age. The model was validated in a second set of patients (n = 41) by blinding the network for the output variable. The overall accuracies of the neural network for the training set, the validation set, and the whole patient cohort were 89.1%, 76.92%, and 87.14%, respectively. A comparative logistic regression analysis revealed only serum creatinine on day 1 posttransplant to be an independent predictor for the output variable (overall accuracy: 79.05%). The neural network showed sensitivity and specificity for the whole patient cohort to be 0.875 and 0.87, respectively, whereas using logistic regression sensitivity and specificity yields 0.37 and 0.94, respectively. This study proposes a neural network model that seemed to predict a delayed decrease in serum creatinine among pediatric kidney recipients. The availability of the source code may allow development of stand-alone neural networks to validate our model in prospective studies.

  13. Coronary disease risk curve of serum creatinine is linear in Turkish men, U-shaped in women.

    Science.gov (United States)

    Onat, Altan; Can, Günay; Ademoğlu, Evin; Çelik, Etem; Karagöz, Ahmet; Örnek, Ender

    2013-01-01

    The highest levels of glomerular filtration rate are associated with increased coronary heart disease (CHD) risk, an issue we investigated in separate sexes in a population prone to metabolic syndrome. In total, 1948 participants of the Turkish Adult Risk Factor study with available creatinine determinations were studied at a mean 3.4 years' follow-up. Using quartiles of creatinine, risk in Cox models of incident CHD or the likelihood of combined prevalent and incident CHD was assessed. Women in the lowest creatinine quartile demonstrated the lowest risk profile across diverse variables, except showing low high-density lipoprotein cholesterol and average apolipoprotein A-I and lipoprotein (a) concentrations implicating impaired atheroprotective properties. Whereas serum creatinine in men was not significantly associated with 6 proinflammatory variables comprised in linear regression analysis, apolipoprotein A-I and lipoprotein (a) were significant positive covariates in women, the latter tending to negative association in women without metabolic syndrome. In men, the highest (>1.10 mg/dL), compared with the lowest, creatinine quartile significantly predicted CHD risk, at 1.85-fold relative risks, after adjustment for established risk factors. The risk curve in women was U-shaped, the top and bottom quartiles tending to display higher risk (odds ratio, 1.28 [95% confidence interval, 0.91-1.80]) compared with the 2 intermediate quartiles. Increasing serum creatinine values are associated strongly and independently with CHD risk in men but not in women in whom the risk curve is U-shaped. The phenomenon of low creatinine levels underlies some hitherto unexplained relevant observations, and low measurements may be attributed to inassayability secondary to involvement in autoimmune activation.

  14. RENAL FUNCTION TEST ON THE BASIS OF SERUM CREATININE AND UREA IN TYPE-2 DIABETICS AND NONDIABETICS

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    P. Singh

    2014-01-01

    Full Text Available Background: Type-2 diabetes mellitus has quickly become a global health problem due to rapidly increasing population growth, aging, urbanization and increasing prevalence of obesity and physical inactivity. Diabetic nephropathy is one of the major causes of chronic renal failure. Both serum urea and creatinine are widely used to assess the function of kidney. This study was conducted to observe the impaired renal function in type 2 diabetics and compare with non-diabetics controls. Method: To determine the incidence of renal dysfunction in diabetics in Nepalgunj medical college and Hospital , Nepalgunj , Banke, Nepal , blood samples from 100 diabetic subjects and 100 non-diabetic controls were taken between the period 1st February  , 2012  to  31st January , 2013 for investigation of  plasma glucose fasting(FPG, blood urea and serum creatinine. These biochemical parameters were determined by using a fully automated clinical chemistry analyzer. Results: Our findings showed that the level of blood urea (P<0.0001, 95%Cl and serum creatinine (P≈0.0004,95%Cl were significantly higher in type 2 diabetics as compared to non-diabetics in both male and female. There was no significant difference between diabetic male and female. 15 out of 100 diabetes samples have high urea level whereas 7 out of 100 had increased creatinine level. In control only 3 samples had high urea value and 1 had high creatinine level. There was statistical significant increased in urea level with increased in blood sugar level. Conclusion: Blood urea and creatinine is widely accepted to assess the renal functions. Good control of blood glucose level is absolute requirement to prevent progressive renal impairment.

  15. Creatinine index as a surrogate of lean body mass derived from urea Kt/V, pre-dialysis serum levels and anthropometric characteristics of haemodialysis patients.

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    Bernard Canaud

    Full Text Available BACKGROUND AND OBJECTIVES: Protein-energy wasting is common in long-term haemodialysis (HD patients with chronic kidney disease and is associated with increased morbidity and mortality. The creatinine index (CI is a simple and useful nutritional parameter reflecting the dietary skeletal muscle protein intake and skeletal muscle mass of the patient. Because of the complexity of creatinine kinetic modeling (CKM to derive CI, we developed a more simplified formula to estimate CI in HD patients. DESIGN, SETTING, PARTICIPANTS & MEASUREMENTS: A large database of 549 HD patients followed over more than 20 years including monthly CKM-derived CI values was used to develop a simple equation based on patient demographics, predialysis serum creatinine values and dialysis dose (spKt/V using mixed regression models. RESULTS: The equation to estimate CI was developed based on age, gender, pre-dialysis serum creatinine concentrations and spKt/V urea. The equation-derived CI correlated strongly with the measured CI using CKM (correlation coefficient  = 0.79, p-value <0.001. The mean error of CI prediction using the equation was 13.47%. Preliminary examples of few typical HD patients have been used to illustrate the clinical relevance and potential usefulness of CI. CONCLUSIONS: The elementary equation used to derive CI using demographic parameters, pre-dialysis serum creatinine concentrations and dialysis dose is a simple and accurate surrogate measure for muscle mass estimation. However, the predictive value of the simplified CI assessment method on mortality deserves further evaluation in large cohorts of HD patients.

  16. Oliguria without serum creatinine increase after living donor liver transplantation is associated with adverse post-operative outcomes.

    Science.gov (United States)

    Mizota, T; Minamisawa, S; Imanaka, Y; Fukuda, K

    2016-08-01

    Acute kidney injury (AKI) is a common complication after liver transplantation and is associated with significant morbidity and mortality. Although clinical guidelines recommend defining AKI based on serum creatinine increase and oliguria, the validity and utility of the oliguric component of AKI definition remains largely unexplored. This study examined the incidence and the impact on clinical outcomes of oliguria meeting the urine output criterion of AKI in patients undergoing liver transplantation. The authors hypothesised that oliguria was an independent risk factor for adverse post-operative outcomes. This study retrospectively examined 320 patients who underwent living donor liver transplantation at our centre. AKI stages were allocated according to recent guidelines based on serum creatinine or urine output within 7 days of surgery. The incidence of oliguria meeting the urine output criterion of AKI was 50.3%. Compared with creatinine criterion alone, incorporating oliguria into the diagnostic criteria dramatically increased the measured incidence of AKI from 39.7% to 62.2%. Compared with patients diagnosed without AKI using either criterion, oliguric patients without serum creatinine increase had significantly longer intensive care unit stays (median: 5 vs. 4 days, P = 0.016), longer hospital stays (median: 60 vs. 49 days, P = 0.014) and lower chronic kidney disease-free survival rate on post-operative day 90 (54.2% vs. 73.3%, P = 0.008). Oliguria is common after liver transplantation, and incorporating oliguria into the diagnostic criteria dramatically increases the measured incidence of AKI. Oliguria without serum creatinine increase was significantly associated with adverse post-operative outcomes. © 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  17. Multi-modal CT in acute stroke: wait for a serum creatinine before giving intravenous contrast? No!

    Science.gov (United States)

    Ang, Timothy E; Bivard, Andrew; Levi, Christopher; Ma, Henry; Hsu, Chung Y; Campbell, Bruce; Donnan, Geoffrey; Davis, Stephen M; Parsons, Mark

    2015-10-01

    Multi-modal CT (MMCT) to guide decision making for reperfusion treatment is increasingly used, but there remains a perceived risk of contrast-induced nephropathy (CIN). At our center, MMCT is used empirically without waiting for serum-creatinine (sCR) or renal profiling. To determine the incidence of CIN, examine the risk factors predisposing to its development, and investigate its effects on clinical outcome in the acute stroke population. An institution-wide protocol was implemented for acute stroke presentations to have MMCT (100-150 ml nonionic tri-iodinated contrast, perfusion CT and CT angiography) without waiting for serum-creatinine to minimize delays. Intravenous saline is routinely infused (80-125 ml/h) for at least 24-h after MMCT. Serial creatinine levels were measured at baseline, risk period, and follow-up. Renal profiles and clinical progress were reviewed up to 90 days. We analyzed 735 consecutive patients who had MMCT for the evaluation of acute ischemic or hemorrhagic stroke during the last five-years. A total of 623 patients met the inclusion criteria for analysis: 16 cases (2·6%) biochemically qualified as CIN; however, the risk period serum-creatinine for 15 of these cases was confounded by dehydration, urinary tract infection, or medications. None of the group had progression to chronic kidney disease or required dialysis. The incidence of CIN is low when MMCT is used routinely to assess acute stroke patients. In this population, CIN was a biochemical phenomenon that did not have clinical manifestations, cause chronic kidney disease, require dialysis, or negatively impact on 90-day mRS outcomes. Renal profiling and waiting for a baseline serum-creatinine are an unnecessary delay to emergency reperfusion treatment. © 2015 World Stroke Organization.

  18. 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.

  19. Do Serum Creatinine Levels Show Clinically Significant Fluctuations on Serial Determinations on the Siemens Advia 1800 Analyzer?

    Science.gov (United States)

    Levitan, Daniel; Harper, Aaron E; Sun, Yi; Scarpa Carniello, Jose V; Momeni, Amir; Kagan, Joshua; Alexis, Herol; Eid, Ikram; Harris, Loretta; Marshal, Barbara; Tafani, Edlira; Pincus, Matthew

    2017-01-01

    The goal of this work was to determine whether there are clinically significant fluctuations in the level of serum creatinine on serial determinations, especially in the borderline range (1.1-1.3 mg/dl), after specimen storage. Sixty-one serum samples were analyzed. They were divided into three categories based on the initial serum creatinine measurement: low (≤1.0 mg/dl), borderline (1.1-1.3 mg/dl), and high (≥1.4 mg/dl). The specimens were stored at 4°C and run on the Siemens Advia 1800 chemistry analyzer on days 1, 3, and 11. Statistical comparisons of the three groups were made using the unpaired t-test, yielding a two-tailed P-value for each group comparison. The P-values ranged from 0.0829 to 0.3892, indicating no statistically significant difference between the standard deviations of each group. Mild-to-moderate fluctuations in precision occur in successive serum creatinine determinations. The overwhelming majority of these fluctuations should not affect clinical decision making. © 2016 Wiley Periodicals, Inc.

  20. Relevance of Changes in Serum Creatinine During a Heart Failure Trial of Decongestive Strategies: Insights From the DOSE Trial.

    Science.gov (United States)

    Brisco, Meredith A; Zile, Michael R; Hanberg, Jennifer S; Wilson, F Perry; Parikh, Chirag R; Coca, Steven G; Tang, W H Wilson; Testani, Jeffrey M

    2016-10-01

    Worsening renal function (WRF) is a common endpoint in decompensated heart failure clinical trials because of associations between WRF and adverse outcomes. However, WRF has not universally been identified as a poor prognostic sign, challenging the validity of WRF as a surrogate endpoint. Our aim was to describe the associations between changes in creatinine and adverse outcomes in a clinical trial of decongestive therapies. We investigated the association between changes in creatinine and the composite endpoint of death, rehospitalization or emergency room visit within 60 days in 301 patients in the Diuretic Optimization Strategies Evaluation (DOSE) trial. WRF was defined as an increase in creatinine >0.3 mg/dL and improvement in renal function (IRF) as a decrease >0.3 mg/dL. When examining linear changes in creatinine from baseline to 72 hours (the coprimary endpoint of DOSE), increasing creatinine was associated with lower risk for the composite outcome (HR = 0.81 per 0.3 mg/dL increase, 95% CI 0.67-0.98, P = .026). Compared with patients with stable renal function (n = 219), WRF (n = 54) was not associated with the composite endpoint (HR = 1.17, 95% CI = 0.77-1.78, P = .47). However, compared with stable renal function, there was a strong relationship between IRF (n = 28) and the composite endpoint (HR = 2.52, 95% CI = 1.57-4.03, P creatinine, was paradoxically associated with improved outcomes. This was driven by absence of risk attributable to WRF and a strong risk associated with IRF. These results argue against using changes in serum creatinine as a surrogate endpoint in trials of decongestive strategies. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Changes in the level of urea, creatine and creatinine in the liver and serum of irradiated rats

    International Nuclear Information System (INIS)

    El Kashef, H.S.; Saada, H.N.

    1991-01-01

    This study aims to compare between the susceptibility of two tissues (liver and serum) toγ-radiation with respect to some protein end-products; namely urea, creatine and creatinine. The results indicated that in control rat liver, the concentration of urea, creatine and creatinine ranged between 262-266, 106-108 and 18.86-19.48 μg/g fresh tissue, respectively. In blood serum, the concentration of these end-products were 327-383, 94-97 and 12.36-12.51μg/ml blood serum. Whole body -irradiation at dose 5.5 Gy caused significant changes in the levels of both urea and creatine in the blood serum on the 7th and 14th post irradiation days, while the level of creatinine was not altered. As for the liver of whole body γ -irradiated rats, significant changes were observed in the content of urea at the all post-irradiation days except at the 3 rd day. The creatinine content of the liver was significantly decreased on the 3 rd, 14th and 21st days after irradiation. Similar decrease was noticed in the content of creatine, but on the 7th day, significant increase was observed. The variation in the studied parameters started early in the liver and lated longer, but it started later and lasted shorter in the serum of irradiated rats. It could be suggested that the liver of irradiated rats is more sensitive to the radiation dose 5.5 Gy than the blood.1 fig.,2 tab

  2. Estimating the concentration of urea and creatinine in the human serum of normal and dialysis patients through Raman spectroscopy.

    Science.gov (United States)

    de Almeida, Maurício Liberal; Saatkamp, Cassiano Junior; Fernandes, Adriana Barrinha; Pinheiro, Antonio Luiz Barbosa; Silveira, Landulfo

    2016-09-01

    Urea and creatinine are commonly used as biomarkers of renal function. Abnormal concentrations of these biomarkers are indicative of pathological processes such as renal failure. This study aimed to develop a model based on Raman spectroscopy to estimate the concentration values of urea and creatinine in human serum. Blood sera from 55 clinically normal subjects and 47 patients with chronic kidney disease undergoing dialysis were collected, and concentrations of urea and creatinine were determined by spectrophotometric methods. A Raman spectrum was obtained with a high-resolution dispersive Raman spectrometer (830 nm). A spectral model was developed based on partial least squares (PLS), where the concentrations of urea and creatinine were correlated with the Raman features. Principal components analysis (PCA) was used to discriminate dialysis patients from normal subjects. The PLS model showed r = 0.97 and r = 0.93 for urea and creatinine, respectively. The root mean square errors of cross-validation (RMSECV) for the model were 17.6 and 1.94 mg/dL, respectively. PCA showed high discrimination between dialysis and normality (95 % accuracy). The Raman technique was able to determine the concentrations with low error and to discriminate dialysis from normal subjects, consistent with a rapid and low-cost test.

  3. Early serum creatinine changes and outcomes in patients admitted for acute heart failure: the cardio-renal syndrome revisited.

    Science.gov (United States)

    Núñez, Julio; Garcia, Sergio; Núñez, Eduardo; Bonanad, Clara; Bodí, Vicent; Miñana, Gema; Santas, Enrique; Escribano, David; Bayes-Genis, Antonio; Pascual-Figal, Domingo; Chorro, Francisco J; Sanchis, Juan

    2017-08-01

    The changes in renal function that occurred in patients with acute decompensated heart failure (ADHF) are prevalent, and have multifactorial etiology and dissimilar prognosis. To what extent the prognostic role of such changes may vary according to the presence of renal insufficiency at admission is not clear. Accordingly, we sought to determine whether early creatinine changes (ΔCr) (admission to 48-72 hours) had an effect on 1-year mortality relative to the presence of renal insufficiency at admission. We included 705 consecutive patients admitted with the diagnosis of ADHF. Admission renal insufficiency was defined as serum creatinine ≥1.4mg/dl (A-RI cr ) or estimated glomerular filtration rate renal insufficiency (24.7% and 42.8% for A-RIcr and A-RIGFR, respectively) had higher prevalence of extreme values in ΔCr in either direction (increasing/decreasing). At 1-year follow-up, 114 (16.2%) deaths were registered. The multivariable analysis showed a significant interaction between admission renal insufficiency and ΔCr ( p=0.004 and p=0.019 for A-RIcr and A-RIGFR, respectively). In the presence of renal insufficiency, the continuum of ΔCr followed a positive and almost linear relationship with mortality risk. Conversely, in patients without renal insufficiency, those changes adopted a 'J-shape' trajectory with increased mortality at both ends of the curve distribution. In patients with ADHF the effect of ΔCr on 1-year mortality varied according to its magnitude and the presence of admission renal insufficiency. There was a graded-association with mortality when renal insufficiency was present on admission.

  4. New combined serum creatinine and cystatin C quadratic formula for GFR assessment in children.

    Science.gov (United States)

    Chehade, Hassib; Cachat, Francois; Jannot, Anne-Sophie; Meyrat, Blaise-Julien; Mosig, Dolores; Bardy, Daniel; Parvex, Paloma; Girardin, Eric

    2014-01-01

    The estimated GFR (eGFR) is important in clinical practice. To find the best formula for eGFR, this study assessed the best model of correlation between sinistrin clearance (iGFR) and the solely or combined cystatin C (CysC)- and serum creatinine (SCreat)-derived models. It also evaluated the accuracy of the combined Schwartz formula across all GFR levels. Two hundred thirty-eight iGFRs performed between January 2012 and April 2013 for 238 children were analyzed. Regression techniques were used to fit the different equations used for eGFR (i.e., logarithmic, inverse, linear, and quadratic). The performance of each model was evaluated using the Cohen κ correlation coefficient and the percentage reaching 30% accuracy was calculated. The best model of correlation between iGFRs and CysC is linear; however, it presents a low κ coefficient (0.24) and is far below the Kidney Disease Outcomes Quality Initiative targets to be validated, with only 84% of eGFRs reaching accuracy of 30%. SCreat and iGFRs showed the best correlation in a fitted quadratic model with a κ coefficient of 0.53 and 93% accuracy. Adding CysC significantly (Pquadratic model accuracy to 97%. Therefore, a combined SCreat and CysC quadratic formula was derived and internally validated using the cross-validation technique. This quadratic formula significantly outperformed the combined Schwartz formula, which was biased for an iGFR≥91 ml/min per 1.73 m(2). This study allowed deriving a new combined SCreat and CysC quadratic formula that could replace the combined Schwartz formula, which is accurate only for children with moderate chronic kidney disease.

  5. The Relationship between Serum Hemoglobin and Creatinine Levels and Intra-Hospital Mortality and Morbidity in Acute Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Afsoon Fazlinezhad

    2014-09-01

    Full Text Available Background: Studies have shown that Glomerular Filtration Rate (GFR and Hemoglobin (Hb concentrations are two predictive values for ST-elevation Myocardial Infarction (MI mortality.. Objectives: This study aimed to investigate the relationship between GFR and Hb concentrations and intra-hospital mortality and electrocardiographic (ECG and echocardiographic abnormalities in ST-elevation MI patients admitted to a highly equipped hospital in Mashhad. The results will help define some factors to manage these patients more efficiently.. Patients and Methods: This descriptive study aimed to assess the relationship between Hb and GFR concentrations and mortality and morbidity among 294 randomly selected patients with ST-elevation MI. Echocardiography, ECG, and routine laboratory tests, including Hb and creatinine, were performed for all the patients. Then, the data were entered into the SPSS statistical software, version 16 and were analyzed using chi-square, t-test, and ANOVA. P < 0.05 was considered as statistically significant.. Results: Intra-hospital mortality rate was 10.5%. Besides, the results showed higher levels of serum blood sugar (P < 0.001, higher levels of creatinine (P < 0.001, lower levels of GFR (P < 0.001, lower ejection fraction (P < 0.001, higher grades of left ventricular diastolic dysfunction (P = 0.002, and lower mean Hb concentration (P = 0.022 in the dead compared to the alive cases. Besides, the patients with mechanical complications had lower Hb levels (P = 0.008. The results showed no significant relationship between creatinine level and mechanical and electrical complications (P = 0.430 and P = 0.095, respectively. However, ejection fraction was significantly associated with GFR (P = 0.016.. Conclusions: According to the results, low levels of Hb and GFR could predict mortality caused by ST-elevation MI and ECG abnormalities could notify intra-hospital death. Moreover, lower Hb levels were associated with mechanical

  6. Comparison of DTPA clearance, 24-hour urine collection and serum creatinine in estimating glomerular filtration rate (GFR)

    International Nuclear Information System (INIS)

    Pohlen, J.; Zein, H. El.; Babicheva, R.; Bell, A.; Dixson, H.; Penny, M.; Lee, K.

    2003-01-01

    Full text: A retrospective study was performed to compare 3 different methods of estimating GFR: DTPA clearance, 24-hour urine collection and serum creatinine using the Cockcroft-Gault equation. 40 patients (22 female, 18 male, mean age 61 (range 23-82) years) referred between 1997 and 2000 for DTPA renal scans and assessment of GFR were studied. The DTPA renal scan used an administered dose of 413-874MBq. Blood samples were drawn at 60 minutes and 150 minutes. Blood samples were centrifuged and two 1 ml aliquots of each sample were pipetted and counted in a Wallac well counter. A 3.7 kBq Cobalt 57 and technetium dilution standards were used to calibrate the well counter against the dose calibrator. Urinary 24-hour collections and serum creatinine levels were measured in a NATA accredited pathology laboratory. GFR estimated by DTPA clearance gave results in the range 42-168 ml/min/1.73m2. Analysis of GFR estimates normalised for body area for all 3 methods gave correlation coefficients of 0.79 for DTPA clearance vs serum creatinine, 0.72 for DTPA clearance vs 24- hour urine collection and 0.80 for 24-hour urine collection vs serum creatinine. The correlation was stronger for patients with impaired renal function and estimated GFR less than 80 ml/min/1.73m2 (r= 0.87, 0.86, 0.86 respectively). The DTPA clearance correlates well with other routine measurements used to estimate GFR. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  7. Positive Impact of Nutritional Interventions on Serum Symmetric Dimethylarginine and Creatinine Concentrations in Client-Owned Geriatric Dogs

    OpenAIRE

    Hall, Jean A.; MacLeay, Jennifer; Yerramilli, Maha; Obare, Edward; Yerramilli, Murthy; Schiefelbein, Heidi; Paetau-Robinson, Inke; Jewell, Dennis E.

    2016-01-01

    A prospective study was conducted in client-owned geriatric dogs to evaluate the short-term effects of a test food on serum symmetric dimethylarginine (SDMA) and creatinine (Cr) concentrations. Test food contained functional lipids (fish oil), antioxidants (lipoic acid, vitamins C and E), L-carnitine, botanicals (fruits and vegetables), controlled sodium concentration, and high quality protein sources (high bioavailability and an ideal amino acid composition). Dogs (n = 210) were fed either t...

  8. Effect of Ashwagandha (Withania Somnifera Root Extract Against Gentamicin Induced Changes of Serum Urea and Creatinine Levels in Rats

    Directory of Open Access Journals (Sweden)

    Nayma Sultana

    2011-12-01

    Full Text Available AbstractBackground: Kidney is an important excretory organ. Its damage can be occurred due to prolonged use and higher doses of drugs, exposure to some chemicals, toxins, or infectious agents. Herbal plants as Ashwagandha (Withania somnifera may have free radical scavenging activity thereby can be used for the prevention and treatment of kidney damage.Objective: To observe the nephroprotective effect of Ashwagandha (Withania somnifera root against gentamicin induced nephrotoxicity in Wistar albino rats.Methods: This experimental study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC, Dhaka from 1st July 2010 to 30th June 2011. A total number of 35 Wistar albino rats, age ranged from 90 to 120 days, weighing between 150 to 200 grams were included in this study. After acclimatization for 14 days, they were divided into control group (Group A and experimental group (Group B. Control group was again subdivided into group A1 (baseline control, consisted of 10 rats and group A2 (gentamicin treated control group, consisted of 10 rats. Again, experimental group (Group B- Ashwagandha pretreated and gentamicin treated group consisted of 15 rats. All groups of animals received basal diet for 22 consecutive days. In addition to this, group A2 also received gentamicin subcutaneously (100mg /kg body weight/day for the last eight (15th to 22nd day consecutive days. Again, group B received ashwagandha root extract (500mg/kg body weight/ day; orally for 22 consecutive days and gentamicin subcutaneously (100mg/kg body weight /day for last eight (15th to 22nd day days. All the animals were sacrificed on 23rd day. Then blood and kidney sample were collected. Estimation of serum urea, creatinine levels were done by using standard Laboratory kits. The statistical analysis was done by one way ANOVA and Bonferroni test as applicable.Results: The mean serum urea, creatinine levels were significantly (p<0.001 higher in gentamicin

  9. Performance of Serum Creatinine and Kidney Injury Biomarkers for Diagnosing Histologic Acute Tubular Injury.

    Science.gov (United States)

    Moledina, Dennis G; Hall, Isaac E; Thiessen-Philbrook, Heather; Reese, Peter P; Weng, Francis L; Schröppel, Bernd; Doshi, Mona D; Wilson, F Perry; Coca, Steven G; Parikh, Chirag R

    2017-12-01

    The diagnosis of acute kidney injury (AKI), which is currently defined as an increase in serum creatinine (Scr) concentration, provides little information on the condition's actual cause. To improve phenotyping of AKI, many urinary biomarkers of tubular injury are being investigated. Because AKI cases are not frequently biopsied, the diagnostic accuracy of concentrations of Scr and urinary biomarkers for histologic acute tubular injury is unknown. Cross-sectional analysis from multicenter prospective cohort. Hospitalized deceased kidney donors on whom kidney biopsies were performed at the time of organ procurement for histologic evaluation. (1) AKI diagnosed by change in Scr concentration during donor hospitalization and (2) concentrations of urinary biomarkers (neutrophil gelatinase-associated lipocalin [NGAL], liver-type fatty acid-binding protein [L-FABP], interleukin 18 [IL-18], and kidney injury molecule 1 [KIM-1]) measured at organ procurement. Histologic acute tubular injury. Of 581 donors, 98 (17%) had mild acute tubular injury and 57 (10%) had severe acute tubular injury. Overall, Scr-based AKI had poor diagnostic performance for identifying histologic acute tubular injury and 49% of donors with severe acute tubular injury did not have AKI. The area under the receiver operating characteristic curve (AUROC) of change in Scr concentration for diagnosing severe acute tubular injury was 0.58 (95% CI, 0.49-0.67) and for any acute tubular injury was 0.52 (95% CI, 0.45-0.58). Compared with Scr concentration, NGAL concentration demonstrated higher AUROC for diagnosing both severe acute tubular injury (0.67; 95% CI, 0.60-0.74; P=0.03) and any acute tubular injury (0.60; 95% CI, 0.55-0.66; P=0.005). In donors who did not have Scr-based AKI, NGAL concentrations were higher with increasing severities of acute tubular injury (subclinical AKI). However, compared with Scr concentration, AUROCs for acute tubular injury diagnosis were not significantly higher for urinary L

  10. C-reactive protein and serum creatinine, but not haemoglobin A1c, are independent predictors of coronary heart disease risk in non-diabetic Chinese.

    Science.gov (United States)

    Salim, Agus; Tai, E Shyong; Tan, Vincent Y; Welsh, Alan H; Liew, Reginald; Naidoo, Nasheen; Wu, Yi; Yuan, Jian-Min; Koh, Woon P; van Dam, Rob M

    2016-08-01

    In western populations, high-sensitivity C-reactive protein (hsCRP), and to a lesser degree serum creatinine and haemoglobin A1c, predict risk of coronary heart disease (CHD). However, data on Asian populations that are increasingly affected by CHD are sparse and it is not clear whether these biomarkers can be used to improve CHD risk classification. We conducted a nested case-control study within the Singapore Chinese Health Study cohort, with incident 'hard' CHD (myocardial infarction or CHD death) as an outcome. We used data from 965 men (298 cases, 667 controls) and 528 women (143 cases, 385 controls) to examine the utility of hsCRP, serum creatinine and haemoglobin A1c in improving the prediction of CHD risk over and above traditional risk factors for CHD included in the ATP III model. For each sex, the performance of models with only traditional risk factors used in the ATP III model was compared with models with the biomarkers added using weighted Cox proportional hazards analysis. The impact of adding these biomarkers was assessed using the net reclassification improvement index. For men, loge hsCRP (hazard ratio 1.25, 95% confidence interval: 1.05; 1.49) and loge serum creatinine (hazard ratio 4.82, 95% confidence interval: 2.10; 11.04) showed statistically significantly associations with CHD risk when added to the ATP III model. We did not observe a significant association between loge haemoglobin A1c and CHD risk (hazard ratio 1.83, 95% confidence interval: 0.21; 16.06). Adding hsCRP and serum creatinine to the ATP III model improved risk classification in men with a net gain of 6.3% of cases (p-value = 0.001) being reclassified to a higher risk category, while it did not significantly reduce the accuracy of classification for non-cases. For women, squared hsCRP was borderline significantly (hazard ratio 1.01, 95% confidence interval: 1.00; 1.03) and squared serum creatinine was significantly (hazard ratio 1.81, 95% confidence interval: 1.49; 2

  11. CCQM-K11.2 determination of glucose in human serum and CCQM-K12.2 determination of creatinine in human serum

    Science.gov (United States)

    Wise, Stephen A.; Phinney, Karen W.; Duewer, David L.; Sniegoski, Lorna T.; Welch, Michael J.; Pritchett, Jeanita; Pabello, Guiomar; Avila Calderon, Marco A.; Balderas, Miryan; Qinde, Liu; Kooi, Lee Tong; Rego, Eliane; Garrido, Bruno; Allegri, Gabriella; de La Cruz, Marcia; Barrabin, Juliana; Monteiro, Tânia; Lee, Hwashim; Kim, Byungjoo; Delatour, Vincent; Peignaux, Maryline; Kawaguchi, Migaku; Bei, Xu; Can, Quan; Nammoonnoy, Jintana; Schild, Katrin; Ohlendorf, Rüdiger; Henrion, Andre; Ceyhan Gören, Ahmet; Yılmaz, Hasibe; Bilsel, Mine; Konopelko, L.; Krylov, A.; Lopushanskaya, E.

    2018-01-01

    Glucose and creatinine are two of the most frequently measured substances in human blood/serum for assessing the health status of individuals. Because of their clinical significance, CCQM-K11 glucose in human serum and CCQM-K12 creatinine in human serum were the fourth and fifth key comparisons (KCs) performed by the Organic Analysis Working Group (OAWG). These KCs were conducted in parallel and were completed in 2001. The initial subsequent KCs for glucose, CCQM-K11.1, and creatinine, CCQM-K12.1, were completed in 2005. Measurements for the next KCs for these two measurands, CCQM-K11.2 and CCQM-K12.2, were completed in 2013. While designed as subsequent KCs, systematic discordances between the participants' and the anchor institution's results in both comparisons lead the OAWG to request reference results from two experienced laboratories that had participated in the 2001 comparisons. Based on the totality of the available information, the OAWG converted both CCQM-K11.2 and CCQM-K12.2 to 'Track C' KCs where the key comparison reference value is estimated by consensus. These comparisons highlighted that carrying out comparisons for complex chemical measurements and expecting to be able to treat them under the approaches used for formal CIPM subsequent comparisons is not an appropriate strategy. The approach used here is a compromise to gain the best value from the comparison; it is not an approach that will be used in the future. Instead, the OAWG will focus on Track A and Track C comparisons that are treated as stand-alone entities. Participation in CCQM-K11.2 demonstrates a laboratory's capabilities to measure a polar (pKow > 2), low molecular mass (100 g/mol to 500 g/mol) metabolite in human serum at relatively high concentrations (0.1 mg/g to 10 mg/g). Participation in CCQM-K12.2 demonstrates capabilities to measure similar classes of metabolites at relatively low concentrations (1 μg/g to 30 μg/g). The capabilities required for the analysis of complex

  12. Increased urinary neutrophil gelatinase-associated lipocalin in very-low-birth-weight infants with oliguria and normal serum creatinine.

    Science.gov (United States)

    Shin, So Young; Ha, Ji Yong; Lee, Sang Lak; Lee, Won Mok; Park, Jae Hyun

    2017-06-01

    In infants, oliguria is defined as a urine output of serum cystatin C (CysC) levels in very-low-birth-weight infants (VLBWIs) with a normal serum creatinine (Cr) level. Fifty-seven VLBWIs were enrolled in the study. Urinary NGAL, serum CysC and Cr levels and urinary NGAL/Cr ratios were measured. Infants with Apgar scores of >5 at 5 min and/or a serum Cr level of >1.5 mg/dL or those treated for patent ductus arteriosus were excluded. In case of antibiotic treatment, blood and urine samples were collected at ≥48 h after discontinuation of antibiotic treatment. There was a significant difference in gestational age between infants with oliguric episodes during hospitalization and those without, but not in birth weight, perinatal or postnatal factors. Gestational age was negatively correlated with urinary NGAL and serum CysC levels and urinary NGAL/Cr ratio (p serum Cr level and urinary NGAL/Cr ratio (p serum CysC or serum Cr levels. The urinary NGAL level [area under the curve (AUC) 0.886, 95% confidence interval (CI) 0.814-0.937] and urinary NGAL/Cr ratio (AUC 0.853, 95% CI 0.775-0.911) showed significantly greater discrimination for oliguria than serum CysC (AUC 0.610, 95% CI: 0.515-0.699) or serum Cr (AUC 0.747, 95%CI 0.659-0.823) levels. Urinary NGAL level and urinary NGAL/Cr ratio were more sensitive markers for the presence of oliguria in VLBWIs with normal serum Cr levels than serum CysC level.

  13. New ICA criteria for the diagnosis of acute kidney injury in cirrhotic patients: can we use an imputed value of serum creatinine?

    Science.gov (United States)

    Rosi, Silvia; Piano, Salvatore; Frigo, Anna C; Morando, Filippo; Fasolato, Silvano; Cavallin, Marta; Gola, Elisabetta; Romano, Antonietta; Montagnese, Sara; Sticca, Antonietta; Gatta, Angelo; Angeli, Paolo

    2015-09-01

    The new International Club of Ascites diagnostic criteria to diagnose acute kidney injury at hospital admission suggests the possibility of using a presumed baseline serum creatinine, defined as the last of at least two stable creatinine values during the last 3 months. Nevertheless, the possibility of the lack of such a value still remains. In these patients, the KDIGO criteria suggest to use an inverse application of MDRD equation assuming that baseline glomerular filtration rate is 75 ml/min per 1.73 m(2) (imputed baseline creatinine). We tested the accuracy of this approach to detect acute kidney injury at admission in patients with decompensated cirrhosis and creatinine creatinine-based equations and measured by inulin clearance. A diagnosis of acute kidney injury was made using an imputed value of serum creatinine as baseline. The diagnosis of AKI based on an imputed baseline creatinine identified only 20.1% of patients with measured glomerular filtration rate ≤60 ml/min/1.73 m(2) without any predictive value on 90-day survival. In patients with cirrhosis and ascites with a creatinine creatinine is not accurate. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Different association of cigarette smoking with GFR estimated from serum creatinine and that from serum cystatin C in the general population.

    Science.gov (United States)

    Yamada, Yuichi; Noborisaka, Yuka; Ishizaki, Masao; Yamazaki, Michiko; Honda, Ryumon; Yokoyama, Hitoshi; Kakuma, Tatsuyuki

    2015-08-01

    Previous studies have shown that GFR estimated from serum creatinine (eGFRcr) is higher in smokers although the implications remain unclear. We aimed to clarify the associations of smoking with eGFRcys (GFR estimated from serum cystatin C) and eGFRcr, cys (the surmised most precise GFR estimate based on serum creatinine and cystatin C) in a working population. Cross-sectional observation in 1,587 male workers aged 25-64 years. For eGFRcr, JEQcr proposed by the Japanese Society of Nephrology (JSN) and jEPIcr by the Chronic Kidney Disease Epidemiological Collaboration (CKD-EPI) modified for Japanese, and for eGFRcys, JEQcys proposed by JSN and EPIcys by CKD-EPI were calculated together with eGFRcr,cys of JEQaver (the average of JEQcr and JEQcys) and jEPIcr,cys by CKD-EPI modified for Japanese. Mean JEQcys was 95.1 mL/min/1.73 m(2) in contrast to 80.9 in JEQcr, with this difference considerable. Serum cystatin C was higher in smokers and obese subjects while serum creatinine was lower in smokers and slender subjects. JEQcys and EPIcys were lower in smokers while JEQcr and jEPIcr were higher in smokers adjusting for body mass index (BMI). eGFRcr,cys (JEQaver and jEPIcr,cys) did not differ between the never smokers and current smokers. eGFRcr,cys predicted by the equations composed of eGFRcr, BMI, and smoking habits showed a good accordance with calculated eGFRcr,cys. Either eGFRcr, eGFRcys or both were not reliable indicators of renal function in workers who smoked. The possibly more precise estimate of eGFRcr,cys could be predicted by eGFRcr, BMI and smoking in such a generally healthy population.

  15. Evaluation the short term effects on serum creatinine concentration in patients with normal renal function, mild and moderate renal insufficiency after intravenous injection of gadopentetate dimeglumine

    International Nuclear Information System (INIS)

    Luo Jian; Liu Jing; Wang Xiaoying; Yang Xuedong; Jiang Xuexiang

    2010-01-01

    Objective: To explore the effects of gadopentetate dimeglumine injection on renal function. Methods: The study included 623 consecutive patients. Their serum creatinine concentrations before and within 3 days after injection of gadopentetate dimeglumine were analyzed. Their eGFR (estimated glomerular filtration rate) were calculated. Patients were divided into two groups according to their injection dose: group received single dose and group received double dose. Patients in each group were subdivided into three subgroups according to their eGFR: subgroup of normal renal function, subgroup of mild renal insufficiency and subgroup of moderate renal insufficiency. Paried sample t test and group design paired sample Rank Sum test were used for statistical analysis. Results: There was no adverse reaction or occurrence of acute renal insufficiency. The mean level of serum creatinine dropped from (74.0± 17.2) μmol/L to (71.5±19.0) μmol/L (t=5.39, P 0.05) in subgroup of mild renal insufficiency under group received double dose and increased from (118.3±15.3) μmol/L to (135.7±8.5) μmol/L (t=2.02, P<0.05) in subgroup of moderate renal insufficiency under group received double dose, the mean level of serum creatinine dropped in all other subgroups. Conclusions: Single dose gadopentetate dimeglumine is safe for patients with normal renal function and mild, moderate renal insufficiency in short term, but patients with abnormal renal function should be followed up after double dose injection. (authors)

  16. Trends in serum creatinine testing in Oxfordshire, UK, 1993-2013: a population-based cohort study.

    Science.gov (United States)

    Oke, Jason; Shine, Brian; McFadden, Emily; Stevens, Richard; Lasserson, Daniel; Perera, Rafael

    2015-12-16

    To determine how many kidney function tests are done, on whom, how frequently they are performed and how they have changed over time. Retrospective study of all serum creatinine, urine albumin and urine creatinine tests. Primary and secondary care in Oxfordshire from 1993 to 2013. Unselected population of 1,220,447 people. The total number of creatinine and urinary protein tests ordered from primary and secondary care and the number of tests per year stratified by categories of estimated glomerular filtration rate (eGFR). The frequency of testing in patients having their kidney function monitored. Creatinine requests from primary care increased steadily from 1997 and exceeded 220,000 requests in 2013. Tests corresponding to normal kidney function (eGFR >60/mL/min/1.73 m(2)) constituted 59% of all kidney function tests in 1993 and accounted for 83% of all tests in 2013. Test corresponding to chronic kidney disease (CKD) stages 3-5 declined after 2007. Reduced kidney function, albuminuria, male gender, diabetes and age were independently associated with more frequent monitoring. For a female patient between 61 and 80 years and with stage 3a CKD, the average number of serum creatinine tests (95% CI) was 3.23/year (3.19 to 3.26) and for a similar woman with diabetes, the average number of tests was 5.50 (5.44 to 5.56) tests per year. There has been a large increase in the number of kidney function tests over the past two decades. However, we found little evidence that this increase is detecting more CKD. Tests are becoming more frequent in people with and without evidence of renal impairment. Future work using a richer data source could help unravel the underlying reasons for the increased testing and determine how much is necessary and useful. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Evaluation of the serumic levels of creatinine, urea and uric acid in rainbow trouts (Oncorhyncus mykiss affected by nephrocalsinosis

    Directory of Open Access Journals (Sweden)

    j Mortazavi Tabrizi

    2007-11-01

    Full Text Available In order to investigate the alternation in serumic levels of creatinine, urea and uric acid in rainbow trouts (Oncorhyncus mykiss affected by nephrocalsinosis, samples were taken during the winter of 1385 from three fish farms with different water sources of river, spring and well water recirculation system. Five samples were taken from each of the 8 different weight groups and a total of 120 specimens were collected randomly. After collecting the specimens, blood and renal tissue sampling was performed on all the fish with the tissue samples fixed in 10% buffered formalin and the separated sera stored at -200C for further evaluations. Renal Samples were transferred to the pathology laboratory and tissue sections were prepared and stained with hematoxylin and eosin. From the 120 collected specimens, 6 were affected by nephrocalcinosis with histopathologic evidence of severe dilation of renal tubules, presence of dense basophilic materials inside the dilated tubules and hyaline cast formation in some renal tubules. Amongst the 6 cases with nephrocalcinosis, 3(2.5% were from the farm with well water recirculation system, 2 (1.66% from the farm with river water supply and 1 (0.83% from the farm which used the spring water source.  Evaluation of the amounts of urea, creatinine and uric acid indicated that there was a significant difference in mean creatinine levels between different weight groups (P< 0.05. In conclusion, according to the results of this study there is only a significant statistical difference in the amount of creatinine between healthy fish and those affected by nephrocalcinosis in each farm.

  18. Final report on CCQM-K80: Comparison of value-assigned CRMs and PT materials: Creatinine in human serum

    Science.gov (United States)

    Camara, Johanna E.; Duewer, David L.; Gasca Aragon, Hugo; Lippa, Katrice A.; Toman, Blaza

    2013-01-01

    The 2009 CCQM-K80 'Comparison of value-assigned CRMs and PT materials: creatinine in human serum' is the first in a series of key comparisons directly testing the chemical measurement services provided to customers by National Metrology Institutes (NMIs) and Designated Institutes. CCQM-K80 compared the assigned serum creatinine values of certified reference materials (CRMs) using measurements made on these materials under repeatability conditions. Six NMIs submitted 17 CRM materials for evaluation, all intended for sale to customers. These materials represent nearly all of the higher-order CRMs then available for this clinically important measurand. The certified creatinine mass fraction in the materials ranged from 3 mg/kg to 57 mg/kg. All materials were stored and prepared according the specifications provided by each NMI. Samples were processed and analyzed under repeatability conditions by one analyst using isotope dilution liquid chromatography-mass spectrometry. The instrumental repeatability imprecision, expressed as a percent relative standard deviation, was 1.2%. Given the number of materials and the time required for each analysis, the measurements were made in two measurement campaigns ('runs'). In both campaigns, replicate analyses (two injections of one preparation separated in time) were made on each of two or three independently prepared aliquots from one randomly selected unit of each of the 17 materials. The mean value, between-campaign, between-aliquot and between-replicate variance components, standard uncertainty of the mean value, and the number of degrees of freedom associated with the standard uncertainty were estimated using a linear mixed model. Since several of the uncertainties estimated using this traditional frequentist approach were associated with a single degree of freedom, Markov Chain Monte Carlo Bayesian analysis was used to estimate 95% level-of-confidence coverage intervals, U95. Uncertainty-weighted generalized distance

  19. Use of multiple imputation method to improve estimation of missing baseline serum creatinine in acute kidney injury research.

    Science.gov (United States)

    Siew, Edward D; Peterson, Josh F; Eden, Svetlana K; Moons, Karel G; Ikizler, T Alp; Matheny, Michael E

    2013-01-01

    Baseline creatinine (BCr) is frequently missing in AKI studies. Common surrogate estimates can misclassify AKI and adversely affect the study of related outcomes. This study examined whether multiple imputation improved accuracy of estimating missing BCr beyond current recommendations to apply assumed estimated GFR (eGFR) of 75 ml/min per 1.73 m(2) (eGFR 75). From 41,114 unique adult admissions (13,003 with and 28,111 without BCr data) at Vanderbilt University Hospital between 2006 and 2008, a propensity score model was developed to predict likelihood of missing BCr. Propensity scoring identified 6502 patients with highest likelihood of missing BCr among 13,003 patients with known BCr to simulate a "missing" data scenario while preserving actual reference BCr. Within this cohort (n=6502), the ability of various multiple-imputation approaches to estimate BCr and classify AKI were compared with that of eGFR 75. All multiple-imputation methods except the basic one more closely approximated actual BCr than did eGFR 75. Total AKI misclassification was lower with multiple imputation (full multiple imputation + serum creatinine) (9.0%) than with eGFR 75 (12.3%; Pmultiple imputation + serum creatinine) (15.3%) versus eGFR 75 (40.5%; PMultiple imputation improved specificity and positive predictive value for detecting AKI at the expense of modestly decreasing sensitivity relative to eGFR 75. Multiple imputation can improve accuracy in estimating missing BCr and reduce misclassification of AKI beyond currently proposed methods.

  20. 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.

  1. Accurate quantification of creatinine in serum by coupling a measurement standard to extractive electrospray ionization mass spectrometry

    Science.gov (United States)

    Huang, Keke; Li, Ming; Li, Hongmei; Li, Mengwan; Jiang, You; Fang, Xiang

    2016-01-01

    Ambient ionization (AI) techniques have been widely used in chemistry, medicine, material science, environmental science, forensic science. AI takes advantage of direct desorption/ionization of chemicals in raw samples under ambient environmental conditions with minimal or no sample preparation. However, its quantitative accuracy is restricted by matrix effects during the ionization process. To improve the quantitative accuracy of AI, a matrix reference material, which is a particular form of measurement standard, was coupled to an AI technique in this study. Consequently the analyte concentration in a complex matrix can be easily quantified with high accuracy. As a demonstration, this novel method was applied for the accurate quantification of creatinine in serum by using extractive electrospray ionization (EESI) mass spectrometry. Over the concentration range investigated (0.166 ~ 1.617 μg/mL), a calibration curve was obtained with a satisfactory linearity (R2 = 0.994), and acceptable relative standard deviations (RSD) of 4.6 ~ 8.0% (n = 6). Finally, the creatinine concentration value of a serum sample was determined to be 36.18 ± 1.08 μg/mL, which is in excellent agreement with the certified value of 35.16 ± 0.39 μg/mL.

  2. 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

  3. Assessment of biochemical markers in the early post-burn period for predicting acute kidney injury and mortality in patients with major burn injury: comparison of serum creatinine, serum cystatin-C, plasma and urine neutrophil gelatinase-associated lipocalin.

    Science.gov (United States)

    Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kym, Dohern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Kim, Hyun Soo

    2014-07-14

    The reported mortality rates range from 28% to 100% in burn patients who develop acute kidney injury (AKI) and from 50% to 100% among such patients treated with renal replacement therapy. Recently, the serum cystatin C and plasma and urine neutrophil gelatinase-associated lipocalin (NGAL) levels have been introduced as early biomarkers for AKI; the levels of these biomarkers are known to increase 24 to 48 hours before the serum creatinine levels increase. In this study, we aimed to estimate the diagnostic utility of the cystatin C and plasma and urine NGAL levels in the early post-burn period as biomarkers for predicting AKI and mortality in patients with major burn injuries. From May 2011 to July 2012, 90 consecutive patients with a burn wound area comprising ≥ 20% of the total body surface area (TBSA) were enrolled in this study. Whole blood and urine samples were obtained for measuring the serum creatinine, serum cystatin C, and urine and plasma NGAL levels at 0, 3, 6, 12, 24, and 48 hours after admission. Receiver operating characteristic curve, area under the curve, and multivariate logistic regression analyses were performed to assess the predictive values of these biomarkers for AKI and mortality. In the multivariate logistic regression analysis, all variables, including age, percentage TBSA burned, sex, inhalation injury, and serum creatinine levels, serum cystatin C levels, and plasma and urine NGAL levels were independently associated with AKI development. Moreover, age, sex, percentage TBSA burned, and plasma and urine NGAL levels were independently associated with mortality. However, inhalation injury and the serum creatinine and cystatin C levels were not independently associated with mortality. Massively burned patients who maintained high plasma and urine NGAL levels until 12 hours after admission were at the risk of developing early AKI and early mortality with burn shock. However, the plasma and urine NGAL levels in the early post-burn period

  4. I.v. N-acetylcysteine and emergency CT: use of serum creatinine and cystatin C as markers of radiocontrast nephrotoxicity.

    Science.gov (United States)

    Poletti, Pierre-Alexandre; Saudan, Patrick; Platon, Alexandra; Mermillod, Bernadette; Sautter, Anna-Maria; Vermeulen, Bernard; Sarasin, François P; Becker, Christoph D; Martin, Pierre-Yves

    2007-09-01

    The purpose of this study was to assess the effect of i.v. administration of N-acetylcysteine (NAC) on serum levels of creatinine and cystatin C, two markers of renal function, in patients with renal insufficiency who undergo emergency contrast-enhanced CT. Eighty-seven adult patients with renal insufficiency who underwent emergency CT were randomized to two groups. In the first group, in addition to hydration, patients received a 900-mg injection of NAC 1 hour before and another immediately after injection of iodine contrast medium. Patients in the second group received hydration only. Serum levels of creatinine and cystatin C were measured at admission and on days 2 and 4 after CT. Nephrotoxicity was defined as a 25% or greater increase in serum creatinine or cystatin C concentration from baseline value. A 25% or greater increase in serum creatinine concentration was found in nine (21%) of 43 patients in the control group and in two (5%) of 44 patients in the NAC group (p = 0.026). A 25% or greater increase in serum cystatin C concentration was found in nine (22%) of 40 patients in the control group and in seven (17%) of 41 patients in the NAC group (p = 0.59). On the basis of serum creatinine concentration only, i.v. administration of NAC appears protective against the nephrotoxicity of contrast medium. No effect is found when serum cystatin C concentration is used to assess renal function. The effect of NAC on serum creatinine level remains unclear and may not be related to a renoprotective action.

  5. Changes in serum cystatin C, creatinine, and C-reactive protein after cardiopulmonary bypass in patients with normal preoperative kidney function.

    Science.gov (United States)

    Svensson, Anders S; Kvitting, John-Peder Escobar; Kovesdy, Csaba P; Cederholm, Ingemar; Szabó, Zoltán

    2016-06-01

    The use of cardiopulmonary bypass (CPB) can cause changes in serum creatinine and cystatin C independent of glomerular filtration rate. We aimed to quantify the temporal changes of these biomarkers and C-reactive protein (CRP) after CPB. This was a prospective study at an academic medical centre between April and October 2013. We compared postoperative changes in serum creatinine and cystatin C in 38 patients with normal preoperative kidney function who underwent cardiac surgery using CPB and did not develop perioperative acute kidney injury (AKI). The effect of inflammation on intra-individual changes was examined in mixed effects regressions, using measurements of pre- and postoperative CRP. Both serum creatinine (79.9 ± 22.7 vs. 92.6 ± 21.4 µmol/L, P = 0.001) and cystatin C (1.16 ± 0.39 vs. 1.33 ± 0.37 mg/L, P = 0.012) decreased significantly in the first 8 h postoperatively compared to preoperatively, as a result of haemodilution. Thereafter serum creatinine returned to preoperative levels, whereas serum cystatin C continued to rise and was significantly elevated at 72 h post-CPB compared to preoperative levels (1.53 ± 0.48 vs. 1.33 ± 0.37 mg/L, P = 0.003). CRP levels increased significantly post-CPB and were significantly associated with increases in both serum creatinine and cystatin C. Serum creatinine and cystatin C appear not to be interchangeable biomarkers during and immediately after CPB. Processes unrelated to kidney function such as acute inflammation have a significant effect on post-CPB changes in these biomarkers, and may result in significant increases in serum cystatin C that could erroneously be interpreted as AKI. © 2015 Asian Pacific Society of Nephrology.

  6. The Impact of Baseline Serum Creatinine on Complete Remission Rate and Long-Term Outcome in Patients with Severe Lupus Nephritis

    Directory of Open Access Journals (Sweden)

    Stephen M. Korbet

    2016-08-01

    Full Text Available Background/Aim: We assess the impact of serum creatinine at baseline on complete remission rate and long-term outcome in severe lupus nephritis (SLN. Methods: A total of 86 adult patients with SLN [International Society of Nephrology/Renal Pathology Society (ISN/RPS class IV lesions] were evaluated based on baseline serum creatinine levels (≤1.0, 1.01-1.5, 1.51-2.0, 2.01-3.0, and >3.0 mg/dl; n = 22, 23, 16, 12, and 13, respectively. The complete remission rates (serum creatinine level of ≤1.4 mg/dl and proteinuria of ≤0.33 g/day and long-term outcomes (stable renal function, dialysis, and death were compared. The patients were followed for 121 ± 64 months. Results: The baseline clinical features were similar, but the chronicity index was significantly higher with increasing levels of serum creatinine. Complete remission rates were significantly higher in patients with lower levels of serum creatinine (86 vs. 52 vs. 19 vs. 25 vs. 0%, p 16 times as likely (OR 16.2; 95% CI: 4.2-61.5 to attain a complete remission and >6 times as likely (OR 6.1; 95% CI: 1.9-18.6 to have stable renal function at the last follow-up as compared to patients with a serum creatinine level of >1.0 mg/dl. The 15-year renal survival rate was greatest among those patients with a baseline serum creatinine level of ≤1.0 mg/dl (76 vs. 57 vs. 48 vs. 25 vs. 10%, p Conclusion: The prognosis of SLN is significantly affected by the serum creatinine level at baseline. The complete remission rate is highest, and the long-term prognosis most favorable, in patients with a baseline serum creatinine level of ≤1.0 mg/dl. This emphasizes the importance of early diagnosis and treatment.

  7. Lack of Serum Creatinine Decrease After Coronary Angiography Despite Prophylactic Hydration After Routine Coronary Angiography/Angioplasty in Stable Angina Patients--Pilot Study.

    Science.gov (United States)

    Burchardt, Pawel; Rzezniczak, Janusz; Synowiec, Tomasz; Angerer, Dariusz; Palasz, Anna; Zurawski, Jakub

    2016-01-01

    To prevent contrast induced renal dysfunction a periprocedural prophylactic hydration is applied. Due to dilution it should cause a drop in serum creatinine concentration (SCR). Surprisingly, no reduction in SCR after contrast admission is found in up to 25% of patients as early as 12-18 hours after coronary angiography/angioplasty. This study aims to find a clinical explanation as well as predict circumstances for this phenomenon. Retrospective clinical and laboratory data was used from 341 patients who underwent elective coronary angiography/angioplasty, received a prophylactic hydration, and had serum creatinine concentration measured prior to, and 12-18 hours after invasive procedure with iodine contrast administration. To exclude an improper hydration due to no creatinine decrease, the number of red blood cells was analysed as well as hemoglobin and hematocrit in blood donations collected during the study time points. The resulting lack of serum creatinine reduction could be explained by dehydration (measured by increase in number of RBC, HGB and HCT) only in 13.5% , 10.8%, and 20% of cases, respectively. Any form of abnormal glucose metabolism combined with either baseline serum creatinine concentration creatinine clearance >86.77 mL/min, or GFR by CKD EPI >80.08 mL/min/1.73 m2, or GFR by MDRD >74.48 mL/min/1.73 m2 were the predictors for no creatinine decrease at outcome. Additionally, it was demonstrated that the lack of creatinine decrease was more often observed among those patients whose initial renal function was better than in the subjects with reduction of SCR. This observation requires further prospective investigation on extended group of patients. © 2016 The Author(s) Published by S. Karger AG, Basel.

  8. Dopamine-Induced Changes in Serum Erythropoietin and Creatinine Clearance Reflect Risk Factors for Progression of IgA Nephropathy.

    Science.gov (United States)

    Sulikowska, Beata; Johnson, Richard J; Wiechecka-Korenkiewicz, Joanna; Korenkiewicz, Jadwiga; Marszalek, Andrzej; Odrowaz-Sypniewska, Grazyna; Manitius, Jacek

    2015-08-01

    The infusion of low-dose dopamine is normally associated with an increase in creatinine clearance, thereby allowing one to assess renal functional reserve. Increased renal blood flow is also associated with a reduction in erythropoietin (EPO) levels. We evaluated the use of dopamine infusion in subjects with IgA nephropathy to determine if these functional changes correlate with risk factors for progression and compared this to the renal biopsy findings. Changes in creatinine clearance and EPO levels were determined in 46 non-nephrotic IgA patients with relative preserved renal function after the infusion of low dose dopamine. Control subjects (n = 15) were evaluated using similar protocols. Subjects with IgA nephropathy could be separated into those who showed a fall in EPO levels (n = 24) and those who showed no change or a rise in EPO levels (n = 22). Subjects showing the expected fall in EPO demonstrated a higher increase in creatinine clearance, similar to that observed in control subjects. Most importantly, subjects who showed a fall in EPO had less proteinuria, less N-acetyl-β-D-glucosaminidase excretion, lower serum uric acid, blood pressure, and less features of metabolic syndrome despite similar inflammation and fibrosis on biopsy as compared to the others. A decrease in EPO in response to dopamine is associated with a clinical phenotype that is less likely to develop progressive renal disease. These studies suggest that a fall in EPO in response to dopamine likely reflects preserved tubulointerstitial function that cannot be assessed by renal biopsy alone.

  9. Use of Multiple Imputation Method to Improve Estimation of Missing Baseline Serum Creatinine in Acute Kidney Injury Research

    Science.gov (United States)

    Peterson, Josh F.; Eden, Svetlana K.; Moons, Karel G.; Ikizler, T. Alp; Matheny, Michael E.

    2013-01-01

    Summary Background and objectives Baseline creatinine (BCr) is frequently missing in AKI studies. Common surrogate estimates can misclassify AKI and adversely affect the study of related outcomes. This study examined whether multiple imputation improved accuracy of estimating missing BCr beyond current recommendations to apply assumed estimated GFR (eGFR) of 75 ml/min per 1.73 m2 (eGFR 75). Design, setting, participants, & measurements From 41,114 unique adult admissions (13,003 with and 28,111 without BCr data) at Vanderbilt University Hospital between 2006 and 2008, a propensity score model was developed to predict likelihood of missing BCr. Propensity scoring identified 6502 patients with highest likelihood of missing BCr among 13,003 patients with known BCr to simulate a “missing” data scenario while preserving actual reference BCr. Within this cohort (n=6502), the ability of various multiple-imputation approaches to estimate BCr and classify AKI were compared with that of eGFR 75. Results All multiple-imputation methods except the basic one more closely approximated actual BCr than did eGFR 75. Total AKI misclassification was lower with multiple imputation (full multiple imputation + serum creatinine) (9.0%) than with eGFR 75 (12.3%; Pserum creatinine) (15.3%) versus eGFR 75 (40.5%; P<0.001). Multiple imputation improved specificity and positive predictive value for detecting AKI at the expense of modestly decreasing sensitivity relative to eGFR 75. Conclusions Multiple imputation can improve accuracy in estimating missing BCr and reduce misclassification of AKI beyond currently proposed methods. PMID:23037980

  10. Evaluation, including effects of storage and repeated freezing and thawing, of a method for measurement of urinary creatinine

    DEFF Research Database (Denmark)

    Garde, A H; Hansen, Åse Marie; Kristiansen, J

    2003-01-01

    The aims of this study were to elucidate to what extent storage and repeated freezing and thawing influenced the concentration of creatinine in urine samples and to evaluate the method for determination of creatinine in urine. The creatinine method was based on the well-known Jaffe's reaction and.......1 mmol/L), was 0.3 mmol/L, and the recovery of a certified reference material was 97%. The relative precision at 3.15 mmol/L was 2.3%. It was concluded that the method is appropriate for measurement of urinary creatinine....

  11. Early trends in serum phosphate and creatinine levels are associated with mortality following major hepatectomy.

    Science.gov (United States)

    Herbert, Garth S; Prussing, Kara B; Simpson, Amber L; D'Angelica, Michael I; Allen, Peter J; DeMatteo, Ronald P; Jarnagin, William R; Kingham, T Peter

    2015-12-01

    Mortality after major hepatectomy remains high and is frequently related to post-hepatectomy liver failure (PHLF). Other than pre-existing liver disease and a small future liver remnant, few patient factors or early postoperative indicators identify patients at elevated risk for PHLF and mortality. Data on demographics, comorbidities, operative procedures and postoperative laboratory trends were reviewed for patients submitted to major hepatectomy (at least three Couinaud segments) for malignancy during 1998-2013. These factors were compared among patients who died within 90 days, survivors who met the 50-50 criteria and all remaining survivors. A total of 1528 patients underwent major hepatectomy during the study period. Of these, 947 had metastatic colorectal cancer and underwent resection of a median of four segments. Overall, 49 patients (3.2%) died within 90 days of surgery and 48 patients (3.1%) met the 50-50 criteria for PHLF; 30 of these patients survived 90 days. Operative blood loss was higher in patients who died within 90 days compared with survivors (1.0 l versus 0.5 l; P trends in creatinine and phosphate (between the day of surgery and PoD 1) identify patients at risk for PHLF and mortality. © 2015 International Hepato-Pancreato-Biliary Association.

  12. Serum Uric Acid Levels and Uric Acid/Creatinine Ratios in Stable Chronic Obstructive Pulmonary Disease (COPD) Patients: Are These Parameters Efficient Predictors of Patients at Risk for Exacerbation and/or Severity of Disease?

    Science.gov (United States)

    Durmus Kocak, Nagihan; Sasak, Gulsah; Aka Akturk, Ulku; Akgun, Metin; Boga, Sibel; Sengul, Aysun; Gungor, Sinem; Arinc, Sibel

    2016-11-03

    BACKGROUND Serum uric acid (sUA) levels were previously found to be correlated with hypoxic states. We aimed to determine the levels of sUA and sUA/creatinine ratios in stable COPD patients and to evaluate whether sUA level and sUA/creatinine ratio can be used as predictors of exacerbation risk and disease severity. MATERIAL AND METHODS This cross-sectional study included stable COPD patients and healthy controls. The sUA levels and sUA/creatinine ratios in each group were evaluated and their correlations with the study parameters were investigated. ROC analyses for exacerbation risk and disease severity were reported. RESULTS The study included 110 stable COPD patients and 52 healthy controls. The mean sUA levels and sUA/creatinine ratios were significantly higher in patients with COPD compared to healthy controls. The most common comorbidities in COPD patients were hypertension, diabetes, and coronary artery disease. While sUA levels were significantly higher in patients with hypertension (p=0.002) and malignancy (p=0.033), sUA/creatinine ratios was higher in patients with malignancy (p=0.004). The ROC analyses indicated that sUA/creatinine ratios can be more useful than sUA levels in predicting exacerbation risk (AUC, 0.586 vs. 0.426) and disease severity (AUC, 0.560 vs. 0.475) especially at higher cut-off values, but with low specificity. CONCLUSIONS Our study suggested that sUA levels and sUA/creatinine ratios increased in patients with stable COPD, especially among patients with certain comorbidities compared to healthy controls. At higher cut-off values, sUA levels and especially sUA/creatinine ratios, might be useful in predicting COPD exacerbation risk and disease severity. Also, their association with comorbidities, especially with malignancy and hypertension, may benefit from further investigation.

  13. Underestimating chronic kidney disease by urine dipstick without serum creatinine as a screening tool in the general Japanese population.

    Science.gov (United States)

    Uchida, Daisuke; Kawarazaki, Hiroo; Shibagaki, Yugo; Yasuda, Takashi; Tominaga, Naoto; Watanabe, Tsuyoshi; Asahi, Koichi; Iseki, Kunitoshi; Iseki, Chiho; Tsuruya, Kazuhiko; Yamagata, Kunihiro; Moriyama, Toshiki; Narita, Ichiei; Fujimoto, Shoichi; Konta, Tsuneo; Kondo, Masahide; Kasahara, Masato; Kimura, Kenjiro

    2015-06-01

    It is not known if urine dipstick alone can identify chronic kidney disease (CKD) in the general Japanese population. We designed a cross-sectional study using data obtained in 2008 from a nationwide community-based health examination program for adults aged 40-74. The data consisted of blood tests, urine tests and questionnaire related to metabolic disorders. Those who had both serum creatinine measured and urine dipstick tested were analyzed. Data were obtained from 538,846 people with a mean age of 62.8 years, consisting of 41.6 % males. Our study showed that 14.4 % had an eGFR below 60 mL/min/1.73 m(2), 5.2 % had proteinuria and 18.1 % had CKD. Within the population with CKD, non-proteinuric CKD accounted for 71.4 %. The proportion of non-proteinuric CKD was highest in stage G3a (91.8 %) followed by G3b (77.0 %) disease, and was greater in the more elderly and in females. The proportion of non-proteinuric CKD was 47.9 % in diabetes mellitus, 69.3 % in dyslipidemia, 66.8 % in hypertension and 57.1 % in metabolic syndrome. Furthermore, non-proteinuric CKD accounted for 78.1 % of the population without these lifestyle diseases, suggesting that even in the population without apparent risk, CKD is still prevalent and can be missed when urine dipstick is the only screening method used. This study showed that a considerable population of CKD might be overlooked when only dipstick proteinuria is assessed for CKD screening. Hence, we strongly recommend that both urinalysis and serum creatinine measurement should be a part of the nationwide CKD screening system.

  14. Re-recognition of Age-dependent Reference Range for the Serum Creatinine Level in Teenagers - A Case of Slowly Progressive Tubulointerstitial Nephritis which Occurred in an Adolescent.

    Science.gov (United States)

    Ono, Hiroyuki; Nagai, Kojiro; Shibata, Eriko; Matsuura, Motokazu; Kishi, Seiji; Inagaki, Taizo; Minato, Masanori; Yoshimoto, Sakiya; Ueda, Sayo; Obata, Fumiaki; Nishimura, Kenji; Tamaki, Masanori; Kishi, Fumi; Murakami, Taichi; Abe, Hideharu; Kinoshita, Yukiko; Urushihara, Maki; Kagami, Shoji; Doi, Toshio

    2017-08-15

    For the first time, a 15-year-old boy was found to have a slight degree of proteinuria and microscopic hematuria during annual school urinalysis screening. His kidney function had already severely deteriorated. A kidney biopsy revealed tubulointerstitial nephritis (TIN) with diffuse inflammatory cell infiltration. His medical records showed his serum creatinine level to be 0.98 mg/dL two years ago, which was abnormally high considering his age. Although the etiology of slowly progressive TIN was unclear, glucocorticoid and immunosuppressant therapy improved his kidney function. This case report suggests that all doctors should recognize the reference range for the serum creatinine level in teenagers.

  15. Serum Uric Acid to Creatinine Ratio and Risk of Metabolic Syndrome in Saudi Type 2 Diabetic Patients.

    Science.gov (United States)

    Al-Daghri, Nasser M; Al-Attas, Omar S; Wani, Kaiser; Sabico, Shaun; Alokail, Majed S

    2017-09-21

    This study aimed to investigate whether uric acid to creatinine (UA/Cr) ratio is associated with higher risk of metabolic syndrome (MetS) and its components. 332 adult Saudi type 2 diabetes mellitus (T2DM) patients were divided into UA/Cr tertiles. Risk for full MetS was significantly highest in individuals that constitutes the uppermost serum UA/Cr tertile [Odds ratio (OR): 1.80, 95% confidence interval (CI): 1.0-3.3; p < 0.001) after adjustment for age, gender and BMI. Similarly, risk for individual components of MetS like central obesity, hypertriglyceridemia, low HDL-cholesterol and hypertension was significantly highest in this tertile with OR's of 2.61 (1.2-5.6), 1.42 (0.7-2.3), 1.45 (0.7-2.8) and 1.16 (0.6-2.2) respectively (all p-values < 0.001) after adjustment for age, gender, BMI and other components of MetS. Furthermore, serum UA/Cr levels increased with increasing number of MetS components (mean values of 4.44, 4.49, 4.64, 4.89 and 4.91 respectively for 1,2,3,4 and 5 MetS components, p-values < 0.001 after adjusting for age, gender and BMI). Our data suggest that serum UA/Cr in T2DM patients is strongly associated with full MetS as well as its individual components. These findings are of considerable clinical importance as serum UA/Cr may be used as a marker in the pathogenesis of MetS.

  16. Serum cystatin C levels in preterm newborns in our setting: Correlation with serum creatinine and preterm pathologies

    Directory of Open Access Journals (Sweden)

    Leonor Bardallo Cruzado

    2015-05-01

    Conclusions: Serum CysC decreased within 48–72 h of life, and this decline showed significance (P < .05. The levels increased after 7 days in all 3 GA groups, and there was no difference in CysC levels among the groups. More studies in preterm infants with hypotension and respiratory disease are required. CysC is a better glomerular filtration rate (GFR marker in ≤1.500 g preterm infants.

  17. Impact of Gate 99mTc DTPA GFR, Serum Creatinine and Urea in Diagnosis of Patients with Chronic Kidney Failure

    Science.gov (United States)

    Miftari, Rame; Nura, Adem; Topçiu-Shufta, Valdete; Miftari, Valon; Murseli, Arbenita; Haxhibeqiri, Valdete

    2017-01-01

    Aim: The aim of this study was determination of validity of 99mTcDTPA estimation of GFR for early detection of chronic kidney failure Material and methods: There were 110 patients (54 males and 56 females) with kidney disease referred for evaluation of renal function at UCC of Kosovo. All patients were included in two groups. In the first group were included 30 patients confirmed with renal failure, whereas in the second group were included 80 patients with other renal disease. In study were included only patients with ready results of creatinine, urea and glucose in the blood serum. For estimation of GFR we have used the Gate GFR DTPA method. The statistical data processing was conducted using statistical methods such as arithmetic average, the student t-test, percentage or rate, sensitivity, specificity and accuracy of the test. Results: The average age of all patients was 36 years old. The average age of female was 37 whereas of male 35. Patients with renal failure was significantly older than patients with other renal disease (p<0.005). Renal failure was found in 30 patients (27.27%). The concentration of urea and creatinine in blood serum of patients with renal failure were significantly higher than in patients with other renal disease (P< 0.00001). GFR in patients with renal failure were significantly lower than in patients with other renal disease, 51.75 ml/min (p<0.00001). Sensitivity of uremia and creatininemia for detection of renal failure were 83.33%, whereas sensitivity of 99mTcDTPA GFR was 100%. Specificity of uraemia and creatininemia were 63% whereas specificity of 99mTcDTPA GFR was 47.5%. Diagnostic accuracy of blood urea and creatinine in detecting of renal failure were 69%, whereas diagnostic accuracy of 99mTcDTPA GFR was 61.8%. Conclusion: Gate 99mTc DTPA scintigraphy in collaboration with biochemical tests are very sensitive methods for early detection of patients with chronic renal failure. PMID:28883673

  18. The discrepancy between serum creatinine and cystatin C can predict renal function after treatment for postrenal acute kidney injury: multicenter study and pooled data analysis.

    Science.gov (United States)

    Matsuki, Masahiro; Tanaka, Toshiaki; Maehana, Takeshi; Kyoda, Yuki; Ichihara, Koji; Hashimoto, Kohei; Yanase, Masahiro; Matsukawa, Masanori; Adachi, Hideki; Takahashi, Satoshi; Masumori, Naoya

    2017-10-01

    Although serum cystatin C and creatinine are used as practical markers of renal function, the discrepancy between them in postrenal acute kidney injury (AKI) cases was reported. The aim of this study was to determine whether the preoperative serum cystatin C (pre-CysC) level could predict clinical outcomes after treatment in patients with postrenal AKI. Patients who underwent urological interventions with postrenal AKI were enrolled in this prospective observational study. Associations among preoperative serum creatinine (pre-sCr), pre-CysC, and nadir postoperative serum creatinine (post-sCr) were evaluated. In addition, based on our results in combination with detailed data from the literature, a predictive equation for postoperative serum creatinine (post-sCr) was developed by simple regression analysis and validated using Bland-Altman plots. Finally, 19 patients were eligible for analysis in this study. The value calculated by subtracting pre-CysC (mg/L) from pre-sCr (mg/dl) had a strong correlation to the decrement of serum creatinine (r = 0.9508, p < 0.0001). We added the data of 16 patients obtained from the literature to our series, which were totally randomized into 2 groups, training set and validation set in a 2:1 ratio (n = 23 and 12, respectively) to develop and validate a predictive equation for post-sCr. The mean difference between the predictive and actual post-sCr, -0.68 mg/dl (95% CI -1.62 to 0.26) in the validation set was within the limits of agreement. We showed that the discrepancy between pre-sCr and pre-CysC could predict improvement of renal function after intervention in patients with postrenal AKI.

  19. Fluid overload and changes in serum creatinine after cardiac surgery: predictors of mortality and longer intensive care stay. A prospective cohort study

    Science.gov (United States)

    2012-01-01

    Introduction Fluid overload is a clinical problem frequently related to cardiac and renal dysfunction. The aim of this study was to evaluate fluid overload and changes in serum creatinine as predictors of cardiovascular mortality and morbidity after cardiac surgery. Methods Patients submitted to heart surgery were prospectively enrolled in this study from September 2010 through August 2011. Clinical and laboratory data were collected from each patient at preoperative and trans-operative moments and fluid overload and creatinine levels were recorded daily after cardiac surgery during their ICU stay. Fluid overload was calculated according to the following formula: (Sum of daily fluid received (L) - total amount of fluid eliminated (L)/preoperative weight (kg) × 100). Preoperative demographic and risk indicators, intra-operative parameters and postoperative information were obtained from medical records. Patients were monitored from surgery until death or discharge from the ICU. We also evaluated the survival status at discharge from the ICU and the length of ICU stay (days) of each patient. Results A total of 502 patients were enrolled in this study. Both fluid overload and changes in serum creatinine correlated with mortality (odds ratio (OR) 1.59; confidence interval (CI): 95% 1.18 to 2.14, P = 0.002 and OR 2.91; CI: 95% 1.92 to 4.40, P serum creatinine. Fluid overload (%): b coefficient = 0.17; beta coefficient = 0.55, P creatinine (mg/dL): b coefficient = 0.01; beta coefficient = 0.11, P = 0.003). Conclusions Although both fluid overload and changes in serum creatinine are prognostic markers after cardiac surgery, it seems that progressive fluid overload may be an earlier and more sensitive marker of renal dysfunction affecting heart function and, as such, it would allow earlier intervention and more effective control in post cardiac surgery patients. PMID:22651844

  20. Mechanisms underlying early rapid increases in creatinine in paraquat poisoning.

    Directory of Open Access Journals (Sweden)

    Fahim Mohamed

    Full Text Available Acute kidney injury (AKI is common after severe paraquat poisoning and usually heralds a fatal outcome. The rapid large increases in serum creatinine (Cr exceed that which can be explained by creatinine kinetics based on loss of glomerular filtration rate (GFR.This prospective multi-centre study compared the kinetics of two surrogate markers of GFR, serum creatinine and serum cystatin C (CysC, following paraquat poisoning to understand and assess renal functional loss after paraquat poisoning. Sixty-six acute paraquat poisoning patients admitted to medical units of five hospitals were included. Relative changes in creatinine and CysC were monitored in serial blood and urine samples, and influences of non-renal factors were also studied.Forty-eight of 66 patients developed AKI (AKIN criteria, with 37 (56% developing moderate to severe AKI (AKIN stage 2 or 3. The 37 patients showed rapid increases in creatinine of >100% within 24 hours, >200% within 48 hours and >300% by 72 hours and 17 of the 37 died. CysC concentration increased by 50% at 24 hours in the same 37 patients and then remained constant. The creatinine/CysC ratio increased 8 fold over 72 hours. There was a modest fall in urinary creatinine and serum/urine creatinine ratios and a moderate increase in urinary paraquat during first three days.Loss of renal function contributes modestly to the large increases in creatinine following paraquat poisoning. The rapid rise in serum creatinine most probably represents increased production of creatine and creatinine to meet the energy demand following severe oxidative stress. Minor contributions include increased cyclisation of creatine to creatinine because of acidosis and competitive or non-competitive inhibition of creatinine secretion. Creatinine is not a good marker of renal functional loss after paraquat poisoning and renal injury should be evaluated using more specific biomarkers of renal injury.

  1. Mechanisms Underlying Early Rapid Increases in Creatinine in Paraquat Poisoning

    Science.gov (United States)

    Mohamed, Fahim; Endre, Zoltan; Jayamanne, Shaluka; Pianta, Timothy; Peake, Philip; Palangasinghe, Chathura; Chathuranga, Umesh; Jayasekera, Kithsiri; Wunnapuk, Klintean; Shihana, Fathima; Shahmy, Seyed; Buckley, Nicholas

    2015-01-01

    Background Acute kidney injury (AKI) is common after severe paraquat poisoning and usually heralds a fatal outcome. The rapid large increases in serum creatinine (Cr) exceed that which can be explained by creatinine kinetics based on loss of glomerular filtration rate (GFR). Methods and Findings This prospective multi-centre study compared the kinetics of two surrogate markers of GFR, serum creatinine and serum cystatin C (CysC), following paraquat poisoning to understand and assess renal functional loss after paraquat poisoning. Sixty-six acute paraquat poisoning patients admitted to medical units of five hospitals were included. Relative changes in creatinine and CysC were monitored in serial blood and urine samples, and influences of non-renal factors were also studied. Results Forty-eight of 66 patients developed AKI (AKIN criteria), with 37 (56%) developing moderate to severe AKI (AKIN stage 2 or 3). The 37 patients showed rapid increases in creatinine of >100% within 24 hours, >200% within 48 hours and >300% by 72 hours and 17 of the 37 died. CysC concentration increased by 50% at 24 hours in the same 37 patients and then remained constant. The creatinine/CysC ratio increased 8 fold over 72 hours. There was a modest fall in urinary creatinine and serum/urine creatinine ratios and a moderate increase in urinary paraquat during first three days. Conclusion Loss of renal function contributes modestly to the large increases in creatinine following paraquat poisoning. The rapid rise in serum creatinine most probably represents increased production of creatine and creatinine to meet the energy demand following severe oxidative stress. Minor contributions include increased cyclisation of creatine to creatinine because of acidosis and competitive or non-competitive inhibition of creatinine secretion. Creatinine is not a good marker of renal functional loss after paraquat poisoning and renal injury should be evaluated using more specific biomarkers of renal injury

  2. The value of Measuring Urinary β2-Microglobulin and Serum Creatinine for Detecting Tubulointerstitial Nephritis and Uveitis Syndrome in Young Patients with Uveitis

    NARCIS (Netherlands)

    Hettinga, YM; Scheerlinck, Laura; Lilien, Marc; Rothova, Aniki; de Boer, JH

    2015-01-01

    IMPORTANCE Tubulointerstitial nephritis and uveitis (TINU) syndrome is characterized by tubulointerstitial and ocular inflammation. Thus far, the value of noninvasive diagnostic tests is not known. OBJECTIVE To determine whether urinary β2-microglobulin (β2M), urinary protein, and serum creatinine

  3. Impact of chronic renal insufficiency on the early and late clinical outcomes of carotid artery stenting using serum creatinine vs glomerular filtration rate.

    Science.gov (United States)

    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.

  4. 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.

  5. Serum creatinine levels and risk of metabolic syndrome in a middle-aged and older Chinese population.

    Science.gov (United States)

    Wang, Jing; Li, Xiulou; Han, Xu; Yang, Kun; Liu, Bing; Li, Yaru; Peipei Wu; Xuezhen Liu; Kuai Yu; Xiayun Dai; Yuan, Jing; Yao, Ping; Zhang, Xiaomin; Huan Guo; Youjie Wang; Weihong Chen; Sheng Wei; Miao, Xiaoping; Xinwen Min; Liang, Yuan; Handong Yang; Hu, Frank B; Tangchun Wu; He, Meian

    2015-02-02

    The prevalence of metabolic syndrome (MetS) persistently increased. Several studies have found serum creatinine (SCr) concentrations related to cardiovascular disease and type 2 diabetes. The relationship between SCr concentrations and MetS is unknown. We measured SCr concentrations and MetS in 22363 individuals (10,151 males, 12,212 females) from the Dongfeng-Tongji Cohort in Shiyan, China from 2008 to 2009. The prevalence of MetS was 30.6% in the study population. In the multivariable-adjusted logistic regression analyses, higher SCr concentrations were associated with a higher risk of MetS (P trend<0.0001). Compared with the lowest extreme quintiles, subjects with the highest quintiles had 1.34 fold risk of MetS (95% confidence interval (CI): 1.22-1.47). The SCr concentrations were also associated with the individual component of MetS. In addition, higher SCr concentrations were associated with higher risk of MetS with more components. There is a graded positive association between the SCr concentrations and MetS risk in a middle aged and older Chinese population. Higher SCr concentrations, even within normal ranges, were associated with higher risk of MetS. The SCr might be a useful indicator of MetS and its related diseases. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Comparison of the Efficacy of Serum Creatinine and Microalbuminuria in Early Diagnosis of Renal Injury in Asphyxiated Infants in Calabar, Southern Nigeria

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    Sunny Oteikwu Ochigbo

    2017-06-01

    Full Text Available Background: Microalbuminuria and serum creatinine are the specific markers of acute renal injury. Perinatal asphyxia is responsible for 50% of all neonatal deaths and nonoliguric acute renal injuryis one of its complications. This study was undertaken to determine the efficacy of serum creatinine and microalbuminuria for early diagnosis of renal injury in severely asphyxiated neonates in Calabar, Nigeria.Methods: This prospective cross-sectional study was performed among severely asphyxiated newborns admitted into the neonatal wards of the University of Calabar Teaching Hospital (UCTH. Standard methods for the determination of blood urea and electrolyte were executed. Micral-test strips have been applied using urine dipstick and the result of the test was negative only for albumin. The developed colors have been compared five minutes after the first test.Results: Fifty full-term newborns were enrolled and their serum electrolytes, creatinine and the creatinine clearance were essentially normal. Six neonates demonstrated positive results in the microalbominuria assessment, while the rest were negative in this regard. The test has 0% sensitivity and 100% specificity, while the positive and negative predictive values were 0% and 88%, respectively.Conclusion: Microalbuminuria is not a useful marker for early diagnosis of acute renal failure in the newborns with severe prenatal asphyxia, but further studies are recommended.

  7. 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

  8. Meta-analysis: Serum creatinine changes following contrast enhanced CT imaging

    International Nuclear Information System (INIS)

    Kooiman, Judith; Pasha, Sharif M.; Zondag, Wendy; Sijpkens, Yvo W.J.; Molen, Aart J. van der; Huisman, Menno V.; Dekkers, Olaf M.

    2012-01-01

    Purpose: Contrast induced nephropathy (CIN) is defined as a decrease in renal function following administration of contrast media. The aim of this meta-analysis was to asses the overall risk of CIN, chronic loss of kidney function and the need for renal replacement therapy (RRT) after intravenous contrast enhanced CT-scan. Secondly, we aimed to identify subgroups at increased risk for CIN. Materials and methods: A literature search in Pubmed, Medline, Embase and Cochrane databases was performed. Data extraction was carried out independently by two reviewers. Meta-analysis and meta-regression were performed using an exact likelihood approach. Results: Forty studies evaluating the incidence of CIN after CT were included. The pooled incidence of CIN was 6.4% (95% CI 5.0–8.1). The risk of RRT after CIN was low, 0.06% (95% CI 0.01–0.4). The decline in renal function persisted in 1.1% of patients (95% CI 0.6–2.1%). Patients with chronic kidney disease (odds ratio 2.26, p < 0.001) or diabetes mellitus (odds ratio 3.10, p < 0.001) were at increased risk for the development of CIN. Conclusion: CIN occurred in 6% of patients after contrast enhanced CT. In 1% of all patients undergoing contrast enhanced CT the decline in renal function persisted

  9. Meta-analysis: Serum creatinine changes following contrast enhanced CT imaging

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    Kooiman, Judith, E-mail: j.kooiman@lumc.nl [Department of Thrombosis and Haemostasis, LUMC, Leiden (Netherlands); Pasha, Sharif M., E-mail: s.m.pasha@lumc.nl [Department of Thrombosis and Haemostasis, LUMC, Leiden (Netherlands); Zondag, Wendy, E-mail: w.zondag@lumc.nl [Department of Thrombosis and Haemostasis, LUMC, Leiden (Netherlands); Sijpkens, Yvo W.J., E-mail: ysijpens@bronovo.nl [Department of Nephrology, Bronovo Hospital, The Hague (Netherlands); Molen, Aart J. van der, E-mail: molen@lumc.nl [Department of Radiology, LUMC, Leiden (Netherlands); Huisman, Menno V., E-mail: m.v.huisman@lumc.nl [Department of Thrombosis and Haemostasis, LUMC, Leiden (Netherlands); Dekkers, Olaf M., E-mail: o.m.dekkers@lumc.nl [Department of Clinical Epidemiology and Department of Endocrinology, LUMC, Leiden (Netherlands)

    2012-10-15

    Purpose: Contrast induced nephropathy (CIN) is defined as a decrease in renal function following administration of contrast media. The aim of this meta-analysis was to asses the overall risk of CIN, chronic loss of kidney function and the need for renal replacement therapy (RRT) after intravenous contrast enhanced CT-scan. Secondly, we aimed to identify subgroups at increased risk for CIN. Materials and methods: A literature search in Pubmed, Medline, Embase and Cochrane databases was performed. Data extraction was carried out independently by two reviewers. Meta-analysis and meta-regression were performed using an exact likelihood approach. Results: Forty studies evaluating the incidence of CIN after CT were included. The pooled incidence of CIN was 6.4% (95% CI 5.0–8.1). The risk of RRT after CIN was low, 0.06% (95% CI 0.01–0.4). The decline in renal function persisted in 1.1% of patients (95% CI 0.6–2.1%). Patients with chronic kidney disease (odds ratio 2.26, p < 0.001) or diabetes mellitus (odds ratio 3.10, p < 0.001) were at increased risk for the development of CIN. Conclusion: CIN occurred in 6% of patients after contrast enhanced CT. In 1% of all patients undergoing contrast enhanced CT the decline in renal function persisted.

  10. Doubling of serum creatinine and the risk of cardiovascular outcomes in patients with chronic kidney disease and type 2 diabetes mellitus: a cohort study

    Directory of Open Access Journals (Sweden)

    Schneider C

    2016-06-01

    Full Text Available Cornelia Schneider,1,2 Blai Coll,3 Susan S Jick,4 Christoph R Meier1,2,4 1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; 2Hospital Pharmacy, University Hospital Basel, Basel, Switzerland; 3Renal Development, AbbVie, North Chicago, IL, USA; 4Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, MA, USA Background: Doubling of serum creatinine is often used as a marker for worsening kidney function in nephrology trials. Most people with chronic kidney disease die of other causes before reaching end-stage renal disease. We were interested in the association between doubling of serum creatinine and the risk of a first-time diagnosis of angina pectoris, congestive heart failure (CHF, myocardial infarction (MI, stroke, or transient ischemic attack in patients with chronic kidney disease and with diagnosed type 2 diabetes mellitus. Methods: We identified all adult patients registered in the “Clinical Practice Research Datalink” between 2002 and 2011 with incident chronic kidney disease and type 2 diabetes mellitus and did a cohort study with a Cox proportional hazard analysis. Results: We identified in total 27,811 patients, 693 developed angina pectoris, 1,069 CHF, 508 MI, 970 stroke, and 578 transient ischemic attacks. Patients whose serum creatinine doubled during follow-up had increased risks of CHF (hazard ratio [HR] 2.98, 95% confidence interval [CI] 2.27–3.89, MI (HR 2.53, 95% CI 1.62–3.96, and stroke (HR 1.93, 95% CI 1.38–2.69, as compared with patients whose serum creatinine did not double. The relative risks of angina pectoris (HR 1.18, 95% CI 0.66–2.10 or a transient ischemic attack (HR 1.32, 95% CI 0.78–2.22 were similar in both groups. Conclusion: Diabetic patients with a doubling of serum creatinine were at an increased risk of CHF, MI, or stroke, compared with diabetic

  11. Population-based estimation of renal function in healthy young Indian adults based on body mass index and sex correlating renal volume, serum creatinine, and cystatin C

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    Rajagopalan P

    2016-09-01

    Full Text Available Prashanth Rajagopalan,1 Georgi Abraham,2 Yuvaram NV Reddy,2 Ravivarman Lakshmanasami,1 ML Prakash,1 Yogesh NV Reddy2 1Department of General Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, 2Department of Nephrology, Madras Medical Mission Hospital, Chennai, India Abstract: This population-based prospective study was undertaken in Mahatma Gandhi Medical College to estimate the renal function in young healthy Indian adults. A young healthy heterogeneous Indian cohort comprising 978 individuals, predominantly medical students, was assessed by a detailed questionnaire, and variables such as height, weight, body mass index (BMI, birth weight, and blood pressure were documented. Laboratory investigations included serum creatinine, serum cystatin C, blood sugar, urine protein, and imaging of the kidneys with ultrasound. The mean age of the cohort was 25±6 years, comprising 672 males and 306 females. The estimated glomerular filtration rates (eGFRs by the Cockcroft–Gault formula for BMI <18.5 kg/m2, 18.5–24.99 kg/m2, 25–29.99 kg/m2, and ≥30 kg/m2 were 71.29±10.45 mL/min, 86.38±13.46 mL/min, 98.88±15.29 mL/min, and 109.13±21.57 mL/min, respectively; the eGFRs using cystatin C for the four groups of BMI were 84.53±18.14 mL/min, 84.01±40.11 mL/min, 79.18±13.46 mL/min, and 77.30±10.90 mL/min, respectively. This study attempts to establish a normal range of serum creatinine and cystatin C values for the Indian population and shows that in young healthy Indian adults, eGFR and kidney volume vary by BMI and sex. Keywords: eGFR, birth weight, renal volume

  12. Simultaneous determination of creatinine and creatine in human serum by double-spike isotope dilution liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gas chromatography-mass spectrometry (GC-MS).

    Science.gov (United States)

    Fernández-Fernández, Mario; Rodríguez-González, Pablo; Añón Álvarez, M Elena; Rodríguez, Felix; Menéndez, Francisco V Álvarez; García Alonso, J Ignacio

    2015-04-07

    This work describes the first multiple spiking isotope dilution procedure for organic compounds using (13)C labeling. A double-spiking isotope dilution method capable of correcting and quantifying the creatine-creatinine interconversion occurring during the analytical determination of both compounds in human serum is presented. The determination of serum creatinine may be affected by the interconversion between creatine and creatinine during sample preparation or by inefficient chemical separation of those compounds by solid phase extraction (SPE). The methodology is based on the use differently labeled (13)C analogues ((13)C1-creatinine and (13)C2-creatine), the measurement of the isotopic distribution of creatine and creatinine by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and the application of multiple linear regression. Five different lyophilized serum-based controls and two certified human serum reference materials (ERM-DA252a and ERM-DA253a) were analyzed to evaluate the accuracy and precision of the proposed double-spike LC-MS/MS method. The methodology was applied to study the creatine-creatinine interconversion during LC-MS/MS and gas chromatography-mass spectrometry (GC-MS) analyses and the separation efficiency of the SPE step required in the traditional gas chromatography-isotope dilution mass spectrometry (GC-IDMS) reference methods employed for the determination of serum creatinine. The analysis of real serum samples by GC-MS showed that creatine-creatinine separation by SPE can be a nonquantitative step that may induce creatinine overestimations up to 28% in samples containing high amounts of creatine. Also, a detectable conversion of creatine into creatinine was observed during sample preparation for LC-MS/MS. The developed double-spike LC-MS/MS improves the current state of the art for the determination of creatinine in human serum by isotope dilution mass spectrometry (IDMS), because corrections are made for all the possible errors

  13. Serum Creatinine Distinguishes Duchenne Muscular Dystrophy from Becker Muscular Dystrophy in Patients Aged ≤3 Years: A Retrospective Study

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    Liang Wang

    2017-05-01

    Full Text Available Here, we investigated correlations between serum creatinine (SCRN levels and clinical phenotypes of dystrophinopathy in young patients. Sixty-eight patients with dystrophinopathy at the Neuromuscular Clinic, The First Affiliated Hospital, Sun Yat-sen University, were selected for this study. The diagnosis of dystrophinopathy was based on clinical manifestation, biochemical changes, and molecular analysis. Some patients underwent muscle biopsies; SCRN levels were tested when patients were ≤3 years old, and reading frame changes were analyzed. Each patient was followed up, and motor function and clinical phenotype were assessed when the same patients were ≥4 years old. Our findings indicated that in young patients, lower SCRN levels were associated with increased disease severity (p < 0.01 and that SCRN levels were the highest in patients exhibiting mild Becker muscular dystrophy (BMD (p < 0.001 and the lowest in patients with Duchenne muscular dystrophy (DMD (p < 0.01 and were significantly higher in patients carrying in-frame mutations than in patients carrying out-of-frame mutations (p < 0.001. SCRN level cutoff values for identifying mild BMD [18 µmol/L; area under the curve (AUC: 0.947; p < 0.001] and DMD (17 µmol/L; AUC: 0.837; p < 0.001 were established. These results suggest that SCRN might be a valuable biomarker for distinguishing DMD from BMD in patients aged ≤3 years and could assist in the selection of appropriate treatment strategies.

  14. Serum Creatinine Back-Estimation in Cardiac Surgery Patients: Misclassification of AKI Using Existing Formulae and a Data-Driven Model.

    Science.gov (United States)

    Bernardi, Martin Hermann; Schmidlin, Daniel; Ristl, Robin; Heitzinger, Clemens; Schiferer, Arno; Neugebauer, Thomas; Wrba, Thomas; Hiesmayr, Michael; Druml, Wilfred; Lassnigg, Andrea

    2016-03-07

    A knowledge of baseline serum creatinine (bSCr) is mandatory for diagnosing and staging AKI. With often missing values, bSCr is estimated by back-calculation using several equations designed for the estimation of GFR, assuming a "true" GFR of 75 ml/min per 1.73 m(2). Using a data set from a large cardiac surgery cohort, we tested the appropriateness of such an approach and compared estimated and measured bSCr. Moreover, we designed a novel data-driven model (estimated serum creatinine [eSCr]) for estimating bSCr. Finally, we analyzed the extent of AKI and mortality rate misclassifications. Data for 8024 patients (2833 women) in our cardiac surgery center were included from 1997 to 2008. Measured and estimated bSCr were plotted against age for men and women. Patients were classified to AKI stages defined by the Kidney Disease Improving Global Outcomes (KDIGO) group. Results were compared with data from another cardiac surgery center in Zurich, Switzerland. The Modification of Diet in Renal Disease and the Chronic Kidney Disease Epidemiology Collaboration formulae describe higher estimated bSCr values in younger patients, but lower values in older patients compared with the measured bSCr values in both centers. The Pittsburgh Linear Three Variables formula correctly describes the increasing bSCr with age, however, it underestimates the overall bSCr level, being in the range of the 25% quantile of the measured values. Our eSCr model estimated measured bSCr best. AKI stage 1 classification using all formulae, including our eSCr model, was incorrect in 53%-80% of patients in Vienna and in 74%-91% in Zurich; AKI severity (according to KDIGO stages) and also mortality were overestimated. Mortality rate was higher among patients falsely classified into higher KDIGO stages by estimated bSCr. bSCr values back-estimated using currently available eGFR formulae are inaccurate and cannot correctly classify AKI stages. Our model eSCr improves the prediction of AKI but to a still

  15. Serum creatinine and cystatin C provide conflicting evidence of acute kidney injury following acute ingestion of potassium permanganate and oxalic acid.

    Science.gov (United States)

    Wijerathna, Thilini Madushanka; Gawarammana, Indika Bandara; Dissanayaka, Dhammika Menike; Palanagasinghe, Chathura; Shihana, Fathima; Dassanayaka, Gihani; Shahmy, Seyed; Endre, Zoltan Huba; Mohamed, Fahim; Buckley, Nicholas Alan

    2017-11-01

    Acute kidney injury (AKI) is common following deliberate self-poisoning with a combination washing powder containing oxalic acid (H 2 C 2 O 4 ) and potassium permanganate (KMnO 4 ). Early and rapid increases in serum creatinine (sCr) follow severe poisoning. We investigated the relationship of these increases with direct nephrotoxicity in an ongoing multicenter prospective cohort study in Sri Lanka exploring AKI following poisoning. Multiple measures of change in kidney function were evaluated in 48 consenting patients who had serial sCr and serum cystatin C (sCysC) data available. Thirty-eight (38/48, 79%) patients developed AKI (AKIN criteria). Twenty-eight (58%) had AKIN stage 2 or 3. Initial increases in urine creatinine (uCr) excretion were followed by a substantial loss of renal function. The AKIN stage 2 and 3 (AKIN2/3) group had very rapid rises in sCr (a median of 118% at 24 h and by 400% at 72 h post ingestion). We excluded the possibility that the rapid rise resulted from the assay used or muscle damage. In contrast, the average sCysC increase was 65% by 72 h. In most AKI, sCysC increases to the same extent but more rapidly than sCr, as sCysC has a shorter half-life. This suggests either a reduction in Cystatin C production or, conversely, that the rapid early rise of sCr results from increased production of creatine and creatinine to meet energy demands following severe oxidative stress mediated by H 2 C 2 O 4 and KMnO 4 . Increased early creatinine excretion supports the latter explanation, since creatinine excretion usually decreases transiently in AKIN2/3 from other causes.

  16. The Complexities of Interpreting Reversible Elevated Serum Creatinine Levels in Drug Development: Does a Correlation with Inhibition of Renal Transporters Exist?

    Science.gov (United States)

    Chu, Xiaoyan; Bleasby, Kelly; Chan, Grace Hoyee; Nunes, Irene; Evers, Raymond

    2016-09-01

    In humans, creatinine is formed by a multistep process in liver and muscle and eliminated via the kidney by a combination of glomerular filtration and active transport. Based on current evidence, creatinine can be taken up into renal proximal tubule cells by the basolaterally localized organic cation transporter 2 (OCT2) and the organic anion transporter 2, and effluxed into the urine by the apically localized multidrug and toxin extrusion protein 1 (MATE1) and MATE2K. Drug-induced elevation of serum creatinine (SCr) and/or reduced creatinine renal clearance is routinely used as a marker for acute kidney injury. Interpretation of elevated SCr can be complex, because such increases can be reversible and explained by inhibition of renal transporters involved in active secretion of creatinine or other secondary factors, such as diet and disease state. Distinction between these possibilities is important from a drug development perspective, as increases in SCr can result in the termination of otherwise efficacious drug candidates. In this review, we discuss the challenges associated with using creatinine as a marker for kidney damage. Furthermore, to evaluate whether reversible changes in SCr can be predicted prospectively based on in vitro transporter inhibition data, an in-depth in vitro-in vivo correlation (IVIVC) analysis was conducted for 16 drugs with in-house and literature in vitro transporter inhibition data for OCT2, MATE1, and MATE2K, as well as total and unbound maximum plasma concentration (Cmax and Cmax,u) data measured in the clinic. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  17. Fluid Balance, Change in Serum Creatinine and Urine Output as Markers of Acute Kidney Injury Post Cardiac Surgery: An Observational Study

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    Katrina Chau

    2014-08-01

    Full Text Available Background: Acute kidney injury (AKI is defined as oliguria or rise in serum creatinine but oliguria alone as a diagnostic criterion may over-diagnose AKI. Objectives: Given the association between fluid overload and AKI, we aimed to determine if positive fluid balance can complement the known parameters in assessing outcomes of AKI. Design: Prospective observational study. Setting: Teaching hospital in Vancouver, Canada. Patients: 111 consecutive patients undergoing elective cardiac surgery from January to April 2012. Measurements: Outcomes of cardiac surgery intensive care unit (CSICU and hospital length of stay (LOS in relation to fluid balance, urine output and serum creatinine. Methods: All fluid input and output was recorded for 72 hours post-operatively. Positive fluid balance was defined as >6.5 cc/kg. Daily serum creatinine and hourly urine output were recorded and patients were defined as having AKI according to the AKIN criteria. Results: Of the patients who were oliguric, those with fluid overload trended towards longer LOS than those without fluid overload [CSICU LOS: 62 and 39 hours (unadjusted p-value 0.02, adjusted p-value 0.58; hospital LOS: 13 and 9 days (unadjusted p-value: 0.05, adjusted p-value: 0.16]. Patients with oliguria who were fluid overloaded had similar LOS to patients with overt AKI (change in serum creatinine ≥ 26.5 μmol/L, [CSICU LOS: 62 and 69 hours (adjusted p value: 0.32 and hospital LOS: 13 and 14 days (adjusted p value: 0.19]. Patients with oliguria regardless of fluid balance had longer CSICU LOS (adjusted p value: 0.001 and patients who were fluid overloaded in the absence of AKI had longer hospital LOS (adjusted p value: 0.02. Limitations: Single centre, small sample, LOS as outcome. Conclusions: Oliguria and positive fluid balance is associated with a trend towards longer LOS as compared to oliguria alone. Fluid balance may therefore be a useful marker of AKI, in addition to urine output and serum

  18. Solid-state sensor incorporated in microfluidic chip and magnetic-bead enzyme immobilization approach for creatinine and glucose detection in serum

    Science.gov (United States)

    Lin, Yen-Heng; Chiang, Chien-Hung; Wu, Min-Hsien; Pan, Tung-Ming; Luo, Ji-Dung; Chiou, Chiuan-Chian

    2011-12-01

    Solid-state sensors are stable and inexpensive electric transducers for biomedical measurement. This study proposes a microfluidic chip incorporated with a solid-state sensor for measuring glucose and creatinine in blood serum. Magnetic beads are employed to immobilize enzymes and deliver them in a micro-channel. Glucose and creatinine can be measured at 2-8 mM and 10-2 to 10 mM, respectively, which is a meaningful range in human blood. The immobilization approach also addresses the issue of the long-term preservation of enzymes in microfluidic devices. The proposed device is suitable for multi-target measurement in a point-of-care system.

  19. Can preoperative serum level of creatinine predict new-onset atrial fibrillation in non-diabetic male patients undergoing open heart surgery? A retrograde view.

    Directory of Open Access Journals (Sweden)

    Seyed Jalil Mirhosseini

    2013-12-01

    Full Text Available Renal dysfunction is a risk marker in patients who candidate for coronary artery bypass graft (CABG. Renal disorder is associated with prolonged stays in intensive care unit and hospital, morbidity and mortality. Aim of this study is specific evaluation of association between preoperative creatinine (Cr with atrial fibrillation (AF after elective off-pump CABG in non-diabetic male patients with normal ejection fraction. Two hundred non-diabetic male patients with normal ejection fraction undergoing elective off pump CABG surgery enrolled in this cross-sectional study and were stratified by present or absence of postoperative atrial fibrillation: patients with postoperative new-onset atrial fibrillation (n=100 as group 1 and patients without new-onset postoperative atrial fibrillation as group 2 (n=100. Preoperative serological test of the participants, such as serum creatinine, were recorded in their medical dossiers. Data were analyzed in SPSS-16 software and tested for association between atrial fibrillation with creatinine level by using student t test, chi-square test or logistic regression. Cr level in patients with and without AF three days before surgery were 1.8±0.3 and 1.0±0.4 respectively (P value for Cr=0.00. On surgical day, mean Cr level in patients with and without AF were 1.6±0.2 and 1.1±0.5 respectively (P value for Cr = 0.00. Of the 100, male patients with postoperative AF, duration and frequency of recurrence of AF were not associated with Cr at three days before surgery and on surgical days (P>0.05. Patients with postoperative AF had unsuitable status of renal function compare to patients without AF; however, preoperative serum creatinine cannot associate with duration and frequency of recurrence of AF.

  20. The EuBIVAS Project: Within- and Between-Subject Biological Variation Data for Serum Creatinine Using Enzymatic and Alkaline Picrate Methods and Implications for Monitoring.

    Science.gov (United States)

    Carobene, Anna; Marino, Irene; Coşkun, Abdurrahman; Serteser, Mustafa; Unsal, Ibrahim; Guerra, Elena; Bartlett, William A; Sandberg, Sverre; Aarsand, Aasne Karine; Sylte, Marit Sverresdotter; Røraas, Thomas; Sølvik, Una Ørvim; Fernandez-Calle, Pilar; Díaz-Garzón, Jorge; Tosato, Francesca; Plebani, Mario; Jonker, Niels; Barla, Gerhard; Ceriotti, Ferruccio

    2017-09-01

    The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) European Biological Variation Study (EuBIVAS) has been established to deliver rigorously determined biological variation (BV) indices. EuBIVAS determined BV for serum creatinine using the enzymatic and alkaline picrate measurement methods. In total, 91 healthy individuals (38 males, 53 females; age range, 21-69 years) were bled for 10 consecutive weeks at 6 European laboratories. An equivalent protocol was followed at each center. Sera were stored at -80 °C before analysis. Analyses for each patient were performed in duplicate within a single run on an ADVIA 2400 system (San Raffaele Hospital, Milan). The data were subjected to outlier and homogeneity analysis before performing CV-ANOVA to determine BV and analytical variation (CV A ) estimates with confidence intervals (CI). The within-subject BV estimates [CV I (95% CI)] were similar for enzymatic [4.4% (4.2-4.7)] and alkaline picrate [4.7% (4.4-4.9)] methods and lower than the estimate presently available online (CV I = 5.9%). No significant male/female BV differences were found. Significant differences were observed in mean creatinine values between men and women and between Turkish individuals and those of other nationalities. Between-subject BV (CV G ) estimates, stratified accordingly, produced CV G values similar to historical BV data. CV A was 1.1% for the enzymatic and 4.4% for alkaline picrate methods, indicating that alkaline picrate methods fail to fulfill analytical performance specifications for imprecision (CV APS ). The serum creatinine CV I obtained by EuBIVAS specifies a more stringent CV APS than previously identified. The alkaline picrate method failed to meet this CV APS , raising questions regarding its future use. © 2017 American Association for Clinical Chemistry.

  1. Preprocedure and Postprocedure Predictive Values of Serum β2-Microglobulin for Contrast-Induced Nephropathy in Patients Undergoing Coronary Computed Tomography Angiography: A Comparison With Creatinine-Based Parameters and Cystatin C.

    Science.gov (United States)

    Li, Suhua; Zheng, Zhenda; Tang, Xixiang; Peng, Long; Luo, Yanting; Dong, Ruimin; Zhao, Yunyue; Liu, Jinlai

    2015-01-01

    This study aimed to investigate the values of serum β2-microglobulin to predict contrast-induced nephropathy (CIN) before and early after coronary computed tomography angiography (CCTA), comparing with creatinine-based parameters and cystatin C. A total of 424 patients were enrolled. Serum β2-microglobulin, cystatin C, and creatinine were measured at 0, 24, and 48 hours of CCTA. Contrast-induced nephropathy was defined as an elevation of serum creatinine level by 25% or higher or 0.5 mg/dL or greater from baseline within 48 hours. The estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease study equation. Receiver operating characteristic curves and multivariate logistic regression analysis were used to detect the efficiency of biomarkers in predicting CIN. Fifty-two subjects (12.26%) developed CIN. Before CCTA, CIN was predicted by both baseline β2-microglobulin (area under the receiver operating characteristic curve [AUC], 0.791; P creatinine and eGFR were not predictive. After CCTA, CIN was predicted by both the absolute post-CCTA levels of β2-microglobulin, cystatin C, creatinine, and eGFR (AUC, 0.842 vs 0.961 vs 0.691 vs 0.688 at 24 hours, P Serum β2-microglobulin, with values superior to creatinine-based parameters and similar with cystatin C, was a useful biomarker for the prediction of CIN at pre-CCTA and early post-CCTA.

  2. 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.

  3. Serum creatinine level and ESR values associated to clinical pathology types and prognosis of patients with renal injury caused by ANCA-associated vasculitis.

    Science.gov (United States)

    Liang, Hongda; Xin, Miaomiao; Zhao, Lei; Wang, Liqin; Sun, Mingshu; Wang, Jibo

    2017-12-01

    The correlation between serum creatinine and erythrocyte sedimentation rate (ESR) values and clinical pathology and prognosis in patients with renal injury caused by anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis were analyzed. Eighty-six patients with ANCA-associated vasculitis (AAV) treated in the Affiliated Hospital of Qingdao University were enrolled in the study. Patients were assigned into an elderly group (n=45) or a non-elderly group (n=41) according to age. The serum creatinine (Scr) level was measured via the sarcosine oxidase method, and the erythrocyte sedimentation rate (ESR) was measured using the full-automatic ESR analyzer; the relationship between Scr and ESR values and the pathology type of patients was statistically analyzed. The mean levels of Scr and ESR in the 86 patients were 406.87±12.37 µmol/l and 83.83±7.64 mm/1 h, respectively. Importantly, the levels of Scr and the ESR in the elderly group were significantly higher than those in the non-elderly group (Ptypes, while in the same patients the numbers of focal and mixed types were lower (Pvalue was 392.5 µmol/l; while the AUC of the ESR level was 0.864, the sensitivity 89.2%, the specificity 88.5% and the cut-off value 72.8 mm/1 h. Logistic regression analysis showed that the levels of Scr (OR=2.315, P<0.01) and ESR (OR=1.847, P<0.01) were independent factors affecting the prognosis of patients. Based on our findings, the seric Scr level and the ESR are closely related to the clinicopathological features of the disease in patients with renal injury caused by ANCA-associated vasculitis, and they can be used as prognosis and treatment evaluation markers.

  4. 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.

  5. Detection of renal dysfunction based on serum creatinine levels in a Brazilian community: the Bambuí Health and Ageing Study.

    Science.gov (United States)

    Passos, V M A; Barreto, S M; Lima-Costa, M F F

    2003-03-01

    There are few population-based studies of renal dysfunction and none conducted in developing countries. In the present study the prevalence and predictors of elevated serum creatinine levels (SCr > or = 1.3 mg/dl for men and 1.1 mg/dl for women) were determined among Brazilian adults (18-59 years) and older adults (>60 years). Participants included all older adults (N = 1742) and a probabilistic sample of adults (N = 818) from Bambu town, MG, Southeast Brazil. Predictors were investigated using multiple logistic regression. Mean SCr levels were 0.77 +/- 0.15 mg/dl for adults, 1.02 +/- 0.39 mg/dl for older men, and 0.81 +/- 0.17 mg/dl for older women. Because there were only 4 cases (0.48%) with elevated SCr levels among adults, the analysis of elevated SCr levels was restricted to older adults. The overall prevalence of elevated SCr levels among the elderly was 5.09% (76/1494). The prevalence of hypercreatinemia increased significantly with age (chi = 26.17, P = 0.000), being higher for older men (8.19%) than for older women (5.29%, chi = 5.00, P = 0.02). Elevated SCr levels were associated with age 70-79 years (odds ratio [OR] = 2.25, 95% confidence interval [CI]: 1.15-4.42), hypertension (OR = 3.04, 95% CI: 1.34-6.92), use of antihypertensive drugs (OR = 2.46, 95% CI: 1.26-4.82), chest pain (OR = 3.37, 95% CI: 1.31-8.74), and claudication (OR = 3.43, 95% CI: 1.30-9.09) among men, and with age >80 years (OR = 4.88, 95% CI: 2.24-10.65), use of antihypertensive drugs (OR = 4.06, 95% CI: 1.67-9.86), physical inactivity (OR = 2.11, 95% CI: 1.11-4.02) and myocardial infarction (OR = 3.89, 95% CI: 1.58-9.62) among women. The prevalence of renal dysfunction observed was much lower than that reported in other population-based studies, but predictors were similar. New investigations are needed to confirm the variability in prevalence and associated factors of renal dysfunction among populations.

  6. Relationship between silicon concentration and creatinine clearance

    International Nuclear Information System (INIS)

    Miura, Y.; Nakai, K.; Itoh, C.; Horikiri, J.; Sera, K.; Sato, M.

    1998-01-01

    Silicon levels in dialysis patients are markedly increasing. Using PIXE we determined the relationship between silicon concentration and creatinine clearance in 30 samples. Urine silicon concentration were significantly correlated to creatinine clearance (p<0.001). And also serum silicon concentration were significantly correlated to creatinine clearance (p<0.0001). (author)

  7. Comparison of estimated GFR equations based on serum cystatin C alone and in combination with serum creatinine in patients with coronary artery disease.

    Science.gov (United States)

    Doğaner, Yusuf Çetin; Aydoğan, Ümit; Rohrer, James Edwin; Aydoğdu, Aydoğan; Çaycı, Tuncer; Barçın, Cem; Sağlam, Kenan

    2015-07-01

    Several new equations (GFRCKD-EPI-cr, GFRCKD-EPI-CysC, GFRCKD-EPI Cr+CysC) are used for the calculation of estimated GFR (eGFR) to evaluate renal function. These equations explicitly demonstrate the association of coronary artery disease (CAD) and severe renal impairment cases. However, these equations are considered insufficient to explain the relation with normal or mildly impaired eGFR and CAD. Our hypothesis was to indicate the inversely proportional relationship of eGFR values, calculated by the different equations, with the presence of CAD in patients with normal or mildly impaired renal function. Eighty-eight patients who underwent elective coronary angiographic intervention were enrolled into the study. The study population was divided into two groups based on angiographic documents: patients with normal coronary arteries (CAD-) and patients with CAD (CAD +). These patients were stable and decided to implement angiography for the purpose of suspicion about CAD and control. Since it is thought that eGFR equations based on creatinine are inadequate to determine chronic kidney disease (CKD) and overestimate CKD diagnosis, cystatin C-based equations are considered an alternative. Due to the potential effects of inflammatory events of the markers used in equations, patients with diabetes mellitus, severe CKD, and inflammatory bowel disease were excluded from the study. The average age of all participants was 51.93±9.31 (32-65 years); 80.7% (n=71) was male. A statistical difference was found between the CAD (-) group and the CAD (+) group in terms of the variables of age (45.46±8.48 vs. 54.95±8.11, pequations defined by the Chronic Kidney Disease Epidemiology: GFRCKD-EPI-cr (85.86±14.20 vs. 79.45±10.25, p=0.018), GFRCKD-EPI-CysC (58.61±21.87 vs. 100.82±32.00, pequation (OR, 1.059; 95% CI, 1.028 to 1.090, pequations based on cystatin C or combined with creatinine may have superiority to GFR equations based on creatinine alone in CAD patients. However, the

  8. Deceiving proteins! A case of lymphoma and high creatinine

    OpenAIRE

    Metraiah, El Hakem Abdelkarim; Regan, Helen; Louw, Johanna; Kidder, Dana

    2017-01-01

    Estimation of kidney function by measuring serum creatinine is one the commonest laboratory tests conducted in clinical practice. Enzymatic methods are often used to measure serum creatinine. Clinicians should be aware of the limitations of these methods, such as test interference with paraproteins.We present a case of falsely elevated serum creatinine in a patient referred for renal biopsy. The combination of fluctuating creatinine and normal blood urea level was unusual. Serum protein elect...

  9. Final report on EURAMET.QM-K12: EURAMET key comparison on the determination of the mass fraction of creatinine in serum

    Science.gov (United States)

    Bell, David; Hopley, Chris; Ellison, Stephen L. R.; O'Connor, Gavin

    2013-01-01

    Creatinine is a well-known marker for the evaluation of kidney function. Its routine measurement is undertaken by many clinical laboratories and comparable results over distance and time are required for effective diagnosis. To address this need many National Measurement Institutes (or designated institutes) provide services in this area via the provision of higher order standards or reference measurements. The organic analysis working group of the consultative committee for amount of substance have conducted two previous key comparisons to assess the equivalence of institutes who provide such services. The purpose of this study was to enable institutes who missed the previous studies to demonstrate their capability for characterizing serum materials containing 1 µg/g to 100 µg/g of creatinine. The study material consisted of two lyophilized serum samples which were used in an external quality control proficiency testing scheme. No target values were available for these materials and all participants reported results within the one month timeframe given for analysis. Five institutes participated in the key study and a single institute submitted results for the parallel pilot study. All participants in the key study used isotope dilution with either gas or liquid chromatography coupled with mass spectrometry. The pilot study laboratory used a novel isotope dilution surface-enhanced Raman spectroscopy method. The comparison reference value for each material was set as the mean of all results submitted by those participating in the key study. The choice of the reference value estimator was constrained as it was deemed more appropriate to treat the data in a similar manner to CCQM-K12 if the relative degrees of equivalence were to be compared. This resulted in reference values of (54.27 ± 0.72) µg/g and (38.01 ± 0.42) µg/g for the two separate materials. The relative degrees of equivalence were calculated and these were compared with the relative degrees of

  10. External validation of aminoglycoside models used in web calculators and clinical decision support systems after laboratory conversion to serum creatinine isotope dilution mass spectrometry assay.

    Science.gov (United States)

    Wolowich, William R; Steinberg, Jennifer G

    2012-04-01

    Models to predict gentamicin t(½) from serum creatinine (SCr) estimated creatinine clearance (CrCl) are currently being incorporated into smart-device applications and clinical decision support modules without external validation. The aim of this study was to determine whether such models remain viable after conversion to isotope dilution mass spectrometry (IDMS) SCr assay. This study analyzed data from retrospective reviews of the medical records of nonobese adults receiving the aminoglycoside gentamicin and having ≥2 evaluable serum gentamicin concentrations after laboratory IDMS SCr conversion, from January 2008 to August 2009, at a tertiary care hospital in Florida. A literature search found a number of cited aminoglycoside models. This group of models was classified as group 1. The World Wide Web was also searched for the term aminoglycoside dosing calculators, with 6 models found and referred to as group 2. Predictive performance measures were used to compare the model results with the t(½) calculated from gentamicin concentrations using the Nelder-Mead algorithm. The records of 39 patients met the inclusion criteria (23 men, 16 women; age range, 18-86 years; range of estimated CrCl, 55-115 mL/min) and provided the "gold standard" aminoglycoside t(½). A gentamicin t(½) was predicted from several published models (group 1) and from other models used in online smart-device applications (group 2) and clinical decision modules. The median (interquartile range) root mean square errors were 0.48 (0.44 to 0.65) and 0.48 (0.45 to 0.70) hours from group-1 and -2 models, respectively. The median mean relative prediction errors were 9% (-14% to +13%) and 11% (+1% to +21%) from groups 1 and 2. The median mean absolute prediction errors were 21% (19% to 28%) and 21% (20% to 30%) from groups 1 and 2. Adjusting SCr by +20% improved the predictive ability in 3 of 12 cited models and in 5 of 6 models used in applications. Models to predict gentamicin t(½) should be

  11. Estimating glomerular filtration rate by serum creatinine or/and cystatin C equations: An analysis of multi-centre Chinese subjects.

    Science.gov (United States)

    Ye, Xiaoshuang; Liu, Xun; Song, Dan; Zhang, Xiaoxuan; Zhu, Bei; Wei, Lu; Pei, Xiaohua; Wu, Jianqing; Lou, Tanqi; Zhao, Weihong

    2016-05-01

    Various equations based on serum creatinine or/and cystatin C, required further validation in a Chinese population. We compared the performance of six Chinese equations (Mascr, Peiscr, Macys, Fengcys, Mascr-cys and Fengscr-cys) with the CKD-EPI equations in multi-centre Chinese subjects and evaluated their applicability in clinical practice. A total of 1522 adult patients from four different hospitals of China were enrolled in the study. (99m) Tc-DTPA renal dynamic imaging was used as the reference GFR (rGFR), and serum creatinine and cystatin C were measured by standardized assays. An optimal score system was implemented in the study. The average rGFR of recruited subjects was 67.30±28.89 mL/min per 1.73m(2) . All estimated GFR (eGFR) correlated well with rGFR. In accordance with Bland-Altman analysis, the Fengscr-cys equations achieved optimal overall performance (score 14 vs 0-6), with least bias (median difference, -0.57 mL/min per 1.73m(2) ; median absolute difference, 8.83 mL/min per 1.73m(2) ), best precision (17.99 mL/min per 1.73m(2) ), highest accuracy (percentage of eGFR within 15%, 30% and 50% of the rGFR (P15 , P30 and P50 ; 49.7%, 78.7% and 91.8%, respectively); root-mean-square-error (RMSE, 16.28)). The Fengcys equation, a typical cystatin C based equation, was another well-behaved formula with an impressive performance. The Ma equations performed much poorer than the CKD-EPI equations. Consistent results can be observed in the GFR- /age- and sex-specific subgroups, while none equation yielded ideal accuracy in GFR<60 mL/min per 1.73 m(2) subgroup. The Fengscr-cys equation appeared to achieve the best performance for GFR estimation in overall Chinese adult patients. However, further research is warranted to improve the accuracy of available equations in GFR less than 60 mL/min per 1.73 m(2) individuals. © 2015 Asian Pacific Society of Nephrology.

  12. Antimalarial drug induced decrease in creatinine clearance

    NARCIS (Netherlands)

    Landewé, R. B.; Vergouwen, M. S.; Goeei The, S. G.; van Rijthoven, A. W.; Breedveld, F. C.; Dijkmans, B. A.

    1995-01-01

    To confirm the antimalarial drug induced increase of creatinine to determine the factors contributing to this effect. Patients with rheumatoid arthritis (RA) (n = 118) who have used or still use antimalarials (chloroquine or hydroxychloroquine). Serum creatinines prior to antimalarials and serum

  13. Comparison between swallowing and chewing of garlic on levels of serum lipids, cyclosporine, creatinine and lipid peroxidation in Renal Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Ghorbanihaghjo Amir

    2005-05-01

    Full Text Available Abstract Abstract Hyperlipidemia and increased degree of oxidative stress are among the important risk factors for Atherosclerosis in renal transplant recipients (RTR. The Medical treatment of hyperlipidemia in RTR because of drugs side effects has been problematic, therefore alternative methods such as using of Garlic as an effective material in cholesterol lowering and inhibition of LDL Oxidation has been noted. For evaluation of garlic effect on RTR, 50 renal transplant patients with stable renal function were selected and divided into 2 groups. They took one clove of garlic (1 gr by chewing or swallowing for two months, after one month wash-out period, they took garlic by the other route. Results indicated that although lipid profile, BUN, Cr, serum levels of cyclosporine and diastolic blood pressure did not change, Systolic blood pressure decreased from138.2 to 132.8 mmHg (p=0.001 and Malondialdehyde (MDA decreased from 2.4 to1.7 nmol/ml (p=0.009 by swallowing route, Cholesterol decreased from 205.1 to 195.3 mg/dl (p=0.03, triglyceride decreased from 195.7 to 174.8 mg/dl (p=0.008, MDA decreased from 2.5 to 1.6 nmol/ml (p=0.001, systolic blood pressure decreased from 137.5 to 129.8 mmHg (p=0.001, diastolic blood pressure decreased from 84.6 to 77.6 mmHg (p=0.001 and Cr decreased from 1.51 to 1.44 mg/dl (p=0.03 by chewing route too. However HDL, LDL and cyclosporine serum levels had no significant differences by both of swallowing and chewing routes. We conclude that undamaged garlic (swallowed had no lowering effect on lipid level of serum. But Crushed garlic (chewed reduces cholesterol, triglyceride, MDA and blood pressure. Additionally creatinine reduced without notable decrease in cyclosporine serum levels may be due to cyclosporine nephrotoxicity ameliorating effect of garlic.

  14. A retrospective study of 1,098 blood samples with anemia from adult cats: frequency, classification, and association with serum creatinine concentration.

    Science.gov (United States)

    Furman, E; Leidinger, E; Hooijberg, E H; Bauer, N; Beddies, G; Moritz, A

    2014-01-01

    Frequency and classification of anemia in terms of regeneration status and erythrocyte indices are not well described in cats. To determine frequency and regenerative status of anemia in samples from adult cats, to assess the sensitivity and specificity of macrocytosis and hypochromasia for detecting regenerative anemia (RA), and to evaluate the association of anemia with increased serum creatinine concentration (SC). Laboratory records from 30,503 blood samples from cats (2003-2011). Clinicopathologic data reviewed retrospectively. Anemia defined as hematocrit (Ht) ≤27%, red blood cell count (RBC) ≤5.5 × 10(6)/μL and hemoglobin (Hb) ≤9.0 g/dL. RA defined by manual absolute reticulocyte count >50 × 10(3)/μL. Macrocytosis was defined as mean corpuscular volume (MCV) >55 fL and hypochromasia as mean corpuscular hemoglobin concentration (MCHC) anemia, 633 of 1,098 (57.7%) classified as nonregenerative (NRA) and 465 of 1,098 (42.3%) as regenerative. RBC, Ht, and Hb were significantly lower in the RA compared to NRA group (P Anemia was more severe in cats with RA. Erythrocyte indices were not sensitive indicators of RA. Copyright © 2014 by the American College of Veterinary Internal Medicine.

  15. Stimulated urine C-peptide creatinine ratio vs serum C-peptide level for monitoring of β-cell function in the first year after diagnosis of Type 1 diabetes.

    Science.gov (United States)

    Tatovic, D; Luzio, S; Dunseath, G; Liu, Y; Alhadj Ali, M; Peakman, M; Dayan, C M

    2016-11-01

    To determine if urine C-peptide/creatinine ratio is a useful tool for monitoring β-cell function in new-onset Type 1 diabetes. Data were obtained from a prospective immunomodulation study in people with Type 1 diabetes ≤ 3 months from diagnosis, with a standard mixed-meal tolerance test and measurement of urine C-peptide/creatinine ratio carried out at 0, 3, 6, 9 and 12 months. The change in the insulin-dose-adjusted HbA 1c level was also correlated with the change in serum/urine C-peptide level during the 12-month follow-up period. A significant reduction in urine C-peptide/creatinine ratio, measured after a mixed-meal, was reached at 9 months (-45.4%), whilst the reduction in stimulated serum C-peptide level reached significance after 3 months (-54.7%) in placebo-treated participants. Neither change in stimulated serum C-peptide nor change in urine C-peptide level correlated with each other, and nor did change in insulin-dose-adjusted HbA 1c level in the first 6 months, but all measures correlated significantly in the second half of the 12-month follow-up period. Mixed-meal-stimulated urine C-peptide/creatinine ratio was similar to, although less sensitive than, stimulated serum C-peptide level in monitoring β-cell function during the first year after diagnosis. Because the former is significantly less invasive, it warrants inclusion in further studies in Type 1 diabetes and may represent an attractive alternative outcome measure in cohort studies and in children. © 2016 Diabetes UK.

  16. Does NGAL reduce costs? A cost analysis of urine NGAL (uNGAL) & serum creatinine (sCr) for acute kidney injury (AKI) diagnosis.

    Science.gov (United States)

    Parikh, Amay; Rizzo, John A; Canetta, Pietro; Forster, Catherine; Sise, Meghan; Maarouf, Omar; Singer, Eugenia; Elger, Antje; Elitok, Saban; Schmidt-Ott, Kai; Barasch, Jonathon; Nickolas, Thomas L

    2017-01-01

    Urine neutrophil gelatinase-associated lipocalin (uNGAL) is a sensitive and specific diagnostic test for acute kidney injury (AKI) in the Emergency Department (ED), but its economic impact has not been investigated. We hypothesized that uNGAL used in combination with serum creatinine (sCr) would reduce costs in the management of AKI in patients presenting to the ED in comparison to using sCr alone. A cost simulation model was developed for clinical algorithms to diagnose AKI based on sCr alone vs. uNGAL plus sCr (uNGAL+sCr). A cost minimization analysis was performed to determine total expected costs for patients with AKI. uNGAL test characteristics were validated with eight-hundred forty-nine patients with sCr ≥1.5 from a completed study of 1635 patients recruited from EDs at two U.S. hospitals from 2007-8. Biomarker test, AKI work-up, and diagnostic imaging costs were incorporated. For a hypothetical cohort of 10,000 patients, the model predicted that the expected costs were $900 per patient (pp) in the sCr arm and $950 in the uNGAL+sCr arm. uNGAL+sCr resulted in 1,578 fewer patients with delayed diagnosis and treatment than sCr alone (2,013 vs. 436 pts) at center 1 and 1,973 fewer patients with delayed diagnosis and treatment than sCr alone at center 2 (2,227 vs. 254 patients). Although initial evaluation costs at each center were $50 pp higher in with uNGAL+sCr, total costs declined by $408 pp at Center 1 and by $522 pp at Center 2 due to expected reduced delays in diagnosis and treatment. Sensitivity analyses confirmed savings with uNGAL + sCr for a range of cost inputs. Using uNGAL with sCr as a clinical diagnostic test for AKI may improve patient management and reduce expected costs. Any cost savings would likely result from avoiding delays in diagnosis and treatment and from avoidance of unnecessary testing in patients given a false positive AKI diagnosis by use of sCr alone.

  17. Interdialytic creatinine change versus predialysis creatinine as indicators of nutritional status in maintenance hemodialysis.

    Science.gov (United States)

    Walther, Carl P; Carter, Caitlin Wise; Low, Chai L; Williams, Peter; Rifkin, Dena E; Steiner, Robert W; Ix, Joachim H

    2012-02-01

    Protein-energy wasting is common in patients on maintenance hemodialysis and is strongly associated with poor quality of life and mortality. However, clinical assessment of protein-energy wasting remains difficult. Predialysis creatinine levels are associated with mortality risk but may be influenced by both muscle mass and dialysis dose. This might be overcome by examining the rate of rise in creatinine between dialysis sessions. We conducted an observational cohort study among 81 patients on maintenance hemodialysis at our Veterans Affairs unit. Predialysis serum creatinine and change in serum creatinine between midweek dialysis sessions served as the predictor variables of interest and clinically available proxies of nutritional status and time to mortality served as the outcome variables. Linear regression and Cox proportional hazards models evaluated relationships, respectively. The mean age of the study participants was 63 ± 10 years, 77 (95%) were male, mean body mass index was 27 ± 6 kg/m(2) and 69% had diabetes. Median follow-up time was 13 months, during which 12 patients (15%) died. Interdialytic change in serum creatinine showed a strong direct correlation with predialysis serum creatinine (R = 0.96). Higher levels of both markers were associated with younger age, less residual urine volume and higher serum albumin, serum phosphorus and normalized protein catabolic rate (P nutritional status and mortality in hemodialysis patients and are highly correlated. Interdialytic change in creatinine provided little additional information about nutritional status or mortality risk above and beyond predialysis creatinine levels alone.

  18. Diagnostic performance of serum blood urea nitrogen to creatinine ratio for distinguishing prerenal from intrinsic acute kidney injury in the emergency department.

    Science.gov (United States)

    Manoeuvrier, Guillaume; Bach-Ngohou, Kalyane; Batard, Eric; Masson, Damien; Trewick, David

    2017-05-25

    The blood urea nitrogen to creatinine ratio (BCR) has been used since the early 1940s to help clinicians differentiate between prerenal acute kidney injury (PR AKI) and intrinsic AKI (I AKI). This ratio is simple to use and often put forward as a reliable diagnostic tool even though little scientific evidence supports this. The aim of this study was to determine whether BCR is a reliable tool for distinguishing PR AKI from I AKI. We conducted a retrospective observational study over a 13 months period, in the Emergency Department (ED) of Nantes University Hospital. Eligible for inclusion were all adult patients consecutively admitted to the ED with a creatinine >133 μmol/L (1.5 mg/dL). Sixty thousand one hundred sixty patients were consecutively admitted to the ED. 2756 patients had plasma creatinine levels in excess of 133 μmol/L, 1653 were excluded, leaving 1103 patients for definitive inclusion. Mean age was 75.7 ± 14.8 years old, 498 (45%) patients had PR AKI and 605 (55%) I AKI. BCR was 90.55 ± 39.32 and 91.29 ± 39.79 in PR AKI and I AKI groups respectively. There was no statistical difference between mean BCR of the PR AKI and I AKI groups, p = 0.758. The area under the ROC curve was 0.5 indicating that BCR had no capacity to discriminate between PR AKI and I AKI. Our study is the largest to investigate the diagnostic performance of BCR. BCR is not a reliable parameter for distinguishing prerenal AKI from intrinsic AKI.

  19. Relationship between patients' outcomes and the changes in serum creatinine and urine output and RIFLE classification in a large critical care cohort database.

    Science.gov (United States)

    Harris, Steve K; Lewington, Andrew J P; Harrison, David A; Rowan, Kathy M

    2015-08-01

    We report the stepwise application of the RIFLE classification in 155,624 admissions in the UK Intensive Care National Audit & Research Centre Case Mix Programme database. The assumptions required to define RIFLE and their relationship with renal replacement therapy (RRT) and ICU mortality were assessed. Previous reports had not explored the method of estimating baseline creatinine, the position of class boundaries, or interactions between urine volume (AKI-U) and the peak/estimated baseline creatinine (AKI-Cr) within 24 h of ICU admission. The risk of developing AKI strongly depended on the assumed GFR increasing from 36 to 58% across the recommended range. AKI-U was often seen without AKI-Cr, and moderate oliguria (under 850 ml/24 h) was a stronger predictor of mortality than any degree of AKI-Cr partly because mortality fell when peak/estimated baseline creatinine ratios exceed fourfold. Mild oliguria (850-1500 ml/24 h) was common (38,928 admissions, 26%) and had a similar association with mortality (relative risk 1.6, 95% CI: 1.5-1.6) as did AKI-Cr defined Failure (risk ratio 1.5, 95% CI: 1.5-1.6). However, AKI-Cr was a strong predictor for RRT, which was used in 17,802 (11%) of admissions. Nearly half (48%) of the Failure patients never received RRT; nonetheless, most (66%) survived critical care. Thus, although the RIFLE classification may be attempted in large population cohorts, there is significant heterogeneity of both renal and, in particular, vital outcomes within each class.

  20. Renal dysfunction in falciparum--malaria is detected more often when assessed by serum concentration of cystatin C instead of creatinine

    NARCIS (Netherlands)

    Günther, A.; Burchard, G. D.; Slevogt, H.; Abel, W.; Grobusch, M. P.

    2002-01-01

    OBJECTIVES: To estimate the frequency of renal dysfunction in falciparum malaria by serum concentration of cystatin C, a new sensitive indicator of the glomerular filtration rate (GFR). METHODS: Retrospective study of stored sera and patient files. Assessment of renal function by serum concentration

  1. Creatinine Change on Vasoconstrictors as Mortality Surrogate in Hepatorenal Syndrome: Systematic Review & Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Justin M Belcher

    Full Text Available Hepatorenal syndrome is a severe complication of cirrhosis and associates with significant mortality. Vasoconstrictor medications improve renal function in patients with hepatorenal syndrome. However, it is unclear to what extent changes in serum creatinine during treatment may act as a surrogate for changes in mortality. We have performed a meta-analysis of randomized trials of vasoconstrictors assessing the association between changes in serum creatinine, taken as a continuous variable, and mortality, both while on treatment and during the follow-up period for survivors.The electronic databases of PubMed, Web of Science and Embase were searched for randomized trials evaluating the efficacy of vasoconstrictor therapy for treatment of HRS type 1 or 2. The relative risk (RR for mortality was calculated against delta creatinine. The proportion of treatment effect explained (PTE was calculated for delta creatinine.Seven trials enrolling 345 patients were included. The correlation between delta creatinine and ln (RR was moderately good (R2 = 0.61. The intercept and parameter estimate indicated a fall in creatinine while on treatment of 1 mg/dL resulted in a 27% reduction in RR for mortality compared to the control arm. In patients surviving the treatment period, a fall in creatinine while on treatment of 1 mg/dL resulted in a 16% reduction in RR for post-treatment mortality during follow-up. The PTE of delta creatinine for overall mortality was 0.91 and 0.26 for post-treatment mortality.Changes in serum creatinine in response to vasoconstrictor therapy appear to be a valid surrogate for mortality, even in the period following the completion of treatment.

  2. Creatinine blood test

    Science.gov (United States)

    The creatinine blood test measures the level of creatinine in the blood. This test is done to see how well your kidneys ... There are many other conditions for which the test may be ordered, ... pressure, diabetes, or medicine overdose. Your provider will ...

  3. Recognition and Sensing of Creatinine.

    Science.gov (United States)

    Guinovart, Tomàs; Hernández-Alonso, Daniel; Adriaenssens, Louis; Blondeau, Pascal; Martínez-Belmonte, Marta; Rius, F Xavier; Andrade, Francisco J; Ballester, Pablo

    2016-02-12

    Current methods for creatinine quantification suffer from significant drawbacks when aiming to combine accuracy, simplicity, and affordability. Here, an unprecedented synthetic receptor, an aryl-substituted calix[4]pyrrole with a monophosphonate bridge, is reported that displays remarkable affinity for creatinine and the creatininium cation. The receptor works by including the guest in its deep and polar aromatic cavity and establishing directional interactions in three dimensions. When incorporated into a suitable polymeric membrane, this molecule acts as an ionophore. A highly sensitive and selective potentiometric sensor suitable for the determination of creatinine levels in biological fluids, such as urine or plasma, in an accurate, fast, simple, and cost-effective way has thus been developed. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. 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.

  5. Serum NGAL and Cystatin C Comparison With Urinary Albumin-to-Creatinine Ratio and Inflammatory Biomarkers as Early Predictors of Renal Dysfunction in Patients With Type 2 Diabetes

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    Marcelo R. Bacci

    2017-03-01

    Discussion: Neutrophil gelatinase-associated lipocalin and serum CysC were positively associated with the presence of renal dysfunction and had better performance on receiver operating characteristic analysis than the other markers evaluated in patients with T2D without kidney dysfunction.

  6. Comparison of serum creatinine, cystatin C, and neutrophil gelatinase-associated lipocalin for acute kidney injury occurrence according to risk, injury, failure, loss, and end-stage criteria classification system in early after living kidney donation.

    Science.gov (United States)

    Hekmat, Reza; Mohebi, Mahmood

    2016-01-01

    To evaluate the kidney function after living kidney donation, we measured serum creatinine (SCr), cystatin C, and neutrophil gelatinase-associated lipocalin (NGAL) of 42 living donors before uninephrectomy and in three immediate days after it. We also evaluated the prevalence of the occurrence of the different stages of acute kidney injury (AKI) classified according to risk, injury, failure, loss, and end-stage (RIFLE) criteria, and accuracy of each of these three biomarkers for predicting them were evaluated. Significant serum NGAL (s-NGAL) changes were limited to the 1 st day after donation, whereas SCr and cystatin C changes continued to the third day after donation. s-NGAL level in the 1 st day and serum cystatin C in the 3 rd day after donation, respectively, had the largest area under curve and best sensitivity and specificity for Stage 1 (risk) AKI prediction. During the immediate three days after donation, about half of patients suffered from AKI; mostly Stage 1 (injury). The sequence of the emergence of s-NGAL and s-cystatin C in the 1 st and 3 rd days as biomarkers with highest accuracy and power for RIFLE criteria defined AKI stage discrimination in our study was comparable to previous studies. We conclude that our study suggests that AKI was best detected in the 1 st day after uninephrectomy by the s-NGAL levels, whereas cystatin C was the best in the 3 rd day after donation for detection of AKI.

  7. Comparison between ADVIA Chemistry systems Enzymatic Creatinine_2 method and ADVIA Chemistry systems Creatinine method (kinetic Jaffe method) for determining creatinine.

    Science.gov (United States)

    Hermida, Fernando J; Lorenzo, María J; Pérez, Aida; Fernández, María; Sagastagoia, Olatz; Magadán, Concepción

    2014-10-01

    The aim of this study was two-fold: Firstly, to compare the serum creatinine concentration measured by enzymatic method and uncompensated kinetic Jaffe method, and secondly, to compare the effects of certain interfering substances such as glucose, bilirubin, proteins, triglycerides and hemoglobin on creatinine measurement. The determination of serum creatinine concentrations by enzymatic method and uncompensated kinetic Jaffe method was performed on ADVIA® 2400 analyzer. The interfering substances were tested by adding solutions of interference to serum pool with low (62 μmol/L), medium (221 μmol/L) and elevated (486 μmol/L) creatinine concentration. In the method comparison study, despite the fact that the correlation between both methods for determining serum creatinine is very good (r = 0.998, p kinetic Jaffe method was found, and when the creatinine value is lower than ∼ 180 μmol/L this difference or bis progressively increases. We found a significant positive interference due to proteins and glucose and a significant negative interference due to bilirubin by kinetic Jaffe method, and no interferences by enzymatic method were found. In conclusion, the enzymatic method is the best choice for determining serum creatinine with the ADVIA® 2400 analyzer.

  8. Combining creatinine and volume kinetics identifies missed cases of acute kidney injury following cardiac arrest

    Science.gov (United States)

    2013-01-01

    Introduction Fluid resuscitation in the critically ill often results in a positive fluid balance, potentially diluting the serum creatinine concentration and delaying diagnosis of acute kidney injury (AKI). Methods Dilution during AKI was quantified by combining creatinine and volume kinetics to account for fluid type, and rates of fluid infusion and urine output. The model was refined using simulated patients receiving crystalloids or colloids under four glomerular filtration rate (GFR) change scenarios and then applied to a cohort of critically ill patients following cardiac arrest. Results The creatinine concentration decreased during six hours of fluid infusion at 1 litre-per-hour in simulated patients, irrespective of fluid type or extent of change in GFR (from 0% to 67% reduction). This delayed diagnosis of AKI by 2 to 9 hours. Crystalloids reduced creatinine concentration by 11 to 19% whereas colloids reduced concentration by 36 to 43%. The greatest reduction was at the end of the infusion period. Fluid dilution alone could not explain the rapid reduction of plasma creatinine concentration observed in 39 of 49 patients after cardiac arrest. Additional loss of creatinine production could account for those changes. AKI was suggested in six patients demonstrating little change in creatinine, since a 52 ± 13% reduction in GFR was required after accounting for fluid dilution and reduced creatinine production. Increased injury biomarkers within a few hours of cardiac arrest, including urinary cystatin C and plasma and urinary Neutrophil-Gelatinase-Associated-Lipocalin (biomarker-positive, creatinine-negative patients) also indicated AKI in these patients. Conclusions Creatinine and volume kinetics combined to quantify GFR loss, even in the absence of an increase in creatinine. The model improved disease severity estimation, and demonstrated that diagnostic delays due to dilution are minimally affected by fluid type. Creatinine sampling should be delayed at least

  9. Impact of Gate 99mTc DTPA GFR, Serum Creatinine and Urea in Diagnosis of Patients with Chronic Kidney Failure

    OpenAIRE

    Miftari, Rame; Nura, Adem; Top?iu-Shufta, Valdete; Miftari, Valon; Murseli, Arbenita; Haxhibeqiri, Valdete

    2017-01-01

    Aim: The aim of this study was determination of validity of 99mTcDTPA estimation of GFR for early detection of chronic kidney failure Material and methods: There were 110 patients (54 males and 56 females) with kidney disease referred for evaluation of renal function at UCC of Kosovo. All patients were included in two groups. In the first group were included 30 patients confirmed with renal failure, whereas in the second group were included 80 patients with other renal disease. In study were ...

  10. Effect of fasting ramadan in diabetes control status - application of extensive diabetes education, serum creatinine with HbA1c statistical ANOVA and regression models to prevent hypoglycemia.

    Science.gov (United States)

    Aziz, Kamran M A

    2013-09-01

    Ramadan fasting is an obligatory duty for Muslims. Unique physiologic and metabolic changes occur during fasting which requires adjustments of diabetes medications. Although challenging, successful fasting can be accomplished if pre-Ramadan extensive education is provided to the patients. Current research was conducted to study effective Ramadan fasting with different OHAs/insulins without significant risk of hypoglycemia in terms of HbA1c reductions after Ramadan. ANOVA model was used to assess HbA1c levels among different education statuses. Serum creatinine was used to measure renal functions. Pre-Ramadan diabetes education with alteration of therapy and dosage adjustments for OHAs/insulin was done. Regression models for HbA1c before Ramadan with FBS before sunset were also synthesized as a tool to prevent hypoglycemia and successful Ramadan fasting in future. Out of 1046 patients, 998 patients fasted successfully without any episodes of hypoglycemia. 48 patients (4.58%) experienced hypoglycemia. Χ(2) Test for CRD/CKD with hypoglycemia was also significant (p-value Ramadan diabetes management. Some relevant patents are also outlined in this paper.

  11. Elevated plasma creatinine due to creatine ethyl ester use.

    Science.gov (United States)

    Velema, M S; de Ronde, W

    2011-02-01

    Creatine is a nutritional supplement widely used in sport, physical fitness training and bodybuilding. It is claimed to enhance performance. We describe a case in which serum creatinine is elevated due to the use of creatine ethyl esther. One week after withdrawal, the plasma creatinine had normalised. There are two types of creatine products available: creatine ethyl esther (CEE) and creatine monohydrate (CM). Plasma creatinine is not elevated in all creatine-using subjects. CEE , but not CM, is converted into creatinine in the gastrointestinal tract. As a result the use of CEE may be associated with elevated plasma creatinine levels. Since plasma creatinine is a widely used marker for renal function, the use of CEE may lead to a false assumption of renal failure.

  12. Preoperative Serum Interleukin-6 Is a Potential Prognostic Factor for Colorectal Cancer, including Stage II Patients

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    Kazuyoshi Shiga

    2016-01-01

    Full Text Available Aims. To evaluate the prognostic significance of serum interleukin-6 (IL-6 in colorectal cancer (CRC. Patients and Methods. Preoperative serum IL-6 was measured in 233 CRC patients and 13 healthy controls. Relationships between IL-6 and various clinicopathological factors were evaluated, and the overall survival (OS and disease-free survival (DFS rates according to IL-6 status were calculated for all patients and according to disease stage. Results. The mean IL-6 level was 6.6 pg/mL in CRC patients and 2.6 pg/mL in healthy controls. Using a cutoff of 6.3 pg/mL, obtained using receiver operating characteristic curve analysis, 57 patients had a high IL-6 level. The mean value was higher for stage II disease than for stage III disease. IL-6 status correlated with C-reactive protein (CRP and carcinoembryonic antigen levels, obstruction, and pT4 disease. The OS differed according to the IL-6 status for all patients, whereas the DFS differed for all patients and for those with stage II disease. The Cox proportional hazards model showed that pT4 disease was an independent risk factor for recurrence in all CRC patients; IL-6, CRP, and pT4 were significant risk factors in stage II patients. Conclusions. The preoperative IL-6 level influences the risk of CRC recurrence.

  13. Changes in serum creatinine, uric acid, creatine kinase, and glomerular filtration rate in street runners. http://dx.doi.org/10.5007/1980-0037.2013v15n1p71

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    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.

  14. Stamping SERS for creatinine sensing

    Science.gov (United States)

    Li, Ming; Du, Yong; Zhao, Fusheng; Zeng, Jianbo; Santos, Greggy M.; Mohan, Chandra; Shih, Wei-Chuan

    2015-03-01

    Urine can be obtained easily, readily and non-invasively. The analysis of urine can provide metabolic information of the body and the condition of renal function. Creatinine is one of the major components of human urine associated with muscle metabolism. Since the content of creatinine excreted into urine is relatively constant, it is used as an internal standard to normalize water variations. Moreover, the detection of creatinine concentration in urine is important for the renal clearance test, which can monitor the filtration function of kidney and health status. In more details, kidney failure can be imminent when the creatinine concentration in urine is high. A simple device and protocol for creatinine sensing in urine samples can be valuable for point-of-care applications. We reported quantitative analysis of creatinine in urine samples by using stamping surface enhanced Raman scattering (S-SERS) technique with nanoporous gold disk (NPGD) based SERS substrate. S-SERS technique enables label-free and multiplexed molecular sensing under dry condition, while NPGD provides a robust, controllable, and high-sensitivity SERS substrate. The performance of S-SERS with NGPDs is evaluated by the detection and quantification of pure creatinine and creatinine in artificial urine within physiologically relevant concentration ranges.

  15. The Effect of Admission Creatinine Levels on One-Year Mortality in Acute Myocardial Infarction

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    Mehmet Akif Cakar

    2012-01-01

    Full Text Available Background. We have known that patients with renal insufficiency (creatinine level have increased mortality for coronary artery disease. In this study, the relationship between admission creatinine level and one year mortality are evaluated in patients with acute myocardial infarction (AMI. Method. 160 AMI patients (127 men and 33 women with a mean age of 59 ± 13 were enrolled in the study. Serum creatinine levels were measured within 12 hours of AMI. The patients were divided into two groups according to admission serum creatinine level. (1 elevated group (serum creatinine > 1.3 mg/dL and (2 normal group (≤1.3 mg/dL. One year mortality rates were evaluated. Results. Elevated serum creatinine is observed in the 27 patients (16.9%. The mean creatinine level is 1.78 ± 7 mg/dL in the elevated group and 0.9 ± 0.18 mg/dL in the normal group (P<0.0001. The mortality rate of the elevated group (n=7, 25.9% is higher than that of the normal group (n=9, 6.8%. A significant increase in one year mortality is also observed (P=002 60. Conclusion. The mildly elevated admission serum creatinine levels are markedly increased to one year mortality in patients with AMI.

  16. Is Serum Hypovitaminosis D Associated with Chronic Widespread Pain Including Fibromyalgia? A Meta-analysis of Observational Studies.

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    Hsiao, Ming-Yen; Hung, Chen-Yu; Chang, Ke-Vin; Han, Der-Sheng; Wang, Tyng-Guey

    2015-01-01

    Chronic widespread pain (CWP) is a global musculoskeletal disorder leading to disability and a reduced quality of life. Low levels of serum vitamin D has long been proposed to be associated with CWP, but previous research remains inconclusive. To determine whether hypovitaminosis D was independently associated with CWP. Meta-analysis of observational study. Electronic databases were searched for studies published up to November 2014 comparing the prevalence of hypovitaminosis D and serum vitamin D levels between participants with and without CWP. The crude and adjusted odds ratios (ORs) of hypovitaminosis D with CWP were calculated. Subgroup analysis according to gender, threshold of hypovitaminosis, and definition of patients was performed, as well as meta-regression to test the linear relationship between crude ORs and the latitude of study locations. Twelve studies were included, comprising 1,854 patients with CWP. The patient group showed a significantly higher risk of hypovitaminosis D than the control group (crude OR, 1.63; 95% CI, 1.20-2.23). The association was slightly attenuated after adjusting confounders, with a pooled adjusted OR of 1.41 (95% CI, 1.00-2.00). There was an increase in ORs of hypovitaminosis D using a lower diagnostic value of serum vitamin D (8 and 10 ng/mL). The subgroup analysis according to gender and definition of CWP did not reveal significant between-group differences. The meta-regression showed no linear relationship between latitude and the crude ORs. There was a positive crude association between hypovitaminosis D and CWP, and the association was likely to remain after adjusting confounding factors. Use of a cut-off value of hypovitaminosis D (8-10 ng/mL) could better define the population with and without CWP. Further prospective follow-up studies are warranted to clarify the causal relationship between hypovitaminosis D and CWP.

  17. Superiority of cystatin c to creatinine as a biomarker of kidney function

    African Journals Online (AJOL)

    Conversely, cystatin C is superior to creatinine as a marker of kidney function. We recently managed two children who had major risk factors for chronic kidney disease (CKD) but had serially apparently normal serum creatinine levels. However, using a cystatin C-based method, they were already in CKD stage 2. Cystatin C ...

  18. A review on creatinine measurement techniques.

    Science.gov (United States)

    Mohabbati-Kalejahi, Elham; Azimirad, Vahid; Bahrami, Manouchehr; Ganbari, Ahmad

    2012-08-15

    This paper reviews the entire recent global tendency for creatinine measurement. Creatinine biosensors involve complex relationships between biology and micro-mechatronics to which the blood is subjected. Comparison between new and old methods shows that new techniques (e.g. Molecular Imprinted Polymers based algorithms) are better than old methods (e.g. Elisa) in terms of stability and linear range. All methods and their details for serum, plasma, urine and blood samples are surveyed. They are categorized into five main algorithms: optical, electrochemical, impedometrical, Ion Selective Field-Effect Transistor (ISFET) based technique and chromatography. Response time, detection limit, linear range and selectivity of reported sensors are discussed. Potentiometric measurement technique has the lowest response time of 4-10 s and the lowest detection limit of 0.28 nmol L(-1) belongs to chromatographic technique. Comparison between various techniques of measurements indicates that the best selectivity belongs to MIP based and chromatographic techniques. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Equations to Estimate Creatinine Excretion Rate : The CKD Epidemiology Collaboration

    NARCIS (Netherlands)

    Ix, Joachim H.; Wassel, Christina L.; Stevens, Lesley A.; Beck, Gerald J.; Froissart, Marc; Navis, Gerjan; Rodby, Roger; Torres, Vicente E.; Zhang, Yaping (Lucy); Greene, Tom; Levey, Andrew S.

    Background and objectives Creatinine excretion rate (CER) indicates timed urine collection accuracy. Although equations to estimate CER exist, their bias and precision are untested and none simultaneously include age, sex, race, and weight. Design, setting, participants, & measurements Participants

  20. Evaluation of estimated creatinine clearance before steady state in acute kidney injury by creatinine kinetics.

    Science.gov (United States)

    Yashiro, Masatomo; Ochiai, Miyuki; Fujisawa, Nao; Kadoya, Yuko; Kamata, Tadashi

    2012-08-01

    A simple method to calculate estimated creatinine clearance using two serum creatinine concentration (Cr) values in acute kidney injury (AKI) was developed (eCrCl-AKI). We aimed to evaluate its accuracy and to clarify its contribution to the classification of AKI. We validated the errors in eCrCl-AKI in a simulation study after various reductions in creatinine clearance (CrCl) at various levels of chronic kidney disease (CKD). We compared the eCrCl-AKI-based classification of RIFLE criteria with the Cr-based classification or that proposed by Waikar and Bonventre. The regression equations of eCrCl-AKI on time were determined and Cr values were reconstructed by creatinine kinetics substituting CrCl with eCrCl-AKI in actual patients. Most errors in eCrCl-AKI were relatively small (from -13.6 to +7.9%) with the exception of two Cr values that straddled the changing trend of Cr. The classification according to RIFLE criteria based on Cr was unstable and did not enable adequate classification, especially in milder reductions of CrCl with advanced CKD. The classification based on eCrCl-AKI was stable and enabled adequate classification. There were good agreements between measured Cr and reconstructed Cr with eCrCl-AKI. The regression equations of eCrCl-AKI revealed changes of renal function that were unexpected only from fluctuations of Cr. eCrCl-AKI can provide relatively accurate estimates for fluctuating CrCl. eCrCl-AKI enables more stable and earlier classification of AKI than Cr, at least in the simulation study. The more widespread use of eCrCl-AKI in actual clinical settings of AKI is necessary to evaluate this formula.

  1. Equations to estimate creatinine excretion rate: the CKD epidemiology collaboration.

    Science.gov (United States)

    Ix, Joachim H; Wassel, Christina L; Stevens, Lesley A; Beck, Gerald J; Froissart, Marc; Navis, Gerjan; Rodby, Roger; Torres, Vicente E; Zhang, Yaping Lucy; Greene, Tom; Levey, Andrew S

    2011-01-01

    Creatinine excretion rate (CER) indicates timed urine collection accuracy. Although equations to estimate CER exist, their bias and precision are untested and none simultaneously include age, sex, race, and weight. Participants (n = 2466) from three kidney disease trials were randomly allocated into equation development (2/3) and internal validation (1/3) data sets. CER served as the dependent variable in linear regression to develop new equations. Their stability was assessed within the internal validation data set. Among 987 individuals from three additional studies the equations were externally validated and compared with existing equations. Mean age was 46 years, 42% were women, and 9% were black. Age, sex, race, weight, and serum phosphorus improved model fit. Two equations were developed, with or without serum phosphorus. In external validation, the new equations showed little bias (mean difference [measured - estimated CER] -0.7% [95% confidence interval -2.5% to 1.0%] and 0.3% [95% confidence interval -2.6% to 3.1%], respectively) and moderate precision (estimated CER within 30% of measured CER among 79% [76% to 81%] and 81% [77% to 85%], respectively). Corresponding numbers within 15% were 51% [48% to 54%] and 54% [50% to 59%]). Compared with existing equations, the new equations had similar accuracy but showed less bias in individuals with high measured CER. CER can be estimated with commonly available variables with little bias and moderate precision, which may facilitate assessment of accuracy of timed urine collections.

  2. Serum levels of IGF-1 are related to human skin characteristics including the conspicuousness of facial pores.

    Science.gov (United States)

    Sugiyama-Nakagiri, Y; Naoe, A; Ohuchi, A; Kitahara, T

    2011-04-01

    Conspicuous facial pores are one type of serious aesthetic defects for many women. However, the mechanism(s) that underlie the conspicuousness of facial pores remains unclear. We previously characterized the epidermal architecture around facial pores that correlates with the appearance of those pores in various ethnic groups including Japanese. The goal of this study was to evaluate the possible relationships between facial pore size, the severity of impairment of epidermal architecture around facial pores and sebum output levels to investigate the possible role of IGF-1 in the pathogenesis of conspicuous facial pores. The subjects consisted of 38 healthy Japanese women (aged 22-41 years). IGF-1 was measured using immunoradiometric assay. Surface replicas were collected to compare pore sizes of cheek skin and horizontal cross-section images of cheek skin were obtained non-invasively from the same subjects using in vivo confocal laser scanning microscopy and the severity of impairment of epidermal architecture around facial pores was determined. The skin surface lipids of each subject were collected from their cheeks and lipid classes were determined using gas chromatography/flame ionization detection. The serum level of IGF-1 correlated significantly with total pore area (R = 0.36, P facial pores (R = 0.43, P pore area (R = 0.32, P facial skin characteristics including facial pore size and with the severity of impairment of epidermal architecture around facial pores. © 2010 The Authors. Journal compilation © 2010 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

  3. Urine creatinine in treatment-naïve HIV subjects in eastern Nigeria

    Science.gov (United States)

    Anyabolu, Ernest Ndukaife

    2016-01-01

    Introduction Human immunodeficiency virus (HIV) infection is a global healthcare problem. Some diseases and physiological states may be altered in HIV-infected individuals. Our objective was to evaluate urine creatinine and factors that influence urine creatinine in treatment-naïve HIV subjects in Nigeria. Methods This was a cross-sectional study involving treatment-naïve HIV subjects in a tertiary hospital in Nigeria. Creatinine in spot and 24-hour urine samples and other relevant investigations were performed. Low urine creatinine or dilute urine was defined as 24-hour urine creatinine (24HUCr) creatinine as 24HUCr 300-3000mg and high urine creatinine or concentrated urine as 24HUCr>3000mg.Theassociation of low urine creatinine and high urine creatinine with potential risk factors was determined. Results The mean spot urine creatinine (SUCr) of the treatment-naïve HIV subjects was 137.21± 98.47(mg/dl), minimum value 13.3mg/dl, maximum value 533.3mg/dl and range of values 520.0mg/dl. The mean 24HUCr was 1507±781mg, minimum value 206mg, maximum value 4849mg and range of values 4643mg. Twenty four-hour urine creatinine3000mg in 24(6.4%) subjects. There was significant association between 24HUCr and serum low density lipoprotein cholesterol (LDL),serum high density lipoprotein cholesterol (HDL). There was high correlation between 24HUCr>3000mg and 24-hour urine osmolality (24HUOsm) (r=0.95), body mass index (BMI) (r=0.74), CD4 cells count (r=-0.71), serum HDL (r=-0.73). Conclusion The prevalence of dilute urine and concentrated urine was low. Twenty-four hour urine osmolality. BMI, CD4 cells count and HDL were strong correlates of high urine creatinine. Lipid abnormalities were common in treatment-naïve HIV subjects with high urine creatinine. There is need for clinicians to routinely conduct urine creatinine and further search for abnormalities of serum lipids, weight changes, depressed immunity and anemia in HIV subjects with dilute or concentrated urine in

  4. The Prognostic Significance of Pretreatment Serum CEA Levels in Gastric Cancer: A Meta-Analysis Including 14651 Patients

    Science.gov (United States)

    Deng, Kai; Yang, Li; Hu, Bing; Wu, Hao; Zhu, Hong; Tang, Chengwei

    2015-01-01

    Background Carcinoembryonic antigen (CEA) is commonly used as a serum tumor marker in clinical practice; however, its prognostic value for gastric cancer patients remains uncertain. This meta-analysis was performed to assess the prognostic value of CEA and investigate CEA as a tumor marker. Methods PubMed, EMBASE and other databases were searched for potentially eligible studies. Forty-one studies reporting the prognostic effect of pretreatment serum CEA expression in gastric cancer patients were selected. Data on 14651 eligible patients were retrieved for the meta-analysis. Based on the data extracted from the available literature, the hazard ratio (HR) and 95% confidence interval (CI) for an adverse prognosis were estimated for gastric cancer patients with elevated pretreatment serum levels of CEA (CEA+) relative to patients with normal pretreatment CEA levels (CEA-). Results The CEA+ patients had a significantly poorer prognosis than the CEA- patients in terms of overall survival (OS: HR 1.716, 95% CI 1.594 - 1.848, P 0.05). In the pooled analyses of multivariate-adjusted HRs, the results suggested that pretreatment serum CEA may be an independent prognostic factor in gastric cancer (OS: HR 1.681, 95% CI 1.425 - 1.982; DSS: HR 1.900, 95% CI 1.441 - 2.505; DFS: HR 2.579, 95% CI 1.935 - 3.436). Conclusion/Significance The meta-analysis based on the available literature supported the association of elevated pretreatment serum CEA levels with a poor prognosis for gastric cancer and a nearly doubled risk of mortality in gastric cancer patients. CEA may be an independent prognostic factor for gastric cancer patients and may aid in determining appropriate treatment which may preferentially benefit the CEA+ patients. PMID:25879931

  5. Degeneration of retinal on bipolar cells induced by serum including autoantibody against TRPM1 in mouse model of paraneoplastic retinopathy.

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    Shinji Ueno

    Full Text Available The paraneoplastic retinopathies (PRs are a group of eye diseases characterized by a sudden and progressive dysfunction of the retina caused by an antibody against a protein in a neoplasm. Evidence has been obtained that the transient receptor potential melastatin 1 (TRPM1 protein was one of the antigens for the autoantibody against the ON bipolar cells in PR patients. However, it has not been determined how the autoantibody causes the dysfunction of the ON bipolar cells. We hypothesized that the antibody against TRPM1 in the serum of patients with PR causes a degeneration of retinal ON bipolar cells. To test this hypothesis, we injected the serum from the PR patient, previously shown to contain anti-TRPM1 antibodies by westerblot, intravitreally into mice and examined the effects on the retina. We found that the electroretinograms (ERGs of the mice were altered acutely after the injection, and the shape of the ERGs resembled that of the patient with PR. Immunohistochemical analysis of the eyes injected with the serum showed immunoreactivity against bipolar cells only in wild-type animals and not in TRPM1 knockout mice,consistent with the serum containing anti-TRPM1 antibodies. Histology also showed that some of the bipolar cells were apoptotic by 5 hours after the injection in wild type mice, but no bipolar cell death was found in TRPM1 knockout mice, . At 3 months, the inner nuclear layer was thinner and the amplitudes of the ERGs were still reduced. These results indicate that the serum of a patient with PR contained an antibody against TRPM1 caused an acute death of retinal ON bipolar cells of mice.

  6. Chronic kidney disease prevalence in Rivas, Nicaragua: use of a field device for creatinine measurement.

    Science.gov (United States)

    Minnings, Kailey; Kerns, Eric; Fiore, Melissa; Fiore, Madeline; Parekh, Rulan S; DuBois, Jeff; Isbell, T Scott; Ferguson, Ryan; Fiore, Louis

    2015-04-01

    An epidemic of chronic kidney disease (CKD) has been identified in Pacific coastal regions of Central America, and screening in the field in these low income countries remains logistically problematic. We tested the performance characteristics of a point of care creatinine analyzer compared to standardized serum creatinine measurements. Measurements were conducted in 100 persons from a local health center (n=34) and hospital (n=66) in Rivas, Nicaragua using both a point-of-care analyzer (StatSensor Xpress, Nova Biomedical) and serum creatinine by Jaffe kinetic method with a Roche Cobas Integra 400 analyzer. Percent coefficient of variation, sensitivity and specificity of the StatSensor Xpress were determined. The average coefficient of variation (CV) was 1.28% for the serum creatinine and CV for the StatSensor Xpress analyzer was 6.8%. The median intra-individual creatinine results obtained with the StatSensor Xpress device were 0.32 mg/dL higher than those by serum creatinine by Jaffe kinetic method. The sensitivity and specificity of the StatSensor Xpress device for identifying subjects with abnormal creatinine (defined as >1.2 mg/dL) was 100% and 79%, respectively. Point of care testing for creatinine demonstrated acceptable repeatability, excellent sensitivity (100%) and modest specificity (79%). Using the point of care testing will allow for generalized screening in the field in low income countries; however, confirmation for elevated levels >1.2 mg/dL will require a second laboratory test confirmation. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  7. Detection of ingested nitromethane and reliable creatinine assessment using multiple common analytical methods.

    Science.gov (United States)

    Murphy, Christine M; Devlin, John J; Beuhler, Michael C; Cheifetz, Paul; Maynard, Susan; Schwartz, Michael D; Kacinko, Sherri

    2018-04-01

    Nitromethane, found in fuels used for short distance racing, model cars, and model airplanes, produces a falsely elevated serum creatinine with standard creatinine analysis via the Jaffé method. Erroneous creatinine elevation often triggers extensive testing, leads to inaccurate diagnoses, and delayed or inappropriate medical interventions. Multiple reports in the literature identify "enzymatic assays" as an alternative method to detect the true value of creatinine, but this ambiguity does not help providers translate what type of enzymatic assay testing can be done in real time to determine if there is indeed false elevation. We report seven cases of ingested nitromethane where creatinine was determined via Beckman Coulter ® analyser using the Jaffé method, Vitros ® analyser, or i-Stat ® point-of-care testing. Nitromethane was detected and semi-quantified using a common clinical toxic alcohol analysis method, and quantified by headspace-gas chromatography-mass spectrometry. When creatinine was determined using i-Stat ® point-of-care testing or a Vitros ® analyser, levels were within the normal range. Comparatively, all initial creatinine levels obtained via the Jaffé method were elevated. Nitromethane concentrations ranged from 42 to 310 μg/mL. These cases demonstrate reliable assessment of creatinine through other enzymatic methods using a Vitros ® analyser or i-STAT ® . Additionally, nitromethane is detectable and quantifiable using routine alcohols gas chromatography analysis and by headspace-gas chromatography-mass spectrometry.

  8. THE COMPARATIVE ANALYSIS OF RENAL FUNCTION IN LIVER DISEASES USING COCKCROFT-GAULT FORMULAE AND CREATININE CLEARANCE

    Directory of Open Access Journals (Sweden)

    Karem Ravi Teja

    2018-01-01

    Full Text Available BACKGROUND Kidney dysfunction in liver disease can be due to different aetiologies and can have diverse manifestations. Most of the abnormalities of kidney function in cirrhosis are of functional origin namely, sodium retention, impaired free water excretion and renal vasoconstriction with decrease in renal perfusion and glomerular filtration rate. Renal dysfunction in chronic liver disease usually follows a progressive course- the final phase being Hepatorenal Syndrome (HRS. MATERIALS AND METHODS This study included patients with chronic liver disease being treated as inpatients in the Department of General Medicine, Konaseema Institute of Medical Sciences, Amalapuram. Evidence for chronic liver disease being defined by a compatible clinical profile (signs of liver cell failure or reduced liver span along with biochemical (altered liver function tests, reversal of albuminglobulin ratio or sonographic evidence (altered echotexture of liver or tissue diagnosis (positive liver biopsy for cirrhosis. RESULTS Eighteen percent, i.e. 5 out of the 28 patients with creatinine clearance more than 60 mL/minute by Cockcroft-Gault formula were found to have creatinine clearance values less than 40 mL/minute when done by timed urine collection P value calculated was found to be less than 0.0001, which is statistically significant. CONCLUSION In chronic liver disease, serum creatinine alone is not a reliable marker to assess renal dysfunction. Calculating creatinine clearance by using Cockcroft-Gault formula overestimates renal function in cirrhotics. Creatinine clearance measured by timed urine collections should be done routinely to assess renal reserve in advanced liver disease. Alcoholism appears to have adverse effect on renal function when compared with other aetiologies of cirrhosis.

  9. Growth performance, haematological characteristic and serum ...

    African Journals Online (AJOL)

    Growth performance, haematological characteristic and serum biochemistry of Japanese quails fed with diets containing African pear seed meal. ... haemoglobin concentration (MCHC) serum total protein (PRO), Albumin (ALB), glucose (GLU), creatinine (CREAT), cholesterol (CHOL) and Alkaline phosphatase (ALP).

  10. GC-MS determination of creatinine in human biological fluids as pentafluorobenzyl derivative in clinical studies and biomonitoring: Inter-laboratory comparison in urine with Jaffé, HPLC and enzymatic assays.

    Science.gov (United States)

    Tsikas, Dimitrios; Wolf, Alexander; Mitschke, Anja; Gutzki, Frank-Mathias; Will, Wolfgang; Bader, Michael

    2010-10-01

    In consideration of its relatively constant urinary excretion rate, creatinine in urine is a useful biochemical parameter to correct the urinary excretion rate of endogenous and exogenous biomolecules. Assays based on the reaction of creatinine and picric acid first reported by Jaffé in 1886 still belong to the most frequently used laboratory approaches for creatinine measurement in urine. Further analytical methods for creatinine include HPLC-UV, GC-MS, and LC-MS and LC-MS/MS approaches. In the present article we report on the development, validation and biomedical application of a new GC-MS method for the reliable quantitative determination of creatinine in human urine, plasma and serum. This method is based on the derivatization of creatinine (d(0)-Crea) and the internal standard [methyl-trideutero]creatinine (d(3)-Crea) with pentafluorobenzyl (PFB) bromide in the biological sample directly or after dilution with phosphate buffered saline, extraction of the reaction products with toluene and quantification in 1-μl aliquots of the toluene extract by selected-ion monitoring of m/z 112 for d(0)-Crea-PFB and m/z 115 for d(3)-Crea-PFB in the electron-capture negative-ion chemical ionization mode. The limit of detection of the method is 100 amol of creatinine. In an inter-laboratory study on urine samples from 100 healthy subjects, the GC-MS method was used to test the reliability of currently used Jaffé, enzymatic and HPLC assays in clinical and occupational studies. The results of the inter-laboratory study indicate that all three tested methods allow for satisfactory quantification of creatinine in human urine. The GC-MS method is suitable for use as a reference method for urinary creatinine in humans. In serum, creatine was found to contribute to creatinine up to 20% when measured by the present GC-MS method. The application of the GC-MS method can be extended to other biological samples such as saliva. Copyright © 2010 Elsevier B.V. All rights reserved.

  11. Effects of hydrochlorothiazide and furosemide on creatinine ...

    African Journals Online (AJOL)

    Hydrochlorothiazide and furosemide have been reported to alter the glomerular filtration rate (GFR) and possibly the creatinine excretion by the kidneys. Also, therapy with these diuretics, especially in the elderly, can be complicated by volume depletion resulting in prerenal azotemia. Creatinine clearance (Clcr) is ...

  12. Vitamin D status and 5-year changes in urine albumin creatinine ratio and parathyroid hormone in a general population

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta

    2013-01-01

    and negatively correlated with glomerular filtration rate. We investigated the association between vitamin D status and 5-year changes in urine albumin creatinine ratio (UACR) and parathyroid hormone (PTH). A random sample of 6,784 individuals aged 30-60 years from a general population participated in the Inter......99 study in 1999-2001. Vitamin D (serum-25-hydroxyvitamin D) was measured at baseline by high-performance liquid chromatography. UACR and PTH were measured at baseline and follow-up. Increased UACR was defined as UACR >4.0 mg/g reflecting the upper quartile at baseline. We included 4,330 individuals...

  13. Simultaneous GC-ECNICI-MS measurement of nitrite, nitrate and creatinine in human urine and plasma in clinical settings.

    Science.gov (United States)

    Hanff, Erik; Lützow, Moritz; Kayacelebi, Arslan Arinc; Finkel, Armin; Maassen, Mirja; Yanchev, Georgi Radoslavov; Haghikia, Arash; Bavendiek, Udo; Buck, Anna; Lücke, Thomas; Maassen, Norbert; Tsikas, Dimitrios

    2017-03-15

    Creatinine in urine is a useful biochemical parameter to correct the urinary excretion rate of endogenous and exogenous substances. Nitrite (ONO - ) and nitrate (ONO 2 - ) are metabolites of nitric oxide (NO), a signalling molecule with multiple biological functions. Under certain and standardized conditions, the concentration of nitrate in the urine is a suitable measure of whole body NO synthesis. The urinary nitrate-to-nitrite molar ratio (U NOx R) may indicate nitrite-dependent renal carbonic anhydrase (CA) activity. In clinical studies, urine is commonly collected by spontaneous micturition. In those cases the nitrate and nitrite excretion must be corrected for creatinine excretion. Pentafluorobenzyl (PFB) bromide (PFB-Br) is a useful derivatization reagent of numerous inorganic and organic compounds, including urinary nitrite, nitrate and creatinine, for highly sensitive and specific quantitation by GC-MS. Here, we report on the simultaneous PFB-Br derivatization (60min, 50°C) of ONO - , O 15 NO - , ONO 2 - , O 15 NO 2 - , creatinine (d o -Crea) and [methylo- 2 H 3 ]creatinine (d 3 -Crea) in acetonic dilutions of native human urine and plasma samples (4:1, v/v) and their simultaneous quantification by GC-MS as PFBNO 2 , PFB 15 NO 2 , PFBONO 2 , PFBO 15 NO 2 , d o -Crea-PFB and d 3 -Crea-PFB, respectively. Electron capture negative-ion chemical ionization (ECNICI) of these derivatives generates anions due to [M-PFB] - , i.e., the starting analytes. Quantification is performed by selected-ion monitoring (SIM) of m/z 46 (ONO - ), m/z 47 (O 15 NO - ), m/z 62 (ONO 2 - ), m/z 63 (O 15 NO 2 - ), m/z 112 (d o -Crea), and m/z 115 (d 3 -Crea). Retention times were 2.97min for PFB-ONO 2 /PFB-O 15 NO 2 , 3.1min for PFB-NO 2 /PFB- 15 NO 2 , and 6.7min for d o -Crea-PFB/d 3 -Crea-PFB. We used this method to investigate the effects of long-term oral NaNO 3 or NaCl (serving as placebo) supplementation (each 0.1mmol/kg body weight per day for 3 weeks) on creatinine excretion

  14. Creatinina sérica, cistatina C e proteína β-traço no estadiamento diagnóstico e na predição da progressão da doença renal crônica não diabética Serum creatinine, cystatin C, and β-trace protein in diagnostic staging and predicting progression of primary nondiabetic chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Katharina-Susanne Spanaus

    2011-02-01

    Full Text Available HISTÓRICO: A redução da função renal basal é um fator de risco bem definido para a progressão da doença renal crônica (DRC. Avaliamos a taxa de filtração glomerular (TFG medida e os marcadores séricos creatinina, cistatina C e proteína χ-traço (PBT para a acurácia diagnóstica na definição do estágio da lesão renal e como preditores do risco de progressão da DRC. MÉTODOS: Dosamos as concentrações dos marcadores em 227 pacientes com DRC primária não diabética e com vários graus de lesão renal e seguimos 177 pacientes prospectivamente por até sete anos para avaliar a progressão da DRC. RESULTADOS: No início, creatinina, cistatina C e PBT se correlacionaram fortemente com a TFG medida pela depuração do ioexol. As concentrações dos três marcadores aumentaram progressivamente com a diminuição da TFG, e seus desempenhos diagnósticos para a detecção até mesmo de discretas deteriorações da função renal (TFG INTRODUCTION: Impaired baseline kidney function is a well-defined risk factor for progression of chronic kidney disease (CKD. We evaluated measured glomerular filtration rate (GFR and the serum markers creatinine, cystatin C, and χ-trace protein (BTP for diagnostic accuracy in defining the stage of kidney impairment and as risk predictors of CKD progression. METHODS: We measured serum marker concentrations in 227 patients with primary nondiabetic CKD and various degrees of renal impairment and followed 177 patients prospectively for up to seven years to assess progression of CKD. RESULTS: At baseline, creatinine, cystatin C, and BTP were strongly correlated with GFR as measured by iohexol clearance. Concentrations of all three markers increased progressively with decreasing GFR, and their diagnostic performance for the detection of even minor deteriorations of renal function (GFR < 90 ml · min-1 · (1.73 m²-1 was similar. Sixty-five patients experienced progression of CKD, defined as doubling of

  15. A New Equation to Estimate Muscle Mass from Creatinine and Cystatin C.

    Directory of Open Access Journals (Sweden)

    Sun-wook Kim

    Full Text Available With evaluation for physical performance, measuring muscle mass is an important step in detecting sarcopenia. However, there are no methods to estimate muscle mass from blood sampling.To develop a new equation to estimate total-body muscle mass with serum creatinine and cystatin C level, we designed a cross-sectional study with separate derivation and validation cohorts. Total body muscle mass and fat mass were measured using dual-energy x-ray absorptiometry (DXA in 214 adults aged 25 to 84 years who underwent physical checkups from 2010 to 2013 in a single tertiary hospital. Serum creatinine and cystatin C levels were also examined.Serum creatinine was correlated with muscle mass (P < .001, and serum cystatin C was correlated with body fat mass (P < .001 after adjusting glomerular filtration rate (GFR. After eliminating GFR, an equation to estimate total-body muscle mass was generated and coefficients were calculated in the derivation cohort. There was an agreement between muscle mass calculated by the novel equation and measured by DXA in both the derivation and validation cohort (P < .001, adjusted R2 = 0.829, β = 0.95, P < .001, adjusted R2 = 0.856, β = 1.03, respectively.The new equation based on serum creatinine and cystatin C levels can be used to estimate total-body muscle mass.

  16. Comparison of renal function assessment by cystatin c and creatinine based equations for e-gfr in type 2 diabetics in different stages of albuminuria

    International Nuclear Information System (INIS)

    Qamar, A.; Ahmad, T.M.; Hayat, A.; Khan, M.A.; Rehman, S. Z.

    2017-01-01

    To compare e-GFR estimated by creatinine or cystatin C based and combined creatinine and cystatin C based equations in type 2 diabetics in different stages of albuminuria. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Chemical Pathology, Army Medical College Rawalpindi in collaboration with endocrinology outpatient department Military Hospital Rawalpindi, from Nov 2015 to Nov 2016. Material and Methods: A total of 119 type 2 diabetic subjects of either gender, aged 30- 60 years were enrolled in the study with duration of diabetes less than 15 years and were divided into further sub groups on the basis of degree of albuminuria determined by spot urine albumin to creatinine ratio (uACR). Fifty age matched disease free controls with no history of any systemic disease were also included in the study. Known patients of type 1 diabetes, chronic inflammatory disorders, uncontrolled hypertension, thyroid disease, chronic kidney disease, on lipid lowering drugs, steroids, ACE inhibitors and pregnant ladies were excluded from the study. Serum creatinine serum cystatin C were assessed on fully automated chemistry analyzer selectra. E-GFR was calculated by online GFR calculator by National Kidney Foundation. Comparison of means of e-GFR calculated by various equations was carried out by one way ANOVA and post-hoc Tukey tests. Degree of agreement between various equations for the estimation of GFR was assessed by kappa statistics. A p-value less than 0.05 were considered statistically significant. Results: Mean e-GFR (ml/min/1.73m2) was lowest in cystatin C based CKD-EPI equation (89.56 +- 39.84) followed by combined cystatin C and creatinine based CKD-EPI (92.34 +- 37.88). Values of e-GFR by creatinine based CKD-EPI equation (95.84 +- 27.24), and by creatinine based MDRD equation (105.37 +- 64.98) were both higher. In creatinine based MDRD, equation normo albuminuria and micro albuminuria groups did not show statistically

  17. Creatinine plasma at uncontrolled type 2 diabetes mellitus and controlled type 2 diabetes mellitus patients at primary health care in Binjai city, Indonesia

    Science.gov (United States)

    Rusdiana; Savira, M.; Syahputra, M.; Santoso, A.

    2018-03-01

    The aim of the study knowing the comparison creatinine plasma levels at uncontrolled type 2 diabetes mellitus and controlled type 2 diabetes mellitus patients at Primary Health Care in Binjai city of North Sumatera in Indonesia. This cross-sectional study was conductedon 40 type 2 Diabetes Mellitus patients who attended Primary Health Care in Binjai. Patients with age > 40 years old, (both sexes) were included in the study. We recorded different demographic parameter as age, Body Mass Index, Blood Pressure, and personal history status. And we examined the biochemicalparameters including Hba1c, Fasting Blood Sugar Levels (FBL) and creatinine serum. We separated into two groups base on HbA1c test, controlled type 2 diabetes mellitus and uncontrolled type 2 diabetes mellitus. We measured FBL by using the portable measuring instrument, and Thamrin clinical laboratory measured Hba1c, andwe measured creatinine plasmaby spectrophotometry in Biochemistry laboratory. With statistical analysis using T-test found that there was asignificant differencein creatinine plasma levels between uncontrolled type 2 diabetes mellitus with controlled type 2 diabetes mellitus (p<0.005).

  18. Urine Albumin and Albumin/ Creatinine Ratio

    Science.gov (United States)

    ... and Iron-binding Capacity (TIBC, UIBC) Trichomonas Testing Triglycerides Troponin Tryptase Tumor Markers Uric Acid Urinalysis Urine ... may also vary. Creatinine, a byproduct of muscle metabolism, is normally released into the urine at a ...

  19. Relationship between phosphorus and creatinine clearance in peritoneal dialysis: clinical implications.

    Science.gov (United States)

    Sedlacek, M; Dimaano, F; Uribarri, J

    2000-11-01

    Elevated serum phosphorus levels are associated with increased morbidity and mortality in dialysis patients. To study the determinants of serum phosphorus levels and phosphorus clearance, we measured phosphorus concentrations in 24-hour collections of dialysate and residual urine output during routine urea kinetics in 56 peritoneal dialysis patients. Dietary records were used to estimate oral phosphorus intake, and the net gastrointestinal absorption of phosphorus was determined measuring the amount of phosphorus excreted in 24 hours. Dialysate to plasma ratios of phosphorus and creatinine were very similar, and the peritoneal clearances of phosphorus and creatinine correlated well and were of the same magnitude. High transporters in the peritoneal equilibration test had greater phosphorus and creatinine clearances than low transporters. In patients with residual urine output, the renal clearances of phosphorus and creatinine also correlated well. Comparing two groups of patients with a similar Kt/V of 2 and greater but different levels of creatinine clearance, either greater or less than 60 L/wk, the patients with the greater creatinine clearance also had a greater phosphorus clearance (7.0 +/- 2.2 versus 4.3 +/- 0.7 mL/min/1.73 m(2)) and significantly lower serum phosphorus levels (4.8 +/- 0.9 versus 5.9 +/- 1.4 mg/dL) despite a greater daily amount of phosphorus absorption (490 +/- 190 versus 336 +/- 100 mg/d). In summary, creatinine clearance measurements provide a good estimate of phosphorus clearance and how much dietary phosphorus and therefore protein can be tolerated.

  20. GFR Prediction From Cystatin C and Creatinine in Children

    DEFF Research Database (Denmark)

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

    2012-01-01

    area, and SCr is serum creatinine level. The accuracy and precision of these models were compared with 7 previously published prediction models using random subsampling cross-validation. Local constants and coefficients were calculated for all models. Root mean square error, R2, and percentage...... prediction models resulting from theoretical considerations corroborated by forward stepwise variable selection: GFR (mL/min) = 0.542 × (BCM/SCysC)0.40 × (height × BSA/SCr)0.65 and GFR (mL/min) = 0.426 × (weight/SCysC)0.39 × (height × BSA/SCr)0.64, where SCysC is serum cystatin C level, BSA is body surface...

  1. Is elevated creatinine a reliable marker for methanol toxicity in nitromethane-containing model fuel ingestions in children?

    Science.gov (United States)

    Padmanabhan, Pradeep; Spiller, Henry A; Ross, Mitchell P; Bosse, George M

    2011-01-01

    In the absence of a rapid serum methanol level estimation, it is difficult to assess the risk from unintentional childhood ingestion of model fuels containing methanol and nitromethane (MFNM). Previous reports have documented false elevations of serum creatinine from the nitromethane in these fuels, suggesting its utility as a readily available marker of significant methanol ingestion. We performed a 2-year retrospective chart review of cases of ingestion of MFNM in children, with both a methanol level and measured creatinine level. Seven children, ages 19 months to 3 years, ingested MFNM. All seven children were seen in a hospital and had measured methanol and creatinine levels. All blood samples for methanol and creatinine were drawn within 3 hours of ingestion with methanol estimation delayed up to 24 hours. Creatinine ranged from 0.39 (0.034 mmol/l) to 10.7 mg/dl (0.95 mmol/l). All methanol levels were methanol analysis results. Transient elevations of creatinine occurred in five of the seven children. Blood urea nitrogen was within normal limits, and there was no history of renal impairment in these children, suggesting the elevated creatinine was mostly related to nitromethane ingestion. No child had a significantly elevated methanol level. Elevated creatinine level, as measured by Jaffe colorimetric method, is not a reliable marker for elevated methanol levels after unintentional ingestion of MFNM.

  2. Ranitidine has no influence on tubular creatinine secretion

    NARCIS (Netherlands)

    van den Berg, J. G.; Koopman, M. G.; Arisz, L.

    1996-01-01

    Oral cimetidine competitively inhibits tubular secretion of creatinine. We investigated the potential of oral ranitidine, a comparable H2-receptor antagonist, to block tubular creatinine secretion. In 10 healthy subjects, clearances of inulin and endogenous creatinine were simultaneously measured

  3. Gold nanoparticles-based colorimetric and visual creatinine assay

    International Nuclear Information System (INIS)

    He, Yi; Zhang, Xianhui; Yu, Haili

    2015-01-01

    We demonstrate a selective and sensitive method for determination of creatinine using citrate-stabilized gold nanoparticles (AuNPs) as a colorimetric probe. It is based on a direct cross-linking reaction that occurs between creatinine and AuNPs that causes aggregation of AuNPs and results in a color change from wine red to blue. The absorption peak is shifted from 520 to 670 nm. Under the optimized conditions, the shift in the absorption peak is related the logarithm of the creatinine concentration in the 0.1 to 20 mM range, and the instrumental detection limit (LOD) is 80 μM. This LOD is about one order of magnitude better than that that of the Jaffé method (720 μM). The assay displays good selectivity over interfering substances including various inorganic ions, organic small compounds, proteins, and biothiols. It was successfully employed to the determination of creatinine in spiked human urine. (author)

  4. Detecting microalbuminuria by urinary albumin/creatinine concentration ratio

    DEFF Research Database (Denmark)

    Jensen, J S; Clausen, P; Borch-Johnsen, K

    1997-01-01

    BACKGROUND: Microalbuminuria, i.e. a subclinical increase of the albumin excretion rate in urine, may be a novel atherosclerotic risk factor. This study aimed to test whether microalbuminuria can be identified by measurement of urinary albumin concentration or urinary albumin/creatinine concentra......BACKGROUND: Microalbuminuria, i.e. a subclinical increase of the albumin excretion rate in urine, may be a novel atherosclerotic risk factor. This study aimed to test whether microalbuminuria can be identified by measurement of urinary albumin concentration or urinary albumin....../creatinine concentration ratio, instead of the usual measurement of the albumin excretion rate in a timed urine collection. METHODS: All 2579 subjects analysed were screened in a population based epidemiological study. Participants with diabetes mellitus, renal disease, haematuria, or urinary tract infection were...... not included. Urinary albumin (Ualb) and creatinine (Ucreat) concentrations were measured in an overnight collected sample by enzyme-linked immunosorbent and colorimetric assays, respectively. Urinary albumin excretion rate (UAER) and urinary albumin/creatinine concentration ratio (Ualb/Ucreat) were calculated...

  5. 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)

  6. Hemograma e perfil bioquímico sérico, inclusive hemogasométrico, de bezerros infectados experimentalmente com Salmonella Dublin Blood cell counts and serum biochemical profile, including blood gas levels, in Salmonella Dublin-infected calves

    Directory of Open Access Journals (Sweden)

    D.G. Silva

    2010-04-01

    Full Text Available O objetivo do estudo foi avaliar o hemograma e o perfil bioquímico sérico, inclusive hemogasométrico, de bezerros infectados experimentalmente com Salmonella Dublin. Foram utilizados 12 bezerros sadios da raça Holandesa com 10 a 15 dias de idade, distribuídos aleatoriamente em dois grupos experimentais: grupo-controle (n= 6 e grupo infectado com 10(8UFC de Salmonella Dublin (n=6. Os bezerros foram submetidos ao exame físico diário, e as amostras de sangue foram coletadas minutos antes da inoculação (0h e 24, 48, 72, 96, 120, 144 e 168h após a inoculação. Além do hemograma e das análises hemogasométricas, foram mensuradas as atividades séricas das enzimas aspartato aminotransferase (AST, fosfatase alcalina (ALP, creatina cinase (CK, gamaglutamiltransferase (GGT e lactato desidrogenase (LDH, e os teores de albumina, bilirrubinas, cálcio total, cálcio ionizado, sódio, potássio, cloretos, creatinina, ferro, fibrinogênio, fósforo, glicose, magnésio, proteína totais e ureia. As principais alterações foram: redução das concentrações de albumina, ferro, glicose, magnésio e proteína total, aumento do teor de fibrinogênio, leucocitose e acidose metabólica e hiponatremia.The blood cell counts and biochemical profile, including blood gas levels, were evaluated, in Salmonella Dublin-infected calves. Twelve healthy 10 to 15-day old Holstein calves were randomly allotted into two groups: control (n=6 and group orally infected with 10(8 CFU Salmonella Dublin (n=6. The calves were submitted to physical examination and the blood samples were taken just before the inoculation (0h and at 24, 48, 72, 96, 120, 144, and 168h later. Besides, blood cell counts, blood gas levels, and the serum concentrations of aspartate aminotransferase (AST, alkaline phosphatase (ALP, creatine kinase (CK, gammaglutamyltransferase (GGT, lactate desidrogenase (LDH, albumin, bilirubin, total calcium, ionic calcium, sodium, potassium, chlorides, creatinine

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

    DEFF Research Database (Denmark)

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

    ) aged 2-14 years. GFR was 14-147 mL/min/1.73m2. BCM was estimated using bioimpedance spectroscopy. Log-transformed data on BCM/CysC, serum creatinine (SCr), body-surface-area (BSA), height×BSA/SCr, CysC, weight, sex, age, height, serum urea and albumin were considered possible explanatory variables...

  8. Requirement for specific gravity and creatinine adjustments for urinary steroids and luteinizing hormone concentrations in adolescents.

    Science.gov (United States)

    Singh, Gurmeet K S; Balzer, Ben W R; Desai, Reena; Jimenez, Mark; Steinbeck, Katharine S; Handelsman, David J

    2015-11-01

    Urinary hormone concentrations are often adjusted to correct for hydration status. We aimed to determine whether first morning void urine hormones in growing adolescents require adjustments and, if so, whether urinary creatinine or specific gravity are better adjustments. The study population was adolescents aged 10.1 to 14.3 years initially who provided fasting morning blood samples at 0 and 12 months (n = 343) and first morning urine every three months (n = 644). Unadjusted, creatinine and specific gravity-adjusted hormonal concentrations were compared by Deming regression and Bland-Altman analysis and grouped according to self-rated Tanner stage or chronological age. F-ratios for self-rated Tanner stages and age groups were used to compare unadjusted and adjusted hormonal changes in growing young adolescents. Correlations of paired serum and urinary hormonal concentration of unadjusted and creatinine and specific gravity-adjusted were also compared. Fasting first morning void hormone concentrations correlated well and were unbiased between unadjusted or adjusted by either creatinine or specific gravity. Urine creatinine concentration increases with Tanner stages, age and male gender whereas urine specific gravity was not influenced by Tanner stage, age or gender. Adjustment by creatinine or specific gravity of urinary luteinizing hormone, estradiol, testosterone, dihydrotestosterone and dehydroepiandrosterone concentrations did not improve correlation with paired serum concentrations. Urine steroid and luteinizing hormone concentrations in first morning void samples of adolescents are not significantly influenced by hydration status and may not require adjustments; however, if desired, both creatinine and specific gravity adjustments are equally suitable. © The Author(s) 2015.

  9. FRET-Aptamer Assays for Bone Marker Assessment, C-Telopeptide, Creatinine, and Vitamin D

    Science.gov (United States)

    Bruno, John G.

    2013-01-01

    Astronauts lose 1.0 to 1.5% of their bone mass per month on long-duration spaceflights. NASA wishes to monitor the bone loss onboard spacecraft to develop nutritional and exercise countermeasures, and make adjustments during long space missions. On Earth, the same technology could be used to monitor osteoporosis and its therapy. Aptamers bind to targets against which they are developed, much like antibodies. However, aptamers do not require animal hosts or cell culture and are therefore easier, faster, and less expensive to produce. In addition, aptamers sometimes exhibit greater affinity and specificity vs. comparable antibodies. In this work, fluorescent dyes and quenchers were added to the aptamers to enable pushbutton, one-step, bind-and-detect fluorescence resonance energy transfer (FRET) assays or tests that can be freeze-dried, rehydrated with body fluids, and used to quantitate bone loss of vitamin D levels with a handheld fluorometer in the spacecraft environment. This work generated specific, rapid, one-step FRET assays for the bone loss marker C-telopeptide (CTx) when extracted from urine, creatinine from urine, and vitamin D congeners in diluted serum. The assays were quantified in nanograms/mL using a handheld fluorometer connected to a laptop computer to convert the raw fluorescence values into concentrations of each analyte according to linear standard curves. DNA aptamers were selected and amplified for several rounds against a 26- amino acid form of CTx, creatinine, and vitamin D. The commonalities between loop structures were studied, and several common loop structures were converted into aptamer beacons with a fluorophore and quencher on each end. In theory, when the aptamer beacon binds its cognate target (CTx bone peptide, creatinine, or vitamin D), it is forced open and no longer quenched, so it gives off fluorescent light (when excited) in proportion to the amount of target present in a sample. This proportional increase in fluorescence is

  10. 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

  11. Automated monosegmented flow analyser. Determination of glucose, creatinine and urea.

    Science.gov (United States)

    Raimundo Júnior, I M; Pasquini, C

    1997-10-01

    An automated monosegmented flow analyser containing a sampling valve and a reagent addition module and employing a laboratory-made photodiode array spectrophotometer as detection system is described. The instrument was controlled by a 386SX IBM compatible microcomputer through an IC8255 parallel port that communicates with the interface which controls the sampling valve and reagent addition module. The spectrophotometer was controlled by the same microcomputer through an RS232 serial standard interface. The software for the instrument was written in QuickBasic 4.5. Opto-switches were employed to detect the air bubbles limiting the monosegment, allowing precise sample localisation for reagent addition and signal reading. The main characteristics of the analyser are low reagent consumption and high sensitivity which is independent of the sample volume. The instrument was designed to determine glucose, creatinine or urea in blood plasma and serum without hardware modification. The results were compared against those obtained by the Clinical Hospital of UNICAMP using commercial analysers. Correlation coefficients among the methods were 0.997, 0.982 and 0.996 for glucose, creatinine and urea, respectively.

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

    DEFF Research Database (Denmark)

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

    ) aged 2-14 years (mean 8.8 years). GFR was 14-147 mL/min/1.73m2 (mean 97 mL/min/1.73m2). BCM was estimated using bioimpedance spectroscopy (Xitron Hydra 4200). Log-transformed data on BCM/CysC, serum creatinine (SCr), body-surface-area (BSA), height x BSA/SCr, serum CysC, weight, sex, age, height, serum...

  13. Frequency and causes of discrepancy between Kt/V and creatinine clearance.

    Science.gov (United States)

    Satko, S G; Burkart, J M; Bleyer, A J; Jordan, J R; Manning, T

    1999-01-01

    This study examines the frequency of discrepancy between Kt/V urea and creatinine clearance (Ccr) measurements in patients on peritoneal dialysis (PD) and the reasons for this discrepancy. Nonrandomized, retrospective data analysis. Single PD unit of a university teaching hospital. All adult patients receiving PD at our center from January 1995 to December 1996. Actual (a) and desired (d) body weight (BW) were used to calculate urea volume of distribution (V) and body surface area (BSA). Patients were divided into four groups based upon their total small solute clearances (Kt/V and Ccr, normalized by actual weight) and three additional groups based upon actual/desired (a/d) body weight ratio. An additional analysis was performed for the subset of anuric patients. Data collected for all patients included the following: total Kt, total Ccr, 4-hour dialysate/ plasma (D/P) creatinine, serum albumin concentration, duration of PD, actual body weight, age, and height. Twenty-three percent of the clearance measurements in our study were discrepant, defined as having values for either Kt/V or Ccr (but not both) above the accepted targets of Kt/V > or = 2.0/wk and Ccr > or = 60 L/wk/ 1.73 m2. Patients with both values above target are more likely to have higher residual renal function. Patients who are significantly less than BWd and patients on PD for a longer time are more likely to have adequate Kt/V but not Ccr. Furthermore, patients who are less than 90% or greater than 110% of BWd have markedly different values for Kt/V and Ccr when BWa versus BWd values are used. Kt/V and Ccr values are frequently discrepant; a number of factors affect these two measurements to varying degrees, including weight, degree of residual renal function, and duration of PD.

  14. Analysis of clinical factors for the determination of optimal serum level of thyrotropin after recombinant human thyroid-stimulating hormone administration

    International Nuclear Information System (INIS)

    Son, Seung Hyun; Lee, Sang Woo; Jung, Ji Hoon; Kim, Choon Young; Kim, Do Hoon; Jeong, Shin Young; Ahn, Byeong Cheol; Lee, Jae Tae

    2015-01-01

    To determine the optimal levels of thyroid-stimulating hormone (TSH) levels after administration of recombinant human TSH (rhTSH) to patients with differentiated thyroid cancer (DTC), we have analyzed the clinical parameters that affected the degree of the increase in serum levels of TSH. We retrospectively analyzed 276 patients with differentiated thyroid cancer (DTC), post-thyroidectomy and remnant ablation. Pearson’s correlation coefficient test was used to evaluate the correlation between serum levels of TSH after rhTSH stimulation and various clinical factors, including age, sex, height, weight, body mass index (BMI), body surface area (BSA), serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate (GFR). Linear regression analysis was used to determine the predictors of the degree of increase in serum TSH level after rhTSH stimulation. After the rhTSH injections, all subjects achieved TSH levels of >30 μU/mL, with a mean of 203.8 ± 83.4 μU/mL. On univariate analysis, age (r = 0.255) and serum creatinine (r = 0.169) level were positive predictors for higher levels of serum TSH after rhTSH stimulation, while weight (r = –0.239), BMI (r = –0.223), BSA (r = –0.217), and estimated GFR (r = –0.199) were negative predictors. Multiple linear regression analysis revealed that serum creatinine was the most powerful independent predictor for serum levels of TSH, followed by age, BSA, and BMI. An increment in serum TSH after rhTSH stimulation was significantly affected by age, BSA, BMI, and creatinine, with creatinine being the most powerful predictor. By understanding the difference in the increased levels of TSH in various subjects, their dose of rhTSH can be adjusted during scheduling for radioiodine ablation, or during follow-up (recurrence surveillance) after surgery and ablation

  15. Analysis of clinical factors for the determination of optimal serum level of thyrotropin after recombinant human thyroid-stimulating hormone administration

    Energy Technology Data Exchange (ETDEWEB)

    Son, Seung Hyun; Lee, Sang Woo; Jung, Ji Hoon; Kim, Choon Young; Kim, Do Hoon; Jeong, Shin Young; Ahn, Byeong Cheol; Lee, Jae Tae [Dept. of Nuclear Medicine, Kyungpook National University Medical Center and School of Medicine, Daegu (Korea, Republic of)

    2015-12-15

    To determine the optimal levels of thyroid-stimulating hormone (TSH) levels after administration of recombinant human TSH (rhTSH) to patients with differentiated thyroid cancer (DTC), we have analyzed the clinical parameters that affected the degree of the increase in serum levels of TSH. We retrospectively analyzed 276 patients with differentiated thyroid cancer (DTC), post-thyroidectomy and remnant ablation. Pearson’s correlation coefficient test was used to evaluate the correlation between serum levels of TSH after rhTSH stimulation and various clinical factors, including age, sex, height, weight, body mass index (BMI), body surface area (BSA), serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate (GFR). Linear regression analysis was used to determine the predictors of the degree of increase in serum TSH level after rhTSH stimulation. After the rhTSH injections, all subjects achieved TSH levels of >30 μU/mL, with a mean of 203.8 ± 83.4 μU/mL. On univariate analysis, age (r = 0.255) and serum creatinine (r = 0.169) level were positive predictors for higher levels of serum TSH after rhTSH stimulation, while weight (r = –0.239), BMI (r = –0.223), BSA (r = –0.217), and estimated GFR (r = –0.199) were negative predictors. Multiple linear regression analysis revealed that serum creatinine was the most powerful independent predictor for serum levels of TSH, followed by age, BSA, and BMI. An increment in serum TSH after rhTSH stimulation was significantly affected by age, BSA, BMI, and creatinine, with creatinine being the most powerful predictor. By understanding the difference in the increased levels of TSH in various subjects, their dose of rhTSH can be adjusted during scheduling for radioiodine ablation, or during follow-up (recurrence surveillance) after surgery and ablation.

  16. Assessment of proteinuria by using protein: creatinine index in random urine sample.

    Science.gov (United States)

    Khan, Dilshad Ahmed; Ahmad, Tariq Mahmood; Qureshil, Ayaz Hussain; Halim, Abdul; Ahmad, Mumtaz; Afzal, Saeed

    2005-10-01

    To assess the quantitative measurement of proteinuria by using random urine protein:creatinine index/ratio in comparison with 24 hours urinary protein excretion in patients of renal diseases having normal glomerular filtration rate. One hundred and thirty patients, 94 males and 36 females, with an age range of 5 to 60 years; having proteinuria of more than 150 mg/day were included in this study. Qualitative urinary protein estimation was done on random urine specimen by dipstick. Quantitative measurement of protein in the random and 24 hours urine specimens were carried out by a method based on the formation of a red complex of protein with pyrogallal red in acid medium on Micro lab 200 (Merck). Estimation of creatinine was done on Selectra -2 (Merck) by Jaffe's reaction. The urine protein:creatinine index and ratio were calculated by dividing the urine protein concentration (mg/L) by urine creatinine concentration (mmol/L) multilplied by 10 and mg/mg respectively. The protein:creatinine index and ratio of more than 140 and 0.18 respectively in a random urine sample indicated pathological proteinuria. An excellent correlation (r=0.96) was found between random urine protein:creatinine index/ratio and standard 24 hours urinary protein excretion in these patients (pprotein:creatinine index in random urine is a convenient, quick and reliable method of estimation of proteinuria as compared to 24 hours of urinary protein excretion for diagnosis and monitoring of renal diseases in our medical setup.

  17. Atividade da gama glutamil transpeptidase urinária, dosagens séricas de uréia e creatinina como meios diagnósticos auxiliares na nefrotoxicidade induzida por aminoglicosídeo em cães Urinary gamma glutamyl transpeptidase activity, urinalysis, bun and creatinine serum dosages as a auxiliary diagnostic mean in dogs nephrotoxicity induced by aminoglycosides

    Directory of Open Access Journals (Sweden)

    Carla Rosane de Aguiar Hennemann

    1997-06-01

    Full Text Available Foram utilizados 11 cães, hígidos, com idade entre 1 e 5 anos. Inicialmente procedeu-se à determinação dos valores basais através de cinco colheitas diárias de urina e sangue, e realizou-se a urinálise, determinação da atividade da gama glutamil transpeptidase urinária, dosagens sérica de uréia e creatinina. A nefrotoxicidade foi induzida com a utilização de10mg/kg de gentamicina, 3 vezes ao dia, durante 14 dias. As colheitas de urina foram realizadas a cada 24 hors e o sangue foi colhido a cada 48 horas, durante 14 dias. Após este período os cães foram submetidos à eutanásia, procedendo-se à necropsia, e estudo histopatológico dos rins. Os sinais clínicos apresentados foram apatia, anorexia, poliúria, oligúria, anúria, polidipsia, vômito e diarréia. Pela urinálise observou-se a ocorrência de proteinúria, glicosúria, hematúria, cilindrúria, celulúria e isostenúria; os valores de gama glutamil transpeptidase urinária elevaram-se de forma crescente a partir de 24 horas de administração da gentamicina até o final do experimento, a azotemia foi observada no 12° e 14° dias da pesquisa. Na avaliação histopatológica observou-se nefrose tubular aguda. Com base nos resultados obtidos pode-se concluir que a mensuração da atividade da gama glutamil transpeptidase urinária é um sensível indicador de lesão tubular renal possibilitando o diagnóstico precoce, juntamente com a urinálise.Eleven healthy dogs, ranging from one to five years old, were used for this study. Base line values were determined through five daily samples of urine for urinalysis and urinary gamma glutamyl transpeptidase activity, and blood for serum dosage of BUN and creatinine. Nephrotoxicity was induced using 10mg/kg of gentamicin, 3 times a day (tid, for 14 days. Urine samples were drawn every 24 hours and blood samples every 48 hours, for 14 days. After this period, the dogs were euthanized and necropsy was done for further

  18. Serum Biochemical Profile of Post Partum Metritic Cow

    Directory of Open Access Journals (Sweden)

    Magnus P. K.

    2009-02-01

    Full Text Available Present study was conducted to find out the relationship between serum biochemical profile and postpartum metritis. Mainly serum glucose, total protein, albumin, albumin globulin ratio, blood urea nitrogen (BUN, creatinine and calcium were studied. Colorimetric method was used for quantitative estimation of biochemical profile. Twenty-seven animals with recent history of calving and subsequent metritis were included in the study. On analysis, serum glucose was found to be 22.3 ± 2.18 mg/dl, total protein 6.1 ± 0.51 g/dl, albumin 2.8 ± 0.29 g/dl, BUN 27 ± 0.19 mg/dl, creatinine 1.8 ± 0.13 mg/dl and calcium was 7.0 ± 0.43 mg/dl. On comparison of this result with normal values it was found that glucose and calcium was below the normal level and albumin fraction was less than the globulin. It was concluded that in postpartum metritis, cattle exhibit hypocalcaemia, hypoglycaemia and reduced globulin fraction, whereas total protein, albumin, BUN and creatinine did not exhibit much variation. Ketone bodies were present in urine of 90% of tested animals. [Vet. World 2009; 2(1.000: 27-28

  19. 24h Urinary Protein Levels and Urine Protein/Creatinine Ratios Could Probably Forecast the Pathological Classification of HSPN.

    Science.gov (United States)

    Ye, Qing; Shang, Shi-Qiang; Liu, Ai-Min; Zhang, Ting; Shen, Hong-Qiang; Chen, Xue-Jun; Mao, Jian-Hua

    2015-01-01

    This study aimed to assess the relevance of laboratory tests in Henoch-Schönlein purpura nephritis (HSPN) classification, and determine accurate classification factors. This prospective study included 694 HSPN patients who underwent ultrasound-guided percutaneous renal biopsy (PRB). Renal specimens were scored according to International Study of Kidney Disease in Children (ISKDC) classification. Meanwhile, blood samples were immediately collected for laboratory examination. The associations between laboratory parameters and HSPN classification were assessed. Significant differences in levels of serum Th1/Th2 cytokines, immunoglobulins, T-lymphocyte subsets, complement, and coagulation markers were obtained between HSPN patients and healthy children. Interestingly, 24h urinary protein (24h-UPRO) levels and urine protein/urine creatinine ratios could determine HPSN grade IIb, IIIa, and IIIb incidences, with areas under ROC curve of 0.767 and 0.731, respectively. At 24h-UPRO >580.35mg/L, prediction sensitivity and specificity were 75.2% and 70.0%, respectively. These values became 53.0% and 82.3%, respectively, with 24h-UPRO exceeding 1006.25mg/L. At urine protein/urine creatinine > 0.97, prediction sensitivity and specificity were 65.5% and 67.2%, respectively, values that became 57.4% and 80.0%, respectively, at ratios exceeding 1.2. Cell and humoral immunity, coagulation and fibrinolytic systems are all involved in the pathogenesis of HSPN, and type I hypersensitivity may be the disease trigger of HSPN. 24h-UPRO levels and urine protein/creatinine ratios could probably forecast the pathological classification of HSPN.

  20. Prevalence of Persistent Proteinuria using Urine Protein/Creatinine ...

    African Journals Online (AJOL)

    Those with persistent proteinuria were quantitated using the modified Biuret method while urine creatinine was measured with the modified Jaffe Kinetic method (done with the Biolabo creatinine kit). Urine protein:creatinine ratios > 0.20 were confirmed as persistent proteinuria. Results: Out of the 1,600 pupil, 761(47.6%) ...

  1. Relation of albumin/creatinine ratio to C-reactive protein and to the metabolic syndrome.

    Science.gov (United States)

    Messerli, Adrian W; Seshadri, Niranjan; Pearce, Gregory L; Sachar, Ravish; Hoogwerf, Byron J; Sprecher, Dennis L

    2003-09-01

    We hypothesized that the association of high sensitivity C-reactive protein (CRP) with urinary albumin excretion (UAE) is predominately mediated through its correlation with the metabolic syndrome. Serum CRP and urine albumin:creatinine ratios (ACR) from 720 preventive cardiology patients were analyzed to estimate age- and gender-adjusted relative risk of high CRP and metabolic syndrome for high ACR. These data demonstrate that CRP independently predicts the presence of UAE, a marker of endothelial dysfunction.

  2. A probiotic mixture including galactooligosaccharides decreases fecal β-glucosidase activity but does not affect serum enterolactone concentration in men during a two-week intervention.

    Science.gov (United States)

    Kekkonen, Riina A; Holma, Reetta; Hatakka, Katja; Suomalainen, Tarja; Poussa, Tuija; Adlercreutz, Herman; Korpela, Riitta

    2011-05-01

    A high serum concentration of enterolactone, an enterolignan produced by colonic microbiota from precursors in cereals, vegetables, and fruits, is associated with reduced risk of acute coronary events. Probiotics and prebiotics modify colonic metabolism and may affect the serum enterolactone concentration. The effects of a probiotic mixture alone and with galactooligosaccharides (GOS) on serum enterolactone concentration and fecal metabolism were investigated in 18 healthy men. Participants received 3 interventions, each for 2 wk: 1) probiotics [Lactobacillus rhamnosus strains GG (LGG) and LC705, Propionibacterium freudenreichii ssp. shermanii JS, and Bifidobacterium breve Bb99, for a total amount of 2 × 10(10) CFU/d]; 2) probiotics and GOS 3.8 g/d; 3) probiotics, GOS, and rye bread (minimum 120 g/d). Serum enterolactone and fecal dry weight, enzyme activities, pH, SCFA, lactic acid bacteria, bifidobacteria, propionibacteria, and the strains LGG and LC705 were determined. The serum enterolactone concentration (nmol/L) tended to be decreased from baseline [mean (95% CI) 18.6 (10.8-26.4)] by probiotics alone [15.2 (7.8-22.7); P = 0.095], was not significantly affected by probiotics with GOS [21.5 (13.2-29.8)], and was increased by probiotics with GOS and rye bread [24.6 (15.4-33.7); P < 0.05]. Probiotics alone did not affect fecal β-glucosidase activity and bifidobacteria, but probiotics with GOS decreased β-glucosidase activity and increased bifidobacteria compared with baseline (P < 0.05) and with probiotics alone (P < 0.01). In conclusion, this probiotic mixture with or without GOS does not significantly affect serum enterolactone concentration. Because probiotics with GOS decreased fecal β-glucosidase activity but not serum enterolactone, the reduced fecal β-glucosidase, within the range of activities measured, does not seem to limit the formation of enterolactone.

  3. Role of calculated glomerular filtration rate using percutaneous nephrostomy creatinine clearance in the era of radionuclide scintigraphy

    Directory of Open Access Journals (Sweden)

    Sunil Raghunath Patil

    2017-01-01

    Conclusions: GFR based on radionuclide scintigraphy may be insufficient for evaluation of residual renal function to determine the management of obstructed kidney with borderline function. For adequate decision-making, other factors including creatinine clearance via PCN should also be considered. Gates method tends to overestimate GFR as compared to calculated creatinine clearance at low GFR levels.

  4. 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.

  5. Diagnosis of premature rupture of membranes by assessment of urea and creatinine in vaginal washing fluid.

    Science.gov (United States)

    Kariman, Nourossadat; Afrakhte, Maryam; Hedayati, Mehdi; Fallahian, Masoumeh; Alavi Majd, Hamid

    2013-02-01

    Rupture of fetal membranes can occur at any gestational age. Premature rupture of membranes (PROM) means rupture of fetal membranes before the onset of labor. The purpose of this study was to evaluate and compare the reliability of the vaginal washing fluid urea and creatinine for the diagnosis of PROM and to determine cut-off values. A total of 179 pregnant women were recruited. All patients underwent different examinations. These included nitrazine paper test, fern test, amniotic fluid pooling, vaginal washing fluid urea and creatinine sampling. The one group consisted of 126 pregnant women between 14 and 41 weeks of gestation with the complaint of vaginal fluid leakage. Patients who had positive pooling, nitrazine paper test and fern test were considered as confirmed PROM group (group 1). On the other side, patients with pooling (-) and/or nitrazine paper test (-) and/or fern test (-) were taken as suspected unconfirmed PROM cases (group 2). The control group consisted of 53 pregnant women between 14 and 41 weeks of gestation without any complaint or complication. Weconducted one-way ANOVA test on the urea and creatinine measures and post-hoc comparison test. Cut-off value was determined by receiver operating characteristic (ROC) curve. Vaginal fluid concentrations of urea and creatinine were significantly different between the three groups (pmembranes by evaluation of vaginal fluid creatinine concentration with a cut-off value of 0.45 mg/dl, respectively. This study demonstrates that of two markers investigated creatinine has the higher diagnostic power.

  6. A comparison of observed versus estimated baseline creatinine for determination of RIFLE class in patients with acute kidney injury

    NARCIS (Netherlands)

    Bagshaw, Sean M.; Uchino, Shigehiko; Cruz, Dinna; Bellomo, Rinaldo; Morimatsu, Hiroshi; Morgera, Stanislao; Schetz, Miet; Tan, Ian; Bouman, Catherine; Macedo, Etienne; Gibney, Noel; Tolwani, Ashita; Oudemans-van Straaten, Heleen M.; Ronco, Claudio; Kellum, John A.; French, Craig; Mulder, John; Pinder, Mary; Roberts, Brigit; Botha, John; Mudholkar, Pradeen; Holt, Andrew; Hunt, Tamara; Honoré, Patrick Maurice; Clerbaux, Gaetan; Schetz, Miet Maria; Wilmer, Alexander; Yu, Luis; Macedo, Ettiene V.; Laranja, Sandra Maria; Rodrigues, Cassio José; Suassuna, José Hermógenes Rocco; Ruzany, Frederico; Campos, Bruno; Leblanc, Martine; Senécal, Lynne; Gibney, R. T. Noel; Johnston, Curtis; Brindley, Peter; Tan, Ian K. S.; Chen, Hui De; Wan, Li; Rokyta, Richard; Krouzecky, Ales; Neumayer, Hans-Helmut; Detlef, Kindgen-Milles; Mueller, Eckhard; Tsiora, Vicky; Sombolos, Kostas; Mustafa, Iqbal; Suranadi, Iwayan; Bar-Lavie, Yaron; Nakhoul, Farid; Ceriani, Roberto; Bortone, Franco; Zamperetti, Nereo; Pappalardo, Federico; Marino, Giovanni; Calabrese, Prospero; Monaco, Francesco; Liverani, Chiara; Clementi, Stefano; Coltrinari, Rosanna; Marini, Benedetto; Fuke, Nobuo; Miyazawa, Masaaki; Katayama, Hiroshi; Kurasako, Toshiaki; Hirasawa, Hiroyuki; Oda, Shigeto; Tanigawa, Koichi; Tanaka, Keiichi; Oudemans-van Straaten, Helena Maria; de Pont, Anne-Cornelie J. M.; Bugge, Jan Frederik; Riddervold, Fridtjov; Nilsen, Paul Age; Julsrud, Joar; Teixeira e Costa, Fernando; Marcelino, Paulo; Serra, Isabel Maria; Yaroustovsky, Mike; Grigoriyanc, Rachik; Lee, Kang Hoe; Loo, Shi; Singh, Kulgit; Barrachina, Ferran; Llorens, Julio; Sanchez-Izquierdo-Riera, Jose Angel; Toral-Vazquez, Darío; Wizelius, Ivar; Hermansson, Dan; Gaspert, Tomislav; Maggiorini, Marco; Davenport, Andrew; Lombardi, Raúl; Llopart, Teresita; Venkataraman, Ramesh; Kellum, John; Murray, Patrick; Trevino, Sharon; Benjamin, Ernest; Hufanda, Jerry; Paganini, Emil; Warnock, David; Guirguis, Nabil

    2009-01-01

    The RIFLE classification scheme for acute kidney injury (AKI) is based on relative changes in serum creatinine (SCr) and on urine output. The SCr criteria, therefore, require a pre-morbid baseline value. When unknown, current recommendations are to estimate a baseline SCr by the MDRD equation.

  7. An analysis on the roles of angiogenesis-related factors including serum vitamin D, soluble endoglin (sEng), soluble fms-like tyrosine kinase 1 (sFlt1), and vascular endothelial growth factor (VEGF) in the diagnosis and severity of late-onset preeclampsia.

    Science.gov (United States)

    Cim, Numan; Kurdoglu, Mertihan; Ege, Serhat; Yoruk, Ibrahim; Yaman, Gorkem; Yildizhan, Recep

    2017-07-01

    The aim of this study was to evaluate the roles of proangiogenic factors including serum vitamin D and vascular endothelial growth factor (VEGF) and anti-angiogenic factors including soluble endoglin (sEng) and soluble fms-like tyrosine kinase 1 (sFlt1) in the diagnosis and severity of late-onset preeclampsia. The study was conducted at Yuzuncu Yil University Research and Education Hospital Department of Gynecology and Obstetrics. The study included a patient group of 40 women with late-onset preeclampsia who were pregnant at ≥32 weeks of gestation according to the last menstrual period (LMP) or ultrasonographic fetal biometric measurement and a control group of 40 healthy pregnant women who presented to our clinic for routine pregnancy examination and were at the same age and gestational period with those in the patient group. The two groups were compared in terms of maternal age, gravida, parity, week of gestation, systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, white blood cell (WBC), hemoglobin (Hgb), platelet count, urea, creatinine, liver function tests (AST, ALT, LDH), vitamin D 3 , 25(OH) vitamin D 3 , 1,25(OH) vitamin D 3 , sEng, sFlt1, and VEGF levels, mode of delivery, the infant APGAR score at 1 and 5 min after delivery, and infant weight at delivery. The groups were similar in terms of age, gravida, parity, week of gestation, serum vitamin D 3 , 25(OH) vitamin D 3 , 1,25(OH) 2 vitamin D 3 and VEGF levels, and infant weight at delivery (p > 0.05). Systolic/diastolic blood pressure, total protein in spot urine sample, 24-h urine protein, WBC, Hgb, serum urea, creatine, AST, ALT, and LDH were significantly higher in the preeclamptic group compared to the healthy group (p preeclampsia compared to the women with mild preeclampsia (p preeclampsia (p > 0.05). Both sEng and sFlt1 levels are remarkably high in patients with late-onset preeclampsia; however, only sEng may be a useful tool in the

  8. Synthesis, Characterization and Biological Activities of Creatinine Amides and Creatinine Schiff Bases.

    Science.gov (United States)

    Mumtaz, Amara; Zahoor, Fareeha; Zaib, Sumera; Nawaz, Muhammad Azhar H; Saeed, Aamer; Waseem, Amir; Khan, Afsar; Hussain, Izhar; Iqbal, Jamshed

    2017-01-30

    In spite of substantial progress in scientific cognizance and medical technology, still infectious diseases are among the leading cause of morbidity and mortality. Creatinine and Schiff bases are well known for their diverse range of biological activities and thought to be emerging and useful therapeutic target for the treatment of several diseases. The present work was aimed to illustrate the influence of substitution of amides and Schiff bases on creatinine and their antimicrobial, antioxidant and anti-urease effectiveness was determined. Creatinine substituted amides (1-2) and creatinine Schiff bases (3-7) were synthesized and characterized by NMR and IR spectral data in combination with elemental analysis. All the compounds (1-7) were investigated on Jack bean urease for their urease inhibitory potential. Investigation of antimicrobial activity of the compounds was made by the agar dilution method. Moreover, 1,1-diphenyl-2- picrylhydrazyl (DPPH) method was used to determine their antioxidant potential. Molecular docking studies were also carried out to elucidate their relationship with the binding pockets of the enzyme. The compounds were found to be potent inhibitors of urease. The synthesized derivatives exhibited significant inhibition against Gram-positive and Gram-negative bacterial strains, as compared to standard, ciprofloxacin. Creatinine based derivatives exhibited potential antifungal activity when tested on infectious and pathogenic fungal strains. Similarly, most of the compounds exhibited good antioxidant activity. These derivatives may serve as a source of potential antioxidants and also help to retard microbial growth in food industry. Similarly, the studies provide a basis for further research to develop more potent urease inhibitory compounds of medicinal /agricultural interest. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Creatinine-based equation to estimate the glomerular filtration rate in Japanese children and adolescents with chronic kidney disease.

    Science.gov (United States)

    Uemura, Osamu; Nagai, Takuhito; Ishikura, Kenji; Ito, Shuichi; Hataya, Hiroshi; Gotoh, Yoshimitsu; Fujita, Naoya; Akioka, Yuko; Kaneko, Tetsuji; Honda, Masataka

    2014-08-01

    Renal inulin clearance is the gold standard for evaluation of kidney function, but cannot be measured easily in children. Therefore, we utilize the serum creatinine (Cr)-based estimated GFR (eGFR) measuring serum Cr by the enzymatic method, and we have reported simple serum Cr-based eGFR in Japanese children aged between 2 and 11 years old. Furthermore, we should use serum Cr-based eGFR in Japanese adolescents as well as children with chronic kidney disease for evaluation of renal function. The inulin clearance and serum Cr level determined by an enzymatic method were measured in 131 pediatric chronic kidney disease (CKD) patients between the ages of 2 and 18 years old with no underlying disease affecting renal function except CKD to determine the serum Cr-based eGFR in Japanese children and adolescents. We offer the complex estimated GFR equation using polynomial formulae for reference serum creatinine levels with body length in Japanese children except infants, resulting in the following equation:[Formula: see text] Reference serum Cr levels (y) are shown by the following two equations of body length (x):[Formula: see text] The new polynomial eGFR formula showing the relationship with body length and serum Cr level may be applicable for clinical screening of renal function in Japanese children and adolescents aged between 2 and 18 years.

  10. Evaluation and comparison of Abbott Jaffe and enzymatic creatinine methods: Could the old method meet the new requirements?

    Science.gov (United States)

    Küme, Tuncay; Sağlam, Barıs; Ergon, Cem; Sisman, Ali Rıza

    2018-01-01

    The aim of this study is to evaluate and compare the analytical performance characteristics of the two creatinine methods based on the Jaffe and enzymatic methods. Two original creatinine methods, Jaffe and enzymatic, were evaluated on Architect c16000 automated analyzer via limit of detection (LOD) and limit of quantitation (LOQ), linearity, intra-assay and inter-assay precision, and comparability in serum and urine samples. The method comparison and bias estimation using patient samples according to CLSI guideline were performed on 230 serum and 141 urine samples by analyzing on the same auto-analyzer. The LODs were determined as 0.1 mg/dL for both serum methods and as 0.25 and 0.07 mg/dL for the Jaffe and the enzymatic urine method respectively. The LOQs were similar with 0.05 mg/dL value for both serum methods, and enzymatic urine method had a lower LOQ than Jaffe urine method, values at 0.5 and 2 mg/dL respectively. Both methods were linear up to 65 mg/dL for serum and 260 mg/dL for urine. The intra-assay and inter-assay precision data were under desirable levels in both methods. The higher correlations were determined between two methods in serum and urine (r=.9994, r=.9998 respectively). On the other hand, Jaffe method gave the higher creatinine results than enzymatic method, especially at the low concentrations in both serum and urine. Both Jaffe and enzymatic methods were found to meet the analytical performance requirements in routine use. However, enzymatic method was found to have better performance in low creatinine levels. © 2017 Wiley Periodicals, Inc.

  11. Selective recognition of creatinine - Development of a colorimetric sensor.

    Science.gov (United States)

    Sivasankaran, Unni; Jos, Theresa Chiramal; Girish Kumar, Krishnapillai

    2018-03-01

    The present report describes a simple and cost effective protocol for colourimetric determination of creatinine (CR), L-cysteine stabilized copper nanoparticles (L-cys-CuNPs) exhibited selective and sensitive interaction with CR. Utilizing this interaction, a colourimetric sensor has been developed based on the reduction in LSPR intensity as monitored by a UV-visible spectrophotometer. The developed sensor exhibited a linear dynamic range of 5.33 × 10 -6 to 3.33 × 10 -7  M. Proposed sensor is simple and cost - effective compared to methods based on noble metal nanoparticles and the sensitivity to determine CR was as low as 4.54 × 10 -10  M. The sensor was successfully applied for quantification of CR in artificial serum and urine samples. Sensor developed in this work has a high potential for rapid and on-site determination of CR in physiological and clinical samples. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Clinical utility of spot urine protein-to-creatinine ratio modified by estimated daily creatinine excretion in children.

    Science.gov (United States)

    Yang, Eun Mi; Yoon, Bo Ae; Kim, Soo Wan; Kim, Chan Jong

    2017-06-01

    The spot urine protein-to-creatinine ratio (UPCR) is widely used to predict 24-h urine protein (24-h UP) excretion. In patients with low daily urine creatinine excretion (UCr), however, the UPCR may overestimate 24-h UP. The aim of this study was to predict 24-h UP using UPCR adjusted by estimated 24-h UCr in children. This study included 442 children whose 24-h UP and spot UPCR were measured concomitantly. Estimated 24-h UCr was calculated using three previously existing equations. We estimated the 24-h UP excretion from UPCR by multiplying the estimated UCr. The results were compared with the measured 24-h UP. There was a strong correlation between UPCR and 24-h UP (r = 0.801, P < 0.001), and the correlation improved after multiplying the UPCR by the measured UCr (r = 0.847, P < 0.001). Using the estimated UCr rather than the measured UCr, there was high accuracy and strong correlation between the estimated UPCR weighted by the Cockcroft-Gault equation and 24-h UP. Improvement was also observed in the subgroup (proteinuria vs. non-proteinuria) analysis, particularly in the proteinuria group. The spot UPCR multiplied by the estimated UCr improved the accuracy of prediction of the 24-h UP in children.

  13. Point-of-care creatinine testing in patients receiving contrast-enhanced computed tomography scan.

    Science.gov (United States)

    Bargnoux, Anne-Sophie; Beaufils, Olivier; Oguike, Maryse; Lopasso, Aurélie; Dupuy, Anne-Marie; Sebbane, Mustapha; Badiou, Stéphanie; Fesler, Pierre; Cristol, Jean-Paul

    2018-03-01

    The aim of this study was to evaluate the creatinine assay on the ABL800 FLEX© blood gas analyzer for the screening of pre-existing renal impairment before radiographic contrast administration in the emergency department (ED), by comparing it with standard practice using central laboratory blood testing. The evaluation comprised two elements. The first, conducted in the central laboratory, focused on the analytical performance of the ABL800 creatinine assay. This included assessment of imprecision and accuracy by comparison with central laboratory standard creatinine assay. We also compared ABL 800 estimated glomerular filtration rate (eGFR) and 99m Tc-DTPA measured GFR (mGFR). The second part, conducted in ED sought to determine the impact that implementation of the creatinine at the point-of-care (POC) has on the timeframe in which ED patients are submitted for computed tomography scan (CT). The ABL800 enzymatic creatinine assay met the National Kidney Disease Education Program acceptance criteria for imprecision and showed good agreement with the isotope dilution mass spectrometry-traceable Roche enzymatic assay used in the central laboratory. Furthermore, ABL800 eGFR was in total agreement with mGFR by a reference method. The implementation of POC testing creatinine in the ED significantly reduced patient waiting times for contrast enhanced CT (1.73[0.75-3.01] vs 2.57 [1.53-3.48] hours, for period with and without ABL800 respectively, p=0.04). The ABL800 assay is comparable with central laboratory reference method in terms of analytical performance and superior in terms of turnaround time. Implementation of creatinine at POC reduces delay results, potentially allowing ED clinical staff to make more rapid clinical decisions and reduce patient waiting time. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. 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

  15. A dietary pattern including nopal, chia seed, soy protein, and oat reduces serum triglycerides and glucose intolerance in patients with metabolic syndrome.

    Science.gov (United States)

    Guevara-Cruz, Martha; Tovar, Armando R; Aguilar-Salinas, Carlos A; Medina-Vera, Isabel; Gil-Zenteno, Lidia; Hernández-Viveros, Isaac; López-Romero, Patricia; Ordaz-Nava, Guillermo; Canizales-Quinteros, Samuel; Guillen Pineda, Luz E; Torres, Nimbe

    2012-01-01

    Metabolic syndrome (MetS) is a health problem throughout the world and is associated with cardiovascular disease and diabetes. Thus, the purpose of the present work was to evaluate the effects of a dietary pattern (DP; soy protein, nopal, chia seed, and oat) on the biochemical variables of MetS, the AUC for glucose and insulin, glucose intolerance (GI), the relationship of the presence of certain polymorphisms related to MetS, and the response to the DP. In this randomized trial, the participants consumed their habitual diet but reduced by 500 kcal for 2 wk. They were then assigned to the placebo (P; n = 35) or DP (n = 32) group and consumed the reduced energy diet plus the P or DP beverage (235 kcal) minus the energy provided by these for 2 mo. All participants had decreases in body weight (BW), BMI, and waist circumference during the 2-mo treatment (P < 0.0001); however, only the DP group had decreases in serum TG, C-reactive protein (CRP), and AUC for insulin and GI after a glucose tolerance test. Interestingly, participants in the DP group with MetS and the ABCA1 R230C variant had a greater decrease in BW and an increase in serum adiponectin concentration after 2 mo of dietary treatment than those with the ABCA1 R230R variant. The results from this study suggest that lifestyle interventions involving specific DP for the treatment of MetS could be more effective if local foods and genetic variations of the population are considered.

  16. Discrepancy between circadian rhythms of inulin and creatinine clearance

    NARCIS (Netherlands)

    van Acker, B. A.; Koomen, G. C.; Koopman, M. G.; Krediet, R. T.; Arisz, L.

    1992-01-01

    To elucidate the disparity between circadian rhythmicity of inulin and creatinine clearance, we simultaneously measured inulin and creatinine clearances every 3 hours during 1 day in 14 normal subjects and in 8 patients with nephrotic syndrome. All patients and normal subjects had a circadian rhythm

  17. Serum cystatin C and urinary neutrophil gelatinase-associated lipocalin in pediatric acute kidney injury; a cross-sectional study

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    Neamatollah Ataei

    2017-10-01

    Full Text Available Background: Acute kidney injury (AKI refers to insults that lead to decreased kidney function within hours to weeks and can be associated with complications including chronic kidney failure, end-stage renal disease and even death. Although various biomarkers have been proposed to predict AKI in children, but no consensus has been reached on the best diagnostic method. Accordingly, the present study aimed to assess the correlation between urine NGAL levels and development of AKI in children and determine which one of the biomarkers of urine NGAL, serum Cystatin C and serum creatinine has a stronger association with AKI in the pediatric population. Methods: The present cross-sectional study was conducted on children younger than 14 years of age, hospitalized in the intensive care unit of Children’s Medical Centre in Tehran, Iran, during 2016. Urine NGAL, serum Cystatin C and serum creatinine levels of these subjects were measured on admission to the intensive care unit. The concentrations of serum Cystatin C and serum creatinine were measured again after 48 hours to determine the AKI status of the subjects. Data were analyzed to determine the association between GFR and the concentrations of evaluated biomarkers and to compare the levels of biomarkers between the four groups of no AKI, injury, failure, loss and end-stage. Results: A total of 104 children (59 boys and 45 girls, average age=28.0±3.5 months were included in this study. The mean level of uNGAL on admission in the No-AKI group (153.79±29.82 was significantly lower than the children in the injury (1225.0 ±275.0 and failure (756.56±147.79 groups (df:3, 100; F=10.74; p<0.0001. The mean concentration of Cystatin C on admission in the three groups of risk (0.94±0.30, injury (1.75±0.05 and failure (1.75±0.36 was also significantly higher than the No-AKI (0.27±0.04 (df:3, 100; F=19.21; p<0.0001. However, there was no significant correlation between the level of serum creatinine on

  18. Association of serum adiponectin level with albuminuria in chronic kidney disease patients.

    Science.gov (United States)

    Kim, Ha Yeon; Bae, Eun Hui; Ma, Seong Kwon; Chae, Dong Wan; Choi, Kyu Hun; Kim, Yong-Soo; Hwang, Young-Hwan; Ahn, Curie; Kim, Soo Wan

    2016-06-01

    Adiponectin, a peptide hormone secreted from adipocytes, exerts anti-diabetic, anti-atherogenic, and anti-inflammatory properties. We aimed to determine the relationship between serum adiponectin levels and albuminuria, and evaluate determinant factors for serum adiponectin in patients with chronic kidney disease (CKD). In total, 1442 CKD patients were included and divided into three groups according to their albumin-to-creatinine ratios: patients with normoalbuminuria (N = 228), microalbuminuria (N = 444), and macroalbuminuria (N = 761). Serum adiponectin was specifically assayed with a commercially available enzyme-linked immunosorbent assay kit. Serum adiponectin was significantly higher in patients with macroalbuminuria than in those without macroalbuminuria (9.7 ± 6.0, 12.4 ± 9.0, and 14.9 ± 11.0 μg/mL in patients with normoalbuminuria, microalbuminuria, and macroalbuminuria, respectively). Univariate linear regression analysis showed that the serum adiponectin concentrations were correlated with age, the albumin-to-creatinine ratio, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol, whereas they were negatively correlated with body mass index, the estimated glomerular filtration rate, and serum albumin and triglyceride levels. The stepwise regression multiple analysis showed that sex; the estimated glomerular filtration rate; body mass index; total cholesterol, high-density lipoprotein cholesterol, and triglyceride levels; and logarithm of the albumin-to-creatinine ratio were independently associated with the logarithm of serum adiponectin levels (r = 0.55, p albuminuria, and these levels are associated with renal insufficiency and lipid profiles.

  19. Performance Characteristics of Kidney Injury Molecule-1 In Relation to Creatinine, Urea, and Microalbuminuria in the Diagnosis of Kidney Disease.

    Science.gov (United States)

    Sinkala, Musalula; Zulu, Mildred; Kaile, Trevor; Simakando, Marah; Chileshe, Chisanga; Kafita, Doris; Nkhoma, Panji

    2017-01-01

    The diagnosis and evaluation of impaired renal function remains a challenge owing to lack of reliable biomarker for assessment of kidney function. The existing panel of biomarkers currently displays several limitations, and recently kidney injury molecule-1 (KIM-1) has been suggested as a sensitive biomarker of renal function and proposed to enter clinical practice. This study was conducted to determine the diagnostic value of serum creatinine, urea, and microalbuminuria (MAU) in relation to the novel biomarker, KIM-1. Serum creatinine, urea, MAU, and KIM-1 were measured in forty individuals with and forty without kidney disease. Data were analyzed using multivariate methods of assessing diagnostic efficiency, test agreement, condition effects, and variability. The area under the receiver-operator characteristic curve revealed a diagnostic advantage of creatinine (0.924 ± 0.0066) and urea (0.925 ± 0.0068) over MAU (0.880 ± 0.078) and KIM-1 (0.35 ± 0.124). Overall diagnostic efficiency was higher for creatinine and urea (89.5% and 90.9%, respectively), followed by MAU (85.7%) and then KIM-1 (56.3%). Logistic regression analysis showed that creatinine and urea ( R 2 = 0.75 and R 2 = 0.72, respectively, P < 0.001 for both) were better predictors of kidney disease than MAU ( R 2 = 0.64, P < 0.001) and KIM-1 ( R 2 = 0.046, P = 0.116). Further analysis of agreement showed that urea had an excellent agreement with creatinine (kappa r = 0.835, P < 0.001), with KIM-1 (kappa r = -0.198, P = 0.087) showing a poor agreement with creatinine. Our results indicate that elevated serum creatinine and urea above specific cutoff points reliably identifies patients with acute kidney injury or chronic kidney disease. However, more researches are warranted to further validate the diagnostic efficiency and application of MAU and for KIM-1 before its implementation in clinical practice.

  20. Cystatin C levels in healthy kidney donors and its correlation with GFR by creatinine clearance

    International Nuclear Information System (INIS)

    Ayub, S.; Khan, S.; Zafar, M.N.

    2014-01-01

    Objective: To determine Serum Cystatin C (S.CysC) levels in healthy potential kidney donors and its correlation with Serum Creatinine (S.Cr), Glomerular filtration rate (GFR) by 24 hour urinary Creatinine clearance (CCL) and GFR by formulae of Cockcroft Gault (CCG) and Modification of diet in Renal Disease (MDRD). Methods: A Cross sectional study was conducted at Sindh Institute of Urology and Transplantation (SIUT), Karachi, between June and December 2012. One hundred and three potential healthy kidney donors were enrolled in the study to measure their S.CysC and correlate it with S.Cr, CCL and GFR by CCG and MDRD. Statistical analysis was done by SPSS 17. Results: The mean age of the healthy kidney donors was 32.19+8.27 years with a M:F ratio of 1.86:1. The mean Serum Creatinine (S.Cr) was 0.86+0.18 mg/dl and mean S.CysC was 0.88+0.12 mg/dl. S.CysC showed significant correlation with S.Cr (r = 0.78, p<0.001), CCL (r = 0.67, p<0.001), GFR CCG (r = 0.54, p<0.001) and GFR MDRD (r = 0.67, p<0.001). Correlation of S.CysC was better than S.Cr for CCL, S.Cr (0.60) vs S.CysC (0.67) and GFR CCG, S.Cr (0.41) vs S.CysC (0.54). Correlation was comparable for MDRD, S.Cr (0.67) vs S.Cys (0.67). Conclusion: S.CysC is better marker of kidney function in potential healthy kidney donors. It is a reliable, convenient and economical marker that can be used especially in routine clinical practice. (author)

  1. Creatinine and urea biosensors based on a novel ammonium ion-selective copper-polyaniline nano-composite.

    Science.gov (United States)

    Zhybak, M; Beni, V; Vagin, M Y; Dempsey, E; Turner, A P F; Korpan, Y

    2016-03-15

    The use of a novel ammonium ion-specific copper-polyaniline nano-composite as transducer for hydrolase-based biosensors is proposed. In this work, a combination of creatinine deaminase and urease has been chosen as a model system to demonstrate the construction of urea and creatinine biosensors to illustrate the principle. Immobilisation of enzymes was shown to be a crucial step in the development of the biosensors; the use of glycerol and lactitol as stabilisers resulted in a significant improvement, especially in the case of the creatinine, of the operational stability of the biosensors (from few hours to at least 3 days). The developed biosensors exhibited high selectivity towards creatinine and urea. The sensitivity was found to be 85 ± 3.4 mAM(-1)cm(-2) for the creatinine biosensor and 112 ± 3.36 mAM(-1)cm(-2) for the urea biosensor, with apparent Michaelis-Menten constants (KM,app), obtained from the creatinine and urea calibration curves, of 0.163 mM for creatinine deaminase and 0.139 mM for urease, respectively. The biosensors responded linearly over the concentration range 1-125 µM, with a limit of detection of 0.5 µM and a response time of 15s. The performance of the biosensors in a real sample matrix, serum, was evaluated and a good correlation with standard spectrophotometric clinical laboratory techniques was found. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Association between serum interleukin-6 and serum 3,5,3'-triiodothyronine in nonthyroidal illness

    NARCIS (Netherlands)

    Boelen, A.; Platvoet-ter Schiphorst, M. C.; Wiersinga, W. M.

    1993-01-01

    Increased serum concentrations of FFA, bilirubin, and carboxyl-methyl-propyl-furanpropionic acid, accumulating in chronic renal failure in direct relationship with serum creatinine, have all been implicated in the pathogenesis of the low T3 syndrome during illness. Cytokines may also be involved in

  3. Random urine protein creatinine ratio as a preadmission test in hypertensive pregnancies with urinary protein creatinine ratio.

    Science.gov (United States)

    Eslamian, Laleh; Behnam, Fariba; Tehrani, Zahra Foroohesh; Jamal, Ashraf; Marsoosi, Vajiheh

    2011-01-01

    To evaluate the value of random urinary protein creatinine ratio in prediction of 24h proteinuria in hypertensive pregnancies. Random urine samples and routine 24h urine collections were collected from hypertensive pregnant women (n=100). Reliability of random urinary protein-creatinine ratio was assessed by receiver operator characteristic (ROC) curve to detect significant proteinuria (≥300mg/day) using 24h. Urine protein as a gold standard. Forty six patients (46%) had significant proteinuria. The random protein creatinine ratio was correlated to 24h urine protein excretion (r(2)=0.777, Pprotein creatinine ratio best predicted significant proteinuria with sensitivity, specificity, positive and negative predictive values of 87%, 92.6%, 90.6% and 89.3% respectively. Random urinary protein creatinine ratio is a simple inexpensive and excellent alternative to 24h urine collection. It's helpful in diagnosis of preeclampsia and can be used as a pre admission test in PIH cases.

  4. 17-Year-Old Boy with Renal Failure and the Highest Reported Creatinine in Pediatric Literature

    Directory of Open Access Journals (Sweden)

    Vimal Master Sankar Raj

    2015-01-01

    Full Text Available The prevalence of chronic kidney disease (CKD is on the rise and constitutes a major health burden across the world. Clinical presentations in early CKD are usually subtle. Awareness of the risk factors for CKD is important for early diagnosis and treatment to slow the progression of disease. We present a case report of a 17-year-old African American male who presented in a life threatening hypertensive emergency with renal failure and the highest reported serum creatinine in a pediatric patient. A brief discussion on CKD criteria, complications, and potential red flags for screening strategies is provided.

  5. Urine Albumin-Creatinine Ratio Versus Albumin Excretion for Albuminuria Staging : A Prospective Longitudinal Cohort Study

    NARCIS (Netherlands)

    Vart, Priya; Scheven, Lieneke; Lambers Heerspink, Hiddo J; de Jong, Paul E; de Zeeuw, Dick; Gansevoort, Ron T

    Background: New guidelines advocate the use of albumin-creatinine ratio (ACR) in a urine sample instead of 24-hour urinary albumin excretion (UAE) for staging albuminuria. Concern has been expressed that this may result in misclassification for reasons including interindividual differences in

  6. Diagnosis of premature rupture of membranes by assessment of urea and creatinine in vaginal washing fluid

    Science.gov (United States)

    Kariman, Nourossadat; Afrakhte, Maryam; Hedayati, Mehdi; Fallahian, Masoumeh; Alavi Majd, Hamid

    2013-01-01

    Background: Rupture of fetal membranes can occur at any gestational age. Premature rupture of membranes (PROM) means rupture of fetal membranes before the onset of labor. Objective: The purpose of this study was to evaluate and compare the reliability of the vaginal washing fluid urea and creatinine for the diagnosis of PROM and to determine cut-off values. Materials and Methods: A total of 179 pregnant women were recruited. All patients underwent different examinations. These included nitrazine paper test, fern test, amniotic fluid pooling, vaginal washing fluid urea and creatinine sampling. The one group consisted of 126 pregnant women between 14 and 41 weeks of gestation with the complaint of vaginal fluid leakage. Patients who had positive pooling, nitrazine paper test and fern test were considered as confirmed PROM group (group 1). On the other side, patients with pooling (-) and/or nitrazine paper test (-) and/or fern test (-) were taken as suspected unconfirmed PROM cases (group 2). The control group consisted of 53 pregnant women between 14 and 41 weeks of gestation without any complaint or complication. Weconducted one-way ANOVA test on the urea and creatinine measures and post-hoc comparison test. Cut-off value was determined by receiver operating characteristic (ROC) curve. Results: Vaginal fluid concentrations of urea and creatinine were significantly different between the three groups (p<0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were all 100% in detecting premature rupture of membranes by evaluation of vaginal fluid creatinine concentration with a cut-off value of 0.45 mg/dl, respectively. Conclusion: This study demonstrates that of two markers investigated creatinine has the higher diagnostic power. PMID:24639733

  7. Paper-based Platform for Urinary Creatinine Detection.

    Science.gov (United States)

    Sittiwong, Jarinya; Unob, Fuangfa

    2016-01-01

    A new paper platform was developed for the colorimetric detection of creatinine. The filter paper was coated with 3-propylsulfonic acid trimethoxysilane and used as the platform. Creatinine in a cationic form was extracted onto the paper via an ion-exchange mechanism and detected through the Jaffé reaction, resulting in a yellow-orange color complex. The color change on the paper could be observed visually, and the quantitative detection of creatinine was achieved through monitoring the color intensity change. The color intensity of creatinine complexes on the paper platform as a function of the creatinine concentration provided a linear range for creatinine detection in the range of 10 - 60 mg L(-1) and a detection limit of 4.2 mg L(-1). The accuracy of the proposed paper-based method was comparable to the conventional standard Jaffé method. This paper platform could be applied for simple and rapid detection of creatinine in human urine samples with a low consumption of reagent.

  8. Multicommutated flow analysis system for determination of creatinine in physiological fluids by Jaffe method.

    Science.gov (United States)

    Tymecki, Łukasz; Korszun, Jakub; Strzelak, Kamil; Koncki, Robert

    2013-07-17

    For the needs of photometric determination of creatinine according to Jaffe protocol a dedicated paired emitter detector diode (PEDD) detector has been developed. This PEDD device has been constructed in the compact form of flow-through cell (30 μL total volume and 7 mm optical pathlength) integrated with 505 nm LED-based emitter and 525 nm LED-based detector compatible with multicommutated flow analysis (MCFA) system. This fully mechanized MCFA system configured of microsolenoid valves and pumps is operating under microprocessor control. The developed analytical system offers determination of creatinine in the submillimolar range of concentrations with detection limit at ppm level. The throughput offered by the system operating according to multi-point fixed-time procedure for kinetic measurements is 15-40 samples per hour depending on the mode of measurements. The developed PEDD-based MCFA system has been successfully applied for the determination of creatinine in real samples of human urine as well as serum. The developed sampling unit used the system is free from effects caused by differences in sample viscosity. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. DETERMINATION OF PLASMA LEVELS OF UREA AND CREATININE IN PANTANAL HORSES POCONÉ REGION - MT

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    M. R. Guazina

    2016-09-01

    Full Text Available This study aimed to determine the plasma levels of urea and creatinine, besides evaluating the influence of sex and age factors on these substances in Pantaneiros horses, animals of high economic and social importance in the Pantanal. In Poconé-MT region, 80 animals were used, which were divided into four groups: Group 1: male foals (n= 20, aged 8 months and 2 years, Group 2: female foals (n= 20, aged 8 months and 2 years, Group 3: adult males (n= 20, aged from 3 years, Group 4: adult females (n= 20, aged from 3 years. All animals were classified as healthy after clinical examinations, as well as serum negativity for Equine Infectious Anemia (EIA. Blood samples for subsequent laboratory analysis were taken from the jugular vein. The mean values of urea and creatinine found for Pantaneiros horses were similar to other breeds of horses and did not vary influenced by the sexual factor, however plasma levels of creatinine increased with the age

  10. Comparison of Different Measures of Fat Mass and Their Association with Serum Cystatin C Levels

    Directory of Open Access Journals (Sweden)

    Boon Wee Teo

    2014-01-01

    Full Text Available Introduction. Cystatin C (CysC is a glomerular filtration rate (GFR marker affected by GFR and obesity. Because percentage body fat (%BF distribution is affected by ethnicity, different measures of %BF may improve CysC prediction. This study aims to create multivariate models that predict serum CysC and determine which %BF metric gives the best prediction. Methods. Serum CysC was measured by nephelometric assay. We estimated %BF by considering weight, body mass index, waist-hip ratio, triceps skin fold, bioimpedance, and Deurenberg and Yap %BF equations. A base multivariate model for CysC was created with a %BF metric added in turn. The best model is considered by comparing P values, R2, Akaike information criterion (AIC, and Bayesian information criterion (BIC. Results. There were 335 participants. Mean serum CysC and creatinine were 1.27 mg/L and 1.44 mg/dL, respectively. Variables for the base model were age, gender, ethnicity, creatinine, serum urea, c-reactive protein, log GFR, and serum albumin. %BF had a positive correlation with CysC. The best model for predicting CysC included bioimpedance-derived %BF (P=0.0011, with the highest R2 (0.917 and the lowest AIC and BIC (−371, −323. Conclusion. Obesity is associated with CysC, and the best predictive model for CysC includes bioimpedance-derived %BF.

  11. Effect of ultraviolet light on creatinine measurement in jaundiced specimens

    International Nuclear Information System (INIS)

    Nisbet, J.A.; D'Souza, R.

    1986-01-01

    During initial evaluation of a creatinine method using the RA-1000 analyser, experiments with addition of bilirubin indicated negligible interference. However the finding of a 'zero' creatinine value in an extremely jaundiced specimen prompted to re-examine the method. In contrast to earlier findings with normal plasma containing added bilirubin, the authors found that plasma from moderately or severely jaundiced patients gave creatinine values lower than those obtained with a reference method. Since bilirubin has been implicated in the interference, the authors studied the effect of destroying bilirubin with ultraviolet light to see if this provided a practical solution to the problem. (Auth.)

  12. Decrease in urinary creatinine excretion in early stage chronic kidney disease.

    Directory of Open Access Journals (Sweden)

    Elena Tynkevich

    Full Text Available BACKGROUND: Little is known about muscle mass loss in early stage chronic kidney disease (CKD. We used 24-hour urinary creatinine excretion rate to assess determinants of muscle mass and its evolution with kidney function decline. We also described the range of urinary creatinine concentration in this population. METHODS: We included 1072 men and 537 women with non-dialysis CKD stages 1 to 5, all of them with repeated measurements of glomerular filtration rate (mGFR by (51Cr-EDTA renal clearance and several nutritional markers. In those with stage 1 to 4 at baseline, we used a mixed model to study factors associated with urinary creatinine excretion rate and its change over time. RESULTS: Baseline mean urinary creatinine excretion decreased from 15.3 ± 3.1 to 12.1 ± 3.3 mmol/24 h (0.20 ± 0.03 to 0.15 ± 0.04 mmol/kg/24 h in men, with mGFR falling from ≥ 60 to <15 mL/min/1.73 m(2, and from 9.6 ± 1.9 to 7.6 ± 2.5 (0.16 ± 0.03 to 0.12 ± 0.03 in women. In addition to mGFR, an older age, diabetes, and lower levels of body mass index, proteinuria, and protein intake assessed by urinary urea were associated with lower mean urinary creatinine excretion at baseline. Mean annual decline in mGFR was 1.53 ± 0.12 mL/min/1.73 m(2 per year and that of urinary creatinine excretion rate, 0.28 ± 0.02 mmol/24 h per year. Patients with fast annual decline in mGFR of 5 mL/min/1.73 m(2 had a decrease in urinary creatinine excretion more than twice as big as in those with stable mGFR, independent of changes in urinary urea as well as of other determinants of low muscle mass. CONCLUSIONS: Decrease in 24-hour urinary creatinine excretion rate may appear early in CKD patients, and is greater the more mGFR declines independent of lowering protein intake assessed by 24-hour urinary urea. Normalizing urine analytes for creatininuria may overestimate their concentration in patients with reduced kidney function and low muscle mass.

  13. Urine Neutrophil Gelatinase Associated Lipocalin to Creatinine Ratio: A Novel Index for Steroid Response in Idiopathic Nephrotic Syndrome.

    Science.gov (United States)

    Nickavar, Azar; Safaeian, Baranak; Sadeghi-Bojd, Simin; Lahouti Harah dashti, Arash

    2016-01-01

    To find the value of urine neutrophil gelatinase associated lipocalin (NGAL) in differentiating steroid response in children with idiopathic nephrotic syndrome (INS). A total of 52 children with INS (n = 27, steroid resistant; n = 25, steroid responsive) aged 1-16 y, along with 18 healthy control children were enrolled in this study. Urine NGAL as well as urine protein, and serum creatinine were analyzed during active phase of INS. Serum creatinine (P 0.032), and urine NGAL/Cr (P 0.001) were significantly higher in steroid resistant than steroid sensitive patients. The optimal cutoff value for urine NGAL/Cr with the highest sensitivity and specificity was 0.46 ng/mg and cut off value of 0.01 and 1.15 ng/mg had maximum sensitivity and specificity, respectively. Urine NGAL/Cr could be considered as a marker of steroid resistance in children with idiopathic nephrotic syndrome.

  14. Comparison of the endogenous creatinine clearance, the creatinin clearance calculated without urine collection and the isotope clearance

    International Nuclear Information System (INIS)

    Mohacsi, Gabor; Lang, Jenoe; Csernay, Laszlo; Sonkodi, Sandor; Orvostudomanyi Egyetem, Szeged

    1987-01-01

    Observations are reported relating to the endogenous creatinine clearance, the Tc-99m-EDTA-complex clearance and the creatinine clearance estimated via a selected mathematical formula, with special regard to the problems of renal insufficiency and the nephrotic syndrome. The activity applied was in the range of 3.7-7.4 MBq. It was observed that measurement of the isotope clearance can also be applied to determine the endogeneous creatinine clearance in otherwise less suitable patients. A reliable result is obtained even if the renal function is restricted, but the accuracy of the method may be reduced in nephrotic syndrome cases. (author) 24 refs

  15. Serum Soluble (ProRenin Receptor Levels in Maintenance Hemodialysis Patients.

    Directory of Open Access Journals (Sweden)

    Yoshifumi Amari

    Full Text Available The (prorenin receptor [(PRR] is cleaved by furin to generate soluble (PRR [s(PRR], which reflects the status of the tissue renin-angiotensin system. Hemodialysis patients have advanced atherosclerosis. The aim of this study was to investigate the relationships between serum s(PRR levels and background factors, including indices of atherosclerosis, in hemodialysis patients. Serum s(PRR levels were measured in hemodialysis patients and clearance of s(PRR through the membrane of the dialyzer was examined. Furthermore, relationships between serum s(PRR levels and background factors were assessed. Serum s(PRR levels were significantly higher in hemodialysis patients (30.4 ± 6.1 ng/ml, n = 258 than those in subjects with normal renal function (21.4 ± 6.2 ng/ml, n = 39, P < 0.0001. Clearance of s(PRR and creatinine were 56.9 ± 33.5 and 147.6 ± 9.50 ml/min, respectively. Serum s(PRR levels were significantly higher in those with ankle-brachial index (ABI of < 0.9, an indicator of severe atherosclerosis, than those with ABI of ≥ 0.9 (32.2 ± 5.9 and 30.1 ± 6.2 ng/ml, respectively, P < 0.05. An association between low ABI and high serum s(PRR levels was observed even after correction for age, history of smoking, HbA1c, and LDL-C. Serum s(PRR levels were significantly higher in hemodialysis patients when compared with subjects with normal renal function, although s(PRR is dialyzed to some extent, but to a lesser extent than creatinine. High serum s(PRR levels may be associated with atherosclerosis independent of other risk factors, suggesting that serum s(PRR could be used as a marker for atherosclerotic conditions in hemodialysis patients.

  16. Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement

    NARCIS (Netherlands)

    Knight, E.L.; Verhave, Jacobien C.; Spiegelman, D.; Hillege, Hans; Curhan, G.C.; De Jong, Paul E.; de Zeeuw, Dick

    Factors influencing serum cystatin C levels other than renal function and the impact on renal function measurement. Background It is well known that serum creatinine may be used as a marker of renal function only if taking into account factors that influence creatinine production, such as age,

  17. Clinical significance of serum and urinary HER2/neu protein levels in primary non-muscle invasive bladder cancer

    Directory of Open Access Journals (Sweden)

    Ozgur Arikan

    2015-12-01

    Full Text Available Objective: We aimed to compare serum and urinary HER2/neu levels between healthy control group and patients with non-muscle invasive bladder cancer. Additionally, we evaluated relationship of HER2/neu levels with tumor stage, grade, recurrence and progression. Materials and Methods: Fourty-four patients with primary non-muscle invasive bladder tumors (Group 2 and 40 healthy control group (Group 1 were included the study. Blood and urinary samples were collected from all patients and HER2/neu levels were measured by ELISA method. Blood and urinary HER2/neu levels and additionally, ratio of urinary HER2/neu levels to urinary creatinine levels were recorded. Demographic data and tumor characteristics were recorded. Results: Mean serum HER2/neu levels were similar between two groups and statistically significant difference wasn't observed. Urinary HER2/neu levels were significantly higher in group 2 than group 1. Ratio of urinary HER2/neu to urinary creatinine was significantly higher in group 2 than group 1, (p=0,021. Serum and urinary HER2/ neu levels were not associated with tumor stage, grade, recurrence and progression while ratio of urinary HER2/neu to urinary creatinin levels were significantly higher in high-grade tumors. HER2/neu, the sensitivity of the test was found to be 20.5%, and the specificity was 97.5%, also for the urinary HER2/neu/urinary creatinine ratio, the sensitivity and specificity of the test were found to be 31.8% and 87.5%, respectively. Conclusions: Urinary HER2/neu and ratio of urinary creatinine urine were significantly higher in patients with bladder cancer compared to healthy subjects. Large series and controlled studies are needed for use as a tumor marker.

  18. Increased proapoptotic serum activity in patients with chronic mood disorders.

    Science.gov (United States)

    Politi, Pierluigi; Brondino, Natascia; Emanuele, Enzo

    2008-02-01

    Growing evidence suggests that endothelial dysfunction may be present in patients with chronic mood disorders. We hypothesized that circulating factors in the sera of patients with chronic mood disorders could induce vascular endothelial damage that in turn may be responsible for increased vascular risk. In this study, we sought to determine whether serum of patients with chronic mood disorders could directly induce apoptosis in human endothelial cells. We examined the proapoptotic activity by an ex vivo proapoptotic activity assay in the serum of 100 individuals: 25 patients with major depressive disorder (MDD) and no lifetime diagnosis of anxiety disorder, 25 patients with bipolar disorder (BPD) with a current comorbid anxiety disorder, 25 patients with BPD and no anxiety, and 25 age- and gender-matched healthy controls. The proapoptotic serum activity of all mood disorder patients was significantly higher than that of the control group (all p values<0.01). This association was found to be independent from potential confounders including age, gender, smoking status, body mass index, blood pressure parameters, family history of cardiovascular disease, serum creatinine, plasma glucose, total cholesterol, triglycerides, NT-proBNP, and C-reactive protein (beta=0.44, t=2.93, p=0.012). Together our findings indicate that chronic mood disorders are associated with higher proapoptotic serum capacity. Although subject to future confirmation, it is possible that the increased systemic proapoptotic activity of the serum in these patients could exert deleterious vascular effects resulting in endothelial dysfunction.

  19. [Clinical Significance of Urinary Microalbumin to Creatinine Ratio in Physical Examinations].

    Science.gov (United States)

    Guo, Qin; Luo, Wei; Yin, Dai-shu; Jia, Cheng-yao

    2016-01-01

    To-determine the association between urinary microalbumin to creatinine ratio (mALB/Cr) and metabolic indicators in people undergoing physical examinations. A total of 4 184 people who took physical examinations in West China Hospital, Sichuan University from November 2013 to October 2014 participated in this study. We measured their body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), waistline, hipline, Waist-to-hip ratio (WHR), urinary mALB/Cr, serum glucose (GLU), total cholesterol (TC), triglyceride (TG) , high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), blood urea nitrogen (BUN), serum creatinine (SCr) , uric acid (UA), cystatin C (Cys-C), glomerular filtration rate (eGFR) and homocysteine (Hcy). (1) The participants had a median (interquartile range) mALB/Cr of 5.7 (3.1-11.8) mg/g: 5.4 (3.0-11.3) mg/g for males and 6.3 (3.6-13.2) mg/g for females (P 300 mg/g). (5) Logistic regression demonstrated that age, SBP, WHR, GLU, TG and eGFR were significant predictors of albuminuria. A high level of abnormal/positive mALB/Cr was found in people undergoing physical examinations. Increased age, SBP, WHR, GLU, TG and decreased eGFR are major risk factors of abnormal mALB/Cr. mALB/Cr should be monitored, especially in the elderly and those with high-metabolic-syndrome.

  20. Determination of Urinary Neopterin/Creatinine Ratio to Distinguish Active Tuberculosis from Latent Mycobacterium tuberculosis Infection

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    Michael Eisenhut

    2016-01-01

    Full Text Available Background. Biomarkers to distinguish latent from active Mycobacterium (M. tuberculosis infection in clinical practice are lacking. The urinary neopterin/creatinine ratio can quantify the systemic interferon-gamma effect in patients with M. tuberculosis infection. Methods. In a prospective observational study, urinary neopterin levels were measured by enzyme linked immunosorbent assay in patients with active tuberculosis, in people with latent M. tuberculosis infection, and in healthy controls and the urinary neopterin/creatinine ratio was calculated. Results. We included a total of 44 patients with M. tuberculosis infection and nine controls. 12 patients had active tuberculosis (8 of them culture-confirmed. The median age was 15 years (range 4.5 to 49. Median urinary neopterin/creatinine ratio in patients with active tuberculosis was 374.1 micromol/mol (129.0 to 1072.3, in patients with latent M. tuberculosis infection it was 142.1 (28.0 to 384.1, and in controls it was 146.0 (40.3 to 200.0, with significantly higher levels in patients with active tuberculosis (p<0.01. The receiver operating characteristics curve had an area under the curve of 0.84 (95% CI 0.70 to 0.97 (p<0.01. Conclusions. Urinary neopterin/creatinine ratios are significantly higher in patients with active tuberculosis compared to patients with latent infection and may be a significant predictor of active tuberculosis in patients with M. tuberculosis infection.

  1. Quantitation of proteinuria in nephrotic syndrome by spot urine protein creatinine ratio estimation in children.

    Science.gov (United States)

    Biswas, A; Kumar, R; Chaterjee, A; Ghosh, J K; Basu, K

    2009-01-01

    In Nephrotic Syndrome the amount of protein excretion is a reflection of activity of disease. Quantitative measurement of proteinuria by a 24-hour urine collection has been the accepted method of evaluation. Recent studies have shown that calculation of protein/creatinine ratio in a spot urine sample correlates well with the 24-hour urine protein (24-HUP) excretion. A study was conducted to compare the accuracy of a spot urinary protein/creatinine ratio (P/C ratio) and urinary dipstick with the 24-hour urine protein. Fifty two samples from 26 patients of nephrotic syndrome were collected. This included a 24-hour urine sample followed by the next voided random spot sample. The protein/creatinine ratio was calculated and dipstick was performed on the spot sample. This was compared with the 24-hour urine protein excretion. The correlation between the three samples was statistically highly significant (pprotein/creatinine ratio in Indian children was also estimated on 50 normal children admitted in the ward without any renal diseases calculated to be 0.053 (SE of mean+/-0.003).

  2. Random Urine Protein Creatinine Ratio as a Preadmission Test in Hypertensive Pregnancies with Urinary Protein Creatinine Ratio

    OpenAIRE

    Laleh Eslamian; Fariba Behnam; Zahra Foroohesh Tehrani; Ashraf Jamal; Vajiheh Marsoosi

    2011-01-01

    To evaluate the value of random urinary protein creatinine ratio in prediction of 24h proteinuria in hypertensive pregnancies. Method: Random urine samples and routine 24h urine collections were collected from hypertensive pregnant women (n=100). Reliability of random urinary protein-creatinine ratio was assessed by receiver operator characteristic (ROC) curve to detect significant proteinuria (300mg/day) using 24h. Urine protein as a gold standard. Forty six patients (46%) had significant p...

  3. Comparison of associations of urine protein-creatinine ratio versus albumin-creatinine ratio with complications of CKD: a cross-sectional analysis.

    Science.gov (United States)

    Fisher, Herrick; Hsu, Chi-Yuan; Vittinghoff, Eric; Lin, Feng; Bansal, Nisha

    2013-12-01

    Urine albumin-creatinine ratio (ACR) and protein-creatinine ratio (PCR) are important markers of kidney damage and are used for prognosis in persons with chronic kidney disease (CKD). Despite how commonly these measurements are done in clinical practice, relatively few studies have directly compared the performance of these 2 measures with regard to associations with clinical outcomes, which may inform clinicians about which measure of urinary protein excretion is best. We studied the association of ACR and PCR with common complications of CKD. Cross-sectional study. 3,481 participants with CKD in the Chronic Renal Insufficiency Cohort (CRIC) Study. ACR and PCR. We examined the association between ACR and PCR with measures of common CKD complications: serum hemoglobin, bicarbonate, parathyroid hormone, phosphorus, potassium, and albumin. Restricted cubic spline analyses adjusted for estimated glomerular filtration rate (eGFR; calculated by the MDRD [Modification of Diet in Renal Disease] Study equation) were performed to study the continuous association with our predictors with each outcome. Mean eGFR was 43±13 (SD)mL/min/1.73 m2 and median values for PCR and ACR were 140 and 46 mg/g, respectively. In continuous analyses adjusted for eGFR, higher ACRs and PCRs were similar and both were associated with lower serum hemoglobin, bicarbonate, and albumin levels and higher parathyroid hormone, phosphorus, and potassium levels. Across all outcomes, the associations of ACR and PCR were similar, with only small absolute differences in the outcome measure. Similar associations were seen in patients with diabetes mellitus. Participants largely had moderate CKD with low values for ACR and PCR, so results may not be generalizable to all CKD populations. In persons with CKD, ACR and PCR are relatively similar in their associations with common complications of CKD. Thus, routine measurement of PCR may provide similar information as ACR in managing immediate complications of CKD

  4. Trueness verification of actual creatinine assays in the European market demonstrates a disappointing variability that needs substantial improvement. An international study in the framework of the EC4 creatinine standardization working group.

    Science.gov (United States)

    Delanghe, Joris R; Cobbaert, Christa; Galteau, Marie-Madeleine; Harmoinen, Aimo; Jansen, Rob; Kruse, Rolf; Laitinen, Päivi; Thienpont, Linda M; Wuyts, Birgitte; Weykamp, Cas; Panteghini, Mauro

    2008-01-01

    The European In Vitro Diagnostics (IVD) directive requires traceability to reference methods and materials of analytes. It is a task of the profession to verify the trueness of results and IVD compatibility. The results of a trueness verification study by the European Communities Confederation of Clinical Chemistry (EC4) working group on creatinine standardization are described, in which 189 European laboratories analyzed serum creatinine in a commutable serum-based material, using analytical systems from seven companies. Values were targeted using isotope dilution gas chromatography/mass spectrometry. Results were tested on their compliance to a set of three criteria: trueness, i.e., no significant bias relative to the target value, between-laboratory variation and within-laboratory variation relative to the maximum allowable error. For the lower and intermediate level, values differed significantly from the target value in the Jaffe and the dry chemistry methods. At the high level, dry chemistry yielded higher results. Between-laboratory coefficients of variation ranged from 4.37% to 8.74%. Total error budget was mainly consumed by the bias. Non-compensated Jaffe methods largely exceeded the total error budget. Best results were obtained for the enzymatic method. The dry chemistry method consumed a large part of its error budget due to calibration bias. Despite the European IVD directive and the growing needs for creatinine standardization, an unacceptable inter-laboratory variation was observed, which was mainly due to calibration differences. The calibration variation has major clinical consequences, in particular in pediatrics, where reference ranges for serum and plasma creatinine are low, and in the estimation of glomerular filtration rate.

  5. SERUM PARAOXONASE ACTIVITY IN RENAL TRANSPLANT RECIPIENTS

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    Saritha Gadicherla

    2017-12-01

    Full Text Available BACKGROUND Serum paraoxonase is an enzyme synthesised in the liver. It is known to prevent atherosclerosis by inhibiting oxidation of lowdensity lipoprotein. Renal transplant recipients have increased tendency for developing atherosclerosis and cardiovascular disease. Reduced activity of serum paraoxonase contributes to accelerated atherosclerosis and increased cardiovascular complications in these patients. The aim of this study was to estimate serum paraoxonase activity in renal transplant recipients and compare it with healthy controls. MATERIALS AND METHODS 30 renal transplant recipients and 30 age and sex matched healthy controls were taken for the study. Serum paraoxonase activity, blood urea, serum creatinine and uric acid were estimated in these groups. The serum paraoxonase activity was correlated with urea, creatinine and uric acid levels. RESULTS Serum paraoxonase activity was reduced in renal transplant recipients compared to healthy controls. There was a negative correlation between paraoxonase activity and the levels of urea, creatinine and uric acid levels. CONCLUSION In this study, the paraoxonase activity was reduced in renal transplant recipients compared to controls. The increased cardiovascular disease in these patients could be due to reduced paraoxonase activity.

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

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    Christopher J. Kirwan

    2013-01-01

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

  7. Significance of Serum Leptin Assessment in Chronic Renal Patients on Dialysis

    International Nuclear Information System (INIS)

    Salem, E.S; Tawfik, M.S; ELaseily, E.S.

    2013-01-01

    The number of patients suffering from renal failure indicating dialysis has been increasing worldwide. Leptin hormone plays an important role in the development of malnutrition in these patients. Bone produces different hormones, such as osteocalcin (OC), which influences energy expenditure in humans. Disturbances in mineral metabolism and bone disease are common complications of chronic kidney disease (CKD). There are increasing evidences suggesting that these disorders in mineral and bone metabolism are associated with increased risk of cardiovascular calcification, morbidity, and mortality, especially among those who undergo maintenance renal dialysis. The present study was carried out to evaluate the importance of serum leptin assessment in renal dialysis patients. Serum leptin level was estimated by radioimmunoassay (RIA) using recombinant human leptin (Leptin- Human Ria-CT). Immunoradiometric assay kit (host IRMA) was used for in-vitro quantitative measurement of human intact OC. Serum creatinine level was determined by colorimetric method. This study included 60 patients (twenty suffering from CKD, thirty on dialysis and ten healthy controls). Serum leptin, OC and creatinine were found to be higher in patients of both groups compared to that of controls. Maximum increase was observed in patients on dialysis. From these results it is possible to conclude that, although patients with chronic renal disease exhibited significant increase in serum leptin, yet sudden additional increase can be related to serious pathology that can end in renal failure. The present study also highlighted the importance of OC as a marker of disturbed mineral-bone metabolism in chronic kidney disease (CKD) patients and those receiving dialysis that could lead to the atherosclerosis, extravascular calcification, morbidity and mortality. KeywoRdSLeptin, osteocalcin, Radioimmunoassay (RIA), Chronic kidney disease, Renal dialysis, Creatinine.

  8. Pemberian diet ekstra formula komersial dan diet ekstra filtrat ikan gabus intradialisis serta pengaruhnya terhadap kadar serum albumin dan kreatinin pasien dengan hemodialisis di RSU Dr. Saiful Anwar Malang

    Directory of Open Access Journals (Sweden)

    Etik Sulistyowati

    2008-11-01

    Conclusion: There was significant effect of the supply of commercial formula and local catfish filtrate extra diet to increase of albumin serum level of the subject and there was no significant effect of the supply of extra diet to creatinine serum level; however, the supply of local catfish filtrate extra diet could maintain creatinine serum level.

  9. Preliminary Studies on Some Haematological and Serum ...

    African Journals Online (AJOL)

    The mean serum values of sodium, potassium, chloride and bicarbonate, as well as urea, creatinine and alanine aminotransferase(ALT) enzyme did not differ from the normal values, while the mean aspartate aminotransferase (AST) enzyme value appeared to be lower than the normal range.In conclusion, the RBC, PCV ...

  10. Serum Cystatin C Levels in Nigerian Children: Reference Intervals ...

    African Journals Online (AJOL)

    Methods: Fifty-nine children aged two years to 16 years with no evidence of overt kidney disease were recruited from the Paediatric Clinics of the Lagos University Teaching Hospital. Serum cystatin C levels were measured using ELISA method while serum creatinine was measured by a rateblanked and compensated Jaffe ...

  11. Random Urine Protein Creatinine Ratio as a Preadmission Test in Hypertensive Pregnancies with Urinary Protein Creatinine Ratio

    Directory of Open Access Journals (Sweden)

    Laleh Eslamian

    2011-02-01

    Full Text Available To evaluate the value of random urinary protein creatinine ratio in prediction of 24h proteinuria in hypertensive pregnancies. Method: Random urine samples and routine 24h urine collections were collected from hypertensive pregnant women (n=100. Reliability of random urinary protein-creatinine ratio was assessed by receiver operator characteristic (ROC curve to detect significant proteinuria (300mg/day using 24h. Urine protein as a gold standard. Forty six patients (46% had significant proteinuria. The random protein creatinine ratio was correlated to 24h urine protein excretion (r2=0.777, P<0.001 Area under ROC curve to predict proteinuria was 0.926 (95% CI: 0.854-0.995, P<0.001. A cut off value of 0.22mg/mg for protein creatinine ratio best predicted significant proteinuria with sensitivity, specificity, positive and negative predictive values of 87%, 92.6%, 90.6% and 89.3% respectively. Random urinary protein creatinine ratio is a simple inexpensive and excellent alternative to 24h urine collection. It's helpful in diagnosis of preeclampsia and can be used as a pre admission test in PIH cases.

  12. Clearance of serum solutes by hemofiltration in dogs with severe heat stroke.

    Science.gov (United States)

    Chen, Guang-Ming; Lan, Yu-Ying; Wang, Cheng-Feng; Zhan, Hai-Xia; Wang, Wen-Rui; Chen, Jin-Hua; Chen, Jian

    2014-08-22

    We have previously reported that hemofiltration (HF) may be an effective additional means of treating heat stroke when rapid cooling is not effective. Dogs were assigned to a heat stroke (control) or heat stroke + hemofiltration (HF) group (n = 8 each group). After heat stroke induction, dogs in the HF group received HF for 3 h. Serum concentrations of interleukin (IL)-10, tumor necrosis factor (TNF)-α, IL-6, blood urea nitrogen (BUN) and creatinine were measured at baseline and 1, 2, and 3 h after heat stroke. Clearance rates of solutes were determined 1, 2, and 3 h after the start of HF. Serum concentrations of all solutes tended to increase with time after heat stroke in the control group, but decreased (BUN, creatinine) or remained relatively unchanged (TNF-α, IL-6, IL-10) with time in the HF group. Concentrations of all solutes were significantly lower in the HF group compared with the control group at 2 and 3 h (P heat stroke-induced increases in serum cytokine concentrations and is effective for clearing small molecular weight solutes from serum, but less effective for clearing larger molecular weight solutes, including TNF-α, IL-6, and IL-10.

  13. Myocardial damage in successful vessel coronary angioplasty as assessed by creatinine kinase and its myocardium band isoenzyme levels

    International Nuclear Information System (INIS)

    Abbas, S.; Samor, N.A.; Kayani, A.M.

    2008-01-01

    To determine the frequency of myocardial damage in elective, successful, single vessel percutaneous coronary angioplasty by assessing myocardial band (MB), creatinine kinase levels and to find out the association of common modifiable risk factors with myocardial damage in patients undergoing single vessel coronary angioplasty. Fifty patients undergoing elective and successful single vessel percutaneous coronary angioplasty were evaluated with creatinine kinase and creatinine kinase MB levels before and after 8 hours and 1st day following coronary angioplasty. Studied variables included the length of stent deployed, maximum deployment pressure and total balloon inflation time, apart from hypertension, cholesterol level, smoking and diabetes mellitus. Out of 50 patients, 9 had raised creatinine kinase at 8 hours (18%) and 10 had raised creatinine kinase (20%) on 1st day following coronary angioplasty, 7 (14%) patients and 8 (16%) patients had raised creatinine kinase MB levels at 8 hours and 1st day following coronary angioplasty respectively. The rise of either was equal to or more than 3 times the normal limits. Modifiable risk factors, significantly associated with myocardial damage, were diabetes mellitus (p=0.006) and LDL levels (p=0.009) in patients undergoing single vessel coronary angioplasty. Successful elective, uncomplicated, single vessel coronary angioplasty resulted in some myocardial damage evident by mild rise in cardiac enzymes but rise of creatinine kinase MB above 3 times of normal, which signifies percutaneous coronary angioplasty-related myocardial infarction, was not seen. There was a significant association between diabetes mellitus, LDL levels and myocardial damage in patients undergoing coronary angioplasty but no significant association was found between hypertension, smoking and myocardial damage. (author)

  14. Measurement of renal function in a kidney donor: a comparison of creatinine-based and volume-based GFRs

    International Nuclear Information System (INIS)

    Choi, Don Kyoung; Choi, See Min; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han-Yong; Jeon, Hwang Gyun; Park, Bong Hee

    2015-01-01

    We aimed to evaluate the performance of various GFR estimates compared with direct measurement of GFR (dGFR). We also sought to create a new formula for volume-based GFR (new-vGFR) using kidney volume determined by CT. GFR was measured using creatinine-based methods (MDRD, the Cockcroft-Gault equation, CKD-EPI formula, and the Mayo clinic formula) and the Herts method, which is volume-based (vGFR). We compared performance between GFR estimates and created a new vGFR model by multiple linear regression analysis. Among the creatinine-based GFR estimates, the MDRD and C-G equations were similarly associated with dGFR (correlation and concordance coefficients of 0.359 and 0.369 and 0.354 and 0.318, respectively). We developed the following new kidney volume-based GFR formula: 217.48-0.39XA + 0.25XW-0.46XH-54.01XsCr + 0.02XV-19.89 (if female) (A = age, W = weight, H = height, sCr = serum creatinine level, V = total kidney volume). The MDRD and CKD-EPI had relatively better accuracy than the other creatinine-based methods (30.7 % vs. 32.3 % within 10 % and 78.0 % vs. 73.0 % within 30 %, respectively). However, the new-vGFR formula had the most accurate results among all of the analyzed methods (37.4 % within 10 % and 84.6 % within 30 %). The new-vGFR can replace dGFR or creatinine-based GFR for assessing kidney function in donors and healthy individuals. (orig.)

  15. Measurement of renal function in a kidney donor: a comparison of creatinine-based and volume-based GFRs

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Don Kyoung; Choi, See Min; Jeong, Byong Chang; Seo, Seong Il; Jeon, Seong Soo; Lee, Hyun Moo; Choi, Han-Yong; Jeon, Hwang Gyun [Sungkyunkwan University School of Medicine, Department of Urology, Samsung Medical Center, Seoul (Korea, Republic of); Park, Bong Hee [The Catholic University of Korea College of Medicine, Department of Urology, Incheon St. Mary' s Hospital, Seoul (Korea, Republic of)

    2015-11-15

    We aimed to evaluate the performance of various GFR estimates compared with direct measurement of GFR (dGFR). We also sought to create a new formula for volume-based GFR (new-vGFR) using kidney volume determined by CT. GFR was measured using creatinine-based methods (MDRD, the Cockcroft-Gault equation, CKD-EPI formula, and the Mayo clinic formula) and the Herts method, which is volume-based (vGFR). We compared performance between GFR estimates and created a new vGFR model by multiple linear regression analysis. Among the creatinine-based GFR estimates, the MDRD and C-G equations were similarly associated with dGFR (correlation and concordance coefficients of 0.359 and 0.369 and 0.354 and 0.318, respectively). We developed the following new kidney volume-based GFR formula: 217.48-0.39XA + 0.25XW-0.46XH-54.01XsCr + 0.02XV-19.89 (if female) (A = age, W = weight, H = height, sCr = serum creatinine level, V = total kidney volume). The MDRD and CKD-EPI had relatively better accuracy than the other creatinine-based methods (30.7 % vs. 32.3 % within 10 % and 78.0 % vs. 73.0 % within 30 %, respectively). However, the new-vGFR formula had the most accurate results among all of the analyzed methods (37.4 % within 10 % and 84.6 % within 30 %). The new-vGFR can replace dGFR or creatinine-based GFR for assessing kidney function in donors and healthy individuals. (orig.)

  16. Value of Serum Cystatin C Measurement in the Diagnosis of Sepsis-Induced Kidney Injury and Prediction of Renal Function Recovery.

    Science.gov (United States)

    Leem, Ah Young; Park, Moo Suk; Park, Byung Hoon; Jung, Won Jai; Chung, Kyung Soo; Kim, Song Yee; Kim, Eun Young; Jung, Ji Ye; Kang, Young Ae; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Song, Joo Han

    2017-05-01

    Acute kidney injury (AKI) is common in critically ill patients. Serum cystatin C has emerged as a reliable marker of AKI. We sought to assess the value of serum cystatin C for early detection and prediction of renal function recovery in patients with sepsis. Sepsis patients (113 AKI patients and 49 non-AKI patients) admitted to the intensive care unit (ICU) were included. Serum creatinine and cystatin C levels and glomerular filtration rate were measured on days 0, 1, 3, and 7. Serum cystatin C levels were significantly higher in AKI patients than in non-AKI patients at all time points. Multivariate analysis showed that only serum cystatin C levels on day 0 were associated with AKI development [odds ratio (OR)=19.30; 95% confidence interval (CI)= 2.58-144.50, pICU patients with sepsis. © Copyright: Yonsei University College of Medicine 2017

  17. Cause-Specific Mortality According to Urine Albumin Creatinine Ratio in the General Population

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Ahluwalia, Tarun Veer Singh

    2014-01-01

    -specific mortality. METHODS: We included a total of 9,125 individuals from two population-based studies, Monica10 and Inter99, conducted in 1993-94 and 1999-2001, respectively. Urine albumin creatinine ratio was measured from spot urine samples by standard methods. Information on causes of death was obtained from......BACKGROUND: Urine albumin creatinine ratio, UACR, is positively associated with all-cause mortality, cardiovascular disease and diabetes in observational studies. Whether a high UACR is also associated with other causes of death is unclear. We investigated the association between UACR and cause...... The Danish Register of Causes of Death until 31 December 2010. There were a total of 920 deaths, and the median follow-up was 11.3 years. RESULTS: Multivariable Cox regression analyses with age as underlying time axis showed statistically significant positive associations between UACR status and risk of all-cause...

  18. 21 CFR 862.1225 - Creatinine test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Creatinine test system. 862.1225 Section 862.1225 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems § 862...

  19. Urea and Creatinine Clearances in the Three Trimesters of Pregnancy

    African Journals Online (AJOL)

    Abstract. The aim of this study was to determine the creatinine and urea clearances, as indices of glomerular filtration rate (GFR) during the three trimesters of pregnancy. A total of 108 healthy subjects between the ages of 18 and 37years were divided into non-pregnant women (28+5years, n=30), 1st trimester of pregnancy ...

  20. Plasma Creatinine, Age and Body Surface Area in Nigerian Children ...

    African Journals Online (AJOL)

    In a bid to establish reference values for plasma creatinine in children and adolescents using age, and body surface area (BSA), 462 apparently healthy Nigerian children/adolescents aged one day to 15 years were studied. They were recruited from well baby clinics, as well as primary and secondary schools. Plasma ...

  1. Increases In Plasma Urea And Creatinine In Experimental ...

    African Journals Online (AJOL)

    Alterations in both plasma urea and creatinine levels were monitored over a period of twenty eight (28) days in experimentally infected rabbits. A total of 15 animals were randomly divided into three groups of n=5. The groups were control (group I), infected and treated (group II) and infected but untreated (group III) ...

  2. Albumin: Creatinine Ratio during long term Diabetes Mellitus in the ...

    African Journals Online (AJOL)

    Albumin: Creatinine Ratio during long term Diabetes Mellitus in the Assessment of early Nephropathy in Sudanese Population. ... Further studies with 24 hour urine sample are recommended for assessment of Microalbuminuria in long term Diabetic patients, provided that the patients are on a normal diet with regular ...

  3. Analysis of 25(OHD serum concentrations of hospitalized elderly patients in the Shanghai area.

    Directory of Open Access Journals (Sweden)

    Xudong Mao

    Full Text Available OBJECTIVE: To find an association between basic characteristics, seasons as well as disease types and 25-Hydroxyvitamin D serum concentrations in Chinese patients. METHODS: We randomly selected 5470 Chinese patients with various diseases, who were hospitalized between May 2012 and August 2013 in Shanghai and analyzed their serum 25-Hydroxyvitamin D2 (25 (OHD2 and 25-Hydroxyvitamin D3 (25(OHD3 concentrations with liquid chromatography-tandem mass spectrometry (LC-MS/MS as well as their parathyroid hormone (PTH and serum creatinine blood levels. The resulting data were analyzed by linear regression and variance analyses or multivariate analysis with covariance. RESULTS: The 25(OHD serum concentrations were lowest in December. Among the subjects with a median age of 83.0 ± 16.0, the median 25(OHD2, 25(OHD3 and total 25(OHD serum concentrations were 1.00 ± 1.80 ng/ml, 12.20 ± 8.50 ng/ml and 14.80 ± 9.80 respectively, indicating a prevalent 25(OHD deficiency. According to our multivariate analysis of covariance, the factors affecting 25(OHD2 and 25(OHD3 serum concentrations included age, creatinine, PTH, season and type of disease, whereas gender correlated only with 25(OHD2 and 25(OHD2 and D3 values correlated negatively with each other. Our results further revealed that 25(OHD3 levels were low while 25(OHD2 levels were high among patients with lung diseases, dyskinesia and coronary heart diseases. In addition, participants with diabetes and cerebral infarction had higher 25(OHD3 serum concentrations compared with lung disease patients. CONCLUSION: Vitamin D intake particularly during winter and summer seasons is important especially for elderly lung disease, dyskinesia and coronary heart disease patients to improve their quality of life.

  4. Serum Uric Acid Level Predicts Progression of IgA Nephropathy in Females but Not in Males.

    Directory of Open Access Journals (Sweden)

    Yasuyuki Nagasawa

    Full Text Available Immunoglobulin A nephropathy (IgAN is one of most common forms of glomerulonephritis. At this point, the clinical impact of hyperuricemia on IgAN is not clear. The aim of the present study was to explore the clinical impact of hyperuricemia on the progression of IgAN.Multicenter retrospective cohort study.935 IgAN patients who were diagnosed by kidney biopsy at Osaka University Hospital, Osaka General Hospital, and Osaka Rosai Hospital. were included in this study.Uric acid levels at renal biopsy.The outcome of interest was the time from the kidney biopsy to the time when a 50% increase in the baseline serum creatinine level was observed, which was defined as "progression".The baseline characteristics according to the kidney biopsy at the time of diagnosis were collected from the medical records, and included age, gender, body mass index, hypertension, diabetes (use of antidiabetic drugs, serum levels of creatinine, urinary protein, smoking status, RAAS blockers and steroid therapy.An elevated serum uric acid level was an independent risk factor for progression in female patients (per 1.0 mg/dL, multivariate-adjusted incident rate ratio 1.33 [95% confidence interval 1.07, 1.64], P = 0.008 but not in male patients (1.02 [0.81, 1.29], P = 0.855. To control a confounding effect of renal function on an association between serum uric acid level and progression in female patients, age- and serum creatinine-matched and propensity score-matched analyses were performed, and these results also supported the effect by uric acid on kidney disease progression independent of basal kidney function.A cohort analyzed retorospectively.This study revealed that an elevated uric acid level was an independent risk factor for ESKD in female IgAN patients. Therefore, uric acid might be a treatable target in female IgAN patients.

  5. Urinary oxalate to creatinine ratios in healthy Turkish schoolchildren.

    Science.gov (United States)

    Dursun, Ismail; Çelik, İlknur; Poyrazoglu, Hakan M; Köse, Kader; Tanrıkulu, Esen; Sahin, Habibe; Yılmaz, Kenan; Öztürk, Ahmet; Yel, Sibel; Gündüz, Zübeyde; Düşünsel, Ruhan

    2017-11-01

    we aimed to establish reference values for urinary oxalate to creatinine ratios in healthy children aged 6-15 years and to investigate the relationship between their nutritional habits and oxalate excretion. Random urine specimens from 953 healthy children aged 6-15 years were obtained and analyzed for oxalate and creatinine. Additionally, a 24-h dietary recall form was prepared and given to them. The ingredient composition of the diet was calculated. The children were divided into three groups according to age: Group I (69 years, n = 353), Group II (10-12 years, n = 335), and Group III (13-15 years, n = 265). The 95th percentile of the oxalate to creatinine ratio for subjects aged 6-9, 10-12, and 13-15 years were 0.048, 0.042, and 0.042 mg/mg, respectively. The oxalate to creatinine ratio was significantly higher in Group 1 than in Group 2 and Group 3. Urinary oxalate excretion was positively correlated with increased protein intake and negatively correlated with age. A significant positive correlation was determined between urinary oxalate excretion and the proline, serine, protein, and glycine content of diet. Dietary proline intake showed a positive correlation with the urine oxalate to creatinine ratio and was found to be an independent predictor for urinary oxalate. These data lend support to the idea that every country should have its own normal reference values to determine the underlying metabolic risk factor for kidney stone disease since regional variation in the dietary intake of proteins and other nutrients can affect normal urinary excretion of oxalate.

  6. Correlation of 24-hour urinary protein quantification with spot urine protein:creatinine ratio in lupus nephritis.

    Science.gov (United States)

    Matar, H E; Peterson, P; Sangle, S; D'Cruz, D P

    2012-07-01

    Twenty-four hour urine collection has been the foundation for monitoring patients with lupus nephritis. However, the use of protein to creatinine ratios in spot urine samples is now widely used. We aimed to evaluate the validity of this method cross-sectionally and longitudinally. A cross-sectional retrospective study was conducted. Records of 486 lupus nephritis patients were searched for paired results of 24-h quantification of urinary protein and a random spot urine protein to creatinine ratio and were examined over a three-year period. Ninety-five lupus nephritis patients had paired results and were included in the final analysis, male/female 14/81, mean age 36.5 years. Over a three-year period there were a total of 137 samples from 95 patients. For the entire dataset, there was a significant correlation between protein:creatinine ratio and 24-h urine collection protein (mg), Spearman Rho correlation coefficient was 0.869, p protein:creatinine ratio correlates well with 24-h urinary total protein excretion. Having a simple, reliable, reproducible and cost-effective test such as the spot urine protein:creatinine ratio is therefore a valuable tool with which to monitor disease progression.

  7. The association between creatinine versus cystatin C-based eGFR and cardiovascular risk in children with chronic kidney disease using a modified PDAY risk score.

    Science.gov (United States)

    Sharma, Sheena; Denburg, Michelle R; Furth, Susan L

    2017-08-01

    Children with chronic kidney disease (CKD) have a high prevalence of cardiovascular disease (CVD) risk factors which may contribute to the development of cardiovascular events in adulthood. Among adults with CKD, cystatin C-based estimates of glomerular filtration rate (eGFR) demonstrate a stronger predictive value for cardiovascular events than creatinine-based eGFR. The PDAY (Pathobiological Determinants of Atherosclerosis in Youth) risk score is a validated tool used to estimate the probability of advanced coronary atherosclerotic lesions in young adults. To assess the association between cystatin C-based versus creatinine-based eGFR (eGFR cystatin C and eGFR creatinine, respectively) and cardiovascular risk using a modified PDAY risk score as a proxy for CVD in children and young adults. We performed a cross-sectional study of 71 participants with CKD [median age 15.5 years; inter-quartile range (IQR) 13, 17], and 33 healthy controls (median age 15.1 years; IQR 13, 17). eGFR was calculated using age-appropriate creatinine- and cystatin C-based formulas. Median eGFR creatinine and eGFR cystatin C for CKD participants were 50 (IQR 30, 75) and 53 (32, 74) mL/min/1.73 m 2 , respectively. For the healthy controls, median eGFR creatinine and eGFR cystatin were 112 (IQR 85, 128) and 106 mL/min/1.73m 2 (95, 123) mL/min/1.73 m 2 , respectively. A modified PDAY risk score was calculated based on sex, age, serum lipoprotein concentrations, obesity, smoking status, hypertension, and hyperglycemia. Modified PDAY scores ranged from -2 to 20. The Spearman's correlations of eGFR creatinine and eGFR cystatin C with coronary artery PDAY scores were -0.23 (p = 0.02) and -0.28 (p = 0.004), respectively. Ordinal logistic regression also showed a similar association of higher eGFR creatinine and higher eGFR cystatin C with lower PDAY scores. When stratified by age children [-0.29 (p = 0.008) vs. -0.32 (p = 0.004), respectively]. Despite a smaller sample size, the correlation in

  8. [Validation of plasma creatinine measurement on UniCel DxC 600 according to LAB GTA 04 recommendation].

    Science.gov (United States)

    Chianea, Denis; Renard, Christophe; Garcia, Carine; Mbongo, Elvire; Monpeurt, Corine; Vest, Philippe

    2010-01-01

    The accreditation process, according to NF EN ISO 15189, implies a prior evaluation of the new reagent on-site for the implementation of each new assay technique. Thus, our new standardized method for determination of creatinine (non compensated method) in plasma or serum on UniCel DxC 600 (Beckman Coulter) has been tested according to LAB GTA 04 protocol. The reagent meets the quality criteria recommended by Valtec protocol, except fidelity with the low concentration standard (50 micromol/L). Besides there is no problem of results transferability with the two other techniques used in the laboratory (Jaffe compensated and enzymatic methods performed on Cobas Integra 800).

  9. Reducing prescribing errors through creatinine clearance alert redesign.

    Science.gov (United States)

    Melton, Brittany L; Zillich, Alan J; Russell, Scott A; Weiner, Michael; McManus, M Sue; Spina, Jeffrey R; Russ, Alissa L

    2015-10-01

    Literature has shown that computerized creatinine clearance alerts reduce errors during prescribing, and applying human factors principles may further reduce errors. Our objective was to apply human factors principles to creatinine clearance alert design and assess whether the redesigned alerts increase usability and reduce prescribing errors compared with the original alerts. Twenty Veterans Affairs (VA) outpatient providers (14 physicians, 2 nurse practitioners, and 4 clinical pharmacists) completed 2 usability sessions in a counterbalanced study to evaluate original and redesigned alerts. Each session consisted of fictional patient scenarios with 3 medications that warranted prescribing changes because of renal impairment, each associated with creatinine clearance alerts. Quantitative and qualitative data were collected to assess alert usability and the occurrence of prescribing errors. There were 43% fewer prescribing errors with the redesigned alerts compared with the original alerts (P = .001). Compared with the original alerts, redesigned alerts significantly reduced prescribing errors for allopurinol and ibuprofen (85% vs 40% and 65% vs 25%, P = .012 and P = .008, respectively), but not for spironolactone (85% vs 65%). Nine providers (45%) voiced confusion about why the alert was appearing when they encountered the original alert design. When laboratory links were presented on the redesigned alert, laboratory information was accessed 3.5 times more frequently. Although prescribing errors were high with both alert designs, the redesigned alerts significantly improved prescribing outcomes. This investigation provides some of the first evidence on how alerts may be designed to support safer prescribing for patients with renal impairment. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Improved Performance of the Potentiometric Biosensor for the Determination of Creatinine

    DEFF Research Database (Denmark)

    Andersen, Jens Enevold Thaulov; Rasmussen, Claus/Dallerup; Zachau-Christiansen, Birgit

    2007-01-01

    The development of potentiometric biosensors for the determination of creatinine is attractive because it is a frequently analysed species in clinical chemistry. Contemporary methods of analysing creatinine engage chemicals harmful to the environment and generate large volumes of waste disposals....... By introducing a membrane-based potentiometric biosensor with immobilised creatinine deaminase, the measurements can be performed by miniaturised portable devices that are easy to handle and allow rapid analysis at a minimum consumption of chemicals. Thus, the enzymatic creatinine biosensors was revisited...

  11. 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.

  12. Improving the measurement of longitudinal change in renal function: automated detection of changes in laboratory creatinine assay

    Directory of Open Access Journals (Sweden)

    Norman Poh

    2015-04-01

    Full Text Available IntroductionRenal function is reported using the estimates of glomerular filtration rate (eGFR. However, eGFR values are recorded without reference to the particular serum creatinine (SCr assays used to derive them, and newer assays were introduced at different time points across the laboratories in the United Kingdom. These changes may cause systematic bias in eGFR reported in routinely collected data, even though laboratory-reported eGFR values have a correction factor applied.DesignAn algorithm to detect changes in SCr that in turn affect eGFR calculation method was developed. It compares the mapping of SCr values on to eGFR values across a time series of paired eGFR and SCr measurements.SettingRoutinely collected primary care data from 20,000 people with the richest renal function data from the quality improvement in chronic kidney disease trial.ResultsThe algorithm identified a change in eGFR calculation method in 114 (90% of the 127 included practices. This change was identified in 4736 (23.7% patient time series analysed. This change in calibration method was found to cause a significant step change in the reported eGFR values, producing a systematic bias. The eGFR values could not be recalibrated by applying the Modification of Diet in Renal Disease equation to the laboratory reported SCr values.ConclusionsThis algorithm can identify laboratory changes in eGFR calculation methods and changes in SCr assay. Failure to account for these changes may misconstrue renal function changes over time. Researchers using routine eGFR data should account for these effects.  

  13. Point of care testing provides an accurate measurement of creatinine, anion gap, and osmolal gap in ex-vivo whole blood samples with nitromethane.

    Science.gov (United States)

    Cao, D; Maynard, S; Mitchell, A M; Kerns, W P; Beuhler, M

    2014-07-01

    Nitromethane interferes with Jaffé measurements of creatinine, potentially mimicking acute kidney injury. We determined the proportional contribution of nitromethane in blood samples to creatinine measured by the Jaffé colorimetric and the point-of-care (POC) reactions and determined whether the difference can reliably estimate the concentration of nitromethane. Additionally, we determined whether the presence of nitromethane interferes with anion/osmolal gaps and ascertained the stability of nitromethane in serum after 7 days. Nitromethane was added to whole blood from four healthy volunteers to achieve concentrations of 0, 0.25, 0.5, 1, and 2 mmol/L. The following tests were performed: creatinine (Jaffé and POC), electrolytes (associated with Jaffé and POC), osmolality and nitromethane concentration (gas chromatography [GC]). Remaining samples were refrigerated and reanalyzed using GC at 7 days. Anion and osmolal gaps were calculated. Proportional recovery and degradation of nitromethane were measured using GC. Data were analyzed for agreement with single-factor ANOVA (p = 0.05). Mean creatinine for POC and Jaff methods were 0.93 vs. 0.76 mg/dL, respectively. Jaff creatinine concentrations increased linearly with increasing nitromethane concentrations (R(2) = 1, p = 0.01): measured creatinine (mg/dL) = 7.1*nitromethane (mmol/L) = 0.79. POC creatinine remained unchanged across the range of nitromethane concentrations (p = 0.99). Anion and osmolal gaps also remained unchanged. Nitromethane was reliably identified in all sample concentrations using GC on Day 0. Detection of 0.25 mmol/L nitromethane was not consistently recovered on Day 7. Nitromethane degradation was most pronounced at 2 mmol/L concentrations (81% recovery). Nitromethane alters apparent concentration of creatinine using the Jaffé reaction in a linear fashion but not when using the POC reaction. Measured difference between Jaffé and POC creatinine may identify the presence and estimate

  14. Diagnostic accuracy of spot urine protein-to-creatinine ratio for proteinuria and its association with adverse pregnancy outcomes in Chinese pregnant patients with pre-eclampsia.

    Science.gov (United States)

    Cheung, H C; Leung, K Y; Choi, C H

    2016-06-01

    International guidelines have endorsed spot urine protein-to-creatinine ratio of >30 mg protein/mmol creatinine as an alternative to a 24-hour urine sample to represent significant proteinuria. This study aimed to determine the accuracy of spot urine protein-to-creatinine ratio in predicting significant proteinuria and adverse pregnancy outcome. This case series was conducted in a regional obstetric unit in Hong Kong. A total of 120 Chinese pregnant patients with pre-eclampsia delivered at Queen Elizabeth Hospital from January 2011 to December 2013 were included. Relationship of spot urine protein-to-creatinine ratio and 24-hour proteinuria; accuracy of the ratio against 24-hour urine protein at different cut-offs; and relationship of such ratio and adverse pregnancy outcome were studied. Spot urine protein-to-creatinine ratio was correlated with 24-hour urine protein with Pearson correlation coefficient of 0.914 (Purine protein-to-creatinine ratio for diagnosing proteinuria in Chinese pregnant patients (33 mg/mmol) was similar to that stated in the international literature (30 mg/mmol). A cut-off of 20 mg/mmol provided a 100% sensitivity, and 52 mg/mmol provided a 100% specificity. There was no significant difference in spot urine protein-to-creatinine ratio between cases with and without adverse pregnancy outcome. Spot urine protein-to-creatinine ratio had a positive and significant correlation with 24-hour urine results in Chinese pre-eclamptic women when the ratio was <200 mg/mmol. Nonetheless, this ratio was not predictive of adverse pregnancy outcome.

  15. Detection of urinary creatinine using gold nanoparticles after solid phase extraction

    Science.gov (United States)

    Sittiwong, Jarinya; Unob, Fuangfa

    2015-03-01

    Label-free gold nanoparticles (AuNPs) were utilized in the detection of creatinine in human urine after a sample preparation by extraction of creatinine on sulfonic acid functionalized silica gel. With the proposed sample preparation method, the interfering effects of the urine matrix on creatinine detection by AuNPs were eliminated. Parameters affecting creatinine extraction were investigated. The aggregation of AuNPs induced by creatinine resulted in a change in the surface plasmon resonance signal with a concomitant color change that could be observed by the naked eye and quantified spectrometrically. The effect of AuNP concentration and reaction time on AuNP aggregation was investigated. The method described herein provides a determination of creatinine in a range of 15-40 mg L-1 with a detection limit of 13.7 mg L-1 and it was successfully used in the detection of creatinine in human urine samples.

  16. Major determinants of serum homocysteine concentrations in a Korean population.

    Science.gov (United States)

    Kim, Hyun Ja; Kim, Mi Kyung; Kim, Jeong Uk; Ha, Hun Young; Choi, Bo Youl

    2010-04-01

    The objective of this study was to identify the factors that determine serum homocysteine concentrations in Korean population. In a community-based study, 871 participants completed detailed questionnaires and physical examination. We found that increased age, male sex, family history of stroke, deficiencies of serum folate and vitamin B12, and elevated serum creatinine significantly increased the risk of hyperhomocysteinemia. However, hormonal and behavioral factors (smoking, alcohol drinking, coffee consumption, and sedentary time) were not associated with the risk of hyperhomocysteinemia. The risk of hyperhomocysteinemia was steeply increased in subjects with two or more risk factors among four selected risk factors (deficiencies of serum folate and vitamin B12, elevated creatinine, and family history of stroke) compared to subjects who did not have any risk factors, especially subjects over the age of 65 yr (odds ratio [OR], 33.5; 95% confidence interval [CI], 3.71-302.0 in men; OR, 39.2; 95% CI, 7.95-193.2 in women). In conclusion, increased age, male sex, family history of stroke, deficiencies of serum folate and vitamin B12, and elevated serum creatinine are important determinants of serum homocysteine concentrations with interaction effects between these factors.

  17. 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.

  18. Biosensors Based on Nano-Gold/Zeolite-Modified Ion Selective Field-Effect Transistors for Creatinine Detection.

    Science.gov (United States)

    Ozansoy Kasap, Berna; Marchenko, Svitlana V; Soldatkin, Oleksandr O; Dzyadevych, Sergei V; Akata Kurc, Burcu

    2017-12-01

    The combination of advantages of using zeolites and gold nanoparticles were aimed to be used for the first time to improve the characteristic properties of ion selective field-effect transistor (ISFET)-based creatinine biosensors. The biosensors with covalently cross-linked creatinine deiminase using glutaraldehyde (GA) were used as a control group, and the effect of different types of zeolites on biosensor responses was investigated in detail by using silicalite, zeolite beta (BEA), nano-sized zeolite beta (Nano BEA) and zeolite BEA including gold nanoparticle (BEA-Gold). The presence of gold nanoparticles was investigated by ICP, STEM-EDX and XPS analysis. The chosen zeolite types allowed investigating the effect of aluminium in the zeolite framework, particle size and the presence of gold nanoparticles in the zeolitic framework.After the synthesis of different types of zeolites in powder form, bare biosensor surfaces were modified by drop-coating of zeolites and creatinine deiminase (CD) was adsorbed on this layer. The sensitivities of the obtained biosensors to 1 mM creatinine decreased in the order of BEA-Gold > BEA > Nano BEA > Silicalite > GA. The highest sensitivity belongs to BEA-Gold, having threefold increase compared to GA, which can be attributed to the presence of gold nanoparticle causing favourable microenvironment for CD to avoid denaturation as well as increased surface area. BEA zeolites, having aluminium in their framework, regardless of particle size, gave higher responses than silicalite, which has no aluminium in its structure. These results suggest that ISFET biosensor responses to creatinine can be tailored and enhanced upon carefully controlled alteration of zeolite parameters used to modify electrode surfaces.

  19. Weights, hematology and serum chemistry of seven species of free-ranging tropical pelagic seabirds

    Science.gov (United States)

    Work, Thierry M.

    1996-01-01

    I established reference values for weight, hematology, and serum chemistry for seven species of free-ranging Hawaiian tropical pelagic seabirds comprising three orders (Procellariiformes, Pelecaniformes, Charadriiformes) and six families (Procellariidae, Phaethontidae, Diomedeidae, Sulidae, Fregatidae, and Laridae). Species examined included 84 Hawaiian dark-rumped petrels (Pterodoma phaeopygia), 90 wedge-tailed shearwaters (Puffinus pacificus), 151 Laysan albatrosses (Diomedea immutabilis), 69 red-footed boobies (Sula sula), 154 red-tailed tropicbirds (Phaeton rubricauda), 90 great frigatebirds (Fregata minor), and 72 sooty terns (Sterna fuscata). Hematocrit, total plasma solids, total and differential white cell counts, serum glucose, calcium, phosphorus, uric acid, total protein, albumin, globulin, aspartate aminotransferase and creatinine phosphokinase were analyzed. Among and within species, hematology and chemistry values varied with age, sex, season, and island of collection. Despite this variation, order-wide trends were observed.

  20. Serum chemerin levels are inversely associated with renal function in a general population

    DEFF Research Database (Denmark)

    Zylla, Stephanie; Rettig, Rainer; Völzke, Henry

    2018-01-01

    function in humans, and no population-based analyses have yet been performed. The potential influence of MetS-related phenotypes on the assumed association has been largely neglected. We aimed to investigate the association of serum chemerin with renal function in a general population with special regard...... to possible interactions between chemerin and metabolic phenotypes. DESIGN, PATIENTS AND MEASUREMENTS: Linear and logistic regression models were applied to analyse data from 4082 subjects of the German Study of Health in Pomerania. Main outcomes included estimated glomerular filtration rate (eGFR), serum...... creatinine and cystatin C and chronic kidney disease. RESULTS: Inverse associations of chemerin with eGFR were observed. The components of the MetS emerged as modulating factors in this relation and enhanced the association. Logistic regression models confirmed the relation between chemerin and e...

  1. Urine Protein and Urine Protein to Creatinine Ratio

    Science.gov (United States)

    ... Culture Blood Gases Blood Ketones Blood Smear Blood Typing Blood Urea Nitrogen (BUN) BNP and NT-proBNP ... Luteinizing Hormone (LH) Lyme Disease Tests Magnesium Maternal Serum Screening, Second Trimester Measles and Mumps Tests Mercury ...

  2. Cloning and expression of a urate oxidase and creatinine hydrolase fusion gene in Escherichia coli.

    Science.gov (United States)

    Cheng, Xin; Liu, Fang; Zhang, Yanxin; Jiang, Yunsheng

    2013-01-01

    To construct a plasmid containing a urate oxidase and creatinine hydrolase fusion gene and transform the plasmid into Escherichia coli to decompose uric acid and creatinine. According to the GenBank data for the urate oxidase gene, specific primers were designed to amplify and remove the stop codon for the urate oxidase gene. The gene was then ligated into the plasmid pMG36e to construct pMG36e-U. Then, using the GenBank database for the creatinine hydrolase gene, primers were designed to amplify the creatinine hydrolase gene. This gene was ligated into pMG36e-U to form pMG36e-U/C. Next, this construct was transformed into E. coli, which was confirmed by screening the recombinant E. coli and sodium dodecylsulfonate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis. The engineered bacteria were cultured with a specific concentration of creatinine and uric acid for 24 h. Then, the concentrations of creatinine and uric acid in the culture fluid were measured. The recombinant gene fragment was approximately 1.68 kb, and it contained the urate oxidase and creatinine hydrolase genes. The transformed E. coli expressed creatinine hydrolase and uric acid oxidase. The creatinine decomposition rate increased by 43.5%, and the uric acid decomposition rate increased by 42.32%. The constructed recombinant plasmid containing a fusion gene of creatinine hydrolase and uric acid oxidase was transformed into E. coli, and the enzymatic activities were expressed.

  3. Relationship of serum magnesium level and supplemental magnesium dosage with post coronary artery bypass graft surgery arrhythmias

    Directory of Open Access Journals (Sweden)

    Najafi M

    2007-06-01

    Full Text Available Background: Atrial and ventricular arrhythmias are among the most common complications after coronary artery bypass graft (CABG surgery. Previous studies demonstrated that cardiopulmonary bypass itself results in reduced serum magnesium levels. In this study, we evaluated the effect of total blood magnesium level (TMG on the prevention of perioperative arrhythmias with routine regimens of 2-4 grams supplemental magnesium (SMG. Methods: TMG was measured in patients who were scheduled for CABG on three occasions: just before anesthesia, just after entering the intensive care unit (ICU after completion of the sugery, and on the first morning after the operation. Patients were evaluated for primary cardiac rhythm and other variables that could have an influence on the magnesium level, including serum creatinine, urine output in the operating room and diuretic therapy. The SMG dosage was also recorded in the operating room and ICU. Patients were then evaluated for the rate and type of arrhythmia for the next three days. Results: The mean TMG levels in 174 cases were 2.2 (0.5, 2.6 (0.6 and 2.4 (0.6 mg/dl for the three occasions, respectively. The mean SMG was 2.5 (1.2 grams. Of 164 patients, 51 (31% developed the following post-operative arrhythmias: AF (7.3%, non-AF SVA (15.2% and ventricular (16.5%. The mean serum creatinine level and urine output were 1.2 mg/dl and 1800 ml, respectively. Although there was a significant difference between the TMG levels on the three different occasions (P<0.001, all values were within normal range. When we stratified the TMG levels of the patients based on administered SMG, the Mentel-Haenszel test revealed no significant difference between the first and third TMG (P=0.6. Although the TMG levels were higher in arrhythmic patients compared to those without arrhythmia (2.25 vs. 2.14 mg/dl, both values were within the normal range and there was no significant difference between the two groups. Serum creatinine levels

  4. Is the urine spot protein/creatinine ratio a valid diagnostic test for pre-eclampsia?

    Science.gov (United States)

    Sethuram, R; Kiran, T S Usha; Weerakkody, A N A

    2011-01-01

    The objective of this study was to assess the value of the spot protein/creatinine ratio as the diagnostic test for pre-eclampsia by correlating it to the 24 h urine protein. For the spot test, this study uses the cut-off value recognised by the International Society for the Study of Hypertension in Pregnancy (ISSHP). Ours was a correlational study made in the setting of the antenatal assessment unit/antenatal ward in a District General Hospital. Patients at >24 weeks' gestation with hypertension and >1+ proteinuria (n = 32) were included in the study. A 10 ml sample of urine was collected for the spot protein/creatinine ratio (PCR) before the 24 h collection was started. Spot PCR samples were stored at -18°C until the end of the study period. The results of the spot PCR were correlated to 24 h results using Pearson's correlation coefficient. Main outcome measures were correlation coefficient, sensitivity, specificity, positive and negative predictive values. Correlation was significant (r(2) = 0.82). Sensitivity, 83%; specificity, 92%; positive likelihood ratio, 10.3; negative likelihood ratio, 0.18. The spot PCR correlates well to the 24 h urine protein. The new cut-off values recognised by the ISSHP are producing consistent results. The evidence in favour of the spot PCR needs to be reassessed by larger studies.

  5. Colorimetric Detection of Creatinine Based on Plasmonic Nanoparticles via Synergistic Coordination Chemistry.

    Science.gov (United States)

    Du, Jianjun; Zhu, Bowen; Leow, Wan Ru; Chen, Shi; Sum, Tze Chien; Peng, Xiaojun; Chen, Xiaodong

    2015-09-02

    A simple and portable colorimetric assay for creatinine detection is fabricated based on the synergistic coordination of creatinine and uric acid with Hg(2+) on the surface of gold nanoparticles, which exhibits good selectivity and sensitivity. Point-of-care clinical creatinine monitoring can be supported for monitoring renal function and diagnosing corresponding renal diseases at home. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Serum Cystatin C, Markers of Chronic Kidney Disease, and Retinopathy in Persons with Diabetes

    Directory of Open Access Journals (Sweden)

    Chee Wai Wong

    2015-01-01

    Full Text Available Purpose. We examined the association of CKD defined by serum creatinine, serum cystatin C, and albuminuria with moderate diabetic retinopathy (DR. Methods. We examined 1,119 Indian adults with diabetes, aged 40–80 years, who participated in the Singapore Indian Eye Study (2007–2009, a population-based cross-sectional study. The associations of CKD defined by each of the three markers alone and in combination with moderate DR were examined using logistic regression models adjusted for potential confounding factors including duration of diabetes, smoking, body mass index, systolic blood pressure, and HbA1c. Results. The prevalence of moderate DR was significantly higher among those with CKD defined by triple markers (41.1% compared to CKD defined separately by creatinine (26.6%, cystatin C (20.9%, and albuminuria (23.4%. People with CKD defined by triple markers had a fourteenfold higher odds of moderate DR (OR (95% CI = 13.63 (6.08–30.54 compared to those without CKD by any marker. Nearly half (48.7% of participants with cystatin C ≥ 1.12 mg/L have moderate DR. Conclusions. CKD defined by a triple marker panel was strongly associated with moderate DR in this Asian population with diabetes.

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

    Science.gov (United States)

    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. Serum chemistry, hematologic, and post-mortem findings in free-ranging bobcats (Lynx rufus) with notoedric mange

    Science.gov (United States)

    Serieys, Laurel E.K.; Foley, Janet; Owens, Sean; Woods, Leslie; Boydston, Erin E.; Lyren, Lisa M.; Poppenga, Robert H.; Clifford, Deana L.; Stephenson, Nicole; Rudd, Jaime; Riley, Seth P.D.

    2013-01-01

    Notoedric mange was responsible for a population decline of bobcats (Lynx rufus) in 2 Southern California counties from 2002–2006 and is now reported to affect bobcats in Northern and Southern California. With this study we document clinical laboratory and necropsy findings for bobcats with mange. Bobcats in this study included free-ranging bobcats with mange (n = 34), a control group of free-ranging bobcats without mange (n = 11), and a captive control group of bobcats without mange (n = 19). We used 2 control groups to evaluate potential anomalies due to capture stress or diet. Free-ranging healthy and mange-infected bobcats were trapped or salvaged. Animals were tested by serum biochemistry, complete blood count, urine protein and creatinine, body weight, necropsy, and assessment for anticoagulant rodenticide residues in liver tissue. Bobcats with severe mange were emaciated, dehydrated, and anemic with low serum creatinine, hyperphosphatemia, hypoglycemia, hypernatremia, and hyperchloremia, and sometimes septicemic when compared to control groups. Liver enzymes and leukocyte counts were elevated in free-ranging, recently captured bobcats whether or not they were infested with mange, suggesting capture stress. Bobcats with mange had lower levels of serum cholesterol, albumin, globulin, and total protein due to protein loss likely secondary to severe dermatopathy. Renal insufficiency was unlikely in most cases, as urine protein:creatinine ratios were within normal limits. A primary gastrointestinal loss of protein or blood was possible in a few cases, as evidenced by elevated blood urea nitrogen, anemia, intestinal parasitism, colitis, gastric hemorrhage, and melena. The prevalence of exposure to anticoagulant rodenticides was 100% (n = 15) in bobcats with mange. These findings paint a picture of debilitating, multisystemic disease with infectious and toxic contributing factors that can progress to death in individuals and potential decline in populations.

  9. Serum chemistry, hematologic, and post-mortem findings in free-ranging bobcats (Lynx rufus) with notoedric mange.

    Science.gov (United States)

    Serieys, Laurel E K; Foley, Janet; Owens, Sean; Woods, Leslie; Boydston, Erin E; Lyren, Lisa M; Poppenga, Robert H; Clifford, Deana L; Stephenson, Nicole; Rudd, Jaime; Riley, Seth P D

    2013-12-01

    Notoedric mange was responsible for a population decline of bobcats ( Lynx rufus ) in 2 Southern California counties from 2002-2006 and is now reported to affect bobcats in Northern and Southern California. With this study we document clinical laboratory and necropsy findings for bobcats with mange. Bobcats in this study included free-ranging bobcats with mange (n = 34), a control group of free-ranging bobcats without mange (n = 11), and a captive control group of bobcats without mange (n = 19). We used 2 control groups to evaluate potential anomalies due to capture stress or diet. Free-ranging healthy and mange-infected bobcats were trapped or salvaged. Animals were tested by serum biochemistry, complete blood count, urine protein and creatinine, body weight, necropsy, and assessment for anticoagulant rodenticide residues in liver tissue. Bobcats with severe mange were emaciated, dehydrated, and anemic with low serum creatinine, hyperphosphatemia, hypoglycemia, hypernatremia, and hyperchloremia, and sometimes septicemic when compared to control groups. Liver enzymes and leukocyte counts were elevated in free-ranging, recently captured bobcats whether or not they were infested with mange, suggesting capture stress. Bobcats with mange had lower levels of serum cholesterol, albumin, globulin, and total protein due to protein loss likely secondary to severe dermatopathy. Renal insufficiency was unlikely in most cases, as urine protein:creatinine ratios were within normal limits. A primary gastrointestinal loss of protein or blood was possible in a few cases, as evidenced by elevated blood urea nitrogen, anemia, intestinal parasitism, colitis, gastric hemorrhage, and melena. The prevalence of exposure to anticoagulant rodenticides was 100% (n = 15) in bobcats with mange. These findings paint a picture of debilitating, multisystemic disease with infectious and toxic contributing factors that can progress to death in individuals and potential decline in populations.

  10. Possible association of high urinary magnesium and taurine to creatinine ratios with metabolic syndrome risk reduction in Australian aboriginals.

    Science.gov (United States)

    Hamada, Atsumi; Taguchi, Takashi; Mori, Hideki; Thorpe, Marjorie; Yamori, Yukio; Mori, Mari

    2011-01-01

    Background. Because of the epidemic of metabolic syndrome (MS) in Australian Aboriginals known for their higher cardiovascular mortality and shorter life expectancy, we analyzed the possible relationship of their MS risks with the current dietary custom. Methods. The subjects were 84 people aged 16-79 years. The health examination was conducted according to the basic protocol of WHO-CARDIAC (Cardiovascular Diseases and Alimentary Comparison) Study. Results. The highest prevalence among MS risks was abdominal obesity (over 60%). After controlling for age and sex, the odds of obesity decreased significantly with high level of urinary magnesium/creatinine ratio (Mg/cre) (OR, 0.11; 95% CI, 0.02-0.57; P creatinine ratio were revealed. Conclusions. The high prevalence of obesity in the Aboriginal people of this area may partly be due to the reduction of beneficial nutrients intake including Mg and taurine.

  11. Effects of lead shot ingestion on delta-aminolevulinic acid dehydratase activity, hemoglobin concentration, and serum chemistry in bald eagles

    Science.gov (United States)

    Hoffman, D.J.; Pattee, O.H.; Wiemeyer, Stanley N.; Mulhern, B.

    1981-01-01

    Lead shot ingestion by bald eagles (Haliaeetus leucocephalus) is considered to be widespread and has been implicated in the death of eagles in nature. It was recently demonstrated under experimental conditions that ingestion of as few as 10 lead shot resulted in death within 12 to 20 days. In the present study hematological responses to lead toxicity including red blood cell ALAD activity, hemoglobin concentration and 23 different blood serum chemistries were examined in five captive bald eagles that were unsuitable for rehabilitation and release. Eagles were dosed by force-feeding with 10 lead shot; they were redosed if regurgitation occurred. Red blood cell ALAD activity was inhibited by nearly 80% within 24 hours when mean blood lead concentration had increased to 0.8 parts per million (ppm). By the end of 1 week there was a significant decrease (20-25%) in hematocrit and hemoglobin, and the mean blood lead concentration was over 3 ppm. Within as little as 1-2 weeks after dosing, significant elevations in serum creatinine and serum alanine aminotransferase occurred, as well as a significant decrease in the ratio of serum aspartic aminotransferase to serum alanine aminotransferase. The mean blood lead concentration was over 5 ppm by the end of 2 weeks. These changes in serum chemistry may be indicative of kidney and liver alterations.

  12. In-capillary determination of creatinine with electrophoretically mediated microanalysis: characterization of the effects of reagent zone and buffer conditions.

    Science.gov (United States)

    Mason, Philip E; Schildt, Derek C; Strein, Timothy G

    2009-01-02

    Previous work has demonstrated proof-of-concept for carrying out the clinically useful Jaffe reaction between creatinine and picrate within a capillary tube using electrophoretically mediated microanalysis (EMMA). Here, it is shown that careful control of reagent plug length as well as concentration and pH of the background electrolyte (BGE) can result in a marked improvement in the sensitivity of this assay. Increasing the length of the picrate reagent zone is shown to give rise to as much as a 3-4-fold enhancement, and increasing the concentration and/or pH of the borate buffer also results in an additional, albeit modest, improvement in sensitivity. Interestingly, borate BGE concentrations approaching 100mM give rise to an unexplained drop in reaction efficiency, an effect which can be avoided by utilizing lower borate concentration with higher pH. The improvements appear to primarily minimize electrodispersion of the picrate reagent, allowing higher picrate concentration in the reaction zone. The same conditions also appear to minimize the electrodispersion of the in-line product as well. With optimized EMMA parameters, the sensitivity of the in-line Jaffe chemistry can be enhanced to an extent that there is no need for the two capillary "high sensitivity" detection system required in previous work. Using optimized conditions, three different human serum samples spanning the expected clinical range of creatinine concentrations were successfully analyzed. Overall, this work illustrates the importance of systematically characterizing the conditions under which EMMA analyses are carried out.

  13. Characterization of murine anti-human Fab antibodies for use in an immunoassay for generic quantification of human Fab fragments in non-human serum samples including cynomolgus monkey samples.

    Science.gov (United States)

    Stubenrauch, Kay; Wessels, Uwe; Essig, Ulrich; Kowalewsky, Frank; Vogel, Rudolf; Heinrich, Julia

    2013-01-01

    Generic immunoassay formats in animal serum have been described for pharmacokinetic (PK) analysis of human full-length antibodies, but not of human antigen binding fragment (Fab) proteins. Here we characterize two murine monoclonal antibodies (mAb) raised against human immunoglobulin G (IgG) which bind to unique epitopes in the Fab region of human IgG. mAb M-1.7.10 is directed against the constant domain of the kappa light chain and mAb M-1.19.31 binds to the constant domain 1 (CH1) of the heavy chain. Surface plasmon resonance analysis showed that mAb M-1.7.10 does not cross-react with sera from mouse, rat, rabbit, dog, marmoset, rhesus macaque, baboon and cynomolgus monkey, but binds to human and chimpanzee serum (dissociation constant K(D) of 6.8 × 10(-12) and 3.1 × 10(-11)M, respectively). mAb M-1.19.31 shows a higher K(D) for human and chimpanzee IgG (2.0 × 10(-9)M and 5.8 × 10(-10)M, respectively), but also does not bind to serum of the other species. Therefore, mAb M-1.7.10 was used as capture and mAb M-1.19.31 as detection reagent in a generic enzyme linked immunosorbent assay (ELISA) to quantify the human anti-IGF-1R Fab in mouse serum. The generic human Fab assay showed a limit of detection of 31.5 ng/mL anti-IGF-1R Fab. Intra- and inter-assay precision was less than 12% and the accuracy range for all controls was within ±20% of the target concentration. The generic human Fab ELISA was applied to determine serum levels of human anti-IGF-1R Fab after intravenous (iv) administration of 10mg/kg to mice. The resulting concentration-time profile was nearly identical to that obtained by analysis with a validated specific ELISA for anti-IGF-1R Fab. The mean relative concentration of anti-IGF-1R Fab analyzed by the generic assay was 82-118% of that of the specific assay. This equivalence was confirmed in a cynomolgus monkey study with the full length human mAb anti-TROP-2 IgG. Both specific ELISAs used mAb M-1.7.10 as detection reagent and their targets for

  14. Variability of creatinine measurements in clinical laboratories: results from the CRIC study.

    Science.gov (United States)

    Joffe, Marshall; Hsu, Chi-yuan; Feldman, Harold I; Weir, Matthew; Landis, J R; Hamm, L Lee

    2010-01-01

    Estimating equations using serum creatinine (SCr) are often used to assess glomerular filtration rate (GFR). Such creatinine (Cr)-based formulae may produce biased estimates of GFR when using Cr measurements that have not been calibrated to reference laboratories. In this paper, we sought to examine the degree of this variation in Cr assays in several laboratories associated with academic medical centers affiliated with the Chronic Renal Insufficiency Cohort (CRIC) Study; to consider how best to correct for this variation, and to quantify the impact of such corrections on eligibility for participation in CRIC. Variability of Cr is of particular concern in the conduct of CRIC, a large multicenter study of subjects with chronic renal disease, because eligibility for the study depends on Cr-based assessment of GFR. A library of 5 large volume plasma specimens from apheresis patients was assembled, representing levels of plasma Cr from 0.8 to 2.4 mg/dl. Samples from this library were used for measurement of Cr at each of the 14 CRIC laboratories repetitively over time. We used graphical displays and linear regression methods to examine the variability in Cr, and used linear regression to develop calibration equations. We also examined the impact of the various calibration equations on the proportion of subjects screened as potential participants who were actually eligible for the study. There was substantial variability in Cr assays across laboratories and over time. We developed calibration equations for each laboratory; these equations varied substantially among laboratories and somewhat over time in some laboratories. The laboratory site contributed the most to variability (51% of the variance unexplained by the specimen) and variation with time accounted for another 15%. In some laboratories, calibration equations resulted in differences in eligibility for CRIC of as much as 20%. The substantial variability in SCr assays across laboratories necessitates calibration

  15. Serum sickness

    Science.gov (United States)

    ... the problem should be stopped. Avoid using that medicine or antiserum in the future. ... Call your provider if you received medicine or antiserum in the last 4 weeks and have symptoms of serum sickness.

  16. The urine albumin-to-creatinine ratio is a reliable indicator for evaluating complications of chronic kidney disease and progression in IgA nephropathy in China

    Directory of Open Access Journals (Sweden)

    Lu Huan

    2016-05-01

    Full Text Available OBJECTIVE: This study investigated the correlation between the albumin-to-creatinine ratio in the urine and 24-hour urine proteinuria and whether the ratio can predict chronic kidney disease progression even more reliably than 24-hour proteinuria can, particularly in primary IgA nephropathy. METHODS: A total of 182 patients with primary IgA nephropathy were evaluated. Their mean urine albumin-to-creatinine ratio and 24-hour proteinuria were determined during hospitalization. Blood samples were also analyzed. Follow-up data were recorded for 44 patients. A cross-sectional study was then conducted to test the correlation between these parameters and their associations with chronic kidney disease complications. Subsequently, a canonical correlation analysis was employed to assess the correlation between baseline proteinuria and parameters of the Oxford classification. Finally, a prospective observational study was performed to evaluate the association between proteinuria and clinical outcomes. Our study is registered in the Chinese Clinical Trial Registry, and the registration number is ChiCTR-OCH-14005137. RESULTS: A strong correlation (r=0.81, p<0.001 was found between the ratio and 24-hour proteinuria except in chronic kidney disease stage 5. First-morning urine albumin-to-creatinine ratios of ≥125.15, 154.44 and 760.31 mg/g reliably predicted equivalent 24-hour proteinuria ‘thresholds’ of ≥0.15, 0.3 and 1.0 g/24 h, respectively. In continuous analyses, the albumin-to-creatinine ratio was significantly associated with anemia, acidosis, hypoalbuminemia, hyperphosphatemia, hyperkalemia, hypercholesterolemia and higher serum cystatin C. However, higher 24-hour proteinuria was only associated with hypoalbuminemia and hypercholesterolemia. Higher tubular atrophy and interstitial fibrosis scores were also associated with a greater albumin-to-creatinine ratio, as observed in the canonical correlation analysis. Finally, the albumin-to-creatinine

  17. 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.

  18. Interrelationship of βeta-2 microglobulin, blood urea nitrogen and creatinine in streptozotocin -induced diabetes mellitus in rabbits

    Directory of Open Access Journals (Sweden)

    Shahram Javadi

    2013-12-01

    Full Text Available Measurement of serum creatinine (Cr and blood urea nitrogen (BUN are used as indicators of glomerular filtration rate. The increased levels of these biomarkers are usually detectable at advanced stages of kidney complications. The aim of this study was to find the interrelationship of beta-2 microglobulin (β2M, BUN and Cr in streptozotocin (STZ-induced diabetes mellitus in rabbits. Diabetes was induced by a single intraperitoneal (IP injection of 65 mg kg-1 of STZ in rabbits. The levels of serum insulin, glucose and three above mentioned biomarkers were measured one day before (day -1 and on days 1-3 after injection of STZ and continued weekly to the end of the experiment (12 weeks. A statistically significant increase of serum β2M, BUN, Cr and glucose levels, and a significant decrease of insulin levels were observed in diabetic animals. However, β2M levels increased as early as one day after STZ injection compared to Cr and BUN that elevated at day two, suggesting a probable diagnostic advantage of β2M over currently used biomarkers in diabetic related kidney complications.

  19. Evaluation of dementia by acrolein, amyloid-β and creatinine.

    Science.gov (United States)

    Igarashi, Kazuei; Yoshida, Madoka; Waragai, Masaaki; Kashiwagi, Keiko

    2015-10-23

    Plasma, urine and cerebrospinal fluid (CSF) were examined for biochemical markers of dementia. Protein-conjugated acrolein (PC-Acro) and the amyloid-β (Aβ)40/42 ratio in plasma can be used to detect mild cognitive impairment (MCI) and Alzheimer's disease (AD). In plasma, PC-Acro and the Aβ40/42 ratio in MCI and AD were significantly higher relative to non-demented subjects. Furthermore, urine acrolein metabolite, 3-hydroxypropyl mercapturic acid (3-HPMA)/creatinine (Cre) and amino acid-conjugated acrolein (AC-Acro)/Cre in AD were significantly lower than MCI. It was also shown that reduced urine 3-HPMA/Cre correlated with increased plasma Aβ40/42 ratio in dementia. The Aβ40/PC-Acro ratio in CSF, together with Aβ40 and Aβ40/42 ratio, was lower in AD than MCI. Increased plasma PC-Acro and Aβ40/42 ratio and decreased urine 3-HPMA/Cre correlated with cognitive ability (MMSE). These results indicate that the measurements of acrolein derivatives together with Aβ and Cre in biologic fluids is useful to estimate severity of dementia. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Association of Serum Adropin Concentrations with Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Wenchao Hu

    2016-01-01

    Full Text Available Objective. Adropin is a newly identified regulatory protein encoded by the Enho gene and is critically involved in energy homeostasis and insulin sensitivity. This study aims to determine the correlation of serum adropin concentrations with diabetic nephropathy (DN. Methods. This study consisted of 245 patients with type 2 diabetes mellitus (T2DM and 81 healthy subjects. Then T2DM patients were divided into normoalbuminuria, microalbuminuria, and macroalbuminuria subgroups based on urine albumin to creatinine ratio (ACR. Results. T2DM patients showed significantly lower serum adropin concentrations than those in the controls. T2DM patients with macroalbuminuria had significantly decreased serum adropin concentrations compared with the other three groups. In addition, T2DM patients with microalbuminuria showed lower serum adropin concentrations than those in patients with normoalbuminuria. Logistic regression analysis showed that serum adropin was correlated with decreased risk of developing T2DM and DN. Pearson correlation analysis indicated that serum adropin was negatively correlated with body mass index (BMI, blood urea nitrogen, creatinine, and ACR and positively correlated with glomerular filtration rate. Furthermore, multiple linear regression analysis showed that BMI and ACR were negatively correlated with serum adropin levels. Conclusion. Serum adropin concentrations are negatively associated with renal function. Adropin may be implicated in the pathogenesis of DN development.

  1. Serum amylase and lipase activities after exploratory laparotomy in dogs.

    Science.gov (United States)

    Bellah, J R; Bell, G

    1989-09-01

    Serum amylase and lipase activities and creatinine concentration were determined before surgery, and at 1 and 2 days after exploratory laparotomy in 24 dogs. Examination of all viscera was done during each laparotomy, but a surgical procedure was not performed. The mean serum activities for lipase were: before surgery, 0.71 (0.0 to 2.0) Cherry Crandall units (CCU)/L; 1 day after surgery, 2.1 (0.0 to 4.5) CCU/L; and 2 days after surgery, 1.19 (0.0 to 3.9) CCU/L. The mean serum activities for amylase were: before surgery, 1,958 (1,027 to 3,426) IU/L; 1 day after surgery, 1,538 (937 to 2,659) IU/L; and 2 days after surgery, 1,663 (1,066 to 2,274) IU/L. Serum creatinine concentrations before surgery, 1 day after surgery, and 2 days after surgery were 0.88 (0.2 to 1.7) mg/dl, 0.78 (0.4 to 1.3) mg/dl, and 0.78 (0.3 to 1.3) mg/dl, respectively. Mean preoperative, day-1, and day-2 serum amylase activities and serum creatinine concentrations did not differ significantly from each other. Mean preoperative and day-2 serum lipase activities did not differ significantly; however, mean serum lipase activity was significantly greater when day 1 activities were compared with preoperative activities (P = 0.0002). Post-mortem examinations revealed no gross or histologic evidence of pancreatitis in any dog. The results of this study show that a 3 or more fold increase in serum lipase activity may occur after routine exploratory laparotomy in dogs without clinical signs or gross evidence of pancreatitis. Histologic evidence of pancreatitis was not found in the right pancreatic lobes in any dog.

  2. Point of care creatinine measurement for diagnosis of renal disease using a disposable microchip

    NARCIS (Netherlands)

    Ávila Muñoz, Mónica; Floris, J.; Staal, S.S.; Ríos, Ángel; Eijkel, Jan C.T.; van den Berg, Albert

    2013-01-01

    A point-of-care device for the determination of elevated creatinine levels in blood is reported. This device potentially offers a new and simple clinical regime for the determination of creatinine that will give huge time savings and removal of several steps of determination. The test employs a

  3. The influence of ketoacids on plasma creatinine assays in diabetic ketoacidosis

    NARCIS (Netherlands)

    Kemperman, F. A.; Weber, J. A.; Gorgels, J.; van Zanten, A. P.; Krediet, R. T.; Arisz, L.

    2000-01-01

    OBJECTIVE: Analysis of the interference of ketoacids on various routine plasma creatinine assays during a clinical episode of diabetic ketoacidosis (DKA). DESIGN: Observational study. Blood samples were drawn before, during and after standard in-hospital treatment. Plasma creatinine was measured

  4. Effects of bentonite on plasma urea and creatinine of wistar albino rats.

    African Journals Online (AJOL)

    The in vivo effect of Nigerian calcium bentonite clay on wistar albino rat plasma urea and creatinine levels were investigated. The rats were fed for a period of four weeks with varying concentrations of the bentonite clay, and the urea and creatinine levels determined using spectrophotometric methods. Test results showed ...

  5. Circadian rhythm of proteinuria: consequences of the use of urinary protein:creatinine ratios

    NARCIS (Netherlands)

    Koopman, M. G.; Krediet, R. T.; Koomen, G. C.; Strackee, J.; Arisz, L.

    1989-01-01

    Proteinuria in patients with glomerular disease has a circadian rhythm, but for creatinine such a rhythm is either absent or of low amplitude. We found in 18 of 23 admitted patients (group I) and in seven outpatients (group II) a marked circadian rhythm of the protein: creatinine ratio. Estimates of

  6. A quest for normal values of serum aminotransferase and its association with age and body mass index

    International Nuclear Information System (INIS)

    Farooq, M.A.; Farooq, Y.; Khan, M.A.

    2016-01-01

    Objective: To determine the reference range for serum alanine aminotransferase (ALT) levels for young healthy individuals in our population and to find out effects of age and body mass index on alanine aminotransferase. Study Design: Descriptive cross sectional study. Place and Duration of Study: Military Hospital Rawalpindi; from Dec 2009 to April 2010. Material and Methods: Five hundred and fifty three young healthy adults were included in the study. Detailed history was taken. Parameters like Age, height and weight were measured. Relevant investigations were carried out for each subject which included blood complete picture, Chest X-Ray, ECG, Urine routine examination, liver function tests, serum urea, serum creatinine, serum uric acid, plasma glucose (F), Anti HCV antibodies, HBsAg, HIV antibodies and VDRL. Data was analyzed using SPSS version 22. Results: Age of subjects ranged from 19 to 50 years (29 +- 6) years, BMI 15.59 to 29.8, (21.58 +- 2). Serum alanine aminotransferase ranged from 17 to 81 IU/l, (29.9 +- 8) IU/l. Serum alanine aminotransferase for subjects with body mass index more than 25 Kg/m2 was 29.6 +- 7 IU/L. There is no significant difference in value of mean ALT overall and in those with BMI of more than 25 (p=0.149) Conclusion: Mean serum alanine aminotransferase value in young healthy adults included in this study was 29.9 +- 8 IU/L which is lower than normal reference provided at present which is 40 IU/l. Statistical analysis revealed that serum ALT is not significantly influenced by age and BMI. (author)

  7. Insulin treatment corrects hepcidin but not YKL-40 levels in persons with type 2 diabetes mellitus matched by body mass index, waist-to-height ratio, C-reactive protein and Creatinine.

    Science.gov (United States)

    Vela, Driton; Leshoski, Jovica; Vela, Zana; Jakupaj, Muharrem; Mladenov, Mitko; Sopi, Ramadan B

    2017-08-25

    It has been shown that hepcidin and YKL-40 levels change in persons with insulin resistance in different circumstances. However, variations of the levels of these parameters through the stages of prediabetes and type 2 diabetes mellitus are unclear. We hypothesized that hepcidin levels will decrease in persons with prediabetes, while these levels will tend to correct when persons with diabetes are treated with insulin. Finally we sought to determine the levels of YKL-40 in all groups of participants included in the study. Serum hepcidin levels and YKL-40 levels were measured in control group (n = 20), persons with prediabetes (n = 30) and persons with diabetes on insulin therapy (n = 30) using ELISA method. Patients in all three groups were matched by Body Mass Index, Waist-to-Height Ratio, C-Reactive Protein and creatinine levels. Hepcidin levels were lower in persons with prediabetes compared to control, while persons with diabetes on insulin therapy had higher values than those with prediabetes (p = 0,00001). YKL-40 levels showed no significant changes. Serum hepcidin levels in matched persons with prediabetes are a stronger marker of early changes in glucose metabolism compared to YKL-40 levels. Also, treatment with insulin corrects hepcidin levels, but not YKL-40 levels. Correcting levels of hepcidin is important for reducing iron-overload, which is a risk factor for diabetes.

  8. Urinary excretion profiles of 11-nor-9-carboxy-Delta9-tetrahydrocannabinol: a Delta9-THC-COOH to creatinine ratio study #2.

    Science.gov (United States)

    Fraser, Albert D; Worth, David

    2003-04-23

    Subjects with a history of chronic marijuana use were screened for cannabinoids in urine specimens with the EMIT((R)) II Plus cannabinoids assay with a cut-off value of 50 ng/ml. All presumptively positive specimens were submitted for confirmatory analysis for the major urinary cannabinoid metabolite (Delta(9)-THC-COOH) by GC-MS with a cut-off value of 15 ng/ml. Creatinine was analyzed in each specimen as an index of dilution. Huestis and Cone [J. Anal. Toxicol. 22 (1998) 445] reported that serial monitoring of Delta(9)-THC-COOH to creatinine ratios in paired urine specimens collected at least 24h apart could differentiate new drug use from residual Delta(9)-THC-COOH excretion. The best accuracy (85.4%) for predicting new marijuana use was a Delta(9)-THC-COOH/creatinine ratio > or =0.5 (dividing the Delta(9)-THC-COOH to creatinine ratio of specimen 2 by the specimen 1 ratio). In a previous study in this laboratory [J. Anal. Toxicol. 23 (1999) 531], urine specimens were collected from chronic marijuana users at least 24h apart and dilute urine specimens (creatinine values THC-COOH in chronic users of marijuana based on the Huestis 0.5 ratio. Urine specimens (N=946) were collected from 37 individuals with at least 48h between collections. All urine specimens were included in the data review irrespective of creatinine concentration. The mean urinary Delta(9)-THC-COOH concentration was 302.4 ng/ml, mean Delta(9)-THC-COOH/creatinine ratio (ng/ml Delta(9)-THC-COOH/(mmol/l) creatinine) was 29.3 and the Huestis ratio calculation indicated new drug use in 83% of all sequentially paired urine specimens. The data were sub-divided into three groups (A-C) based on the mean Delta(9)-THC-COOH/creatinine values. Interindividual Delta(9)-THC-COOH/creatinine mean values ranged from 2.2 to 13.8 in group A (264 specimens, N=15 subjects) where 80.7% of paired specimens indicated new drug use. In group B, mean Delta(9)-THC-COOH/creatinine values ranged from 15.3 to 37.8 in 444 specimens

  9. The marker of cobalamin deficiency, plasma methylmalonic acid, correlates to plasma creatinine

    DEFF Research Database (Denmark)

    Hvas, A M; Juul, S; Gerdes, Lars Ulrik

    2000-01-01

    OBJECTIVE: To examine the relationship between the two diagnostic tests, plasma methylmalonic acid and plasma cobalamins, and their association with plasma creatinine, age and sex. DESIGN: Cross-sectional study of simultaneous laboratory measurements. SETTING: County of Aarhus, Denmark. SUBJECTS......: Records on 1689 patients who had their first plasma methylmalonic acid measurement during 1995 and 1996, and who had a simultaneous measurement of plasma cobalamins. Plasma creatinine values measured within a week of measurements of plasma methylmalonic acid and plasma cobalamins were available for 1255...... of the patients. MAIN OUTCOME MEASURES: Predictors of variation in plasma methylmalonic acid; plasma cobalamins, plasma creatinine, age and sex. RESULTS: Plasma methylmalonic acid was positively correlated with plasma creatinine, even for plasma creatinine within the normal range. These associations remained...

  10. Cystatin C more accurately detects mildly impaired renal function than creatinine in children receiving treatment for malignancy.

    Science.gov (United States)

    Blufpand, Hester N; Tromp, Jorien; Abbink, Floor C H; Stoffel-Wagner, Birgit; Bouman, Anneke A; Schouten-van Meeteren, Antoinette Y N; van Wijk, Joanna A E; Kaspers, Gertjan J L; Bökenkamp, Arend

    2011-08-01

    Monitoring of renal function is crucial in pediatric oncology. The use of creatinine to estimate glomerular filtration rate (GFR) is hampered by its dependency on muscle mass. Muscle wasting is common in children with cancer, leading to overestimation of GFR. Data on cystatin C are sparse in pediatric oncology, although this marker could be particularly useful in this population. Inulin clearance, estimated GFR using serum cystatin C according to Filler (eGFRcys) and serum creatinine according to Schwartz (eGFRcrea) were measured in 68 children with malignancy and 121 controls. We analyzed the difference between measured and estimated GFR and performance, bias and accuracy. Multiple linear regression analysis showed overestimation of GFR by eGFRcrea in females (B = -21.18; P = 0.001), and in patients with malignancy (B = -21.77; P = 0.014). eGFRcys overestimated GFR in females (B = -10.47; P = 0.001), but was independent of treatment for malignancy. Agreement with gold standard in detecting GFR below 90 ml/min/1.73 m(2) is better for eGFRcys (AUC 0.854) than for eGFRcrea (AUC 0.675) in the group with cancer. They performed comparably in the control group. Bland-Altman analysis showed considerable bias for eGFRcrea compared to eGFRcys (-14.3 ml/min/1.73 m(2) vs. -7.3 ml/min/1.73 m(2)). The proportion of estimates within 30% of true GFR for eGFRcrea (72.1%) was lower than for eGFRcys (82.4%) in the group with cancer. In the control group eGFRcrea (84.3%) outperformed eGFRcys (76.0%). When using the 50% limits of agreement, eGFRcys outperformed eGFRcrea in both groups. Cystatin C more accurately detects mildly impaired renal function than creatinine in children receiving treatment for malignancy. Copyright © 2011 Wiley-Liss, Inc.

  11. Serum Lipid Profiles, Lipid Ratios and Chronic Kidney Disease in a Chinese Population

    Directory of Open Access Journals (Sweden)

    Liying Zhang

    2014-07-01

    Full Text Available Aim: To examine the association of serum lipids, lipid ratios with Chronic Kidney Disease (CKD in a Chinese population. Methods: Data were drawn from a cross-sectional survey in China. CKD was defined as estimated glomerular filtration rate (eGFR < 60 mL/min/1.73m2 or albuminuria-to-creatinine ratio (ACR > 30 mg/g. Multivariable logistic regressions and multivariate regression models were used. Serum lipids and lipid ratios included total cholesterol (TC, triglyceride (TG, low-density lipoprotein cholesterol (LDL-C, high-density lipoprotein cholesterol (HDL-C, TG/HDL-C ratio, TC/HDL-C ratio and LDL-C/HDL-C ratio. Results: In men, only logarithm-transformed (log TG was associated with CKD. The odds ratio (every SD increment was 1.39 (95% CI 1.03–1.87, P = 0.03. In women, none of the serum lipids and lipid ratios was associated with CKD. Using multivariate regression models, it was shown that log TG and log TG/HDL-C were negatively correlated with eGFR (P < 0.05 in men and LDL-C and log LDL-C/HDL-C ratio were correlated with ACR in men. In female subjects, serum TC, log TG, log TG/HDL-C and log TC/HDL-C were negatively correlated with eGFR (P < 0.05. All of serum lipid profiles and lipid related ratio were not correlated with ACR in women. Conclusion: Serum TG is the only suitable predictor for CKD in men. However, in women, none of serum lipids and lipid ratio can be used as a predictor for CKD. Log TG and log TG/HDL-C are negatively correlated with eGFR in both genders.

  12. Radioimmunological determination of digoxin in serum

    International Nuclear Information System (INIS)

    Gruber, G.; Sorger, D.

    1979-01-01

    The tested quality signs of the digoxin-RIA (Medica) correspond to other RIA-test methods. The digoxin-RIA (Medica) is, therefore, well suited for clinical examinations. In the dilanacin-(digoxin-) long-term therapy with the maintenance dose of 0.5 mg digoxin a day 75.4% of the patients examined (n = 65) were within the therapeutic field. In each case 12.3% were underdigitalised or overdigitalised, respectively. In the 8 patients in the toxic region only the half showed signs of digoxin intoxication. It is referred to the importance of creatinine and potassium in the serum, to the digoxin creatinene and potassium in the serum, to the digoxin clearance depending on age, to the body weight and the body surface, respectively, in very obese patients for the height of the serum digoxin level and for the compatibility of this heart glycoside. (author)

  13. [Pitfalls in measuring urinary proteins: age-related changes in urinary creatinine excretion that affect the urine protein/creatinine ratio].

    Science.gov (United States)

    Yuno, Tomoji; Hisada, Yukimasa; Nishimura, Yasuyuki

    2011-02-01

    Knowing the amount of protein excreted in the urine is important in determining the severity and activity of renal diseases. In general, screening tests have been carried out using the urine dipstick. However, there are limitations in determining the amount of urinary protein excretion using qualitative tests for protein in spot urine samples due to the concentration and dilution of urine. Therefore, when using spot urine samples, it is helpful to calculate the urine protein/creatinine ratio (P/C) by simultaneous measurement of urinary creatinine for determining daily protein excretion. We examined P/C measurements using the dipstick method in 22,718 subjects who visited our hospital for health examinations. The results showed positive rates for qualitative urinary protein (1 + and more) of 4.2% for males and 2.7% for females. Also positive rates for P/C (150 mg/g.cre and more) were found of 7.7% for males and 10.2% for females. The results showed a reversal of positive rates for males and females compared with the results of qualitative urinary protein. In addition, P/C showed a higher positive rate in 70 years old or older both for males and females. The distribution of urinary creatinine levels simultaneously measured by dipstick method showed that the percentage of diluted urine with urinary creatinine level less than 50 mg/dL was 6.8% for males and 18.3% for females overall. Females showed a higher rate and the percentage tended to increase with age both for males and females. From these results, it was suggested that changes in urinary creatinine excretion with age that affect the P/C ratio are large. We then measured the albumin excretion rate in the 24-hour urine as well as examined the correlation between the urinary creatinine concentration and albumin index with regard to age and sex in 1,280 diabetic patients. The results showed that daily urinary creatinine excretion overall in males, overall in females, in males over 80 years old and in females over

  14. LC-MS-MS Measurements of Urinary Creatinine and the Application of Creatinine Normalization Technique on Cotinine in Smokers’ 24 Hour Urine

    Directory of Open Access Journals (Sweden)

    Hongwei Hou

    2012-01-01

    Full Text Available A simple and sensitive high performance liquid chromatography-tandem mass spectrometry (HPLC-ESI-MS-MS method was developed and validated for the quantification of creatinine in human urine. The analysis was carried out on an Agilent Zorbax Eclipse XDB-C18 column (2.1×150 mm, 3.5 μm. The mobile phase was 0.1% formic acid in water and 0.1% formic acid in acetonitrile (50/50, v/v. Linear calibration curves were obtained in the concentration range of 1–2000.0 ng/mL, with a lower limit of quantification of 0.99 ng/mL. The intra- and interday precision (RSD values were below 3%. The method was successfully applied to a bioequivalence study of creatinine in Chinese smokers and nonsmokers. The total cotinine in 24 h urine and cotinine : creatinine ratio were also positively associated (Pearson R=0.942, P<0.0001. However, cotinine : creatinine ratio varied significantly across smoking groups for the difference of individual. 24 h urinary cotinine was more appropriate for expressing correlation with tar than cotinine : creatinine ratio.

  15. Increased serum asymmetric dimethylarginine levels in hyperemesis gravidarum.

    Science.gov (United States)

    Akdemir, Nermin; Akhin, Okan

    2012-02-01

    We sought to investigate the serum levels of asymmetric dimethylarginine in pregnant women with hyperemesis gravidarum. Thirty-seven patients with hyperemesis gravidarum and 33 healthy controls were included in the study. Participants in the control group had no symptoms, or suffered only mild nausea without vomiting. The groups did not differ in age, weight, gestational week, or levels of hemoglobin, glucose or creatinine. The group with hyperemesis gravidarum had higher levels of blood urea nitrogen and liver transaminase than the controls (p = 0.005, 0.01, and 0.04, respectively). They also had lower levels of sodium and thyroid-stimulating hormone (p = 0.004 and 0.03, respectively). Serum levels of asymmetric dimethylarginine were 0.79 ± 0.39 μM in the group with hyperemesis gravidarum and 0.68 ± 0.21 μM in the control group (p = 0.001). The results of this study showed the role of endothelial dysfunction in the pathogenesis of hyperemesis gravidarum.

  16. Association of creatinine clearance with neutropenia in breast cancer patients undergoing chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide (FAC).

    Science.gov (United States)

    Montoya, J E; Luna, H G; Morelos, A B; Catedral, M M; Lava, A L; Amparo, J R; Cristal-Luna, G R

    2013-04-01

    Fluorouracil, doxorubicin, cyclophosphamide protocol (FAC) is a commonly used regimen for breast cancer due to its proven efficacy, acceptable toxicity, high affordability. While hepatic insufficiency dosing for doxorubicin and fluorouracil have been set, there is paucity of data in the literature on how to reduce doses in renal insufficiency. We sought to determine whether there is an association with pre-chemotherapy creatinine clearance, and the occurrence of clinically significant grade 3 to 5 neutropenia during the course of FAC chemotherapy. A retrospective study involving chart review from 2009 to June 2012, of breast cancer patients given FAC was conducted. Demographic profile, pre-chemotherapy complete blood count and creatinine clearance (CrCl) were recorded. Occurrence of Grade 3 to 5 neutropenia was the endpoint of the study. Descriptive statistics, one tailed t test, logistic regression analysis were done between the outcome and variables. A total of 53 patients were included in the study. The mean age of the patients was 49.77 ± 10.82 years. Patients had an ECOG performance status range of 1 to 3. Patients received mean 5.64 ± 0.92 cycles of FAC protocol chemotherapy. Pre-treatment chemotherapy WBC was 7.41 ± 2.68x109/L, Hemoglobin was 12.60 ± 1.16 g/dL, ANC 4656.89 ± 2379.32. Pre treatment CrCl was 90.79 ± 31.49 ml/min. Thirteen subjects, or 24.53% developed at least grade 3 neutropenia. Patients who developed neutropenia were significantly different from those who did not in terms of baseline WBC p=0.046 and Weight p=0.0119, CrCl p=0.032. Using logistic regression analysis, only creatinine clearance was a significant predictor of neutropenia. There was an inverse association between creatinine clearance and neutropenia, OR 0.887, 95% confidence interval (CI): 0.808- 0.973, p=0.011. The study revealed that breast cancer patients treated with FAC, there was an inverse association between creatinine clearance and occurrence of neutropenia.

  17. Calcium supplementation increases blood creatinine concentration in a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Elizabeth L Barry

    Full Text Available Calcium supplements are widely used among older adults for osteoporosis prevention and treatment. However, their effect on creatinine levels and kidney function has not been well studied.We investigated the effect of calcium supplementation on blood creatinine concentration in a randomized controlled trial of colorectal adenoma chemoprevention conducted between 2004-2013 at 11 clinical centers in the United States. Healthy participants (N = 1,675 aged 45-75 with a history of colorectal adenoma were assigned to daily supplementation with calcium (1200 mg, as carbonate, vitamin D3 (1000 IU, both, or placebo for three or five years. Changes in blood creatinine and total calcium concentration were measured after one year of treatment and multiple linear regression was used to estimate effects on creatinine concentrations.After one year of treatment, blood creatinine was 0.013±0.006 mg/dL higher on average among participants randomized to calcium compared to placebo after adjustment for other determinants of creatinine (P = 0.03. However, the effect of calcium treatment appeared to be larger among participants who consumed the most alcohol (2-6 drinks/day or whose estimated glomerular filtration rate (eGFR was less than 60 ml/min/1.73 m2 at baseline. The effect of calcium treatment on creatinine was only partially mediated by a concomitant increase in blood total calcium concentration and was independent of randomized vitamin D treatment. There did not appear to be further increases in creatinine after the first year of calcium treatment.Among healthy adults participating in a randomized clinical trial, daily supplementation with 1200 mg of elemental calcium caused a small increase in blood creatinine. If confirmed, this finding may have implications for clinical and public health recommendations for calcium supplementation.ClinicalTrials.gov NCT00153816.

  18. Normal values of urine total protein- and albumin-to-creatinine ratios in term newborns.

    Science.gov (United States)

    El Hamel, Chahrazed; Chianea, Thierry; Thon, Séverine; Lepichoux, Anne; Yardin, Catherine; Guigonis, Vincent

    2017-01-01

    It is important to have an accurate assessment of urinary protein when glomerulopathy or kidney injury is suspected. Currently available normal values for the neonate population have limited value, in part because they are based on small populations and obsolete creatinine assays. We have performed a prospective study with the aim to update the normal upper values of the urinary total protein-to-creatinine and albumin-to-creatinine ratios in term newborns. Urine samples were collected from 277 healthy, full-term newborns within the first 48 hours (D0-1) and between 72 and 120 h of life (D3-4). Total protein, albumin, creatinine and osmolality were measured and the upper limit of normal (upper-limit) values determined. At D0-1 and D3-4, the upper-limit values for the total protein-to-creatinine ratio were 1431 and 1205 mg/g (162 and 136 g/mol) and those for the albumin-to-creatinine ratio were 746 and 301 mg/g (84 and 34 g/mol), respectively. The upper-limit values were significantly higher at D0-1 than at D3-4 only for the albumin-to-creatinine ratio. This study determined the upper limit of normal values for urinary total protein-to-creatinine and albumin-to-creatinine ratios in the largest population of newborns studied to date. These values can therefore be considered as the most clinically relevant data currently available for the detection and diagnosis of glomerular injury in daily clinical practice in this population.

  19. Urinary protein/creatinine ratio versus 24-hour proteinuria in the evaluation of lupus nephritis.

    Science.gov (United States)

    Solorzano, Grace Tamara Moscoso; Silva, Marcus Vinicius Madureira E; Moreira, Sílvia Regina; Nishida, Sonia Kiyomi; Kirsztajn, Gianna Mastroianni

    2012-03-01

    The urinary protein/creatinine ratio has been used instead of 24-hour proteinuria in Nephrology practice for the follow-up of glomerular diseases, considering the advantages of collection and the low cost. However, there are still doubts as to its applicability both for an isolated evaluation and for the follow-up of patients with lupus nephritis. To evaluate 24-hour proteinuria determinations and random urine samples, performing urinary creatinine correction and urinary protein/creatinine ratio in subjects with lupus nephritis. 24-hour proteinuria and urinary protein/creatinine ratio were determined by conventional methods (automated Pyrogallol for proteinuria and alkaline picrate for creatinine). Seventy-eight urine samples of 41 patients diagnosed with systemic lupus erythematosus, according to the American Rheumatology Association, with lupus nephritis, were analyzed, and a good correlation between 24-hour proteinuria and urinary protein/creatinine ratio (r = 0.9010 and r² = 0.813) was observed. However, a poor correlation between random proteinuria (without creatinine correction) versus 24-hour proteinuria (r = 0.635 and r² = 0.403) or versus urinary protein/creatinine ratio (r = 0.754 and r² = 0.569) was seen. 24-hour proteinuria and urinary protein/creatinine ratio were useful in the follow-up of each case. However, we observed that the absolute values were different, which did not allow the replacement of one for the other during follow-up, especially when this result is used to define the activity of the disease. Based on these results, we suggest a period of intersection from one to the other (two to three determinations by both methods), and the choice of one marker for proteinuria follow-up, if necessary.

  20. Assessing validity of serum cystatin C for predicting metabolic syndrome.

    Science.gov (United States)

    Asefy, Zahra; Mirinejad, MirMoosa; Amirrasooli, Hooshang; Tagikhani, Mohammad

    2014-04-01

    Serum concentration of cystatin C a marker of glomerular filtration has been associated with Cardiovascular Disease (CVD). The aim of this study was to evaluate cystatin C as a marker of diabetic kidney disease in normoalbuminuric diabetic patients without Chronic Kidney Disease (CKD). The study population consisted of 65 subjects with metabolic syndrome and 32 subjects free of metabolic syndrome (control group). HDL-C, LDL-C, blood urea, triglycerides, glucose, HbA1c, serum cystatin C and serum creatinine were measured in both groups. GFR was calculated in both groups using Cockrofta Gault equation. Metabolic syndrome presented higher cystatin C levels than normal samples (0.98 8 0.26 1.24 8 0.24 p metabolic syndrome was significantly associated with elevated cystatin C levels. Diabetic patients also presented a slightly greater creatinine (1.11 8 0.09 1.04 0.15 p metabolic syndrome and may identify a certain degree of renal dysfunction even when serum creatinine does not exceed normal level.

  1. Digoxin serum levels with respect to some biochemical and clinical indicators

    International Nuclear Information System (INIS)

    Sedlak, J.; Curilla, E.

    1984-01-01

    Digoxin serum levels were examined in 40 patients using enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) and correlated with levels of potassium, magnesium, creatinine, urea, glomerular filtration (GF) and with clinical signs of different degrees of digitalis serum concentration. The digoxin level assessed by ELISA and RIA methods correlated fairly closely. An average dependence was found between digoxin levels and levels of creatinine, urea and GF. A correlation was observed between a high level of digoxin and clinical signs of digitalis intoxication

  2. Preparation of Citric Acid Crosslinked Chitosan/Poly(Vinyl Alcohol Blend Membranes for Creatinine Transport

    Directory of Open Access Journals (Sweden)

    Retno Ariadi Lusiana

    2016-08-01

    Full Text Available Preparation of membrane using crosslinking reaction between chitosan and citric acid showed that functional group modification increased the number of active carrier groups which lead to better transport capacity of the membrane. In addition, the substitution of the carboxyl group increased creatinine permeation of chitosan membrane. The transport capacity of citric acid crosslinked chitosan membrane for creatinine was found to be 6.3 mg/L. The presence of cyanocobalamin slightly hindered the transport of creatinine although compounds did not able to pass through citric acid crosslinked chitosan/poly(vinyl alcohol blend membrane, as compounds no found in the acceptor phase.

  3. 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.

  4. Serum uric acid and its association with metabolic syndrome and carotid atherosclerosis in obese children.

    Science.gov (United States)

    Pacifico, Lucia; Cantisani, Vito; Anania, Caterina; Bonaiuto, Elisabetta; Martino, Francesco; Pascone, Roberto; Chiesa, Claudio

    2009-01-01

    The association between hyperuricemia, metabolic syndrome (MS), and atherosclerotic vascular disease has been reported in adults, but very little is known about this association in children. The aims of our study were to ascertain the correlates of uric acid (UA) in a sample of obese children, and to investigate whether UA is associated with carotid intima-media thickness (IMT) independently from classical risk factors including MS. We analyzed carotid IMT along with serum triglycerides, total and high-density lipoprotein cholesterol, glucose, insulin, insulin resistance index (as homeostasis model assessment of insulin resistance), alanine aminotransferase, gamma-glutamyltransferase, creatinine, and UA in 120 obese children and 50 healthy control children. UA concentrations were significantly higher in obese children compared with controls; moreover, they correlated with the most established cardiovascular risk factors. In the group of obese children, after adjustment for age, sex, pubertal stage, and creatinine, an independent association between UA levels and the presence of MS syndrome was observed (unstandardized coefficient, 0.044 (95% confidence intervals (CI) 0.015-0.072); Pcreatinine, and MS (considered as a single clinical entity), or the individual components of MS simultaneously included, the association between UA and carotid IMT was significant (P<0.01). In obese children and adolescents, increased UA levels are associated with carotid atherosclerosis.

  5. 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.

  6. Serum cystatin C level: An excellent predictor of mortality in patients with cirrhotic ascites.

    Science.gov (United States)

    Seo, Yeon Seok; Park, Soo Young; Kim, Moon Young; Kim, Sang Gyune; Park, Jun Yong; Yim, Hyung Joon; Jang, Byoung Kuk; Park, Seung Ha; Kim, Ji Hoon; Suk, Ki Tae; Kim, Jin Dong; Kim, Tae Yeob; Cho, Eun Young; Lee, Jun Sung; Jung, Soung Won; Jang, Jae Young; An, Hyonggin; Tak, Won Young; Baik, Soon Koo; Hwang, Jae Seok; Kim, Young Seok; Sohn, Joo Hyun; Um, Soon Ho

    2018-04-01

    Although serum cystatin C level is considered a more accurate marker of renal function in patients with liver cirrhosis, its prognostic efficacy remains uncertain. This study aimed to evaluate the prognostic efficacy of serum cystatin C level in patients with cirrhotic ascites. Patients with cirrhotic ascites from 15 hospitals were prospectively enrolled between September 2009 and March 2013. Cox regression analyses were performed to identify independent predictive factors of mortality and development of type 1 hepatorenal syndrome (HRS-1). In total, 350 patients were enrolled in this study. The mean age was 55.4 ± 10.8 years, and 267 patients (76.3%) were men. The leading cause of liver cirrhosis was alcoholic liver disease (64.3%), followed by chronic viral hepatitis (29.7%). Serum creatinine and cystatin C levels were 0.9 ± 0.4 mg/dL and 1.1 ± 0.5 mg/L, respectively. Multivariate analyses revealed that international normalized ratio and serum bilirubin, sodium, and cystatin C levels were independent predictors of mortality and international normalized ratio and serum sodium and cystatin C levels were independent predictors of the development of HRS-1. Serum creatinine level was not significantly associated with mortality and development of HRS-1 on multivariate analysis. Serum cystatin C level was an independent predictor of mortality and development of HRS-1 in patients with cirrhotic ascites, while serum creatinine level was not. Predictive models based on serum cystatin C level instead of serum creatinine level would be more helpful in the assessment of the condition and prognosis of patients with cirrhotic ascites. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  7. A Closer Look at Evolution: Variants (SNPs) of Genes Involved in Skin Pigmentation, Including EXOC2, TYR, TYRP1, and DCT, Are Associated With 25(OH)D Serum Concentration

    NARCIS (Netherlands)

    Saternus, R.; Pilz, S.; Graber, S.; Kleber, M.; Marz, W.; Vogt, T.; Reichrath, J.

    2015-01-01

    VitaminDdeficiency iscommonin the Caucasian populationandis associated with increased incidence and unfavorable outcome of many diseases, including various types of cancer, infectious, cardiovascular, andautoimmunediseases. Individual factors that predispose for a person's vitaminDstatus, such as

  8. [The National Serum Bank].

    Science.gov (United States)

    Magos-López, C; Sánchez-Villarreal, F; Gutiérrez, G; Tapia-Conyer, R

    1992-01-01

    A National Serum Bank was established to store sera obtained during the National Seroepidemiological Survey performed in Mexico in 1987. More than 70,000 serum samples were obtained from subjects of either sex 1-99 years of age in each of the 32 states of the country. The current collection of sera includes 28,704 male samples and 40,629 female samples. This paper describes the procedures for handling serum samples, including reception registry, storage and distribution to several laboratories for detection of measles, rubella, poliomyelitis, AIDS, diphtheria, pertussis, tetanus, brucella, salmonella, amoeba, toxoplasma, American trypanosomiasis and cysticercus. Determinations of total cholesterol were also made in order to describe its distribution and to identify the prevalence of hypercholesterolemia.

  9. Serum Biochemical Phenotypes in the Domestic Dog.

    Directory of Open Access Journals (Sweden)

    Yu-Mei Chang

    Full Text Available The serum or plasma biochemical profile is essential in the diagnosis and monitoring of systemic disease in veterinary medicine, but current reference intervals typically take no account of breed-specific differences. Breed-specific hematological phenotypes have been documented in the domestic dog, but little has been published on serum biochemical phenotypes in this species. Serum biochemical profiles of dogs in which all measurements fell within the existing reference intervals were retrieved from a large veterinary database. Serum biochemical profiles from 3045 dogs were retrieved, of which 1495 had an accompanying normal glucose concentration. Sixty pure breeds plus a mixed breed control group were represented by at least 10 individuals. All analytes, except for sodium, chloride and glucose, showed variation with age. Total protein, globulin, potassium, chloride, creatinine, cholesterol, total bilirubin, ALT, CK, amylase, and lipase varied between sexes. Neutering status significantly impacted all analytes except albumin, sodium, calcium, urea, and glucose. Principal component analysis of serum biochemical data revealed 36 pure breeds with distinctive phenotypes. Furthermore, comparative analysis identified 23 breeds with significant differences from the mixed breed group in all biochemical analytes except urea and glucose. Eighteen breeds were identified by both principal component and comparative analysis. Tentative reference intervals were generated for breeds with a distinctive phenotype identified by comparative analysis and represented by at least 120 individuals. This is the first large-scale analysis of breed-specific serum biochemical phenotypes in the domestic dog and highlights potential genetic components of biochemical traits in this species.

  10. Protein/creatinine ratio on random urine samples for prediction of proteinuria in preeclampsia.

    Science.gov (United States)

    Roudsari, F Vahid; Ayati, S; Ayatollahi, H; Shakeri, M T

    2012-01-01

    To evaluate Protein/Creatinine ratio on random urine samples for prediction of proteinuria in preeclampsia. This study was performed on 150 pregnant women who were hospitalized as preeclampsia in Ghaem Hospital during 2006. At first, a 24-hours urine sample was collected for each patient to determine protein/creatinine ratio. Then, 24-hours urine collection was analyzed for the evaluation of proteinuria. Statistical analysis was performed with SPSS software. A total of 150 patients entered the study. There was a significant relation between the 24-hours urine protein and protein/creatinine ratio (r = 0.659, P protein/creatinine ratio is more accurate, reliable, and cost-effective, it can be replaced by the method of measurement the 24-hours urine protein.

  11. EVALUATION OF DISPOSABLE DIAPERS FOR QUANTATIVE MEASUREMENTS OF PESTICIDE METABOLITES AND CREATININE IN URINE SAMPLES

    Science.gov (United States)

    This project consisted of a laboratory study to evaluate an extraction and analysis method for quantifying biomarkers of pesticide exposure and creatinine in urine samples collected with commercially-available disposable diapers. For large exposure studies, such as the National ...

  12. Serum Neutrophil Gelatinase-Associated Lipocalin in Infants and Children with Sepsis-Related Conditions with or without Acute Renal Dysfunction

    Directory of Open Access Journals (Sweden)

    Mohammed Farouk M. Afify

    2016-01-01

    Full Text Available Purpose To validate serum neutrophil gelatinase-associated lipocalin (NGAL as an early biomarker for acute kidney injury (AKI in sepsis-related conditions and its predictive and prognostic values. Patients and Methods This study included 65 patients, who were clinically evaluated for sepsis, severe sepsis, or septic shock, and 20 apparently healthy served as controls. Patients were divided into two groups: Group I (AKI-sepsis: 65 newly admitted patients diagnosed as sepsis, who were further divided into three subgroups according to the severity: systemic inflammatory response syndrome, severe sepsis, and septic shock, and Group II (control group: 20 apparently healthy subjects matched for age and sex, serum creatinine and serum NGAL concentrations were estimated initially within 24 hours of admission and after 72 hours of admission in all patients and control groups. Results Serum NGAL increased significantly with increasing severity of renal impairment. Receiver-operating characteristic analysis suggested that serum NGAL cutoff value of 40 ng/mL within the first 24 hours of admission is highly specific and sensitive for predicting AKI, with sensitivity of 90.9% and specificity of 75.8%. Conclusion We concluded that early measurement of serum NGAL level in sepsis can serve as a clinically useful marker for early prediction of AKI and for grading of its severity.

  13. Diagnostic Accuracy of Urine Protein/Creatinine Ratio Is Influenced by Urine Concentration

    OpenAIRE

    Yang, Chih-Yu; Chen, Fu-An; Chen, Chun-Fan; Liu, Wen-Sheng; Shih, Chia-Jen; Ou, Shuo-Ming; Yang, Wu-Chang; Lin, Chih-Ching; Yang, An-Hang

    2015-01-01

    Background The usage of urine protein/creatinine ratio to estimate daily urine protein excretion is prevalent, but relatively little attention has been paid to the influence of urine concentration and its impact on test accuracy. We took advantage of 24-hour urine collection to examine both urine protein/creatinine ratio (UPCR) and daily urine protein excretion, with the latter as the reference standard. Specific gravity from a concomitant urinalysis of the same urine sample was used to indic...

  14. End-Stage Renal Disease Outcomes among the Kaiser Permanente Southern California Creatinine Safety Program (Creatinine SureNet): Opportunities to Reflect and Improve.

    Science.gov (United States)

    Sim, John J; Batech, Michael; Danforth, Kim N; Rutkowski, Mark P; Jacobsen, Steven J; Kanter, Michael H

    2017-01-01

    The Kaiser Permanente Southern California (KPSC) creatinine safety program (Creatinine SureNet) identifies and outreaches to thousands of people annually who may have had a missed diagnosis for chronic kidney disease (CKD). We sought to determine the value of this outpatient program and evaluate opportunities for improvement. Longitudinal cohort study (February 2010 through December 2015) of KPSC members captured into the creatinine safety program who were characterized using demographics, laboratory results, and different estimations of glomerular filtration rate. Age- and sex-adjusted rates of end-stage renal disease (ESRD) were compared with those in the overall KPSC population. Among 12,394 individuals, 83 (0.7%) reached ESRD. The age- and sex-adjusted relative risk of ESRD was 2.7 times higher compared with the KPSC general population during the same period (94.7 vs 35.4 per 100,000 person-years; p safety program. If the Chronic Kidney Disease Epidemiology Collaboration equation were used, fewer people would have been captured while improving the accuracy for diagnosing CKD. Urine testing was low even among patients with confirmed CKD. Our findings demonstrate the importance of a creatinine safety net program in an integrated health system but also suggest opportunities to improve CKD care and screening.

  15. The Effect of Concentrate Supplementation on Creatinine Excretion in Thin-Tailed Lambs and Sheep

    Science.gov (United States)

    Purnami, N. A.; Prima, A.

    2018-02-01

    An experimental study was carried out to examine the effect of concentrates supplementation on creatinine excretion in lambs and sheep. The study used 8 male thin tailed lambs (aged ±3-4 months, weighed ±15.20 kg) and 8 sheep (aged ±1 year and weighed ±22.71kg). The animals were fed the diet contained 100% napier grass (100G) and 50% napier grass 50% concentrate as much as 3.5% of body weight (50G50C). This study used a complete randomized nested design. The parameters observed were dry matter intake (DMI) and creatinine excretion. The results showed that the diet significantly affect (P<0.05) DMI. The consumption of 100G was lower than that of 50G50C both lambs (0.32 vs 0.62 kg/d) and sheep (0.47 vs 0.88 kg/d). On the other hand, the diet did not affect the creatinine excretion (P 0.05) either G100 or G50C50 in lambs or sheep. However, the creatinine excretion in sheep (185.66 mg/d) was higher than that of lambs (299.1 md/d) (P<0.05). It can be concluded that concentrate supplementation of grass diet increased DMI but did not affect creatinine excretion. The creatinine excretion of sheep was higher than that of lambs .

  16. Quantifying creatinine and urea in human urine through Raman spectroscopy aiming at diagnosis of kidney disease

    Science.gov (United States)

    Saatkamp, Cassiano Junior; de Almeida, Maurício Liberal; Bispo, Jeyse Aliana Martins; Pinheiro, Antonio Luiz Barbosa; Fernandes, Adriana Barrinha; Silveira, Landulfo, Jr.

    2016-03-01

    Due to their importance in the regulation of metabolites, the kidneys need continuous monitoring to check for correct functioning, mainly by urea and creatinine urinalysis. This study aimed to develop a model to estimate the concentrations of urea and creatinine in urine by means of Raman spectroscopy (RS) that could be used to diagnose kidney disease. Midstream urine samples were obtained from 54 volunteers with no kidney complaints. Samples were subjected to a standard colorimetric assay of urea and creatinine and submitted to spectroscopic analysis by means of a dispersive Raman spectrometer (830 nm, 350 mW, 30 s). The Raman spectra of urine showed peaks related mainly to urea and creatinine. Partial least squares models were developed using selected Raman bands related to urea and creatinine and the biochemical concentrations in urine measured by the colorimetric method, resulting in r=0.90 and 0.91 for urea and creatinine, respectively, with root mean square error of cross-validation (RMSEcv) of 312 and 25.2 mg/dL, respectively. RS may become a technique for rapid urinalysis, with concentration errors suitable for population screening aimed at the prevention of renal diseases.

  17. Urinalysis vs urine protein–creatinine ratio to predict significant proteinuria in pregnancy

    Science.gov (United States)

    Dwyer, BK; Gorman, M; Carroll, IR; Druzin, M

    2009-01-01

    Objective To compare the urine protein–creatinine ratio with urinalysis to predict significant proteinuria (≥300 mg per day). Study Design A total of 116 paired spot urine samples and 24-h urine collections were obtained prospectively from women at risk for preeclampsia. Urine protein–creatinine ratio and urinalysis were compared to the 24-h urine collection. Result The urine protein–creatinine ratio had better discriminatory power than urinalysis: the receiver operating characteristic curve had a greater area under the curve, 0.89 (95% confidence interval (CI) 0.83 to 0.95) vs 0.71 (95% CI 0.64 to 0.77, Purine protein–creatinine ratio (cutoff ≥0.28) is more sensitive than urinalysis (cutoff ≥1+): 66 vs 41%, P = 0.001 (with 95 and 100% specificity, respectively). Furthermore, the urine protein–creatinine ratio predicted the absence or presence of proteinuria in 64% of patients; urinalysis predicted this in only 19%. Conclusion The urine protein–creatinine ratio is a better screening test. It provides early information for more patients. PMID:18288120

  18. Urinalysis vs urine protein-creatinine ratio to predict significant proteinuria in pregnancy.

    Science.gov (United States)

    Dwyer, B K; Gorman, M; Carroll, I R; Druzin, M

    2008-07-01

    To compare the urine protein-creatinine ratio with urinalysis to predict significant proteinuria (>or=300 mg per day). A total of 116 paired spot urine samples and 24-h urine collections were obtained prospectively from women at risk for preeclampsia. Urine protein-creatinine ratio and urinalysis were compared to the 24-h urine collection. The urine protein-creatinine ratio had better discriminatory power than urinalysis: the receiver operating characteristic curve had a greater area under the curve, 0.89 (95% confidence interval (CI) 0.83 to 0.95) vs 0.71 (95% CI 0.64 to 0.77, Purine protein-creatinine ratio (cutoff >or=0.28) is more sensitive than urinalysis (cutoff >or=1+): 66 vs 41%, P=0.001 (with 95 and 100% specificity, respectively). Furthermore, the urine protein-creatinine ratio predicted the absence or presence of proteinuria in 64% of patients; urinalysis predicted this in only 19%. The urine protein-creatinine ratio is a better screening test. It provides early information for more patients.

  19. Opium and heroin alter biochemical parameters of human's serum.

    Science.gov (United States)

    Kouros, Divsalar; Tahereh, Haghpanah; Mohammadreza, Afarinesh; Minoo, Mahmoudi Zarandi

    2010-05-01

    Iran is a significant consumer of opium, and, generally, of opioids, in the world. Addiction is one of the important issues of the 21st century and is an imperative issue in Iran. Long-term consumption of opioids affects homeostasis. To determine the effects of opium and heroin consumption on serum biochemical parameters. In a cross-sectional study, subjects who had consumed heroin (n = 35) or opium (n = 42) for more than two years and 35 nonaddict volunteers as the control group were compared in regard to various biochemical parameters such as fasting blood sugar (FBS), Na(+), K(+), Ca(2+), blood urea nitrogen (BUN), uric acid (UA), triglyceride (TG), cholesterol, creatinine, and total protein. Chromatography was used to confirm opioid consumption, and the concentration of biochemical parameters was determined by laboratory diagnostic tests on serum. No significant differences were found in Na(+), Ca(2+), BUN, UA, TG, creatinine, and total protein concentrations among the three groups. FBS, K(+), and UA levels were significantly lower in opium addicts compared to the control group. Serum Ca(2+) concentration of heroin addicts showed a significant decrease compared to that of the control group. Both addict groups showed a significant decrease in serum cholesterol levels. Chronic use of opium and heroin can change serum FBS, K(+), Ca(2+), UA, and cholesterol. This study, one of few on the effects of opium on serum biochemical parameters in human subjects, has the potential to contribute to the investigation of new approaches for further basic studies.

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

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    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.

  1. Serum cystatin C and cerebral microbleeds in patients with acute cerebral stroke.

    Science.gov (United States)

    Zhang, Jin-Biao; Jü, Xiao-Hua; Wang, Jing; Sun, Hai-Rong; Li, Fang

    2014-02-01

    Recent studies have shown that kidney dysfunction is associated with cerebral microbleeds (CMB). Cystatin C is a more useful measurement than creatinine-based estimating equations for evaluating kidney function. The purpose of this study was to clarify the relationship between cystatin C levels and CMB in patients with acute cerebral stroke. This cross-sectional study included a total of 485 patients with acute ischemic stroke and 129 patients with cerebral hemorrhage. The serum levels of cystatin C were significantly higher in acute cerebral stroke patients with CMB than in those without (pstroke. The odds ratio (95% confidence interval) in patients with acute cerebral infarction and cerebral hemorrhage were 2.92 (1.81-6.93) and 2.98 (1.76-6.97), respectively. The present study suggests that elevated levels of cystatin C are associated with the presence of CMB in acute stroke patients, independent of conventional risk factors. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Association between Obesity, Serum Lipids, and Colorectal Polyps in Old Chinese People

    Directory of Open Access Journals (Sweden)

    Wen Yang

    2013-01-01

    Full Text Available Background. Colorectal cancer mostly arises from the polyps of colon. The aim of our study was to examine the association of body mass index (BMI and serum lipids with the colorectal polyps in old Chinese people. Methods. The risk of developing colorectal polyps was studied in 244 subjects (212 men and 32 women, 74.63 ± 11.63 years old who underwent colonoscopy for the first time from January 2008 to July 2012 at the Navy General Hospital, Beijing, China. According to the results of colonoscopy, all the subjects were divided into 112 normal control, 38 right colorectal polyps, 53 left colorectal polyps, and 41 both right and left colorectal polyps groups. The total plasma cholesterol, plasma triglyceride, plasma creatinine concentration, blood urinary nitrogen, and fasting glucose were determined using a multichannel analyzer. Results. There were significant differences among normal control, right colorectal polyps, left colorectal polyps, and both right and left polyps groups, which were the BMI, total cholesterol, triglycerides, creatinine, and urinary nitrogen. In binary logistic regression analysis, there were two risk factors associated with the occurrence of colorectal polyps, which included BMI and systolic blood pressure. Conclusions. Colorectal polyps were significantly associated with increased BMI, total cholesterol, and triglycerides levels.

  3. Changes in serum biochemical factors associated with opium addiction after addiction desertion.

    Science.gov (United States)

    Afarinesh, Mohammad Reza; Haghpanah, Tahereh; Divsalar, Kouros; Dehyadegary, Elham; Shaikh-Aleslami, Azar; Mahmoodi, Majid

    2014-01-01

    The long time use of opium has some effects on serums biochemical factors, the determination of this variation is a new approach in understanding off addiction and relive of drug abuser health. Hence in this study, these indicators in person who were withdrawing of opium have been studied. In this cross-sectional study bloods biochemical factors such as fasting blood sugar (FBS), sodium (Na), calcium (Ca), uric acid (UA), blood urea nitrogen (BUN), creatinine, cholesterol, total protein, and fibrinogen in three groups serum were studied: (1) Who had been permanent opium users more than 2 years (case). (2) Dependent person who has taken one month addiction withdrawal course (control). (3) A healthy group that had been demographically similar to the other groups. According to these study findings, FBS serum level in the case group is lower than control group. Serum level of Na, creatinine, and blood triglyceride (TG) in case study are higher than group control. Concentration of potassium, Ca, UA, BUN, cholesterol, total serum protein, fibrinogen, and thrombin time in case study and group control showed no significant difference. Also, in withdrawing case serum level of Na, Ca, UA, BUN, creatinine, and TG significantly increase and thrombin time decrease. According to this study not only the longtime use of opium but also opium with drawerin opium dependent people can change their serum biochemical factors. So recognition, treatment, and prevention of this change could be a new step in improving of health and condition of patients.

  4. Weights, hematology and serum chemistry of free-ranging brown boobies (Sula leucogaster) in Johnston Atoll, Central Pacific

    Science.gov (United States)

    Work, Thierry M.

    1999-01-01

    Hematologic and serum chemistry values are reported for 105 brown boobies (Sula leucogaster) from Johnston Atoll, Central Pacific. Hematocrit, estimated total plasma solids, total and differential white cell counts, serum glucose, calcium, phosphorus, uric acid, total protein, albumin, globulin, aspartate aminotransferase, and creatinine phosphokinase were analyzed. Hematologic and serum chemistry values varied with age and sex. Values were compared with those of red-footed boobies and other tropical and temperate marine pelecaniforms.

  5. Urine Albumin-Creatinine Ratio Versus Albumin Excretion for Albuminuria Staging: A Prospective Longitudinal Cohort Study.

    Science.gov (United States)

    Vart, Priya; Scheven, Lieneke; Lambers Heerspink, Hiddo J; de Jong, Paul E; de Zeeuw, Dick; Gansevoort, Ron T

    2016-01-01

    New guidelines advocate the use of albumin-creatinine ratio (ACR) in a urine sample instead of 24-hour urinary albumin excretion (UAE) for staging albuminuria. Concern has been expressed that this may result in misclassification for reasons including interindividual differences in urinary creatinine excretion. Prospective longitudinal cohort study. We examined 7,623 participants of the PREVEND and RENAAL studies for reclassified when using ACR instead of 24-hour UAE, the characteristics of reclassified participants, and their outcomes. Albuminuria was categorized into 3 ACR and UAE categories: 300mg/g or mg/24 h, respectively. Baseline ACR and 24-hour UAE. Cardiovascular (CV) morbidity and mortality and all-cause mortality. When using ACR in the early morning void instead of 24-hour UAE, 88% of participants were classified in corresponding albuminuria categories. 307 (4.0%) participants were reclassified to a higher, and 603 (7.9%), to a lower category. Participants who were reclassified to a higher ACR category in general had a worse CV risk profile compared with nonreclassified participants, whereas the reverse was true for participants reclassified to a lower ACR category. Similarly, Cox proportional hazards regression analyses showed that reclassification to a higher ACR category was associated with a tendency for increased risk for CV morbidity and mortality and all-cause mortality, whereas reclassification to a lower ACR category was associated with a tendency for lower risk. Net reclassification improvement, adjusted for age, sex, and duration of follow-up, was 0.107 (P=0.002) for CV events and 0.089 (P<0.001) for all-cause mortality. Early morning void urine collection instead of spot urine collection. Our results indicate that there is high agreement between early morning void ACR and 24-hour UAE categories. Reclassification is therefore limited, but when present, is generally indicative of the presence of CV risk factors and prognosis. Copyright © 2016

  6. The Stockholm CREAtinine Measurements (SCREAM) project: protocol overview and regional representativeness.

    Science.gov (United States)

    Runesson, Björn; Gasparini, Alessandro; Qureshi, Abdul Rashid; Norin, Olof; Evans, Marie; Barany, Peter; Wettermark, Björn; Elinder, Carl Gustaf; Carrero, Juan Jesús

    2016-02-01

    We here describe the construction of the Stockholm CREAtinine Measurement (SCREAM) cohort and assess its coverage/representativeness of the Stockholm county in Sweden. SCREAM has the principal aims to estimate the burden and consequences of chronic kidney disease (CKD) and to identify inappropriate drug use (prescription of nephrotoxic, contraindicated or ill-dosed drugs). SCREAM is a repository of laboratory data of individuals, residing or accessing healthcare in the region of Stockholm, who underwent creatinine assessments between 2006-11. Laboratory tests were linked to administrative databases with complete information on socioeconomic status, demographic data, healthcare utilization, diagnoses, vital status and dispensed prescription medicines. SCREAM identified 1 118 507 adult Stockholm citizens with available creatinine tests between 2006-11. This corresponded to 66% of the complete population in the region. Geographical coverage was uniform, ranging between 62 and 72% throughout its 26 municipalities. Population coverage was higher across older age strata (50% coverage for age range 18-44 years, >75% for 45-64 years and >90% coverage for ≥65 years). Of note, 97 and 98% of all individuals with a diagnosis of diabetes mellitus or cardiovascular disease, respectively, were captured by SCREAM. Further, 89% of all deaths registered in the period occurred in individuals with a creatinine test undertaken. SCREAM represents the largest cohort to estimate the burden and healthcare implications of CKD in Sweden. The coverage and representativeness of the region of Stockholm was high and in accordance to both the commonness of creatinine assessment, and the medical indications for creatinine testing. The inclusion of individuals who sought medical care and had a creatinine test undertaken resulted in a slight over-representation of elderly and comorbid patients.

  7. Back-calculating baseline creatinine with MDRD misclassifies acute kidney injury in the intensive care unit.

    Science.gov (United States)

    Pickering, John W; Endre, Zoltán H

    2010-07-01

    The purpose of this study was to assess the viability of back-calculation with the Modification of Diet in Renal Disease (MDRD) formula to determine baseline creatinine on the basis of acute kidney injury (AKI) metrics, RIFLE criteria, and Acute Kidney Injury Network (AKIN) criteria for the purpose of clinical trial outcomes or epidemiology. This study was a retrospective analysis of prospectively collected data from patients with measured baseline creatinines before entry to the intensive care unit (ICU). The AKI status was determined using five different baseline creatinines: the measured creatinine (the standard) and an estimated creatinine determined by back-calculation using MDRD assuming a GFR of 75 ml/min (epCr75), 100 ml/min (epCr100), randomly generating a value on a lognormal curve (epCrRnd), and choosing the lowest creatinine value within the first week in the ICU (epCrlow). A subgroup of patients without chronic kidney disease (CKD) was similarly analyzed. Of 224 patients, 70 (31%) had AKI according to RIFLE and 93 (42%) according to AKIN. The epCr75 and epCr100 distributions greatly overestimated the proportion with AKI. The epCrlow overestimated AKI according to AKIN but correctly estimated AKI according to RIFLE. The mean of 1000 epCrRnd distributions correctly estimated AKI according to RIFLE and AKIN. Each estimated distribution performed better in the non-CKD population with the exception of epCrRnd. However, only the epCrlow distribution accurately determined the proportion with AKI. A measured rather than estimated value should be used for baseline creatinine in trials or epidemiologic studies of AKI.

  8. Association of serum total bilirubin with renal outcome in Japanese patients with stages 3-5 chronic kidney disease.

    Science.gov (United States)

    Sakoh, Teppei; Nakayama, Masaru; Tanaka, Shigeru; Yoshitomi, Ryota; Ura, Yoriko; Nishimoto, Hitomi; Fukui, Akiko; Shikuwa, Yui; Tsuruya, Kazuhiko; Kitazono, Takanari

    2015-09-01

    Serum bilirubin has been reported to be associated with the progression of kidney disease in patients with diabetic nephropathy. Less is known, however, about the relationship between bilirubin and chronic kidney disease (CKD) of other etiologies. This study was designed to clarify whether serum total bilirubin concentration is associated with kidney disease progression in patients with CKD independent of etiology. This prospective observational study enrolled 279 consecutive patients with stages 3-5 CKD. The renal endpoint was the composite of the doubling of serum creatinine or end-stage renal disease requiring dialysis. Patients were divided into three groups by their serum total bilirubin concentrations: ≤0.3 (lowest), 0.4-0.5 (middle), and ≥0.6 (highest) mg/dL. A Cox proportional hazards model was applied to determine the risk factors for poor renal outcome. The median follow-up period was 21months. One-hundred and three patients reached renal end points. After multivariable adjustment, a 0.1mg/dL increase in serum bilirubin was associated negatively with poor renal outcome (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.60-0.87). In addition, after adjustment for confounding factors, including traditional and nontraditional cardiovascular risk factors, the middle (HR 3.14, 95% CI 1.36-8.57) and lowest (HR 4.22, 95% CI 1.81-11.59) bilirubin groups had significantly higher HRs for renal outcome than the highest bilirubin group. Lower serum bilirubin concentration was independently associated with adverse renal outcomes, suggesting that the measurement of serum bilirubin is useful for predicting kidney disease progression in patients with moderate to severe CKD. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Effect of Serum Zinc Levels on Humoral Immune Response to Hepatitis B Vaccination in Patients on Dialysis

    Directory of Open Access Journals (Sweden)

    N Nouri-Majalan

    2007-04-01

    Full Text Available Introduction: Zinc deficiency causes abnormalities in immune response. In chronic hemodialysis (HD and continuous ambulatory peritoneal dialysis (CAPD patients, impaired immune responses to vaccination have been reported. Therefore, we performed a study to determine the correlation between serum zinc levels and immune response to hepatitis B vaccination in patients on dialysis. Methods: A cross-sectional study including 95 CRF patients on dialysis (70 HD and 25 CAPD, (63 male and 32 female with three dose regimens of vaccination against HBV was performed. Results: Four months after vaccination, there were 34 (36% patients with sufficient HBs Antibody response (HBs Ab≥ 10 mU/mL and 61 ( 64% patients with insufficient HBs antibody response( HBs Ab< 10mU/mL . The mean serum zinc level was 23.35±3.87 micmol/L (13.20-33 micmol/L. The mean serum zinc concentration was significantly higher in patients with sufficient HBs antibody level than patients with insufficient HBs antibody levels ( 24.94±4.17 versus 22.15±3.46, P= 0.005 . In logistic regression analysis, independent variables that correlated with sufficient HBs Ab level ≥ 10 mU/mL included higher mean serum zinc level [OR=1.44 (1.02-2.02, P=0.006 ] and female gender [OR=1.8 (1.01-4.01, P=0.048] . Factors found to be insignificant included type of dialysis, age, diabetes mellitus as a cause of ESRD, serum creatinine and albumin levels. Conclusion: We conclude that failure to respond to HBV vaccination is significantly related to a low levels of serum zinc. However, clinical trial studies should be performed in order to confirm this finding.

  10. Verification of serum reference intervals for free light chains in a local South African population.

    Science.gov (United States)

    Zemlin, Annalise E; Rensburg, Megan A; Ipp, Hayley; Germishuys, Jurie J; Erasmus, Rajiv T

    2013-11-01

    Monoclonal serum free light chain measurements are used to follow up and manage patients with monoclonal gammopathies, and abnormal serum free light chain ratios are associated with risk of progression in certain diseases. We aimed to validate the reference intervals in our population. Reference intervals for κ and λ free light chains were established on 120 healthy adults. Creatinine levels were measured to exclude renal dysfunction and serum protein electrophoresis was performed. All creatinine values were within normal limits. After exclusion of subjects with abnormal serum protein electrophoreses, 113 subjects were available for analysis. The 95% reference interval was 6.3-20.6 mg/L for κ free light chains, 8.7-25.9 mg/L for λ free light chains and 0.46-1.23 for free light chain ratio. Most of the values fell within the manufacturer's recommended limits and therefore could be used for our population.

  11. Relationships between Serum Levels of Atazanavir and Renal Toxicity or Lithiasis

    Directory of Open Access Journals (Sweden)

    C. I. Marinescu

    2015-01-01

    Full Text Available The main aim of this study is to describe the relationship between serum levels of atazanavir, renal toxicity, and lithiasis. This is a prospective observational study of patients being treated with atazanavir (ATV at Son Espases Teaching Hospital, Palma de Mallorca, between 2011 and 2013. The study includes 98 patients. Sixteen were found to have a history of urolithiasis. During a median monitoring period of 23 months, nine patients suffered renal colic, in three of whom ATV crystals were evidenced in urine. Cumulative incidence of renal colic was 9.2 per 100 patients. The variables related to having renal colic were the presence of alkaline urine pH and lower basal creatinine clearance. The mean serum level of ATV was slightly higher in patients with renal colic—1,303 μg/L versus 1,161 μg/L—but did not reach statistical significance. Neither were any significant differences detected by analysing the levels according to the timetable for ATV dosage. Cumulative incidence of renal colic was high in patients being treated with ATV, in 33% of whom the presence of ATV crystals was evidenced in urine. We were unable to demonstrate a relationship between ATV serum levels and renal colic or progression towards renal failure.

  12. Relationships between Serum Levels of Atazanavir and Renal Toxicity or Lithiasis

    Science.gov (United States)

    Marinescu, C. I.; Leyes, M.; Ribas, M. A.; Peñaranda, M.; Murillas, J.; Campins, A. A.; Martin-Pena, L.; Barcelo, B.; Barceló-Campomar, C.; Grases, F.; Frontera, G.; Riera Jaume, Melchor

    2015-01-01

    The main aim of this study is to describe the relationship between serum levels of atazanavir, renal toxicity, and lithiasis. This is a prospective observational study of patients being treated with atazanavir (ATV) at Son Espases Teaching Hospital, Palma de Mallorca, between 2011 and 2013. The study includes 98 patients. Sixteen were found to have a history of urolithiasis. During a median monitoring period of 23 months, nine patients suffered renal colic, in three of whom ATV crystals were evidenced in urine. Cumulative incidence of renal colic was 9.2 per 100 patients. The variables related to having renal colic were the presence of alkaline urine pH and lower basal creatinine clearance. The mean serum level of ATV was slightly higher in patients with renal colic—1,303 μg/L versus 1,161 μg/L—but did not reach statistical significance. Neither were any significant differences detected by analysing the levels according to the timetable for ATV dosage. Cumulative incidence of renal colic was high in patients being treated with ATV, in 33% of whom the presence of ATV crystals was evidenced in urine. We were unable to demonstrate a relationship between ATV serum levels and renal colic or progression towards renal failure. PMID:26064679

  13. Urine Protein/Creatinine Ratios during Labor: A Prospective Observational Study.

    Science.gov (United States)

    Tanamai, Vaya W; Seagle, Brandon-Luke L; Yeh, Judy Y; Brady, Bethany; Miller, Corrie B; Sena, Salvador; Dodge, Jessica; Shahabi, Shohreh; Samuelson, Robert; Norwitz, Errol R; Luo, Guoyang

    2016-01-01

    To evaluate the utility of urine protein/creatinine ratio (uPCR) measurements among healthy parturients at term we performed a prospective cohort study at a community teaching hospital. Serial urine samples were collected. Ninety-three women contributed 284 urine samples. uPCRs were determined. Multiple imputation and paired sampled analysis was performed when appropriate. Two-thirds (63/93) of women had at least one measured uPCR ≥ 0.3. One-third (31/93) had a uPCR ≥ 0.3 at admission, including 39.1% (9/23) of women not in labor. Median (IQR) uPCRs increased during labor and after delivery: latent phase/no labor, 0.15 (0.06-0.32); active phase, 0.29 (0.10-0.58); early postpartum, 0.45 (0.18-1.36) (all p 0.3 in the immediate postpartum period (p urine dipstick protein result did not exclude uPCR ≥ 0.3. uPCRs were similar when compared by method of urine collection. uPCR ≥ 0.3 is common among healthy women with uncomplicated pregnancies at term. uPCR increases during labor and is not a reliable measure of pathologic proteinuria at term or during the peripartum period.

  14. Assessment of a veterinary dipstick for determination of urine protein/creatinine ratio in canines.

    Science.gov (United States)

    Mamone, Christina; Mitchell, Mark; Beaufrere, Hugues; Acierno, Mark

    2014-01-01

    The urine protein/creatinine ratio (UPC) is a widely used screening test of glomerular barrier function. It usually requires sending urine samples to a distant laboratory, which is costly and time consuming. A point-of-care urine dipstick that could accurately measure UPC would increase test utility and utilization. The objective of this study was to determine if there was good correlation and agreement between UPC as measured by a dipstick and a laboratory analyzer. Thirty-one canines undergoing UPC measurement as part of a diagnostic workup were included in the study. A total of 2 mL of urine was collected via cystocentesis. Urine was applied to the dipstick then presented to two blinded reviewers to analyze. The remaining urine was submitted to a clinical pathology laboratory for analysis. UPC data from the dipsticks and the analyzer was converted into an ordinal scale. Correlation and agreement between the individual reviews and the analyzer was calculated. Agreement between reviewers was substantial; however, correlation and agreement between the individual reviews and the analyzer was low. On the basis of this information, use of this veterinary urinary dipstick to determine UPC cannot be recommended at this time.

  15. Diagnostic Accuracy of Urine Protein/Creatinine Ratio Is Influenced by Urine Concentration.

    Science.gov (United States)

    Yang, Chih-Yu; Chen, Fu-An; Chen, Chun-Fan; Liu, Wen-Sheng; Shih, Chia-Jen; Ou, Shuo-Ming; Yang, Wu-Chang; Lin, Chih-Ching; Yang, An-Hang

    2015-01-01

    The usage of urine protein/creatinine ratio to estimate daily urine protein excretion is prevalent, but relatively little attention has been paid to the influence of urine concentration and its impact on test accuracy. We took advantage of 24-hour urine collection to examine both urine protein/creatinine ratio (UPCR) and daily urine protein excretion, with the latter as the reference standard. Specific gravity from a concomitant urinalysis of the same urine sample was used to indicate the urine concentration. During 2010 to 2014, there were 540 adequately collected 24h urine samples with protein concentration, creatinine concentration, total volume, and a concomitant urinalysis of the same sample. Variables associated with an accurate UPCR estimation were determined by multivariate linear regression analysis. Receiver operating characteristic (ROC) curves were generated to determine the discriminant cut-off values of urine creatinine concentration for predicting an accurate UPCR estimation in either dilute or concentrated urine samples. Our findings indicated that for dilute urine, as indicated by a low urine specific gravity, UPCR is more likely to overestimate the actual daily urine protein excretion. On the contrary, UPCR of concentrated urine is more likely to result in an underestimation. By ROC curve analysis, the best cut-off value of urine creatinine concentration for predicting overestimation by UPCR of dilute urine (specific gravity ≦ 1.005) was ≦ 38.8 mg/dL, whereas the best cut-off values of urine creatinine for predicting underestimation by UPCR of thick urine were ≧ 63.6 mg/dL (specific gravity ≧ 1.015), ≧ 62.1 mg/dL (specific gravity ≧ 1.020), ≧ 61.5 mg/dL (specific gravity ≧ 1.025), respectively. We also compared distribution patterns of urine creatinine concentration of 24h urine cohort with a concurrent spot urine cohort and found that the underestimation might be more profound in single voided samples. The UPCR in samples with low

  16. Serum ferritin

    International Nuclear Information System (INIS)

    Rochna Viola, E.M.; Diaz de Domingo, N.B.; Lazarowski, A.

    1981-01-01

    Serum ferritin (SF) concentration as determined by the immunoradiometric method allows the direct measurement of a fraction of the body ferritin pool. In normal subjects, SF is an excellent index of body iron stores. In certain conditions associated with increased ferritin synthesis (such as liver disease, inflammation, malignancy, chronic disorders, ineffective erythropoiesis, or during ferrotherapy), SF may not accurately reflect body iron stores. In hyposideremic anemias SF concentration permits to differentiate those due to iron deficiency from those due to chronic disorders. With a good assay quality, subnormal SF levels are incontrovertible in the diagnosis of iron deficiency. SF determination has been investigated as possible tumor marker. When performed in combination with the alpha-fetoprotein assay, SF enhances the specificity of serodiagnosis of hepatoma. SF results must be interpreted bearing in mind the possible participation of circumstances that i) modify the body iron stores and ii) lead to increased ferritin synthesis. (author) [es

  17. 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.

  18. Evaluation of the Urine Protein/Creatinine Ratio Measured with the Dipsticks Clinitek Atlas PRO 12.

    Science.gov (United States)

    Hermida, Fernando J; Soto, Sonia; Benitez, Alfonso J

    2016-01-01

    Screening for urine proteins is recommended for the detection of albuminuria in high risk groups. The aim of this study was to compare the Clinitek Atlas PRO12 reagent urine strip with quantitative methods for the determination of protein/creatinine ratio and to evaluate the usefulness of the semi-quantitative Clinitek Atlas PRO12 reagent urine strip as a tool in the early detection of albuminuria among the general population. Six hundred first morning urine specimens were collected from outpatients with various clinical conditions. The results showed that the test data for the urine dipstick Clinitek Atlas PRO12 show good agreement with the quantitative measurement of protein, creatinine and protein/creatinine ratio. In addition, this study shows that 97.2% of the samples which gave "normal" protein/creatinine ratios by the semi-quantitative method, showed albumin/creatinine ratio < 30 mg/g by the quantitative methods. Our results show that Clinitek Atlas PRO12 reagent strips can be used for the purposes of albuminuria screening in the general population.

  19. Correlation between the protein/creatinine ratio in spot urine and 24-hour urine protein.

    Science.gov (United States)

    Montero, Nuria; Soler, M José; Pascual, M José; Barrios, Clara; Márquez, Eva; Rodríguez, Eva; Berrada, Ali; Riera, Marta; Coca, Lluís; Orfila, M Antonia; Pascual, Julio

    2012-07-17

    Measurement of the protein content in a 24-hour urine sample is the definitive method of establishing the presence of abnormal proteinuria. However, the urine collection is cumbersome. The spot urine protein to creatinine ratio seems to be a reliable diagnostic tool for urine protein measurement. Our aim was to evaluate the spot urine protein/creatinine ratio against 24-h urine total protein excretion in different proteinuria ranges by comparing samples collected simultaneously in patients of Hospital del Mar during the last year. Observational, cross-sectional study of 159 consecutive paired determinations of 24-h urine total protein excretion and the spot urine protein/creatinine ratio (P/C) in renal patients. The strength of the correlation was determined by calculating the intraclass correlation coefficient (ICC) and the Spearman correlation coefficient (SCC). Among all groups, there was a significant correlation between 24-hour proteinuria and the P/C ratio (SCC: r=0.91, Purine protein/creatinine ratio and 24-h urine total protein excretion in proteinuria levels from 300 mg/day to 3,499 mg/day. A lower correlation was also maintained in 24-h urine total protein urine protein/creatinine ratio and 24-h urine total protein excretion in nephrotic-range proteinuria.

  20. Association between urine protein/creatinine ratio and cognitive dysfunction in Lewy body disorders.

    Science.gov (United States)

    Oh, Yoon-Sang; Kim, Joong-Seok; Park, Hyung-Eun; Song, In-Uk; Park, Jeong-Wook; Yang, Dong-Won; Son, Byung-Chul; Lee, Si-Hoon; Lee, Kwang-Soo

    2016-03-15

    Impaired renal function and proteinuria have been associated with cognitive impairment and dementia. Chronic kidney disease is considered to be an independent risk factor for Lewy body spectrum disorders (LBD). However, few studies have mentioned an association between proteinuria and cognition in LBD. We investigated the relationship between proteinuria and cognitive dysfunction in patients with Parkinson's disease (PD) and dementia with Lewy bodies (DLB). Among 186 patients with LBD, 53 had PD-normal cognition (PD-NC), 76 had PD-mild cognitive impairment (PD-MCI), 43 had PD-dementia (PDD) and 14 had DLB. The urine protein/creatinine ratio was calculated using the spot urine test and brain magnetic resonance scans was obtained in all patients. The urine protein/creatinine ratio was significantly higher in patients with PDD and DLB than in those with PD-MCI, PD-NC patients and healthy controls, and was correlated with white matter hyperintensities on magnetic resonance imaging. All abnormal neuropsychological test results were associated with increased urine protein/creatinine ratio. After controlling for age, education, symptom duration, diabetes mellitus, hypertension, and parkinsonian motor severity, the urine protein/creatinine ratio was significantly associated with decreased cognition. The urine protein/creatinine ratio was associated with cognitive status in LBD. These finding suggests that increased protein excretion is associated with cognitive dysfunction in patients with LBD. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Prognostic value of renal biopsy and clinical variables in patients with lupus nephritis and normal serum creatinine

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Starklint, Henrik; Petersen, J

    1999-01-01

    To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI).......To evaluate factors with possible influence on the renal outcome in patients with lupus nephritis but without chronic renal insufficiency (CRI)....

  2. The effect of inter-laboratory variability on the protein:creatinine (UPC) ratio in canine urine.

    Science.gov (United States)

    Rossi, G; Bertazzolo, W; Dondi, F; Binnella, M; Gruarin, M; Scarpa, P; Paltrinieri, S

    2015-04-01

    Quantification of proteinuria is a fundamental step in staging dogs with chronic kidney disease and in monitoring the course of disease or the efficacy of anti-proteinuric treatments. Analytical precision and accuracy of the proteinuria assessment could be affected by several factors such as biological variability, different operators and quality control materials. The aim of this study was to assess whether inter-laboratory variability could affect the urinary protein to creatinine (UPC) ratio and whether this variability may affect patient classification according to the International Renal Interest Society (IRIS) sub-staging system. The same urine samples were analysed in three different laboratories using different instruments and different reagent brands. The results of the three laboratories were highly correlated to each other although urinary protein (UP), urinary creatinine (UC) and the UPC ratio of one laboratory were found to be significantly higher than those of the other two. No significant differences between the other two laboratories were recorded. The concordance in classifying dogs according to the IRIS guidelines was good if all three proteinuria categories were analysed separately or if borderline proteinuric (BP) dogs were included in the proteinuric group, and very good if BP dogs were merged into the non-proteinuric group. The inter-laboratory variability in UPC ratio measurement was not so great as to impede the identification of proteinuric dogs, but may influence the estimation of the magnitude of proteinuria. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Possible Association of High Urinary Magnesium and Taurine to Creatinine Ratios with Metabolic Syndrome Risk Reduction in Australian Aboriginals

    Directory of Open Access Journals (Sweden)

    Atsumi Hamada

    2011-01-01

    Full Text Available Background. Because of the epidemic of metabolic syndrome (MS in Australian Aboriginals known for their higher cardiovascular mortality and sho