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Sample records for volume creatinine specific

  1. Comparison of uncertainties related to standardization of urine samples with volume and creatinine concentration

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Ase Marie; Kristiansen, Jesper;

    2004-01-01

    When measuring biomarkers in urine, volume (and time) or concentration of creatinine are both accepted methods of standardization for diuresis. Both types of standardization contribute uncertainty to the final result. The aim of the present paper was to compare the uncertainty introduced when using...... that the uncertainty associated with creatinine standardization (19-35%) was higher than the uncertainty related to volume standardization (up to 10%, when not correcting for deviations from 24 h) for 24 h urine samples. However, volume standardization introduced an average bias of 4% due to missed volumes...... in population studies. When studying a single 24 h sample from one individual, there was a 15-20% risk that the sample was incomplete. In this case a bias of approximately 25% was introduced when using volume standardization, whereas the uncertainty related to creatinine standardization was independent...

  2. 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.

  3. Comparison of uncertainties related to standardization of urine samples with volume and creatinine concentration

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Ase Marie; Kristiansen, Jesper

    2004-01-01

    When measuring biomarkers in urine, volume (and time) or concentration of creatinine are both accepted methods of standardization for diuresis. Both types of standardization contribute uncertainty to the final result. The aim of the present paper was to compare the uncertainty introduced when using...... the two types of standardization on 24 h samples from healthy individuals. Estimates of uncertainties were based on results from the literature supplemented with data from our own studies. Only the difference in uncertainty related to the two standardization methods was evaluated. It was found...... increase in convenience for the participants, when collecting small volumes rather than complete 24 h samples....

  4. Specificity of increased amylase to creatinine clearance ratio in acute pancreatitis.

    Science.gov (United States)

    Lankisch, P G; Koop, H; Otto, J; Oberdieck, U; Winckler, K; Wolfrum, D I

    1977-01-01

    The amylase to creatinine clearance ratio was found to be normal in 11 of 33 patients with acute pancreatitis. The ratio was elevated in 10 of 19 patients with renal insufficiency. Thus, it does not seem to be a specific index in the diagnosis of acute pancreatitis.

  5. [Sensitivity and specificity of blood amylase, amylase and creatinine clearance ratio and urinary amylase/urinary creatinine ratio in the diagnosis of acute pancreatitis].

    Science.gov (United States)

    Ligny, G; Meunier, J C; Hayard, P; Ligny, C; Van Cauter, J

    1987-12-01

    The sensitivity and specificity of amylasemia, the ratios of amylase/creatinine clearance and amylasuria/creatininuria were determined in four groups of patients: a control group (n = 43), patients with acute pancreatitis detected on computed tomography (n = 30, 25 cases of alcoholic pancreatitis), patients with an acute surgical abdomen without pancreatitis (n = 25), and patients with renal failure (n = 20). Sensitivity was defined for the acute pancreatitis group and specificity for the other groups. When amylasemia was greater than 20 UI/dl and the amylasuria/creatininuria ratio greater than 100, sensitivity was 98 per cent. The specificity of these two results in patients with an acute surgical abdomen was 98 per cent. When the ratio amylase/creatinine clearance ratio was greater than 4 sensitivity was 73 per cent and specificity in patients with acute surgical abdomen was 75 per cent. These two values were lower than those of the two preceding tests (p less than 0.01). Sensitivity of the association of an amylasemia greater than 13 UI/dl (m + 2SD) with a clearance ratio greater than 4 was 73 per cent. The amylase/creatinine clearance ratio did not seem to be reliable since its change was delayed with respect to the increase of amylasemia and amylasuria. This ratio has a poor specificity as it increased when the clearance of creatinine decreased in the group with an acute surgical abdomen associated with functional or organic renal failure. In these two groups, the correlation between the amylase/creatinine clearance ratio and creatininemia was significant. This suggested that the clearance of creatinine fell more rapidly than the clearance of amylase as renal failure increased.

  6. 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.)

  7. Cause-specific mortality according to urine albumin creatinine ratio in the general population

    DEFF Research Database (Denmark)

    Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Ahluwalia, Tarunveer 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......-cause mortality, endocrine nutritional and metabolic diseases, mental and behavioural disorders, diseases of the circulatory system, and diseases of the respiratory system with hazard ratios 1.56, 6.98, 2.34, 2.03, and 1.91, for the fourth UACR compared with the first, respectively. Using UACR as a continuous......-cause mortality, endocrine nutritional and metabolic diseases, and diseases of the circulatory system and possibly mental and behavioural disorders, and diseases of the respiratory and digestive system....

  8. Mechanism and specificity of increased amylase/creatinine clearance ratio in pancreatitis.

    Science.gov (United States)

    Marten, A; Beales, D; Elias, E

    1977-09-01

    The amylase/creatinine clearance ratio (Cam/Ccr ratio) was determined in 239 subjects. In 87 hospitalised patients without pancreatic disease (controls) the Cam/Ccr ratio was 3.02 +/- 0.69 (mean +/- ISD). The ratio was above the normal range in all patients with acute pancreatitis but was normal in those with chronic pancreatitis and carcinoma of the pancreas. In 18 patients with choledocholithiasis a raised ratio distinguished those with pancreatitis as assessed independently by the surgeon at laparotomy from those with a macroscopically normal pancreas. Raised Cam/Ccr ratios were also found in diabetics with ketoacidosis and in three patients with fulminant alcoholic liver disease. Though a positive correlation was found between the Cam/Ccr ratio and serum creatinine concentration, abnormally high ratios did not occur in 30 patients with chronic renal failure. A significant increase in Cam/Ccr ratios was produced in six healthy volunteers by intravenous injection of glucagon. However, it is unlikely that hyperglucagonaemia alone accounts for the increased Cam/Ccr ratio seen in acute pancreatitis, as no correlation was found between the clearance ratio and the plasma glucagon concentration in a series of patients. In two other patients in whom excess circulating pancreatic polypeptide was detected the Cam/Ccr ratio was normal. It is concluded that, in view of the sensitivity and relative specificity of finding an increased Cam/Ccr ratio in acute pancreatitis, its determination should be valuable clinically, especially in those cases of hyperamylasaemia where the cause is in doubt. The mechanism whereby the ratio is increased is unknown, and it is unlikely that either glucagon or pancreatic polypeptide is a major factor in its production.

  9. Configuration control on the shape memory stiffness of molecularly imprinted polymer for specific uptake of creatinine

    Science.gov (United States)

    Ang, Qian Yee; Zolkeflay, Muhammad Helmi; Low, Siew Chun

    2016-04-01

    In this study, sol-gel processing was proposed to prepare a creatinine (Cre)-imprinted molecularly imprinted polymer (MIP). The intermolecular interaction constituted by the cross-linkers, i.e., 2-acrylamido-2-methylpropane-sulfonic acid (AMPS) and aluminium ion (Al3+), was studied and compared in order to form a confined matrix that promises the effectiveness of molecular imprinting. In view of the shape recognition, the hydrogen bonded Cre-AMPS did not demonstrate good recognition of Cre, with Cre binding found only at 5.70 ± 0.15 mg g-1 of MIP. Whilst, MIP cross-linked using Al3+ was able to attain an excellent Cre adsorption capacity of 19.48 ± 0.64 mg g-1 of MIP via the stronger ionic interaction of Cre-Al3+. Based on the Scatchard analysis, a higher Cre concentration in testing solution required greater driving force to resolve the binding resistance of Cre molecules, so as to have a precise Cre binding with shape factor. The molecular recognition ability of Cre-MIP in present work was shape-specific for Cre as compared to its structural analogue, 2-pyrrolidinone (2-pyr), by an ideal selectivity coefficient of 6.57 ± 0.10. In overall, this study has come up with a practical approach on the preparation of MIP for the detection of renal dysfunction by point-of-care Cre testing.

  10. The amylase-to-creatinine clearance ratio--a non-specific response to acute illness?

    Science.gov (United States)

    McMahon, M J; Playforth, M J; Rashid, S A; Cooper, E H

    1982-01-01

    It was felt that the apparent specificity of the amylase-to-creatine clearance ratio (ACCR) in several previous studies of pancreatitis might reflect a failure to utilize adequately ill control subjects. The ACCR and the renal clearances of beta 2-microglobulin (B2-m), similarly related to creatinine (BCCR) as well as the urinary concentration of albumin, were compared in 27 patients with acute pancreatitis, 8 with a perforated peptic ulcer and 7 with mild biliary colic, during the first 5 days in hospital. Acute pancreatitis was graded as mild (6), moderate (14) or severe (7), using a combination of clinical data, diagnostic peritoneal lavage and multiple criteria. Further assessment of the severity of the acute illness was obtained from measurement of C-reactive protein (C-RP). Lowest C-RP levels were found in the patients with mild pancreatitis and biliary colic, and highest levels in the patients with severe pancreatitis and perforated ulcer (P less than 0.002). Similarly, ACCR and BCCR levels were significantly lower in the two mild groups than in the two severe ones (P less than 0.01 and less than 0.002 respectively), although plasma amylase was raised only in patients with pancreatitis and plasma B2-m was similar in all groups. Electrophoresis of urine showed dense bands of tubuloprotein in patients from both severe groups. Urine albumin was higher in severe pancreatitis than in perforated ulcer (P less than 0.1), perhaps indicating a more specific glomerular lesion in pancreatitis. Thus a rise in amylase clearance appeared to be related to the severity of the acute illness, and may be a component of a non-specific tubuloproteinuria. In this study patients with a perforated peptic ulcer had increases in ACCR similar to those seen in patients with severe pancreatitis, and we are therefore doubtful whether ACCR has any role in the clinical diagnosis of pancreatic disease.

  11. ESTIMATES OF AGE-SPECIFIC URINARY EXCRETION RATES FOR CREATININE AMONG CHILDREN

    Science.gov (United States)

    The results of this study suggest that naïve adjustment by creatinine concentration, without consideration of the age-dependence of the physiological mechanisms controlling its excretion, may introduce sizeable error and is inappropriate when comparing metabolite concentrations a...

  12. Synthesis of an imprinted hybrid organic-inorganic polymeric sol-gel matrix toward the specific binding and isotherm kinetics investigation of creatinine.

    Science.gov (United States)

    Chang, Yong-Sheun; Ko, Ting-Hsien; Hsu, Ting-Jung; Syu, Mei-Jywan

    2009-03-15

    Hybrid organic-inorganic polymeric sol-gel materials imprinted with creatinine template molecules were synthesized for the specific binding of creatinine. Creatinine is a metabolite from creatine and is the final product from kidney metabolism. Therefore, creatinine can be an important index to estimate the function of the kidney. It was then chosen as the target molecule in this work. To achieve the specific binding toward creatinine, molecular imprinting was used to create a polymeric matrix for the regarding purpose. Sol-gel was further added to create a rigid network structure for the absorption of creatinine. An inorganic precursor, tetraethoxysilane (TEOS), was mixed with an organic functional monomer, 2-acrylamido-2-methylpropane-sulfonic acid (AMPS), and the creatinine template to form a hybrid organic-inorganic imprinted polymer. The chemical functionality was achieved as well as a confined matrix via the polymerization and the hydrolysis-condensation of the sol-gel. The imprinting effect from the hybrid materials against the corresponding nonimprinted was investigated. BET (Brunauer-Emmett-Teller) analysis was carried out for the imprinted and the nonimprinted materials. The specificity of the hybrid materials was further examined by capping the surface silanol groups with chloro-trimethylsilane (CTMS) and 1,1,1,3,3,3-hexamethyldisilazane (HMDS), respectively. The capping effect was compared and discussed from the binding results. Selectivity of the materials toward creatinine was obtained using mixture solutions in the presence of creatinine and its analogues. Reutilization and storage stability of the hybrid organic-inorganic imprinted material were also studied. Additionally, the affinity distribution of the hybrid imprinted materials derived from the allosteric model was also analyzed from the adsorption isotherm data.

  13. Decreases in urine specific gravity and urinary creatinine in dogs with different diseases but with normal renal function.

    Science.gov (United States)

    Fojut-Pałka, B; Winnicka, A

    2008-01-01

    The subject of this study was to determine urine specific gravity (USg) and urinary creatinine (UCrn) in dogs with different diseases but with normal renal function. Sick dogs with different diseases were divided into nine groups. Dogs suffering from polyuria/polydipsia, vomits, diarrhoea and females in oestrus or pregnant were excluded from the studies. The healthy dogs served as a control group. Over a three-year period, a total of 267 dogs were examined clinically as well as using imaging and laboratory diagnostics methods. In sick dogs, USg and UCrn were found to be essentially decreased (except animals with neurological and uterine diseases, and neurological diseases, respectively), as compared with normal dogs. In clinically healthy animals of the control group, UCrn and USg did not significantly differ between the females and males. As for the control group, no correlation between UCrn/USg and the body weight/age was found, either.

  14. Creatinine blood test

    Science.gov (United States)

    Serum creatinine ... Creatinine is a chemical waste product of creatine. Creatine is a chemical made by the body and ... done to see how well your kidneys work. Creatinine is removed from the body entirely by the ...

  15. Specificity of serum amylase and amylase creatinine clearance ratio in the diagnosis of acute and chronic pancreatitis.

    Science.gov (United States)

    Grosberg, S J; Wapnick, S; Purow, E; Purow, J R

    1979-07-01

    In 31 patients with pancreatitis, the amylase to creatinine clearance ratio (CACR) was significantly greater than for controls (10.7 +/- 1.7 vs. 2.6 +/- 0.3, P less than .001). Sixteen pancreatitis patients with serum amylase (SAm) within the normal range had a mean CACR significantly greater than that of 19 hospital control patients with normal SAm (9.2 +/- 1.5 vs. 3.0 +/- 0.4, P less than .001). For control patients a highly significant inverse correlation between SAm and CACR was observed. No relationship was detected between these parameters for pancreatitis patients. The results suggest that the CACR may be of aid in establishing the diagnosis of pancreatitis even in patients without hyperamylasemia.

  16. 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.

    Science.gov (United States)

    Rajagopalan, Prashanth; Abraham, Georgi; Reddy, Yuvaram Nv; Lakshmanasami, Ravivarman; Prakash, M L; Reddy, Yogesh Nv

    2016-01-01

    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/m(2), 18.5-24.99 kg/m(2), 25-29.99 kg/m(2), and ≥30 kg/m(2) 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.

  17. Creatinine clearance test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003611.htm Creatinine clearance test To use the sharing features on this page, please enable JavaScript. The creatinine clearance test helps provide information about how well the ...

  18. 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

    Directory of Open Access Journals (Sweden)

    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

  19. Creatinine in the dog: a review.

    Science.gov (United States)

    Braun, J P; Lefebvre, H P; Watson, A D J

    2003-01-01

    Creatinine is the analyte most frequently measured in human and veterinary clinical chemistry laboratories as an indirect measure of glomerular filtration rate (GFR). Although creatinine metabolism and the difficulties of creatinine measurement have been reviewed in human medicine, similar reviews are lacking in veterinary medicine. The aim of this review is to summarize information and data about creatinine metabolism, measurement, and diagnostic significance in the dog. Plasma creatinine originates from the degradation of creatine and creatine phosphate, which are present mainly in muscle and in food. Creatinine is cleared by glomerular filtration with negligible renal secretion and extrarenal metabolism, and its clearance is a good estimate of GFR. Plasma and urine creatinine measurements are based on the nonspecific Jaffé reaction or specific enzymatic reactions; lack of assay accuracy precludes proper interlaboratory comparison of results. Preanalytical factors such as age and breed can have an impact on plasma creatinine (P-creatinine) concentration, while many intraindividual factors of variation have little effect. Dehydration and drugs mainly affect P-creatinine concentration in dogs by decreasing GFR. P-creatinine is increased in renal failure, whatever its cause, and correlates with a decrease in GFR according to a curvilinear relationship, such that P-creatinine is insensitive for detecting moderate decreases of GFR or for monitoring progression of GFR in dogs with severely reduced kidney function. Low sensitivity can be obviated by determining endogenous or exogenous clearance rates of creatinine. A technique for determining plasma clearance following IV bolus injection of exogenous creatinine and subsequent serial measurement of P-creatinine does not require urine collection and with additional studies may become an established technique for creatinine clearance in dogs.

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

    Directory of Open Access Journals (Sweden)

    Ramesh Venkatapathy

    2014-01-01

    Full Text Available 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. Serum and salivary creatinine levels were estimated using automatic analyser. Statistical Analysis. The serum and salivary creatinine levels between controls and cases were compared using t-test. Correlation between serum and salivary creatinine was obtained in controls and cases using Pearson correlation coefficient. Receiver operating characteristic analysis was done to assess the diagnostic performance of salivary creatinine. Cut-off values were established for salivary creatinine. Results. Serum and salivary creatinine levels were significantly higher in CKD patients than controls. The correlation was negative in controls and positive in cases. Area under the curve for salivary creatinine was found to be 0.967. A cut-off value of 0.2 mg/dL gave a sensitivity of 97.1% and specificity of 86.5%. Conclusion. Saliva can be used as a noninvasive alternative to serum for creatinine estimation.

  1. Breckinridge Project, initial effort. Report III, Volume 2. Specifications

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-01-01

    Report III, Volume 2 contains those specifications numbered K through Y, as follows: Specifications for Compressors (K); Specifications for Piping (L); Specifications for Structures (M); Specifications for Insulation (N); Specifications for Electrical (P); Specifications for Concrete (Q); Specifications for Civil (S); Specifications for Welding (W); Specifications for Painting (X); and Specifications for Special (Y). The standard specifications of Bechtel Petroleum Incorporated have been amended as necessary to reflect the specific requirements of the Breckinridge Project and the more stringent specifications of Ashland Synthetic Fuels, Inc. These standard specifications are available for the Initial Effort (Phase Zero) work performed by all contractors and subcontractors.

  2. Baseline design of an OTEC pilot plantship. Volume C. Specifications

    Energy Technology Data Exchange (ETDEWEB)

    Glosten, L. R.; Bringloe, Thomas; Soracco, Dave; Fenstermacher, Earl; Magura, Donald; Sander, Olof; Richards, Dennis; Seward, Jerry

    1979-05-01

    Volume C is part of a three-volume report that presents a baseline engineering design of an Ocean Thermal Energy Conversion (OTEC) plantship. This volume provides the specifications for the hull, cold-water pipe, ship outfitting and machinery, OTEC power system, electrical system, and folded-tube heat exchangers.

  3. Compiler writing system detail design specification. Volume 1: Language specification

    Science.gov (United States)

    Arthur, W. J.

    1974-01-01

    Construction within the Meta language for both language and target machine specification is reported. The elements of the function language as a meaning and syntax are presented, and the structure of the target language is described which represents the target dependent object text representation of applications programs.

  4. 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.

  5. Dose and volume specification for reporting interstitial therapy

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-30

    The ICRU has previously published reports dealing with Dose Specification for Reporting External Beam Therapy with Photons and Electrons (ICRU Report 29, ICRU, 1978), Dose Specification for Reporting External Beam Therapy (ICRU Report 50, ICRU, 1993) and Dose and Volume Specification for Reporting Intracavitary Therapy in Gynecology (ICRU Report 38, ICRU, 1985). The present report addresses the problem of absorbed dose specification for report interstitial therapy. Although specific to interstitial therapy, many of the concepts developed in this report are also applicable to certain other kinds of brachytherapy applications. In particular, special cases of intraluminal brachytherapy and plesio-brachytherapy via surface molds employing x or gamma emitters are addressed in this report.

  6. 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.

  7. 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...

  8. Standard technical specifications: Combustion engineering plants. Volume 1, Revision 1: Specifications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    This report documents the results of the combined effort of the NRC and the industry to produce improved Standard Technical Specifications (STS), Revision 1 for Combustion Engineering Plants. The changes reflected in Revision 1 resulted from the experience gained from license amendment applications to convert to these improved STS or to adopt partial improvements to existing technical specifications. This NUREG is the result of extensive public technical meetings and discussions between the Nuclear Regulatory Commission (NRC) staff and various nuclear power plant licensees, Nuclear Steam Supply System (NSSS) Owners Groups, NSSS vendors, and the Nuclear Energy Institute (NEI). The improved STS were developed based on the criteria in the Final Commission Policy Statement on Technical Specifications Improvements for Nuclear Power Reactors, dated July 22, 1993. The improved STS will be used as the basis for individual nuclear power plant licensees to develop improved plant-specific technical specifications. This report contains three volumes. Volume 1 contains the Specifications for all chapters and sections of the improved STS. Volume 2 contains the Bases for Chapters 2.0 and 3.0, and Sections 3.1--3.3 of the improved STS. Volume 3 contains the Bases for Sections 3.4--3.9 of the improved STS.

  9. 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.

  10. Relação entre excreção de creatinina e dieta, atividade física e volume urinário, em crianças de 5 -| 12 anos de idade Relationship between creatinine excretion, diet, physical activity and urinary volume in children 5 to 12 years of age

    Directory of Open Access Journals (Sweden)

    Ignez Salas Martins

    1975-09-01

    Full Text Available Foi feito um estudo da excreção da creatinina e sua relação com a dieta, atividade física e volume urinário em indivíduos entre 5 -| 12 anos de idade, mantendo suas condições habituais de vida. A análise qualitativa da dieta mostrou que a possibilidade de ingestão de creatina e creatinina ocorreu na hora do almoço. No que se refere à atividade física, o período da manhã e o noturno foram de relativo repouso, concentrando-se as atividades físicas no período da tarde. Não houve diferença, estatisticamente, significante entre a excreção média de creatinina dos períodos da manhã e da tarde e também entre a excreção média dos períodos diurno e noturno, sugerindo, conseqüentemente, uma não relação entre dieta, atividade física e excreção de creatinina. Houve uma diferença estatisticamente significante entre o volume médio urinário do período diurno e o do período noturno, sugerindo com isso uma independência entre ele e a creatinina excretada. Encontrou-se, entretanto, uma correlação significante entre ambos que, possivelmente esteja ligada ao fato das amostras terem sido colhidas em épocas de frio intenso, em que os indivíduos ingerem pouco líquido, e conseqüentemente a urina estivesse com uma concentração elevada de seus diferentes constituintes.A study on the relationship between creatinine excretion and diet, physical activity and urinary volume was carried out on children from 5 to 12 years of age, observing usual life conditions. Qualitative analysis of diet revealed that possibly ingestion of creatine and creatinine ocurred with the noon meal. Regarding physical activity the data showed that the peak of activity occurred in the afternoon. The differences between average excretion of creatine corresponding to morning and afternoon periods were not statistically significant, the same being observed when diurnal and nocturnal averages of excretion were considered. On the other hand, the average

  11. The influence of a cooked meat meal on creatinine plasma concentration and creatinine clearance.

    OpenAIRE

    Mayersohn, M; Conrad, K A; Achari, R

    1983-01-01

    1 The influence of a meal containing cooked meat (225 g) on creatinine plasma concentration, creatinine urinary excretion and creatinine clearance was determined in six healthy male subjects. 2 The meat meal produced an average 52% increase in creatinine plasma concentration within 1.5 to 3.5 h after ingestion. The 24 h area under the creatinine plasma concentration-time curve increased by about 19%. Urinary creatinine excretion during 24 h increased by an average of 13%. Creatinine clearance...

  12. Creatinine

    Science.gov (United States)

    Advertisement Proceeds from website advertising help sustain Lab Tests Online. AACC is a not-for-profit organization and does not endorse non-AACC products and services. Advertising & Sponsorship: Policy | Opportunities ...

  13. Lactate to creatinine ratio in amniotic fluid : a pilot study

    NARCIS (Netherlands)

    Torrance, Helen L.; Pistorius, Lourens; Voorbij, Hieronymus A. M.; Visser, Gerard H. A.

    2013-01-01

    Measurement of amniotic fluid (AF) lactate concentration in complicated pregnancies may provide information on the extent of fetal acidemia. However, normalisation for AF volume may be necessary by calculating the lactate: creatinine (L: C) ratio. We measured these AF parameters and compared them to

  14. Smaller superior temporal gyrus volume specificity in schizotypal personality disorder

    Science.gov (United States)

    Goldstein, Kim E.; Hazlett, Erin A.; New, Antonia S.; Haznedar, M. Mehmet; Newmark, Randall E.; Zelmanova, Yuliya; Passarelli, Vincent; Weinstein, Shauna R.; Canfield, Emily L.; Meyerson, David A.; Tang, Cheuk Y.; Buchsbaum, Monte S.; Siever, Larry J.

    2009-01-01

    Background Superior temporal gyrus (STG/BA22) volume is reduced in schizophrenia and to a milder degree in schizotypal personality disorder (SPD), representing a less severe disorder in the schizophrenia-spectrum. SPD and Borderline personality disorder (BPD) are severe personality disorders characterized by social and cognitive dysfunction. However, while SPD is characterized by social withdrawal/anhedonia, BPD is marked by hyper-reactivity to interpersonal stimuli and hyper-emotionality. This is the first morphometric study to directly compare SPD and BPD patients in temporal volume. Methods We compared three age-gender- and education-matched groups: 27 unmedicated SPD individuals with no BPD traits, 52 unmedicated BPD individuals with no SPD traits, and 45 healthy controls. We examined gray matter volume of frontal and temporal lobe Brodmann areas (BAs), and dorsal/ventral amygdala from 3T magnetic resonance imaging. Results In the STG, an auditory association area reported to be dysfunctional in SPD and BPD, the SPD patients had significantly smaller volume than healthy controls and BPD patients. No group differences were found between BPD patients and controls. Smaller BA22 volume was associated with greater symptom severity in SPD patients. Reduced STG volume may be an important endophenotype for schizophrenia-spectrum disorders. SPD is distinct from BPD in terms of STG volume abnormalities which may reflect different underlying pathophysiological mechanisms and could help discriminate between them. PMID:19473820

  15. Partial specific volume of cellulose N-phenyl carbamate

    Science.gov (United States)

    Wohlfarth, Ch.

    This document is part of Subvolume D2 'Polymer Solutions - Physical Properties and their Relations I (Thermodynamic Properties: PVT -Data and miscellaneous Properties of polymer Solutions) of Volume 6 `Polymers' of Landolt-Börnstein - Group VIII `Advanced Materials and Technologies'.

  16. Mod-5A wind turbine generator program design report. Volume 4: Drawings and specifications, book 5

    Science.gov (United States)

    1984-01-01

    The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. There are four volumes. This volume contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. Detail drawings of several assemblies and subassemblies are given. This is the fifth book of volume 4.

  17. Age and gender-specific reference values of orbital fat and muscle volumes in Caucasians

    NARCIS (Netherlands)

    Regensburg, N.I.; Wiersinga, W.M.; van Velthoven, M.E.J.; Berendschot, T.T.J.M.; Zonneveld, F.W.; Baldeschi, L.; Saeed, P.; Mourits, M.P.

    2011-01-01

    To provide age and gender-specific reference values for orbital fat and muscle volumes (MV) in Caucasian adults. Computed tomographic scans of 160 orbits from 52 men and 55 women, aged 20-80 years, not affected by orbital disease were evaluated. Orbital bony cavity volume (OV), fat volume (FV) and M

  18. Age and gender-specific reference values of orbital fat and muscle volumes in Caucasians

    NARCIS (Netherlands)

    Regensburg, N.I.; Wiersinga, W.M.; van Velthoven, M.E.J.; Berendschot, T.T.J.M.; Zonneveld, F.W.; Baldeschi, L.; Saeed, P.; Mourits, M.P.

    2011-01-01

    To provide age and gender-specific reference values for orbital fat and muscle volumes (MV) in Caucasian adults. Computed tomographic scans of 160 orbits from 52 men and 55 women, aged 20-80 years, not affected by orbital disease were evaluated. Orbital bony cavity volume (OV), fat volume (FV) and

  19. Labeling of creatinine with technetium-99m

    Energy Technology Data Exchange (ETDEWEB)

    Yurt Lambrecht, F. [Ege Univ., Bornova, Izmir (Turkey). Dept. of Nuclear Applications, Inst. of Nuclear Sciences; Durkan, K. [Dokuz Eylul Univ., Buca, Izmir (Turkey). Chemistry Technicianship Program, Izmir Vocational School; Soylu, A. [Dokuz Eylul Univ., Narlidere, Izmir (Turkey). Dept. of Pediatrics, Medical Faculty

    2004-07-01

    Creatinine is a clinically important index of renal glomerular filtration rate. Urine creatinine levels can be used as a screening test to evaluate kidney function or can be part of the creatinine clearance test. In case of kidney dysfunction or muscle disorders the creatinine concentration in serum/plasma may rise to a higher value than in healthy body. Technetium- 99m has been used in nuclear medicine and in biomedical research to label molecular and cellular structures employed as radiotracers. {sup 99m}Tc is utilized to label molecules and cells, used as radiopharmaceuticals, and also to label biological species. It presents many desirable characteristics. SnCl{sub 2} method is frequently used as a reducing agent in the {sup 99m}Tc- labeling process. Creatinine metabolism might be investigated by using labeled {sup 99m}Tc- creatinine in healthy or uremic rats. (orig.)

  20. Diminished creatinine clearance in anorexia nervosa: reversal with weight gain.

    OpenAIRE

    Boag, F; Weerakoon, J; Ginsburg, J.; Havard, C W; Dandona, P

    1985-01-01

    To assess whether patients with anorexia nervosa have abnormalities in creatinine clearance, we measured plasma creatinine concentration, urinary creatinine excretion, and creatinine clearance in 10 patients with anorexia nervosa before and during treatment. Urinary creatinine excretion and creatinine clearance were diminished in all patients. Nine patients had significant decreases in their plasma creatinine and creatinine clearance was increased even when corrected for body weight and body ...

  1. The screening value of the amylase-creatinine clearance ratio in acute pancreatitis.

    Science.gov (United States)

    Van Hee, R; Hubens, A

    1979-01-01

    The screening value of the amylase creatinine clearance ratio in acute pancreatitis is studied. A series of 28 patients with pancreatic disease is compared with 80 controls and 82 patients with other intra-abdominal disease. The greatest specificity of the amylase creatinine clearance ratio value is reached at the 3.5 level. The amylase creatinine clearance ratio value proves to be of interest, not only in the diagnosis of acute pancreatitis but also in differentiating mild and heavy forms of pancreatitis.

  2. Blood creatinine level in postmortem cases.

    Science.gov (United States)

    Nishida, Atsushi; Funaki, Hironao; Kobayashi, Masaki; Tanaka, Yuka; Akasaka, Yoshihisa; Kubo, Toshikazu; Ikegaya, Hiroshi

    2015-05-01

    Blood chemical analysis for the diagnosis of diseases in forensic cases should be conducted in the same way as for clinical cases. However, it is sometimes difficult to obtain serum samples in forensic cases because of postmortem changes such as hemolysis and putrefaction. This study aimed to evaluate renal function in postmortem cases by blood creatinine analysis. The blood creatinine level was measured by high performance liquid chromatography (HPLC) using whole blood samples taken from 77 postmortem cases, and the relationships between blood creatinine level, postmortem interval, and cause of death were examined. The median blood creatinine level was found to be 1.15 mg/dL, with no significant differences between blood samples taken from different parts of the body. The blood creatinine level was stable for 3 days after death and gradually increased after that period, in line with a previous study using enzymatic analysis that found the serum creatinine level was stable in the early postmortem period. The blood creatinine level was high in the cases of blunt injury, intoxication, and in deaths caused by fire. This was considered to reflect acute renal dysfunction. However, the postmortem blood creatinine level remained higher than the clinical normal value despite omitting cases with renal dysfunction from the analysis. Therefore, we next investigated the change in postmortem creatinine levels in mice and found that the blood creatinine level increased with the emergence of rigor mortis. Our findings indicate that HPLC is useful in the postmortem evaluation of renal function even in the cases where serum cannot be obtained. However, the presence of rigor mortis should be considered in the evaluation of blood creatinine values.

  3. 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...

  4. Alternative method for measurement of albumin/creatinine ratio using spectrophotometric sequential injection analysis.

    Science.gov (United States)

    Siangproh, Weena; Teshima, Norio; Sakai, Tadao; Katoh, Shuji; Chailapakul, Orawon

    2009-09-15

    A simple, automatic and practical system for successive determination of albumin and creatinine has been developed by combining sequential injection analysis (SIA) and highly sensitive dye-binding assays. Albumin detection was based on the increase in the absorbance due to complex formation between albumin and eosin Y in acidic media. The absorbance of the complex was monitored at 547 nm. For the creatinine assay, the concentration of creatinine was measured by reaction with alkaline picrate to form a colored product which absorbs at 500 nm. The influences of experimental variables such as effects of pH, reagent concentration, standard/sample volume and interferences were investigated. Under optimal conditions, the automated method showed linearity up to 20 mg L(-1) for albumin and 100 mg L(-1) for creatinine. The 3 sigma detection limits were 0.6 and 3.5 mg L(-1) for albumin and creatinine, respectively, and the relative standard deviations (n=10) were 2.49% for 20 mg L(-1) albumin, and 3.14% for 20 mg L(-1) creatinine. Application of the proposed method to the direct analysis of urinary samples yielded results which agreed with those obtained from the Bradford protein assay and a creatinine enzymatic assay according to a paired t-test. The results obtained should be a step towards developing a fully automated and reliable analytical system for clinical research, which requires direct determination of albumin and creatinine and/or its ratios.

  5. Plasma Creatinine Clearance in the Dog

    Science.gov (United States)

    Frazier, Loy W.

    1977-01-01

    Lists materials and methods for an experiment that demonstrates the concept of glomerular filtration rate (GFR) using anesthesized dogs. In the dog, GFR is equivalent to the renal plasma clearance of exogenous creatinine. (CS)

  6. Mod-5A wind turbine generator program design report. Volume 4: Drawings and specifications, book 3

    Science.gov (United States)

    1984-01-01

    The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. This volume contains the drawings and specifications developed for the final design. This volume is divided into 5 books of which this is the third, containing drawings 47A380074 through 47A380126. A full breakdown parts listing is provided as well as a where used list.

  7. Mod-5A wind turbine generator program design report. Volume 4: Drawings and specifications, book 4

    Science.gov (United States)

    1984-01-01

    The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator are documented. There are four volumes. This volume contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. This volume contains 5 books of which this is the fourth, providing drawings 47A380128 through 47A387125. In addition to the parts listing and where-used list, the logic design of the controller software and the code listing of the controller software are provided. Also given are the aerodynamic profile coordinates.

  8. Mod-5A wind turbine generator program design report. Volume 4: Drawings and specifications, book 2

    Science.gov (United States)

    1984-01-01

    The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. There are four volumes. This volume contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. This is the second book of volume four. Some of the items it contains are specs for the emergency shutdown panel, specs for the simulator software, simulator hardware specs, site operator terminal requirements, control data system requirements, software project management plan, elastomeric teeter bearing requirement specs, specs for the controls electronic cabinet, and specs for bolt pretensioning.

  9. Preliminary design of the Carrisa Plains solar central receiver power plant. Volume II. Plant specifications

    Energy Technology Data Exchange (ETDEWEB)

    Price, R. E.

    1983-12-31

    The specifications and design criteria for all plant systems and subsystems used in developing the preliminary design of Carrisa Plains 30-MWe Solar Plant are contained in this volume. The specifications have been organized according to plant systems and levels. The levels are arranged in tiers. Starting at the top tier and proceeding down, the specification levels are the plant, system, subsystem, components, and fabrication. A tab number, listed in the index, has been assigned each document to facilitate document location.

  10. Standard technical specifications General Electric plants, BWR/6. Volume 1, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    This report documents the results of the combined effort of the NRC and the industry to produce improved Standard Technical Specifications (STS), Revision 1 for General Electric BWR/6 Plants. The changes reflected in Revision 1 resulted from the experience gained from license amendment applications to convert to these improved STS or to adopt partial improvements to existing technical specifications. This NUREG is the result of extensive public technical meetings and discussions between the Nuclear Regulatory Commission (NRC) staff and various nuclear power plant licensees, Nuclear Steam Supply System (NSSS) Owners Groups, NSSS vendors, and the Nuclear Energy Institute (NEI). The improved STS were developed based on the criteria in the Final Commission Policy Statement on Technical Specifications Improvements for Nuclear Power Reactors, dated July 22, 1993. The improved STS will be used as the basis for individual nuclear power plant licensees to develop improved plant-specific technical specifications. This report contains three volumes. Volume 1 contains the Specifications for all chapters and sections of the improved STS. Volume 2 contains the Bases for Chapters 2.0 and 3.0, and Sections 3.1--3.3 of the improved STS. Volume 3 contains the Bases for Sections 3.4--3.10 of the improved STS.

  11. The value of the amylase/creatinine clearance ratio in the diagnosis of acute pancreatitis.

    Science.gov (United States)

    Solomon, A R

    1978-01-01

    Acute pancreatitis usually confronts the clinician with a difficult diagnostic task. For years, the primary laboratory diagnostic tests were the serum and urine amylase and the serum lipase determinations. Recent studies have introduced the concept of the amylase/creatinine clearance ratio as a means of increasing the specificity of the laboratory diagnosis. This paper reviews the laboratory evaluation of acute pancreatitis with emphasis on the rationale, derivation, and specificity of the amylase/creatinine clearance ratio.

  12. Investigation of the Temperature-Dependent Specific Volume of Supported Polystyrene Films Upon Confinement

    Science.gov (United States)

    Huang, Xinru; Roth, Connie

    2015-03-01

    The experimentally observed large changes in the glass transition temperature Tg of ultrathin supported and free-standing polymer films with decreasing thickness h have puzzled the field for more than two decades. An open question at present is what material property changes correspond to the large shifts in film dynamics upon confinement. Thermodynamic theories have predicted that the observed Tg(h) decrease in ultrathin polymer films may be tied to small shifts in the specific volume of the liquid-line above Tg. Here we use ellipsometry to investigate the temperature-dependent specific volume for supported polystyrene (PS) films of different thicknesses. Using the Lorentz-Lorenz parameter as a measure of the relative change in film density, we calculate the specific volume from temperature-dependent measurements of the index of refraction. While the slope of the liquid-line (thermal expansion coefficient) remains constant upon confinement, the Tg(h) decrease is accompanied with a broadening of the transition and a small increase in the glassy-line thermal expansion, consistent with a larger fraction of the sample remaining liquid to lower temperatures. We find that both the liquid and glass specific volume lines shift together with decreasing thickness indicative of small 0.5-1% changes in overall film density with decreasing thickness.

  13. Field Operations and Enforcement Manual for Air Pollution Control. Volume III: Inspection Procedures for Specific Industries.

    Science.gov (United States)

    Weisburd, Melvin I.

    The Field Operations and Enforcement Manual for Air Pollution Control, Volume III, explains in detail the following: inspection procedures for specific sources, kraft pulp mills, animal rendering, steel mill furnaces, coking operations, petroleum refineries, chemical plants, non-ferrous smelting and refining, foundries, cement plants, aluminum…

  14. Field Operations and Enforcement Manual for Air Pollution Control. Volume III: Inspection Procedures for Specific Industries.

    Science.gov (United States)

    Weisburd, Melvin I.

    The Field Operations and Enforcement Manual for Air Pollution Control, Volume III, explains in detail the following: inspection procedures for specific sources, kraft pulp mills, animal rendering, steel mill furnaces, coking operations, petroleum refineries, chemical plants, non-ferrous smelting and refining, foundries, cement plants, aluminum…

  15. Four hour creatinine clearance is better than plasma creatinine for monitoring renal function in critically ill patients

    OpenAIRE

    Pickering, John W.; Frampton, Christopher M; Walker, Robert J; Shaw, Geoffrey M; Endre, Zoltán H

    2012-01-01

    Introduction Acute kidney injury (AKI) diagnosis is based on an increase in plasma creatinine, which is a slowly changing surrogate of decreased glomerular filtration rate. We investigated whether serial creatinine clearance, a direct measure of the glomerular filtration rate, provided more timely and accurate information on renal function than serial plasma creatinine in critically ill patients. Methods Serial plasma creatinine and 4-hour creatinine clearance were measured 12-hourly for 24 h...

  16. Mod-5A Wind Turbine Generator Program Design Report. Volume 4: Drawings and Specifications, Book 1

    Science.gov (United States)

    1984-01-01

    The design, development and analysis of the 7.3 MW MOD-5A wind turbine generator is documented. Volume 4 contains the drawings and specifications that were developed in preparation for building the MOD-5A wind turbine generator. This is the first of five books of volume four. It contains structural design criteria, generator step-up transformer specs, specs for design, fabrication and testing of the system, specs for the ground control enclosure, systems specs, slip ring specs, and control system specs.

  17. Changes in the temperature-dependent specific volume of supported polystyrene films with film thickness

    Science.gov (United States)

    Huang, Xinru; Roth, Connie B.

    2016-06-01

    Recent studies have measured or predicted thickness-dependent shifts in density or specific volume of polymer films as a possible means of understanding changes in the glass transition temperature Tg(h) with decreasing film thickness with some experimental works claiming unrealistically large (25%-30%) increases in film density with decreasing thickness. Here we use ellipsometry to measure the temperature-dependent index of refraction of polystyrene (PS) films supported on silicon and investigate the validity of the commonly used Lorentz-Lorenz equation for inferring changes in density or specific volume from very thin films. We find that the density (specific volume) of these supported PS films does not vary by more than ±0.4% of the bulk value for film thicknesses above 30 nm, and that the small variations we do observe are uncorrelated with any free volume explanation for the Tg(h) decrease exhibited by these films. We conclude that the derivation of the Lorentz-Lorenz equation becomes invalid for very thin films as the film thickness approaches ˜20 nm, and that reports of large density changes greater than ±1% of bulk for films thinner than this likely suffer from breakdown in the validity of this equation or in the difficulties associated with accurately measuring the index of refraction of such thin films. For larger film thicknesses, we do observed small variations in the effective specific volume of the films of 0.4 ± 0.2%, outside of our experimental error. These shifts occur simultaneously in both the liquid and glassy regimes uniformly together starting at film thicknesses less than ˜120 nm but appear to be uncorrelated with Tg(h) decreases; possible causes for these variations are discussed.

  18. Creatinine clearance versus serum creatinine as a risk factor in cardiac surgery.

    Science.gov (United States)

    Walter, Jörg; Mortasawi, Amir; Arnrich, Bert; Albert, Alexander; Frerichs, Inez; Rosendahl, Ulrich; Ennker, Jürgen

    2003-06-17

    Renal impairment is one of the predictors of mortality in cardiac surgery. Usually a binarized value of serum creatinine is used to assess the renal function in risk models. Creatinine clearance can be easily estimated by the Cockcroft and Gault equation from serum creatinine, gender, age and body weight. In this work we examine whether this estimation of the glomerular filtration rate can advantageously replace the serum creatinine in the EuroSCORE preoperative risk assessment. In a group of 8138 patients out of a total of 11878 patients, who underwent cardiac surgery in our hospital between January 1996 and July 2002, the 18 standard EuroSCORE parameters could retrospectively be determined and logistic regression analysis performed. In all patients scored, creatinine clearance was calculated according to Cockcroft and Gault. The relationship between the predicted and observed 30-days mortality was evaluated in systematically selected intervals of creatinine clearance and significance values computed by employing Monte Carlo methods. Afterwards, risk scoring was performed using a continuous or a categorical value of creatinine clearance instead of serum creatinine. The predictive ability of several risk score models and the individual contribution of their predictor variables were studied using ROC curve analysis. The comparison between the expected and observed 30-days mortalities, which were determined in different intervals of creatinine clearance, revealed the best threshold value of 55 ml/min. A significantly higher 30-days mortality was observed below this threshold and vice versa (both with p Differential ROC analysis revealed that CC is superior to SC in providing predictive power within the logistic regression. Variable rank comparison identified CC as the best single variable predictor, even better than the variable age, former number 1, and SC, previously number 9 in the standard set of EuroSCORE variables. The renal function is an important determinant

  19. Feasibility study for a numerical aerodynamic simulation facility. Volume 2: Hardware specifications/descriptions

    Science.gov (United States)

    Green, F. M.; Resnick, D. R.

    1979-01-01

    An FMP (Flow Model Processor) was designed for use in the Numerical Aerodynamic Simulation Facility (NASF). The NASF was developed to simulate fluid flow over three-dimensional bodies in wind tunnel environments and in free space. The facility is applicable to studying aerodynamic and aircraft body designs. The following general topics are discussed in this volume: (1) FMP functional computer specifications; (2) FMP instruction specification; (3) standard product system components; (4) loosely coupled network (LCN) specifications/description; and (5) three appendices: performance of trunk allocation contention elimination (trace) method, LCN channel protocol and proposed LCN unified second level protocol.

  20. A facile low-cost enzymatic paper-based assay for the determination of urine creatinine.

    Science.gov (United States)

    Talalak, Kwanrutai; Noiphung, Julaluk; Songjaroen, Temsiri; Chailapakul, Orawon; Laiwattanapaisal, Wanida

    2015-11-01

    Creatinine is one of many markers used to investigate kidney function. This paper describes a low-cost enzymatic paper-based analytical device (enz-PAD) for determining urine creatinine. The disposable dead volumes of creatinine enzyme reagents from an automatic analyser cassette were utilised. Whatman No. 3 paper was cut into long rectangular shapes (4×40 mm(2)) on which the enzyme reagents, R1 and R2, were adsorbed in two consecutive regions. The assay was performed by immersing test strips into urine samples contained in microwells to allow creatinine in the sample to react with immobilised active ingredients and, then, traverse via capillary action to the detection area where chromogen products accumulated. The method is based on hydrogen peroxide (H2O2) formation via creatinine conversion using creatininase, creatinase, and sarcosine oxidase. The liberated H2O2 reacts with 4-aminophenazone and 2,4,6-triiodo-3-hydroxybenzoic acid to form quinoneimine with a pink-red colour at the detection zone. The linear range of the creatinine assay was 2.5-25 mg dL(-1) (r(2)=0.983), and the detection limit was 2.0 mg dL(-1). The colorimetric enz-PAD for the creatinine assay was highly correlated with a conventional alkaline picrate method when real urine samples were evaluated (r(2)=0.977; n=40). This simple and nearly zero-cost paper-based device provides a novel alternative method for screening urinary creatinine and will be highly beneficial for developing countries.

  1. Creatinine Diffusion Modeling in Capacitive Sensors

    Science.gov (United States)

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

    2016-12-01

    In this paper, creatinine diffusion in capacitive sensors is discussed. The factors influencing the response time of creatinine biosensors are mathematically formulated and then three novel approaches for decreasing the response time are presented. At first, a piezoelectric actuator is used to vibrate the microtube that contains the blood sample, in order to reduce the viscosity of blood, and thus to increase the coefficient of diffusion. Then, the blood sample is assumed to be pushed through a porous medium, and the relevant conditions are investigated. Finally, the effect of the dentate shape of dielectric on response time is studied. The algorithms and the mathematical models are presented and discussed, and the results of simulations are illustrated. The response times for the first, second and third method are 60, 0.036 and about 31 s, respectively. It is also found that pumping results in very fast responses.

  2. 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.

  3. Urine volume dependency of specific dehydroepiandrosterone (DHEA) and cortisol metabolites in healthy children.

    Science.gov (United States)

    Shi, Lijie; Wudy, Stefan A; Maser-Gluth, Christiane; Hartmann, Michaela F; Remer, Thomas

    2011-01-01

    Urine volume should be considered as a confounder when using urinary free cortisol (UFF) and cortisone (UFE) to assess glucocorticoid (GC) status. We aimed to examine whether adrenal androgen (AA) metabolites may be also affected by urine volume in healthy children. To compare the flow dependence of GC and AA metabolites, specific GC metabolites were examined. In 24-h urine samples of 120 (60 boys) healthy children (4-10 yr), steroid profiles were determined by GC-MS analysis, UFF and UFE by radioimmunoassay. To assess daily AA and GC secretion rates, 7 quantitatively most important AA (∑C19) and GC (∑C21) metabolites were summed. Sum of DHEA and its 16α-hydroxylated metabolites were denoted as DHEA&M. Association of urine volume with AA (∑C19, DHEA&M, DHEA, 16α-hydroxy-DHEA, 3β,16α,17β-androstenetriol) and GC (∑C21, UFF, UFE, 6β-hydroxycortisol, 20α-dihydrocortisol) were examined in linear regression models. Among the examined AA metabolites, 16α-hydroxy-DHEA (β=0.56, pDHEA (β=0.43, p=0.05) showed relatively strong association with urine volume. A trend was seen for ∑C19 (β=0.23, p=0.08), but not for DHEA&M (p>0.1). Regarding GC metabolites, urine volume showed a stronger association with cortisol's direct metabolites, i.e., cortisone, 6β-hydroxycortisol and 20α-dihydrocortisol (β=0.4-0.6, pDHEA, 16α-hydroxy-DHEA, 6β-hydroxycortisol, and 20α-dihydrocortisol may also depend on urine volume. The intrarenal production of the latter three and cortisone might explain their relative strong water-flow-dependency. Total AA or GC secretion marker appears not to be relevantly confounded by urine volume. Copyright © 2010 Elsevier Inc. All rights reserved.

  4. Label free sensing of creatinine using a 6 GHz CMOS near-field dielectric immunosensor.

    Science.gov (United States)

    Guha, S; Warsinke, A; Tientcheu, Ch M; Schmalz, K; Meliani, C; Wenger, Ch

    2015-05-07

    In this work we present a CMOS high frequency direct immunosensor operating at 6 GHz (C-band) for label free determination of creatinine. The sensor is fabricated in standard 0.13 μm SiGe:C BiCMOS process. The report also demonstrates the ability to immobilize creatinine molecules on a Si3N4 passivation layer of the standard BiCMOS/CMOS process, therefore, evading any further need of cumbersome post processing of the fabricated sensor chip. The sensor is based on capacitive detection of the amount of non-creatinine bound antibodies binding to an immobilized creatinine layer on the passivated sensor. The chip bound antibody amount in turn corresponds indirectly to the creatinine concentration used in the incubation phase. The determination of creatinine in the concentration range of 0.88-880 μM is successfully demonstrated in this work. A sensitivity of 35 MHz/10 fold increase in creatinine concentration (during incubation) at the centre frequency of 6 GHz is gained by the immunosensor. The results are compared with a standard optical measurement technique and the dynamic range and sensitivity is of the order of the established optical indication technique. The C-band immunosensor chip comprising an area of 0.3 mm(2) reduces the sensing area considerably, therefore, requiring a sample volume as low as 2 μl. The small analyte sample volume and label free approach also reduce the experimental costs in addition to the low fabrication costs offered by the batch fabrication technique of CMOS/BiCMOS process.

  5. Assurance specification documentation standard and Data Item Descriptions (DID). Volume of the information system life-cycle and documentation standards, volume 4

    Science.gov (United States)

    Callender, E. David; Steinbacher, Jody

    1989-01-01

    This is the fourth of five volumes on Information System Life-Cycle and Documentation Standards. This volume provides a well organized, easily used standard for assurance documentation for information systems and software, hardware, and operational procedures components, and related processes. The specifications are developed in conjunction with the corresponding management plans specifying the assurance activities to be performed.

  6. Sensitivity of the amylase-creatinine clearance ratio in acute pancreatitis.

    Science.gov (United States)

    Farrar, W H; Calkins, G

    1978-06-01

    An elevated amylase-creatinine clearance ratio has been established as being highly specific for the diagnosis of acute pancreatitis. In the present study, the sensitivity of this test was compared to that of the serum amylase and the one-hour urinary amylase test in 29 patients with acute pancreatitis. Abnormal elevations of the amylase-creatinine clearance ratio were found less frequently than abnormal elevations of the serum and one-hour urinary amylases. Moreover, abnormal elevations of the amylase-creatinine clearance ratio showed less deviation from normal and values returned to normal sooner than those of the serum and one-hour urinary amylases. When compared to the serum amylase and the one-hour urinary amylase tests, the amylase-creatinine clearance ratio is a relatively insensitive test in patients with acute pancreatitis.

  7. Amylase-creatinine clearance ratios and serum amylase isoenzymes in moderate renal insufficiency.

    Science.gov (United States)

    Banks, P A; Sidi, S; Gelman, M L; Lee, K H; Warshaw, A L

    1979-12-01

    Both the amylase-creatinine clearance ratio (normal 1.55%) and proportion of pancreatic isoamylase in serum (normal 41.0%) increase in acute pancreatitis, and are therefore useful measurements to support that diagnosis. Whether renal insufficiency interferes with the accuracy and specificity of these tests has been debated. Our study indicates that even moderate renal insufficiency (creatinine clearance 30.5 ml/minute) raises the amylase-creatinine clearance ratio (3.23%) close enough to values characteristic of acute pancreatitis (4.41%) to cause potential diagnostic confusion. The fraction of pancreatic isoamylase in serum is also increased (69.9%), but not to the levels of acute pancreatitis (91.0%). We therefore caution against the use of the amylase-creatinine clearance ratio for the diagnosis of acute pancreatitis in patients with moderate renal insufficiency.

  8. Urine Protein and Urine Protein to Creatinine Ratio

    Science.gov (United States)

    ... products and services. Advertising & Sponsorship: Policy | Opportunities Urine Protein and Urine Protein to Creatinine Ratio Share this page: Was this page helpful? Also known as: 24-Hour Urine Protein; Urine Total Protein; Urine Protein to Creatinine Ratio; ...

  9. Prediction total specific pore volume of geopolymers produced from waste ashes by fuzzy logic

    Directory of Open Access Journals (Sweden)

    Ali Nazari

    2012-04-01

    Full Text Available In the present work, total specific pore volume of inorganic polymers (geopolymers made from seeded fly ash and rice husk bark ash has been predicted by fuzzy logic. Different specimens, made from a mixture of fly ash and rice husk bark ash in fine and coarse form together with alkali activator made of water glass and NaOH solution, were subjected to porosimetry tests at 7 and 28 days of curing. The curing regime was different: one set of the specimens were cured at room temperature until reaching to 7 and 28 days and the other sets were oven cured for 36 hours at the range of 40-90 °C and then cured at room temperature until 7 and 28 days. A model based on fuzzy logic for predicting the total specific pore volume of the specimens has been presented. To build the model, training and testing using experimental results from 120 specimens were conducted. The used data as the inputs of fuzzy logic models are arranged in a format of six parameters that cover the percentage of fine fly ash in the ashes mixture, the percentage of coarse fly ash in the ashes mixture, the percentage of fine rice husk bark ash in the ashes mixture, the percentage of coarse rice husk bark ash in the ashes mixture, the temperature of curing and the time of water curing. According to the input parameters, in the fuzzy logic model, the pore volume of each specimen was predicted. The training and testing results in the fuzzy logic model have shown a strong potential for predicting the total specific pore volume of the geopolymer specimens in the considered range.

  10. Amylase creatinine clearance ratio after biliary surgery.

    Science.gov (United States)

    Donaldson, L A; McIntosh, W; Joffe, S N

    1977-01-01

    The amylase creatinine clearance ratio (ACCR) is considered to be a more sensitive index of acute pancreatitis than the serum amylase level. Serial ACCR estimations were undertaken in 25 patients undergoing an elective cholecystectomy. Using accepted criteria, 28% of these patients developed, in the postoperative period, biochemical evidence of pancreatic gland damage, although the serum amylase level remained normal. This raised ACCR was particularly noted in patients who had undergone an exploration of the common bile duct. The ACCR would appear to be a more sensitive index of pancreatic gland disruption secondary to biliary surgery than the serum amylase level.

  11. Universal convergence of the specific volume changes of globular proteins upon unfolding.

    Science.gov (United States)

    Schweiker, Katrina L; Fitz, Victoria W; Makhatadze, George I

    2009-11-24

    Both pressure and temperature are important environmental variables, and to obtain a complete understanding of the mechanisms of protein folding, it is necessary to determine how protein stability is dependent on these fundamental thermodynamic parameters. Although the temperature dependence of protein stability has been widely explored, the dependence of protein stability on pressure is not as well studied. In this paper, we report the results of the direct thermodynamic determination of the change in specific volume (DeltaV/V) upon protein unfolding, which defines the pressure dependence of protein stability, for five model proteins (ubiquitin, eglin c, ribonuclease A, lysozyme, and cytochrome c). We have shown that the specific volumetric changes upon unfolding for four of the proteins (ubiquitin, eglin c, ribonuclease A, and lysozyme) appear to converge to a common value at high temperatures. Analysis of various contributions to the change in volume upon protein unfolding allowed us to put forth the hypothesis that the change in volume due to hydration is very close to zero at this temperature, such that DeltaV/V is defined largely by the total volume of cavities and voids within a protein, and that this is a universal property of all small globular proteins without prosthetic groups. To test this hypothesis, additional experiments were performed with variants of eglin c that had site-directed substitutions at two buried positions, to create an additional cavity in the protein core. The results of these experiments, coupled with the structural analysis of cytochrome c showing a lower packing density compared to those of the other four proteins, provided further support for the hypothesis. Finally, we have shown that the deviation of the high-temperature DeltaV value of a given protein from the convergence value can be used to determine the size of the excess cavities in globular proteins.

  12. 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.

  13. Solid Waste Operations Complex W-113, Detail Design Report (Title II). Volume 3: Specifications

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-01

    The Solid Waste Retrieval Facility--Phase 1 (Project W113) will provide the infrastructure and the facility required to retrieve from Trench 04, Burial ground 4C, contact handled (CH) drums and boxes at a rate that supports all retrieved TRU waste batching, treatment, storage, and disposal plans. This includes (1) operations related equipment and facilities, viz., a weather enclosure for the trench, retrieval equipment, weighing, venting, obtaining gas samples, overpacking, NDE, NDA, shipment of waste and (2) operations support related facilities, viz., a general office building, a retrieval staff change facility, and infrastructure upgrades such as supply and routing of water, sewer, electrical power, fire protection, roads, and telecommunication. Title I design for the operations related equipment and facilities was performed by Raytheon/BNFL, and that for the operations support related facilities including infrastructure upgrade was performed by KEH. These two scopes were combined into an integrated W113 Title II scope that was performed by Raytheon/BNFL. Volume 3 is a compilation of the construction specifications that will constitute the Title II materials and performance specifications. This volume contains CSI specifications for non-equipment related construction material type items, performance type items, and facility mechanical equipment items. Data sheets are provided, as necessary, which specify the equipment overall design parameters.

  14. The generalization of charged AdS black hole specific volume and number density

    Science.gov (United States)

    Wang, Zi-Liang; He, Miao; Fang, Chao; Sun, Dao-Quan; Deng, Jian-Bo

    2017-04-01

    In this paper, by proposing a generalized specific volume, we restudy the P- V criticality of charged AdS black holes in the extended phase space. The results show that most of the previous conclusions can be generalized without change, but the ratio {\\tilde{ρ }}_c should be 3 {\\tilde{α }}/16 in general case. Further research on the thermodynamical phase transition of black hole leads us to a natural interpretation of our assumption, and more black hole properties can be generalized. Finally, we study the number density for charged AdS black hole in higher dimensions, the results show the necessity of our assumption.

  15. Product specification documentation standard and Data Item Descriptions (DID). Volume of the information system life-cycle and documentation standards, volume 3

    Science.gov (United States)

    Callender, E. David; Steinbacher, Jody

    1989-01-01

    This is the third of five volumes on Information System Life-Cycle and Documentation Standards which present a well organized, easily used standard for providing technical information needed for developing information systems, components, and related processes. This volume states the Software Management and Assurance Program documentation standard for a product specification document and for data item descriptions. The framework can be applied to any NASA information system, software, hardware, operational procedures components, and related processes.

  16. Specific volume and compressibility of bilayer lipid membranes with incorporated Na,K-ATPase.

    Science.gov (United States)

    Hianik, Tibor; Rybár, Peter; Krivánek, Roland; Petríková, Mária; Roudna, Milena; Apell, Hans Jürgen

    2011-06-01

    Ultrasound velocimetry and densitometry methods were used to study the interactions of the Na,K-ATPase with the lipid bilayer in large unilamellar liposomes composed of dioleoyl phosphatidylcholine (DOPC). The ultrasound velocity increased and the specific volume of the phospholipids decreased with increasing concentrations of protein. These experiments allowed us to determine the reduced specific apparent compressibility of the lipid bilayer, which decreased by approx. 11% with increasing concentrations of the Na,K-ATPase up to an ATPase/DOPC molar ratio = 2 × 10⁻⁴. Assuming that ATPase induces rigidization of the surrounding lipid molecules one can obtain from the compressibility data that 3.7 to 100 times more lipid molecules are affected by the protein in comparison with annular lipids. However, this is in contradiction with the current theories of the phase transitions in lipid bilayers. It is suggested that another physical mechanisms should be involved for explanation of observed effect.

  17. Technical specifications manual for the MARK-1 pulsed ionizing radiation detection system. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, R.S.; Harker, Y.D.; Jones, J.L.; Hoggan, J.M.

    1993-03-01

    The MARK-1 detection system was developed by the Idaho National Engineering Laboratory for the US Department of Energy Office of Arms Control and Nonproliferation. The completely portable system was designed for the detection and analysis of intense photon emissions from pulsed ionizing radiation sources. This manual presents the technical design specifications for the MARK-1 detection system and was written primarily to assist the support or service technician in the service, calibration, and repair of the system. The manual presents the general detection system theory, the MARK-1 component design specifications, the acquisition and control software, the data processing sequence, and the system calibration procedure. A second manual entitled: Volume 2: Operations Manual for the MARK-1 Pulsed Ionizing Radiation Detection System (USDOE Report WINCO-1108, September 1992) provides a general operational description of the MARK-1 detection system. The Operations Manual was written primarily to assist the field operator in system operations and analysis of the data.

  18. CT-measured regional specific volume change reflects regional ventilation in supine sheep.

    Science.gov (United States)

    Fuld, Matthew K; Easley, R Blaine; Saba, Osama I; Chon, Deokiee; Reinhardt, Joseph M; Hoffman, Eric A; Simon, Brett A

    2008-04-01

    Computer tomography (CT) imaging techniques permit the noninvasive measurement of regional lung function. Regional specific volume change (sVol), determined from the change in lung density over a tidal breath, should correlate with regional ventilation and regional lung expansion measured with other techniques. sVol was validated against xenon (Xe)-CT-specific ventilation (sV) in four anesthetized, intubated, mechanically ventilated sheep. Xe-CT used expiratory gated axial scanning during the washin and washout of 55% Xe. sVol was measured from the tidal changes in tissue density (H, houndsfield units) of lung regions using the relationship sVol = [1,000(Hi - He)]/[He(1,000 + Hi)], where He and Hi are expiratory and inspiratory regional density. Distinct anatomical markings were used to define corresponding lung regions of interest between inspiratory, expiratory, and Xe-CT images, with an average region of interest size of 1.6 +/- 0.7 ml. In addition, sVol was compared with regional volume changes measured directly from the positions of implanted metal markers in an additional animal. A linear relationship between sVol and sV was demonstrated over a wide range of regional sV found in the normal supine lung, with an overall correlation coefficient (R(2)) of 0.66. There was a tight correlation (R(2) = 0.97) between marker-measured volume changes and sVol. Regional sVol, which involves significantly reduced exposure to radiation and Xe gas compared with the Xe-CT method, represents a safe and efficient surrogate for measuring regional ventilation in experimental studies and patients.

  19. Patient-specific coronary artery blood flow simulation using myocardial volume partitioning

    Science.gov (United States)

    Kim, Kyung Hwan; Kang, Dongwoo; Kang, Nahyup; Kim, Ji-Yeon; Lee, Hyong-Euk; Kim, James D. K.

    2013-03-01

    Using computational simulation, we can analyze cardiovascular disease in non-invasive and quantitative manners. More specifically, computational modeling and simulation technology has enabled us to analyze functional aspect such as blood flow, as well as anatomical aspect such as stenosis, from medical images without invasive measurements. Note that the simplest ways to perform blood flow simulation is to apply patient-specific coronary anatomy with other average-valued properties; in this case, however, such conditions cannot fully reflect accurate physiological properties of patients. To resolve this limitation, we present a new patient-specific coronary blood flow simulation method by myocardial volume partitioning considering artery/myocardium structural correspondence. We focus on that blood supply is closely related to the mass of each myocardial segment corresponding to the artery. Therefore, we applied this concept for setting-up simulation conditions in the way to consider many patient-specific features as possible from medical image: First, we segmented coronary arteries and myocardium separately from cardiac CT; then the myocardium is partitioned into multiple regions based on coronary vasculature. The myocardial mass and required blood mass for each artery are estimated by converting myocardial volume fraction. Finally, the required blood mass is used as boundary conditions for each artery outlet, with given average aortic blood flow rate and pressure. To show effectiveness of the proposed method, fractional flow reserve (FFR) by simulation using CT image has been compared with invasive FFR measurement of real patient data, and as a result, 77% of accuracy has been obtained.

  20. Mean reticulocyte volume: a specific parameter to screen for hereditary spherocytosis.

    Science.gov (United States)

    Xu, Yuchan; Yang, Wang; Liao, Lin; Deng, Zengfu; Qiu, Yuling; Chen, Wenqiang; Lin, Faquan

    2016-02-01

    This study assessed the value of mean reticulocyte volume (MRV) for differential diagnosis of hereditary spherocytosis (HS) so as to develop conventional and new specific screen indexes. Subjects in this study were divided into three groups: 53 cases in HS group, 217 cases in hemolytic anemia control group (109 cases of thalassemia (THAL), 56 cases of glucose-6-phosphate dehydrogenase G6PD deficiency anemia, and 52 cases of autoimmune hemolytic anemia (AIHA)), and 100 cases in healthy control group. We analyzed erythrocyte and reticulocyte parameters including MRV, mean sphered corpuscular volume, mean corpuscular hemoglobin concentration, and immature reticulocyte fraction. Results demonstrated that MRV was significantly lower in the HS group but significantly higher in the AIHA and G6PD deficiency anemia groups than that in the healthy control group (P = 0.000). MRV was not significantly different between the AIHA and G6PD deficiency anemia groups (P = 0.977) and between the healthy control and THAL groups (P = 0.168). The area under the ROC curve of MRV for diagnosis of HS was 0.942, with a standard error of 0.019, 95% confidence interval of 0.905-0.979, and optimal critical diagnosis point of 95.77 fL. When the MRV was ≤95.77 fL, the sensitivity and specificity for diagnosis of HS were 86.80% and 91.20%, respectively. Therefore, MRV is a general and specific new index for screening HS and important for differential diagnosis of different types of hemolytic anemia.

  1. 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.

  2. Picric acid capped silver nanoparticles as a probe for colorimetric sensing of creatinine in human blood and cerebrospinal fluid samples.

    Science.gov (United States)

    Parmar, Ankita K; Valand, Nikunj N; Solanki, Kalpesh B; Menon, Shobhana K

    2016-02-21

    Creatinine is the most important parameter to be determined in the diagnosis of renal, muscular and thyroid function. The most common method for the determination of creatinine is Jaffe's reaction, a routine practice for blood and urine analysis. However, in cases of icteric and haemolyzed blood samples, interference occurs during the estimation of creatinine by other constituents present in the blood like bilirubin, creatine, and urea, which lead to wrong diagnosis. To overcome such difficulty, we have developed a silver nanoparticle (Ag NPs) based sensor for the selective determination of creatinine. In this study, a new approach has been given to the traditional Jaffe's reaction, by coating Ag NPs with picric acid (PA) to form an assembly that can selectively detect creatinine. The Ag NPs based sensor proficiently and selectively recognizes creatinine due to the ability of picric acid to bind with it and form a complex. The nanoassembly and the interactions were investigated by transmission electron microscopy (TEM), dynamic light scattering (DLS) analysis, UV-Vis spectroscopy, FT-IR spectroscopy and ESI-MS, which demonstrated the binding affinity of creatinine with PA-capped Ag NPs. A linear correlation was obtained in the range of 0.01 μM-1 μM with an R(2) value of 0.9998 and a lower detection limit of 8.4 nM. The sensor was successfully applied to different types of blood and CSF samples for the determination of creatinine, and the results were compared to that of the Jaffe's method. With the advantages of high sensitivity, selectivity and low sample volume, this method is potentially suitable for the on-site monitoring of creatinine.

  3. Volume estimation using food specific shape templates in mobile image-based dietary assessment

    Science.gov (United States)

    Chae, Junghoon; Woo, Insoo; Kim, SungYe; Maciejewski, Ross; Zhu, Fengqing; Delp, Edward J.; Boushey, Carol J.; Ebert, David S.

    2011-03-01

    As obesity concerns mount, dietary assessment methods for prevention and intervention are being developed. These methods include recording, cataloging and analyzing daily dietary records to monitor energy and nutrient intakes. Given the ubiquity of mobile devices with built-in cameras, one possible means of improving dietary assessment is through photographing foods and inputting these images into a system that can determine the nutrient content of foods in the images. One of the critical issues in such the image-based dietary assessment tool is the accurate and consistent estimation of food portion sizes. The objective of our study is to automatically estimate food volumes through the use of food specific shape templates. In our system, users capture food images using a mobile phone camera. Based on information (i.e., food name and code) determined through food segmentation and classification of the food images, our system choose a particular food template shape corresponding to each segmented food. Finally, our system reconstructs the three-dimensional properties of the food shape from a single image by extracting feature points in order to size the food shape template. By employing this template-based approach, our system automatically estimates food portion size, providing a consistent method for estimation food volume.

  4. Vivaldi: A Domain-Specific Language for Volume Processing and Visualization on Distributed Heterogeneous Systems.

    Science.gov (United States)

    Choi, Hyungsuk; Choi, Woohyuk; Quan, Tran Minh; Hildebrand, David G C; Pfister, Hanspeter; Jeong, Won-Ki

    2014-12-01

    As the size of image data from microscopes and telescopes increases, the need for high-throughput processing and visualization of large volumetric data has become more pressing. At the same time, many-core processors and GPU accelerators are commonplace, making high-performance distributed heterogeneous computing systems affordable. However, effectively utilizing GPU clusters is difficult for novice programmers, and even experienced programmers often fail to fully leverage the computing power of new parallel architectures due to their steep learning curve and programming complexity. In this paper, we propose Vivaldi, a new domain-specific language for volume processing and visualization on distributed heterogeneous computing systems. Vivaldi's Python-like grammar and parallel processing abstractions provide flexible programming tools for non-experts to easily write high-performance parallel computing code. Vivaldi provides commonly used functions and numerical operators for customized visualization and high-throughput image processing applications. We demonstrate the performance and usability of Vivaldi on several examples ranging from volume rendering to image segmentation.

  5. The elevated serum urea : creatinine ratio in canine babesiosis in South Africa is not of renal origin

    Directory of Open Access Journals (Sweden)

    M.P. De Scally

    2006-06-01

    Full Text Available Pigmented serum, usually due to free haemoglobin and/or bilirubin, is a common finding in dogs with babesiosis, resulting in interference with all biochemical tests that rely on photochemistry. This is particularly true of urea and creatinine determinations, complicating the diagnosis of acute renal failure, which is a serious complication of babesiosis. A disproportionately raised serum urea concentration of unknown origin occurs in severely anaemic canine babesiosis patients and gives rise to an increased serum urea:creatinine ratio. The assay for cystatin-C, an excellent measure of glomerular filtration rate, is unaffected by free serum haemoglobin, and due to its different intrinsic origins, is free of influence by the metabolic derangements and organ pathology, other than renal disease, encountered in canine babesiosis. Serum cystatin-C was used to compare the concentrations of serum urea and serum creatinine in dogs with the severely anaemic form of canine babesiosis as well as a canine babesiosis-free reference group. Mean serum urea and mean serum urea:creatinine ratio were significantly elevated in the babesia-infected group relative to the reference population in this study. Mean serum creatinine and mean serum cystatin-C were within the reference ranges. Therefore an elevated urea:creatinine ratio in canine babesiosis in the presence of a normal serum creatinine concentration is considered to be caused by an elevated serum urea concentration and is most likely of non-renal origin. Serum creatinine was therefore as specific a measure of renal function as serum cystatin-C in canine babesiosis in this study. The sensitivity of serum creatinine as a measure of renal function was not established by this study. Serum urea, however, proved to be of little use compared to serum cystatin-C and serum creatinine. Serum urea should therefore not be used to diagnose renal failure in canine babesiosis.

  6. Amylase: creatinine clearance ratio and urinary excretion of lysozyme in acute pancreatitis and acute duodenal perforation.

    Science.gov (United States)

    Berger, G M; Cowlin, J; Turner, T J

    1976-09-18

    The amylase:creatinine clearance ratio in patients suffering from acute pancreatitis or acute duodenal perforation was higher than normal in both groups of patients. These findings cast doubt on the value of this parameter as a specific index of acute pancreatitis. The mechanism or mechanisms underlying the increased amylase excretion have not been determined. However, the markedly elevated urinary excretion of lysozyme observed in some patients suggests, by analogy, that diminished tubular reabsorption of amylase may contribute towards the elevated amylase:creatinine ratio.

  7. Elevated creatinine after ingestion of model aviation fuel: interference with the Jaffe reaction by nitromethane.

    Science.gov (United States)

    Booth, C; Naidoo, D; Rosenberg, A; Kainer, G

    1999-10-01

    A 2 years 9 month-old-boy who ingested model aviation fuel was found to have an elevated serum creatinine concentration of 0.53 mmol/L (normal range 0.02-0.05 mmol/L) by the Jaffe (alkaline picrate) reaction. However, when the creatinine concentration was measured using a specific enzymatic assay, it was within the normal range. It was shown that nitromethane, a constituent of aviation fuel, interferes with the Jaffe reaction, leading to a falsely elevated creatinine reading. This phenomenon has been reported only once previously and, despite its potential clinical importance, nitromethane does not appear in published lists of substances that interfere with the Jaffe reaction.

  8. Kidney injury biomarkers and urinary creatinine variability in nominally healthy adults.

    Science.gov (United States)

    Stiegel, M A; Pleil, J D; Sobus, J R; Angrish, M M; Morgan, M K

    2015-01-01

    Environmental exposure diagnostics use creatinine concentrations in urine aliquots as the internal standard for dilution normalization of all other excreted metabolites when urinary excretion rate data are not available. This is a reasonable approach for healthy adults as creatinine is a human metabolite that is continually produced in skeletal muscles and presumably excreted in the urine at a stable rate. However, creatinine also serves as a biomarker for glomerular filtration rate (efficiency) of the kidneys, so undiagnosed kidney function impairment could affect this commonly applied dilution calculation. The United States Environmental Protection Agency (US EPA) has recently conducted a study that collected approximately 2600 urine samples from 50 healthy adults, aged 19-50 years old, in North Carolina in 2009-2011. Urinary ancillary data (creatinine concentration, total void volume, elapsed time between voids), and participant demographic data (race, gender, height, and body weight) were collected. A representative subset of 280 urine samples from 29 participants was assayed using a new kidney injury panel (KIP). In this article, we investigated the relationships of KIP biomarkers within and between subjects and also calculated their interactions with measured creatinine levels. The aims of this work were to document the analytical methods (procedures, sensitivity, stability, etc.), provide summary statistics for the KIP biomarkers in "healthy" adults without diagnosed disease (distribution, fold range, central tendency, variance), and to develop an understanding as to how urinary creatinine level varies with respect to the individual KIP proteins. Results show that new instrumentation and data reduction methods have sufficient sensitivity to measure KIP levels in nominally healthy urine samples, that linear regression between creatinine concentration and urinary excretion explains only about 68% of variability, that KIP markers are poorly correlated with

  9. Reliable nanomaterial classification of powders using the volume-specific surface area method

    Science.gov (United States)

    Wohlleben, Wendel; Mielke, Johannes; Bianchin, Alvise; Ghanem, Antoine; Freiberger, Harald; Rauscher, Hubert; Gemeinert, Marion; Hodoroaba, Vasile-Dan

    2017-02-01

    The volume-specific surface area (VSSA) of a particulate material is one of two apparently very different metrics recommended by the European Commission for a definition of "nanomaterial" for regulatory purposes: specifically, the VSSA metric may classify nanomaterials and non-nanomaterials differently than the median size in number metrics, depending on the chemical composition, size, polydispersity, shape, porosity, and aggregation of the particles in the powder. Here we evaluate the extent of agreement between classification by electron microscopy (EM) and classification by VSSA on a large set of diverse particulate substances that represent all the anticipated challenges except mixtures of different substances. EM and VSSA are determined in multiple labs to assess also the level of reproducibility. Based on the results obtained on highly characterized benchmark materials from the NanoDefine EU FP7 project, we derive a tiered screening strategy for the purpose of implementing the definition of nanomaterials. We finally apply the screening strategy to further industrial materials, which were classified correctly and left only borderline cases for EM. On platelet-shaped nanomaterials, VSSA is essential to prevent false-negative classification by EM. On porous materials, approaches involving extended adsorption isotherms prevent false positive classification by VSSA. We find no false negatives by VSSA, neither in Tier 1 nor in Tier 2, despite real-world industrial polydispersity and diverse composition, shape, and coatings. The VSSA screening strategy is recommended for inclusion in a technical guidance for the implementation of the definition.

  10. Increasing the sensitivity of the Jaffe reaction for creatinine

    Science.gov (United States)

    Tom, H. Y.

    1973-01-01

    Study of analytical procedure has revealed that linearity of creatinine calibration curve can be extended by using 0.03 molar picric acid solution made up in 70 percent ethanol instead of water. Three to five times more creatinine concentration can be encompassed within linear portion of calibration curve.

  11. Stability of creatinine and cystatin C in whole blood

    NARCIS (Netherlands)

    Spithoven, E. M.; Bakker, S. J. L.; Kootstra-Ros, J.E.; de Jong, P. E.; Gansevoort, R. T.

    2013-01-01

    Background: As yet little is known about the effect of delayed separation of whole blood stored at room temperature on the stability of the kidney function markers creatinine and cystatin C. Methods: We used plasma samples of 45 patients with a wide range of creatinine and cystatin C concentration.

  12. Stability of creatinine and cystatin C in whole blood

    NARCIS (Netherlands)

    Spithoven, E.M.; Bakker, S.J.; Kootstra-Ros, J.E.; Jong, P.E. de; Gansevoort, R.T.; Drenth, J.P.; Wetzels, J.F.M.

    2013-01-01

    BACKGROUND: As yet little is known about the effect of delayed separation of whole blood stored at room temperature on the stability of the kidney function markers creatinine and cystatin C. METHODS: We used plasma samples of 45 patients with a wide range of creatinine and cystatin C concentration.

  13. 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.

  14. Distribution of creatinine following intravenous and oral administration to rats.

    Science.gov (United States)

    Watanabe, J; Hirate, J; Iwamoto, K; Ozeki, S

    1981-05-01

    To evaluate the distribution of creatinine in rats, urinary, fecal and expiratory excretion, plasma levels and whole-body autoradiography following intravenous or oral administration of [carbonyl-14C]creatinine was investigated. More than 90% of the exogeneous creatinine was excreted in the urine in 24 hr following intravenous administration, and both fecal and expiratory excretion were only about 1%. In case of oral administration, however, it was found that expiratory excretion could not be neglected, ranging from about 1 to 30%. Plasma creatinine concentration-time curves following the intravenous administration (70.4 micrograms/kg or 400 mg/kg as creatinine) were analyzed according to a two-compartment open model. There were significant but very small differences in the pharmacokinetic parameters for these two doses. When these parameters were compared with those of urea, k12 and k21, which are transfer rate constants between compartment 1 and 2, for creatinine were significantly smaller than those of urea. On the other hand, k10 was larger in creatinine. Furthermore, (V'd)extrap for creatinine was about three times that of urea. Whole-body autoradiograms at 5 minutes following intravenous administration showed that exogeneous creatinine distributes with higher concentrations in liver, lung and kidney than in muscle and fat. This results was remarkably different from that of urea which distributes almost uniformly throughout the body at the same time. This difference observed in the autoradiograms would be the consequence of the fact that urea has larger k12 and k21 than creatinine.

  15. Partial specific volume and solvent interactions of amphipol A8-35.

    Science.gov (United States)

    Gohon, Yann; Pavlov, Georgy; Timmins, Peter; Tribet, Christophe; Popot, Jean-Luc; Ebel, Christine

    2004-11-15

    Amphipols are small amphiphilic polymers that can stabilize and keep soluble membrane proteins in aqueous solutions in the absence of detergent. A prerequisite to solution studies of membrane protein/amphipol complexes is the determination of the partial specific volume v2 and effective charge z of the polymer. The ratio (R) of the buoyant molar masses of particles in D2O and H2O solutions, obtained from sedimentation velocity (sH/sD method) and sedimentation equilibrium experiments, and their contrast match point (CMP), determined in small-angle neutron scattering experiments, depend on v2 and z. When z is known, v2 can be estimated from R with a good accuracy as long as v2 is close to 1. The effects of labile H/D exchange and of polyelectrolyte counter-ion dissociation in general cannot be neglected. The accuracy, advantages, and limits of the sH/sD method have been studied in details using model macromolecules (DNA, protein, and polysaccharide). The sH/sD method appears particularly advantageous for the study of heterogeneous samples. Measurements of density, sD/sH buoyant molar masses in H2O, D2O, and D2(18)O, and CMP of hydrogenated and partially deuterated A8-35, a polyacrylate-based amphipol containing 35 underivatized carboxylates per 100 monomers, led to a consistent description of its buoyancy and charge properties.

  16. 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.

  17. Sex-specific gray matter volume differences in females with developmental dyslexia.

    Science.gov (United States)

    Evans, Tanya M; Flowers, D Lynn; Napoliello, Eileen M; Eden, Guinevere F

    2014-05-01

    Developmental dyslexia, characterized by unexpected reading difficulty, is associated with anomalous brain anatomy and function. Previous structural neuroimaging studies have converged in reports of less gray matter volume (GMV) in dyslexics within left hemisphere regions known to subserve language. Due to the higher prevalence of dyslexia in males, these studies are heavily weighted towards males, raising the question whether studies of dyslexia in females only and using the same techniques, would generate the same findings. In a replication study of men, we obtained the same findings of less GMV in dyslexics in left middle/inferior temporal gyri and right postcentral/supramarginal gyri as reported in the literature. However, comparisons in women with and without dyslexia did not yield left hemisphere differences, and instead, we found less GMV in right precuneus and paracentral lobule/medial frontal gyrus. In boys, we found less GMV in left inferior parietal cortex (supramarginal/angular gyri), again consistent with previous work, while in girls differences were within right central sulcus, spanning adjacent gyri, and left primary visual cortex. Our investigation into anatomical variants in dyslexia replicates existing studies in males, but at the same time shows that dyslexia in females is not characterized by involvement of left hemisphere language regions but rather early sensory and motor cortices (i.e., motor and premotor cortex, primary visual cortex). Our findings suggest that models on the brain basis of dyslexia, primarily developed through the study of males, may not be appropriate for females and suggest a need for more sex-specific investigations into dyslexia.

  18. Sex-specific Gray Matter Volume Differences in Females with Developmental Dyslexia

    Science.gov (United States)

    Evans, Tanya M.; Flowers, D. Lynn; Napoliello, Eileen M.; Eden, Guinevere F.

    2013-01-01

    Developmental dyslexia, characterized by unexpected reading difficulty, is associated with anomalous brain anatomy and function. Previous structural neuroimaging studies have converged in reports of less gray matter volume (GMV) in dyslexics within left hemisphere regions known to subserve language. Due to the higher prevalence of dyslexia in males, these studies are heavily weighted towards males, raising the question whether studies of dyslexia in females only and using the same techniques, would generate the same findings. In a replication study of men we obtained the same findings of less GMV in dyslexics in left middle/inferior temporal gyri and right postcentral/supramarginal gyri as reported in the literature. However, comparisons in women with and without dyslexia did not yield left hemisphere differences and instead we found less GMV in right precuneus and paracentral lobule/medial frontal gyrus. In boys, we found less GMV in left inferior parietal cortex (supramarginal/angular gyri), again consistent with previous work, while in girls differences were within right central sulcus, spanning adjacent gyri, and left primary visual cortex. Our investigation into anatomical variants in dyslexia replicates existing studies in males, but at the same time shows that dyslexia in females is not characterized by involvement of left hemisphere language regions but rather early sensory and motor cortices (i.e. motor and premotor cortex, primary visual cortex). Our findings suggest that models on the brain basis of dyslexia, primarily developed through the study of males, may not be appropriate for females and suggest a need for more sex-specific investigations into dyslexia. PMID:23625146

  19. Specific and generic stem biomass and volume models of tree species in a West African tropical semi-deciduous forest

    DEFF Research Database (Denmark)

    Goussanou, Cédric A.; Guendehou, Sabin; Assogbadjo, Achille E.

    2016-01-01

    The quantification of the contribution of tropical forests to global carbon stocks and climate change mitigation requires availability of data and tools such as allometric equations. This study made available volume and biomass models for eighteen tree species in a semi-deciduous tropical forest...... in West Africa. Generic models were also developed for the forest ecosystem, and basic wood density determined for the tree species. Non-destructive sampling approach was carried out on five hundred and one sample trees to analyse stem volume and biomass. From the modelling of volume and biomass...... predictive ability for biomass. Given tree species richness of tropical forests, the study demonstrated the hypothesis that species-specific models are preferred to generic models, and concluded that further research should be oriented towards development of specific models to cover the full range...

  20. BIOSENSOR BASED ON CREATININE DEIMINASE AND рH-SENSITIVE FIELD-EFFECT TRANSISTOR FOR CREATININE ANALYSIS IN BLOOD SERUM

    Directory of Open Access Journals (Sweden)

    S. V. Marchenko

    2013-10-01

    Full Text Available Creatinine is one of the most important analytes in up-to-date clinical analysis. Detection of this metabolite in different physiological body fluids is helpful for the estimation of kidney, muscle, and thyreoid disorders. Creatinine is a marker of renal glomerular filtration and is commonly considered as a diagnostic characteristic of the kidney function, the level of which should be controlled to assess the hemodialysis procedure. The experiments were carried out by potentiometric measuring method. A biosensitive element for creatinine detection was created on the basis of highly selective enzyme creatinine deiminase. The enzyme immobilization onto the surface of pH-sensitive field-effect transistor was performed using photopolymer. The creatinine deiminase-based bioselective element was developed. The main analytical characteristics of the developed biosensor were optimized, optimal conditions for the experiments with real samples were found. It was shown that biosensor based on creatinine deiminase is stable. The responses of biosensor were reproducible and liner range was from 0 to 2 mM with detection limit 0,02 mM. Quantitative determination of creatinine concentration in blood serum was elaborated; the data of biosensor measurement were compared with those obtained by the control method, high correlation was shown R = 0,96. A biosensor based on pH-sensitive field-effect transistor and immobilized creatinine deiminase, advantageous for its high sensitivity and selectivity, might be utilized for the quantitative evaluation of creatinine concentration in blood serum of the patients with renal failure as well as for monitoring hemodialysis efficiency.

  1. CALCIUM, CREATININE AND URINARY PHOSPHATE/CREATININE RATIO CONCENTRATIONS IN NEONATES OF VARIOUS GESTATIONAL AGES

    Directory of Open Access Journals (Sweden)

    O. I. Fomina

    2014-01-01

    Full Text Available Objective: specify peculiarities of calcium and phosphates excretion in neonates of various gestational ages and types of feeding in neonatal period. Patients and methods. Calcium-creatinine (Ca/Cr and phosphate-creatinine (P/Cr ratio concentrations were determined in 96 healthy neonates of 38-40 weeks of gestational age and 146 premature infants of 28-37 weeks of gestational age of various types of feeding. Results. The Ca/Cr ratio concentration in healthy term infants in the early neonatal period amounted to 0.9-2.2 (median – 1.8, the P/Cr ratio concentration – 0.8-2.1 (median – 1.6. The Ca/Cr ratio concentration in premature infants (28-37 weeks of gestational age amounted to 0.9-2.4 (median – 1.9, which is comparable to this parameter’s value in term infants. The P/Cr ratio concentration amounted to 0.7-3.1 (median – 2.4, which exceeds this parameter’s value in term infants. The lesser the gestational age and birth weight, the higher the Ca/Cr and P/Cr ratio concentrations. The authors revealed hypercalciuria and hyperphosphaturia in premature infants with a very low body weight fed with specialized formulas. Conclusions. Use of specialized formulas in small premature infants (gestational age < 33 weeks with VLBW results in excessive calcium and phosphates excretion. It is reasonable to monitor their concentrations using a non-invasive and informative method of determining Ca/Cr and P/Cr ratios. Feeding of premature infants with BW > 1,500 g with breast milk only (in case of the mother’s adequate lactation allows avoiding hypercalciuria and hyperphosphaturia and preventing risk of a renal pathology. 

  2. Feasibility of developing a portable driver performance data acquisition system for human factors research: Design specifications. Volume 3

    Energy Technology Data Exchange (ETDEWEB)

    Carter, R.J.; Barickman, F.S.

    1998-01-01

    A two-phase, multi-year research program entitled ``development of a portable driver performance data acquisition system for human factors research was recently completed. The primary objective of the project was to develop a portable data acquisition system for crash avoidance research (DASCAR) that will allow driver performance data to be collected using a large variety of vehicle types and that would be capable of being installed on a given vehicle type within a relatively short-time frame. During Phase 1 a feasibility study for designing and fabricating DASCAR was conducted. In phase 2 of the research DASCAR was actually developed and validated. This technical memorandum documents the results from the feasibility study. It is subdivided into three volumes. Volume one addresses the last five items in the phase 1 research and the first issue in the second phase of the project. Volume 2 presents the related appendices. Volume three (this report) displays the design specifications developed for DASCAR during the ``develop design requirements and specifications for a portable driver performance data acquisition system`` task. Design specifications were assembled for each DASCAR element. The specifications were prepared in sufficient detail to allow a third party to use them to design, develop, procure, and subsequently construct the data acquisition system. This report also covers the background to the program.

  3. Prostate-specific antigen as an estimator of prostate volume in the management of patients with symptomatic benign prostatic hyperplasia

    NARCIS (Netherlands)

    Mochtar, CA; Kiemeney, LALM; van Riemsdijk, MM; Barnett, GS; Laguna, MP; Debruyne, FMJ; de la Rosette, JJMCH

    2003-01-01

    Objectives: To assess the ability of serum prostate specific antigen (PSA) to estimate prostate volume (PV) to aid in the management of patients with benign prostatic hyperplasia (BPH). Methods: From 1989 to 2002, data were collected from 2264 patients complaining of lower urinary tract symptoms (LU

  4. Transperitoneal transport of creatinine. A comparison of kinetic models

    DEFF Research Database (Denmark)

    Fugleberg, S; Graff, J; Joffe, P;

    1994-01-01

    Six kinetic models of transperitoneal creatinine transport were formulated and validated on the basis of experimental results obtained from 23 non-diabetic patients undergoing peritoneal dialysis. The models were designed to elucidate the presence or absence of diffusive, non-lymphatic convective...... including all three forms of transport is superior to other models. We conclude that the best model of transperitoneal creatinine transport includes diffusion, non-lymphatic convective transport and lymphatic convective transport....

  5. Gray-white matter and cerebrospinal fluid volume differences in children with Specific Language Impairment and/or Reading Disability.

    Science.gov (United States)

    Girbau-Massana, Dolors; Garcia-Marti, Gracian; Marti-Bonmati, Luis; Schwartz, Richard G

    2014-04-01

    We studied gray-white matter and cerebrospinal fluid (CSF) alterations that may be critical for language, through an optimized voxel-based morphometry evaluation in children with Specific Language Impairment (SLI), compared to Typical Language Development (TLD). Ten children with SLI (8;5-10;9) and 14 children with TLD (8;2-11;8) participated. They received a comprehensive language and reading test battery. We also analyzed a subgroup of six children with SLI+RD (Reading Disability). Brain images from 3-Tesla MRIs were analyzed with intelligence, age, gender, and total intracranial volume as covariates. Children with SLI or SLI+RD exhibited a significant lower overall gray matter volume than children with TLD. Particularly, children with SLI showed a significantly lower volume of gray matter compared to children with TLD in the right postcentral parietal gyrus (BA4), and left and right medial occipital gyri (BA19). The group with SLI also exhibited a significantly greater volume of gray matter in the right superior occipital gyrus (BA19), which may reflect a brain reorganization to compensate for their lower volumes at medial occipital gyri. Children with SLI+RD, compared to children with TLD, showed a significantly lower volume of: (a) gray matter in the right postcentral parietal gyrus; and (b) white matter in the right inferior longitudinal fasciculus (RILF), which interconnects the temporal and occipital lobes. Children with TLD exhibited a significantly lower CSF volume than children with SLI and children with SLI+RD respectively, who had somewhat smaller volumes of gray matter allowing for more CSF volume. The significant lower gray matter volume at the right postcentral parietal gyrus and greater cerebrospinal fluid volume may prove to be unique markers for SLI. We discuss the association of poor knowledge/visual representations and language input to brain development. Our comorbid study showed that a significant lower volume of white matter in the right

  6. Automated measurement of urinary creatinine by multichannel kinetic spectrophotometry.

    Science.gov (United States)

    Ohira, Shin-Ichi; Kirk, Andrea B; Dasgupta, Purnendu K

    2009-01-15

    Urinary creatinine analysis is required for clinical diagnosis, especially for evaluation of renal function. Creatinine adjustment is also widely used to estimate 24-h excretion from spot samples. Few convenient validated approaches are available for in-house creatinine measurement for small- to medium-scale studies. Here we apply the Jáffe reaction to creatinine determination with zone fluidic multichannel kinetic spectrophotometry. Diluted urine sample and reagent, alkaline picric acid, were mixed by a computer-programmed dispenser and rapidly delivered to a four-channel detection cell. The absorbance change was monitored by a flow-through light-emitting diode-photodiode-based detector. Validation results against high-performance liquid chromatography-ultraviolet (HPLC-UV)/mass spectrometry (MS) are presented. Responses for 10-fold diluted samples were linear within clinically relevant ranges (0-250 mg/L after dilution). The system can analyze 70 samples per hour with a limit of detection of 0.76 mg/L. The relative standard deviation was 1.29% at 100 mg/L creatinine (n=225). Correlation with the HPLC (UV quantitation/MS confirmation) system was excellent (linear, r2=0.9906). The developed system allows rapid, simple, cost-effective, and robust creatinine analysis and is suitable for the analysis of large numbers of urine samples.

  7. A simple and rapid creatinine sensing via DLS selectivity, using calix[4]arene thiol functionalized gold nanoparticles.

    Science.gov (United States)

    Sutariya, Pinkesh G; Pandya, Alok; Lodha, Anand; Menon, Shobhana K

    2016-01-15

    A new, simple, ultra-sensitive and selective approach has been reported for the "on spot" colorimetric detection of creatinine based on calix[4]arene functionalized gold nanoparticles (AuNPs) with excellent discrimination in the presence of other biomolecules. The lower detection limit of the method is 2.16nM. The gold nanoparticles and p-tert-butylcalix[4]arene were synthesized by microwave assisted method. Specifically, in our study, we used dynamic light scattering (DLS) which is a powerful method for the determination of small changes in particle size, improved selectivity and sensitivity of the creatinine detection system over colorimetric method. The nanoassembly is characterized by Transmission electron microscopy (TEM), DLS, UV-vis and ESI-MS spectroscopy, which demonstrates the binding affinity due its ability of hydrogen bonding and electrostatic interaction between -NH group of creatinine and pSDSC4. It exhibits fast response time (creatinine and has long shelf-life (>5 weeks). The developed pSDSC4-AuNPs based creatinine biosensor will be established as simple, reliable and accurate tool for the determination of creatinine in human urine samples.

  8. 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.

  9. Fast vaporization solid phase microextraction and ion mobility spectrometry: A new approach for determination of creatinine in biological fluids.

    Science.gov (United States)

    Jafari, Mostafa; Ebrahimzadeh, Homeira; Banitaba, Mohamma Hossein

    2015-11-01

    In this work a rapid and simple method for creatinine determination in urine and plasma samples based on aqueous derivatization of creatinine and complete vaporization of sample (as low as 10 µL), followed by ion mobility spectrometry analysis has been proposed. The effect of four important parameters (extraction temperature, total volume of solution, desorption temperature and extraction time) on ion mobility signal has been studied. Under the optimized conditions, the quantitative response of ion mobility spectrometry for creatinine was linear in the range of 0-500 mg L(-1) with a detection limit of 0.6 mg L(-1) in urine and 0-250 mg L(-1) with a detection limit of 2.6 mg L(-1) in plasma sample. The limit of quantitation of creatinine was 2.1 mg L(-1) and 8.7 mg L(-1) in urine and plasma samples, respectively. The relative standard deviation of the method was found to be 13%. The method was successfully applied to the analysis of creatinine in biological samples, showing recoveries from 92% to 104% in urine and 101-110% in plasma samples.

  10. Sex Differences in Brain Volume Are Related to Specific Skills, Not to General Intelligence

    Science.gov (United States)

    Burgaleta, Miguel; Head, Kevin; Alvarez-Linera, Juan; Martinez, Kenia; Escorial, Sergio; Haier, Richard; Colom, Roberto

    2012-01-01

    It has been proposed that males would show higher mean scores than females in general intelligence ("g") because (1) men have, on average, larger brains than women, and (2) brain volume correlates with "g." Here we report a failure to support the conclusion derived from these premises. High resolution MRIs were acquired in a sample of one hundred…

  11. STUDY OF URINARY CALCIUM AND URINARY CREATININE LEVELS AND URINARY CALCIUM/CREATININE RATIO IN GESTATIONAL HYPERTENSIVE PATIENTS

    Directory of Open Access Journals (Sweden)

    Swapna

    2015-06-01

    Full Text Available BACKGROUND: Gestational hypertension (BP>140/90mmHg or pregnancy induced hypertension usually precedes pre - eclampsia (BP>140/90mmHg associated with proteniuria. Many tests to predict pre - eclampsia are coming up on the horizon. Hypocalciuria is one such test to predict pre - eclampsia which may be present before other clinical signs and symptoms. AIM: To determine urinary calcium, urinary creatinine and urinary calcium/creatinine ratio in pregnancy induced hypertension and in normal pregnant women. MATERIAL AND METHODS: The study included 100 subjects with gestational age between 24 - 38 weeks and divided into two groups’ viz. control group and study group . The control group included 50 subjects who were normal pregnant women and study group included 50 subjects who were gestational hypertensive patients. Urinary calcium was estimated by Ortho - Cresolphthalein Complexone (CPC method, urinary creatinine was estimated by Jaffe’s method in all the subjects. RESULTS: The estimated mean levels (Mean±SD of urinary calcium, creatinine in control group were 263.0±80.3, 0.95±0.16 respectively and in patients with gestational hypertension they were 86.2±19.5, 1.21±0. 37 respectively. The statistical analysis by unpaired t - test shows that the levels of urinary calcium were significantly decreased (p<0.001 and the urinary creatinine were significantly increased (p <0.001 in gestational hypertensive patients when compar ed to healthy controls. The mean urinary calcium/creatinine ratio in control group were 0.28±0.08 and in gestational hypertensive patients were 0.07±0.03.The statistical analysis by unpaired t - test shows that the levels of urinary calcium/creatinine ratio were significantly decreased (p<0.001 in gestational hypertensive patients when compared to healthy controls. CONCLUSION: This study suggests that a regular evaluation of urinary calcium/creatinine ratio after 20wks of gestation may be an effective screen ing method for

  12. Standard technical specifications combustion engineering plants: Bases (Sections 2.0--3.3). Volume 2, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    This report documents the results of the combined effort of the NRC and the industry to produce improved Standard Technical Specifications (STS), Revision 1 for General Electric BWR/6 Plants. The changes reflected in Revision 1 resulted from the experience gained from license amendment applications to convert to these improved STS or to adopt partial improvements to existing technical specifications. This NUREG is the result of extensive public technical meetings and discussions between the Nuclear Regulatory Commission (NRC) staff and various nuclear power plant licensees, Nuclear Steam Supply System (NSSS) Owners Groups, NSSS vendors, and the Nuclear Energy Institute (NEI). The improved STS were developed based on the criteria in the Final Commission Policy Statement on Technical Specifications Improvements for Nuclear Power Reactors, dated July 22, 1993. The improved STS will be used as the basis for individual nuclear power plant licensees to develop improved plant-specific technical specifications. This report contains three volumes.

  13. Glass Transition Temperature- and Specific Volume- Composition Models for Tellurite Glasses

    Energy Technology Data Exchange (ETDEWEB)

    Riley, Brian J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Vienna, John D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2017-09-01

    This report provides models for predicting composition-properties for tellurite glasses, namely specific gravity and glass transition temperature. Included are the partial specific coefficients for each model, the component validity ranges, and model fit parameters.

  14. Prediction of differential creatinine clearance in chronically obstructed kidneys by non-contrast helical computerized tomography

    Directory of Open Access Journals (Sweden)

    Ng C.F.

    2004-01-01

    Full Text Available PURPOSE: We investigate the use of non-contrast helical computerized tomography (NCHCT in the measurement of differential renal parenchymal volume as a surrogate for differential creatinine clearance (CrCl for unilateral chronically obstructed kidney. MATERIALS AND METHODS: Patients with unilateral chronically obstructed kidneys with normal contralateral kidneys were enrolled. Ultrasonography (USG of the kidneys was first done with the cortical thickness of the site with the most renal substance in the upper pole, mid-kidney, and lower pole of both kidneys were measured, and the mean cortical thickness of each kidney was calculated. NCHCT was subsequently performed for each patient. The CT images were individually reviewed with the area of renal parenchyma measured for each kidney. Then the volume of the slices was summated to give the renal parenchymal volume of both the obstructed and normal kidneys. Finally, a percutaneous nephrostomy (PCN was inserted to the obstructed kidney, and CrCl of both the obstructed kidney (PCN urine and the normal side (voided urine were measured two 2 after the relief of obstruction. RESULTS: From March 1999 to February 2001, thirty patients were enrolled into the study. Ninety percent of them had ureteral calculi. The differential CrCl of the obstructed kidney (%CrCl was defined as the percentage of CrCl of the obstructed kidney as of the total CrCl, measured 2 weeks after relief of obstruction. The differential renal parenchymal volume of the obstructed kidney (%CTvol was the percentage of renal parenchymal volume as of the total parenchymal volume. The differential USG cortical thickness of the obstructed kidney (%USGcort was the percentage of mean cortical thickness as of the total mean cortical thickness. The Pearson's correlation coefficient (r between %CTvol and %CrCl and that between %USGcort and %CrCl were 0.756 and 0.543 respectively. The regression line was %CrCl = (1.00 x %CTvol - 14.27. The %CTvol

  15. Chemiluminescence of creatinine/H2O2/Co(2+) and its application for selective creatinine detection.

    Science.gov (United States)

    Hanif, Saima; John, Peter; Gao, Wenyue; Saqib, Muhammad; Qi, Liming; Xu, Guobao

    2016-01-15

    Creatinine is an important biomarker in clinical diagnosis and biomonitoring programs as well as urinary metabolomic/metabonomics research. Current methods are either nonselective, time consuming or require heavy and expensive instruments. In this study, chemiluminescence of creatinine with hydrogen peroxide has been reported for the first time, and its chemiluminescence is remarkably enhanced in the presence of cobalt ions. By utilizing these phenomena, we have developed a sensitive and selective chemiluminescence method for creatinine determination by coupling with flow injection analysis. The calibration curve is linear in the range of 1×10(-7)-3×10(-5)mol/L with a limit of detection (S/N=3) of 7.2×10(-8)mol/L, which is adequate for detecting creatinine in the clinically accepted range. The relative standard deviation for seven measurements of 3×10(-5)mol/L creatinine is 1.2%. The chemiluminescence method was then utilized to detect creatinine in human urine samples after simple dilution with water. It takes less than 1min each measurement and the recoveries for spiked urine samples were 100-103%. The interference study demonstrates that some common species in urine, such as amino acids, ascorbic acid and creatine, have negligible effects on creatinine detection. The present method does not use expensive instruments, enzymes and separation technique. This method has the advantages of sensitivity, selectivity, simplicity, rapidity, and low cost. It holds great promise for basic or comprehensive metabolic panel, drug screening, anti-dopping, and urinary metabolomic/metabonomics research.

  16. Sex-specific Gray Matter Volume Differences in Females with Developmental Dyslexia

    OpenAIRE

    Evans, Tanya M.; Flowers, D. Lynn; Napoliello, Eileen M.; Eden, Guinevere F.

    2013-01-01

    Developmental dyslexia, characterized by unexpected reading difficulty, is associated with anomalous brain anatomy and function. Previous structural neuroimaging studies have converged in reports of less gray matter volume (GMV) in dyslexics within left hemisphere regions known to subserve language. Due to the higher prevalence of dyslexia in males, these studies are heavily weighted towards males, raising the question whether studies of dyslexia in females only and using the same techniques,...

  17. Detecting microalbuminuria by urinary albumin/creatinine concentration ratio

    DEFF Research Database (Denmark)

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

    1997-01-01

    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......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...

  18. Thermophysical Properties of Matter - the TPRC Data Series. Volume 5. Specific Heat - Nonmetallic Solids

    Science.gov (United States)

    1970-01-01

    of the volume consists of the ate level may also use it as a teaching tool to point presentation of numerical data compiled over the out to his...46, Chemistry, Chap. X, Interscience, New York, 1959. 1966. 61. Skinner, H. A. (Editor), Experinental Thermochemistry , 47. Wallace, W. E., Craig, R. S...tMuel!er, E. F. and Rossini, F. D., "The Calory and the Joule in Thermodynamics and Thermochemistry ," Am. J. etc. Phys. 12(1), 1-7, 19,14. e. Number

  19. NASIS data base management system: IBM 360 TSS implementation. Volume 3: Data set specifications

    Science.gov (United States)

    1973-01-01

    The data set specifications for the NASA Aerospace Safety Information System (NASIS) are presented. The data set specifications describe the content, format, and medium of communication of every data set required by the system. All relevant information pertinent to a particular data set is prepared in a standard form and centralized in a single document. The format for the data set is provided.

  20. Regional Specificity of Sex Effects on Subcortical Volumes Across the Lifespan in Healthy Aging

    NARCIS (Netherlands)

    Li, Wenjing; van Tol, Marie-Jose; Li, Meng; Miao, Wen; Jiao, Yonghong; Heinze, Hans-Jochen; Bogerts, Bernhard; He, Huiguang; Walter, Martin

    2014-01-01

    When conceptualizing age-specific onsets and sex-specific characteristics of neuropsychiatric diseases in a neurobiological context, it may be crucially important to consider differential trajectories of aging. Here, we investigated effects of age, sex, and their interactions on absolute and relativ

  1. Proximal tubular secretion of creatinine by organic cation transporter OCT2 in cancer patients

    NARCIS (Netherlands)

    G. Ciarimboli (Giuliano); C.S. Lancaster (Cynthia); E. Schlatter (Eberhard); R.M. Franke (Ryan); J.A. Sprowl (Jason); H. Pavenstädt (Hermann); V. Massmann (Vivian); D. Guckel (Denise); A.H.J. Mathijssen (Ron); W. Yang (Wenjian); C.H. Pui (Ching-Hon); M.V. Relling (Mary); E. Herrmann (Eva); A. Sparreboom (Alex)

    2012-01-01

    textabstractPurpose: Knowledge of transporters responsible for the renal secretion of creatinine is key to a proper interpretation of serum creatinine and/or creatinine clearance as markers of renal function in cancer patients receiving chemotherapeutic agents. Experimental Design: Creatinine transp

  2. Standard technical specifications, Westinghouse Plants: Bases (Sections 2.0--3.3). Volume 2, Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-04-01

    This NUREG contains the improved Standard Technical Specifications (STS) for Westinghouse plants. Revision 1 incorporates the cumulative changes to Revision 0, which was published in September 1992. The changes reflected in Revision 1 resulted from the experience gained from license amendment applications to convert to these improved STS or to adopt partial improvements to existing technical specifications. This NUREG is the result of extensive public technical meetings and discussions between the Nuclear Regulatory Commission (NRC) staff and various nuclear power plant licensees, Nuclear Steam Supply System (NSSS) Owners Groups, specifically the Westinghouse Owners Group (WOG), NSSS vendors, and the Nuclear Energy Institute (NEI). The improved STS were developed based on the criteria in the Final Commission Policy Statement on Technical Specifications Improvements for Nuclear Power Reactors, dated July 22, 1993 (58 FR 39132). Licensees are encouraged to upgrade their technical specifications consistent with those criteria and conforming, to the extent practical and consistent with the licensing basis for the facility, to Revision 1 to the improved STS. The Commission continues to place the highest priority on requests for complete conversions to the improved STS. Licensees adopting portions of the improved STS to existing technical specifications should adopt all related requirements, as applicable, to achieve a high degree of standardization and consistency.

  3. 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.

  4. Evaluating an alternative method for rapid urinary creatinine determination

    Science.gov (United States)

    Creatinine (CR) is an endogenously-produced chemical routinely assayed in urine specimens to assess kidney function, sample dilution. The industry-standard method for CR determination, known as the kinetic Jaffe (KJ) method, relies on an exponential rate of a colorimetric change,...

  5. 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 §...

  6. A volume law for specification of linear channel storage for estimation of large floods

    Science.gov (United States)

    Zhang, Shangyou; Cordery, Ian; Sharma, Ashish

    2000-02-01

    A method of estimating large floods using a linear storage-routing approach is presented. The differences between the proposed approach and those traditionally used are (1) that the flood producing properties of basins are represented by a linear system, (2) the storage parameters of the distributed model are determined using a volume law which, unlike other storage-routing models, accounts for the distribution of storage in natural basins, and (3) the basin outflow hydrograph is determined analytically and expressed in a succinct mathematical form. The single model parameter is estimated from observed data without direct fitting, unlike most traditionally used methods. The model was tested by showing it could reproduce observed large floods on a number of basins. This paper compares the proposed approach with a traditionally used storage routing approach using observed flood data from the Hacking River basin in New South Wales, Australia. Results confirm the usefulness of the proposed approach for estimation of large floods.

  7. QUANTIFICATION OF PROTEINURIA IN PRE ECLAMPSIA USING PROTEIN AND CREATININE RATIO IN RANDOM URINE SPECIMEN

    Directory of Open Access Journals (Sweden)

    Padmaja

    2015-05-01

    Full Text Available Hypertensive disorders complicating pregnancy are common and form one of the d eadly triad along with haemorrhage and infection that results in much of the maternal morbidity and mortality related to pregnancy. Proteinuria is essential for the diagnosis of preeclampsia. As the Proteinuria increases, the likelihood of complications al so increases and hence a rapid and accurate detection and quantization of Proteinuria is essential for the management of hypertensive pregnant women. The protein creatinine ratio in a single urine specimen has been used for the rapid and accurate detection of proteinuria in hypertensive pregnant women as it avoids collection errors and gives physiologically more relevant information. OBJECTIVES OF THE STUDY : To study the clinical profile of preeclampsia patients. To assess the degree of Proteinuria by 24 ho ur urine protein and spot urine protein Creatinine ratio in the study population To study if the spot urine protein and creatinine ratio will provide accurate quantification of proteinuria in hypertensive pregnant women. MATERIALS AND METHODS: This was obs ervational study it was conducted in King George Hospital for a period of one year & 60 patients were included for the study. RESULTS: In the present study: spot urine p/c ratio sensitivity 100%, specificity 66.67%, and positive predictive value of 98.27% added. CONCLUSION: quantization of proteinuria, when properly interpreted, can provide valuable information

  8. Cumulative Intracranial Tumor Volume (CITV) Enhances the Prognostic Value of the Lung-Specific Graded Prognostic Assessment (GPA) Model.

    Science.gov (United States)

    Marcus, Logan P; Marshall, Deborah; Hirshman, Brian R; McCutcheon, Brandon A; Gonda, David D; Koiso, Takao; Hattangadi-Gluth, Jona A; Carter, Bob S; Yamamoto, Masaaki; Chen, Clark C

    2016-08-01

    Management of patients afflicted with brain metastasis requires tailoring of therapeutic strategies based on survival expectations. Therefore, the development of prognostic indices is of critical importance in this patient population. To determine whether the cumulative intracranial tumor volume (CITV) of brain metastasis augments the prognostic value of the lung-specific Graded Prognostic Assessment (GPA) index. Patient data were derived from 365 lung cancer patients with brain metastasis who were consecutively treated with stereotactic radiosurgery at the University of California, San Diego/San Diego Gamma Knife Center. CITV was analyzed to determine the volume cutoff that maximized sensitivity and specificity for 1-year survival. Multivariate Cox proportional hazard modeling was performed, and overall survival was estimated by the Kaplan-Meier method risk stratifying with or without this optimal CITV. The prognostic value of these models (lung-specific GPA ± CITV) was quantitatively compared with the use of net reclassification improvement (>0) and integrated discrimination improvement. For the University of California, San Diego/San Diego Gamma Knife Center cohort, the CITV cutoff that had the greatest survival discrimination at 1 year was 4 cm. The addition of CITV to the lung-specific GPA indexes significantly improved the prognostic value of lung-specific GPA, with net reclassification improvement >0 of 0.430 (95% confidence interval, 0.228-0.629) and integrated discrimination improvement of 0.029 (95% confidence interval, 0.004-0.073). These findings were validated in an independent cohort of 1638 lung cancer patients with brain metastasis who were treated with stereotactic radiosurgery at the Katsuta Hospital Mito Gamma House in Japan. In independent cohorts, the addition of CITV to the lung-specific GPA index significantly improved the prognostic value of this index. AUC, area under the receiver-operating characteristic curveBM, brain metastasis

  9. Site-specific analysis of hybrid geothermal/fossil power plants. Volume One. Roosevelt Hot Springs KGRA

    Energy Technology Data Exchange (ETDEWEB)

    1977-06-01

    The economics of a particular hybrid plant must be evaluated with respect to a specific site. This volume focuses on the Roosevelt Hot Springs KGRA. The temperature, pressure, and flow rate data given suggests the site deserves serious consideration for a hybrid plant. Key siting considerations which must be addressed before an economic judgment can be attempted are presented as follows: the availability, quality, and cost of coal; the availability of water; and the availability of transmission. Seismological and climate factors are presented. (MHR)

  10. 火药比容标准物质的研制%Development of Reference Material of Propellant Specific Volume

    Institute of Scientific and Technical Information of China (English)

    赵宏立; 刘来东; 靳建伟; 赵宝明; 宋长文

    2013-01-01

    A reference material, mainly composed of nitrocellulose (NC),nitroglycerine (NG), centralite and vaseline ,was developed for verifying instruments specific volume of propellant. The homogeneity of characteristic value of the reference material was tested by means of the variance analysis method, and its stability had been examined for more than one year. The reference material of propellant specific volume was determined by multi-department based on same principles, and the certified result was 627.2L/kg. The combined standard uncertainty and expanded uncertainty of standard value of reference material were also evaluated, and the expanded uncertainty was determined 9.0L/kg(k=2). The result showed that the reference material had good homogeneity and stability, its characteristic value was accurate and reliable. The reference material could meet the requirement of transferring the certified value of specific volume, calibrate and verify the instruments specific volume of propellant.%研制了以硝化棉、硝化甘油、中定剂和凡士林为主要成分的火药比容标准物质,采用方差分析方法检验了标准物质的均匀性,并进行了1a以上的稳定性考核;通过多家单位采用同一原理方法进行标准物质定值,分析评估了标准物质标准值的合成标准不确定度和扩展不确定度,得到标准比容值为627.2L/kg,扩展不确定度为9.0L/kg(k=2)。结果表明,该标准物质特性量值准确、可靠,均匀性和稳定性好,能够满足火药比容量值传递的要求,达到校准和检定火药比容测量仪的目的。

  11. Thermophysical Properties of Matter - The TPRC Data Series. Volume 4. Specific Heat - Metallic Elements and Alloys

    Science.gov (United States)

    1971-01-01

    use it as a teaching tool to point out to his students the topography of the state of knowledge on the specific heat of metals. We believe there is...Experimental Thermochemistry , Vol. I, Interscience, New York, 1956. 60. Weissberger, A. (Editor), "Calorimetry" in Technique of Organic Chemistry Vol. I...Physical Methods of Organic Chemistry, Chap. X, Interscience, New York, 1959. 61. Skinner, H. A. (Editor), Experimental Thermochemistry , Vol. II

  12. Determination of the volume-specific surface area by using transmission electron tomography for characterization and definition of nanomaterials

    Directory of Open Access Journals (Sweden)

    Francisco Michel

    2011-05-01

    Full Text Available Abstract Background Transmission electron microscopy (TEM remains an important technique to investigate the size, shape and surface characteristics of particles at the nanometer scale. Resulting micrographs are two dimensional projections of objects and their interpretation can be difficult. Recently, electron tomography (ET is increasingly used to reveal the morphology of nanomaterials (NM in 3D. In this study, we examined the feasibility to visualize and measure silica and gold NM in suspension using conventional bright field electron tomography. Results The general morphology of gold and silica NM was visualized in 3D by conventional TEM in bright field mode. In orthoslices of the examined NM the surface features of a NM could be seen and measured without interference of higher or lower lying structures inherent to conventional TEM. Segmentation by isosurface rendering allowed visualizing the 3D information of an electron tomographic reconstruction in greater detail than digital slicing. From the 3D reconstructions, the surface area and the volume of the examined NM could be estimated directly and the volume-specific surface area (VSSA was calculated. The mean VSSA of all examined NM was significantly larger than the threshold of 60 m2/cm3. The high correlation between the measured values of area and volume gold nanoparticles with a known spherical morphology and the areas and volumes calculated from the equivalent circle diameter (ECD of projected nanoparticles (NP indicates that the values measured from electron tomographic reconstructions are valid for these gold particles. Conclusion The characterization and definition of the examined gold and silica NM can benefit from application of conventional bright field electron tomography: the NM can be visualized in 3D, while surface features and the VSSA can be measured.

  13. Enhancement of the amylase-creatinine clearance ratio in pregnancy.

    Science.gov (United States)

    Naeije, R; Neuray, F; Van Melsen, A; Delcourt, A

    1979-01-01

    The renal clearance of amylase, expressed as a proportion of simultaneous creatinine clearance (Cam/-Ccr), was determined in 131 women in various stages of pregnancy. No abnormal serum levels of amylase were found. A moderate but significant increase in Cam/Ccr occurred during the last 15 weeks of pregnancy. Possible causes for this change were investigated in smaller groups of subjects. No increase in rapidly cleared isoamylase could be detected. No modification in renal tubular handling of protein could be evidenced, as assessed by measurements of the renal clearance of beta 2 microglobulin, expressed as a proportion of simultaneous creatinine clearance. An incrased glomerular permeability to amylase probably accounts for elevated Cam/Ccr in pregnancy.

  14. [Amylase-creatinine clearance ratios in burned patients (author's transl)].

    Science.gov (United States)

    Minaire, Y; Marichy, J; Forichon, J; Motin, J

    1978-09-01

    The amylase/creatinine clearance ratio (ACCR) has been examined every 3 days, in 34 burned patients during the 20 days following the accident. This ratio was often abnormal since it was found increased at least on one occasion, in 75% of these patients, to be compared with 23 and 13% for amylase in serum and urine respectively. In another group of 9 burned patients, the ACCR was monitored for time-period between 10 to 52 days. It was observed that a high frequency in increased ACCR was associated with a fatal outcome. Finally simultaneous measurements of ACCR and of the beta2 microglobulin/creatinine clearance ratio (MCCR) showed that increased ACCR were statistically associated with increased MCCR suggesting a decreased renal tubular reabsorption of low molecular weight proteins in these burned patients.

  15. Disposition and transportation of surplus radioactive low specific activity nitric acid. Volume 1, Environmental Assessment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    DOE is deactivating the PUREX plant at Hanford; this will involve the disposition of about 692,000 liters (183,000 gallons) of surplus nitric acid contaminated with low levels of U and other radionuclides. The nitric acid, designated as low specific activity, is stored in 4 storage tanks at PUREX. Five principal alternatives were evaluated: transfer for reuse (sale to BNF plc), no action, continued storage in Hanford upgraded or new facility, consolidation of DOE surplus acid, and processing the LSA nitric acid as waste. The transfer to BNF plc is the preferred alternative. From the analysis, it is concluded that the proposed disposition and transportation of the acid does not constitute a major federal action significantly affecting the quality of the human environment within the meaning of NEPA; therefore an environmental impact statement is not required.

  16. The GLAS Standard Data Products Specification-Data Dictionary, Version 1.0. Volume 15

    Science.gov (United States)

    Lee, Jeffrey E.

    2013-01-01

    The Geoscience Laser Altimeter System (GLAS) is the primary instrument for the ICESat (Ice, Cloud and Land Elevation Satellite) laser altimetry mission. ICESat was the benchmark Earth Observing System (EOS) mission for measuring ice sheet mass balance, cloud and aerosol heights, as well as land topography and vegetation characteristics. From 2003 to 2009, the ICESat mission provided multi-year elevation data needed to determine ice sheet mass balance as well as cloud property information, especially for stratospheric clouds common over polar areas. It also provided topography and vegetation data around the globe, in addition to the polar-specific coverage over the Greenland and Antarctic ice sheets.This document contains the data dictionary for the GLAS standard data products. It details the parameters present on GLAS standard data products. Each parameter is defined with a short name, a long name, units on product, type of variable, a long description and products that contain it. The term standard data products refers to those EOS instrument data that are routinely generated for public distribution. These products are distributed by the National Snow and Ice Data Center (NSDIC).

  17. [Ratio of amylase clearance and creatinine clearance in the diagnosis of acute pancreatitis].

    Science.gov (United States)

    Haffter, D; Reichlin, B; Gyr, K

    1981-05-30

    In 21 healthy volunteers the ratio of amylase clearance and creatinine clearance (Cam/Ccr) was determined in urine collected at admission, after a 1-hour collection period and after a 2-hour collection period. The normal values were 1.8 +/- 1.6%, 1.9 +/- 2% and 2.0 +/- 1.7% respectively. They were comparable with those published by others. The reproducibility of the method was acceptable (r = 0.62). When compared with serum amylase determinations, Cam/Ccr showed neither better sensitivity in 19 patients suffering an acute episode of proven pancreatitis, nor better specificity in 19 patients with acute abdomen but no evidence of pancreatitis.

  18. Vancomycin pharmacokinetics in infants: relationship to postconceptional age and serum creatinine.

    Science.gov (United States)

    Kildoo, C W; Lin, L M; Gabriel, M H; Folli, H L; Modanlou, H D

    1989-01-01

    Multidose pharmacokinetics of vancomycin were studied in 15 infants with gestational age less than 36 weeks and suspected or confirmed Staphylococcus epidermidis infections. Postconceptional age (PCA) at the time of the study ranged from 26 to 44 weeks. Vancomycin individual doses ranged from 6.7 to 10.6 mg/kg and were infused over 60 min. Five postinfusion samples were obtained in 13 infants, while 4 samples were obtained in 2 patients. Vancomycin pharmacokinetic parameters were determined by fitting the data to a two-compartment model using a weighted least-squares nonlinear regression method. Mean vancomycin body clearance (CL), volume of distribution (Vdss) and terminal elimination half-life were 1.37 ml/min, 0.58 liters and 5.6 h, respectively. When standardized for patient weight, the CL and Vdss values were 1.07 ml/min/kg and 0.48 liters/kg, respectively. The CL (ml/min/kg) was strongly inversely correlated with the serum creatinine (r = -0.82), while a weaker but significant association was noted with PCA (r = 0.41). These data suggest that in sick infants, in addition to the PCA, serum creatinine should be considered when determining the initial vancomycin dosing regimen.

  19. Prostate-specific Antigen Mass Density--A Measure Predicting Prostate Cancer Volume and Accounting for Overweight and Obesity-related Prostate-specific Antigen Hemodilution.

    Science.gov (United States)

    Kryvenko, Oleksandr N; Diaz, Mireya; Matoso, Andres; Kates, Max; Cohen, Jason; Swanson, Gregory P; Epstein, Jonathan I

    2016-04-01

    To test prostate-specific antigen mass density (PSAMD) as a predictor of total tumor volume (TTV) at radical prostatectomy (RP). We conducted a detailed pathologic analysis of 469 RP from men with NCCN low-risk prostate cancer who had Gleason score of 3 + 3 = 6 (grade group 1) at RP. We then compared the ability of PSA, PSA density (PSAD), PSA mass (PSAM-absolute amount of PSA in patient's circulation), and PSAM density (PSAM divided by prostate weight without seminal vesicles) to predict TTV at RP. PSAM was calculated by multiplying plasma volume (estimated body surface [weight, kg(0.425) × height, m(0.72) × 0.007184] × 1.67) by PSA. Performance of the above measures in different BMI categories was assessed. Kruskal-Wallis test was used to compare the means and Spearman's rank correlation coefficient to assess the correlations. The 469 men were normal weight (n = 129), overweight (n = 253), and obese (n = 87). Mean age of the patients' was 57.4 years and PSA of 4.53 ng/ml. Increase of prostate weight with body mass index (BMI) was reflected in PSAM (both P Prostate weight had stronger (negative) association with PSAMD (r = -0.394; <.001) than TTV. PSAMD is the biochemical measure with the best correlation with TTV at RP. Unlike other measures, it is not affected by BMI-related hemodilution. Thresholds should be established to use this more objective measure clinically in surveillance algorithms and in planning radical prostatectomy. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Glacier length, area and volume changes in the Himalaya: an overview and specific examples

    Science.gov (United States)

    Bolch, T.; Bhambri, R.; Kamp, U.; Pieczonka, T.

    2011-12-01

    advancing glaciers. This is consistent with existing studies of the Karakoram glaciers. However, area and length changes show indirect signals only while the mass balance is most directly linked to climate. Debris cover on glaciers which is common throughout the Himalaya further influences glacier melt. Existing studies show that area and length changes are reduced in comparison to debris-free glaciers. Currently no long-term in-situ glacier mass balance measurements exist. Remote sensed derived geodetic mass balance estimations are a suitable tool to improve the knowledge on the reaction of glaciers to climate change. Detailed investigations on the debris-covered glaciers in Khumbu Himalaya based on stereo Corona, ASTER and Cartosat-1 data revealed a specific mass balance of -0.32 ± 0.08 m w.e. a-1 between 1972 and 2007 which is within the global mean. The surface lowering is significant for all glaciers despite thick debris-cover. Consistently, preliminary results of the large debris-covered Zemu Glacier in Sikkim/Eastern Indian Himalaya indicate significant mass loss but only a slight reduction in length. Further analyses are under way and also climatic considerations will be addressed.

  1. Streptomycin interference in Jaffe reaction - Possible false positive creatinine estimation in excessive dose exposure

    DEFF Research Database (Denmark)

    Syal, Kirtimaan; Srinivasan, Anand; Banerjee, Dibyajyoti

    2013-01-01

    Objectives: To study the potential of commonly used aminoglycoside antibiotics to form non-creatinine chromogen with alkaline picrate reagent. Design and methods: We studied the non-creatinine chromogen formation of various concentrations of streptomycin, amikacin, kanamycin, netilmicin, gentamicin...

  2. Direct determination of creatinine based on poly(ethyleneimine)/phosphotungstic acid multilayer modified electrode.

    Science.gov (United States)

    Han, Ping; Xu, Shimei; Feng, Shun; Hao, Yanjun; Wang, Jide

    2016-05-01

    In this work, the direct determination of creatinine was achieved using a poly(ethyleneimine)/phosphotungstic acid multilayer modified electrode with the assistance of Copper(II) ions by cyclic voltammetry. The quantity of creatinine were determined by measuring the redox peak current of Cu(II)-creatinine complex/Cu(I)-creatinine complex. Factors affecting the response current of creatinine at the modified electrode were optimized. A linear relationship between the response current and the concentration of creatinine ranging from 0.125 to 62.5μM was obtained with a detection limit of 0.06μM. The proposed method was applied to determine creatinine in human urine, and satisfied results were gotten which was validated in accordance with high performance liquid chromatography. The proposed electrode provided a promising alternative in routine sensing for creatinine without enzymatic assistance.

  3. Creatinine related reference ranges for urinary homovanillic acid and vanillylmandelic acid at 6 months of age.

    OpenAIRE

    M Cole; Parker, L.; Craft, A W; Bell, S.; G. Dale; McGill, A C; Seviour, J. A.; Smith, J

    1993-01-01

    The relationship between homovanillic acid (HVA), vanillylmandelic acid (VMA), and creatinine in the urine of 6 month old babies has been studied and reference ranges in the form of centiles constructed for HVA and VMA against creatinine. Over 10,000 urine samples were collected from babies in four health districts in the north of England. HVA and VMA concentration, either independently or when divided by creatinine concentration, were dependent upon the absolute concentration of creatinine i...

  4. Age and gender specific normal values of left ventricular mass, volume and function for gradient echo magnetic resonance imaging: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Allansdotter-Johnsson Ase

    2009-01-01

    Full Text Available Abstract Background Knowledge about age-specific normal values for left ventricular mass (LVM, end-diastolic volume (EDV, end-systolic volume (ESV, stroke volume (SV and ejection fraction (EF by cardiac magnetic resonance imaging (CMR is of importance to differentiate between health and disease and to assess the severity of disease. The aims of the study were to determine age and gender specific normal reference values and to explore the normal physiological variation of these parameters from adolescence to late adulthood, in a cross sectional study. Methods Gradient echo CMR was performed at 1.5 T in 96 healthy volunteers (11–81 years, 50 male. Gender-specific analysis of parameters was undertaken in both absolute values and adjusted for body surface area (BSA. Results Age and gender specific normal ranges for LV volumes, mass and function are presented from the second through the eighth decade of life. LVM, ESV and EDV rose during adolescence and declined in adulthood. SV and EF decreased with age. Compared to adult females, adult males had higher BSA-adjusted values of EDV (p = 0.006 and ESV (p Conclusion LV volumes, mass and function vary over a broad age range in healthy individuals. LV volumes and mass both rise in adolescence and decline with age. EF showed a rapid decline in adolescence compared to changes throughout adulthood. These findings demonstrate the need for age and gender specific normal ranges for clinical use.

  5. Dried blood spot analysis of creatinine with LC-MS/MS in addition to immunosuppressants analysis

    NARCIS (Netherlands)

    Koster, Remco A.; Greijdanus, Ben; Alffenaar, Jan-Willem C.; Touw, Daan J.

    2015-01-01

    In order to monitor creatinine levels or to adjust the dosage of renally excreted or nephrotoxic drugs, the analysis of creatinine in dried blood spots (DBS) could be a useful addition to DBS analysis. We developed a LC-MS/MS method for the analysis of creatinine in the same DBS extract that was use

  6. 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.

  7. 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 su

  8. PHYSICAL ACTIVITY ALTERS URINARY ALBUMIN/ CREATININE RATIO IN TYPE 1 DIABETIC PATIENT

    Directory of Open Access Journals (Sweden)

    Sazi Imamoglu

    2004-03-01

    Full Text Available While the best way to identify microalbuminuria is to determine albumin excretion rate (AER in a 24 h urine sample. Published data have shown that calculation of an albumin/creatinine ratio (ACR in a spot urine sample has reasonable rate of sensitivity and specificity. We aimed to evaluate the effect of daily exercise on ACR and estimate the best time for the examination of the ACR in a spot urine sample. Sixteen eligible patients with Type 1 diabetes mellitus were asked to perform varying degree of exercise periods. Urinary albumin and creatinine excretion rates during each period were determined. ACR and AER of timed urinary samples were compared with the 24 hour urinary AER. We found significant correlations between timed and 24 hour urinary AER. According to diagnostic performance tests, ACR and AER of timed urine samples were both found to be significantly more sensitive during resting period when compared with mild or moderate active periods. It is concluded that ACR and AER of a timed urine sample are sensitive and specific methods for determining microalbuminuria, while overnight resting samples give the impression of being more diagnostic.

  9. Time-specific measurements of energy deposition from radiation fields in simulated sub-micron tissue volumes

    Energy Technology Data Exchange (ETDEWEB)

    Famiano, M.A.

    1997-07-07

    A tissue-equivalent spherical proportional counter is used with a modified amplifier system to measure specific energy deposited from a uniform radiation field for short periods of time ({approximately}1 {micro}s to seconds) in order to extrapolate to dose in sub-micron tissue volumes. The energy deposited during these time intervals is compared to biological repair processes occurring within the same intervals after the initial energy deposition. The signal is integrated over a variable collection time which is adjusted with a square-wave pulse. Charge from particle passages is collected on the anode during the period in which the integrator is triggered, and the signal decays quickly to zero after the integrator feedback switch resets; the process repeats for every triggering pulse. Measurements of energy deposited from x rays, {sup 137}Cs gamma rays, and electrons from a {sup 90}Sr/{sup 90}Y source for various time intervals are taken. Spectral characteristics as a function of charge collection time are observed and frequency plots of specific energy and collection time-interval are presented. In addition, a threshold energy flux is selected for each radiation type at which the formation of radicals (based on current measurements) in mammalian cells equals the rate at which radicals are repaired.

  10. Prostate specific antigen in a community-based sample of men without prostate cancer: Correlations with prostate volume, age, body mass index, and symptoms of prostatism

    NARCIS (Netherlands)

    J.L.H.R. Bosch (Ruud); W.C.J. Hop (Wim); C.H. Bangma (Chris); W.J. Kirkels (Wim); F.H. Schröder (Fritz)

    1995-01-01

    textabstractThe correlation between both prostate specific antigen levels (PSA) and prostate specific antigen density (PSAD) and age, prostate volume parameters, body mass index, and the International Prostate Symptom Score (IPSS) were studied in a community‐based population. A sample of 502 men age

  11. The amylase creatinine clearance ratio in acute pancreatitis.

    Science.gov (United States)

    Murray, W R; Mackay, C

    1977-03-01

    One hundred and twenty-two patients have been studied in order to evaluate the usefulness of the amylase creatinine clearance ratio (ACCR) as a simple diagnostic test for acute pancreatitis. Sixteen out of 17 patients with acute pancreatitis had significant elevations in ACCR; in only 10 of these 17 cases was the serum amylase greater than 1200iu/l. The mean ACCR was within the normal range in control patients, in patients with chronic gastro-intestinal disease and in patients with acute abdominal conditions excluding pancreatitis; however, the mean serum amylase was significantly greater in patients with acute abdominal conditions than in the control group (P less than 0-05). The ACCR remained significantly elevated in patients with acute pancreatitis for longer than either serum or urine amylase values. The findings of the study suggest that the amylase creatinine clearance ratio is a simple yet reliable diagnostic test which could be used when screening patients suspected of having acute pancreatitis.

  12. Detection of urinary creatinine using gold nanoparticles after solid phase extraction.

    Science.gov (United States)

    Sittiwong, Jarinya; Unob, Fuangfa

    2015-03-05

    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 15-40mgL(-1) with a detection limit of 13.7mgL(-1) and it was successfully used in the detection of creatinine in human urine samples.

  13. Urinary creatinine adjusted reference ranges for homovanillic and vanillylmandelic acid in children and adults.

    Science.gov (United States)

    Cole, M; Craft, A W; Parker, L; Bell, S; Seviour, J A; McGill, A C; Dale, G

    1995-04-30

    The relationship between urinary homovanillic acid (HVA), vanillylmandelic acid (VMA) and creatinine is investigated and reference ranges are constructed for HVA and VMA. A total of 769 urine samples were obtained from children and adults. The ratios HVA/creatinine and VMA/creatinine were highly correlated with creatinine concentration; hence, reference to creatinine was found to be an inappropriate adjustment for urinary dilution. An alternative method based upon linear regression is proposed. After allowing for differing levels of creatinine, HVA and VMA were found to be significantly correlated with age, height and weight for individuals aged less than 20 years. In those aged over 20 years, HVA was significantly correlated with weight and VMA with age. Differences between sexes were found in the levels of HVA and VMA, the exception being VMA in the over 20 age group. Reference ranges were constructed for HVA and VMA which are variously dependent upon creatinine, age, sex and weight.

  14. Multitier specification for NSEP (National Security/Emergency Preparedness) enhancement of fiber-optic long-distance telecommunication networks. Volume 2. Multitier specification background and technical support information. Technical information bulletin

    Energy Technology Data Exchange (ETDEWEB)

    Peach, D.F.

    1987-12-01

    This report provides an overview of the enhancements to a fiber-optic communication system/installation that will increase durability. These enhancements are grouped, based on their value in protecting the system, such that a Multitier Specification is created that presents multiple levels of hardness. Mitigation of effects due to electromagnetic pulse (EMP) and gamma radiation, and protection from vandalism and weather events are discussed. The study concludes that the probability of survival can be significantly increased with expeditious use of design and installation enhancements. The report is presented in two volumes. Volume I presents the Multitier Specification in a format that is usable for management review. The attributes of specified physical parameters, and the levels of protection stated in Volume I, are discussed in more detail in Volume II.

  15. Amylase/creatinine clearance ratio in diabetic ketoacidosis: a case report.

    Science.gov (United States)

    Boybeyi, Ozlem; Ergür, Ayça Törel; Dursun, Zarife Esra; Gülerman, Fulya

    2014-11-01

    Diabetic ketoacidosis (DKA) accompanies any other intra-abdominal pathology. Serum amylase/lipase levels are commonly used in order to rule out acute pancreatitis in patients having abdominal pain in DKA. A more specific and noninvasive diagnostic tool - amylase/creatinine clearance ratio (ACCR) - can be used to rule out pancreatitis in patients with DKA. A 14-year-old girl was admitted with abdominal pain and nausea. She had been followed up for type 1 diabetes mellitus for the last 5 years. The serum amylase levels were increased up to 687 U/L (normal: 28-120 U/L) on the third day of hospitalization. Simultaneous serum and urinary amylase concentrations were measured, and ACCR was calculated (1.2%). The diagnosis of pancreatitis was ruled out. The serum amylase levels decreased in the following days, and she was discharged. ACCR determination is a simple and specific test to diagnose pancreatitis, especially in patients with DKA.

  16. Massive fluid requirements and an unusual BUN/creatinine ratio for pre-renal failure in patients with cholera.

    Directory of Open Access Journals (Sweden)

    Muhammad Tariq

    Full Text Available BACKGROUND: Cholera is an important infectious cause of secretory diarrhea. The primary symptom of infection is the sudden onset of watery diarrhea with subsequent volume depletion causing renal insufficiency. The objective of this research is to study the level of dehydration at presentation and subsequent fluid management in patients with cholera. METHODS: This study was conducted on 191 patients of Cholera admitted at a tertiary care hospital in Karachi, Pakistan during the period of 5 years. Medical charts were evaluated retrospectively for initial hydration status, baseline lab investigations on admission and discharge and fluid therapy given to all the patients while their stay in the hospital and the data was analyzed on SPSS 15.0. RESULTS: Out of the 191 patients, 83(43% were males and 108 (57% were females with mean age of 42.3 years (SD+/-18.34. The average duration of symptoms was 3.75 days (SD+/-2.04. Of 191 patients, 175 (92.1% presented with dehydration, 80 (42.3% were given Ringer's Lactate (R/L + Normal Saline (N/S, 45 (24% patients were given R/L + N/S + Oral Rehydration Therapy (ORS, 27 (14.3% of the patients were kept on R/L only and remaining were given various combinations of R/L, N/S, ORS and Dextrose Saline (D/S. On admission mean Blood Urea Nitrogen (BUN was 24.54 (SD+/-16.6, mean creatinine was 2.47 (SD+/-2.35 and mean BUN/Creatinine ratio was 11.63 (SD+/-5.7. CONCLUSION: Aggressive fluid rehydration remains the cornerstone of management of cholera. Instead of presenting with a classical BUN/Creatinine ratio of >20:1, patients with pre-renal failure in cholera may present with a BUN/Creatinine ratio of <15:1.

  17. Cognitive function at 2443 μmol/l creatinine.

    Science.gov (United States)

    Schneider, Sabrina; Malecki, Anne-Kathrin; Boenisch, Olaf; Schönfeld, Robby; Kielstein, Jan T

    2012-08-15

    One hallmark of uremia is the impairment of neuro-cognitive function. Anecdotal clinical description from the early days of chronic dialysis therapy impressively illustrates the improvement of those functions by chronic hemodialysis treatment. Fortunately, today, uremia is only rarely observed in industrialized countries as many patients seek medical/nephrological attention prior to the occurrence of deadly complications of uremia. We report a rare case of severe uremia and describe the day to day improvement in neuro-cognitive function by dialysis using state of the arte test battery--starting at a serum creatinine of 2443 μmol/l. Especially executive functions, which are assumed to be localized in the frontal cerebral regions, are impaired in severe uremia and improve remarkably with the correction of severe uremia, i.e., initiation of dialysis.

  18. Fibre-specific responses to endurance and low volume high intensity interval training: striking similarities in acute and chronic adaptation.

    Directory of Open Access Journals (Sweden)

    Trisha D Scribbans

    Full Text Available The current study involved the completion of two distinct experiments. Experiment 1 compared fibre specific and whole muscle responses to acute bouts of either low-volume high-intensity interval training (LV-HIT or moderate-intensity continuous endurance exercise (END in a randomized crossover design. Experiment 2 examined the impact of a six-week training intervention (END or LV-HIT; 4 days/week, on whole body and skeletal muscle fibre specific markers of aerobic and anaerobic capacity. Six recreationally active men (Age: 20.7 ± 3.8 yrs; VO2peak: 51.9 ± 5.1 mL/kg/min reported to the lab on two separate occasions for experiment 1. Following a muscle biopsy taken in a fasted state, participants completed an acute bout of each exercise protocol (LV-HIT: 8, 20-second intervals at ∼ 170% of VO2peak separated by 10 seconds of rest; END: 30 minutes at ∼ 65% of VO2peak, immediately followed by a muscle biopsy. Glycogen content of type I and IIA fibres was significantly (p<0.05 reduced, while p-ACC was significantly increased (p<0.05 following both protocols. Nineteen recreationally active males (n = 16 and females (n = 3 were VO2peak-matched and assigned to either the LV-HIT (n = 10; 21 ± 2 yrs or END (n = 9; 20.7 ± 3.8 yrs group for experiment 2. After 6 weeks, both training protocols induced comparable increases in aerobic capacity (END: Pre: 48.3 ± 6.0, Mid: 51.8 ± 6.0, Post: 55.0 ± 6.3 mL/kg/min LV-HIT: Pre: 47.9 ± 8.1, Mid: 50.4 ± 7.4, Post: 54.7 ± 7.6 mL/kg/min, fibre-type specific oxidative and glycolytic capacity, glycogen and IMTG stores, and whole-muscle capillary density. Interestingly, only LV-HIT induced greater improvements in anaerobic performance and estimated whole-muscle glycolytic capacity. These results suggest that 30 minutes of END exercise at ∼ 65% VO2peak or 4 minutes of LV-HIT at ∼ 170% VO2peak induce comparable changes in the intra-myocellular environment (glycogen content and signaling activation

  19. Urinary creatinine concentrations in the U.S. population: implications for urinary biologic monitoring measurements.

    Science.gov (United States)

    Barr, Dana B; Wilder, Lynn C; Caudill, Samuel P; Gonzalez, Amanda J; Needham, Lance L; Pirkle, James L

    2005-02-01

    Biologic monitoring (i.e., biomonitoring) is used to assess human exposures to environmental and workplace chemicals. Urinary biomonitoring data typically are adjusted to a constant creatinine concentration to correct for variable dilutions among spot samples. Traditionally, this approach has been used in population groups without much diversity. The inclusion of multiple demographic groups in studies using biomonitoring for exposure assessment has increased the variability in the urinary creatinine levels in these study populations. Our objectives were to document the normal range of urinary creatinine concentrations among various demographic groups, evaluate the impact that variations in creatinine concentrations can have on classifying exposure status of individuals in epidemiologic studies, and recommend an approach using multiple regression to adjust for variations in creatinine in multivariate analyses. We performed a weighted multivariate analysis of urinary creatinine concentrations in 22,245 participants of the Third National Health and Nutrition Examination Survey (1988-1994) and established reference ranges (10th-90th percentiles) for each demographic and age category. Significant predictors of urinary creatinine concentration included age group, sex, race/ethnicity, body mass index, and fat-free mass. Time of day that urine samples were collected made a small but statistically significant difference in creatinine concentrations. For an individual, the creatinine-adjusted concentration of an analyte should be compared with a "reference" range derived from persons in a similar demographic group (e.g., children with children, adults with adults). For multiple regression analysis of population groups, we recommend that the analyte concentration (unadjusted for creatinine) should be included in the analysis with urinary creatinine added as a separate independent variable. This approach allows the urinary analyte concentration to be appropriately adjusted for

  20. 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.

  1. Serum creatinine and albumin decline predict the contraction of nosocomial aspiration pneumonia in patients undergoing hemodialysis.

    Science.gov (United States)

    Minakuchi, Hitoshi; Wakino, Shu; Hayashi, Koichi; Inamoto, Hajime; Itoh, Hiroshi

    2014-08-01

    Aspiration pneumonia (AP) is prevalent in older adults and the hemodialysis (HD) population has been getting older. Therefore, it is speculated that increasing number of HD patients would suffer from AP. However, the clinical aspects of AP in HD patients have not been elucidated. Consecutive HD patients with nosocomial AP hospitalized in our university hospital from April 2007 to December 2008 were recruited. Their clinical characteristics, risk factors for contraction, and the fatality of AP and treatment options were described. Nineteen out of 356 hospitalized HD patients had AP and 8 out of 19 AP patients died, indicating the incidence rate and fatality rate were 5.34% and 42.1%, respectively. Multiple regression analysis revealed that the risk factors for contracting AP included age, body mass index, serum creatinine levels (Cre) and the monthly decline rate of Cre. It also revealed that serum albumin (Alb) and basal total cholesterol levels, the decline rate of Alb and Cre levels, and the duration of AP were independent risk factors for fatality. Survivors were most often treated with tube feeding. Both contraction rate and fatality of nosocomial AP were high among HD patients. Both the malnutrition as well as the decline rate for nutrition and muscle volume indicated by falls in Alb and Cre, respectively, had clinical relevance in AP. Maintaining nutritional state by tube feeding and muscle volume seems to be the mainstay for the prevention and the treatment of AP in HD patients.

  2. 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

  3. High creatinine clearance in critically ill patients with community-acquired acute infectious meningitis

    Directory of Open Access Journals (Sweden)

    Lautrette Alexandre

    2012-09-01

    Full Text Available Abstract Background A high dose of anti-infective agents is recommended when treating infectious meningitis. High creatinine clearance (CrCl may affect the pharmacokinetic / pharmacodynamic relationships of anti-infective drugs eliminated by the kidneys. We recorded the incidence of high CrCl in intensive care unit (ICU patients admitted with meningitis and assessed the diagnostic accuracy of two common methods used to identify high CrCl. Methods Observational study performed in consecutive patients admitted with community-acquired acute infectious meningitis (defined by >7 white blood cells/mm3 in cerebral spinal fluid between January 2006 and December 2009 to one medical ICU. During the first 7 days following ICU admission, CrCl was measured from 24-hr urine samples (24-hr-UV/P creatinine and estimated according to Cockcroft-Gault formula and the simplified Modification of Diet in Renal Disease (MDRD equation. High CrCl was defined as CrCl >140 ml/min/1.73 m2 by 24-hr-UV/P creatinine. Diagnostic accuracy was performed with ROC curves analysis. Results Thirty two patients were included. High CrCl was present in 8 patients (25% on ICU admission and in 15 patients (47% during the first 7 ICU days for a median duration of 3 (1-4 days. For the Cockcroft-Gault formula, the best threshold to predict high CrCl was 101 ml/min/1.73 m2 (sensitivity: 0.96, specificity: 0.75, AUC = 0.90 ± 0.03 with a negative likelihood ratio of 0.06. For the simplified MDRD equation, the best threshold to predict high CrCl was 108 ml/min/1.73 m2 (sensitivity: 0.91, specificity: 0.80, AUC = 0.88 ± 0.03 with a negative likelihood ratio of 0.11. There was no difference between the estimated methods in the diagnostic accuracy of identifying high CrCl (p = 0.30. Conclusions High CrCl is frequently observed in ICU patients admitted with community-acquired acute infectious meningitis. The estimated methods of CrCl could be used as a screening tool to

  4. The impact of elevated serum creatinine on the prognosis of acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    李帮清

    2006-01-01

    Objective To evaluate the clinical features and outcomes in patients suffering from acute myocardial infarction combined with elevated serum creatinine. Methods We enrolled 340 consecutive patients suffering from acute myocardial infarction admitted into our hospital from 2003.2.1 -2004.8.31. The patients were divided into the following 2 groups, 269 patients in a group with normal serum creatinine and 71 patients in a group with elevated serum creatinine, according to the normal limit of

  5. Cystatin C, creatinine, estimated glomerular filtration, and long-term mortality in stroke patients.

    Science.gov (United States)

    Hojs Fabjan, Tanja; Penko, Meta; Hojs, Radovan

    2014-02-01

    Renal dysfunction is associated with mortality in patients after ischemic stroke. Cystatin C is a potentially superior marker of renal function compared to creatinine and estimated glomerular filtration rate (GFR). In our observational cohort study, 390 Caucasian patients suffered from acute ischemic stroke (mean age 70.9 years; 183 women and 207 men) were included and prospectively followed up to maximal 56 months. Serum creatinine and cystatin C were measured at admission to the hospital; GFR was estimated according to CKD-EPI creatinine and CKD-EPI creatinine/cystatin equations. According to values of serum creatinine, estimated GFR and serum cystatin C patients were divided into quintiles. In the follow-up period, 191 (49%) patients died. For serum cystatin C and estimated GFR based on creatinine and cystatin C, the mortality and the hazard ratios for long-term mortality increased from the first to the fifth quintile nearly linearly. The associations of serum creatinine and estimated GFR categories based on creatinine with long-term mortality were J-shaped. As compared with lowest quintile of serum cystatin C, the fifth quintile was associated with long-term mortality significantly also after multivariate adjustment (age, gender, initial stroke severity, known risk factors for stroke mortality). In contrast, in adjusted analysis serum creatinine and estimated GFR (CKD-EPI creatinine and CKD-EPI creatinine/cystatin) were not associated with long-term mortality. In summary, serum cystatin C was independently and better associated with the risk of long-term mortality in patients suffering from ischemic stroke than were creatinine and estimated GFR using both CKD-EPI equations.

  6. The assessment of 24 24-h urine volume by measurement of urine specific gravity with dipstick in adults with nephrolithiasis

    Directory of Open Access Journals (Sweden)

    Mohamad Hatef Khorami

    2012-01-01

    Conclusion: The use of behavioral modification with dipstick is an effective method for control and maintenance of optimal urine volume, and it has resulted in more patient compliance for drinking water and is more effective for prevention of renal stone.

  7. 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 (Pcreatinine increase of at least 0.5 mg/dL (Pcreatinine 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.

  8. Application of machine learning methods to describe the effects of conjugated equine estrogens therapy on region-specific brain volumes.

    Science.gov (United States)

    Casanova, Ramon; Espeland, Mark A; Goveas, Joseph S; Davatzikos, Christos; Gaussoin, Sarah A; Maldjian, Joseph A; Brunner, Robert L; Kuller, Lewis H; Johnson, Karen C; Mysiw, W Jerry; Wagner, Benjamin; Resnick, Susan M

    2011-05-01

    Use of conjugated equine estrogens (CEE) has been linked to smaller regional brain volumes in women aged ≥65 years; however, it is unknown whether this results in a broad-based characteristic pattern of effects. Structural magnetic resonance imaging was used to assess regional volumes of normal tissue and ischemic lesions among 513 women who had been enrolled in a randomized clinical trial of CEE therapy for an average of 6.6 years, beginning at ages 65-80 years. A multivariate pattern analysis, based on a machine learning technique that combined Random Forest and logistic regression with L(1) penalty, was applied to identify patterns among regional volumes associated with therapy and whether patterns discriminate between treatment groups. The multivariate pattern analysis detected smaller regional volumes of normal tissue within the limbic and temporal lobes among women that had been assigned to CEE therapy. Mean decrements ranged as high as 7% in the left entorhinal cortex and 5% in the left perirhinal cortex, which exceeded the effect sizes reported previously in frontal lobe and hippocampus. Overall accuracy of classification based on these patterns, however, was projected to be only 54.5%. Prescription of CEE therapy for an average of 6.6 years is associated with lower regional brain volumes, but it does not induce a characteristic spatial pattern of changes in brain volumes of sufficient magnitude to discriminate users and nonusers. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. Cell type-specific adaptation of cellular and nuclear volume in micro-engineered 3D environments.

    Science.gov (United States)

    Greiner, Alexandra M; Klein, Franziska; Gudzenko, Tetyana; Richter, Benjamin; Striebel, Thomas; Wundari, Bayu G; Autenrieth, Tatjana J; Wegener, Martin; Franz, Clemens M; Bastmeyer, Martin

    2015-11-01

    Bio-functionalized three-dimensional (3D) structures fabricated by direct laser writing (DLW) are structurally and mechanically well-defined and ideal for systematically investigating the influence of three-dimensionality and substrate stiffness on cell behavior. Here, we show that different fibroblast-like and epithelial cell lines maintain normal proliferation rates and form functional cell-matrix contacts in DLW-fabricated 3D scaffolds of different mechanics and geometry. Furthermore, the molecular composition of cell-matrix contacts forming in these 3D micro-environments and under conventional 2D culture conditions is identical, based on the analysis of several marker proteins (paxillin, phospho-paxillin, phospho-focal adhesion kinase, vinculin, β1-integrin). However, fibroblast-like and epithelial cells differ markedly in the way they adapt their total cell and nuclear volumes in 3D environments. While fibroblast-like cell lines display significantly increased cell and nuclear volumes in 3D substrates compared to 2D substrates, epithelial cells retain similar cell and nuclear volumes in 2D and 3D environments. Despite differential cell volume regulation between fibroblasts and epithelial cells in 3D environments, the nucleus-to-cell (N/C) volume ratios remain constant for all cell types and culture conditions. Thus, changes in cell and nuclear volume during the transition from 2D to 3D environments are strongly cell type-dependent, but independent of scaffold stiffness, while cells maintain the N/C ratio regardless of culture conditions.

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

    Directory of Open Access Journals (Sweden)

    Ye XS

    2014-09-01

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

  11. 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 (ONO2(-)) 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 (UNOxR) 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(-), ONO2(-), O(15)NO2(-), creatinine (do-Crea) and [methylo-(2)H3]creatinine (d3-Crea) in acetonic dilutions of native human urine and plasma samples (4:1, v/v) and their simultaneous quantification by GC-MS as PFBNO2, PFB(15)NO2, PFBONO2, PFBO(15)NO2, do-Crea-PFB and d3-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 (ONO2(-)), m/z 63 (O(15)NO2(-)), m/z 112 (do-Crea), and m/z 115 (d3-Crea). Retention times were 2.97min for PFB-ONO2/PFB-O(15)NO2, 3.1min for PFB-NO2/PFB-(15)NO2, and 6.7min for do-Crea-PFB/d3-Crea-PFB. We used this method to investigate the effects of long-term oral NaNO3 or NaCl (serving as placebo) supplementation (each 0.1mmol/kg body weight per day for 3 weeks) on creatinine excretion and UNOxR in 17 healthy young men

  12. 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.

  13. The amylase-creatinine clearance ratio following cardiopulmonary bypass.

    Science.gov (United States)

    Murray, W R; Mittra, S; Mittra, D; Roberts, L B; Taylor, K M

    1981-08-01

    The incidence of unexplained pancreatitis in patients dying after cardiac operations has been recorded as 16%, with evidence to implicate ischemia in the pathogenesis of the pancreatitis. Increased amylase--to--creatinine clearance ratios (ACCR), suggesting pancreatic dysfunction, have been reported in patients following nonpulsatile cardiopulmonary bypass (CPB). Pulsatile CPB is increasingly recognized to be a more physiological form of perfusion, particularly with respect to capillary blood flow. In this study the ACCR has been determined before, during, and after cardiac operations performed with both nonpulsatile and pulsatile CPB. Twenty patients undergoing elective cardiac operations were studied. Ten patients had nonpulsatile CPB (nonpulsatile group) and 10 had pulsatile CPB (pulsatile group). The two groups were comparable as regards perioperative variables and perfusion parameters. In both groups the ACCR was estimated preoperatively, on three occasions during the operation, and daily on the first 5 postoperative days. A significant elevation in ACCR was observed in nine of 10 patients in the nonpulsatile group but in only one of 10 patients in the pulsatile group (p less than 0.001). The significant improvement of ACCR stability following pulsatile CPB may indicate that this form of perfusion will reduce the risk of pancreatitis following cardiac operations performed with CPB.

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

    Directory of Open Access Journals (Sweden)

    Mohammad Reza Khatami

    2016-01-01

    Full Text Available 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 (P <0.012 and 3.8% based on a serum creatinine increase of at least 0.5 mg/dL (P <0.0001. The serum 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.

  15. Dosing related effects of zoledronic acid on bone markers and creatinine clearance in patients with multiple myeloma and metastatic breast cancer

    DEFF Research Database (Denmark)

    Søe, Kent; Delaissé, Jean-Marie; Jakobsen, Erik H;

    2014-01-01

    phase II clinical trial we investigated the effect of Zol treatment on the serum levels of the bone markers collagen type 1 cross-linked C-telopeptide (CTX) and bone specific alkaline phosphatase (bALP) as well as on creatinine clearance (kidney function) in response to dosing and duration of treatment...

  16. Development and validation of an ultra-high performance liquid chromatography-tandem mass spectrometry method to measure creatinine in human urine.

    Science.gov (United States)

    Fraselle, S; De Cremer, K; Coucke, W; Glorieux, G; Vanmassenhove, J; Schepers, E; Neirynck, N; Van Overmeire, I; Van Loco, J; Van Biesen, W; Vanholder, R

    2015-04-15

    Despite decades of creatinine measurement in biological fluids using a large variety of analytical methods, an accurate determination of this compound remains challenging. Especially with the novel trend to assess biomarkers on large sample sets preserved in biobanks, a simple and fast method that could cope with both a high sample throughput and a low volume of sample is still of interest. In answer to these challenges, a fast and accurate ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method was developed to measure creatinine in small volumes of human urine. In this method, urine samples are simply diluted with a basic mobile phase and injected directly under positive electrospray ionization (ESI) conditions, without further purification steps. The combination of an important diluting factor (10(4) times) due to the use of a very sensitive triple quadrupole mass spectrometer (XEVO TQ) and the addition of creatinine-d3 as internal standard completely eliminates matrix effects coming from the urine. The method was validated in-house in 2012 according to the EMA guideline on bioanalytical method validation using Certified Reference samples from the German External Quality Assessment Scheme (G-Equas) proficiency test. All obtained results for accuracy and recovery are within the authorized tolerance ranges defined by G-Equas. The method is linear between 0 and 5 g/L, with LOD and LOQ of 5 × 10(-3) g/L and 10(-2) g/L, respectively. The repeatability (CV(r) = 1.03-2.07%) and intra-laboratory reproducibility (CV(RW) = 1.97-2.40%) satisfy the EMA 2012 guideline. The validated method was firstly applied to perform the German G-Equas proficiency test rounds 51 and 53, in 2013 and 2014, respectively. The obtained results were again all within the accepted tolerance ranges and very close to the reference values defined by the organizers of the proficiency test scheme, demonstrating an excellent accuracy of the developed method. The

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Automated urinalysis technique determines concentration of creatine and creatinine by colorimetry

    Science.gov (United States)

    Rho, J. H.

    1967-01-01

    Continuous urinalysis technique is useful in the study of muscle wastage in primates. Creatinine concentration in urine is determined in an aliquot mixture by a color reaction. Creatine is determined in a second aliquot by converting it to creatinine and measuring the difference in color intensity between the two aliquots.

  19. Higher body mass index is associated with higher fractional creatinine excretion in healthy subjects

    NARCIS (Netherlands)

    Sinkeler, Steef J.; Visser, Folkert W.; Krikken, Jan A.; Stegeman, Coen A.; van der Heide, Jaap J. Homan; Navis, Gerjan

    2011-01-01

    Background. Accurate glomerular filtration rate (GFR) measurement in normal to high range is important for epidemiological studies and workup for kidney donation. Creatinine-based equations perform poorly in this GFR range. Creatinine clearance (CrCl) provides a substitute, provided urine is collect

  20. 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 h

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

    NARCIS (Netherlands)

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

    2005-01-01

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

  2. Modular Simulator System (MSS). System/Segment Specification for the Generic Modular Simulator System - Visual Module. Volume 11

    Science.gov (United States)

    1993-08-20

    visual scene from the Visual segment’s interface defined in the (insert application aircraft type) lDD . XI-16 S495-10400D 13 August 1993 Volume XI of...light conditions. The day horizon shall be simulated to include atmospheric light dispersions . The night horizon shall consist of a band of illumination

  3. Neuron-specific enolase, but not S100B or myelin basic protein, increases in peripheral blood corresponding to lesion volume after cortical impact in piglets.

    Science.gov (United States)

    Costine, Beth A; Quebeda-Clerkin, Patricia B; Dodge, Carter P; Harris, Brent T; Hillier, Simon C; Duhaime, Ann-Christine

    2012-11-20

    A peripheral indicator of the presence and magnitude of brain injury has been a sought-after tool by clinicians. We measured neuron-specific enolase (NSE), myelin basic protein (MBP), and S100B, prior to and after scaled cortical impact in immature pigs, to determine if these purported markers increase after injury, correlate with the resulting lesion volume, and if these relationships vary with maturation. Scaled cortical impact resulted in increased lesion volume with increasing age. Concentrations of NSE, but not S100B or MBP, increased after injury in all age groups. The high variability of S100B concentrations prior to injury may have precluded detection of an increase due to injury. Total serum markers were estimated, accounting for the allometric growth of blood volume, and resulted in a positive correlation of both NSE and S100B with lesion volume. Even with allometric scaling of blood volume and a uniform mechanism of injury, NSE had only a fair to poor predictive value. In a clinical setting, where the types of injuries are varied, more investigation is required to yield a panel of serum markers that can reliably predict the extent of injury. Allometric scaling may improve estimation of serum marker release in pediatric populations.

  4. Behavior of testosterone and cortisol during an intensity-controlled high-volume training period measured by a training task-specific test in men rowers.

    Science.gov (United States)

    Rämson, Raul; Jürimäe, Jaak; Jürimäe, Toivo; Mäestu, Jarek

    2009-03-01

    The aim of this study was to investigate changes in the stress hormones testosterone and cortisol after a task-specific exercise during a high-volume endurance training cycle in men rowers. Eight highly trained men rowers were investigated during a high-volume, low-intensity training period. A 2-hour, low-intensity, long-distance rowing (LDT) test was conducted at baseline, after a high-volume period, and after the recovery period. Training and performance intensities were obtained at the graded incremental test, were preset individually, and were the same during all LDTs. Fasting blood samples were taken during the same days as the LDTs. Exercise-induced blood samples were taken before, 5 minutes after, and 30 minutes after (post 30') the completion of each LDT. There were no significant changes in fasting cortisol and testosterone values during the whole study period, and there were no significant changes in cortisol and testosterone concentrations during the LDT. However, testosterone concentration was significantly decreased at post 30' compared with posttest values during the second LDT that was held after the 2-week high-training-volume period, and, during the second LDT, post 30' values of cortisol tended to be decreased compared with posttest values (p = 0.063). In conclusion, changes in the concentrations of testosterone and cortisol after long-distance rowing indicate decreased adaptivity after the training-specific performance test.

  5. 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...

  6. 50 years follow-up on plasma creatinine levels after spinal cord injury

    DEFF Research Database (Denmark)

    Elmelund, Marlene; Oturai, P S; Biering-Sørensen, F

    2014-01-01

    STUDY DESIGN: Retrospective chart review. OBJECTIVES: To investigate the role of plasma creatinine (p-creatinine) in monitoring renal deterioration in patients up to 50 years after spinal cord injury (SCI). SETTING: The Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark. METHODS: A total...... of 119 patients with a traumatic SCI during the years 1944-1975 were included in the study. P-creatinine measurements, results from renography and glomerular filtration rate (GFR) measured with 51Cr-EDTA clearance were obtained from medical records and analyzed using a linear mixed model and linear...... regression analyses. RESULTS: When compared with median p-creatinine level in the first 5-year period after injury, the level of p-creatinine was stable throughout the first 30 years and decreased significantly after the 30th until 45th year post injury. Only patients with a functional distribution outside...

  7. Creatinine related reference ranges for urinary homovanillic acid and vanillylmandelic acid at 6 months of age.

    Science.gov (United States)

    Cole, M; Parker, L; Craft, A W; Bell, S; Dale, G; McGill, A C; Seviour, J A; Smith, J

    1993-03-01

    The relationship between homovanillic acid (HVA), vanillylmandelic acid (VMA), and creatinine in the urine of 6 month old babies has been studied and reference ranges in the form of centiles constructed for HVA and VMA against creatinine. Over 10,000 urine samples were collected from babies in four health districts in the north of England. HVA and VMA concentration, either independently or when divided by creatinine concentration, were dependent upon the absolute concentration of creatinine in the sample. After adjustment for creatinine significant differences in the mean concentration of HVA were found between sexes. No such differences were found for VMA. HVA and VMA were also found to be age dependent. Centiles were constructed using a procedure which makes no distributional assumptions about the data. The net effect of utilising these centiles was to increase the predictive value of a positive screening test from 20% to 40% without any increase in the false negative rate.

  8. Multitier specification for NSEP (National Security/Emergency Preparedness) enhancement of fiber-optic long-distance telecommunication networks. Volume 1. The multitier specification - an executive summary. Technical Information Bulletin

    Energy Technology Data Exchange (ETDEWEB)

    Peach, D.F.

    1987-12-01

    Fiber optic telecommunication systems are susceptible to both natural and man-made stress. National Security/Emergency Preparedness (NSEP) is a function of how durable these systems are in light of projected levels of stress. Emergency Preparedness in 1987 is not just a matter of--can they deliver food, water, energy and other essentials--but can they deliver the vital information necessary to maintain corporate function of our country. 'Communication stamina' is a function of 'probability of survival' when faced with stress. This report provides an overview of the enhancements to a fiber-optic communication system/installation that will increase durability. These enhancements are grouped, based on their value in protecting the system, such that a Multitier Specification is created that presents multiple levels of hardness. Mitigation of effects due to high-altitude electromagnetic pulse (HEMP) and gamma radiation, and protection from vandalism and weather events are discussed in the report. The report is presented in two volumes. Volume I presents the Multitier Specification in a format that is usable for management review. The attributes of specified physical parameters, and the levels of protection stated in Volume I, are discussed in more detail in Volume II.

  9. Patient-specific quality assurance for spot scanning proton beams using a large-volume liquid scintillator detector

    Science.gov (United States)

    Robertson, D.; Beddar, S.

    2017-05-01

    A large-volume liquid scintillator detector was used to measure individual energy layers from a clinical prostate treatment plan on a scanning proton beam system. Lateral and beam’s-eye view images of the dose distribution were acquired with two CCD cameras facing adjacent sides of a scintillator tank. The measured dose images were compared with calculated dose distributions from a validated Monte Carlo model. The measured and calculated dose distributions showed good agreement, with the exception of the Bragg peak region of the lateral view, which exhibited ionization quenching. The beam’s-eye and lateral views achieved gamma analysis passing rates of 99.7% and 92.5%, respectively, using gamma criteria of 3%, 3 mm. Large-volume scintillator detectors show promise for quick and accurate measurements of patient treatment fields for scanning proton beam systems.

  10. Indication of BOLD-specific venous flow-volume changes from precisely controlled hyperoxic vs. hypercapnic calibration.

    Science.gov (United States)

    Mark, Clarisse I; Pike, G Bruce

    2012-04-01

    Deriving cerebral metabolic rate of oxygen consumption (CMRO(2)) from blood oxygenation level-dependent (BOLD) signals involves a flow-volume parameter (α), reflecting total cerebral blood volume changes, and a calibration constant (M). Traditionally, the former is assumed a fixed value and the latter is measured under alterations in fixed inspired fractional concentrations of carbon dioxide. We recently reported on reductions in M-variability via precise control of end-tidal pressures of both hypercapnic (HC) and hyperoxic (HO) gases. In light of these findings, our aim was to apply the improved calibration alternatives to neuronal activation, making use of their distinct vasoactive natures to evaluate the α-value. Nine healthy volunteers were imaged at 3 T while simultaneously measuring BOLD and arterial spin-labeling signals during controlled, graded, HC, and HO, followed by visual (VC) and sensorimotor cortices (SMC) activation. On the basis of low M- and CMRO(2)-variability, the comparison of these calibration alternatives accurately highlighted a reduced venous flow-volume relationship (α=0.16±0.02, with α(VC)=0.12±0.04, and α(SMC)=0.20±0.02), as appropriate for BOLD modeling.

  11. 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

    Objectives 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. Methods 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. Results 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%. Conclusions The substantial variability in SCr assays

  12. 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.

  13. Serum creatinine concentration at the onset of uremia: higher levels in black males.

    Science.gov (United States)

    Abuelo, J G; Shemin, D; Chazan, J A

    1992-06-01

    We compared serum creatinine and blood urea nitrogen concentrations, estimated creatinine clearances and frequency of uremic symptoms at the start of chronic hemodialysis in all 20 black and 179 white males treated between 1969 and 1983. Serum creatinine concentrations were significantly higher in black males (16.5 +/- 5.9 mg/dl) than in white males (11.7 +/- 4.7 mg/dl; p = 0.016). There were no significant differences in blood urea nitrogen concentration, estimated creatinine clearance and frequency of uremic symptoms between the two groups. Blood urea nitrogen to serum creatinine ratios were lower in black males, (7.3 +/- 1.9) than in white males (11.4 +/- 3.8; p = 0.0001), and only one black male had a ratio greater than 10 compared to 60% of whites. We concluded that black males tend to have higher serum creatinine concentrations than white males at the onset of uremic symptoms, and that higher striated muscle creatinine production in black males and not lower renal function may be the cause.

  14. Calcium supplementation increases blood creatinine concentration in a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Elizabeth L Barry

    Full Text Available BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. TRIAL REGISTRATION: ClinicalTrials.gov NCT00153816.

  15. Falsely elevated serum creatinine levels secondary to the presence of 5-fluorocytosine.

    Science.gov (United States)

    Mitchell, R T; Marshall, L H; Lefkowitz, L B; Stratton, C W

    1985-08-01

    The Kodak Ektachem (Eastman Kodak Co., Rochester, NY) is a new clinical chemistry analyzer that uses an enzymatic method to measure creatinine. The authors report the case of a patient with falsely elevated creatinine levels that were caused by the presence of 5-fluorocytosine. A review of the literature confirmed that this can occur, but well documented reports are not found. In order to determine the magnitude of this interference, the authors plotted creatinine levels versus 5-FC concentration. Significant interference is seen with therapeutic levels of 5-FC. Both clinicians and pathologists should be aware of this phenomenon.

  16. 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.

  17. Limitation of amylase creatinine clearance ratio as a diagnostic test for postoperative pancreatitis.

    Science.gov (United States)

    Wapnick, S; Evans, M I; Hadas, N; Grosberg, S J

    1980-05-01

    The mean +/- S.E.M. ratio of amylase to creatinine clearance significantly increased at 24 hours after operations on the stomach and gallbladder but not after operations at sites remote from the abdominal cavity. Clinically, the elevated amylase to creatinine clearance ratio was not accompanied by pancreatitis. In dogs, surgical handling of the pancreas alone caused a significant increase in this measurement. The amylase to creatinine clearance ratio is not likely to be helpful in predicting the rare, but serious, postoperative complication of pancreatitis.

  18. Fully automatized renal parenchyma volumetry using a support vector machine based recognition system for subject-specific probability map generation in native MR volume data

    Science.gov (United States)

    Gloger, Oliver; Tönnies, Klaus; Mensel, Birger; Völzke, Henry

    2015-11-01

    In epidemiological studies as well as in clinical practice the amount of produced medical image data strongly increased in the last decade. In this context organ segmentation in MR volume data gained increasing attention for medical applications. Especially in large-scale population-based studies organ volumetry is highly relevant requiring exact organ segmentation. Since manual segmentation is time-consuming and prone to reader variability, large-scale studies need automatized methods to perform organ segmentation. Fully automatic organ segmentation in native MR image data has proven to be a very challenging task. Imaging artifacts as well as inter- and intrasubject MR-intensity differences complicate the application of supervised learning strategies. Thus, we propose a modularized framework of a two-stepped probabilistic approach that generates subject-specific probability maps for renal parenchyma tissue, which are refined subsequently by using several, extended segmentation strategies. We present a three class-based support vector machine recognition system that incorporates Fourier descriptors as shape features to recognize and segment characteristic parenchyma parts. Probabilistic methods use the segmented characteristic parenchyma parts to generate high quality subject-specific parenchyma probability maps. Several refinement strategies including a final shape-based 3D level set segmentation technique are used in subsequent processing modules to segment renal parenchyma. Furthermore, our framework recognizes and excludes renal cysts from parenchymal volume, which is important to analyze renal functions. Volume errors and Dice coefficients show that our presented framework outperforms existing approaches.

  19. Spot urine cortisol–creatinine ratio – A useful screening test in the diagnosis of Cushing's syndrome

    Science.gov (United States)

    Kapoor, Nitin; Job, Victoria; Jayaseelan, L.; Rajaratnam, Simon

    2012-01-01

    Introduction: Although, there are several tests available, not one of them fulfils the criteria of being an ideal screening test. Continuing the search for an ideal screening test, we explored the use of urine spot cortisol-creatinine ratio as a novel method of evaluating patients with Cushing's syndrome. Method: A total of 35 subjects were studied and divided into 3 groups - 15 having cushings syndrome, 15 patients with obesity and 5 normal weight subjects. All patients with cushings syndrome were positive for the other screening tests. Results: The mean (standard deviation) of cortisol:creatinine ratio among the 3 groups (cushings, obese and control subjects) was 36.00(24.74), 7.01(2.73) and 3.49(2.68) respectively. Using the cutoff of 12.27 nano mol/ micro mol(based on data of normal subjects) for the urine cortisol creatinine ratio we get a sensitivity of 93.75% and a specificity of 100%. Also the positive and negative predictive value as calculated with this cutoff is 100% and 93.3% respectively. Conclusion: In this study we found that UCCR is similar in both Obese and Non Obese subjects who did not have cushings syndrome. UCCR is significantly elevated in individuals with Cushing's syndrome as compared to those who do not have cushings syndrome. Also when a cut off of 12.27 nano mol/ micro mol was used this test had a higher sensitivity, however this test had a higher specificity at a cut off of 15.35. PMID:23565435

  20. Spot urine cortisol-creatinine ratio - A useful screening test in the diagnosis of Cushing′s syndrome

    Directory of Open Access Journals (Sweden)

    Nitin Kapoor

    2012-01-01

    Full Text Available Introduction : Although,there are several tests available, not one of them fulfils the criteria of being an ideal screening test. Continuing the search for an ideal screening test, we explored the use of urine spot cortisol-creatinine ratio as a novel method of evaluating patients with Cushing′s syndrome. Method: A total of 35 subjects were studied and divided into 3 groups - 15 having cushings syndrome, 15 patients with obesity and 5 normal weight subjects. All patients with cushings syndrome were positive for the other screening tests. Results : The mean (standard deviation of cortisol:creatinine ratio among the 3 groups (cushings, obese and control subjects was 36.00(24.74, 7.01(2.73 and 3.49(2.68 respectively. Using the cutoff of 12.27 nano mol/ micro mol(based on data of normal subjects for the urine cortisol creatinine ratio we get a sensitivity of 93.75% and a specificity of 100%. Also the positive and negative predictive value as calculated with this cutoff is 100% and 93.3% respectively. Conclusion: In this study we found that UCCR is similar in both Obese and Non Obese subjects who did not have cushings syndrome. UCCR is significantly elevated in individuals with Cushing′s syndrome as compared to those who do not have cushings syndrome. Also when a cut off of 12.27 nano mol/ micro mol was used this test had a higher sensitivity, however this test had a higher specificity at a cut off of 15.35.

  1. Research safety vehicle program (Phase II) specification review. Volume II. Final technical report, Jul 1975--Nov 1976

    Energy Technology Data Exchange (ETDEWEB)

    Pugliese, S.M.

    1977-02-01

    In Phase I of the Research Safety Vehicle Program (RSV), preliminary design and performance specifications were developed for a mid-1980's vehicle that integrates crashworthiness and occupant safety features with material resource conservation, economy, and producibility. Phase II of the program focused on development of the total vehicle design via systems engineering and integration analyses. As part of this effort, it was necessary to continuously review the Phase I recommended performance specification in relation to ongoing design/test activities. This document contains the results of analyses of the Phase I specifications. The RSV is expected to satisfy all of the producibility and safety related specifications, i.e., handling and stability systems, crashworthiness, occupant protection, pedestrian/cyclist protection, etc.

  2. Normal values for plasma creatinine concentration related to maturity in normal term and preterm infants.

    Science.gov (United States)

    Trompeter, R S; Al-Dahhan, J; Haycock, G B; Chik, G; Chantler, C

    1983-09-01

    Creatinine concentration was measured by a kinetic method in 475 plasma samples obtained from 260 term and preterm infants during the first 2 months post-natal age. In term infants plasma creatinine fell from 88 +/- 4.4 mumol/L (mean + SEM) at birth, to 60 +/- 1.9 mumol/L by the fourth day remaining stable thereafter; in preterm infants creatinine fell to 86 +/- 7 mumol/L by the fourth day. Analysis of pooled data from all infants of more than 4 days post natal age revealed a progressive fall in creatinine with increasing post conceptual age. The normal range of values varies with post conceptual age and was not influenced by gestational age at the time of birth.

  3. Kidney injury biomarkers and urinary creatinine variability in nominally healthy adults

    Science.gov (United States)

    Environmental exposure diagnostics use creatinine concentrations in urine aliquots as the internal standard for dilution normalization of all other excreted metabolites when urinary excretion rate data are not available. This is a reasonable approach for healthy adults as creati...

  4. 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 ...

  5. Measurement of creatinine in human plasma using a functional porous polymer structure sensing motif.

    Science.gov (United States)

    Nanda, Sitansu Sekhar; An, Seong Soo A; Yi, Dong Kee

    2015-01-01

    In this study, a new method for detecting creatinine was developed. This novel sensor comprised of two ionic liquids, poly-lactic-co-glycolic acid (PLGA) and 1-butyl-3-methylimidazolium (BMIM) chloride, in the presence of 2',7'-dichlorofluorescein diacetate (DCFH-DA). PLGA and BMIM chloride formed a functional porous polymer structure (FPPS)-like structure. Creatinine within the FPPS rapidly hydrolyzed and released OH(-), which in turn converted DCFH-DA to DCFH, developing an intense green color or green fluorescence. The conversion of DCFH to DCF(+) resulted in swelling of FPPS and increased solubility. This DCF(+)-based sensor could detect creatinine levels with detection limit of 5 µM and also measure the creatinine in blood. This novel method could be used in diagnostic applications for monitoring individuals with renal dysfunction.

  6. Sensitivity and specificity of the Eating Assessment Tool and the Volume-Viscosity Swallow Test for clinical evaluation of oropharyngeal dysphagia

    Science.gov (United States)

    Rofes, L; Arreola, V; Mukherjee, R; Clavé, P

    2014-01-01

    Background Oropharyngeal dysphagia (OD) is an underdiagnosed digestive disorder that causes severe nutritional and respiratory complications. Our aim was to determine the accuracy of the Eating Assessment Tool (EAT-10) and the Volume-Viscosity Swallow Test (V-VST) for clinical evaluation of OD. Methods We studied 120 patients with swallowing difficulties and 14 healthy subjects. OD was evaluated by the 10-item screening questionnaire EAT-10 and the bedside method V-VST, videofluoroscopy (VFS) being the reference standard. The V-VST is an effort test that uses boluses of different volumes and viscosities to identify clinical signs of impaired efficacy (impaired labial seal, piecemeal deglutition, and residue) and impaired safety of swallow (cough, voice changes, and oxygen desaturation ≥3%). Discriminating ability was assessed by the AUC of the ROC curve and sensitivity and specificity values. Key Results According to VFS, prevalence of OD was 87%, 75.6% with impaired efficacy and 80.9% with impaired safety of swallow including 17.6% aspirations. The EAT-10 showed a ROC AUC of 0.89 for OD with an optimal cut-off at 2 (0.89 sensitivity and 0.82 specificity). The V-VST showed 0.94 sensitivity and 0.88 specificity for OD, 0.79 sensitivity and 0.75 specificity for impaired efficacy, 0.87 sensitivity and 0.81 specificity for impaired safety, and 0.91 sensitivity and 0.28 specificity for aspirations. Conclusions & Inferences Clinical methods for screening (EAT-10) and assessment (V-VST) of OD offer excellent psychometric proprieties that allow adequate management of OD. Their universal application among at-risk populations will improve the identification of patients with OD at risk for malnutrition and aspiration pneumonia. PMID:24909661

  7. 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...

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

    Directory of Open Access Journals (Sweden)

    Ji Hye Huh

    Full Text Available 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.

  9. [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.

  10. Power Extension Package (PEP) system definition extension, orbital service module systems analysis study. Volume 4: PEP functional specification

    Science.gov (United States)

    1979-01-01

    The functional, performance, design, and test requirements for the Orbiter power extension package and its associated ground support equipment are defined. Both government and nongovernment standards and specifications are cited for the following subsystems: electrical power, structural/mechanical, avionics, and thermal control. Quality control assurance provisions and preparation for delivery are also discussed.

  11. Power Extension Package (PEP) system definition extension, orbital service module systems analysis study. Volume 5: PEP environmental specification

    Science.gov (United States)

    1979-01-01

    This specification establishes the natural and induced environments to which the power extension package may be exposed during ground operations and space operations with the shuttle system. Space induced environments are applicable at the Orbiter attach point interface location. All probable environments are systematically listed according to each ground and mission phase.

  12. MHD advanced power train. Phase 1, Final report: Volume 3, Power train system description and specification for 200MWe Plant

    Energy Technology Data Exchange (ETDEWEB)

    Jones, A.R.

    1985-08-01

    This System Design Description and Specification provides the basis for the design of the magnetohydrodynamic (MHD) Power Train (PT) for a nominal 200 MWe early commercial tiHD/Steam Power Plant. This document has been developed under Task 2, Conceptual Design, of Contract DE-AC22-83PC60575 and is to be used by the project as the controlling and coordinating documentation during future design efforts. Modification and revision of this specification will occur as the design matures, and tiie-Westinghouse MHD Project Manager will be the focal point for maintaining this document and issuing periodic revisions. This document is intended to delineate the power train and-power train components requirements and assumptions that properly reflect the MHD/Steam Power Plant in the PT design. The parameters discussed in this document have been established through system calculations as well as through constraints set by technology and by limitations on materials, cost, physical processes associated with MHD, and the expected operating data for the plant. The specifications listed in this document have precedence over all referenced documents. Where this specification appears to conflict with the requirements of a reference document, such conflicts should be brought to the attention of the Westinghouse MHD Project Manager for resolution.

  13. Longitudinal Assessment of Serum Creatinine Levels on Graft Survival After Renal Transplantation: Joint Modeling Approach

    Science.gov (United States)

    Maraghi, Elham; Rahimi Foroushani, Abbas; Younespour, Shima; Rostami, Zohreh; Einollahi, Behzad; Eshraghian, Mohammad Reza; Akhoond, Mohammad Reza; Mohammad, Kazem

    2016-01-01

    Background Chronic kidney disease (CKD) is a major public health problem. The eventual outcome of CKD is end-stage renal disease (ESRD). Early diagnosis and proper management play an important role in preventing CKD progression to ESRD. Dialysis and kidney transplantation are the only treatment options available for patients suffering from ESRD. Objectives This study was designed to investigate the etiological role of recipient and donor characteristics on serum creatinine changes within the follow-up period, graft failure risk, and the impact of longitudinal serum creatinine levels on graft survival after renal transplantation. Patients and Methods This study was carried out at the department of nephrology, Baqiyatallah hospital, Baqiyatallah University, Tehran, Iran, between April 2005 and December 2008. During that time period, 461 patients who had undergone renal transplantation were entered in the current study. Time to graft loss and serum creatinine levels at each visit were the primary data gathered for the study. A joint modeling of survival and longitudinal nonsurvival data was used to assess the association between the two processes and investigate the influential factors. Results Median follow-up time was 6.80 months. A linear decreasing trend in serum creatinine level over time was found (P < 0.001). The results showed a positive correlation between serum creatinine levels and risk of graft failure (P < 0.001). Conclusions The major finding of this study is that one unit increase in serum creatinine level suggests an increased risk of graft failure of up to four times. PMID:27795953

  14. Successive determination of urinary bilirubin and creatinine employing simultaneous injection effective mixing flow analysis.

    Science.gov (United States)

    Ponhong, Kraingkrai; Teshima, Norio; Grudpan, Kate; Vichapong, Jitlada; Motomizu, Shoji; Sakai, Tadao

    2015-02-01

    A novel four-channel simultaneous injection effective mixing flow analysis (SIEMA) system has been assembled for successive determination of bilirubin and creatinine in urinary samples. The chemical variables and physical parameters in the flow system were optimized for the enhancement of successive analytical performances. The interferences from urine matrices on the determination of bilirubin and creatinine were eliminated to dilute urine samples. The calibration graphs with the optimum conditions were achieved to be in 0.024-5.0 mg L(-1) for bilirubin and 2-100 mg L(-1) for creatinine. The relative standard deviations (RSDs) at 3 mg L(-1) of bilirubin and at 50 mg L(-1) of creatinine for 11 runs were 1.5 and 1.0%, respectively. The limits of detections (3σ of blank) for bilirubin and creatinine were 7 µg L(-1) and 0.6 mg L(-1), respectively. The sample throughput for stepwise detection was 22 h(-1). The proposed method was applied to the successive determination of bilirubin and creatinine in urine samples.

  15. The Accuracy of Point-of-Care Creatinine Testing in the Emergency Department

    Directory of Open Access Journals (Sweden)

    Moises Moreno

    2015-01-01

    Full Text Available Objective. To determine the accuracy of Point-Of-Care testing (PoCT creatinine values when compared to standard central laboratory testing (IDMS and to demonstrate if and how a discrepancy could lead to improper risk stratification for contrast induced nephropathy (CIN. Methods. We conducted a descriptive retrospective chart review of patients seen in the Emergency Department of a single suburban, community, and academic medical center. We included patients who presented to the department between March 2013 and September 2014 who had blood samples analyzed by both PoCT and IDMS. Results. Mean IDMS creatinine values were 0.23 mg/dL higher when compared with i-Stat values. 95% of the time, the IDMS creatinine value was variable and ranged from −0.45 mg/dL to +0.91 mg/dL when compared to the i-Stat creatinine. When using i-Stat creatinine values to calculate GFR, 47 out of 156 patients had risk category variations compared to using the IDMS value. This affected 30.1% of the total eligible sample population (22.9% to 37.3% with 95% CI. Conclusion. We found a significant discrepancy between PoCT and IDMS creatinine values and found that this discrepancy could lead to improper risk stratification for CIN.

  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

    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. Renal clearance of pancreatic and salivary amylase relative to creatinine in patients with chronic renal insufficiency.

    Science.gov (United States)

    Keogh, J B; McGeeney, K F; Drury, M I; Counihan, T B; O'Donnell, M D

    1978-12-01

    Pancreatic and salivary amylase/creatinine clearance ratios in patients with various degrees of renal impairment were compared with those obtained for control subjects. In chronic renal insufficiency (mean GFR 30 ml/min +/- 15 SD; n = 13) the clearance ratios for pancreatic (mean 3.5 +/- 1.85 SD) and salivary (mean 2.3 +/- 1.3 SD) amylase were significantly higher (P less than 0.05) than those in controls. Corresponding control values (n = 26) were 2.64 +/- 0.86 (pancreatic) and 1.64 +/- 0.95 (salivary). Three patients showed values above the normal limit. In the diabetic group (mean GFR 41 ml/min +/- 22 SD; n = 10) salivary amylase/creatinine clearance ratios (mean 2.36 +/- 1.55 SD) were significantly higher than in controls (P less than 0.05). Three patients showed raised values. Pancreatic amylase clearance was raised in only one of these patients. Three patients with terminal disease (mean GFR 10 ml/min) showed markedly raised (two- to threefold) clearance ratios for both salivary and pancreatic amylase. Of a total of 26 patients, eight had increased total amylase/creatinine clearance ratios. Pancreatic amylase/creatinine clearance was increased in seven patients, while nine patients showed raised salivary amylase/creatinine ratios. Patients with raised clearance ratios did not have clinical evidence of pancreatitis. We suggest that, in the presence of impaired renal function, a high amylase/creatinine clearance ratio need not be indicative of pancreatic disease.

  18. 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.

  19. [Retrospective evaluation of urea and creatinine blood levels in calves with diarrhea].

    Science.gov (United States)

    Wiest, D; Klee, W

    1998-09-01

    Data of 393 calves treated for neonatal diarrhea as in-patients in the II. Medical Animal Clinic of the University of Munich were included in a retrospective study with special regard to the course and prognostic information of blood urea, blood creatinine, urea-creatinine-ratio, and PCV. Mean values, standard deviation and maximum values that were measured upon admission to the clinic: blood urea: 16.86 +/- 12.35; 75.70 mmol/l; blood creatinine: 260.3 +/- 204.4; 1610.2 mumol/l; urea-creatinine-ratio [both in mmol/l]: 70.28 +/- 36.38; 245.8; PCV: 41.66 +/- 9.1; 71.5% (mean +/- S.D). Even very high values for blood urea, blood creatinine, urea-creatinine-ratio, and PCV determined at admission yielded no prognostic information, but unchanged or higher urea values on the second day in the clinic were associated with a deterioration of prognosis.

  20. The influence of creatinine versus GFR on NSAID prescriptions in CKD

    Science.gov (United States)

    Patel, Krupa; Diamantidis, Clarissa; Zhan, Min; Hsu, Van Doren; Walker, Loreen D.; Gardner, James; Weir, Matthew R.; Fink, Jeffrey C.

    2012-01-01

    Background Non-steroidal anti-inflammatory drugs (NSAIDs), including cyclo-oxygenase-2 (COX-2) inhibitors, are generally contraindicated in chronic kidney disease (CKD). This investigation sought to identify the frequency of NSAID/COX2 prescription and determine the influence of serum Cr versus estimated GFR on this practice pattern. Methods An established Veterans Health Administration (VHA) CKD safety cohort (n = 70,154) was examined to determine the frequency of NSAID/COX2 in fiscal year 2005 (FY05) for up to 30 days preceding the index hospitalization and as many as 365 days during that year. Binomial regression was used to determine adjusted prevalence ratios for prescription of NSAID/COX2 with respect to continuous eGFR measurement and serum creatinine (Cr) categories. CKD was defined as eGFR < 60 ml/min/1.73m2. Results 15.4% of subjects had an NSAID/COX2 prescription during the observation period with the proportion prescribed these agents decreasing with declining renal function, but remained significant at any stage of CKD given the renal harm related to these medications. At specific GFR estimates, serum creatinine (Cr) remained a significant predictor of NSAID/COX prescription. At GFR set at 42 ml/min/1.73, the predicted proportion prescribed NSAID/COX2 was 0.29 (95% CI: 0.24,0.36); 0.23 (95% CI: 0.22,0.26); 0.20 (95%: 0.19,0,22); 0.12 (95% CI: 0.10,0.14) for Cr strata of ≤ 1.3 mg/dl, 1.4 – 1.6 mg/dl, 1.7 –2.1 mg/dl, ≥ 2.2 mg/dl, respectively (all p < 0.05). Conclusion A significant proportion of individuals with CKD continue to be prescribed NSAID/COX2 and serum Cr remains an influential guide to NSAID/COX2 prescription, even in GFR ranges where these agents are ill-advised. PMID:22699456

  1. Urinary Uric Acid/Creatinine Ratio - A Marker For Perinatal Asphyxia

    Science.gov (United States)

    Patel, Kinjal Prahaladbhai; Makadia, Mayur Goradhanbhai; Patel, Vishwal Indravardan; Nilayangode, Haridas Neelakandan

    2017-01-01

    Background Perinatal hypoxia is one of the leading causes of perinatal mortality in developing countries. Both apgar score and arterial blood pH predict the neonatal mortality in asphyxia. Apgar score alone does not predict neurologic outcome and as it is influenced by various factors. This study was conducted to evaluate the utility and sensitivity of urinary uric acid to creatinine ratio (UA/Cr ratio) in asphyxia diagnosis, compared to invasive Arterial Blood Gas (ABG) analysis. Aim To assess the urinary uric acid/creatinine ratio as an additional marker for perinatal asphyxia compared with ABG analysis in apgar score monitoring. Materials and Methods The present case control study was conducted at a teaching hospital in Central Gujarat. Data of 40 healthy newborns and 40 asphyxiated newborns were collected. In absence of regional estimates, a sample of size 39 was required to attain a power of 80% at 5% alpha (type I error) considering a moderate effect size of 0.65. (UA/Cr) ratio was measured from the spot urine sample collected during 24-72 hours of birth. Statistical analysis was performed by Independent t-test, Pearson’s correlation coefficient (r) and Receiver Operating Characteristic (ROC) plots. Results The mean (UA/Cr ratio) (2.75±0.18 vs 1.78±0.23) is significantly higher in asphyxiated group than in the control group (p0.05). Urinary UA/Cr ratio with criterion of >2.3 had 100% sensitivity, 100% specificity with AUC of 1 (p<0.0001) had a better predictive value. Conclusions Apgar score is usually reduced in neonates with congenital anomalies and premature neonates. Hence, it is preferable that the clinical diagnosis of asphyxia by apgar scores be supported by other investigations so that early decision can be taken about the level of care the baby needs. pH, lactates and base deficits change with establishment of respiration following resuscitation. However, pH, lactate, base deficit estimations are invasive and need rapid estimations. Non

  2. A Risk Assessment of the Jaffe vs Enzymatic Method for Creatinine Measurement in an Outpatient Population.

    Directory of Open Access Journals (Sweden)

    Robert L Schmidt

    Full Text Available The Jaffe and enzymatic methods are the two most common methods for measuring serum creatinine. The Jaffe method is less expensive than the enzymatic method but is also more susceptible to interferences. Interferences can lead to misdiagnosis but interferences may vary by patient population. The overall risk associated with the Jaffe method depends on the probability of misclassification and the consequences of misclassification. This study assessed the risk associated with the Jaffe method in an outpatient population. We analyzed the discordance rate in the estimated glomerular filtration rate based on serum creatinine measurements obtained by the Jaffe and enzymatic method.Method comparison and risk analysis. Five hundred twenty-nine eGFRs obtained by the Jaffe and enzymatic method were compared at four clinical decision limits. We determined the probability of discordance and the consequence of misclassification at each decision limit to evaluate the overall risk.We obtained 529 paired observations. Of these, 29 (5.5% were discordant with respect to one of the decision limits (i.e. 15, 30, 45 or 60 ml/min/1.73m2. The magnitude of the differences (Jaffe result minus enzymatic result were significant relative to analytical variation in 21 of the 29 (72% of the discordant results. The magnitude of the differences were not significant relative to biological variation. The risk associated with misclassification was greatest at the 60 ml/min/1.73m2 decision limit because the probability of misclassification and the potential for adverse outcomes were greatest at that decision limit.The Jaffe method is subject to bias due to interfering substances (loss of analytical specificity. The risk of misclassification is greatest at the 60 ml/min/1.73m2 decision limit; however, the risk of misclassification due to bias is much less than the risk of misclassification due to biological variation. The Jaffe method may pose low risk in selected populations if e

  3. A random protein-creatinine ratio accurately predicts baseline proteinuria in early pregnancy.

    Science.gov (United States)

    Hirshberg, Adi; Draper, Jennifer; Curley, Cara; Sammel, Mary D; Schwartz, Nadav

    2014-12-01

    Data surrounding the use of a random urine protein:creatinine ratio (PCR) in the diagnosis of preeclampsia is conflicting. We sought to determine whether PCR in early pregnancy can replace the 24-hour urine collection as the primary screening test in patients at risk for baseline proteinuria. Women requiring a baseline evaluation for proteinuria supplied a urine sample the morning after their 24-hour collection. The PCR was analyzed as a predictor of significant proteinuria (≥150 mg). A regression equation to estimate the 24-hour protein value from the PCR was then developed. Sixty of 135 subjects enrolled completed the study. The median 24-hour urine protein and PCR were 90 mg (IQR: 50-145) and 0.063 (IQR: 0.039-0.083), respectively. Fifteen patients (25%) had significant proteinuria. PCR was strongly correlated with the 24-hour protein value (r = 0.99, p proteinuria (AUC = 0.86). A PCR cut-point of 0.079 yielded a sensitivity of 93.3% and a specificity of 57.8%. The resulting regression equation [total protein = 46.5 + 904.2*PCR] accurately estimates the actual 24-hour protein (95% CI: ±88 mg). A random urine PCR accurately estimates the 24-hour protein excretion in the first half of pregnancy and can be used as the primary screening test for baseline proteinuria in at-risk patients.

  4. A patient-specific quality assurance study on absolute dose verification using ionization chambers of different volumes in RapidArc treatments

    Energy Technology Data Exchange (ETDEWEB)

    Syam Kumar, S.A., E-mail: skppm@rediffmail.com [Department of Medical Physics, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu (India); Sukumar, Prabakar; Sriram, Padmanaban; Rajasekaran, Dhanabalan; Aketi, Srinu; Vivekanandan, Nagarajan [Department of Medical Physics, Cancer Institute (WIA), Adyar, Chennai, Tamil Nadu (India)

    2012-01-01

    The recalculation of 1 fraction from a patient treatment plan on a phantom and subsequent measurements have become the norms for measurement-based verification, which combines the quality assurance recommendations that deal with the treatment planning system and the beam delivery system. This type of evaluation has prompted attention to measurement equipment and techniques. Ionization chambers are considered the gold standard because of their precision, availability, and relative ease of use. This study evaluates and compares 5 different ionization chambers: phantom combinations for verification in routine patient-specific quality assurance of RapidArc treatments. Fifteen different RapidArc plans conforming to the clinical standards were selected for the study. Verification plans were then created for each treatment plan with different chamber-phantom combinations scanned by computed tomography. This includes Medtec intensity modulated radiation therapy (IMRT) phantom with micro-ionization chamber (0.007 cm{sup 3}) and pinpoint chamber (0.015 cm{sup 3}), PTW-Octavius phantom with semiflex chamber (0.125 cm{sup 3}) and 2D array (0.125 cm{sup 3}), and indigenously made Circular wax phantom with 0.6 cm{sup 3} chamber. The measured isocenter absolute dose was compared with the treatment planning system (TPS) plan. The micro-ionization chamber shows more deviations when compared with semiflex and 0.6 cm{sup 3} with a maximum variation of -4.76%, -1.49%, and 2.23% for micro-ionization, semiflex, and farmer chambers, respectively. The positive variations indicate that the chamber with larger volume overestimates. Farmer chamber shows higher deviation when compared with 0.125 cm{sup 3}. In general the deviation was found to be <1% with the semiflex and farmer chambers. A maximum variation of 2% was observed for the 0.007 cm{sup 3} ionization chamber, except in a few cases. Pinpoint chamber underestimates the calculated isocenter dose by a maximum of 4.8%. Absolute dose

  5. A patient-specific quality assurance study on absolute dose verification using ionization chambers of different volumes in RapidArc treatments.

    Science.gov (United States)

    Syam Kumar, S A; Sukumar, Prabakar; Sriram, Padmanaban; Rajasekaran, Dhanabalan; Aketi, Srinu; Vivekanandan, Nagarajan

    2012-01-01

    The recalculation of 1 fraction from a patient treatment plan on a phantom and subsequent measurements have become the norms for measurement-based verification, which combines the quality assurance recommendations that deal with the treatment planning system and the beam delivery system. This type of evaluation has prompted attention to measurement equipment and techniques. Ionization chambers are considered the gold standard because of their precision, availability, and relative ease of use. This study evaluates and compares 5 different ionization chambers: phantom combinations for verification in routine patient-specific quality assurance of RapidArc treatments. Fifteen different RapidArc plans conforming to the clinical standards were selected for the study. Verification plans were then created for each treatment plan with different chamber-phantom combinations scanned by computed tomography. This includes Medtec intensity modulated radiation therapy (IMRT) phantom with micro-ionization chamber (0.007 cm(3)) and pinpoint chamber (0.015 cm(3)), PTW-Octavius phantom with semiflex chamber (0.125 cm(3)) and 2D array (0.125 cm(3)), and indigenously made Circular wax phantom with 0.6 cm(3) chamber. The measured isocenter absolute dose was compared with the treatment planning system (TPS) plan. The micro-ionization chamber shows more deviations when compared with semiflex and 0.6 cm(3) with a maximum variation of -4.76%, -1.49%, and 2.23% for micro-ionization, semiflex, and farmer chambers, respectively. The positive variations indicate that the chamber with larger volume overestimates. Farmer chamber shows higher deviation when compared with 0.125 cm(3). In general the deviation was found to be <1% with the semiflex and farmer chambers. A maximum variation of 2% was observed for the 0.007 cm(3) ionization chamber, except in a few cases. Pinpoint chamber underestimates the calculated isocenter dose by a maximum of 4.8%. Absolute dose measurements using the semiflex

  6. Site-specific probabilistic seismic hazard analyses for the Idaho National Engineering Laboratory. Volume 1: Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    This report describes and summarizes a probabilistic evaluation of ground motions for the Idaho National Engineering Laboratory (INEL). The purpose of this evaluation is to provide a basis for updating the seismic design criteria for the INEL. In this study, site-specific seismic hazard curves were developed for seven facility sites as prescribed by DOE Standards 1022-93 and 1023-96. These sites include the: Advanced Test Reactor (ATR); Argonne National Laboratory West (ANL); Idaho Chemical Processing Plant (ICPP or CPP); Power Burst Facility (PBF); Radioactive Waste Management Complex (RWMC); Naval Reactor Facility (NRF); and Test Area North (TAN). The results, probabilistic peak ground accelerations and uniform hazard spectra, contained in this report are not to be used for purposes of seismic design at INEL. A subsequent study will be performed to translate the results of this probabilistic seismic hazard analysis to site-specific seismic design values for the INEL as per the requirements of DOE Standard 1020-94. These site-specific seismic design values will be incorporated into the INEL Architectural and Engineering Standards.

  7. Influence of 320-detector-row volume scanning and AAPM report 111 CT dosimetry metrics on size-specific dose estimate: a Monte Carlo study.

    Science.gov (United States)

    Haba, Tomonobu; Koyama, Shuji; Kinomura, Yutaka; Ida, Yoshihiro; Kobayashi, Masanao

    2016-09-01

    The American Association of Physicists in Medicine (AAPM) task group 204 has recommended the use of size-dependent conversion factors to calculate size-specific dose estimate (SSDE) values from volume computed tomography dose index (CTDIvol) values. However, these conversion factors do not consider the effects of 320-detector-row volume computed tomography (CT) examinations or the new CT dosimetry metrics proposed by AAPM task group 111. This study aims to investigate the influence of these examinations and metrics on the conversion factors reported by AAPM task group 204, using Monte Carlo simulations. Simulations were performed modelling a Toshiba Aquilion ONE CT scanner, in order to compute dose values in water for cylindrical phantoms with 8-40-cm diameters at 2-cm intervals for each scanning parameter (tube voltage, bow-tie filter, longitudinal beam width). Then, the conversion factors were obtained by applying exponential regression analysis between the dose values for a given phantom diameter and the phantom diameter combined with various scanning parameters. The conversion factors for each scanning method (helical, axial, or volume scanning) and CT dosimetry method (i.e., the CTDI100 method or the AAPM task group 111 method) were in agreement with those reported by AAPM task group 204, within a percentage error of 14.2 % for phantom diameters ≥11.2 cm. The results obtained in this study indicate that the conversion factors previously presented by AAPM task group 204 can be used to provide appropriate SSDE values for 320-detector-row volume CT examinations and the CT dosimetry metrics proposed by the AAPM task group 111.

  8. 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

  9. SU-D-213-04: Accounting for Volume Averaging and Material Composition Effects in An Ionization Chamber Array for Patient Specific QA

    Energy Technology Data Exchange (ETDEWEB)

    Fugal, M; McDonald, D; Jacqmin, D; Koch, N; Ellis, A; Peng, J; Ashenafi, M; Vanek, K [Medical University of South Carolina, Charleston, SC (United States)

    2015-06-15

    Purpose: This study explores novel methods to address two significant challenges affecting measurement of patient-specific quality assurance (QA) with IBA’s Matrixx Evolution™ ionization chamber array. First, dose calculation algorithms often struggle to accurately determine dose to the chamber array due to CT artifact and algorithm limitations. Second, finite chamber size and volume averaging effects cause additional deviation from the calculated dose. Methods: QA measurements were taken with the Matrixx positioned on the treatment table in a solid-water Multi-Cube™ phantom. To reduce the effect of CT artifact, the Matrixx CT image set was masked with appropriate materials and densities. Individual ionization chambers were masked as air, while the high-z electronic backplane and remaining solid-water material were masked as aluminum and water, respectively. Dose calculation was done using Varian’s Acuros XB™ (V11) algorithm, which is capable of predicting dose more accurately in non-biologic materials due to its consideration of each material’s atomic properties. Finally, the exported TPS dose was processed using an in-house algorithm (MATLAB) to assign the volume averaged TPS dose to each element of a corresponding 2-D matrix. This matrix was used for comparison with the measured dose. Square fields at regularly-spaced gantry angles, as well as selected patient plans were analyzed. Results: Analyzed plans showed improved agreement, with the average gamma passing rate increasing from 94 to 98%. Correction factors necessary for chamber angular dependence were reduced by 67% compared to factors measured previously, indicating that previously measured factors corrected for dose calculation errors in addition to true chamber angular dependence. Conclusion: By comparing volume averaged dose, calculated with a capable dose engine, on a phantom masked with correct materials and densities, QA results obtained with the Matrixx Evolution™ can be significantly

  10. Critical evaluation of the nonradiological environmental technical specifications. Volume 3. Peach Bottom Atomic Power Station Units 2 and 3

    Energy Technology Data Exchange (ETDEWEB)

    Adams, S.M.; Cunningham, P.A.; Gray, D.D.; Kumar, K.D.; Witten, A.J.

    1976-08-10

    A comprehensive study of the data collected as part of the environmental Technical Specifications program for Units 2 and 3 of the Peach Bottom Nuclear Power Plant was conducted for the Office of Regulatory Research of the U.S. Nuclear Regulatory Commission. The program included an analysis of both the hydrothermal and ecological monitoring data collected from 1967 through 1976. Specific recommendations are made for improving both the present hydrothermal and ecological monitoring programs. Hydrothermal monitoring would be improved by more complete reporting of in-plant operating parameters. In addition, the present boat surveys could be discontinued, and monitoring efforts could be directed toward expanding the present thermograph network. Ecological monitoring programs were judged to be of high quality because standardized collection techniques, consistent reporting formats, and statistical analyses were performed on all of the data and were presented in an annual report. Sampling for all trophic groups was adequate for the purposes of assessing power plant induced perturbations. Considering the extensive period of preoperational data (six years) and operational data (three years) available for analysis, consideration could be given to reducing monitoring effort after data have been collected for a period when both units are operating at full capacity. In this way, an assessment of the potential ecological impact of the Peach Bottom facility can be made under conditions of maximum plant induced perturbations.

  11. Interference with the Jaffé Method for Creatinine Following 5-Aminolevulinic Acid Administration

    Science.gov (United States)

    Quon, Harry; Grossman, Craig E.; King, Rebecca L.; Putt, Mary; Donaldson, Keri; Kricka, Larry; Finlay, Jarod; Malloy, Kelly; Cengel, Keith A.; Busch, Theresa M.

    2013-01-01

    Background The photosensitizer pro-drug 5-aminolevulinic acid (5-ALA) has been administered systemically for photodynamic therapy. Although several toxicities have been reported, nephrotoxicity has never been observed. Materials and Methods Patients with head and neck mucosal dysplasia have been treated on a phase 1 study of escalating light doses in combination with 60 mg/kg of oral 5-ALA. Serum creatinine was measured with the modified Jaffe method or an enzymatic method in the first 24 hours after 5-ALA. Interference by 5-ALA, as well as by its photosensitizing product protoporphyrin IX, was assessed. Results Among 11 subjects enrolled to date, 9 of 11 had blood chemistries collected within the first 5 hours with 7 demonstrating significant grade 3 creatinine elevations (p=0.030). There was no additional evidence of compromised renal function or increased PDT-induced mucositis. Creatinine levels measured by the Jaffe assay increased linearly as a function of the ex-vivo addition of ALA (p<.0001). The exogenous addition of PpIX did not alter creatinine levels. ALA did not interfere with creatinine levels as measured by an enzymatic assay. A total of 4 of the 11 subjects had creatinine levels prospectively measured by both the Jaffe and the enzymatic assays. Only the Jaffe method demonstrated significant elevations as a function of time after ALA administration. Conclusions The transient increase in creatinine after systematic ALA can be attributed, in part, if not entirely, to interference of ALA in the Jaffe reaction. Alternative assays should be employed in situations calling for monitoring of kidney function after systemic ALA. PMID:21112550

  12. Critical evaluation of the nonradiological environmental technical specifications. Volume 4. San Onofre Nuclear Generating Station, Unit 1

    Energy Technology Data Exchange (ETDEWEB)

    Adams, S.M.; Cunningham, P.A.; Gray, D.D.; Kumar, K.D.

    1976-08-10

    A comprehensive study of the data collected as part of the environmental Technical Specifications program for Unit 1 of the San Onofre Nuclear Generating Station (SONGS 1) was conducted for the Office of Nuclear Regulatory Research of the U.S. Nuclear Regulatory Commission. The program included an analysis of the hydrothermal and ecological monitoring data collected during 1975. The hydrothermal analysis includes a discussion of models used in plume predictions prior to plant operation and an evaluation of the present hydrothermal monitoring program. The ecological evaluation was directed toward reviewing the strengths and weaknesses of the various sampling programs designed to monitor the planktonic, benthic, and nektonic communities inhabiting the inshore coastal area in the vicinity of San Onofre.

  13. Changes of serum amylase, its isozyme fractions and amylase-creatinine clearance ratio in dogs with experimentally induced acute pancreatitis.

    Science.gov (United States)

    Akuzawa, M; Morizono, M; Nagata, K; Hayano, S; Sakamoto, H; Yasuda, N; Okamoto, K; Kawasaki, Y; Deguchi, E

    1994-04-01

    To investigate the diagnostic application of amylase to canine pancreatic diseases, serum amylase activities, its isozyme fractions and amylase-creatinine clearance ratio (ACCR) were analyzed in normal intact dogs and dogs experimentally induced acute pancreatitis. There was no statistic difference between normal male and female dogs. Amylase specific activities in pancreatic tissue extracts were more than 2,300 times higher than that in serum, and were also higher than those in other tissues; parotid and mandibular salivary glands, lung, heart, liver, spleen, duodenum, jejunum, ileum and kidney. Following the chloroform injection into the pancreatic tissue, WBC increased from 6 to 240 hr and serum glucose significantly increased at 72 and 96 hr, and no urine glucose was detected. BUN as well as serum and urine creatinine showed normal levels. ACCR increased until 96 hr without statistic significance. Serum amylase activities increased significantly after 3 hr and its isozyme was separated into 4 fractions (Amy1-Amy4) in contrast to 3 fractions (Amy2-Amy4) in intact dogs. Since this extra Amy1 seen from 1 hr increasing after 6 hr similarly to other 3 fractions, the evaluation of serum amylase and its isozyme fractions was indicated to be useful for the diagnosis of acute pancreatitis in dogs.

  14. Creatinine kinase isoenzyme-MB: A simple prognostic biomarker in patients with pulmonary embolism treated with thrombolytic therapy.

    Science.gov (United States)

    Bozbay, Mehmet; Uyarel, Huseyin; Avsar, Sahin; Oz, Ahmet; Keskin, Muhammed; Tanik, Veysel Ozan; Bakhshaliyev, Nijat; Ugur, Murat; Pehlivanoglu, Seckin; Eren, Mehmet

    2015-12-01

    Creatinine kinase isoenzyme-MB (CK-MB) is a biomarker for detecting myocardial injury. The aim of this study was to evaluate the association between admission CK-MB levels and in-hospital and long-term clinical outcomes in pulmonary embolism (PE) patients treated with thrombolytic tissue-plasminogen activator. A total of 148 acute PE patients treated with tissue-plasminogen activator enrolled in the study. The study population was divided into 2 tertiles, based on admission CK-MB levels. The high CK-MB group (n=35) was defined as having a CK-MB level in the third tertile (>31.5 U/L), and the low group (n=113) was defined as having a level in the lower 2 tertiles (≤31.5 U/L). High CK-MB group had a higher incidence of in-hospital mortality (37.1% vs 1.7%, PMB group. In the receiver-operating characteristic curve analysis, a CK-MB value of more than 31.5 U/L yielded a sensitivity of 86.7% and specificity of 83.5% for predicting in-hospital mortality. During long-term follow-up, recurrent PE, major and minor bleeding, and mortality rates were similar in both groups. Creatinine kinase isoenzyme-MB is a simple, widely available, and useful biomarker for predicting adverse in-hospital clinical outcomes in PE. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Beam specific planning target volumes incorporating 4DCT for pencil beam scanning proton therapy of thoracic tumors

    CERN Document Server

    Lin, Liyong; Huang, Sheng; Mayer, Rulon; Thomas, Andrew; Solberg, Timothy D; McDonough, James E; Simone, Charles B

    2015-01-01

    The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties and patient setup variations. Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4DCT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4DCT phases, using +-3% uncertainty in stopping power, and +-3 mm uncertainty in patient setup in each direction were used to create 8X12X10=960 PBS plans for the evaluation of ten patients. Plans were normalized to provide identical coverage between DS and PBS. The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and...

  16. 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.

  17. Effect of glucagon infusion on the renal clearance of amylase relative to creatinine.

    Science.gov (United States)

    Tedesco, F J; Davila, E; Gardner, L B

    1978-10-01

    Recent data seem to support a tubular defect as the mechanism of the elevated renal clearance of amylase relative to creatinine in acute pancreatitis. Glucagon has been proposed by some to be an important factor in this phenomenon. To examine the role of glucagon as this "tubular dysfunction factor", we investigated the effect of intravenously infused glucagon on the fractional excretion of amylase and the tubular handling of a low molecular weight protein, beta2 microglobulin, in normal, healthy volunteers. At glucagon levels far in excess of those seen in pancreatitis, the clearance ratio of beta2 microglobulin relative to creatinine increased, whereas the clearance ratio of amylase relative to creatinine did not increase above the normal range. The dissociation between beta2 microglobulin clearance and amylase clearance allows one to question the theory that tubular dysfunction is the mechanism of the elevated renal clearance of amylase relative to creatinine in acute pancreatitis. Glucagon does not appear to be the sole factor responsible for the elevation of renal clearance of amylase relative to creatinine in acute pancreatitis.

  18. Amylase:creatinine clearance ratios, serum amylase, and lipase after operations with cardiopulmonary bypass.

    Science.gov (United States)

    Smith, C R; Schwartz, S I

    1983-09-01

    Forty-two adults who underwent cardiac operations were studied prospectively for evidence of clinical or subclinical pancreatitis. Clinically detectable pancreatitis was not seen. Serum amylase and lipase levels did not change significantly following operation. The amylase:creatinine clearance ratio (ACCR) immediately following operation was abnormally elevated in 31% of the samples obtained, and the mean ACCR increased from 2.08 +/- 1.85% before operation to 6.2% +/- 6.77% (P less than 0.05). An abnormally elevated ACCR was most often associated with a low urine creatinine concentration. The mean urine creatinine level decreased significantly from 78 +/- 53 mg/dl before operation to 38 +/- 49 mg/dl immediately following operation (P less than 0.02), and 73% of the samples obtained at that time had an abnormally low urine creatinine level (P less than 0.01). The abnormalities observed in ACCR and urine creatinine could not be related to any of several variables presumed to reflect the degree of perioperative physiologic stress, nor could they be related to postoperative hemodynamic performance. It was concluded that ACCR rises following cardiac operation because of perioperative changes in renal function, and not as a reflection of subclinical pancreatic injury.

  19. Two low-cost digital camera-based platforms for quantitative creatinine analysis in urine.

    Science.gov (United States)

    Debus, Bruno; Kirsanov, Dmitry; Yaroshenko, Irina; Sidorova, Alla; Piven, Alena; Legin, Andrey

    2015-10-01

    In clinical analysis creatinine is a routine biomarker for the assessment of renal and muscular dysfunctions. Although several techniques have been proposed for a fast and accurate quantification of creatinine in human serum or urine, most of them require expensive or complex apparatus, advanced sample preparation or skilled operators. To circumvent these issues, we propose two home-made platforms based on a CD Spectroscope (CDS) and Computer Screen Photo-assisted Technique (CSPT) for the rapid assessment of creatinine level in human urine. Both systems display a linear range (r(2) = 0.9967 and 0.9972, respectively) from 160 μmol L(-1) to 1.6 mmol L(-1) for standard creatinine solutions (n = 15) with respective detection limits of 89 μmol L(-1) and 111 μmol L(-1). Good repeatability was observed for intra-day (1.7-2.9%) and inter-day (3.6-6.5%) measurements evaluated on three consecutive days. The performance of CDS and CSPT was also validated in real human urine samples (n = 26) using capillary electrophoresis data as reference. Corresponding Partial Least-Squares (PLS) regression models provided for mean relative errors below 10% in creatinine quantification.

  20. CREATININE DETERMINATION IN URINE BY LIQUID CHROMATOGRAPHY-ELECTROSPRAY IONIZATION-TANDEM MASS SPECTROMETRY METHOD.

    Science.gov (United States)

    Dereziński, Paweł; Klupczyńska, Agnieszka; Sawicki, Wojciech; Kokot, Zenon J

    2016-01-01

    Creatinine determination in urine is used to estimate the completeness of the 24-h urine collection, compensation for variable diuresis and as a preliminary step in protein profiling in urine. Despite the fact that a wide range of methods of measuring creatinine level in biofluids has been developed, many of them are adversely affected by interfering substances. A new liquid chromatography-tandem mass spectrometry method for creatinine determination in urine has been developed. Chromatographic separation was performed by applying C18 column and a gradient elution. Analyses were carried out on a triple quadrupole mass spectrometer equipped with an electrospray ion source. The developed method was fully validated according to the international guidelines. The quantification range of the method was 5-1500 ng/mL, which corresponds to 1-300 mg/dL in urine. Limit of detection and quantitation were 2 and 5 ng/mL, respectively. Additionally, the comparison of creatinine determination by newly developed method to the colorimetric method was performed. The method enables the determination of creatinine in urine samples with a minimal sample preparation, excellent sensitivity and prominent selectivity. Since mass spectrometry allows to measure a number of compounds simultaneously, a future perspective would be to incorporate the determination of other clinically important compounds excreted in urine.

  1. Plasma exogenous creatinine clearance in clinically healthy cats: comparison with urinary exogenous creatinine clearance, tentative reference intervals and indexation to bodyweight.

    Science.gov (United States)

    Reynolds, B S; Massal, M R; Nguyen, P; Grégoire, L L; Périgaud, A E; Concordet, D; Biourge, V; Lefebvre, H P

    2014-10-01

    Glomerular filtration rate (GFR) is considered to be the best indicator of overall kidney function. The major objectives of this study were to compare plasma exogenous creatinine clearance (PECC) with a reference method, to establish reference intervals (RIs) for PECC and to assess the effects of indexation of GFR to bodyweight (BW) in cats. PECC was compared with urinary clearance of exogenous creatinine (UECC) in six clinically healthy domestic shorthair cats (experiment 1). Tentative RIs were determined according to current guidelines and the effects of indexation to BW and of covariables on GFR were assessed in 43 clinically healthy cats of various breeds (experiment 2). PECC was 15% higher than UECC (P cats would not standardize the GFR value, but could introduce bias in clinical interpretation. Significant effects of breed, plasma protein concentration and plasma albumin concentration on GFR were demonstrated. Plasma concentrations of urea and creatinine, when assessed separately, were also weakly correlated with GFR in healthy cats. These combined findings contribute to a better understanding of renal function assessment in cats.

  2. Beam-specific planning target volumes incorporating 4D CT for pencil beam scanning proton therapy of thoracic tumors.

    Science.gov (United States)

    Lin, Liyong; Kang, Minglei; Huang, Sheng; Mayer, Rulon; Thomas, Andrew; Solberg, Timothy D; McDonough, James E; Simone, Charles B

    2015-11-08

    The purpose of this study is to determine whether organ sparing and target coverage can be simultaneously maintained for pencil beam scanning (PBS) proton therapy treatment of thoracic tumors in the presence of motion, stopping power uncertainties, and patient setup variations. Ten consecutive patients that were previously treated with proton therapy to 66.6/1.8 Gy (RBE) using double scattering (DS) were replanned with PBS. Minimum and maximum intensity images from 4D CT were used to introduce flexible smearing in the determination of the beam specific PTV (BSPTV). Datasets from eight 4D CT phases, using ± 3% uncertainty in stopping power and ± 3 mm uncertainty in patient setup in each direction, were used to create 8 × 12 × 10 = 960 PBS plans for the evaluation of 10 patients. Plans were normalized to provide identical coverage between DS and PBS. The average lung V20, V5, and mean doses were reduced from 29.0%, 35.0%, and 16.4 Gy with DS to 24.6%, 30.6%, and 14.1 Gy with PBS, respectively. The average heart V30 and V45 were reduced from 10.4% and 7.5% in DS to 8.1% and 5.4% for PBS, respectively. Furthermore, the maximum spinal cord, esophagus, and heart doses were decreased from 37.1 Gy, 71.7 Gy, and 69.2 Gy with DS to 31.3 Gy, 67.9 Gy, and 64.6 Gy with PBS. The conformity index (CI), homogeneity index (HI), and global maximal dose were improved from 3.2, 0.08, 77.4 Gy with DS to 2.8, 0.04, and 72.1 Gy with PBS. All differences are statistically significant, with p-values <0.05, with the exception of the heart V45 (p = 0.146). PBS with BSPTV achieves better organ sparing and improves target coverage using a repainting method for the treatment of thoracic tumors. Incorporating motion-related uncertainties is essential.

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

    Science.gov (United States)

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

    1976-11-01

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

  4. Longitudinal Assessment of Serum Creatinine Levels on Graft Survival After Renal Transplantation: Joint Modeling Approach

    Directory of Open Access Journals (Sweden)

    Maraghi

    2016-06-01

    Full Text Available Background Chronic kidney disease (CKD is a major public health problem. The eventual outcome of CKD is end-stage renal disease (ESRD. Early diagnosis and proper management play an important role in preventing CKD progression to ESRD. Dialysis and kidney transplantation are the only treatment options available for patients suffering from ESRD. Objectives This study was designed to investigate the etiological role of recipient and donor characteristics on serum creatinine changes within the follow-up period, graft failure risk, and the impact of longitudinal serum creatinine levels on graft survival after renal transplantation. Patients and Methods This study was carried out at the department of nephrology, Baqiyatallah hospital, Baqiyatallah University, Tehran, Iran, between April 2005 and December 2008. During that time period, 461 patients who had undergone renal transplantation were entered in the current study. Time to graft loss and serum creatinine levels at each visit were the primary data gathered for the study. A joint modeling of survival and longitudinal nonsurvival data was used to assess the association between the two processes and investigate the influential factors. Results Median follow-up time was 6.80 months. A linear decreasing trend in serum creatinine level over time was found (P < 0.001. The results showed a positive correlation between serum creatinine levels and risk of graft failure (P < 0.001. Conclusions The major finding of this study is that one unit increase in serum creatinine level suggests an increased risk of graft failure of up to four times.

  5. The effects of body mass index on changes in prostate-specific antigen levels and prostate volume over 15 years of follow-up: implications for prostate cancer detection.

    Science.gov (United States)

    Wallner, Lauren P; Morgenstern, Hal; McGree, Michaela E; Jacobson, Debra J; St Sauver, Jennifer L; Jacobsen, Steven J; Sarma, Aruna V

    2011-03-01

    To investigate the association of body mass index (BMI) and BMI change with change in prostate-specific antigen (PSA) level and to assess the possible roles of PSA hemodilution and prostate volume in explaining the obesity and PSA association. In 1990, a randomly selected cohort of Caucasian men, aged 40 to 79 years, from Olmsted County, Minnesota, completed questionnaires ascertaining demographic characteristics, current medical conditions, and medications biennially, with a subset undergoing blood draws and clinical examinations. Linear mixed models were used to predict annual changes and intercepts of individual changes in BMI, PSA, prostate volume, plasma volume, and PSA mass, adjusting for age in 545 men with at least 2 serial PSA, BMI, and prostate volume measurements. Baseline BMI was inversely associated with the annual percent change in PSA, adjusting for age, baseline PSA, and prostate volume and for the rates of change in BMI and prostate volume (β=-0.003, 95% CI: -0.006 to -0.0003). Baseline obesity was positively associated with mean baseline levels and the rate of change in prostate volume (P=0.002) and plasma volume (both Pobesity was associated with baseline PSA and prostate volume and with the rate of change in PSA over 15 years of follow-up. The inverse association of obesity with prostate cancer diagnosis may be at least partly due to detection bias, which is due to larger prostate volumes and PSA hemodilution in obese men. ©2011 AACR.

  6. Gambaran Kadar Troponin T dan Creatinin Kinase Myocardial Band pada Infark Miokard Akut

    Directory of Open Access Journals (Sweden)

    Rendi Dwi Prasetyo

    2014-09-01

    Full Text Available AbstrakInfark Miokard Akut (IMA adalah kematian sel miokardium akibat terlepasnya plak aterosklerotik dari salah satu arteri koroner yang mencetuskan terjadinya agregasi trombosit, pembentukan trombus, dan spasme koroner. Diagnosis IMA dapat dilakukan dengan cara: anamnesis, abnormalitas Elektrokardiogram (EKG, peningkatan Creatinin Kinase Myocardial Band (CKMB, dan cardiac specific troponin (cTnT. Diagnosis IMA dapat ditegakkan jika terdapat minimal dua dari tiga kriteria yang harus dipenuhi, yaitu: anamnesis, abnormalitas EKG, dan peningkatan aktivitas enzim jantung. Tujuan penelitian ini adalah untuk mengetahui gambaran kadar troponin T dan CKMB pada pasien IMA di RS. Dr. M. Djamil Padang periode 1 Januari 2012 - 31 Desember 2012. Penelitian dilakukan secara retrospektif deskriptif terhadap 54 sampel rekam medik pasien IMA yang dirawat inap di bagian penyakit dalam dan jantung RS. Dr. M. Djamil Padang periode 1 Januari 2012 - 31 Desember 2012. Kadar troponin T diperiksa dengan metode chemiluminescent dan CKMB diperiksa dengan metode enzymatic immunoassay with serum start. Hasil penelitian ini menunjukkan umur terbanyak pasien IMA adalah 40-60 tahun berjumlah 30 orang (55,56%. Jenis kelamin terbanyak pasien IMA adalah laki-laki berjumlah 39 orang (72,22%. Pasien IMA yang memiliki kadar CKMB ≥24 U/L berjumlah 35 orang (64,82%. Pasien IMA yang memiliki kadar troponin T ≥0,1 ng/mL berjumlah 44 orang (81,48%. Didapatkan peningkatan kadar troponin T dan CKMB pada pasien IMA.Kata kunci: infark miokard akut, troponin t, CKMBAbstractAcute Myocardial Infarction (AMI is a muscle necrosis of the heart caused by rupture atherosclerotic plaque from one of coronary artery that cause platelet aggregation, thrombus formation, and coronary spasm. Diagnosis of AMI can be made by some way : anamnesis, electrocardiogram (ECG abnormalities, increase levels of creatinine kinase myocardial band (CKMB and cardiac specific troponin (cTnT. Diagnosis of AMI can be

  7. Sensitivity of Total Protein Creatinine Ratio in Urine for Diagnosis Diabetic Nephropathy

    OpenAIRE

    Fatrinawati, .; Windarwati; Sianipar, Osman

    2017-01-01

    ABSTRACTDiabetic nephropathy is one of diabetic complication characterized by proteinuria and impaired renal function. Confirmation of diagnosis based either on urine value of albumin excretion rate (AER) 30-300 mg/24 hours or albumin creatinine ratio (ACR) 30-300 mg/g or total protein creatinine ratio (TPCR) 150-500 mg/g. It is reported that TPCR measurement is more acceptable since it is convenient, fast and does not require special preparation. The aim of this study is to investigate the a...

  8. Raman spectroscopic approach to monitor the in vitro cyclization of creatine → creatinine

    Science.gov (United States)

    Gangopadhyay, Debraj; Sharma, Poornima; Singh, Sachin Kumar; Singh, Pushkar; Tarcea, Nicolae; Deckert, Volker; Popp, Jürgen; Singh, Ranjan K.

    2015-01-01

    The creatine → creatinine cyclization, an important metabolic phenomenon has been initiated in vitro at acidic pH and studied through Raman spectroscopic and DFT approach. The equilibrium composition of neutral, zwitterionic and protonated microspecies of creatine has been monitored with time as the reaction proceeds. Time series Raman spectra show clear signature of creatinine formation at pH 3 after ∼240 min at room temperature and reaction is faster at higher temperature. The spectra at pH 1 and pH 5 do not show such signature up to 270 min implying faster reaction rate at pH 3.

  9. Previous Creatinine Levels Safely Predict Amantadine Dose for Influenza a Outbreak Control

    Directory of Open Access Journals (Sweden)

    Jane A Buxton

    2001-01-01

    Full Text Available BACKGROUND: Amantadine, an antiviral agent, is the only drug currently approved in Canada for prophylaxis of influenza A virus infection. To minimize side effects, the amantadine dose is adjusted for age and estimated creatinine clearance (CrCl based on plasma creatinine (Cr levels. As amantadine is used more frequently for influenza A outbreak control in care facilities for elderly people, physicians are increasingly called on to prescribe it for residents and to consider the necessity of requesting plasma Cr levels.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  11. Creatinine clearance as predictor of tobramycin elimination in adult patients with cystic fibrosis

    NARCIS (Netherlands)

    Touw, D.J.; Vinks, A.A.T.M.M.; Jacobs, F.; Heijerman, H.G.M.; Bakker, Wim

    1996-01-01

    Assessment of renal function and relating this parameter to aminoglycoside clearance is important for an appropriate individualization of dosage regimens in patients with impaired renal function. However, it has been suggested that in cystic fibrosis (CF), creatinine clearance (CrCl) is not a good p

  12. Plasma creatinine in dogs: intra- and inter-laboratory variation in 10 European veterinary laborat

    NARCIS (Netherlands)

    Mrs. Ulleberg, T.; Robben, J.H.|info:eu-repo/dai/nl/266740790; Nordahl, K.; Mr. Ulleberg, T.; Heiene, R.

    2011-01-01

    Abstract BACKGROUND: There is substantial variation in reported reference intervals for canine plasma creatinine among veterinary laboratories, thereby influencing the clinical assessment of analytical results. The aims of the study was to determine the inter- and intra-laboratory variation in

  13. Cystatin C versus Creatinine in Determining Risk Based on Kidney Function

    NARCIS (Netherlands)

    Shlipak, Michael G.; Matsushita, Kunihiro; Arnlov, Johan; Inker, Lesley A.; Katz, Ronit; Polkinghorne, Kevan R.; Rothenbacher, Dietrich; Sarnak, Mark J.; Astor, Brad C.; Coresh, Josef; Levey, Andrew S.; Gansevoort, Ron T.

    2013-01-01

    BACKGROUND Adding the measurement of cystatin C to that of serum creatinine to determine the estimated glomerular filtration rate (eGFR) improves accuracy, but the effect on detection, staging, and risk classification of chronic kidney disease across diverse populations has not been determined. METH

  14. Chronic kidney disease : Defining clinical cut-offs for albumin:creatinine ratio

    NARCIS (Netherlands)

    Bakker, Stephan J L

    2013-01-01

    Albuminuria is rapidly gaining recognition as a marker of the presence and of the progression of chronic kidney disease (CKD). In a new study, Naresh et al. attempt to define cut-off values for percentage change in urinary albumin:creatinine ratio that reflect changes in CKD status rather than

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Spectroscopic and structural study of the newly synthesized heteroligand complex of copper with creatinine and urea

    Science.gov (United States)

    Gangopadhyay, Debraj; Singh, Sachin Kumar; Sharma, Poornima; Mishra, Hirdyesh; Unnikrishnan, V. K.; Singh, Bachcha; Singh, Ranjan K.

    2016-02-01

    Study of copper complex of creatinine and urea is very important in life science and medicine. In this paper, spectroscopic and structural study of a newly synthesized heteroligand complex of copper with creatinine and urea has been discussed. Structural studies have been carried out using DFT calculations and spectroscopic analyses were carried out by FT-IR, Raman, UV-vis absorption and fluorescence techniques. The copper complex of creatinine and the heteroligand complex were found to have much increased water solubility as compared to pure creatinine. The analysis of FT-IR and Raman spectra helps to understand the coordination properties of the two ligands and to determine the probable structure of the heteroligand complex. The LIBS spectra of the heteroligand complex reveal that the complex is free from other metal impurities. UV-visible absorption spectra and the fluorescence emission spectra of the aqueous solution of Cu-Crn-urea heteroligand complex at different solute concentrations have been analyzed and the complex is found to be rigid and stable in its monomeric form at very low concentrations.

  18. Association Between the Proportion of Sclerotic Glomeruli and Serum Creatinine in Primary Focal Segmental Glomerulosclerosis

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    Ashraf FAKHRJOU

    2012-05-01

    Full Text Available Objective: To evaluate the possible correlation between the extent of sclerotic glomeruli and the level of serum creatinine and its clearance rate in patients with primary focal segmental glomerolusclerosis.Material and Method: In a cross-sectional study, 50 patients with biopsy-proven primary focal segmental glomerolusclerosis were recruited. The proportion of globally and segmentally sclerosed glomeruli was determined during the first histopathological examination of renal biopsy specimens. Correlations of these variables with on admission serum level of creatinine and its clearance rate were investigated.Results: Twenty-four males and 26 females with a mean age of 39.82±16.45 (range: 16-85 years were enrolled in the study. In a significant fashion, the proportions of segmental and global glomerulosclerosis were directly correlated with the serum level of creatinine and inversely with its clearance rate (r=-0.43 with p=0.002 and r=-0.45 with p=0.001, respectively.Conclusion: Apart from the degree of interstitial fibrosis, the serum level of creatinine and its clearance rate are well correlated with the proportions of both segmentally and globally sclerosed glomeruli in primary focal segmental glomerulosclerosis.

  19. Renal failure in a patient with postpolio syndrome and a normal creatinine level.

    Science.gov (United States)

    Leming, Melissa K; Breyer, Michael J

    2012-01-01

    Patients with renal failure who are taking trimethoprim have an increased risk of developing hyperkalemia, which can cause muscle weakness. In patients with postpolio syndrome, a normal creatinine level could be abnormally high, renal failure is possible because of lack of creatinine production, and the muscle weakness from resultant hyperkalemia could be more severe because of their underlying condition. This abnormally high creatinine level has been termed from this point relative renal failure. The objective of the study was to review a case in which relative renal failure and hyperkalemia caused muscle weakness that manifested as shortness of breath and confusion with electrocardiographic changes. A dehydrated patient with relative renal failure and postpolio syndrome had taken trimethoprim-sulfamethoxazole that caused symptomatic hyperkalemia. The patient presented with muscle weakness, shortness of breath, and confusion, with her postpolio syndrome compounding the situation and likely making the muscle weakness more severe. A patient on trimethoprim with renal failure is at an increased risk of developing hyperkalemia. Patients with postpolio syndrome could have severe muscle weakness from the hyperkalemia and could have renal failure even with a normal creatinine level. This case report will remind treating physicians to evaluate such patients for hyperkalemia if they present with muscle weakness, especially if the patient has renal failure and is on trimethoprim.

  20. Chronic kidney disease : Defining clinical cut-offs for albumin:creatinine ratio

    NARCIS (Netherlands)

    Bakker, Stephan J L

    2013-01-01

    Albuminuria is rapidly gaining recognition as a marker of the presence and of the progression of chronic kidney disease (CKD). In a new study, Naresh et al. attempt to define cut-off values for percentage change in urinary albumin:creatinine ratio that reflect changes in CKD status rather than rando

  1. Plasma creatinine in dogs: intra- and inter-laboratory variation in 10 European veterinary laborat

    NARCIS (Netherlands)

    Mrs. Ulleberg, T.; Robben, J.H.; Nordahl, K.; Mr. Ulleberg, T.; Heiene, R.

    2011-01-01

    Abstract BACKGROUND: There is substantial variation in reported reference intervals for canine plasma creatinine among veterinary laboratories, thereby influencing the clinical assessment of analytical results. The aims of the study was to determine the inter- and intra-laboratory variation in plasm

  2. Difficulties in diagnosing acute kidney injury post liver transplantation using serum creatinine based diagnostic criteria

    Institute of Scientific and Technical Information of China (English)

    Banwari; Agarwal; Andrew; Davenport

    2014-01-01

    Renal function in patients with advanced cirrhosis is an important prognostic factor for survival both prior to and following liver transplantation. The importance of renal function is reflected by the introduction of the model for end stage liver disease(MELD) score, which includes serum creatinine. The MELD score has been shown to predict the short term risk of death for transplant wait listed patients and is currently used by many countries to allocate liver transplants on the basis of severity of underlying illness. Changes in serum creatinine are also used to stage acute kidney injury. However prior to liver transplantation the serum creatinine typically over estimates underlying renal function, particularly when a colorimetric Jaffe based assay is used, and paradoxically then under estimates renal function post liver transplantation, particularly when immunophyllins are started early as part of transplant immunosuppression. As acute kidney injury is defined by changes in serum creatinine, this potentially leads to over estimation of the incidence and severity of acute kidney injury in the immediate post-operative period.

  3. Creatinine Ratios in Dogs with Pituitary-Dependent Hypercortisolism during Trilostane Treatment

    NARCIS (Netherlands)

    Galac, S.; Buijtels, J.J.C.W.M.; Kooistra, H.S.

    2009-01-01

    J Vet Intern Med. 2009 Nov-Dec;23(6):1214-9. Epub 2009 Aug 26. Urinary Corticoid : Creatinine Ratios in Dogs with Pituitary-Dependent Hypercortisolism during Trilostane Treatment. Galac S, Buijtels JJ, Kooistra HS. Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine,

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

    Energy Technology Data Exchange (ETDEWEB)

    Thomsen, Henrik S. [Copenhagen University Hospital, Herlev (Denmark). Department of Diagnostic Radiology; Morcos, Sameh K. [Northern General Hospital, Department of Diagnostic Imaging, Sheffield Teaching Hospitals NHS Trust, Sheffield (United Kingdom)

    2005-04-01

    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.)

  5. β2-microglobulin, cystatin C, and creatinine and risk of symptomatic peripheral artery disease

    NARCIS (Netherlands)

    Joosten, Michel M.; Pai, Jennifer K.; Bertoia, Monica L.; Gansevoort, Ron T.; Bakker, Stephan J. L.; Cooke, John P.; Rimm, Eric B.; Mukamal, Kenneth J.

    2014-01-01

    BACKGROUND: β2-Microglobulin and cystatin C may have advantages over creatinine in assessing risk associated with kidney function. We therefore investigated whether emerging filtration markers, β2-microglobulin and cystatin C, are prospectively associated with risk of the development of peripheral a

  6. Towards a Rational Design of Zeolite-Polymer Composite Nanofibers for Efficient Adsorption of Creatinine

    Directory of Open Access Journals (Sweden)

    Ryo Takai

    2016-01-01

    Full Text Available This report describes the compositional and structural design strategy of a zeolite-polymer composite nanofiber mesh for the efficient removal of uremic toxins towards blood purification application. The nanofiber is fabricated by electrospinning composite solution of biocompatible poly(ethylene-co-vinyl alcohol (EVOH and zeolite particles which are capable of selectively adsorbing uremic toxins such as creatinine. By controlling electrospinning conditions carefully, the incorporated zeolites in EVOH were found to correspond closely to the feed ratios. Elemental mapping images of Si show that zeolites were uniformly blended within the fibers. The fabricated composite fibers successfully adsorbed creatinine from solution and the adsorption capacity reached a maximum at 12 h. The crystallinity of the nanofiber was also controlled by varying the composition of ethylene content in EVOH. Less crystallinity resulted in higher creatinine adsorption capacity due to the barrier property of EVOH. Cytotoxicity assay demonstrated that the composite fibers showed less toxicity than free zeolite particles which killed more than 95% of cells. The proposed composite fibers, therefore, have the potential to be utilized as a new approach to removing creatinine selectively from the bloodstream.

  7. Spectroscopic and structural study of the newly synthesized heteroligand complex of copper with creatinine and urea.

    Science.gov (United States)

    Gangopadhyay, Debraj; Singh, Sachin Kumar; Sharma, Poornima; Mishra, Hirdyesh; Unnikrishnan, V K; Singh, Bachcha; Singh, Ranjan K

    2016-02-05

    Study of copper complex of creatinine and urea is very important in life science and medicine. In this paper, spectroscopic and structural study of a newly synthesized heteroligand complex of copper with creatinine and urea has been discussed. Structural studies have been carried out using DFT calculations and spectroscopic analyses were carried out by FT-IR, Raman, UV-vis absorption and fluorescence techniques. The copper complex of creatinine and the heteroligand complex were found to have much increased water solubility as compared to pure creatinine. The analysis of FT-IR and Raman spectra helps to understand the coordination properties of the two ligands and to determine the probable structure of the heteroligand complex. The LIBS spectra of the heteroligand complex reveal that the complex is free from other metal impurities. UV-visible absorption spectra and the fluorescence emission spectra of the aqueous solution of Cu-Crn-urea heteroligand complex at different solute concentrations have been analyzed and the complex is found to be rigid and stable in its monomeric form at very low concentrations.

  8. Urine albumin to creatinine ratio: A marker of early endothelial dysfunction in youth

    Science.gov (United States)

    The urine albumin-to-creatinine ratio (UACR) is a useful predictor of cardiovascular (CV) events in adults. Its relationship to vascular function in children is not clear. We investigated whether UACR was related to insulin resistance and endothelial function, a marker of subclinical atherosclerosis...

  9. Urinary NOx:creatinine ratios during gluten challenge in children with celiac disease.

    NARCIS (Netherlands)

    Koster-Kamphuis, L.; Straaten, E.A. van; Kors, W.A.; Schrijver, J.E. de; Bovee-Oudenhoven, I.M.; Meer, R. van der; Forget, P.P.

    2003-01-01

    OBJECTIVES: Celiac disease is a gluten-induced small bowel enteropathy. Inflammation is known to be associated with enhanced nitric oxide (NO) production. An increase in urinary nitrate and nitrite (NOx) reflects increased NO production. The urinary NOx:creatinine ratio can be used as an indicator

  10. Assessment of Plasma Electrolytes, Urea and Creatinine of Patients for Adenotonsillectomy

    Directory of Open Access Journals (Sweden)

    Paul Oserhemhen Adobamen

    2014-04-01

    Conclusion: Electrolytes, urea, and creatinine derangement; especially hyponatremia, exists in patients admitted for adenotonsillectomy, mainly due to their inability to feed properly. These electrolytes should be assessed and corrected before surgery, to avoid fatal complications. [Arch Clin Exp Surg 2014; 3(2.000: 73-77

  11. Genome Sequence of Creatinine-Fermenting Tissierella creatinophila Strain KRE 4T (DSM 6911)

    Science.gov (United States)

    Nacke, Heiko; Daniel, Rolf

    2017-01-01

    ABSTRACT Tissierella creatinophila strain KRE 4T (DSM 6911) is a strictly anaerobic, creatinine-fermenting, and creatine-fermenting organism, which has been isolated from sewage sludge. The draft genome consists of one circular chromosome (2.5 Mb) and harbors 2,533 predicted protein-encoding genes. PMID:28336595

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

    Science.gov (United States)

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

    2015-01-01

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

  13. Evaluation of the Nova StatSensor® Xpress(TM) Creatinine point-of-care handheld analyzer.

    Science.gov (United States)

    Kosack, Cara Simone; de Kieviet, Wim; Bayrak, Kubra; Milovic, Anastacija; Page, Anne Laure

    2015-01-01

    Creatinine is a parameter that is required to monitor renal function and is important to follow in patients under treatment with potentially toxic renal drugs, such as the anti-HIV drug Tenofovir. A point of care instrument to measure creatinine would be useful for patients monitoring in resource-limited settings, where more instruments that are sophisticated are not available. The StatSensor Xpress Creatinine (Nova Biomedical Cooperation, Waltham, MA, USA) point of care analyzer was evaluated for its diagnostic performance in indicating drug therapy change. Creatinine was measured in parallel using the Nova StatSensor Xpress Creatinine analyzer and the Vitros 5,1FS (Ortho Clinical Diagnostics, Inc, Rochester, USA), which served as reference standard. The precision (i.e., repeatability and reproducibility) and accuracy of the StatSensor Xpress Creatinine analyzer were calculated using a panel of specimens with normal, low pathological and high pathological values. Two different Nova StatSensor Xpress Creatinine analyzers were used for the assessment of accuracy using repeated measurements. The coefficient of variation of the StatSensor Xpress Creatinine analyzers ranged from 2.3 to 5.9% for repeatability and from 4.2 to 9.0% for between-run reproducibility. The concordance correlation agreement was good except for high values (>600 µmol/L). The Bland-Altman analysis in high pathological specimens suggests that the Nova StatSensor Xpress Creatinine test tends to underestimate high creatinine values (i.e., >600 µmol/L). The Nova StatSensor Xpress Creatinine analyzers showed acceptable to good results in terms of repeatability, inter-device reproducibility and between-run reproducibility over time using quality control reagents. The analyzer was found sufficiently accurate for detecting pathological values in patients (age >10 year) and can be used with a moderate risk of misclassification.

  14. Creatinine - urine

    Science.gov (United States)

    ... Results depend on your age and amount of lean body mass. Another way of expressing the normal ... Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative ...

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

    Science.gov (United States)

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

    2014-01-20

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

  16. Impacts of the quinazoline-based alpha1-antagonist, terazosin, and of the sulfonamide derivative, tamsulosin, on serum prostate-specific antigen and prostate volume.

    Science.gov (United States)

    Paick, Jae-Seung; Cho, Min Chul; Song, Sang Hoon; Kim, Soo Woong; Ku, Ja Hyeon

    2008-06-01

    The aim of this study was to compare the impacts of terazosin and tamsulosin, on prostate activity, i.e., serum prostate-specific antigen, total prostate volume (TPV), and transition zone volume (TZV). A total of 90 patients who presented with lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH), ranging in age from 52 to 83 yr (median 65 yr), were included in the study. Patients were given 0.2 mg tamsulosin, 2 mg terazosin, or 4 mg terazosin once daily for an average of 14 months (range, 6-56 months). Subjective (International Prostate Symptom Scores, I-PSS) and objective (maximal flow rate and post-void residual) parameters were assessed both at baseline and at treatment cessation. Serum prostate-specific antigen (PSA) levels were found to be unaffected by treatment (1.2 and 1.3 ng/mL). In total patients, multivariate analysis showed that baseline TPV was the only independent predictor of treatment-related TPV reduction. Moreover, baseline TPV > or =30 g was found to be associated with a higher likelihood of TPV reduction (odds ratio [OR], 3.939; 95% confidence interval [CI], 1.506-10.304; p=0.005), and a baseline TZV of > or =10 g was associated with a 7.1-times greater chance of TZV reduction (OR, 7.100; 95% CI, 2.428-20.763; p<0.001). The same model showed that patients on 2 mg terazosin had a 10.8-fold greater likelihood (OR, 10.770; 95% CI, 1.409-82.323; p=0.022) and that those on 4 mg terazosin had a 9.0-fold greater likelihood (OR, 9.001; 95% CI, 1.724-46.995; p=0.009) of a TZV reduction than those on 0.2 mg tamsulosin. In addition, symptoms improved regardless of prostate activity after taking alpha1-blockers. Our findings suggest that terazosin reduces TZV and demonstrate that the relief of symptoms associated with BPH may not be due to a prostate activity reduction induced by apoptosis in the prostate gland.

  17. 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…

  18. Trueness verification and traceability assessment of results from a routine chemistry system for measurement of urea and creatinine in serum

    Institute of Scientific and Technical Information of China (English)

    赵海建

    2012-01-01

    Objective To verify the trueness and assess the traceability of results from a routine chemistry system procedure for measurement of urea and creatinine in serum. Methods Series of fresh frozen patient sera,whose values of urea or creatinine were assigned by isotope dilution

  19. Creatinine-based estimation of rate of long term renal function loss in lung transplant recipients. Which method is preferable?

    NARCIS (Netherlands)

    Broekroelofs, J; Stegeman, CA; Navis, GJ; de Haan, J; van der Bij, W; de Zeeuw, D; de Jong, PE

    2000-01-01

    Background: Progressive renal function loss during long-term follow up is common after lung transplantation and close monitoring is warranted, Since changes in creatinine generation and excretion may occur after lung transplantation, the reliability of creatinine-based methods of renal function asse

  20. Application of a point of care creatinine device for trend monitoring in kidney transplant patients: Fit for purpose?

    NARCIS (Netherlands)

    Lint, C.L. van; Boog, P.J.M. van der; Romijn, F.P.H.T.M.; Schenk, P.W.; Dijk, S. van; Rövekamp, T.J.M.; Kessler, A.; Siekmann, L.; Rabelink, T.J.; Cobbaert, C.M.

    2015-01-01

    Background: The StatSensor® Xpress-i™, a point-of-care system for blood creatinine measurement, offers patients the possibility of self-monitoring creatinine. In this study, the analytical performance of the StatSensor® for both detecting current renal function and monitoring renal (dys)function in

  1. Can a partial volume edge effect reduction algorithm improve the repeatability of subject-specific finite element models of femurs obtained from CT data?

    Science.gov (United States)

    Peleg, Eran; Herblum, Ryan; Beek, Maarten; Joskowicz, Leo; Liebergall, Meir; Mosheiff, Rami; Whyne, Cari

    2014-01-01

    The reliability of patient-specific finite element (FE) modelling is dependent on the ability to provide repeatable analyses. Differences of inter-operator generated grids can produce variability in strain and stress readings at a desired location, which are magnified at the surface of the model as a result of the partial volume edge effects (PVEEs). In this study, a new approach is introduced based on an in-house developed algorithm which adjusts the location of the model's surface nodes to a consistent predefined threshold Hounsfield unit value. Three cadaveric human femora specimens were CT scanned, and surface models were created after a semi-automatic segmentation by three different experienced operators. A FE analysis was conducted for each model, with and without applying the surface-adjustment algorithm (a total of 18 models), implementing identical boundary conditions. Maximum principal strain and stress and spatial coordinates were probed at six equivalent surface nodes from the six generated models for each of the three specimens at locations commonly utilised for experimental strain guage measurement validation. A Wilcoxon signed-ranks test was conducted to determine inter-operator variability and the impact of the PVEE-adjustment algorithm. The average inter-operator difference in stress values was significantly reduced after applying the adjustment algorithm (before: 3.32 ± 4.35 MPa, after: 1.47 ± 1.77 MPa, p = 0.025). Strain values were found to be less sensitive to inter-operative variability (p = 0.286). In summary, the new approach as presented in this study may provide a means to improve the repeatability of subject-specific FE models of bone obtained from CT data.

  2. Sex-specific prediction of hypothalamic-pituitary-adrenal axis activity by pituitary volume during adolescence: a longitudinal study from 12 to 17 years of age.

    Science.gov (United States)

    Kaess, Michael; Simmons, Julian G; Whittle, Sarah; Jovev, Martina; Chanen, Andrew M; Yücel, Murat; Pantelis, Christos; Allen, Nicholas B

    2013-11-01

    To investigate the longitudinal relationship between pituitary gland volume (PGV) and parameters of hypothalamic-pituitary-adrenal axis (HPAA) functioning during adolescence. Participants were 49 adolescents (19 girls and 30 boys) selected from a larger longitudinal, population-based study of adolescent development. Assessments were conducted at three time points (S1, S2 and S3). MRI sessions were at S1 (age: M=12.62, SD=0.45 years) and S3 (M=16.48, SD=0.53 years) and multiple assessments of salivary cortisol were undertaken at S2 (M=15.51, SD=0.35 years). PGV was measured via previously validated manual tracing methods, and the cortisol awakening response (CAR) and diurnal slope (DSL) were used as indices of HPAA functioning. A significant sex-linked interaction was found for PGV at S1 predicting both CAR (p=0.025) and DSL (p=0.009) at S2. Specifically, PGV at S1 significantly predicted CAR (p=0.033) and DSL (p=0.010) in boys only, with no significant results found for girls. Neither CAR nor DSL at S2 predicted growth of PGV from S1 to S3. PGV in early adolescence predicted HPAA functioning in mid-adolescent boys but not in girls. The results suggest a significant influence of sex-specific development on the relationship between PGV and HPAA activity and reactivity. The findings have potential implications for understanding and interpreting sex-linked and stress related clinical disorders that emerge during mid-to-late adolescence. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Comments on the article by A. J. Lecloux (J Nanopart Res (2015) 17:447) regarding the use of volume-specific surface area (VSSA) to classify nanomaterials

    Science.gov (United States)

    Gibson, Neil; Rauscher, Hubert; Roebben, Gert

    2016-08-01

    In November 2015, an article by A. J. Lecloux was published in this journal (J Nanopart Res, 17:447, 2015). The article focused on the use of volume-specific surface area (VSSA) for the implementation of the European Commission's recommended definition of "nanomaterial". In that paper, VSSA values were calculated for polydisperse particulate materials using a particle number-based averaging method which do not agree with earlier results of VSSA simulations of polydisperse materials reported in 2014 by the Joint Research Centre (JRC) of the European Commission (EC). In this contribution, we explain the difference between traditional view of VSSA which was used by the JRC and the proposed model of Lecloux. Through the use of some simple examples for polydisperse materials, it is demonstrated that the latter produces values which neither correspond to the generally accepted definition of VSSA nor relate to the commonly used experimental methods for determining VSSA using gas adsorption. Lecloux's model therefore does not constitute a basis for practical implementation of the EC's definition of nanomaterial using gas adsorption techniques.

  4. Strong-Coupling Properties of a p-Wave Interacting Fermi Gas on the Viewpoint of Specific Heat at Constant Volume

    Science.gov (United States)

    Inotani, Daisuke; van Wyk, Pieter; Ohashi, Yoji

    2017-02-01

    We theoretically investigate the specific heat CV at constant volume in the normal state of a p-wave interacting Fermi gas. Including fluctuations in the p-wave Cooper channel within the framework of the strong-coupling theory developed by Nozières and Schmitt-Rink, we clarify how CV as a function of temperature varies, as one moves from the weak-coupling regime to the strong-coupling limit. In the weak-coupling regime, CV is shown to be enhanced by p-wave pairing fluctuations, near the superfluid phase transition temperature Tc. Similar enhancement of CV(T ≃ Tc) is also obtained in the strong-coupling regime, which, however, reflects that system is close an ideal Bose gas of p-wave two-body bound molecules. Using these results, we classify the normal state into (1) the normal Fermi gas regime, (2) the p-wave molecular Bose gas regime, and (3) the region between the two, where p-wave pairing fluctuations are dominant. Since the current experiments can only access the normal phase of a p-wave interacting Fermi gas, our results would be useful for experiments to understand strong-coupling properties of this Fermi system above Tc.

  5. The tumor-to-breast volume ratio (TBR) predicts cancer-specific survival in breast cancer patients who underwent modified radical mastectomy.

    Science.gov (United States)

    Wen, Jiahuai; Ye, Feng; Huang, Xiaojia; Li, Shuaijie; Yang, Lu; Xiao, Xiangsheng; Xie, Xiaoming

    2016-06-01

    Breast cancer is the most common cancer in women globally, and tumor size measured as the largest diameter of the tumor focus is currently used in tumor-lymph node-metastasis (TNM) staging for prognosis and treatment decisions. The present study utilized the tumor-to-breast volume ratio (TBR) to evaluate the relative tumor size and determined the prognostic impact of TBR on survival in patients with breast cancer. Two thousand twenty-five consecutive breast cancer patients who underwent modified radical mastectomy between January 2002 and December 2008 at Sun Yat-Sen University Cancer Center were enrolled in this retrospective study. Kaplan-Meier analysis was used to assess the prognostic effect of TBR on cancer-specific survival (CSS), and univariate log-rank test and multivariate Cox proportional hazards regression model were performed to identify independent prognostic factors. The optimal cutoff value of TBR was determined to be 1.70 %, and 1473 and 552 patients were categorized to low-TBR and high-TBR groups, respectively. In the whole patient cohort, CSS was significantly shorter in the high-TBR group (110.2 vs 128.5 months, P breast cancer patients (hazard ratio (HR) 1.489, 95 % CI 1.130-1.961, P = 0.005). High TBR was independently associated with poor prognosis in breast cancer patients. This variable may serve as a valuable parameter to predict the outcomes of breast cancer.

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

    Directory of Open Access Journals (Sweden)

    Drion Iefke

    2012-10-01

    Full Text Available Abstract 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 examined 11 pairs of commutable, value-assigned SCr specimens in the range 52–262 μmol/L, using Jaffe or enzymatic techniques. Regression equations were created for each participating laboratory (by regressing values as measured by participating laboratories on the target values of the samples sent by the external quality organization; area under the curves were examined and used to rank laboratories. The 10th and 90th percentile regression equation were selected for each technique separately. To evaluate the impact of the variability in SCr measurements and its eventual clinical consequences in a real patient population, we used a cohort of 82424 patients aged 19–106 years. The SCr measurements of these 82424 patients were introduced in the 10th and 90th percentile regression equations. The newly calculated SCr values were used to calculate an estimated glomerular filtration rate (eGFR using the 4-variable Isotope Dilution Mass Spectrometry traceable Modification of Diet in Renal Disease formula. Differences in CKD staging were examined, comparing the stratification outcomes for Jaffe and enzymatic SCr techniques. Results Jaffe techniques overestimated SCr: 21%, 12%, 10% for SCr target values 52, 73 and 94 μmol/L, respectively. For enzymatic assay these values were 0%, -1%, -2%, respectively. eGFR using the MDRD formula and SCr measured by Jaffe techniques, staged patients in a lower CKD category. Downgrading to a lower CKD stage occurred in 1-42%, 2-37% and 12–78.9% of patients for the 10th and 90th percentile laboratories respectively in CKD categories 45–60, 60–90 and >90 ml/min/1.73 m2. Using enzymatic techniques, downgrading

  7. Impact on creatinine renal clearance by the interplay of multiple renal transporters: a case study with INCB039110.

    Science.gov (United States)

    Zhang, Yan; Warren, Mark S; Zhang, Xuexiang; Diamond, Sharon; Williams, Bill; Punwani, Naresh; Huang, Jane; Huang, Yong; Yeleswaram, Swamy

    2015-04-01

    Serum creatinine is commonly used as a marker of renal function, but increases in serum creatinine might not represent changes in glomerular filtration rate (GFR). INCB039110 (2-(3-(4-(7H-pyrrolo[2,3-day]pyrimidin-4-yl)-1H-pyrazol-1-yl)-1-(1-(3-fluoro-2-(trifluoromethyl)isonicotinoyl)piperidin-4-yl)azetidin-3-yl)acetonitrile) is an inhibitor of the Janus kinases (JAKs) with selectivity for JAK1. In a phase 1 study, a modest and reversible increase in serum creatinine was observed after treatment with INCB039110. However, a dedicated renal function study with INCB039110, assessed by iohexol plasma clearance, conducted in healthy volunteers indicated no change in GFR. In vitro studies were therefore conducted to investigate the interaction of INCB039110 with five transporters that are likely involved in the renal clearance of creatinine. Cell systems expressing individual or multiple transporters were used, including a novel quintuple-transporter model OAT2/OCT2/OCT3/MATE1/MATE2-K. INCB039110 potently inhibited OCT2-mediated uptake of creatinine as well as MATE1-/MATE2-K-mediated efflux of creatinine. Given the interactions of INCB039110 with multiple transporters affecting creatinine uptake and efflux, an integrated system expressing all five transporters was sought; in that system, INCB039110 caused a dose-dependent decrease in transcellular transport of creatinine with weaker net inhibition compared with the effects on individual transporters. In summary, a molecular mechanism for the increase in serum creatinine by INCB039110 has been established. These studies also underline the limitations of using serum creatinine as a marker of renal function.

  8. Serum amylase determinations and amylase to creatinine clearance ratios in patients with chronic renal insufficiency.

    Science.gov (United States)

    Tedesco, F J; Harter, H R; Alpers, D H

    1976-10-01

    Patients with severe chronic renal failure may have significant hyperamylasemia in the absence of clinical symptoms or signs of acute pancreatitis. Amylase to creatinine clearance (CA/CC) ratios were usually elevated in patients with chronic renal failure and were not helpful in evaluating the possibility of acute pancreatitis. The mean amylase to creatinine clearance ratio for the controls with normal renal function was 1.24 +/- 0.13. In patients with chronic renal failure, it was 3.17 +/- 0.42 (P less than 0.001). Serum amylase isoenzyme patterns revealed no difference in salivary to pancreatic isoenzyme ratios between normals (1.04 +/- 0.12) and patients with severe renal insufficiency without evidence of pancreatic disease (1.07 +/- 0.13). The isoenzymes were helpful in excluding the diagnosis of pancreatic in 1 renal failure patient whose hyperamylasemia was primarily salivary in origin and in confirming the diagnosis in another who had only a pancreatic band.

  9. Trypsin/creatinine clearance ratio and serum immunoreactive trypsin in digestive and pancreatic diseases.

    Science.gov (United States)

    Del Favero, G; Fabris, C; Bonvicini, P; Piccoli, A; Baccaglini, U; Pedrazzoli, S; Burlina, A; Naccarato, R

    1985-01-01

    The behavior of trypsin/creatinine clearance ratio (Ctr/Ccr) and serum immunoreactive trypsin (IRT) was evaluated in a total of 168 subjects with pancreatic cancer, chronic pancreatitis and non-pancreatic digestive diseases. Amylase/creatinine clearance ratio (Cam/Ccr) and serum amylase levels were also evaluated in order to establish their possible relationship with Ctr/Ccr and IRT values. Elevated Ctr/Ccr and IRT values were observed in several patients with pancreatic cancer and chronic pancreatitis. Abnormal IRT and Ctr/Ccr values were found in 28.2 and 4% of non-pancreatic digestive diseases, respectively. IRT and amylase serum levels showed consensual modifications, while Ctr/Ccr showed a behavior different from that of Cam/Ccr. Liver damage seems to play a role in increasing serum IRT levels of patients without pancreatic involvement, while the increased Ctr/Ccr seems to depend on other factors, for instance renal tubular dysfunction.

  10. Reference intervals for serum cystatin C and serum creatinine in adults.

    Science.gov (United States)

    Erlandsen, E J; Randers, E; Kristensen, J H

    1998-06-01

    The aim of this study was to establish reference intervals for cerum cystatin C and serum creatinine in adults. Blood samples were collected from 270 healthy blood donors (135 men and 135 women between 20 and 65 years old with 15 men and 15 women in each five-year-interval). Serum cystatin C was analyzed using an automated particle-enhanced immunoassay (DAKO Cystatin C PET kit) on the Cobas Mira S analyzer. Serum creatinine was analyzed using the Vitros Creatinine Slide, an enzymatic method on the Vitros 950 chemistry analyzer. The calculated reference intervals for serum cystatin C were 0.62-1.15 mg/l in women (median 0.84 mg/l, range 0.56-1.29 mg/l) and 0.51-1.25 mg/l in men (median 0.87 mg/l, range 0.42-1.39 mg/l). The Mann-Whithey U-test revealed no gender-related difference for cystatin C (p = 0.48). A common reference interval in women and men was calculated to be 0.54-1.21 mg/l (median 0.85 mg/l, range 0.42-1.39 mg/l). The non-parametric reference interval for serum creatinine was 57-95 mumol/l in women (median 72 mumol/l, range 44-105 mumol/l) and 69-111 mumol/l in men (median 89 mumol/l, range 58-123 mumol/l).

  11. Amylase-creatinine clearance ratio. A simple test to predict gentamicin nephrotoxicity.

    Science.gov (United States)

    Aderka, D; Tene, M; Graff, E; Levo, Y

    1988-05-01

    The initial target of aminoglycoside nephrotoxicity is the proximal tubule. Yet, no simple test is available to predict such toxicity. Taking advantage of the fact that amylase is filtered in the glomerulus and reabsorbed by the proximal tubules, we prospectively examined in 23 patients if changes in renal amylase creatinine clearance ratio (ACCR) can predict gentamicin nephrotoxicity. Eighteen of these patients had an initial creatinine clearance (rCcr) above 30 mL/min. Eleven of them (group A) had an ACCR above 3.5% (control 3% +/- 1.03%) and all exhibited an average reduction of 32.2% +/- 11.6% in rCcr following one week of gentamicin therapy. In contrast, only one of seven patients (group B) with an initial ACCR below 3.5% had a reduction, albeit transient, in rCcr. During gentamicin therapy, group A patients had a further increase in ACCR which was proportional to the reduction observed in rCcr (r = -.54). Our preliminary data suggest that ACCR may prove a simple and possibly a reliable predictor of kidney function deterioration during gentamicin therapy in patients with rCcr above 30 mL/min: patients with pretherapy ACCR above 3.5% may exhibit a deterioration in the creatinine clearance during the first week of therapy. For patients with pretherapy renal failure (rCcr less than 30 mL/min) the creatinine levels (but not the ACCR) seem to retain their significance in predicting and monitoring further renal function deterioration during aminoglycoside therapy.

  12. Association between urinary sodium, creatinine, albumin, and long-term survival in chronic kidney disease.

    Science.gov (United States)

    McQuarrie, Emily P; Traynor, Jamie P; Taylor, Alison H; Freel, E Marie; Fox, Jonathan G; Jardine, Alan G; Mark, Patrick B

    2014-07-01

    Dietary sodium intake is associated with hypertension and cardiovascular risk in the general population. In patients with chronic kidney disease, sodium intake has been associated with progressive renal disease, but not independently of proteinuria. We studied the relationship between urinary sodium (UNa) excretion and UNa to creatinine ratio and mortality or requirement for renal replacement therapy in chronic kidney disease. Adult patients attending a renal clinic who had ≥1 24-hour UNa measurement were identified. Twenty-four-hour UNa measures were collected and UNa to creatinine ratio calculated. Time to renal replacement therapy or death was recorded. Four hundred twenty-three patients were identified with mean estimated glomerular filtration rate of 48 mL/min per 1.73 m(2). Ninety patients required renal replacement therapy and 102 patients died. Mean slope decline in estimated glomerular filtration rate was -2.8 mL/min per 1.73 m(2) per year. Median follow-up was 8.5 years. Patients who died or required renal replacement therapy had significantly higher UNa excretion and UNa to creatinine ratio, but the association with these parameters and poor outcome was not independent of renal function, age, and albuminuria. When stratified by albuminuria, UNa to creatinine ratio was a significant cumulative additional risk for mortality, even in patients with low-level albuminuria. There was no association between low UNa and risk, as observed in some studies. This study demonstrates an association between UNa excretion and mortality in chronic kidney disease, with a cumulative relationship between sodium excretion, albuminuria, and reduced survival. These data support reducing dietary sodium intake in chronic kidney disease, but additional study is required to determine the target sodium intake.

  13. The Stockholm CREAtinine Measurements (SCREAM) project: protocol overview and regional representativeness

    OpenAIRE

    Runesson, Björn; Gasparini, Alessandro; Qureshi, Abdul Rashid; Norin, Olof; Evans, Marie; Barany, Peter; Wettermark, Björn; Elinder, Carl Gustaf; Carrero, Juan Jesús

    2015-01-01

    Background 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). Methods SCREAM is a repository of laboratory data of individuals, residing or accessing healthcare in the regi...

  14. Renal Drug Dosage Adjustment According to Estimated Creatinine Clearance in Hospitalized Patients With Heart Failure.

    Science.gov (United States)

    Altunbas, Gokhan; Yazc, Mehmet; Solak, Yalcin; Gul, Enes E; Kayrak, Mehmet; Kaya, Zeynettin; Akilli, Hakan; Aribas, Alpay; Gaipov, Abduzhappar; Yazc, Raziye; Ozdemir, Kurtulus

    2016-01-01

    It is of clinical importance to determine creatinine clearance and adjust doses of prescribed drugs accordingly in patients with heart failure to prevent untoward effects. There is a scarcity of studies in the literature investigating this issue particularly in patients with heart failure, in whom many have impaired kidney function. The purpose of this study was to determine the degree of awareness of medication prescription as to creatinine clearance in patients hospitalized with heart failure. Patients hospitalized with a diagnosis of heart failure were retrospectively evaluated. Among screened charts, patients with left ventricular ejection fraction renal dose adjustment were determined and evaluated for appropriate dosing according to eGFR. A total of 388 patients with concomitant heart failure and renal dysfunction were included in the study. The total number of prescribed medications was 2808 and 48.3% (1357 medications) required renal dose adjustment. Of the 1357 medications, 12.6% (171 medications) were found to be inappropriately prescribed according to eGFR. The most common inappropriately prescribed medications were famotidine, metformin, perindopril, and ramipril. A significant portion of medications used in heart failure requires dose adjustment. Our results showed that in a typical cohort of patients with heart failure, many drugs are prescribed at inappropriately high doses according to creatinine clearance. Awareness should be increased among physicians caring for patients with heart failure to prevent adverse events related to medications.

  15. Exposure assessment approach through mycotoxin/creatinine ratio evaluation in urine by GC-MS/MS.

    Science.gov (United States)

    Rodríguez-Carrasco, Yelko; Moltó, Juan Carlos; Mañes, Jordi; Berrada, Houda

    2014-10-01

    In this pilot survey human urine samples were analyzed for presence of 15 mycotoxins and some of their metabolites using a novel urinary multi-mycotoxin GC-MS/MS method following salting-out liquid-liquid extraction. Fifty-four urine samples from children and adults residents in Valencia were analyzed for presence of urinary mycotoxin and expressed in gram of creatinine. Three out of 15 mycotoxins were detected namely, HT-2 toxin, nivalenol and deoxynivalenol (DON). 37 samples showed quantifiable values of mycotoxins. Co-occurrence of these contaminants was also observed in 20.4% of assayed samples. DON was the most frequently detected mycotoxin (68.5%) with mean levels of 23.3 μg/g creatinine (range: 2.8-69.1 μg/g creatinine). The levels of urinary DON were used to carry out an exposure assessment approach. 8.1% of total subjects were estimated to exceed the DON provisional maximum tolerable daily intake (PMTDI) (1 μg/kg b.w.). Two out of 9 exposed children exceeded the DON PMTDI thus, making them the most exposed based on the urinary results.

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

    Directory of Open Access Journals (Sweden)

    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

  17. Clinical evaluation of amylase-creatinine clearance ratio and amylase isoenzyme clearance in chronic renal failure.

    Science.gov (United States)

    Maeda, M; Otsuki, M; Okano, K; Yamasaki, T; Baba, S

    1981-01-01

    Amylase-creatinine clearance ratio (ACCR) and amylase isoenzyme clearance were determined simultaneously in patients with chronic renal failure. ACCR in patients with compensated renal failure (3.5 +/- 0.4%) was not significantly different from normals (2.6 +/- 0.2%), while that in patients with non-compensated renal failure (6.7 +/- 0.4%) was significantly higher than that in normals. Clearance ratio of pancreatic isoamylase (Amylase-1) relative to creatinine clearance (CAmy . 1/Ccr) in patients with both compensated (5.9 +/- 1.0%) and non-compensated (6.8 +/- 0.4%) renal failure was as high as that in patients with acute pancreatitis (6.6 +/- 0.5%). On the other hand, clearance ratio of salivary isoamylase (Amylase-3) relative to creatinine clearance (CAmy . 3/CCr) in patients with compensated renal failure (1.5 +/- 0.3%) was almost the same as that in normals (2.1 +/- 0.1%), while that in patients with non-compensated renal failure was 5.9 +/- 0.7%, which was significantly higher than that in normals. The present study revealed that elevated ACCR in patients with severely impaired renal function was due to the increase of the clearance ratio for both pancreatic and salivary amylase. These facts suggested that glomerular permeability and tubular reabsorption for pancreatic and salivary amylase might play an important role on ACCR in patients with severely impaired renal function.

  18. Mechanism of increased renal clearnace of amylase/creatinine in acute pancreatitis.

    Science.gov (United States)

    Johnson, S G; Ellis, C J; Levitt, M D

    1976-11-25

    We investigated three possible causes of the increased ratio of amylase/creatinine clearance observed in acute pancreatitis. The presence of rapidly cleared isoamylase was excluded by studies of serum and urine, which demonstrated no anomalous isoamylases. In pancreatitis, the ratios (+/-1 S.E.M.) of both pancreatic isoamylase (9.2+/-0.6 per cent) and salivary isoamylase (8.6+/-1.6 per cent) were significantly (P less than 0.01) elevated over respective control values (2.4+/-0.2 and 1.8+/-0.2 per cent). Increased glomerular permeability to amylase was excluded by the demonstration of normal renal clearance of dextrans. We tested tubular reabsorption of protein by measuring the renal clearance of beta2-microglobulin, which is relatively freely filtered at the glomerulus and then avidly reabsorbed by the normal tubule. During acute pancreatitis the ratio of the renal clearance of beta2-microglobulin to that of creatinine was 1.22+/-0.52 per cent, an 80-fold increase over normal (0.015+/-0.002 per cent), with a rapid return toward normal during convalescence. Presumably, this reversible renal tubular defect also reduces amylase reabsorption and accounts for the elevated renal clearance of amylase/creatinine observed in acute pancreatitis.

  19. Comparison of cyclosporine and sirolimus effects on serum creatinine level over five years after kidney transplantation.

    Science.gov (United States)

    Soleimani, A R; Kamkar, I; Nikoueinejad, H; Moraweji, A R

    2013-05-01

    Conversion from cyclosporine to sirolimus (SRL) after organ transplantation may improve renal function. The current study considers the effects of conversion during a 5-year period. Among 98 primary kidney recipients, 88 completed the study on cyclosporine (n = 59) or SRL (n = 29) treatment. Conversion to SRL was performed between 3 and 6 months post-transplantation. The serum creatinine level was tested on 1 day as well as 3, 6, 9, 12, 15, 18, 21, 24, 36, 48, and 60 months after transplantation. The data were analyzed using student t test, chi square, repeated measures, and a mixed model for multivariate analysis. The mean serum creatinine levels in the cyclosporine and SRL groups were 1.78 ± 0.68 and 1.62 ± 1.01, respectively (P = .04). Using repeated measure analysis, there was an interaction between time and the drug (P = .039). A separate comparison showed that serum creatinine levels were significantly different between the 2 groups at time points 11 and 12. Using multivariate analysis to control the possible effect of demographic or clinical features, we confirmed that conversion was the most significant explanation for the renal function improvement. Compared with cyclosporine, we observed a preference for SRL as the maintenance immunosuppressant after renal transplantation. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. New analyser for the determination of urinary vanillylmandelic acid, homovanillic acid and creatinine.

    Science.gov (United States)

    Kawaguchi, S; Hirachi, N; Fukamachi, M

    1991-06-14

    We have developed a novel analyser for the determination of vanillylmandelic acid, homovanillic acid and creatinine in urine by high-performance liquid chromatography using three different types of column, cation-exchange, anion-exchange and reversed-phase and the column-switching technique. In this procedure, 10 microliters of intact urine were directly injected into the cation-exchange column, and the pass-through fraction, containing vanillylmandelic acid and homovanillic acid was transferred to the anion-exchange column by column switching. The fraction partially purified from endogenous urinary impurities on the anion-exchange column was transferred to the reversed-phase column. Vanillylmandelic acid and homovanillic acid, separated by the solvent-switching technique, were detected fluorimetrically (excitation at 280 nm, emission at 320 nm). Then, creatinine eluted from the cation-exchange column is spectrophotometrically detected (254 nm). Therefore the successive simultaneous analysis of the three could be performed in a 15-min cycle; the within-assay coefficients of variation for normal and patients' urines were less than 1.9%, less than 3.3% and less than 3.0% for vanillylmandelic acid, homovanillic acid and creatinine, respectively; the recoveries averaged 100, 103 and 100%, respectively, for supplemented urines.

  1. 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.

  2. Urinary tubular protein-based biomarkers in the rodent model of cisplatin nephrotoxicity: a comparative analysis of serum creatinine, renal histology, and urinary KIM-1, NGAL, and NAG in the initiation, maintenance, and recovery phases of acute kidney injury.

    Science.gov (United States)

    Sinha, Vikash; Vence, Luis M; Salahudeen, Abdulla K

    2013-03-01

    Several biomarkers are becoming available for the early detection of acute kidney injury (AKI), but few have been directly compared. To compare urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and N-acetyl glucosaminidase (NAG) against serum creatinine and renal histological score in the initiation, maintenance, and recovery phases of cisplatin (CP)-induced AKI. Sprague-Dawley rats (300-350 g) were injected once through their tail veins with CP (CP group) at 5.5 mg/kg or with same volume of normal saline vehicle (Control group). Rats were euthanized at 2, 4, 6, 12, and 24 hours, and on days 2, 3, 6, and 10 (n = 12 in the CP group and n = 6 in the Control group at each time point), and urine, blood, and kidney samples were analyzed. A significant increase in serum creatinine was noted by day 3 in the CP group versus Control group [1.46 (0.12) vs 0.28 (0.03) mg/dL; mean (SE); P CP group. Urinary kidney injury molecule-1 levels were significantly higher at 24 hours in the CP group than in the Control group [48.26 (13.13) vs 8.21 (3.31) pg/mg creatinine; P CP than in the Control group [NAG, 8.19 (0.82) vs 3.48 (0.40) pg/mg creatinine, P G 0.05; NGAL, 2911.80 (368.10) vs 1412.60 (250.20) pg/mg creatinine, P CP to discern the time course and pattern of expression.

  3. Mechanical Loading Synergistically Increases Trabecular Bone Volume and Improves Mechanical Properties in the Mouse when BMP Signaling Is Specifically Ablated in Osteoblasts.

    Directory of Open Access Journals (Sweden)

    Ayaka Iura

    Full Text Available Bone homeostasis is affected by several factors, particularly mechanical loading and growth factor signaling pathways. There is overwhelming evidence to validate the importance of these signaling pathways, however, whether these signals work synergistically or independently to contribute to proper bone maintenance is poorly understood. Weight-bearing exercise increases mechanical load on the skeletal system and can improves bone quality. We previously reported that conditional knockout (cKO of Bmpr1a, which encodes one of the type 1 receptors for Bone Morphogenetic Proteins (BMPs, in an osteoblast-specific manner increased trabecular bone mass by suppressing osteoclastogenesis. The cKO bones also showed increased cortical porosity, which is expected to impair bone mechanical properties. Here, we evaluated the impact of weight-bearing exercise on the cKO bone phenotype to understand interactions between mechanical loading and BMP signaling through BMPR1A. Male mice with disruption of Bmpr1a induced at 9 weeks of age, exercised 5 days per week on a motor-driven treadmill from 11 to 16 weeks of age. Trabecular bone volume in cKO tibia was further increased by exercise, whereas exercise did not affect the trabecular bone in the control genotype group. This finding was supported by decreased levels of osteoclasts in the cKO tibiae. The cortical porosity in the cKO bones showed a marginally significant decrease with exercise and approached normal levels. Exercise increased ductility and toughness in the cKO bones. Taken together, reduction in BMPR1A signaling may sensitize osteoblasts for mechanical loading to improve bone mechanical properties.

  4. A nomogram based on age,prostate-specific antigen level,prostate volume and digital rectal examination for predicting risk of prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Ping Tang; Hui Chen; Matthew Uhlman; Yu-Rong Lin; Xiang-Rong Deng; Bin Wang; Wen-Jun Yang; Ke-Ji Xie

    2013-01-01

    Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort.In the present study,we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population.A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included.Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy.Age,prostate-specific antigen (PSA),prostate volume (PV),digital rectal examination (DRE) status,% free PSA and transrectal ultrasound (TRUS) findings were included in the analysis.A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy.A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy.The rate for positive initial prostate biopsy was 41.7% (223/535).The independent variables used to predict a positive initial prostate biopsy were age,PSA,PV and DRE status.The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%,respectively.Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram.The nomogram can be used to identify and Counsel patients who should consider a prostate biopsy,ultimately enhancing accuracy in diagnosing prostate cancer.

  5. The Effect of the Antioxidant Drug “U-74389G” on Creatinine Levels during Ischemia Reperfusion Injury in Rats

    Science.gov (United States)

    Tsompos, Constantinos; Panoulis, Constantinos; Toutouzas, Konstantinos; Zografos, George; Papalois, Apostolos

    2016-01-01

    Objective The aim of this experimental study was to examine the effect of the antioxidant drug “U-74389G” on a rat model using an ischemia reperfusion protocol. The effect of U-74389G was studied biochemically by measuring mean blood creatinine levels. Materials and Methods Forty rats were used in the study. Creatinine levels were measured at 60 min of reperfusion (groups A and C) or at 120 min of reperfusion (groups B and D), where groups A and B were controls and groups C and D received U-74389G administration. Results U-74389G administration significantly decreased the predicted creatinine levels by 21.02 ± 5.06% (p = 0.0001). Reperfusion time non-significantly increased the predicted creatinine levels by 4.20 ± 6.12% (p = 0.4103). However, U-74389G administration and reperfusion time together produced a significant combined effect in decreasing the predicted creatinine levels by 11.69 ± 3.16% (p = 0.0005). Conclusion Independent of reperfusion time, U-74389G administration significantly decreased the creatinine levels in an ischemic rat model. This study demonstrates that short-term U-74389G administration improves renal function by increasing creatinine excretion. PMID:27390579

  6. 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.

  7. Identification of a proteinaceous component in the leaf of moringa oleifera lam. with effects on high serum creatinine

    Directory of Open Access Journals (Sweden)

    S Sahoo

    2014-01-01

    Full Text Available Moringa oleifera Lam. has been an important plant in the history of mankind, both for its nutritional and medicinal uses. Apart from bactericidal effects, the parts of this plant have been effectively used in the treatment of circulatory, respiratory, endocrine, digestive as well as neural disorders. Till date, though, there has been no reported activity of the involvement of any proteinaceous extract from M. oleifera on high levels of serum creatinine. To address this issue, blood samples with high levels of serum creatinine (2 mg/dl and above were treated with leaf extract from M. oleifera. The crude extract was partially purified initially and eventually purified to completion as well. All these proteinaceous fractions were used to treat samples with high levels of serum creatinine as mentioned above. While the treatment of serum sample having high creatinine with crude extract and partially purified protein fractions showed a decrease of approximately 20% in the levels of serum creatinine over a period of 24 h, the samples treated with purified protein fraction reduced the serum creatinine level by 50%. In light of the fact that increased level of serum creatinine levels have adverse downstream effects on the heart, lungs and other organs, this communication assumes significance because it suggests a way of reducing the level of serum creatinine as an emergency measure. Further, the identification and characterisation of this proteinaceous component and possible in vivo experiments would provide a major tool for the treatment of downstream complications associated with increased serum creatinine via a new sources, albeit a natural one.

  8. Identification of a Proteinaceous Component in the Leaf of Moringa Oleifera lam. with Effects on High Serum Creatinine.

    Science.gov (United States)

    Sahoo, S; Raghavendra, K M; Biswas, S

    2014-01-01

    Moringa oleifera Lam. has been an important plant in the history of mankind, both for its nutritional and medicinal uses. Apart from bactericidal effects, the parts of this plant have been effectively used in the treatment of circulatory, respiratory, endocrine, digestive as well as neural disorders. Till date, though, there has been no reported activity of the involvement of any proteinaceous extract from M. oleifera on high levels of serum creatinine. To address this issue, blood samples with high levels of serum creatinine (2 mg/dl and above) were treated with leaf extract from M. oleifera. The crude extract was partially purified initially and eventually purified to completion as well. All these proteinaceous fractions were used to treat samples with high levels of serum creatinine as mentioned above. While the treatment of serum sample having high creatinine with crude extract and partially purified protein fractions showed a decrease of approximately 20% in the levels of serum creatinine over a period of 24 h, the samples treated with purified protein fraction reduced the serum creatinine level by 50%. In light of the fact that increased level of serum creatinine levels have adverse downstream effects on the heart, lungs and other organs, this communication assumes significance because it suggests a way of reducing the level of serum creatinine as an emergency measure. Further, the identification and characterisation of this proteinaceous component and possible in vivo experiments would provide a major tool for the treatment of downstream complications associated with increased serum creatinine via a new sources, albeit a natural one.

  9. Performance of Chronic Kidney Disease Epidemiology Collaboration Creatinine-Cystatin C Equation for Estimating Kidney Function in Cirrhosis

    Science.gov (United States)

    Mindikoglu, Ayse L.; Dowling, Thomas C.; Weir, Matthew R.; Seliger, Stephen L.; Christenson, Robert H.; Magder, Laurence S.

    2013-01-01

    Conventional creatinine-based glomerular filtration rate (GFR) equations are insufficiently accurate for estimating GFR in cirrhosis. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) recently proposed an equation to estimate GFR in subjects without cirrhosis using both serum creatinine and cystatin C levels. Performance of the new CKD-EPI creatinine-cystatin C equation (2012) was superior to previous creatinine- or cystatin C-based GFR equations. To evaluate the performance of the CKD-EPI creatinine-cystatin C equation in subjects with cirrhosis, we compared it to GFR measured by non-radiolabeled iothalamate plasma clearance (mGFR) in 72 subjects with cirrhosis. We compared the “bias”, “precision” and “accuracy” of the new CKD-EPI creatinine-cystatin C equation to that of 24-hour urinary creatinine clearance (CrCl), Cockcroft-Gault (CG) and previously reported creatinine- and/or cystatin C-based GFR-estimating equations. Accuracy of CKD-EPI creatinine-cystatin C equation as quantified by root mean squared error of difference scores [differences between mGFR and estimated GFR (eGFR) or between mGFR and CrCl, or between mGFR and CG equation for each subject] (RMSE=23.56) was significantly better than that of CrCl (37.69, P=0.001), CG (RMSE=36.12, P=0.002) and GFR-estimating equations based on cystatin C only. Its accuracy as quantified by percentage of eGFRs that differed by greater than 30% with respect to mGFR was significantly better compared to CrCl (P=0.024), CG (P=0.0001), 4-variable MDRD (P=0.027) and CKD-EPI creatinine 2009 (P=0.012) equations. However, for 23.61% of the subjects, GFR estimated by CKD-EPI creatinine-cystatin C equation differed from the mGFR by more than 30%. CONCLUSIONS The diagnostic performance of CKD-EPI creatinine-cystatin C equation (2012) in patients with cirrhosis was superior to conventional equations in clinical practice for estimating GFR. However, its diagnostic performance was substantially worse than

  10. Evaluation of urinary 3-methylhistidine excretion in infection by measurements of 1-methylhistidine and the creatinine ratios

    DEFF Research Database (Denmark)

    Sjölin, J; Stjernström, H; Henneberg, S;

    1989-01-01

    as an indicator of meat intake. We studied the basal urinary excretion of 1MH and whether this was influenced by infection and we compared the use of 3MH vs the 3MH:creatinine ratio (3MH:Cr) in detecting changes during infection. The basal excretion of 1MH was 84.9 mumol/24 h and its creatinine molar ratio (1MH...... with only 4 in 3MH. This was due to a higher precision in 3MH:Cr despite the concomitant significant increase in urinary creatinine excretion....

  11. Creatinine, cystatin, and combined-based equations in assessment of renal functions in type 2 diabetic Egyptian patients

    Directory of Open Access Journals (Sweden)

    Mahmoud M Elnokeety

    2017-01-01

    In patients with early overt diabetic nephropathy, serum cystatin C showed a significantly stronger correlation than creatinine with isotopically measured GFR, and among the studied equations for GFR estimation the CKD-EPI Cr-Cyst 2012 equation performed best.

  12. 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

    2014-09-19

    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.

  13. Urinary excretion of 3-methylhistidine and creatinine by healthy Dutch children during day and night. The influence of age and sex

    NARCIS (Netherlands)

    Speek, A.J.; Thissen, J.T.N.M.; Schrijver, J.

    1986-01-01

    The urinary excretion of 3-methylhistidine and creatinine and the urinary 3-methylhistidine to creatinine excretion ratio during day and night were investigated in a group of 103 healthy, normally fed Dutch children (52 boys and 51 girls) aged 2-17 years. The 3-methylhistidine to creatinine ratio of

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

    Science.gov (United States)

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

    2013-09-01

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

  15. Setting the speed limit: a pilot study of the rate of serum creatinine decrease after endoscopic valve ablation in neonates.

    Science.gov (United States)

    Deshpande, A V; Alsaywid, B S; Smith, G H H

    2011-06-01

    In neonates with a posterior urethral valve serum creatinine is increased. It decreases after successful relief of obstruction. Clinicians consider urinary diversion if serum creatinine remains increased. However, the optimal rate of decrease of serum creatinine is not defined. We generated useful data on the rate of serum creatinine decrease in neonates with a posterior urethral valve by introducing the idea of a prediction curve. We reviewed the medical charts of 15 consecutive children treated for a posterior urethral valve in the neonatal period at our institute between 2002 and 2007. The 11 children with a delayed diagnosis of a posterior urethral valve were excluded from analysis. Serial serum creatinine levels in the cohort of 15 patients were analyzed to estimate 1) the rate of decrease after valve ablation and 2) the time needed to achieve a nadir. One child died of renal insufficiency on day 10 of life and was excluded from study. Serum creatinine attained a nadir at about age 6 months but 73% of the total decrease occurred within the first 2 months of life, which was also equal to a 45% decrease from the peak values recorded soon after birth. The rate of decrease did not appear to be influenced by the peak values. Children with normal peak creatinine or intercurrent problems did not follow the trend. The rate of decrease in serum creatinine in the first few months of life may provide useful information on the adequacy of valve ablation. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  16. 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.

  17. Amylase/creatinine clearance ratio and tubular proteinuria in acute pancreatitis.

    Science.gov (United States)

    Lankisch, P G; Wolfrum, D I; Koop, H; Winckler, K

    1979-01-01

    Amylase/creatinine clearance ratio (CAm/CCr), urinary protein concentration and urinary protein pattern were studied in 102 samples from 27 patients with acute pancreatitis and in 46 controls. Raised CAm/CCr, proteinuria and a tubular protein pattern were present in 74, 56 and 96% of the patients, respectively. However, CAm/CCr and proteinuria and CAm/CCr and tubular protein pattern were not correlated. These results do not support the suggestion that an elevated CAm/CCr in acute pancreatitis is due to generalized tubular protein reabsorption failure presenting with tubular proteinuria.

  18. Determination of renal clearances of amylase/creatinine with chromogenic and enzymatic methods.

    Science.gov (United States)

    Hohenwallner, W; Wimmer, E; Sommer, R

    1979-12-01

    Urinary amylase was estimated by chromogenic (amylochrome Roche) as well as enzymatic methods (SKI and Beckman: substrate starch and substrate maltotetraose respectively). Random and timed urines (24 hour collections) were analysed. Clearances of amylase gave different results dependent upon the amylase-test used and the glomerular filtration rate. Correlation between chromogenic and enzymatic methods (starch as substrate) was poor. The ratio of amylase and creatinine clearance was used to test different methods. Reference values for this ratio for the amylochrome method (N = 106) were 2.85 +/- 0.99% and for the Beckman-DS method (N = 60) 2.82 +/- 0.87%.

  19. The value of the urinary protein:creatinine ratio for the detection of significant proteinuria in women with suspected preeclampsia.

    Science.gov (United States)

    Bhide, Amar; Rana, Ritu; Dhavilkar, Mrugaya; Amodio-Hernandez, Montserrat; Deshpande, Deepika; Caric, Vedrana

    2015-05-01

    To explore the correlation between urinary protein:creatinine ratio and 24-h excretion of protein, we studied 149 women referred to a day assessment unit for investigations for suspected preeclampsia. Paired samples were obtained for measurement of urinary protein:creatinine ratio and 24-h protein excretion. Collection of a 24-h urine sample was validated by the daily creatinine excretion. The outcome measure was proteinuria of 300 mg/day or more. Inaccurate 24-h collection was observed in 17% of women. All women (n = 56) with a protein:creatinine ratio >60 mg/mM had significant proteinuria. No woman with protein:creatinine ratio proteinuria. We recommend that a dual cut-off should be used for excluding and "ruling in" the diagnosis of significant proteinuria. A 24-h urine collection should be used only for urinary protein:creatinine ratio values between 18 and 60 mg/mM in the detection of significant proteinuria. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  20. 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.

  1. Urinary protein-to-creatinine ratio versus 24-h proteinuria in the screening for nephropathy in HIV patients.

    Science.gov (United States)

    Antonello, Vicente Sperb; Poli-De-Figueiredo, Carlos Eduardo; Antonello, Ivan Carlos Ferreira; Tovo, Cristiane Valle

    2015-06-01

    To determine the correlation between protein-to-creatinine ratio and 24-h urinary protein, proteinuria was measured in 45 patients attending a public HIV clinic in Porto Alegre, Brazil, using 24-h urinary protein excretion (24hUP) and urinary protein-to-creatinine ratio. Spearman's correlation test was done to evaluate the association between spot protein-to-creatinine ratio and 24hUP. The limits of agreement between the two methods were analysed by the Bland-Altman method. For protein excretion creatinine ratio and 24hUP were +0.112 and -0.097 g/day. A strong correlation (r = 0.957) was found between protein-to-creatinine ratio and 24hUP excretion. The conclusion is that the protein-to-creatinine ratio in spot urine specimens is an accurate, convenient and reliable screening method to estimate the urinary protein excretion in HIV patients to detect abnormal urinary protein loss. Further studies are required to evaluate renal disease in HIV patients with chronic renal disease and higher urinary protein excretion.

  2. Sensitivity of volumetric modulated arc therapy patient specific QA results to multileaf collimator errors and correlation to dose volume histogram based metrics.

    LENUS (Irish Health Repository)

    Coleman, Linda

    2013-11-01

    This study investigates the impact of systematic multileaf collimator (MLC) positional errors on gamma analysis results used for quality assurance (QA) of Rapidarc treatments. In addition, this study evaluates the relationship of these gamma analysis results and clinical dose volume histogram metrics (DVH) for Rapidarc treatment plans.

  3. Impact of PET and MRI threshold-based tumor volume segmentation on patient-specific targeted radionuclide therapy dosimetry using CLR1404

    Science.gov (United States)

    Besemer, Abigail E.; Titz, Benjamin; Grudzinski, Joseph J.; Weichert, Jamey P.; Kuo, John S.; Robins, H. Ian; Hall, Lance T.; Bednarz, Bryan P.

    2017-08-01

    Variations in tumor volume segmentation methods in targeted radionuclide therapy (TRT) may lead to dosimetric uncertainties. This work investigates the impact of PET and MRI threshold-based tumor segmentation on TRT dosimetry in patients with primary and metastatic brain tumors. In this study, PET/CT images of five brain cancer patients were acquired at 6, 24, and 48 h post-injection of 124I-CLR1404. The tumor volume was segmented using two standardized uptake value (SUV) threshold levels, two tumor-to-background ratio (TBR) threshold levels, and a T1 Gadolinium-enhanced MRI threshold. The dice similarity coefficient (DSC), jaccard similarity coefficient (JSC), and overlap volume (OV) metrics were calculated to compare differences in the MRI and PET contours. The therapeutic 131I-CLR1404 voxel-level dose distribution was calculated from the 124I-CLR1404 activity distribution using RAPID, a Geant4 Monte Carlo internal dosimetry platform. The TBR, SUV, and MRI tumor volumes ranged from 2.3-63.9 cc, 0.1-34.7 cc, and 0.4-11.8 cc, respectively. The average  ±  standard deviation (range) was 0.19  ±  0.13 (0.01-0.51), 0.30  ±  0.17 (0.03-0.67), and 0.75  ±  0.29 (0.05-1.00) for the JSC, DSC, and OV, respectively. The DSC and JSC values were small and the OV values were large for both the MRI-SUV and MRI-TBR combinations because the regions of PET uptake were generally larger than the MRI enhancement. Notable differences in the tumor dose volume histograms were observed for each patient. The mean (standard deviation) 131I-CLR1404 tumor doses ranged from 0.28-1.75 Gy GBq-1 (0.07-0.37 Gy GBq-1). The ratio of maximum-to-minimum mean doses for each patient ranged from 1.4-2.0. The tumor volume and the interpretation of the tumor dose is highly sensitive to the imaging modality, PET enhancement metric, and threshold level used for tumor volume segmentation. The large variations in tumor doses clearly demonstrate the need for standard

  4. Urinary BDNF-to-creatinine ratio is associated with aerobic fitness.

    Science.gov (United States)

    Collins, Larisa R; Koven, Nancy S

    2014-01-24

    Circulating levels of brain-derived neurotrophic factor (BDNF) are known to be affected by aerobic exercise. As the previous research focus in humans has been to examine peripheral BDNF levels through blood, serum, and platelet assay, the present study investigated the association between basal urinary BDNF concentration and indices of aerobic fitness in a sample of young adults (n=52). Aerobic fitness was evaluated with self-report of exercise habits and heart rate (HR) assessment during a sub-maximal Step Test. BDNF concentration was determined by enzyme-linked immunosorbent assay and adjusted for creatinine. Results indicated that the basal BDNFlog/creatinine ratio was positively associated with greater frequency of exercise and, during aerobic challenge, a quicker rise in HR upon exercise, lower peak HR during exercise, and lower HR during the recovery period, each indicative of enhanced fitness. These results highlight the utility of urine capture as a non-invasive technique to assess for exercise-mediated changes in peripheral BDNF.

  5. Creatinine normalization of workplace urine drug tests: does it make a difference?

    Science.gov (United States)

    Price, James W

    2013-01-01

    This study examines the effect of creatinine normalization on urine drug concentrations of 5 substances (amphetamines, cocaine, marijuana, opiates, and phencyclidine) and how this affects the proportion of reported positives. The Wilcoxon matched-pairs signed-ranks test was used to compare the mean prenormalization urinary drug concentration with the mean postnormalization urinary drug concentration. Frequency analysis was performed on dichotomous drug test results and the information was used to complete McNemar testing for each drug to determine the difference of proportions for prenormalization positive drug tests to postnormalization positive drug test. Each drug tested (N = 4460) was found to have a statistically significant increase in mean urinary drug concentration after creatinine normalization with effect sizes ranging from small to medium with cocaine having the largest effect size (r = 0.229) and phencyclidine having the lowest effect size (r = 0.121). The differences in proportion of dichotomous results between study and control groups for drugs tested were compared with the McNemar test. Each drug had a statistically significant (P = 0.0010) increase of positive drug tests. This result indicates that specimen dilution does affect the number of laboratory-positive results confirmed.

  6. Analysis of the concordance between the estimated values of creatinine clearance using the Cockcroft-Gault equation and the real value determined in patients from the Hospital Clínica Bíblica

    Directory of Open Access Journals (Sweden)

    Jose Miguel Chaverri-Fernández

    2016-01-01

    Full Text Available Objective: to analyze the effect of the modifications in the Cockcroft-Gault equation for creatinine clearance rate determination (CrCl and its concordance with the real value determined from 24-hours urine collection in a sample of Latin American patients hospitalized in San José de Costa Rica. Method: an observational, retrospective study, with patients submitted to a 24-hour urine collection test, and who met the inclusion criteria. The real and estimated values of creatinine clearance were determined, and their concordance was measured by applying the Intraclass Correlation Coefficient; a descriptive analysis of data was also conducted. Results: there were 507 subjects (61% men; their age was described (ME = 60 years SD = 17 years, as well as their height (ME = 1.66 m SD = 0.09 m, current weight (ME =75 kg SD = 15 kg, body mass index (ME = 27.3 kg/m2 SD = 4.76 kg/m2 and endogenous creatinine clearance rates (ME = 69.72 ml/min SD = 33 ml/min. The best concordance with the equation was obtained with current weight values and serum creatinine without rounding. Conclusions: the application of the Cockcroft-Gault equation that matches more closely the real value is the one that uses current weight and does not round creatinine values below 1 mg/dL. It is suggested to conduct a prospective analysis, determining other variables that could affect CrCl real measures, and to replicate this methodology in specific populations. *ME: Mean **SD: Standard Deviation

  7. Determination of TNT explosive based on its selectively interaction with creatinine-capped CdSe/ZnS quantum dots

    Energy Technology Data Exchange (ETDEWEB)

    Carrillo-Carrión, Carolina; Simonet, Bartolomé M.; Valcárcel, Miguel, E-mail: qa1meobj@uco.es

    2013-08-20

    Graphical abstract: -- Highlights: •Creatinine-modified CdSe/ZnS quantum dots fluorescent probe has been prepared. •This modified QDs has been used for sensing 2,4,6,-trinitrotoluene explosive (TNT). •The selectivity of fluorescence quenching of creatinine-QD for TNT has been evaluated. •The potential application of the proposed methodology for the determination of TNT in spiked soils has been demonstrated. -- Abstract: Here, a creatinine-modified CdSe/ZnS quantum dots fluorescent probe has been prepared and used for sensing 2,4,6,-trinitrotoluene explosive (TNT). The proposed method is based on the selective interaction between creatinine and nitroaromatic compounds according to the well-known Jaffé reaction. The procedure for the synthesis of creatinine-CdSe/ZnS reagent is very simple and reproducible and its fluorescent characteristics are reported. We found that the presence of TNT quenches the original fluorescence of creatinine-QD according to the Stern–Volmer model. Under the working conditions, the calibration plot of I{sub o}/I versus concentration of TNT was linear in the range 10–300 μg L{sup −1} (R{sup 2} = 0.996). The mechanism interaction is discussed. The selectivity of fluorescence quenching of creatinine-QD for TNT has been evaluated. Finally, the potential application of the proposed methodology for the determination of TNT in spiked soils is demonstrated. For the analysis of soil samples a solid-liquid extraction is carried out and a four-point standard addition protocol is used to correct the matrix effect. The method, which is simple and rapid, allows the detection of 0.057 μg g{sup −1} of TNT in soil samples. This sensor could be a useful tool for environmental studies, a crucial topic for nanotechnology nowadays.

  8. THE INFLUENCE OF PVA.cl.CITRIC ACID/CHITOSAN MEMBRANE HYDROPHICILITY ON THE TRANSPORT OF CREATININE AND UREA

    Directory of Open Access Journals (Sweden)

    Retno Ariadi Lusiana

    2013-12-01

    Full Text Available The influence of cross-linking and membrane hydrophilicity on the transport rate had been studied using a membrane prepared from a mixture of chitosan/PVA cross-linked citric acid (PVA.cl.CA for creatinine and urea transport. The optimum mole ratio of PVA:citric acid as well as the best composition of chitosan:PVA.cl.CA were determined using creatinine transport study. Using the optimum compositions, further study was done using different thickness of the membrane in transporting creatinine, urea and a mixture of 3 species (creatinine, urea and vitamin B12. Membrane characterization was done using FT-IR spectrophotometer, water absorption test, TG/DTG and SEM. The results showed that the optimum composition PVA:citric acid was obtained to be 90:1, having % WU of 113.74% and creatinine transport percentage of 18.16%. Meanwhile, the optimum composition of chitosan:PVA.cl.CA was found at 4:6 ratio having % WU and % transport of 136.67% and 24.26%, respectively. The optimum transport capacity was found for membrane thickness of 50 µm with WU% at 139.61% and the percent transport of creatinine and urea each was 38.93% and 60.36%. The presence vitamin B12 in the solution of is proved to disturb the transport of creatinine and urea through the membrane. Finally, hydrophilicity seemed to give substantial contribution in the transport process as well as the mechanical strength of the membrane.

  9. [A family with creatine transporter deficiency diagnosed with urinary creatine/creatinine ratio and the family history: the third Japanese familial case].

    Science.gov (United States)

    Nozaki, Fumihito; Kumada, Tomohiro; Shibata, Minoru; Fujii, Tatsuya; Wada, Takahito; Osaka, Hitoshi

    2015-01-01

    Creatine transporter deficiency (CRTR-D) is an X-linked disorder characterized by hypotonia, developmental delay, and seizures. We report the third Japanese family with CRTR-D. The proband was an 8-year-old boy who presented with hypotonia, severe intellectual disability and two episodes of seizures associated with/without fever. Among 7 siblings (4 males, 3 females), the eldest brother had severe intellectual disability, epilepsy, and sudden death at 17 years of age, while 18-year-old third elder brother had severe intellectual disability, autism, and drug-resistant epilepsy. The proband's urinary creatine/creatinine ratio was increased. A reduced creatine peak on brain magnetic resonance spectroscopy and a known pathogenic mutation in the SLC6A8 gene (c.1661 C > T;p.Pro554Leu) confirmed the diagnosis of CRTR-D. The same mutation was found in the third elder brother. Their mother was a heterozygote. Symptoms of CRTR-D are non-specific. Urinary creatine/creatinine ratio should be measured in patients with hypotonia, developmental delay, seizure and autism whose family history indicates an X-linked inheritance.

  10. Determination of TNT explosive based on its selectively interaction with creatinine-capped CdSe/ZnS quantum dots.

    Science.gov (United States)

    Carrillo-Carrión, Carolina; Simonet, Bartolomé M; Valcárcel, Miguel

    2013-08-20

    Here, a creatinine-modified CdSe/ZnS quantum dots fluorescent probe has been prepared and used for sensing 2,4,6,-trinitrotoluene explosive (TNT). The proposed method is based on the selective interaction between creatinine and nitroaromatic compounds according to the well-known Jaffé reaction. The procedure for the synthesis of creatinine-CdSe/ZnS reagent is very simple and reproducible and its fluorescent characteristics are reported. We found that the presence of TNT quenches the original fluorescence of creatinine-QD according to the Stern-Volmer model. Under the working conditions, the calibration plot of Io/I versus concentration of TNT was linear in the range 10-300μg L(-1) (R(2)=0.996). The mechanism interaction is discussed. The selectivity of fluorescence quenching of creatinine-QD for TNT has been evaluated. Finally, the potential application of the proposed methodology for the determination of TNT in spiked soils is demonstrated. For the analysis of soil samples a solid-liquid extraction is carried out and a four-point standard addition protocol is used to correct the matrix effect. The method, which is simple and rapid, allows the detection of 0.057μg g(-1) of TNT in soil samples. This sensor could be a useful tool for environmental studies, a crucial topic for nanotechnology nowadays.

  11. Quantitation of renal function with 99Tcm-DMSA. A comparison with creatinine clearance in children with single kidney.

    Science.gov (United States)

    Baillet, G; Gagnadoux, M F; De Vernejoul, P; Broyer, M

    1985-11-01

    To study the accuracy of renal function quantification with 99Tcm-DMSA we compared DMSA renal uptake and creatinine clearance in 16 cases of children with single kidney. The age of the patients ranged from two months to fourteen years. Creatinine clearance was normalized to 1.73 m2. DMSA uptake was measured 7 h after intravenous injection. Background subtraction was used and soft tissue attenuation was taken into account. The uptake was normalized in percentage of the injected activity. A significant correlation was found between creatinine clearance and DMSA uptake (rt = 0.866, p less than 0.01). Normal creatinine clearance range in children (80 to 120 ml min-1/1.73 m2) allowed determination of normal uptake range (36 to 60%). This study indicates that in case of asymmetrical renal impairment renal uptake will reflect split renal creatinine clearance. Since the former is much easier to measure, DMSA should play an important role in the evaluation of differential renal function.

  12. 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.

  13. 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

  14. Assessment of the amylase--creatinine clearance ratio in postoperative patients.

    Science.gov (United States)

    Leckie, P A; Ferreira, P; Debas, H T

    1980-08-01

    The value of the amylase--creatinine clearance ratio (ACCR) in the diagnosis of postoperative pancreatitis was prospectively assessed. In 77 patients undergoing operations known to have a significant incidence of postoperative pancreatitis (gastric, biliary or pancreatic) i.e. "high risk" group, the ACCR was abnormally elevated postoperatively in 36 patients (47%). However, overt clinical pancreatitis occurred in only eight patients (10%). In 60 other patients undergoing nonabdominal operations (orthiipedic, head and neck, varicose vein surgery etc.) i.e. "low risk" group, the ACCR was abnormally elevated postoperatively in 23 patients (38%). No patient in this group developed clinical pancreatitis. We conclude, therefore, the ACCR is often abnormally elevated nonspecifically following any type of surgery, and cannot be used as evidence of postoperative pancreatitis. These data do suggest, however, that a normal ACCR, especially on successive daily determinations, might help to exclude the diagnosis of postoperative pancreatitis.

  15. Establish Albumin-creatinine Ratio Reference Value of Adults in the Rural Area of Hebei Province

    Institute of Scientific and Technical Information of China (English)

    Qiao-jing Liang; Wen Huang; Guo-juan Zhang; Ning-li Wang

    2016-01-01

    Objective To establish albumin-creatinine ratio (ACR) reference value of the rural population in Hebei province. Methods This study enrolled 5154 participants. By excluding subjects with hypertension, diabetes, dyslipidemia, cardiovascular and cerebrovascular diseases, kidney diseases, and overweight condition, as well as those with an estimated glomerular filtration rate (eGFR) Results The normal upper limit of ACR was 28.71 mg/g (3.25 mg/mmol) for males and 31.85 mg/g (3.60 mg/mmol) for females. Based on this ACR reference value, the age-gender standardized prevalence of albuminuria in the rural areas of Hebei province was 12.9%. Conclusion The ACR reference value in the rural of Hebei province is higher than that of the Western population.

  16. Quantitative TLC-Image Analysis of Urinary Creatinine Using Iodine Staining and RGB Values.

    Science.gov (United States)

    Kerr, Emily; West, Caroline; Kradtap Hartwell, Supaporn

    2016-04-01

    Digital image analysis of the separation results of colorless analytes on thin-layer chromatography (TLC) plates usually involves using specially tailored software to analyze the images generated from either a UV scanner or UV lamp station with a digital camera or a densitometer. Here, a low-cost alternative setup for quantitative TLC-digital image analysis is demonstrated using a universal staining reagent (iodine vapor), an office scanner and a commonly available software (Microsoft Paint) for analysis of red, green and blue colors (RGB values). Urinary creatinine is used as a model analyte to represent a sample in complicated biological matrices. Separation was carried out on a silica gel plate using a butanol-NH4OH-H2O (40 : 10 : 50, v/v) mobile phase with a 6-cm solvent front. It is important that the TLC plate be stained evenly and with sufficient staining time. Staining the TLC plate in a 23.4 × 18.8 × 6.8 cm chamber containing about 70 g iodine crystals yielded comparable results for the staining times of 30-60 min. The Green value offered the best results in the linear working range (0.0810-0.9260 mg/mL) and precision (2.03% RSD, n = 10). The detection limit was found to be 0.24 µg per 3 µL spot. Urinary creatinine concentrations determined by TLC-digital image analysis using the green value calibration graph agree well with results obtained from high-pressure liquid chromatography (HPLC). © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Repeated serum creatinine measurement in primary care: Not all patients have chronic renal failure.

    Science.gov (United States)

    Gentille Lorente, Delicia; Gentille Lorente, Jorge; Salvadó Usach, Teresa

    2015-01-01

    To assess the prevalence of kidney failure in patients from a primary care centre in a basic healthcare district with laboratory availability allowing serum creatinine measurements. An observational descriptive cross-sectional study. A basic healthcare district serving 23,807 people aged ≥ 18 years. Prevalence of kidney failure among 17,240 patients having at least one laboratory measurement available was 8.5% (mean age 77.6 ± 12.05 years). In 33.2% of such patients an occult kidney failure was found (98.8% were women). Prevalence of chronic kidney failure among 10,011 patients having at least 2 laboratory measurements available (≥ 3 months apart) was 5.5% with mean age being 80.1 ± 10.0 years (most severely affected patients were those aged 75 to 84); 59.7% were men and 76.3% of cases were in stage 3. An occult kidney failure was found in 5.3% of patients with women being 86.2% of them (a glomerular filtration rate<60 ml/min was estimated for plasma creatinine levels of 0.9 mg/dl or higher). Comparison of present findings to those previously reported demonstrates the need for further studies on the prevalence of overall (chronic and acute) kidney failure in Spain in order to estimate the real scope of the disease. Primary care physicians play a critical role in disease detection, therapy, control and recording (in medical records). MDRD equation is useful and practical to estimate glomerular filtration rate. Copyright © 2015 The Authors. Published by Elsevier España, S.L.U. All rights reserved.

  18. Creatinine and cytokines plasma levels related to HLA compatibility in kidney transplant patients

    Directory of Open Access Journals (Sweden)

    Lorraine V. Alves

    2015-10-01

    Full Text Available ABSTRACTIntroduction:The success of kidney transplantation depends on prevention of organ rejection by the recipient’s immune system, which recognizes alloantigens present in transplanted tissue. Human leukocyte antigen (HLA typing is one of the tests used in pre-renal transplantation and represents one of the most important factors for a successful procedure.Objective:The present study evaluated creatinine and cytokines plasma levels in kidney transplant patients according to pre-transplant HLA typing.Methods:We assessed 40 renal transplanted patients selected in two transplant centers in Belo Horizonte (MG.Results:Patients were distributed into three groups according to HLA compatibility and, through statistical analysis, the group with more than three matches (H3 was found to have significantly lower post-transplant creatinine levels, compared to groups with three or fewer matches (H2 and H1, respectively. The median plasma levels of cytokines interleukin 6 (IL-6, tumor necrosis factor alpha (TNF-α, and interleukin 10 (IL-10 were evaluated according to the number of matches. Pro-inflammatory cytokines (IL-6 and TNF-α were significantly higher in groups with lower HLA compatibility. On the other hand, the regulatory cytokine IL-10 had significantly higher plasma levels in the group with greater compatibility between donor and recipient.Conclusion:These findings allow us to infer that pre-transplant HLA typing of donors and recipients can influence post-transplant renal graft function and may contribute to the development and choice of new treatment strategies.

  19. Daily urinary creatinine predicts the weaning of renal replacement therapy in ICU acute kidney injury patients.

    Science.gov (United States)

    Viallet, Nicolas; Brunot, Vincent; Kuster, Nils; Daubin, Delphine; Besnard, Noémie; Platon, Laura; Buzançais, Aurèle; Larcher, Romaric; Jonquet, Olivier; Klouche, Kada

    2016-12-01

    In acute kidney injury (AKI), useless continuation of renal replacement therapy (RRT) may delay renal recovery and impair patient's outcome. In this study, we aimed to identify predictive parameters that may help to a successful RRT weaning for AKI patients. We studied 54 surviving AKI patients in which a weaning of RRT was attempted. On the day of weaning (D0) and the following 2 days (D1 and D2), SAPS II and SOFA scores, 24-h diuresis, 24-h urinary creatinine and urea (UCr and UUr), creatinine and urea generation rates (CrGR and UrGR) and clearances (CrCl and UrCl) were collected. Patients who remained free of RRT 15 days after its discontinuation were considered as successfully weaned. Twenty-six RRT weaning attempts succeeded (S+) and 28 failed (S-). Age, previous renal function, SAPS II and SOFA scores were comparable between groups. At D0, 24-h diuresis was 2300 versus 1950 ml in S+ and S-, respectively, p = 0.05. At D0, D1 and D2, 24-h UUr and UCr levels, UrCl and CrCl, and UUr/UrGR and UCr/CrGR ratios were significantly higher in S+ group. By multivariate analysis, D1 24-h UCr was the most powerful parameter that was associated with RRT weaning success with an area under the ROC curve of 0.86 [0.75-0.97] and an odds ratio of 2.01 [1.27-3.18], p = 0.003. In ICU AKI, 24-h UCr appeared as an efficient and independent marker of a successful weaning of RRT. A 24-h UCr ≥5.2 mmol was associated with a successful weaning in 84 % of patients.

  20. Specific Dyslexia.

    Science.gov (United States)

    Naidoo, Sandhya

    The investigation reported in this volume attempts to clarify some issues relating to the existence, nature, and causes of specific dyslexia. Based on an extended study of 98 boys of at least average intelligence with severe reading and spelling problems, the report provides detailed data relating to their developmental and perinatal histories,…

  1. Volume Entropy

    CERN Document Server

    Astuti, Valerio; Rovelli, Carlo

    2016-01-01

    Building on a technical result by Brunnemann and Rideout on the spectrum of the Volume operator in Loop Quantum Gravity, we show that the dimension of the space of the quadrivalent states --with finite-volume individual nodes-- describing a region with total volume smaller than $V$, has \\emph{finite} dimension, bounded by $V \\log V$. This allows us to introduce the notion of "volume entropy": the von Neumann entropy associated to the measurement of volume.

  2. Creatinine clearance, urinary excretion of glomerular basement membrane antigens and renal histology in congenital nephrotic syndrome of Finnish type.

    Science.gov (United States)

    Huttunen, N P

    1977-04-01

    The endogenous creatinine clearance and urinary excretion rate of glomerular basement membrane (GBM) antigens were followed from 2 to 19 months in fifteen patients with congenital nephrotic syndrome (CNF). The quantitative examination of renal morphology was made on fourteen of these patients. Creatinine clearance increased during the first few months of life and thereafter gradually decreased. The urinary excretion rate of GBM antigens rose during the course of the disease. The creatinine clearance did not correlate significantly with glomerular fibrosis but it did correlate with tubular atrophy and interstitial fibrosis. The urinary excretion of GBM antigens correlated significantly with glomerular and interstitial fibrosis and with tubular atrophy. It is concluded that there is a clear progress in the disease and the renal histological changes probably are caused by accumulation of GBM material in glomeruli.

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

    DEFF Research Database (Denmark)

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

    1989-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Regulatory and Pro-Inflammatory Cytokines in Brazilian Living-Related Renal Transplant Recipients According to Creatinine Plasma Levels.

    Science.gov (United States)

    Mota, Ana Paula Lucas; Menezes, Cristiane Alves da Silva; Alpoim, Patrícia Nessralla; Cardoso, Carolina Neris; Martins, Suellen Rodrigues; Alves, Lorraine Vieira; de Assis Martins-Filho, Olindo; Braga Gomes Borges, Karina; Dusse, Luci Maria SantAna

    2017-07-13

    The maintenance of stable graft function in renal transplanted recipients (RTR) is a challenge for healthcare staff. The ideal biomarkers must have significative predictive values to monitor the intricate renal function response triggered after renal transplantation. The main purpose in this study was to evaluate the regulatory and pro-inflammatory cytokines as biomarkers of allograft function in living-related renal transplant patients. Regulatory and pro-inflammatory cytokine plasma levels were measured by flow cytometry in 120 living-related renal transplanted patients categorized into three groups according to creatinine plasma levels: creatinine less than 1.4 mg/dL (C1), creatinine within 1.4-2.0mg/dL (C2) and more than 2.0 mg/dL (C3). Patients were also classified as "low" or "high" cytokine producers. Clinical data were obtained from patients' medical record. We have found a peak of regulatory cytokines in RTR with low creatinine levels as well as a peak of IL-6 pro-inflammatory cytokine in patients with high creatinine levels. C1 and C3 groups showed a mixed pro-inflammatory (IL-8, IL-6, IL-1β, TNF-α, IL-12 and IFN-γ) and regulatory (IL-4, IL-5 and IL-10) cytokine pattern and C2 had a predominant pro-inflammatory profile. C3 group showed a higher frequency of high pro-inflammatory cytokine producers compared to C1. Our data suggest that regulatory cytokines IL-4, IL-5 and IL-10 could be good biomarkers associated with stable renal function, while pro-inflammatory cytokines seems to be potential markers in RTR related to high creatinine plasma levels, specially IL-6 despite of its borderline values. Copyright © 2017 John Wiley & Sons, Ltd. This article is protected by copyright. All rights reserved.

  6. Association of urinary sodium/creatinine ratio with bone mineral density in postmenopausal women: KNHANES 2008-2011.

    Science.gov (United States)

    Kim, Sung-Woo; Jeon, Jae-Han; Choi, Yeon-Kyung; Lee, Won-Kee; Hwang, In-Ryang; Kim, Jung-Guk; Lee, In-Kyu; Park, Keun-Gyu

    2015-08-01

    Accumulating evidence shows that high sodium chloride intake increases urinary calcium excretion and may be a risk factor for osteoporosis. However, the effect of oral sodium chloride intake on bone mineral density (BMD) and risk of osteoporosis has been inadequately researched. The aim of the present study was to determine whether urinary sodium excretion (reflecting oral sodium chloride intake) associates with BMD and prevalence of osteoporosis in postmenopausal women. This cross-sectional study involved a nationally representative sample consisting of 2,779 postmenopausal women who participated in the Korea National Health and Nutritional Examination Surveys in 2008-2011. The association of urinary sodium/creatinine ratio with BMD and other osteoporosis risk factors was assessed. In addition, the prevalence of osteoporosis was assessed in four groups with different urinary sodium/creatinine ratios. Participants with osteoporosis had significantly higher urinary sodium/creatinine ratios than the participants without osteoporosis. After adjusting for multiple confounding factors, urinary sodium/creatinine ratio correlated inversely with lumbar spine BMD (P = 0.001). Similarly, when participants were divided into quartile groups according to urinary sodium/creatinine ratio, the average BMD dropped as the urinary sodium/creatinine ratio increased. Multiple logistic regression analysis revealed that compared to quartile 1, quartile 4 had a significantly increased prevalence of lumbar spine osteoporosis (odds ratios 1.346, P for trend = 0.044). High urinary sodium excretion was significantly associated with low BMD and high prevalence of osteoporosis in lumbar spine. These results suggest that high sodium chloride intake decreases lumbar spine BMD and increases the risk of osteoporosis in postmenopausal women.

  7. Near Term Hybrid Passenger Vehicle Development Program. Phase I, Final report. Appendix A: mission analysis and performance specification studies. Volume I

    Energy Technology Data Exchange (ETDEWEB)

    Traversi, M.; Barbarek, L.A.C.

    1979-04-20

    Studies are described which were performed for the Near Term Hybrid Vehicle program to determine passenger car usage patterns and to correlate these trip mission characteristics with vehicle design and performance specifications. (LCL)

  8. Comparison between the effects of indapamide and hydrochlorothiazide on creatinine clearance in patients with impaired renal function and hypertension.

    Science.gov (United States)

    Madkour, H; Gadallah, M; Riveline, B; Plante, G E; Massry, S G

    1995-01-01

    The long-term effects of indapamide or hydrochlorothiazide on blood pressure and renal function were examined in patients with impaired renal function and moderate hypertension. Both drugs controlled hypertension and blood pressure remained normal during the 2 years of the study. Despite this comparable control of hypertension, indapamide therapy was associated with a 28.5 +/- 4.4% increase in creatinine clearance while treatment with hydrochlorothiazide was associated with a 17.4 +/- 3.0% decrease in creatinine clearance. The results of the study indicate that indapamide is superior to hydrochlorothiazide in the treatment of patients with impaired renal function and moderate hypertension.

  9. [The amylase-creatinine clearance ratio in the differential diagnosis of pancreatitis and gastroduodenal ulcer with hyperamylasemia].

    Science.gov (United States)

    Pezzangora, V; Della Dora, R; Pagliarini, A; Dell'Olivo, I

    1978-04-01

    The Authors followed 29 patients, hospitaled with a diagnosis of pancreatitis. They all presented the same sympotomatology and a considerable increase of the serum amylase ad urinary amylase. The examination of the ratio between the clearance of amylasis and creatinine permitted to make a differential diagnosis for 8 cases (4rd group) that were nothing but peptic ulcera. Such a diagnosis was confirmed by the radiological contrastographic examination or by the intraoperative report. So if the ratio between the clearance of amylase and creatinine is normal we must think about a pathological situation were the iperamylasemia has a pathogenetic cause different from pancreatitis.

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

    DEFF Research Database (Denmark)

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

    1989-01-01

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

  11. Improving the prognostic value of disease specific Graded Prognostic Assessment (ds-GPA) model for renal cell carcinoma by incorporation of Cumulative Intracranial Tumor Volume (CITV).

    Science.gov (United States)

    Ali, Mir Amaan; Hirshman, Brian R; Wilson, Bayard; Schupper, Alexander J; Joshi, Rushikesh; Proudfoot, James A; Goetsch, Steven J; Alksne, John F; Ott, Kenneth; Aiyama, Hitoshi; Nagano, Osamu; Carter, Bob S; Chiang, Veronica; Serizawa, Toru; Yamamoto, Masaaki; Chen, Clark C

    2017-07-25

    We tested the prognostic value of cumulative intracranial tumor volume (CITV) in the context of ds-GPA model for renal cell carcinoma (RCC) patients with brain metastasis (BM) treated with stereotactic radiosurgery (SRS). Patient and tumor characteristics were collected from RCC cohorts with newly BM who underwent SRS. Univariable and multivariable logistic regression model was used to test the prognostic value of CITV, Karnofsky Performance Score (KPS), and the number of BM. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were used to assess whether CITV improved the prognostic utility of RCC ds-GPA. In univariable logistic regression models, CITV, KPS, and the number of BM independently associated with RCC patient survival. In a multivariable Cox proportional hazard model, the association between CITV and survival remained robust after controlling for KPS and the number of BM (P=.042). The incorporation of the cumulative intracranial tumor volume (CITV) into the RCC ds-GPA model (consisting of KPS and number of BM) improved prognostic accuracy with NRI>0 of 0.3156 (95% CI: 0.0883-0.5428, P=.0065) and integrated discrimination improvement (IDI) of 0.0151 (95% CI: 0.0036-0.0277, P=.0183). These findings were validated in an independent cohort of 107 SRS-treated RCC BM patients. CITV is an important prognostic variable in SRS-treated RCC patients with BM. The prognostic value of the ds-GPA scale for RCC brain metastasis was enhanced by the incorporation of CITV. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Volume Regulated Channels

    DEFF Research Database (Denmark)

    Klausen, Thomas Kjær

    - serves a multitude of functions in the mammalian cell, regulating the membrane potential (Em), cell volume, protein activity and the driving force for facilitated transporters giving Cl- and Cl- channels a major potential of regulating cellular function. These functions include control of the cell cycle...... of volume perturbations evolution have developed system of channels and transporters to tightly control volume homeostasis. In the past decades evidence has been mounting, that the importance of these volume regulated channels and transporters are not restricted to the defense of cellular volume......, controlled cell death and cellular migration. Volume regulatory mechanisms has long been in focus for regulating cellular proliferation and my thesis work have been focusing on the role of Cl- channels in proliferation with specific emphasis on ICl, swell. Pharmacological blockage of the ubiquitously...

  13. USO DE LA EXCRECIÓN DE CREATININA COMO MÉTODO ALTERNATIVO A LA COLECTA TOTAL DE ORINA EN VACAS HOLSTEIN USE OF THE CREATININE EXCRETION AS ALTERNATIVE METHOD TO TOTAL URINE COLLECTION IN HOLSTEIN COWS

    Directory of Open Access Journals (Sweden)

    Libardo Escobar Puerta

    2010-12-01

    Full Text Available La investigación en producción animal requiere la recolección total de orina, para estimar la excreción de compuestos nitrogenados y derivados púricos, lo cual trae grandes dificultades, siendo necesario buscar técnicas alternas. El objetivo de este trabajo fue determinar el volumen de orina de vacas Holstein por colecta total con arneses y por muestras puntuales ”spot”, utilizando la excreción de creatinina como marcador interno y evaluar la variación en la excreción diaria de creatinina utilizando colectas durante siete días. El volumen de orina observado (colecta total y el estimado (muestra spot fueron comparados por una prueba de medias de datos apareados (5% de probabilidad. La comparación entre días de colecta se realizó mediante un modelo mixto con medidas repetidas en el tiempo, del mismo animal (efecto aleatorio y día de evaluación (efecto fijo. Se utilizó el procedimiento MIXED y el comando REPEATED del programa SAS (2001. Para la correlación entre el volumen de orina observado y estimado se utilizó PROC CORR y para la regresión PROC REG de SAS (2001. La excreción de creatinina promedio fue de 29,89 mg/kg PV/día. No se encontró diferencia entre las dos técnicas. El volumen de orina obtenido fue 19,8 L y el estimado 19,7 L. Se encontró una alta correlación entre las dos técnicas (r=0,82; PThe research in animal production requires the total harvesting of tinkles to estimate the excretion of nitrogenated compounds and puric derivates, which brings great difficulties, doing necessary the search of alternating techniques. The objective of this work was to determine the volume of tinkles of Holstein cows by collects total with harness and the gathering samples spot using the excretion creatinine like internal marker and evaluate the variation in daily creatinine excretion using collections for seven days. A paired test (5% probability was used to compare observed (total collection and estimated (samples spot

  14. The frequency of marcroamylasemia and the diagnostic value of the amylase to creatinine clearance ratio in patients with elevated serum amylase activity.

    Science.gov (United States)

    Dürr, H K; Bindrich, D; Bode, J C

    1977-01-01

    190 patients with elevated serum amylase levels were tested for macroamylasemia and the amylase to creatinine clearance ratio. Macroamylasemia was found in 3 patients. In these patients macroamylasemia persisted after the total activity of serum amylase had fallen to nearly normal levels. The Cam/Ccr-ratios were determined 14 times in the 3 macroamylasemic patients. Only one of the 14 values was clearly less than 1%. Cam/Ccr-ratios above 4% were found in 83 patients. In 56 of them the diagnosis of acute pancreatitis could not be confirmed. 19 out of 46 patients with the established diagnosis of acute pancreatitis had Cam/Ccr-ratios below 4%. Cam/Ccr-ratios below 1% were also found in patients without macroamylasemia. It is concluded that high and low Cam/Ccr-ratios are not specific for acute pancreatitis and macroamylasemia, respectively, and--moreover--that a normal Cam/Ccr-ratio excludes neither acute pancreatitis nor macroamylesemia.

  15. 老面发酵程度对馒头比容和白度的影响%The impaction on specific volume and whiteness radiate of steamed bread with sourdough fermentation degree

    Institute of Scientific and Technical Information of China (English)

    马永生; 刘长虹; 李海潮

    2011-01-01

    For the impaction of sourdough fermentation time on the specific volume and the whiteness radiate of steamed bread, utilizing the secondary dough comparison test by whether adding flour. When fermented dough directly molding, with the fermentation time increased, the specific volume and the whiteness radiate of steamd bread are all showing a downward trend that is more related in the gluten content of sourdough. White adding flour, the specific volume and the whiteness radiate achieved the desired value respectively at 16~18 h and 18 h fermentation time. It can been seen by the comparsion test that the gluten content of sourdough, the amount of flour adding during secondary dough has important implications about the quality of steamed bread.%针对老面发酵时间对老面馒头比容和白度的影响,采用二次和面时是否添加面粉进行对比试验。发酵面团直接成型时,随着发酵时间的增加,馒头的比容和白度都呈下降的趋势,这种趋势与老面中面筋含量有较大关系,添加面粉时,馒头的比容和白度分别在老面发酵16~18h和18h时达到理想的值,通过对比试验可以看出,老面团的面筋含量、二次和面时添加面粉对馒头的品质有重要的影响。

  16. Creatinine excretion rate, a marker of muscle mass, is related to clinical outcome in patients with chronic systolic heart failure

    NARCIS (Netherlands)

    ter Maaten, Jozine M.; Damman, Kevin; Hillege, Hans L.; Bakker, Stephan J.; Anker, Stefan D.; Navis, Gerjan; Voors, Adriaan A.

    2014-01-01

    Aims In chronic heart failure (CHF), low body mass as a reflection of low muscle mass has been associated with poor outcome. Urinary creatinine excretion rate (CER) is an established marker of muscle mass, but has not been investigated in CHF. This study aims to evaluate urinary CER as a marker of m

  17. Clinical Validation of Simultaneous Analysis of Tacrolimus, Cyclosporine A and Creatinine in Dried Blood Spots in Kidney Transplant Patients

    NARCIS (Netherlands)

    Veenhof, Herman; Koster, Remco A; Alffenaar, Jan-Willem C; Berger, Stefan P; Bakker, Stephan J L; Touw, Daan J

    2016-01-01

    BACKROUND: Monitoring of creatinine and immunosuppressive drug concentrations such as tacrolimus (TaC) and cyclosporin A (CsA) is important in the outpatient follow-up of kidney transplant recipients. Monitoring by Dried Blood Spot (DBS) provides patients the opportunity to sample a drop of blood fr

  18. A new method of modelling early plasma creatinine changes predicts 1-year graft function after kidney transplantation

    DEFF Research Database (Denmark)

    Krogstrup, Nicoline V; Bibby, Bo Martin; Aulbjerg, Camilla;

    2016-01-01

    BACKGROUND: Delayed graft function after renal transplantation is associated with inferior long-term outcome. To evaluate the impact of slow onset graft function, we aimed to model and correlate early changes in plasma creatinine (p-cr) with long-term graft function. MATERIALS: In a single centre...

  19. Limitations of early serum creatinine variations for the assessment of kidney injury in neonates and infants with cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Mirela Bojan

    Full Text Available BACKGROUND: Changes in kidney function, as assessed by early and even small variations in serum creatinine (ΔsCr, affect survival in adults following cardiac surgery but such associations have not been reported in infants. This raises the question of the adequate assessment of kidney function by early ΔsCr in infants undergoing cardiac surgery. METHODOLOGY: The ability of ΔsCr within 2 days of surgery to assess the severity of kidney injury, accounted for by the risk of 30-day mortality, was explored retrospectively in 1019 consecutive neonates and infants. Patients aged ≤ 10 days were analyzed separately because of the physiological improvement in glomerular filtration early after birth. The Kml algorithm, an implementation of k-means for longitudinal data, was used to describe creatinine kinetics, and the receiver operating characteristic and the reclassification methodology to assess discrimination and the predictive ability of the risk of death. RESULTS: Three clusters of ΔsCr were identified: in 50% of all patients creatinine decreased, in 41.4% it increased slightly, and in 8.6% it rose abruptly. Mortality rates were not significantly different between the first and second clusters, 1.6% [0.0-4.1] vs 5.9% [1.9-10.9], respectively, in patients aged ≤ 10 days, and 1.6% [0.5-3.0] vs 3.8% [1.9-6.0] in older ones. Mortality rates were significantly higher when creatinine rose abruptly, 30.3% [15.1-46.2] in patients aged ≤ 10 days, and 15.1% [5.9-25.5] in older ones. However, only 41.3% of all patients who died had an abrupt increase in creatinine. ΔsCr improved prediction in survivors, but not in patients who died, and did not improve discrimination over a clinical mortality model. CONCLUSIONS: The present results suggest that a postoperative decrease in creatinine represents the normal course in neonates and infants with cardiac surgery, and that early creatinine variations lack sensitivity for the assessment of the severity of

  20. Validation of a noninvasive diagnostic tool to verify neuter status in dogs: The urinary FSH to creatinine ratio.

    Science.gov (United States)

    Albers-Wolthers, C H J; de Gier, J; Oei, C H Y; Schaefers-Okkens, A C; Kooistra, H S

    2016-09-15

    Determining the presence of functional gonadal tissue in dogs can be challenging, especially in bitches during anestrus or not known to have been ovariectomized, or in male dogs with nonscrotal testes. Furthermore, in male dogs treated with deslorelin, a slow-release GnRH agonist implant for reversible chemical castration, the verification of complete downregulation of the hypothalamic-pituitary-gonadal (HPG) axis can be difficult, especially if pretreatment parameters such as the size of the testes or prostate gland are not available. The aims of this study were to validate an immunoradiometric assay for measurement of FSH in canine urine, to determine if the urinary FSH to creatinine ratio can be used to verify the neuter status in bitches and male dogs, as an alternative to the plasma FSH concentration, and to determine if downregulation of the HPG axis is achieved in male dogs during deslorelin treatment. Recovery of added canine FSH and serial dilutions of urine reported that the immunoradiometric assay measures urinary FSH concentration accurately and with high precision. Plasma FSH concentrations (the mean of two samples, taken 40 minutes apart) and the urinary FSH to creatinine ratio were determined before gonadectomy and 140 days (median, range 121-225 days) and 206 days (median, range 158-294 days) after gonadectomy of 13 bitches and five male dogs, respectively, and in 13 male dogs before and 132 days (median, range 117-174 days) after administration of a deslorelin implant. In both bitches and male dogs, the plasma FSH concentration and the urinary FSH to creatinine ratio were significantly higher after gonadectomy, with no overlapping of their ranges. Receiver operating characteristic analysis of the urinary FSH to creatinine ratio revealed a cut-off value of 2.9 in bitches and 6.5 in males to verify the presence or absence of functional gonadal tissue. In male dogs treated with deslorelin, the plasma FSH concentrations and urinary FSH to

  1. 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

    2017-09-11

    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.

  2. A decrease in serum creatinine after ICU admission is associated with increased mortality.

    Science.gov (United States)

    Kang, Hye Ran; Lee, Si Nae; Cho, Yun Ju; Jeon, Jin Seok; Noh, Hyunjin; Han, Dong Cheol; Park, Suyeon; Kwon, Soon Hyo

    2017-01-01

    The elevation of serum creatinine (SCr), acute kidney injury (AKI), is associated with an increase of mortality in critically ill patients. However, it is uncertain whether a decrease in SCr in the intensive care unit (ICU) has an effect on outcomes. In a retrospective study, we enrolled 486 patients who had been admitted to an urban tertiary center ICU between Jan 2014 and Dec 2014. The effect of changes in SCr after ICU admission on 90 day mortality was analyzed. Patients were classified into 3 groups based on change in SCr after ICU admission: a stable SCr group (Δ SCr decreased SCr group (Δ SCr ≥ -0.3 mg/dL during ICU stay) and an increased SCr group with criteria based on the KDIGO AKI criteria. In total, 486 patients were identified. SCr decreased in 123 (25.3%) patients after ICU admission. AKI developed in 125 (24.4%) patients. The overall 90-day mortality rate was 29.0%. In a Kaplan-Meyer analysis, the mortality of the AKI group was higher than that of other groups (pdecrease in SCr had a higher mortality rate than those with stable SCr (pdecrease in SCR (HR, 3.56; 95% CI, 1.59-7.97; p = 0.002) and an increase in SCr (AKI stage 1, HR, 9.35; 95% CI, 4.18-20.9; pdecrease in SCr was associated with mortality in critically ill patients.

  3. Serum Creatinine Level: A Supplemental Index to Distinguish Duchenne Muscular Dystrophy from Becker Muscular Dystrophy

    Directory of Open Access Journals (Sweden)

    Huili Zhang

    2015-01-01

    Full Text Available Background. To improve assessment of dystrophinopathy, the aim of this study was to identify whether serum creatinine (Crn level reflects disease severity. Methods. Biochemical, Vignos score, and genetic data were collected on 212 boys with dystrophinopathy. Results. Serum Crn level had a strong inverse correlation with Vignos score by simple correlation (r=-0.793 and partial correlation analysis after adjustment for age, height, and weight (r=-0.791; both P<0.01. Serum Crn level was significantly higher in patients with in-frame than out-of-frame mutations (Z=-4.716, P<0.01 and in Becker muscular dystrophy (BMD patients than Duchenne muscular dystrophy (DMD patients at ages 4, 5, 7, and 9 yr (all P<0.0125. After adjusting for age, height, and weight, BMD patients still had a significantly higher serum Crn level than DMD patients (β=7.140, t=6.277, P<0.01. Conclusions. Serum Crn level reflected disease severity and may serve as a supplemental index to distinguish DMD from BMD in clinical practice.

  4. Influence of amylase assay technique on renal clearance of amylase-creatinine ratio.

    Science.gov (United States)

    Levitt, M D; Johnson, S G; Ellis, C J; Engel, R R

    1977-06-01

    The influence of amylase assay technique on the renal amylase/creatinine clearance measurement was determined by analysis of serum and urine specimens obtained from 10 normal subjects. CAm/CCr averaged 2.19 +/- 0.18% with a saccharogenic technique, 1.52 +/- 0.2% with an iodometric technique, and 0.80 +/- 0.08% with a chromogenic technique. Each of these values differed significantly (P less than 0.05) from the other two. Recovery studies were carried out by adding partially purified human salivary or pancreatic amylase to human newborn serum or urine (which contain minimal endogenous amylase). Equal amylase activity was recovered from serum and urine by the saccharogenic technique whereas recovery from urine was less than 50% of that from serum using the iodometric and chromogenic techniques. The accuracy of the chromogenic technique is markedly improved by the addition of albumin to the urine assay system. Although it appears that only the saccharogenic method provides an accurate estimate of CAm/CCr, each assay technique distinguished the elevated CAm/CCr of patients with pancreatitis from the normal range established for that technique. Accurate clinical interpretation of CAm/CCr measurment requires knowledge of the amylase assay technique used.

  5. Amylase/creatinine clearance ratio response to hyperglucagonemia in diabetes and obesity.

    Science.gov (United States)

    Kanter, Y; Piell, E; Santo, M

    1986-11-01

    Hyperglucagonemia accompanies several disorders such as acute pancreatitis and diabetic ketoacidosis characterized by increased amylase/creatinine clearance ratio (ACCR). We tested the hypothesis that glucagon may be responsible for the augmental ACCR among diabetic and/or obese subjects. A constant glucagon infusion (15 ng/kg/min) was given to eight noninsulin-dependent diabetics and to eight obese subjects to attain glucagon levels comparable with those obtained during acute pancreatitis. The ACCR significantly increased from 0.9 +/- 0.1 to 1.5 +/- 0.1% (p less than 0.005) in both noninsulin-dependent diabetics and obese subjects, whereas among normal control subjects the ACCR increased from 0.84 +/- 0.8 to 1.3 +/- 0.14% (p less than 0.001). Because the increased values observed in either noninsulin-dependent diabetics or obese subjects are less than the ACCR values observed in acute pancreatitis or in diabetic ketoacidosis, the elevated ACCR in those conditions is only partially explained by the hyperglucagonemia.

  6. Utility of serum creatinine/cystatin C ratio in diagnosis of postrenal acute kidney injury

    Directory of Open Access Journals (Sweden)

    Salih Inal

    2014-01-01

    Full Text Available Background: In obstructive uropathy, despite a severe increase in the serum creatinine (Cr levels, only a mild cystatin C (CysC increase was previously reported. Therefore, we aimed to determine the availability of serum Cr/CysC ratio in predicting postrenal acute kidney injury (AKI. Materials and Methods: This was a cross-sectional study involving 61-adult patients with heterogeneous AKI cases. Patients with bilateral pelvicalyceal dilatation in renal sonography were considered as postrenal AKI group (n = 15 and others were intrinsic AKI group (n = 46. Venous blood sampling for blood urea nitrogen, Cr and CysC measurements were performed on admission. Results: The mean age of study population was 66.3 ± 15.5 years; 38 (62% of which were male. Two groups were similar regarding age, gender, and comorbidities. Cr/CysC ratio was significantly higher in postrenal AKI group (6.9 ± 3.1 vs. 4.4 ± 2.1, P = 0.007. Conclusion: We suggest that serum Cr/CysC ratio seems to be a useful diagnostic tool for detection of postrenal AKI cases, especially for the cases without definite hydronephrosis.

  7. Increased serum urea to creatinine ratio and its negative correlation with arterial pressure in canine babesiosis.

    Science.gov (United States)

    Zygner, Wojciech; Gójska-Zygner, Olga

    2014-09-01

    The increase of the serum urea to creatinine ratio (UCR) was observed in dogs infected with Babesia canis. Previous studies have suggested that decrease of blood pressure can be one of the reasons for this phenomenon. In this work statistically significant increase of the UCR was observed in dogs with babesiosis. Comparison of the UCR between 23 azotaemic dogs and 25 non-azotaemic dogs infected with Babesia canis showed statistically significantly higher mean of the UCR in azotaemic dogs. Correlations between UCR and systolic, diastolic and mean arterial pressure (SAP, DAP and MAP) in 48 dogs infected with B. canis were negative (UCR and SAP: r = -0.3909; UCR and DAP: r = -0.3182; UCR and MAP: r = -0.3682) and statistically significant (p babesiosis. However, the correlations were not high, and there was no statistically significant correlation between UCR and arterial pressures in azotaemic dogs. Thus, it seems that decrease of blood pressure in dogs with babesiosis explains only partially the cause of increased UCR in infected dogs. The other authors suggested hyperureagenesis and myocardial injury as a potential reason for the increased UCR in canine babesiosis. Thus, further studies are needed to determine causes of increased UCR in dogs with babesiosis, especially on the connection between UCR changes and the concentrations of plasma cardiac troponins and ammonia, and the occurrence of occult blood on fecal examination.

  8. 入院肌酐水平在预测慢性心力衰竭患者进行性肾功能损害中的作用%Prediction of creatinine level at admission for worsening renal function in patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    杨晓红; 郑晓晖; 郝增光; 葛慧敏; 王培

    2015-01-01

    目的:研究入院肌酐水平在预测慢性心力衰竭患者进行性肾功能损害中的作用。方法:采用病例对照研究方法,分析2组之间入院肌酐水平的差异及肾功能损害发生的独立危险因素,应用ROC曲线得到预测肾功能损害的肌酐临界值。结果:入院肌酐水平在2组之间存在显著差异(P<0.05),入院肌酐水平与肾功能损害的发生独立相关,OR值为2.248。预测肾功能损害发生的最佳肌酐临界值为112.85umol/L,灵敏度及特异度分别为0.638、0.592。结论:发生肾功能损害者入院肌酐水平明显高于对照组,入院肌酐水平可预测肾功能损害的发生。%Objective:To describe the prediction of creatinine level at admission for worsening renal function( WRF) in patients with chronic heart failure.Methods:Data was collected in a nested case-control study on 211 subjects who were hospitalized with HF (66 patients with WRF, de? ned as a rise in serum creatinine level≥26.5umol/L[0.3mg/dL], and 145 control subjects ).Compared the differentiation of creatinine level at admission between the two groups, and multivariable analysis was used to identify independent predic-tors for WRF.Get the best critical value of creatinine using ROC curve.Results: Creatinine level at admission was higher in the case group (P<0.05).Creatinine level at admission was a independent predictor for WRF (OR=2.248,95%CI:1.088~4.647).The best critical value of creatinine was 112.85umol/L, sensitivity:0.638, specificity:0.592. Conclusion: Creatinine level at admission was higher in the case group.Creatinine level at admission could predict the occurrence of WRF.

  9. Associations of increases in serum creatinine with mortality and length of hospital stay after coronary angiography.

    Science.gov (United States)

    Weisbord, Steven D; Chen, Huanyu; Stone, Roslyn A; Kip, Kevin E; Fine, Michael J; Saul, Melissa I; Palevsky, Paul M

    2006-10-01

    The absence of a universally accepted definition of radiocontrast nephropathy (RCN) has hampered efforts to characterize effectively the incidence and the clinical significance of this condition. The objective of this study was to identify a clinically relevant definition of RCN by assessment of the relationships between increases in serum creatinine (Scr) of varying magnitude after coronary angiography and clinical outcomes. An electronic medical database was used to identify all patients who underwent coronary angiography at the University of Pittsburgh Medical Center during a 12-yr period and abstract Scr levels before and after angiography, as well as demographic characteristics and comorbid conditions. Changes in Scr after angiography were categorized into mutually exclusive categories on the basis of absolute and relative changes from baseline levels, with a separate category denoting "unknown" change. Discrete proportional odds models were used to examine the association between increases in Scr and 30-d in-hospital mortality and length of stay. A total of 27,608 patients who underwent coronary angiography were evaluated. Small absolute (0.25 to 0.5 mg/dl) and relative (25 to 50%) increases in Scr were associated with risk-adjusted odds ratios for in-hospital mortality of 1.83 and 1.39, respectively. Larger increases in Scr generally were associated with greater risks for these clinical outcomes. Small increases in Scr after the administration of intravascular radiocontrast are associated with adverse patient outcomes. This observation will help guide the post-procedure care of patients who undergo coronary angiography and has important implications for future studies that investigate RCN.

  10. Association between albumin:creatinine ratio and 24-hour ambulatory blood pressure in essential hypertension.

    Science.gov (United States)

    Boulatov, V A; Stenehjem, A; Os, I

    2001-04-01

    Microalbuminuria (MAU) is often found in essential hypertension (EH) and represents a sign of renal and cardiovascular damage. In the present study, we aimed to look at the association between ambulatory blood pressure (BP) and urinary albumin excretion (UAE). We studied 140 patients aged 50.1 +/- 11.6 years referred for 24-h ambulatory blood pressure monitoring (ABPM) and, separately, 46 untreated subjects with newly diagnosed EH. Urinary albumin excretion was evaluated by determination of the albumin-to-creatinine ratio (ACR) in the first voided morning urine sample taken the same day as the ABPM was started. According to the ACR, patients were categorized as having normoalbuminuria (ACR or = 3.0 mg/mmol). Mean ACR was significantly higher in hypertensive than normotensive individuals (2.17 +/- 2.67 mg/mmol and 1.72 +/- 2.97 mg/mmol, respectively, P = .012). Average 24-h, daytime and nighttime systolic BP and diastolic BP were lower in patients with normoalbuminuria than in the other two groups and did not differ among the two microalbuminuric groups. Univariate regression analysis showed a close relationship between ACR and ambulatory BP. Strong correlation between BP and ACR in the normoalbuminuric and borderline microalbuminuric range was also obtained in the group of 46 newly diagnosed hypertensive patients. In conclusion, the threshold level of ACR > or = 3.0 mg/mmol currently used to define microalbuminuria may be not applicable to EH. Instead, a threshold level of ACR > or = 1. 5 mg/mmol may be more appropriate.

  11. Changes in urine microalbumin-to-creatinine ratio in children with sickle cell disease over time

    Directory of Open Access Journals (Sweden)

    Ibrahim F. Shatat

    2016-10-01

    Full Text Available Background: Approximately 20% of children with sickle cell disease (SCD have microalbuminuria (MA. Very little is known about the progression of MA in children and young adults with SCD. Methods: In this study, we analyzed 5 year EMR data of 373 children (with ≥2 Microalbumin to creatinine (MA/Cr ratio measurements followed at the Medical University of South Carolina to determine the rate, direction, magnitude and predictors of MA/Cr change over time. Results: Age range was 1 – 22 years; mean 10.2 ± 5.2 years, 49.5% were male. Median follow up duration was 3.12 ±1.16 years. At baseline, 328 children had normal (<20 mg/L MA level. Forty-five (12.1% of children had MA (≥ 20 mg/L, of which 91% were ≥ 8 years and 21 (47% continued to have MA at the end of the study period. On the other hand, during the study period, 24 new patients developed MA and 24 normalized their MA to levels <20 mg/L. In multivariate logistic regression model, age and bilirubin levels were predictive of MA/Cr increase in patients who received at least one blood transfusion during the study period. Baseline MA level was not predictive of the change in MA/Cr. Conclusions: In children and young adults, microalbuminuria is considered a marker of early renal injury. Over time, MA/Cr levels may increase or decrease. Further studies are needed to confirm our findings, assess the reliability of MA as marker of long-term renal injury and identify high risk patients likely to have worsening of MA over time.

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

    Science.gov (United States)

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

    1999-11-01

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

  13. 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.

  14. Serum Creatinine Modifies Associations between Body Mass Index and Mortality and Morbidity in Prevalent Hemodialysis Patients.

    Directory of Open Access Journals (Sweden)

    Yukitoshi Sakao

    Full Text Available High body mass index (BMI is paradoxically associated with better outcomes in hemodialysis (HD patients. This study aimed to examine whether serum creatinine (Cr, a marker of muscle mass, could modify the association between BMI, and mortality and morbidity in prevalent HD patients.A retrospective study was conducted using a nationwide database from the registry of the Japanese Society for Dialysis Therapy. A total of 119,099 patients were selected (age: 65±12 years; median time on HD: 5.6 years; male: 62%, and we examined the association of basal BMI with mortality and morbidity after a 1-year period. Patients were stratified either by BMI into 4 groups or by serum Cr levels into 3 tertiles. Odds ratio (OR [95% confidence interval] was calculated by multivariate logistic regression analysis.Higher BMI did not predict a higher 1-year total mortality. However, when we stratified the patients by serum Cr levels, the risk of cardiac death became significantly higher in obese patients with the lowest Cr levels, in both males (OR 2.82 [1.51-5.27], p<0.01 and females (OR 2.00 [1.03-3.90], p<0.05. The risk of new cerebral infarction was also higher in obese male patients within the lowest Cr tertile. In contrast, there was a significantly lower risk of cardiac, cerebrovascular, and infection-related death in non-obese patients with higher levels of Cr. Higher serum Cr was also related to a lower risk of cardiovascular events and hip fracture in non-obese HD patients.The obesity paradox was found to be present in HD patients only when obesity was defined by BMI. Decreased serum Cr levels were found to be positively associated with clinical poor outcomes in all BMI groups. Thus, irrespective of BMI, the evaluation of serum Cr levels is important to predict mortality and morbidity in patients receiving regular HD.

  15. 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.

  16. 三种方法检测尿中肌酐的结果比对%The results comparison of three methods to assay creatinine in urine with HPLC, spectrophotometry and creatinine diagnostic reagent kit

    Institute of Scientific and Technical Information of China (English)

    李凤贞; 区文凯; 何凤群; 程允杰

    2011-01-01

    目的:验证反相高效液相色谱法(WS/T 98-1996)、分光光度法(WS/T 97-1996)和肌酐测定试剂盒(苦味酸法)三种方法检测尿中肌酐的结果可比性.方法:以同一尿样,在采集后第1天、第3天、第5天以上述三种检测方法进行尿中肌酐的检测,卫生部行标方法按标准检验进行操作,临床生化非标方法按说明书要求进行操作.结果:同一尿样在采集后第1天、第3天、第5天按同一方法检测,尿中肌酐检测值无显著性差异(P>0.05);同一尿样按不同的方法进行检测,尿中肌酐的结果有显著性差异(P 0.05 ) ; And there were significant differences of the creatinine in the collected same urine with HPLC, spectrophotometry and creatinine diagnostic reagent kit (P < 0.01). Conclusion: The results were incompared because there were significant differences of the creatinine in the collected same urine with HPLC,spectrophotometry and creatinine diagnostic reagent kit.

  17. Volume regulation in epithelia

    DEFF Research Database (Denmark)

    Larsen, Erik Hviid; Hoffmann, Else Kay

    2016-01-01

    function of iso-osmotic fluid transport that depends on Na+ recirculation. The causative relationship is discussed for a fluid-absorbing and a fluid-secreting epithelium of which the Na+ recirculation mechanisms have been identified. A large number of transporters and ion channels involved in cell volume...... regulation are cloned. The volume-regulated anion channel (VRAC) exhibiting specific electrophysiological characteristics seems exclusive to serve cell volume regulation. This is contrary to K+ channels as well as cotransporters and exchange mechanisms that may serve both transepithelial transport and cell...

  18. Cardiac CT: are we underestimating the dose? A radiation dose study utilizing the 2007 ICRP tissue weighting factors and a cardiac specific scan volume

    Energy Technology Data Exchange (ETDEWEB)

    Gosling, O., E-mail: Oliver.gosling@pms.ac.u [Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, Devon (United Kingdom); Loader, R.; Venables, P.; Rowles, N.; Morgan-Hughes, G. [Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, Devon (United Kingdom); Roobottom, C. [Peninsula College of Medicine and Dentistry, University of Plymouth, Devon (United Kingdom)

    2010-12-15

    Aim: To calculate the effective dose from cardiac multidetector computed tomography (MDCT) using a computer-based model utilizing the latest International Commission on Radiation Protection (ICRP) 103 tissue-weighting factors (2007), to compare this dose with those calculated with previously published chest conversion factors and to produce a conversion factor specific for cardiac MDCT. Materials and methods: An observational study of 152 patients attending for cardiac MDCT as part of their usual clinical care in a university teaching hospital. The dose for each examination was calculated using the computer-based anthropomorphic ImPACT model (the imaging performance assessment of CT scanners) and this was compared with the dose derived from the dose-length product (DLP) and a chest conversion factor. Results: The median effective dose calculated using the ImPACT calculator (4.5 mSv) was significantly higher than the doses calculated with the chest conversion factors (2.2-3 mSv). Conclusion: The use of chest conversion factors significantly underestimates the effective dose when compared to the dose calculated using the ImPACT calculator. A conversion factor of 0.028 would give a better estimation of the effective dose from prospectively gated cardiac MDCT.

  19. Longitudinal Serum Creatinine Levels in Relation to Graft Loss Following Renal Transplantation: Robust Joint Modeling of Longitudinal Measurements and Survival Time Data

    Directory of Open Access Journals (Sweden)

    Younespour

    2016-08-01

    Full Text Available Background Chronic kidney disease (CKD is a major public health problem that may lead to end-stage renal disease (ESRD. Renal transplantation has become the treatment modality of choice for the majority of patients with ESRD. It is therefore necessary to monitor the disease progression of patients who have undergone renal transplantation. In order to monitor the disease progression, the continuous assessment of kidney function over time is considered. Objectives This study aimed to investigate the etiological role of recipient characteristics in serum creatinine changes within the follow-up period and in relation to the graft failure risk, as well as to evaluate whether or not the serum creatinine level represents an indicator of graft failure following renal transplantation. Methods This retrospective cohort study was conducted at the department of nephrology, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, between April 2005 and December 2008. The study involved 413 renal transplantation patients. The primary outcomes were the determination of the serum creatinine levels at each attendance and the time to graft failure. Robust joint modeling of the longitudinal measurements (serum creatinine level and time-to-event data (time to graft failure were used for the analysis in the presence of outliers in the serum creatinine levels. The data analysis was implemented in WinBUGS 1.4.3. Results There was a positive association between the serum creatinine level and graft failure (HR = 5.13, P < 0.001. A one unit increase in the serum creatinine level suggests an increased risk of graft failure of up to 5.13 times. The serum creatinine level significantly decreased over time (95% CI: (-1.58, -1.08. The recipient’s age was negatively associated with the serum creatinine level (95% CI: (-0.02, -0.001. Conclusions Graft failure is more likely to occur in patients with higher serum creatinine levels.

  20. Comparative formation of 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) in creatinine/phenylalanine and creatinine/phenylalanine/4-oxo-2-nonenal reaction mixtures.

    Science.gov (United States)

    Zamora, Rosario; Alcón, Esmeralda; Hidalgo, Francisco J

    2013-05-01

    The comparative formation of the heterocyclic aromatic amine 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) in both creatinine/phenylalanine (CRN/Phe) and creatinine/phenylalanine/4-oxo-2-nonenal (CRN/Phe/ON) systems was studied to analyse the ability of lipid-derived reactive carbonyls to promote PhIP formation. Although PhIP was produced to some extent in the CRN/Phe system, the presence of the oxidized lipid increased considerably the amount of PhIP produced. This increase seemed to be a consequence of the decrease in the E(a) of the reaction when the lipid was present, which diminished from 112.9 to 80.9 kJ/mol. On the other hand, the addition of the lipid did not seem to produce PhIP by an alternative mechanism because PhIP was formed analogously in both CRN/Phe and CRN/Phe/ON systems as a function of pH, creatinine concentration, phenylalanine concentration, time, temperature, oxygen concentration in the reaction atmosphere, and the addition of different amounts of ammonia. All these results suggest that the ability of lipid oxidation products to produce PhIP is related to their capacity to induce the Strecker degradation of phenylalanine to phenylacetaldehyde. Therefore, any other reactive carbonyl compound that can produce the Strecker degradation of phenylalanine should also be considered as a potential inducer of PhIP formation under appropriate conditions.

  1. 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

    2017-03-01

    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.

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

    Science.gov (United States)

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

    2015-12-01

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

  3. Is Serum Transforming Growth Factor beta-1 Superior to Serum Creatinine for assessing Renal Failure and Renal Transplant Rejection

    OpenAIRE

    Gyanendra Kumar Sonkar, Usha; R.G. Singh

    2009-01-01

    A sustained overexpression of Transforming Growth Factor beta1 (TGF beta1), a cytokine has beenimplicated in the pathogenesis of fibrosis of kidney leading to end stage . The main aim of present studywas to find the utility of TGF beta1 and serum creatinine in differentiating chronic renal failure (CRF)from acute renal failure (ARF), renal transplant rejection (Tx Rej) and stable renal transplant (Tx Stb)and to study has attempted histopathological correlation of rejection cases with TGF beta...

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

    Directory of Open Access Journals (Sweden)

    Christopher J. Kirwan

    2013-01-01

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

  5. Elevated amylase creatinine clearance ratio and normal serum amylase levels in chronic relapsing pancreatitis after partial pancreatectomy.

    Science.gov (United States)

    Cattau, E L; Garcia-Torres, F

    1980-12-01

    A 29-year-old woman admitted for alcohol detoxification five years after a 90% distal pancreatectomy for chronic pancreatitis had abdominal pain similar to that associated with preoperative pancreatitis. Although her clinical course was consistent with recurrent pancreatitis, the serum amylase level remained normal, but the amylase creatinine clearance ratio became elevated and then returned to normal, paralleling her clinical course. The ACCR may be a useful laboratory method in diagnosing chronic recurrent pancreatitis in patients with decreased functional pancreatic tissue.

  6. Analysis of observed values of glucose, creatinine, bilirubin and ALT examinations in Blood(Serum,Plasma) in hospital population

    OpenAIRE

    Soni, Heratkumar D.; Kapadia, Manisha P.; Modi, Kamal R.; Patel, Shaileshkumar M.; Saxena, Puneet

    2015-01-01

    Objectives: Find reference range by Hoffman's method and compare it with published reference range in standard textbooks.Method: Observed values (results) of glucose (FBS, RBS and PP2BS), creatinine, bilirubin (total and direct) and ALT were collected from LIS of biochemistry section of New civil hospital surat laboratory services. Data were analysed using computarised hoffman's method as described by Alex K, Claudiu B and David WS2. Reference range derived by computarised hoffman's method we...

  7. Simultaneous determination of purine metabolites, creatinine and pseudouridine in ruminant urine by reversed-phase high-performance liquid chromatography.

    Science.gov (United States)

    Shingfield, K J; Offer, N W

    1999-02-19

    Determination of purine metabolites, pseudouridine and creatinine in both bovine and ovine urine using high-performance liquid chromatography (HPLC) is described. Following dilution and filtration, urine samples were analysed directly. Separation and quantification was achieved using a Spherisorb ODS II C18 column (250x4.6 mm I.D.) under isocratic conditions. The mobile phase contained 7.5 mM ammonium dihydrogen phosphate, 10 mM sodium 1-heptane sulphonic acid and 1.0 mM triethylamine at pH 3.0. Chromatography was achieved at a flow-rate of 1.0 ml/min and monitoring column effluent at 218 nm. Total analysis time was 60 min. Recovery of all compound standards added to urine was above 96%. In all cases, close spectral matches of compound standards and corresponding identified peaks in ovine and bovine urine were obtained. Lowest detectable concentrations of allantoin, uric acid, xanthine, hypoxanthine, creatinine and pseudouridine were 1.1, 1.0, 1.0, 3.0 and 0.4 micromol/l, respectively. Advantages of simultaneous determination of purine metabolites, creatinine and pseudouridine in ruminant urine collected from both sheep and cattle exist over current methods.

  8. Multidimensional high-performance liquid chromatography on Pinkerton ISRP and RP18 columns: direct serum injection to quantify creatinine.

    Science.gov (United States)

    Puhlmann, A; Dülffer, T; Kobold, U

    1992-10-02

    A two-dimensional high-performance liquid chromatographic method for the determination of creatinine with direct serum injection without sample pretreatment has been developed. The column-switching technique allowed a switch from columns packed with internal surface reversed-phase (ISRP) material to columns of almost any other material, even if the eluents necessary in a particular case do not appear to be directly compatible. A Pinkerton ISRP column, which stands out because of its very good stability when loaded with undiluted serum samples, was used as precolumn. The creatinine-containing fraction was switched to a reversed-phase Shandon RP18 column and was focused there by alteration of the eluent from pH 6.5 to phosphoric acid-ion-pair reagent. The separation occurs via a pH gradient, with ultraviolet detection at 234 nm. This method stands out particularly for its good long-term stability, simple sample handling without pretreatment, high selectivity, a broad linearity (0.3-30 mg/dl creatinine), good reproducibility (inter-assay coefficient of variation less than 3%) and high recovery (97-100%) relative to values obtained with gas chromatography-mass spectrometry.

  9. Serum Creatinine Modifies Associations between Body Mass Index and Mortality and Morbidity in Prevalent Hemodialysis Patients

    Science.gov (United States)

    Sakao, Yukitoshi; Ojima, Toshiyuki; Yasuda, Hideo; Hashimoto, Seiji; Hasegawa, Takeshi; Iseki, Kunitoshi; Tsubakihara, Yoshiharu; Kato, Akihiko

    2016-01-01

    Background High body mass index (BMI) is paradoxically associated with better outcomes in hemodialysis (HD) patients. This study aimed to examine whether serum creatinine (Cr), a marker of muscle mass, could modify the association between BMI, and mortality and morbidity in prevalent HD patients. Methods A retrospective study was conducted using a nationwide database from the registry of the Japanese Society for Dialysis Therapy. A total of 119,099 patients were selected (age: 65±12 years; median time on HD: 5.6 years; male: 62%), and we examined the association of basal BMI with mortality and morbidity after a 1-year period. Patients were stratified either by BMI into 4 groups or by serum Cr levels into 3 tertiles. Odds ratio (OR) [95% confidence interval] was calculated by multivariate logistic regression analysis. Results Higher BMI did not predict a higher 1-year total mortality. However, when we stratified the patients by serum Cr levels, the risk of cardiac death became significantly higher in obese patients with the lowest Cr levels, in both males (OR 2.82 [1.51–5.27], p<0.01) and females (OR 2.00 [1.03–3.90], p<0.05). The risk of new cerebral infarction was also higher in obese male patients within the lowest Cr tertile. In contrast, there was a significantly lower risk of cardiac, cerebrovascular, and infection-related death in non-obese patients with higher levels of Cr. Higher serum Cr was also related to a lower risk of cardiovascular events and hip fracture in non-obese HD patients. Conclusions The obesity paradox was found to be present in HD patients only when obesity was defined by BMI. Decreased serum Cr levels were found to be positively associated with clinical poor outcomes in all BMI groups. Thus, irrespective of BMI, the evaluation of serum Cr levels is important to predict mortality and morbidity in patients receiving regular HD. PMID:26930325

  10. Relationship of plasma creatinine and lactic acid in type 2 diabetic patients without renal dysfunction

    Institute of Scientific and Technical Information of China (English)

    LIU Fang; LU Jun-xi; TANG Jun-ling; LI Li; LU Hui-juan; HOU Xu-hong; JIA Wei-ping; XIANG Kun-san

    2009-01-01

    Background As one of most widely-used biguanides,metformin can induce the lactic acidosis in patients with renal failure though its incidence is very low.However,lactic acidemia induced by mefformin was reported in patients without renal dysfunction.It is unclear that whether lactatemia exists in diabetic patients with normal renal function in Chinese or not and its influencing factors.This study aimed to clarify the influencing factors of lactic acid,and identify a practiced clinical marker to predict the hyperlactacidemia in diabetics with normal renal function.Methods The clinical data and venous blood samples of 1024 type 2 diabetic patients treated with(n=426)or without metformin(n=599)were collected.The lactic acid was assayed by enzyme-electrode method.The biochemical indexes included creatinine(Cr)and hepatase were measured with enzymatic procedures.The lactic acid concentrations of different Cr subgroups were compared,and the correlation and receiver operating characteristic curve analysis were used.Results The mean lactic acid level and the proportion of hyperlactatemia of metformin group were significantly higher than that of non-metformin group(P<0.01),but no lactic acidosis was found in all patients.The correlation and multiple stepwise regression analysis indicated that the correlative factors of lactic acid in turn were Cr,metformin,alanine transferase(ALT),body mass index(BMI),Urine albumin(Ualb),and blood urea nitrogen(BUN)in total patients;and Cr,ALT,BMI and BUN in non-metformin treated patients;Cr and ALT in metformin-group.The lactate concentration increased with the increment of Cr levels,and reached its peak at Cr 111-130 μmol/L,and the optimal cutoff of Cr in predicting hyperlactacidemia was 96.5 μmol/L.Conclusions Metformin can increase the incidence of lactatemia in type 2 diabetic patients without renal dysfunction.Cr,ALT,and BMI are independent associated factors of blood lactic acid levels.There is low proportion of lactatemia in

  11. Determination of serum creatinine prior to iodinated contrast media: is it necessary in all patients?

    Science.gov (United States)

    Choyke, P L; Cady, J; DePollar, S L; Austin, H

    1998-06-01

    The risk of contrast-associated nephrotoxicity (CAN) is increased in the presence of preexisting renal disease. Although routine determination of serum creatinine (Cr) prior to imaging studies is the traditional method of assessing renal function, it is a costly and time-consuming practice. The purpose of this study was to investigate whether a patient survey could identify patients with a high likelihood of having normal Cr values and who, therefore, did not require serum testing. A survey was administered to 673 consecutive adult patients who were scheduled for contrast-enhanced computed tomography. Survey questions were designed to elicit a history of renal disorders as well as additional risk factors for CAN. Each patient had a Cr level determined within 48 hours prior to the injection of iodinated contrast media. Cr levels were assessed in the patients who gave negative responses to all survey questions. The degree to which positive responses to each survey question predicted elevated Cr levels was determined using the odds ratio (OR). Among the 673 respondents, 577 (85%) had normal Cr values (women and 1.7 mg/dL usually do not receive iodinated contrast media. Using this Cr cutoff value, 189 (99%) of 191 patients with negative responses had Cr values less than or equal to the cutoff value. The survey questions most strongly associated with elevated Cr values pertained to preexisting renal disease (OR 13.6), proteinuria (OR 8.7), prior kidney surgery (OR 8.1), hypertension (OR 5.4), gout (OR 4.6), and diabetes (OR 3.2). If the survey had been limited to these six questions, completely negative responses would have occurred in 450 (67%) of 673, 424 (94%) of these 450 would have normal Cr values, and 446 (99%) of 450 would have had Cr values at or below the 1.7 mg/dL cutoff for iodinated contrast. A completely negative response to a simple (six question) patient survey prior to iodinated contrast administration can identify a significant fraction of patients

  12. Urinary protein-to-creatinine ratio indicative of significant proteinuria in normotensive pregnant women.

    Science.gov (United States)

    Baba, Yosuke; Ohkuchi, Akihide; Usui, Rie; Takahashi, Hironori; Matsubara, Shigeki

    2016-07-01

    In hypertensive pregnant women, the protein-to-creatinine (P/C) ratio is well correlated with 24-h proteinuria and a P/C ratio of 0.27 (g/gCr) is used to reflect significant proteinuria (>0.3 g/day). The aim of this study was to obtain data on normotensive pregnant women, which have so far been lacking. The study population consisted of 74 pregnant women who met the following criteria: (i) ≥22 gestational weeks; (ii) a positive result (≥1+) on dipstick test; (iii) a positive result (>0.27) for P/C ratio; and (iv) 24-h urine test performed within 2 days of the P/C ratio. The correlation between the P/C ratio and 24-h proteinuria, the incidence rates of significant proteinuria according to P/C ratios, and appropriate threshold of the P/C ratio to rule in significant proteinuria were determined using the appropriate statistical methods. The P/C ratio was moderately correlated with the 24-h proteinuria, with a correlation coefficient of 0.64 (95% confidence interval, 0.487-0.76). The area under the receiver-operator curve was 0.76 (95% confidence interval, 0.66-0.87); however, no clear shoulder was identifiable. The incidence rates of significant proteinuria according to P/C ratios of 0.27-0.49, 0.50-0.74, 0.75-0.99, and >1 were 41, 66, 100, and 100%, respectively, indicating that all normotensive pregnant women with a P/C ratio > 0.75 had significant proteinuria. Normotensive pregnant women showed a significant correlation between the P/C ratio and 24-h urine protein level. All normotensive pregnant women with a P/C ratio > 0.75 had significant proteinuria, suggesting that a P/C ratio > 0.75 may be the 'rule-in' threshold of significant proteinuria in this population. © 2016 Japan Society of Obstetrics and Gynecology.

  13. 高比容量镍氢电池的制备及电化学性能%Preparation and electrochemical Performances of nickel metal hydride batteries with high specific volume capacity

    Institute of Scientific and Technical Information of China (English)

    杨敏杰; 南俊民; 侯宪鲁; 李伟善

    2008-01-01

    Cylindrical nickel metal hydride (Ni-MH) battery with high specific volume capacity was prepared by using the oxyhydroxide Ni(OH)2 and AB5 type hydrogen storage alloy and adjusting the designing parameters of positive and negative electrodes. The oxyhydroxide Ni(OH)2 was synthesized by oxidizing spherical β-Ni(OH)2 with chemical method. The X-ray diffraction (XRD) patterns and the Fourier transform infrared (FT-IR) spectra indicated that γ-NiOOH was formed on the oxyhydroxide Ni(OH)2 powders, and some H2O molecules were inserted into their crystal lattice spacing. The battery capacity could not be improved when the oxyhydroxide Ni(OH)2 sample was directly used as the positive active materials. However, based on the conductance and residual capacity of the oxyhydroxide Ni(OH)2 powders, AA size Ni-MH battery with 2560 mA·h capacity and 407 W·h·L specific volume energy at 0.2C was obtained by using the commercial spherical β-Ni(OH)2 and AB5-type hydrogen-storage alloy powders as the active materials when 10% mass amount of the oxyhydroxide Ni(OH)2 with 2.50 valence was added to the positive active materials and subsequently the battery designing parameters were adjusted as well. The as-prepared battery showed 70% initial capacity after 80 cycles at 0.5C. The possibility for adjusting the capacity ratio of positive and negative electrodes from 1 : 1.35 to 1 : 1.22 was demonstrated preliminarily. It is considered the as-prepared battery can meet the requirement of some special portable electrical instruments.

  14. [Bacterial contamination of infant urine samples obtained from filter papers used in neuroblastoma-screening tests. (6) Protective effects of preaddition of chlorhexidine digluconate in filter papers or containers for urine on bacterial break-down of creatinine, vanillylmandelic acid and homovanillic acid].

    Science.gov (United States)

    Imai, J; Iwata, H; Gotoh, K; Mori, H; Kawai, M

    1992-10-01

    The effects of chlorhexidine digluconate preadded to urine samples for a neuroblastoma-screening test in preventing the break-down of creatinine (Cre), vanillylmandelic acid (VMA), and homovanillic acid (HVA) by creatinine-cleaving bacteria and the influence of the added disinfectant on the HPLC determination of urinary Cre, VMA, vanillillactic acid (VLA) and HVA. Laboratory or field experiments showed that preadded disinfectant (0.02% volume) nearly completely inhibited the growth of the bacteria and satisfactorily protected urinary Cre, VMA, and HVA from bacterial decomposition. Chlorhexidine digluconate was comparable to benzalkonium chloride in its inhibitory effects on the growth and activities of creatinine-cleaving bacteria. Unlike benzalkonium chloride, chlorhexidine digluconate added to urine samples gave no troubles in subsequent analytical processes. Addition of the disinfectant (0.02% volume) to standard Cre, VMA, VLA, and HVA solution did not affect retention times and sensitivities in HPLC analyses. To estimate influences of the added disinfectant on the serial HPLC determinations of VMA, VLA, and HVA on a large number of urine samples (40, 80, 120, 160, 200, or 5, 500), HPLC analyses were performed on standard VMA, VLA, and HVA solution with repeated injection of the disinfectant in great amounts into a column. The results showed no appreciable changes in the retention times and sensitivities of VMA, VLA, and HVA, and almost complete elution of the disinfectant retained on the column were possible with water-methanol (1:1, 2:8) or methanol washing.(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Characterization of Organic Anion Transporter 2 (SLC22A7): A Highly Efficient Transporter for Creatinine and Species-Dependent Renal Tubular Expression.

    Science.gov (United States)

    Shen, Hong; Liu, Tongtong; Morse, Bridget L; Zhao, Yue; Zhang, Yueping; Qiu, Xi; Chen, Cliff; Lewin, Anne C; Wang, Xi-Tao; Liu, Guowen; Christopher, Lisa J; Marathe, Punit; Lai, Yurong

    2015-07-01

    The contribution of organic anion transporter OAT2 (SLC22A7) to the renal tubular secretion of creatinine and its exact localization in the kidney are reportedly controversial. In the present investigation, the transport of creatinine was assessed in human embryonic kidney (HEK) cells that stably expressed human OAT2 (OAT2-HEK) and isolated human renal proximal tubule cells (HRPTCs). The tubular localization of OAT2 in human, monkey, and rat kidney was characterized. The overexpression of OAT2 significantly enhanced the uptake of creatinine in OAT2-HEK cells. Under physiologic conditions (creatinine concentrations of 41.2 and 123.5 µM), the initial rate of OAT2-mediated creatinine transport was approximately 11-, 80-, and 80-fold higher than OCT2, multidrug and toxin extrusion protein (MATE)1, and MATE2K, respectively, resulting in approximately 37-, 1850-, and 80-fold increase of the intrinsic transport clearance when normalized to the transporter protein concentrations. Creatinine intracellular uptake and transcellular transport in HRPTCs were decreased in the presence of 50 µM bromosulfophthalein and 100 µM indomethacin, which inhibited OAT2 more potently than other known creatinine transporters, OCT2 and multidrug and toxin extrusion proteins MATE1 and MATE2K (IC50: 1.3 µM vs. > 100 µM and 2.1 µM vs. > 200 µM for bromosulfophthalein and indomethacin, respectively) Immunohistochemistry analysis showed that OAT2 protein was localized to both basolateral and apical membranes of human and cynomolgus monkey renal proximal tubules, but appeared only on the apical membrane of rat proximal tubules. Collectively, the findings revealed the important role of OAT2 in renal secretion and possible reabsorption of creatinine and suggested a molecular basis for potential species difference in the transporter handling of creatinine.

  16. Evaluation of random urine sodium and potassium compensated by creatinine as possible alternative markers for 24 hours urinary sodium and potassium excretion.

    Science.gov (United States)

    Koo, Hyunmin; Lee, Sang-Guk; Kim, Jeong-Ho

    2015-03-01

    Sodium and potassium intake was assessed on the basis of its respective excretion levels in 24 hr urine samples. However, owing to the inconvenience of collection, we evaluated random spot urine for alternative sodium and potassium excretion markers. We included 250 patients who submitted 24 hr- and spot urine for clinical tests. However, 22 patients who showed 24 hr urine creatinine excretion levels creatinine (r=0.34, Pcreatinine (r=0.47, Pcreatinine and potassium/creatinine ratios showed a significant correlation with 24 hr urine sodium and potassium excretion, respectively, further studies are required to develop a spot urine test for individualized monitoring of sodium and potassium excretion.

  17. Correlation analysis of plasma creatinine after angiography and other risk factors%造影术后肌酐水平和各危险因素的相关性研究

    Institute of Scientific and Technical Information of China (English)

    双东思; 郭卉; 苏晞; 朱国英; 蔡建华

    2013-01-01

    OBJECTIVE To evaluate the relationship between serum creatinine after angiography and other risk factors.METHODS This study included 54 patients with mild or moderate renal disfunction and type 2 diabetes undergoing cardiovascular angiography.Baseline data (sex,baseline Scr,weight,height,etc.) and serum creatinine at 48 hours post-operation and at 72 hours post-operation were selected.Statistical analysis was performed among baseline Scr,Scr at 48 hours and Scr at 72 hours.The risk factors before angiography (sex,Cr,weight,height,BUN,DBP,ect.) were recorded and the relationship was analyzed by Partial least-squares regression on SIMCA-P software.RESULTS Statistical analysis of paired data showed that serum creatinine (Scr) at 72 hours post-operation significantly increased 3% than baseline (P =0.012;97.37 ± 20.06 vs.94.99 ± 20.27) umoL/1.Serum creatinine at 72 hours post-operation was considered as the peak value of post-operation.PLS showed significant positive correlations between plasma creatinine at 72 hours post-operation and Scr,Age,CHF,SBP,DBP,ACEI,ARB,contrast volume,BS,BUN,NSAIDS,and ALT and negative correlation between plasma creatinine at 72 hours post-operation and woman,weight,hydration,Hb and TC were observed.Scr,sex,weight,height and ACEI were revealed to be the leading correlated factors of plasma creatinine at 72 hours post-operation to VIP analysis.Successful fitting result was proved with predictive modeling analysis.CONCLUSION Serum creatinine at 72 hours post-operation in patients with mild or moderate renal disfunction and type 2 diabetes is the peak value of post-operation.The baseline serum creatinine is the most important risk factor in increased serum creatinine after angiography.%目的 探讨术后肌酐峰值和基线各危险因子的相关性.方法 选取行心血管造影的2型糖尿病并轻-中度肾功能不全的患者54例,收集术前基线资料(性别、基线肌酐、体重、身高等)和术后48 h和72 h肌酐

  18. Intervalos de referencia locales para la excreción urinaria de creatinina en una población adulta Local reference intervals for the excretion of creatinine in urine for an adult population

    Directory of Open Access Journals (Sweden)

    J. Barreto Penie

    2003-04-01

    anglosajones que compartían las mismas propiedades biológicas. No se comprobó correlación entre la edad del sujeto y la excreción urinaria de creatinina. Conclusiones: Se recomienda emplear los valores de la excreción urinaria de creatinina obtenidos localmente y tabulados en este artículo para la realización de estudios de composición corporal y evaluación nutricional.Objetive: To present the height- and sex-specific reference intervals for the urinary excretion of creatinine in cuban subjects with ages between 19-58 years. Background: The standards advanced by Bistrian (1985 for anglosaxon subjects have been traditionally used for the construction of the Index of Creatinine Excretion (ICE. This practice could lead to diagnostic errors in the case of ICE calculation for non-anglosaxon populations differing in dietetic behaviour and body composition. Methods: Values of urinary excretion of Creatinine measured in 103 men and 112 women with ages between 19 and 58 years, and preserved nutritional wellbeing (weight within the interquartile range for height; 18.5 ≤ body mass index ≤ 30.0 kg/m² and renal function (serum Creatinine ≤ 132 µmol/l were drawn retrospectively from the databases of the Section of Urinalysis, Service of Clinical Laboratory, "Hermanos Ameijeiras" Hospital (La Habana, Cuba. For each sex, the regression line urinary- Excrecion-of-Creatinine = c + d · height, where c, d: parameters dependent on the subject’s height, were constructed. The predicted values of the urinary excretion of Creatinine for the cuban subjects were derived from the 100 (1-α% prediction intervals (Pl of the regression line. Results: The urinary excretion of Creatinine for a 170 cm-height, 66.5 kg-weight, cuban male with age between 19-58 years, was 1216.19 mg/24 hours (95% Pl: 821.02-1611.36 mg/24 hours. The urinary excretion of Creatinine for a 160 cm-height, 59.7kKg-weight, cuban female with age between 19-58 years, was 852.00 mg/24 hours (95% Pl: 420.15-1283.84 mg

  19. Compiler writing system detail design specification. Volume 2: Component specification

    Science.gov (United States)

    Arthur, W. J.

    1974-01-01

    The logic modules and data structures composing the Meta-translator module are desribed. This module is responsible for the actual generation of the executable language compiler as a function of the input Meta-language. Machine definitions are also processed and are placed as encoded data on the compiler library data file. The transformation of intermediate language in target language object text is described.

  20. Introduction to the Volume.

    Science.gov (United States)

    Emihovich, Catherine; Schroder, Barbara; Panofsky, Carolyn P.

    1999-01-01

    Introduces a volume that examines the issue of critical thinking and whether or not it is culturally specific, discussing recent research on the subject. The papers focus on critical thinking and culture, historical consciousness and critical thinking, critical thinking as cultural-historical practice, culture and the development of critical…

  1. [Radioisotopic quantification of kidney function using Tc-99m-DMSA. Comparison with creatinine clearance in children with a single kidney].

    Science.gov (United States)

    Baillet, G; Gagnadoux, M F; Mathonnat, F; de Vernejoul, P; Broyer, M

    1986-01-01

    To assess the accuracy of renal function quantification with Tc 99m-DMSA in children, we compared DMSA renal uptake and creatinine clearance in 16 cases of children with single kidney. The age of the patients ranged from two month to fourteen years. DMSA renal uptake was measured 7 hours after injection and was normalized in percent of the injected activity. A significant correlation was found between creatinine clearance and DMSA uptake (Pearson's r = 0.866, p less than 0.01). Normal creatinine clearance in children (80 to 120 ml/min-1 X 1.73 m-2) allowed determination of normal renal uptake (36 to 60%). This study indicates that in cases of asymmetrical renal impairment renal uptake reflects split renal creatinine clearance. Since the former is much easier to measure, DMSA should play an important role in the evaluation of differential renal function.

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

    Directory of Open Access Journals (Sweden)

    Amrah Javaid

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨渝伟

    2013-01-01

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

  4. Amyotrophic lateral sclerosis outcome measures and the role of albumin and creatinine: a population-based study.

    Science.gov (United States)

    Chiò, Adriano; Calvo, Andrea; Bovio, Giacomo; Canosa, Antonio; Bertuzzo, Davide; Galmozzi, Francesco; Cugnasco, Paolo; Clerico, Marinella; De Mercanti, Stefania; Bersano, Enrica; Cammarosano, Stefania; Ilardi, Antonio; Manera, Umberto; Moglia, Cristina; Sideri, Riccardo; Marinou, Kalliopi; Bottacchi, Edo; Pisano, Fabrizio; Cantello, Roberto; Mazzini, Letizia; Mora, Gabriele

    2014-09-01

    There is an urgent need to identify reliable biomarkers of amyotrophic lateral sclerosis (ALS) progression for clinical practice and pharmacological trials. To correlate several hematological markers evaluated at diagnosis with ALS outcome in a population-based series of patients (discovery cohort) and replicate the findings in an independent validation cohort from an ALS tertiary center. The discovery cohort included 712 patients with ALS from the Piemonte and Valle d'Aosta Register for Amyotrophic Lateral Sclerosis from January 1, 2007, to December 31, 2011. The validation cohort comprised 122 patients with ALS at different stages of disease consecutively seen at an ALS tertiary center between January 1, 2007, and January 1, 2009. The following hematological factors were investigated and correlated with survival: total leukocytes, neutrophils, lymphocytes, monocytes, glucose, creatinine, uric acid, albumin, bilirubin, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, creatine kinase, thyroid-stimulating hormones, and erythrocyte sedimentation rate; all analyses were performed separately by sex. The patient of the validation cohort also underwent bioelectrical impedance analysis for the calculation of fat-free mass. Of the 712 patients in the examined period in Piemonte and Valle d'Aosta, 638 (89.6%) were included in the study. Only serum albumin (men: ≤ 4.3 vs >4.3 mg/dL, P 4.3 mg/dL, P 0.82 mg/dL, P = .004; women: ≤ 0.65 vs >0.05 mg/dL, P = .004) and lymphocyte count (men: ≤ 1700 vs >1700/μL, P = .04; women: ≤ 1700 vs >1700/μL, P = .02) were significantly associated with ALS outcome in both sexes with a dose-response effect (better survival with increasing levels). These findings were confirmed in the validation cohort. Multivariable analysis showed that serum albumin (men: hazard ratio [HR], 1.39; 95% CI, 1.05-1.90; P = .02; women: HR, 1.73; 95 % CI, 1.35-2.39; P = .001) and

  5. Sex-specific mediation effect of the right fusiform face area volume on the association between variants in repeat length of AVPR1A RS3 and altruistic behavior in healthy adults.

    Science.gov (United States)

    Wang, Junping; Qin, Wen; Liu, Feng; Liu, Bing; Zhou, Yuan; Jiang, Tianzi; Yu, Chunshui

    2016-07-01

    Microsatellite variants in the arginine vasopressin receptor 1A gene (AVPR1A) RS3 have been associated with normal social behaviors variation and autism spectrum disorders (ASDs) in a sex-specific manner. However, neural mechanisms underlying these associations remain largely unknown. We hypothesized that AVPR1A RS3 variants affect altruistic behavior by modulating the gray matter volume (GMV) of specific brain regions in a sex-specific manner. We investigated 278 young healthy adults using the Dictator Game to assess altruistic behavior. All subjects were genotyped and main effect of AVPR1A RS3 repeat polymorphisms and interaction of genotype-by-sex on the GMV were assessed in a voxel-wise manner. We observed that male subjects with relatively short repeats allocated less money to others and exhibited a significantly smaller GMV in the right fusiform face area (FFA) compared with male long homozygotes. In male subjects, the GMV of the right FFA exhibited a significant positive correlation with altruistic behavior. A mixed mediation and moderation analysis further revealed both a significant mediation effect of the GMV of the right FFA on the association between AVPR1A RS3 repeat polymorphisms and allocation sums and a significant moderation effect of sex (only in males) on the mediation effect. Post hoc analysis showed that the GMV of the right FFA was significantly smaller in male subjects carrying allele 426 than in non-426 carriers. These results suggest that the GMV of the right FFA may be a potential mediator whereby the genetic variants in AVPR1A RS3 affect altruistic behavior in healthy male subjects. Hum Brain Mapp 37:2700-2709, 2016. © 2016 Wiley Periodicals, Inc.

  6. Comparison of time-dependent effects of (+-methamphetamine or forced swim on monoamines, corticosterone, glucose, creatine, and creatinine in rats

    Directory of Open Access Journals (Sweden)

    Gudelsky Gary A

    2008-05-01

    Full Text Available Abstract Background Methamphetamine (MA use is a worldwide problem. Abusers can have cognitive deficits, monoamine reductions, and altered magnetic resonance spectroscopy findings. Animal models have been used to investigate some of these effects, however many of these experiments have not examined the impact of MA on the stress response. For example, numerous studies have demonstrated (+-MA-induced neurotoxicity and monoamine reductions, however the effects of MA on other markers that may play a role in neurotoxicity or cell energetics such as glucose, corticosterone, and/or creatine have received less attention. In this experiment, the effects of a neurotoxic regimen of (+-MA (4 doses at 2 h intervals on brain monoamines, neostriatal GFAP, plasma corticosterone, creatinine, and glucose, and brain and muscle creatine were evaluated 1, 7, 24, and 72 h after the first dose. In order to compare MA's effects with stress, animals were subjected to a forced swim test in a temporal pattern similar to MA administration [i.e., (30 min/session 4 times at 2 h intervals]. Results MA increased corticosterone from 1–72 h with a peak 1 h after the first treatment, whereas glucose was only increased 1 h post-treatment. Neostriatal and hippocampal monoamines were decreased at 7, 24, and 72 h, with a concurrent increase in GFAP at 72 h. There was no effect of MA on regional brain creatine, however plasma creatinine was increased during the first 24 h and decreased by 72 h. As with MA treatment, forced swim increased corticosterone more than MA initially. Unlike MA, forced swim reduced creatine in the cerebellum with no change in other brain regions while plasma creatinine was decreased at 1 and 7 h. Glucose in plasma was decreased at 7 h. Conclusion Both MA and forced swim increase demand on energy substrates but in different ways, and MA has persistent effects on corticosterone that are not attributable to stress alone.

  7. Sector-specific issues and reporting methodologies supporting the General Guidelines for the voluntary reporting of greenhouse gases under Section 1605(b) of the Energy Policy Act of 1992. Volume 2: Part 4, Transportation sector; Part 5, Forestry sector; Part 6, Agricultural sector

    Energy Technology Data Exchange (ETDEWEB)

    1994-10-01

    This volume, the second of two such volumes, contains sector-specific guidance in support of the General Guidelines for the voluntary reporting of greenhouse gas emissions and carbon sequestration. This voluntary reporting program was authorized by Congress in Section 1605(b) of the Energy Policy Act of 1992. The General Guidelines, bound separately from this volume, provide the overall rationale for the program, discuss in general how to analyze emissions and emission reduction/carbon sequestration projects, and address programmatic issues such as minimum reporting requirements, time parameters, international projects, confidentiality, and certification. Together, the General Guidelines and the guidance in these supporting documents will provide concepts and approaches needed to prepare the reporting forms. This second volume of sector-specific guidance covers the transportation sector, the forestry sector, and the agricultural sector.

  8. Relationship of serum uric acid, serum creatinine and serum cystatin C with maternal and fetal outcomes in rural Indian pregnant women

    Directory of Open Access Journals (Sweden)

    Padma Yalamati

    2015-10-01

    Conclusions: Serum creatinine and uric acid are independent risk factors for hypertensive disorders of pregnancy. High serum uric acid is associated with low birth weight and delivery by caesarian section whereas high serum creatinine with preterm delivery only before adjustment for confounding factors and not after adjustment. Serum cystatin C was not significantly associated with the maternal and fetal outcomes. [Int J Reprod Contracept Obstet Gynecol 2015; 4(5.000: 1505-1510

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

    Directory of Open Access Journals (Sweden)

    Karawajczyk Malgorzata

    2008-02-01

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

  10. Pharmacogenetic effects of angiotensin-converting enzyme inhibitors over age-related urea and creatinine variations in patients with dementia due to Alzheimer disease.

    Science.gov (United States)

    Ferreira de Oliveira, Fabricio; Berretta, Juliana Marília; Suchi Chen, Elizabeth; Cardoso Smith, Marilia; Ferreira Bertolucci, Paulo Henrique

    2016-06-30

    Renal function declines according to age and vascular risk factors, whereas few data are available regarding genetically-mediated effects of anti-hypertensives over renal function. To estimate urea and creatinine variations in dementia due to Alzheimer disease (AD) by way of a pharmacogenetic analysis of the anti-hypertensive effects of angiotensin-converting enzyme inhibitors (ACEis). Consecutive outpatients older than 60 years-old with AD and no history of kidney transplant or dialytic therapy were recruited for prospective correlations regarding variations in fasting blood levels of urea and creatinine in one year, considering ACE genotypes of rs1800764 and rs4291 and their respective haplotypes, and treatment with ACEis along with blood pressure variations. For 190 patients, 152 had arterial hypertension, and 122 used ACEis. Minor allele frequencies were 0.492 for rs1800764-C and 0.337 for rs4291-T, both in Hardy-Weinberg equilibrium. There were no overall significant yearly variations in levels of urea and creatinine, but their concurrent variations were positively correlated (ρ ACEis was protective regarding creatinine variations. The use of ACEis was also protective for carriers of rs1800764-CT/rs4291-AA, while carriers of rs1800764-CT/rs4291-AT had steeper reductions in creatinine levels, particularly when they were treated with ACEis. Effects of ACEis over creatinine variations are genetically mediated and independent of blood pressure variations in older people with AD.

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

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    Karimzadeh, Iman; Khalili, Hossein

    2016-06-06

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

  12. The relationship of nitric oxide synthesis capacity, oxidative stress, and albumin-to-creatinine ratio in black and white men: the SABPA study.

    Science.gov (United States)

    Mels, Catharina M C; Huisman, Hugo W; Smith, Wayne; Schutte, Rudolph; Schwedhelm, Edzard; Atzler, Dorothee; Böger, Rainer H; Ware, Lisa J; Schutte, Aletta E

    2016-02-01

    Inadequate substrate availability and increased nitric oxide synthase inhibitor levels attenuate nitric oxide (NO) synthesis, whereas increased vascular oxidative stress may lead to inactivation of NO. We compared markers of NO synthesis capacity and oxidative stress in a bi-ethnic male population. Inter-relationships of ambulatory blood pressure and urinary albumin-to-creatinine ratio with NO synthesis capacity and oxidative stress markers were investigated. NO synthesis capacity markers (L-arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA)) and oxidative stress markers (serum peroxides, total glutathione, glutathione peroxidase (GPx), glutathione reductase (GR), superoxide dismutase (SOD), and catalase) were measured. Black men displayed higher blood pressure and albumin-to-creatinine ratio (all p creatinine ratio. In white men, albumin-to-creatinine ratio was positively associated with ADMA (R (2) = 0.18; β = 0.39; p creatinine ratio displayed a favorable NO synthesis capacity. This may be counteracted by increased inactivation of NO, although it was not linked to vascular or renal phenotypes. In white men, reduced NO synthesis capacity may lower NO bio-availability, thereby influencing the albumin-to-creatinine ratio.

  13. The Effects of Body Mass Index on Changes in Prostate-Specific Antigen Levels and Prostate Volume over 15-years of Follow-up: Implications for Prostate Cancer Detection

    Science.gov (United States)

    Wallner, Lauren P.; Morgenstern, Hal; McGree, Michaela E.; Jacobson, Debra J.; Sauver, Jennifer L.; Jacobsen, Steven J.; Sarma, Aruna V.

    2011-01-01

    Objective To investigate the association of BMI and BMI change with change in PSA level and to assess the possible roles of PSA hemodilution and prostate volume in explaining the obesity and PSA association. Methods In 1990, a randomly selected cohort of Caucasian men, ages 40-79, from Olmsted County, MN completed questionnaires ascertaining demographic characteristics, current medical conditions and medications biennially, with a subset undergoing blood draws and clinical exams. Linear mixed models were used to predict annual changes and intercepts of individual changes in BMI, PSA, prostate volume, plasma volume, and PSA mass, adjusting for age in 545 men with at least two serial PSA, BMI and prostate volume measurements. Results Baseline BMI was inversely associated with the annual percent change in PSA, adjusting for age, baseline PSA, and prostate volume and the rates of change in BMI and prostate volume (β=−0.003, 95% Confidence Interval (CI): −0.006, −0.0003). Baseline obesity was positively associated with mean baseline levels and the rate of change in prostate volume (p=0.002) and plasma volume (both p obesity was associated with baseline PSA and prostate volume and with the rate of change in PSA over 15 years of follow-up. Impact The inverse association of obesity with prostate–cancer diagnosis may be at least partly due to detection bias, which is due to larger prostate volumes and PSA hemodilution in obese men. PMID:21242331

  14. In Acute IgA Nephropathy, Proteinuria and Creatinine Are in the Spot, but Podocyturia Operates in Silence: Any Place for Amiloride?

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    H. Trimarchi

    2017-01-01

    Full Text Available IgA nephropathy is the most frequent cause of primary glomerulonephritis, portends erratic patterns of clinical presentation, and lacks specific treatment. In general, it slowly progresses to end-stage renal disease. The clinical course and the response to therapy are usually assessed with proteinuria and serum creatinine. Validated biomarkers have not been identified yet. In this report, we present a case of acute renal injury with proteinuria and microscopic hematuria in a young male. A kidney biopsy disclosed IgA nephropathy. Podocyturia was significantly elevated compared to normal subjects. Proteinuria, renal function, and podocyturia improved promptly after steroids and these variables remained normal after one year of follow-up, when steroids had already been discontinued and patient continued on valsartan and amiloride. Our report demonstrates that podocyturia is critically elevated during an acute episode of IgA nephropathy, and its occurrence may explain the grim long-term prognosis of this entity. Whether podocyturia could be employed in IgA nephropathy as a trustable biomarker for treatment assessment or even for early diagnosis of IgA nephropathy relapses should be further investigated.

  15. Serum cystatin c is not superior to serum creatinine for early diagnosis of contrast-induced nephropathy in patients who underwent angiography.

    Science.gov (United States)

    Xu, Qian; Wang, Na-Na; Duan, Shao-Bin; Liu, Na; Lei, Rong; Cheng, Wei; Zhou, Shun-Ke

    2017-09-01

    Iodiated contrast-induced nephropathy (CIN) is a serious complication of contrast-enhanced imaging. The aim of this study was to evaluate the diagnostic sensitivities and specificities of serum cystatin C (sCys C) and serum creatinine (sCr) for CIN and to further investigate difference of the incidence, risk factors, and in-hospital and 3-month prognosis of CIN according to sCys C criteria and sCr criteria. We prospectively evaluated 213 patients who underwent angiography. The sCr and sCys C concentrations were detected before and at 48 hours, 72 hours after the procedure. The incidence, risk factors, and in-hospital and 3-month prognosis of CIN were analyzed. Receiver operating characteristic curve (ROC) analysis was performed for sCr and sCys C 48 hours after procedure. The incidence of CIN was 24.4% (sCys C criteria) and 8% (sCr criteria). Diabetes mellitus, dehydration, and hypoalbuminemia were independent risk factors for CIN. Area under the ROC of sCys C 48 hours after procedure was not superior to sCr (0.715 vs 0.790, P=.178). The mortality of patients with CIN in sCr criteria increased significantly (PC was not superior to sCr for predicting CIN in the patients who underwent angiography. © 2016 Wiley Periodicals, Inc.

  16. Renormalized Volume

    Science.gov (United States)

    Gover, A. Rod; Waldron, Andrew

    2017-09-01

    We develop a universal distributional calculus for regulated volumes of metrics that are suitably singular along hypersurfaces. When the hypersurface is a conformal infinity we give simple integrated distribution expressions for the divergences and anomaly of the regulated volume functional valid for any choice of regulator. For closed hypersurfaces or conformally compact geometries, methods from a previously developed boundary calculus for conformally compact manifolds can be applied to give explicit holographic formulæ for the divergences and anomaly expressed as hypersurface integrals over local quantities (the method also extends to non-closed hypersurfaces). The resulting anomaly does not depend on any particular choice of regulator, while the regulator dependence of the divergences is precisely captured by these formulæ. Conformal hypersurface invariants can be studied by demanding that the singular metric obey, smoothly and formally to a suitable order, a Yamabe type problem with boundary data along the conformal infinity. We prove that the volume anomaly for these singular Yamabe solutions is a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. Recently, Graham proved that the first variation of the volume anomaly recovers the density obstructing smooth solutions to this singular Yamabe problem; we give a new proof of this result employing our boundary calculus. Physical applications of our results include studies of quantum corrections to entanglement entropies.

  17. Diagnostic accuracy of salivary creatinine, urea, and potassium levels to assess dialysis need in renal failure patients

    Science.gov (United States)

    Bagalad, Bhavana S.; Mohankumar, K. P.; Madhushankari, G. S.; Donoghue, Mandana; Kuberappa, Puneeth Horatti

    2017-01-01

    Background: The prevalence of chronic renal failure is increasing because of increase in chronic debilitating diseases and progressing age of population. These patients experience accumulation of metabolic byproducts and electrolyte imbalance, which has harmful effects on their health. Timely hemodialysis at regular intervals is a life-saving procedure for these patients. Salivary diagnostics is increasingly used as an alternative to the traditional methods. Thus, the aim of the present study was to determine the diagnostic efficacy of saliva in chronic renal failure patients. Materials and Methods: This case–control study included 82 individuals, of which 41 were chronic renal failure patients and 41 were age- and sex-matched controls. Blood and saliva were collected and centrifuged. Serum and supernatant saliva were used for biochemical analysis. Serum and salivary urea, creatinine, sodium, potassium, calcium, and phosphorus were evaluated and correlated in chronic renal failure patients using unpaired t-test, Pearson's correlation coefficient, diagnostic validity tests, and receiver operative curve. Results: When compared to serum; salivary urea, creatinine, sodium, and potassium showed diagnostic accuracy of 93%, 91%, 73%, and 89%, respectively, based on the findings of study. Conclusion: It can be concluded that salivary investigation is a dependable, noninvasive, noninfectious, simple, and quick method for screening the mineral and metabolite values of high-risk patients and monitoring the renal failure patients.

  18. Effects of fasting in the holy month of Ramadan on the uric acid, urea, and creatinine levels: A narrative review

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    Sayed Alireza Mirsane

    2016-12-01

    Full Text Available Fasting during the month of Ramadan is one of the Five Pillars of Islam. During this holy month, healthy Muslims abstain from eating, drinking, and smoking from dawn to dusk. Although fasting is obligatory for every adult Muslim, if it has hazardous effects on the body, it is prohibited. Due to some Islamic principles, patients are exempted from fasting; however, due to the willingness of some individuals to fast, there are concerns about its effects on urea, uric acid, and creatine levels. Atypical levels of these compounds can cause serious disorders or indicate abnormal renal function. The present narrative review is aimed to investigate the effect of abnormally high levels of urea, uric acid, and creatinine on one’s health and effects of fasting during Ramadan on these indicators. Articles were searched from PubMed, Elsevier and Google Scholar and then they were evaluated. It can be concluded that fasting does not have any adverse effects on the urea, uric acid, and creatinine levels according to the above-mentioned studies.

  19. Determination of creatinine, uric and ascorbic acid in bovine milk and orange juice by hydrophilic interaction HPLC.

    Science.gov (United States)

    Zuo, Ruiting; Zhou, Si; Zuo, Yuegang; Deng, Yiwei

    2015-09-01

    Creatinine (Cr), uric (UA) and ascorbic acid (AA) are common constituents in human fluids. Their abnormal concentrations in human fluids are associated with various diseases. Thus, apart from the endogenous formation in human body, it is also important to examine their sources from food products. In this study, a rapid and accurate HILIC method was developed for simultaneous determination of Cr, UA and AA in bovine milk and orange juice. Milk samples were pretreated by protein precipitation, centrifugation and filtration, followed by HPLC separation and quantification using a Waters Spherisorb S5NH2 column. The developed method has been successfully applied to determine the concentration of UA, AA and Cr in milk and fruit juice samples. The milk samples tested were found to contain UA and creatinine in the concentration range of 24.1-86.0 and 5.07-11.2 μg mL(-1), respectively. The orange juices contain AA over 212 μg mL(-1).

  20. Possible Association of High Urinary Magnesium and Taurine to Creatinine Ratios with Metabolic Syndrome Risk Reduction in Australian Aboriginals

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    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 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<.05. The significant inverse associations of fat intake with Mg/cre and of fast food intake with urinary taurine/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.

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

    Science.gov (United States)

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

    2004-06-01

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

  2. [Excretion of normal and modified RNA catabolites and creatinine in the urine as a function of nutrition in children].

    Science.gov (United States)

    Schöch, G; Heller-Schöch, G; Müller, J; Clemens, P; Holtgrewe, A; Heddrich, M

    1983-05-01

    The urinary excretion of 5 modified and 2 unmodified RNA catabolites and of creatinine has been investigated in two children aged 71/2 and 6 years under different isocaloric diets over 5 days each (phase I-III) and compared with the excretion values during a 12-day and libitum food intake (phase 0). On a diet (phase I) extremely rich in nucleic acids (meat) there is only a slight increase of the modified RNA catabolites and a pronounced increase of creatinine in urine. On a protein-rich diet free from nucleic acids (phase II) the urinary RNA catabolites largely parallel the values seen under ad libitum food intake. On a diet virtually free of nucleic acids and protein (phase III) there is a markedly decreased excretion of modified RNA catabolites. It is concluded that modified RNA catabolites in the urine are mainly of endogenous origin. These "one-way catabolites" permit an assessment of the RNA turnover. Thus, they can serve as a new sensitive biochemical criterion for anabolic and catabolic situations, respectively.

  3. 24-hour creatinine clearance reliability for estimation of glomerular filtration rate in different stages of chronic kidney disease

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    El-Minshawy Osama

    2010-01-01

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

  4. Development and validation of a simple determination of urine metabolites (oxalate, citrate, uric acid and creatinine) by capillary zone electrophoresis.

    Science.gov (United States)

    Muñoz, Jose A; López-Mesas, Montserrat; Valiente, Manuel

    2010-04-15

    Oxalate, citrate, uric acid and creatinine are important urine markers for the evaluation and treatment of urolithiasic patients. They have been traditionally analysed by enzymatic and chromatographic techniques which present practical drawbacks, mainly in the sample pre-treatment step. The purpose of this study was to evaluate those markers in urine samples, by an easy multi-analyte assay using capillary zone electrophoresis. The four urine metabolites were determined, at 25 degrees C, by using a 50 cm x 75 microm capillary in 50 mmol l(-1) phosphate buffer (pH 6.5), at constant voltage of -30 kV and UV detection at 195 nm (for oxalate and citrate) or 30 kV and 234 nm (for creatinine and uric acid). The sample pre-treatment was minimum, 5- and 20-fold dilution of the urine sample and acidification to pH 3-4. Validation parameters (linear range, sensitivity, accuracy, precision and detection limits) were statistically comparable to those obtained with the official methods normally used in the clinical practice. The effect of freezing as a conservation method of urine samples is also discussed in terms of recoveries of the analytes. The analytical method developed is highly useful as a diagnostic tool for detecting metabolic renal disorders due to its simplicity, time consuming, easy automation, cost efficiency and analytical effectiveness, accomplishing with the clinical requirements.

  5. 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.

  6. 术后肌酐微小升高对体外循环下心脏手术患者预后的影响%Effect of minimal increase in postsurgical creatinine on prognosis in patients undergoing cardiac surgery with cardiopulmonary bypass

    Institute of Scientific and Technical Information of China (English)

    杨艳丽; 马骏; 卿恩明; 丁琳; 薛艳艳; 王兆琪

    2016-01-01

    The medical records of patients underwent thoracic surgery with cardiopulmonary bypass (CPB) from July 1,2013 to May 30,2014 were collected and reviewed,the patients who developed postsurgical acute kidney injury (increase in postsurgical serum creatinine>26.6 μmol/L) during hospital stay were excluded,and a total of 1 509 cases were enrolled in the study.Age,gender,body weight,presurgical complications,presurgical ejection fraction,serum concentration of creatinine on presurgical day 1,CPB duration during surgery,aortic clamping time,volume of blood transfused,duration of intensive care unit stay,mechanical ventilation time,length of hospital stay,and the highest serum concentration of creatinine were collected.The patients were divided into 2 groups according to the increase in postsurgical serum creatinine concentrations (the difference between the highest serum concentration of creatinine during hospital stay and the serum concentration of creatinine on presurgical day 1):no increase in creatinine group (n =508) and minimal increase in creatinine group (increase in postsurgical serum creatinine concentrations≤26.6 μmol/L,n=1 001).All the patients were followed up by telephone,and the fatality was recorded.Kaplan-Meier and log-rank analyses were used to analyze the survival condition,and the risk factors for fatality were identified by using multivariate Cox regression analysis.Compared with no increase in creatinine group,age was significantly increased,the constituent ratios of coronary heart disease,hypertension,diabetes mellitus,and pulmonary hypertension were significantly increased,CPB duration and length of hospital stay were significantly prolonged (P<0.05),and no significant change was found in the fatality rate on postsurgical day 30 in minimal increase in creatinine group (P>0.05).The patients were followed up for (298±104) days,and Kaplan-Meier analysis showed that the long-term fatality rate was significantly higher in minimal increase in

  7. Quantitative assessment of global and regional air trappings using non-rigid registration and regional specific volume change of inspiratory/expiratory CT scans: Studies on healthy volunteers and asthmatics

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Sol; Seo, Joon Beom; Lee, Hyun Joo; Chae, Eun Jin; Lee, Sang Min; Oh, Sang Young; Kim, Nam Kug [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT. Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. DeltaSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, DeltaSV0.4 and DeltaSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 DeltaSV, respectively. To assess the gravity effect of air-trapping, DeltaSV values of anterior and posterior lung at three different levels were measured and DeltaSV ratio of anterior lung to posterior lung was calculated. Color-coded DeltaSV map of the whole lung was generated and visually assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed. Mean DeltaSV, DeltaSV0.4, and DeltaSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). DeltaSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as DeltaSV0.5 and DeltaSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. DeltaSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%). Quantitative assessment of DeltaSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.

  8. Estimation of Serum Creatinine by Routine Jaffé’s Method and by Dry Chemistry in Icteric and Hemolytic Serum Samples

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    Padmanabhan Preeti

    2017-03-01

    Full Text Available Background: Newer analytical methods are introduced in clinical biochemistry laboratory for the purpose of improvement of quality, automation, to reduce the cost or to simply measure a new analyte. Serum creatinine is one of the renal function test. Creatinine is measured in serum by modified Jaffé’s method which involves wet chemistry (SCrMJ and the new dry chemistry which utilizes the microslides and involves enzymes (SCrMS. Various kits available commercially which are based on enzymatic methods to overcome the shortcomings and problems inherent in the Jaffé’s method. Aim: The aim of the present study is to compare the results of creatinine estimation by modified Jaffé’s method (SCrMJ or wet chemistry and dry chemistry (SCrMS in icteric and haemolytic serum samples. Methods and Materials: Forty serum samples each of icterus and haemolysis were analyzed by modified Jaffé’s method (SCrMJ (wet method and patented dry chemistry (SCrMS method developed by ortho clinical diagnostics. Results: The Creatinine concentration in serum is comparatively lower when estimated by dry chemistry (SCrMS developed by ortho clinical diagnostics on Vitros 250 analyzer as compared to modified Jaffé’s method (wet chemistry. The values of creatinine are found to be both accurate and precise by the enzymatic method in icteric and haemolytic serum samples. Conclusions: Dry chemistry eliminates the possibility of overestimation of creatinine in icteric and haemolytic samples and estimate the true value of creatinine in serum for better treatment planning

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

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    Pawel Burchardt

    2016-03-01

    Full Text Available Background/Aims: 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. Methods: 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. Results: 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 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. Conclusions: This observation requires further prospective investigation on extended group of patients.

  10. Effect of amino acids on the formation of 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) in creatinine/phenylalanine and creatinine/phenylalanine/4-oxo-2-nonenal reaction mixtures.

    Science.gov (United States)

    Zamora, Rosario; Alcón, Esmeralda; Hidalgo, Francisco J

    2013-12-15

    2-Amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) formation in mixtures of creatinine, phenylalanine, amino acids and 4-oxo-2-nonenal was studied, to analyse the role of amino acids on the generation of this heterocyclic aromatic amine. When oxidised lipid was absent, cysteine, serine, aspartic acid, threonine, asparagine, tryptophan, tyrosine, proline, and methionine increased significantly (p amino acids produced reactive carbonyls that converted phenylalanine into phenylacetaldehyde as a key step in the formation of PhIP. When oxidised lipid was present, amino acids competed with phenylalanine for the lipid, and amino acid degradation products were formed, among which alpha-keto acids seemed to play a role in these reactions. These results suggest that PhIP can be produced by several alternative reaction pathways from all major food components, including amino acids and lipids, in addition to carbohydrates.

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

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    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

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

    Directory of Open Access Journals (Sweden)

    Iwona Maruniak-Chudek

    2012-04-01

    Full Text Available [sub][/sub] Introduction: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.Material/Methods: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.Results/Discussion:At the beginning of the observational period the mean serum concentration of cystatin C in the study group was 1.35 mg/L (95�0CI 1.20–1.49. Surprisingly, the lowest concentration of cystatin was observed in patients with septic shock (1.23 mg/L; 95 0.92–1.54 within the observation period. Higher concentrations were found in neonates with sepsis (1.47 mg/L; 95 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: 1.19–1.86 and severe sepsis (to 1.32 mg/L; 95: 1.07–1.57, while a slight insignificant increase in patient with septic shock (to 1.28 mg/L; 95: 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.Conclusions:Cystatin C is not a

  13. Correlation of spot urine protein-creatinine ratio with 24-hour urinary protein in type 2 diabetes mellitus patients: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Satish Basanagouda Biradar

    2011-01-01

    Full Text Available Background: Diabetic nephropathy is the major cause for chronic renal failure (CRF and proteinuria is an independent risk factor for end stage renal disease. Hence, early identification and quantification of proteinuria is of prime importance in the diagnosis and management. Methods: This study was conducted amongst 42 diabetic subjects from HSK hospital, Bagalkot. Twenty four-hour urine protein and random urine protein to creatinine ratio (P:C was determined. Pearson′s correlation, sensitivity, specificity, positive and negative predictive values were determined using 24-hour urinary protein as a gold standard for spot urine P:C ratio. ROC curve and area under curve was also determined using SPSS (11.5 software. All the results were expressed in mean±SD. Results: Forty two diabetes mellitus patients participated in this study. The average of 24 hour urinary protein was 1.6 ± 1.7 gm/day. The spot urine P:C ratio was 1.27 ± 1.55. There was a positive correlation between 24 hours urinary protein and spot urine P:C ratio (r = 0.925, p < 0.0001. The area under the ROC curve for urine P:C ratio at various cutoff was 0.947 (95% confidence interval: 0.831-0.992, p < 0.0001. The sensitivity and specificity was 80.65% and 100% respectively at P:C ratio cutoff of 0.3. Conclusions: The random urine P:C ratio predicts the amount of 24-hour urinary protein excretion with high accuracy. Hence it can be used as a faster diagnostic substitute for 24-hour urinary protein estimation.

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

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    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.

  15. The Level of Vasopressin is not solely resulted from the Concentration of Endotoxin but Proportional to Creatinine in Dogs with Pyometra

    Directory of Open Access Journals (Sweden)

    W. Y. Shia1, K. C. Tung1, 2, S. C. Chang1, 2, C. H. Yang1, 2, C. H. Lee2, C. C. Chou1 and W. M. Lee1, 2*

    2011-04-01

    Full Text Available Pyometra is one of the most common reproductive disorder characterized as fluid accumulation mainly pus and Gram-negative bacteria isolated from uterus in bitches. Impaired function of vasopressin is found in the disease. The impact of the circulating endotoxin concentration on vasopressin involved water regulation is still unclear. To document the effect of endotoxin on vasopressin-involved water regulation in dogs with pyometra, blood samples were collected for examination of circulating endotoxin concentration, osmolarity values, vasopressin concentrations, blood urea nitrogen (BUN, and creatinine. The results indicated that the concentration change of endotoxin was contrary to BUN and creatinine in dogs with pyometra. The trends of concentrations change of BUN and creatinine were similar with osmolarity and vasopressin. Pyometric dogs with high level of circulating endotoxin had significantly lower (P 20 mg/dL and creatinine (> 1.5 mg/dL also had plasma vasopressin significantly higher (P<0.05 than those with low levels of BUN and creatinine and control dogs. The overall results suggested that elevated vasopressin was not mainly associated with the circulating endotoxin concentration and some other factors may collaborate with endotoxin causing impaired function of vasopressin.

  16. Serum Prolidase Activity and Oxidative Stress in Diabetic Nephropathy and End Stage Renal Disease: A Correlative Study with Glucose and Creatinine

    Science.gov (United States)

    Verma, Akhilesh Kumar; Chandra, Subhash; Singh, Rana Gopal; Singh, Tej Bali; Srivastava, Shalabh; Srivastava, Ragini

    2014-01-01

    Association of oxidative stress and serum prolidase activity (SPA) has been reported in many chronic diseases. The study was aimed at evaluating the correlation of glucose and creatinine to SPA and oxidative stress in patients with diabetic nephropathy (DN) and end stage renal disease (ESRD) concerned with T2DM. 50 healthy volunteers, 50 patients with T2DM, 86 patients with DN, and 43 patients with ESRD were considered as control-1, control-2, case-1, and case-2, respectively. Blood glucose, creatinine, SPA, total oxidant status (TOS), total antioxidant status (TAS), and oxidative stress index (OSI) were measured by colorimetric tests. SPA, TOS, and OSI were significantly increased in case-1 and case-2 than control-1 and control-2, while TAS was significantly decreased (P < 0.001). Blood glucose was linearly correlated to SPA, TOS, TAS, and OSI in control-2, case-1 and case-2 (P < 0.001). Serum creatinine was linearly correlated with SPA, TOS, TAS and OSI in control-2 and case-1 (P < 0.001). In case-2, serum creatinine was significantly correlated with SPA only (P < 0.001). Thus, the study concluded that SPA and oxidative stress significantly correlated with blood glucose and creatinine. SPA, TOS, TAS, and OSI can be used as biomarkers for diagnosis of kidney damage. PMID:25276429

  17. Serum Prolidase Activity and Oxidative Stress in Diabetic Nephropathy and End Stage Renal Disease: A Correlative Study with Glucose and Creatinine

    Directory of Open Access Journals (Sweden)

    Akhilesh Kumar Verma

    2014-01-01

    Full Text Available Association of oxidative stress and serum prolidase activity (SPA has been reported in many chronic diseases. The study was aimed at evaluating the correlation of glucose and creatinine to SPA and oxidative stress in patients with diabetic nephropathy (DN and end stage renal disease (ESRD concerned with T2DM. 50 healthy volunteers, 50 patients with T2DM, 86 patients with DN, and 43 patients with ESRD were considered as control-1, control-2, case-1, and case-2, respectively. Blood glucose, creatinine, SPA, total oxidant status (TOS, total antioxidant status (TAS, and oxidative stress index (OSI were measured by colorimetric tests. SPA, TOS, and OSI were significantly increased in case-1 and case-2 than control-1 and control-2, while TAS was significantly decreased (P<0.001. Blood glucose was linearly correlated to SPA, TOS, TAS, and OSI in control-2, case-1 and case-2 (P<0.001. Serum creatinine was linearly correlated with SPA, TOS, TAS and OSI in control-2 and case-1 (P<0.001. In case-2, serum creatinine was significantly correlated with SPA only (P<0.001. Thus, the study concluded that SPA and oxidative stress significantly correlated with blood glucose and creatinine. SPA, TOS, TAS, and OSI can be used as biomarkers for diagnosis of kidney damage.

  18. 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

    Vitamin D is associated with cardiovascular disease and renal function but the mechanisms are as yet unexplained. Microalbuminuria is associated with a higher risk of kidney function loss, cardiovascular disease, and mortality. Parathyroid hormone is a predictor of cardiovascular mortality...... 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...

  19. Estimating glomerular filtration rate in oncology patients receiving Cisplatin chemotherapy: Predicted creatinine clearance against 99mTc-DTPA methods

    Science.gov (United States)

    Khaidah Syed Sahab, Sharifah; Manap, Mahayuddin; Hamzah, Fadzilah

    2017-05-01

    The therapeutic potential of cisplatin as the best anticancer treatment for solid tumor is limited by its potential nephrotoxicity. This study analyses the incidence of cisplatin induced nephrotoxicity in oncology patients through GFR estimation using 99mTc-DTPA plasma sampling (reference method) and to compare with predicted creatinine clearance and Tc-99m renal scintigraphy. A prospective study of 33 oncology patients referred for GFR estimation in Penang Hospital. The incidence of cisplatin induced nephrotoxicity was analysed via radionuclide and creatinine based method. Of 33 samples, only 21 selected for the study. The dose of cisplatin given was 75 mg/m2 for each cycle. The mean difference of GFR pre and post chemotherapy (PSC 2) was 13.38 (-4.60, 31.36) ml/min/1.73m2 (p 0.136). Of 21 patients, 3 developed severe nephrotoxicity (GFR < 50ml/min/1.73 m2) contributing 14.3% of incidence. Bland-Altman plot showed only PSC 1 is in agreement with PSC 2 technique. Intraclass Correlation Coefficients (ICC) also showed that PSC 1 has high degree of reliability in comparison to PSC 2 (p < 0.001). The other methods do not show reliability and agreement in comparison to PSC 2 (p < 0.05). 3 of 21 patients (14.3%) developed severe nephrotoxicity post cisplatin chemotherapy. This percentage is much less than the reported 20 - 25% of cases from other studies, probably due to small sample size and biased study population due to strict exclusion criteria. Radionuclide method for evaluating GFR is the most sensitive method for the detection of cisplatin induced nephrotoxicity by showing 3 of 21 patients developing severe nephrotoxicity. PSC 1 was found to be a reliable substitute of PSC 2. The other methods are not reliable for detection of early nephrotoxicity. We will recommend the use of single plasma sampling method (PSC 1) for GFR estimation in monitoring post cisplatin chemotherapy patients.

  20. Urine protein/creatinine ratio as a mortality risk predictor in non-diabetics with normal renal function.

    Science.gov (United States)

    Fulks, Michael; Stout, Robert L; Dolan, Vera F

    2012-01-01

    Determine the relative mortality in apparently healthy adults with various levels of urinary protein measured by urine protein/creatinine (p/c) ratio. By use of the Social Security Death Master File, mortality in 2010 was determined for 7.5 million life insurance applicants age 20 to 89 providing urine samples between 1992 and 2006. Relative mortality by Cox regression for bands of p/c ratios was determined using age and sex as covariates and with an age split at 60 after excluding those with hematuria (> 3 red cells/hpf), diabetes, evidence of blood sugar elevation, or eGFR < 60 mL/min. After the exclusions noted above, relative mortality increased to 160% beginning at a p/c ratio of 0.11 mg/mg and rose steadily above that value regardless of sex and age. Most of this risk was not explained by a history of hypertension or elevated systolic blood pressure. Albumin testing identified roughly a third of urine samples with elevated p/c ratios as not containing albumin; those cases appeared to be associated with much lower risk as long as the p/c ratio was < or = 1.0 mg/mg. Low levels of proteinuria identified as urine protein/creatinine ratios of 0.11 mg/mg or higher (much lower than the usual lower cut-off value of 0.21) are associated with substantial excess mortality risk, even after excluding diabetics and those with reduced kidney function or hematuria.

  1. Adjusting eptifibatide doses for renal impairment: a model of dosing agreement among various methods of estimating creatinine clearance.

    Science.gov (United States)

    Healy, Martha F; Speroni, Karen Gabel; Eugenio, Kenneth R; Murphy, Patricia M

    2012-04-01

    Because of the renal elimination and increased risk for bleeding events at supratherapeutic doses of eptifibatide, the manufacturer recommends dosing adjustment in patients with renal dysfunction. Methods commonly used to estimate renal dysfunction in hospital settings may be inconsistent with those studied and recommended by the manufacturer. To compare hypothetical renal dosing adjustments of eptifibatide using both the recommended method and several other commonly used formulas for estimating kidney function. Sex, age, weight, height, serum creatinine, and estimated glomerular filtration rate (eGFR) were obtained retrospectively from the records of patients who received eptifibatide during a 12-month period. Renal dosing decisions were determined for each patient based on creatinine clearance (CrCl) estimates via the Cockcroft-Gault formula (CG) with actual body weight (ABW), ideal body weight (IBW) or adjusted weight (ADJW), and eGFR from the Modification of Diet in Renal Disease formula. Percent agreement and Cohen κ were calculated comparing dosing decisions for each formula to the standard CG-ABW. In this analysis of 179 patients, percent agreement as compared to CG-ABW varied (CG-IBW: 90.50%, CG-ADJW: 95.53%, and eGFR: 93.30%). All κ coefficients were categorized as good. In the 20% of patients receiving an adjusted dose by any of the methods, 68.6% could have received a dose different from that determined using the CG-ABW formula. In the patients with renal impairment (CrCl <50 mL/min) in this study, two thirds would have received an unnecessary 50% dose adjustment discordant from the manufacturer's recommendation. Because failure to adjust eptifibatide doses in patients with renal impairment has led to increased bleeding events, practitioners may be inclined to err on the side of caution. However, studies have shown that suboptimal doses of eptifibatide lead to suboptimal outcomes. Therefore, correct dosing of eptifibatide is important to both patient

  2. Carboplatin dose calculation in lung cancer patients with low serum creatinine concentrations using CKD-EPI and Cockcroft-Gault with different weight descriptors.

    Science.gov (United States)

    Kaag, Dieter

    2013-01-01

    Carboplatin dosing using the Calvert and Cockcroft-Gault formulae in patients with low serum creatinine levels is discussed controversially. We conducted a retrospective analysis applying the CKD-EPI formula and the alternate size descriptors adjusted body weight and predicted normal weight in the Cockcroft-Gault equation for calculating the carboplatin dose. Data were collected retrospectively from 128 lung cancer patients with serum creatinine obese patients they were superior in reducing mean overdose from 24% to roughly 15% (predicted normal weight, CKD-EPI) and 10% (adjusted body weight) and from 25% to 9%, 8% and 4%, respectively. Best performed the combination of Cockcroft-Gault with adjusted body weight. The results show that application of the alternate size descriptor adjusted body weight in the Cockcroft-Gault equation can improve dosing accuracy especially in overweight and obese patients with low serum creatinine levels. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. 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.

  4. Validity of protein-osmolality versus protein-creatinine ratios in the estimation of quantitative proteinuria from random samples of urine in children.

    Science.gov (United States)

    Morgenstern, Bruce Z; Butani, Lavjay; Wollan, Peter; Wilson, David M; Larson, Timothy S

    2003-04-01

    Proteinuria is an important marker of kidney disease. Simple methods to determine the presence of proteinuria in a semiquantitative fashion require measurement of either a protein-creatinine or protein-osmolality ratio. Urine samples from 134 healthy infants and children and 150 children from the pediatric nephrology practice were analyzed to develop normative data for protein-osmolality ratios on random urine samples and compare protein-osmolality with protein-creatinine ratio as a predictor of 24-hour urine protein excretion. Children were grouped according to age. Three groups were established: infants (<2 years), younger children (2 to 8 years), and older children (9 to 18 years). An adult cohort was similarly analyzed. For healthy children older than 2 years, the optimal value discriminating normal from abnormal protein excretion was determined to be a protein-osmolality ratio of 0.15 mg x kg H2O/mOsm. L; for children between 2 and 8 years old, 0.14; and for children older than 8 years, 0.17 (P = not significant between age groups). The corresponding optimal cutoff value for protein-creatinine ratio for the entire group of children older than 2 years is 0.20. Area under the curve analysis of receiver operator characteristic curves showed protein-creatinine ratio was superior to protein-osmolality ratio for predicting abnormal amounts of proteinuria in children and adolescents (P < 0.0001). In adults, both ratios are equally accurate. Given the superiority of protein-creatinine ratio in children, it would be appropriate to screen urine samples for proteinuria using protein-creatinine ratio rather than protein-osmolality ratio.

  5. Combined treatment of crawling creatinine following renal transplantation%肾移植术后爬行肌酐的综合治疗

    Institute of Scientific and Technical Information of China (English)

    孙发林; 李景勤; 张金平; 蒋欣

    2015-01-01

    Objective To study the therapeutic strategy of crawling creatinine after kidney transplantation and its effect. Methods The 20 patients received renal transplantation,their crawling creatinine was treated with half the amount methylprednisolone pulse therapy,changing the immunosuppressant drugs,and using promoting blood circulation,adjusting antihypertensive therapy;after two weeks and three months the creatinine levels drop was observed. Results Among the 20 cases 18 after two weeks down to normal levels of serum creatinine,also two cases to stop crawling and maintain the level of serum creatinine before crawling;after three months in the 18 cases with serum creatinine decreased to normal serum level maintained stability ,4 cases occurred again crawling;the 2 cases of serum creatinine levels stopped crawling maintained their original level. Conclusion The key of treatment of crawling creatinine following renal transplantation is it timely detected and timely treated;for the hospitals without the conditions for performing puncture biopsy,comprehensive treatment is a better approach.%目的:研究肾移植术后爬行肌酐的治疗对策及效果。方法对肾移植术后的20例爬行肌酐患者应用半量甲基泼尼松龙冲击治疗、更改免疫抑制药、应用活血化瘀药物、调整抗高血压药等治疗,观察2周后及3个月后的肌酐下降水平。结果2周后18例患者血肌酐下降至平时水平,2例患者血肌酐水平停止爬行,维持在血肌酐爬行之前的水平;3个月后18例血肌酐下降的患者中14例血肌酐维持稳定,4例再次出现爬行肌酐;2例血肌酐水平停止爬行的患者血肌酐维持原有水平。结论肾移植术后爬行肌酐治疗关键在于及时发现、及时治疗,对于无穿刺病理活检条件的医院,综合治疗是一种较好的方法。

  6. Using bedtime (PM) and early morning (AM) urine cortisol/creatinine ratios to evaluate pituitary-adrenal function in an office practice.

    Science.gov (United States)

    Burch, Warner

    2011-01-01

    To evaluate the use of cortisol/creatinine ratios in urine specimens collected at bedtime (PM) and the following morning (AM) in a general endocrine practice as a means of assessing pituitary-adrenal function in normal volunteers, outpatients with symptoms but no clinical endocrine dysfunction, patients with Cushing syndrome, and patients with known hypopituitarism. Double-voided PM and AM urine samples were collected from 26 healthy control subjects and 131 outpatients who had complaints of fatigue and malaise, inability to lose weight, or nonspecific concerns about potential underlying problems with their metabolism. The findings on physical examination and laboratory studies were normal in each of these outpatients. Urine was assayed for free cortisol and creatinine and expressed as ng of cortisol/mg of creatinine. Eleven patients with documented Cushing syndrome also collected urine specimens, and data for 11 patients with known hypopituitarism were also studied. A clear diurnal pattern of low cortisol excretion at night that increased some 7-fold in the morning (PAM cortisol/creatinine was 91.5 (95% CI, 65.0 to 118.0). The mean AM/PM ratio was 6.9, and the mean difference in AM-PM was 75.7. In the outpatients, there was no significant difference in PM, AM, AM/PM, and AM-PM values in comparison with those in healthy control subjects, and no significant difference was noted in these variables among the 3 groups of outpatients (those with fatigue, weight gain, and metabolism concerns). In 11 patients with Cushing syndrome, the mean PM urine cortisol/creatinine ratio was 127.0 (95% CI, 87.0 to 166.0), and there was loss of diurnal variation with the AM/PM ratio of 1.16 (95% CI, 0.98 to 1.35). Patients with hypopituitarism had little to no increase in AM urine cortisol/creatinine in comparison with PM urine cortisol/creatinine. Determination of PM and AM urine cortisol/creatinine ratios offers a convenient method for assessing pituitary-adrenal function.

  7. Renormalized Volume

    CERN Document Server

    Gover, A Rod

    2016-01-01

    For any conformally compact manifold with hypersurface boundary we define a canonical renormalized volume functional and compute an explicit, holographic formula for the corresponding anomaly. For the special case of asymptotically Einstein manifolds, our method recovers the known results. The anomaly does not depend on any particular choice of regulator, but the coefficients of divergences do. We give explicit formulae for these divergences valid for any choice of regulating hypersurface; these should be relevant to recent studies of quantum corrections to entanglement entropies. The anomaly is expressed as a conformally invariant integral of a local Q-curvature that generalizes the Branson Q-curvature by including data of the embedding. In each dimension this canonically defines a higher dimensional generalization of the Willmore energy/rigid string action. We show that the variation of these energy functionals is exactly the obstruction to solving a singular Yamabe type problem with boundary data along the...

  8. The influence of post-void residual volume on prostate specific antigen in patients with benign prostatic hyperplasia%残余尿对良性前列腺增生症患者血清前列腺特异性抗原的影响

    Institute of Scientific and Technical Information of China (English)

    李锋; 唐来坤; 汪祖林; 羊继平; 宋立; 田峰; 俞仲伟

    2014-01-01

    Objective To study the influence of post-void residual volume on prostate specific antigen (PSA) in patients with benign prostatic hyperplasia (BPH).Methods One hundred and sixty BPH patients who diagnosed by postoperative pathologic manifestations were selected.The patients were divided into 4 groups according to post-void residual volume with 40 cases each:non post-void residual volume (post-void residual volume < 60 ml) group,less post-void residual volume (60 ml≤post-void residual volume < 120 ml) group,middle post-void residual volume (120 ml ≤post-void residual volume < 180 ml) group,mass post-void residual volume (post-void residual volume ≥180 ml) group.The serum PSA levels of 4 groups were observed.Results The PSA level in mass post-void residual volume group [(8.52 ± 6.72) iμ g/L] was significantly higher than that in non post-void residual volume group [(5.26 ± 4.16) μ g/L] and less post-void residual volume group [(5.93 ± 5.20) μ g/L],there were statistical differences (P < 0.05),there was no statistical difference between non post-void residual volume group and less post-void residual volume group (P > 0.05).Conclusions The serum PSA level in BPH patients with non post-void residual volume has no change,while the serum PSA level in BPH patients with mass post-void residual volume is significantly elevated.%目的 研究残余尿对良性前列腺增生症(BPH)患者血清前列腺特异性抗原(PSA)的影响.方法 将接受前列腺手术治疗,术后病理为BPH的患者160例分成无残余尿(残余尿<60 ml)组40例,少量残余尿(60 ml≤残余尿<120 ml)组40例,中量残余尿(120 ml≤残余尿<180 ml)组40例,大量残余尿(残余尿≥180 ml)组40例,比较四组患者血清PSA水平.结果 大量残余尿组PSA[(8.52 ±6.72)μg/L]明显高于无残余尿组[(5.26±4.16) μg/L]和少量残余尿组[(5.93±5.20)μg/L],差异有统计学意义(P<0.05),无残余尿组与少量残余尿组PSA比

  9. Trueness investigation of routine creatinine assays on nine homogeneous systems in Beijing demonstrates an encouraging outcome that meets clinical requirements

    Institute of Scientific and Technical Information of China (English)

    LIU Yan; XU Guo-bin

    2010-01-01

    Background Serum creatinine (Scr) measurement plays a key role in glomerular filtration rate estimation (eGFR),chronic kidney disease (CKD) diagnosis as well as CKD treatment. However, the test results of Scr from different laboratories vary significantly. In order to get comparable results, the European in vitro diagnostic (IVD) directive requires traceability to reference methods and materials. The purpose of this study was to verify the effect of traceability implementation by investigating the trueness of creatinine measurement on nine homogenous systems in Beijing. Methods Commutable frozen human serum reference material, National Institute of Standards & Technology (NIST) Standard Reference Material (SRM) 967, was used to verify the trueness of Scr measurement results from nine homogeneous analytical systems of seven companies which are the most widely used systems in Beijing's third-grade hospitals. The methods referred to the Jaffe's and Enzymatic methods. Results from nine routine measurement systems were assessed using two criteria: biological variability and Clinical Laboratory Improvement Amendments' 88 (CLIA' 88).We simulated a series of broken lines representing the limits of SD and bias that would produce a relative increase (or decrease) of 10% and 20% in the measurement error when estimating GFR (MEeGFR) using the isotope dilution mass spectrometry (IDMS)-traceable Modification of Diet in Renal Disease (MDRD) Study equation. Results of the College of American Pathologists (CAP) 2008-B LN24 Survey were compared with our investigation results. Results Compared with the total error criteria of biological variability, Ortho (traceable to IDMS) met the minimum acceptable criteria; Roche (Jaffe), Roche (Enzymatic), Shino and Daiichi met the desirable criteria at level Ⅰ. At level Ⅱ, Ortho (traceable to gas chromatography/isotope dilution mass spectrometry, GC/IDMS), Dade Behring and Beckman (traceable to rate Jaffe) met the minimum acceptable

  10. Relationship between blood urea, protein, creatinine, triglycerides and macro-mineral concentrations with the quality and quantity of milk in dairy Holstein cows

    National Research Council Canada - National Science Library

    Shahram Nozad; Ali-Gholi Ramin; Gholamali Moghadam; Siamak Asri-Rezaei; Azadeh Babapour; Sina Ramin

    2012-01-01

    ...), creatinine, triglycerides (TGs), cholesterol, and beta-hydroxybutyric acid (BHB) were 25.10 mg dL^sup -1^, 10.15 g dL^sup -1^, 0.81, 62.30, 177.10 and 0.16 mmol L^sup -1^, and for macro-minerals including SCa, SMg, serum in-organic phosphorus...

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

    Directory of Open Access Journals (Sweden)

    Ramanathan Kumaresan

    2011-11-01

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

  12. The risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio

    NARCIS (Netherlands)

    Brisco, Meredith A.; Zile, Michael R.; ter Maaten, Jozine M.; Hanberg, Jennifer S.; Wilson, F. Perry; Parikh, Chirag; Testani, Jeffrey M.

    2016-01-01

    Background: Renal dysfunction (RD) is associated with reduced survival in HF; however, not all RD is mechanistically or prognostically equivalent. Notably, RD associated with "pre-renal" physiology, as identified by an elevated blood urea nitrogen to creatinine ratio (BUN/Cr), identifies a particula

  13. Urine albumin/creatinine ratio and echocardiographic left ventricular structure and function in hypertensive patients with electrocardiographic left ventricular hypertrophy: The LIFE Study

    DEFF Research Database (Denmark)

    Wachtell, K.; Palmieri, V.; Olsen, M.H.;

    2002-01-01

    in a large hypertensive population. Methods The urine albumin/creatinine ratio (UACR) and echocardiographic measures of LV structure and function were obtained in 833 patients with stage I to III hypertension and LV hypertrophy determined by electrocardiogram (ECG) (Cornell voltage-duration or Sokolow...

  14. The risk of death associated with proteinuria in heart failure is restricted to patients with an elevated blood urea nitrogen to creatinine ratio

    NARCIS (Netherlands)

    Brisco, Meredith A.; Zile, Michael R.; ter Maaten, Jozine M.; Hanberg, Jennifer S.; Wilson, F. Perry; Parikh, Chirag; Testani, Jeffrey M.

    2016-01-01

    Background: Renal dysfunction (RD) is associated with reduced survival in HF; however, not all RD is mechanistically or prognostically equivalent. Notably, RD associated with "pre-renal" physiology, as identified by an elevated blood urea nitrogen to creatinine ratio (BUN/Cr), identifies a particula

  15. 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

  16. Urinary C peptide creatinine ratio in pregnant women with normal glucose tolerance and type 1 diabetes: evidence for insulin secretion

    Science.gov (United States)

    Markoska, Ankica; Valaiyapathi, Rajalakshmi; Thorn, Chloe; Dornhorst, Anne

    2017-01-01

    Hypothesis In pregnancy, urinary C peptide creatinine ratio (UCPCR) reflects endogenous insulin secretion in women with normal glucose tolerance and type 1 diabetes. Research design and methods UCPCR and serum C peptide were measured in 90 glucose-tolerant women at 0 and 120 min during a 75 g oral glucose tolerance test (OGTT) at 28 weeks of gestation. UCPCR was measured in 2 samples obtained over 10 weeks apart in 7 pregnant women with longstanding type 1 diabetes. Results UCPCROGTT and serum C peptideOGTT of glucose-tolerant women were significantly correlated at 0 and 120 min (rs0.675, 0.541 respectively, p<0.0001). All 7 pregnant women with type 1 diabetes had detectable first sample UCPCR (median (range) 49 (6–1038) pmol/mmol) that rose in 6 women by 477 (29–1491) pmol/mmol. Conclusions Detectable UCPCR in pregnant women with normal glucose tolerance and type 1 diabetes is likely to reflect endogenous insulin secretion and hence β-cell activity. PMID:28090333

  17. [Method selected for the determination of creatinine in plasma or serum. Choice of optimal conditions of measurement].

    Science.gov (United States)

    Labbé, D; Vassault, A; Cherruau, B; Baltassat, P; Bonète, R; Carroger, G; Costantini, A; Guérin, S; Houot, O; Lacour, B; Nicolas, A; Thioulouse, E; Trépo, D

    1996-01-01

    The method selected by the SFBC (Société française de biologie clinique) is derived from the colorimetric reaction of creatinine with alkaline picrate, measured kinetically, without any pretreatment step. The key parameters of the reaction determining the quality of the results are studied, with special regard to samples including known interferents. The aims of the study were to gain an optimal analytical sensitivity and to reduce main interferences (acetoacetate, bilirubine, glucose, protein) which plague the Jaffé reaction, through a comprehensive study of the reagents, of their concentrations and of the analytical procedures. The selected concentrations (in the test) are: 150 mmol/L sodium hydroxide, 10 mmol/L picric acid and 2 g/L sodium dodecyl sulfate. Ten millilitres of a BRIJ solution (30% volvol) are added to the reagent. The operating procedures are as follow: sample ratio 0.07 to 0.08; wavelength 505 to 510 nm; temperature 37 degrees C; incubation of the specimen with the alkaline reagent 5 mn (at least), before starting the reaction with picric acid. A seric calibrator is recommended. The first measurement is taken 20 to 40 s after starting the reaction. Total measurement time is 120 to 150 seconds.

  18. Association between Urine Creatinine Excretion and Arterial Stiffness in Chronic Kidney Disease: Data from the KNOW-CKD Study

    Directory of Open Access Journals (Sweden)

    Young Youl Hyun

    2016-08-01

    Full Text Available Background/Aims: Previous studies have shown that low muscle mass is associated with arterial stiffness, as measured by pulse wave velocity (PWV, in a population without chronic kidney disease (CKD. This link between low muscle mass and arterial stiffness may explain why patients with CKD have poor cardiovascular outcomes. However, the association between muscle mass and arterial stiffness in CKD patients is not well known. Methods: Between 2011 and 2013, 1,529 CKD patients were enrolled in the prospective Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD. We analyzed 888 participants from this cohort who underwent measurements of 24-hr urinary creatinine excretion (UCr and brachial-ankle PWV (baPWV at baseline examination. The mean of the right and left baPWV (mPWV was used as a marker of arterial stiffness. Results: The baPWV values varied according to the UCr quartile (1,630±412, 1,544±387, 1,527±282 and 1,406±246 for the 1st to 4th quartiles of UCr, respectively, PConclusion: Low muscle mass estimated by low UCr was associated high baPWV in pre-dialysis CKD patients in Korea. Further studies are needed to confirm the causal relationship between UCR and baPWV, and the role of muscle mass in the development of cardiovascular disease in CKD.

  19. The amylase/creatinine clearance ratio in normal pregnancy and pregnancies complicated by pancreatitis, hyperemesis gravidarum, and toxemia.

    Science.gov (United States)

    DeVore, G R; Bracken, M; Berkowitz, R L

    1980-03-15

    The Cam/Ccr% has been suggested to be of value in the diagnosis of pancreatitis. The Cam/Ccr% was determined throughout gestation in normal pregnant and nonpregnant patients. The Cam/Ccr% was lower (p less than 0.05) throughout pregnancy and was a function of increased creatinine clearance. The Cam/Ccr% was increased in pregnant patients with pancreatitis. Two of four patients with the clinical diagnosis of hyperemesis gravidarum demonstrated elevations of the Cam/Ccr%. Toxemia with epigastric pain was noted to be associated with an elevated CamCcr% in all patients, whereas toxemia without epigastric pain was not routinely noted to be associated with an elevated ratio. The normal Cam/Ccr% in pregnancy is lower than the nonpregnant value, and this should be taken into consideration when evaluating a patient with suspected pancreatitis who is pregnant. Patients with the clinical diagnosis of hyperemesis gravidarum and toxemia should be screened with serial Cam/Ccr% for possible evolving pancreatitis.

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

    DEFF Research Database (Denmark)

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

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

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

    DEFF Research Database (Denmark)

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

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

  2. Comparison between doppler ultrasound resistive index, serum creatinine, and histopathologic changes in patients with kidney transplant dysfunction in early posttransplantation period: A single center study with review of literature.

    Science.gov (United States)

    Patel, Kajal N; Patel, Nitin A; Gandhi, Shruti P

    2016-05-01

    To determine the relationship between resistive index (RI) measured by Doppler ultrasound, serum creatinine (SCr), and histopathological changes on biopsy during kidney trans- plant dysfunction in early postoperative period, we studied 47 kidney transplant patients; 61% of the patients had acute transplant rejection, 19% had acute tubular necrosis, 4% had calcineurin inhibitor toxicity, 11% had normal morphology in biopsy, and 5% had changes compatible with pyelonephritis. None of the study patients had interstitial fibrosis or tubular atrophy on biopsy. We found that the sensitivity and specificity of RI in diagnosing transplant dysfunction was highly variable depending on the selected cutoff value. Sensitivity of RI decreased and its specificity increased with increasing the RI thresholds. Using an RI threshold of 0.7 resulted in a high sensitivity of 78% at a cost of very low specificity 40%, whereas using an RI threshold of 0.9 resulted in 100% specificity at a cost of very low sensitivity 16%. Acceptable specificity was only achieved at the expense of very low sensitivity, resulting in poor utility of RI as a screening tool for dysfunction. We found that there were no significant differences in the mean RI value between patients with and without biopsy-proven transplant dysfunction. However, we found a significant correlation between SCr value and RI of 0.383, P = 0.007.

  3. 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.

  4. Accuracy of point-of-care serum creatinine devices for detecting patients at risk of contrast-induced nephropathy: a critical overview.

    Science.gov (United States)

    Martínez Lomakin, Felipe; Tobar, Catalina

    2014-12-01

    Contrast-induced nephropathy (CIN) is a common event in hospitals, with reported incidences ranging from 1 to 30%. Patients with underlying kidney disease have an increased risk of developing CIN. Point-of-care (POC) creatinine devices are handheld devices capable of providing quantitative data on a patient's kidney function that could be useful in stratifying preventive measures. This overview aims to synthesize the current evidence on diagnostic accuracy and clinical utility of POC creatinine devices in detecting patients at risk of CIN. Five databases were searched for diagnostic accuracy studies or clinical trials that evaluated the usefulness of POC devices in detecting patients at risk of CIN. Selected articles were critically appraised to assess their individual risk of bias by the use of standard criteria; 13 studies were found that addressed the diagnostic accuracy or clinical utility of POC creatinine devices. Most studies incurred a moderate to high risk of bias. Overall concordance between POC devices and reference standards (clinical laboratory procedures) was found to be moderate, with 95% limits of agreement often lying between -35.4 and +35.4 µmol/L (-0.4 and +0.4 mg/dL). Concordance was shown to decrease with worsening kidney function. Data on the clinical utility of these devices were limited, but a significant reduction in time to diagnosis was reported in two studies. Overall, POC creatinine devices showed a moderate concordance with standard clinical laboratory creatinine measurements. Several biases could have induced optimism in these estimations. Results obtained from these devices may be unreliable in cases of severe kidney failure. Randomized trials are needed to address the clinical utility of these devices.

  5. 肌酐产物导致红细胞溶血机理探讨%The effection and mechanism that products metabolism of creatinine treated erythrocytes

    Institute of Scientific and Technical Information of China (English)

    胡白瑛

    2011-01-01

    Objective: To study the tenacity that metabolite of creatinine treated erythrocytes. Methods: Metabotist of creatinine of uraemia intestinal bacteria was confirmed by HPLC. Klehsiella pneumoniae were incubated with creatinine. It's metabolite and erythrocytes were incubated, hemoly-sis was observed and GSH was determined in erythrocytes. Results.-Metabolist of creatinine was methylamine, which can bring hemolysis of erythro-cytes(P the hemolysis was not reversed. Added up GSH, it was reversed (P<0. 01). Concentration of GSH in erythrocytes of metabolist of creatinine group was decreased (P<0, 001). Concentration of GSH of creatinine group was 2152. 98fimol/L and that of metabolist of creatinine group was 1047. 49μmo!/L, Conclusions: The toxicity to erythrocytes of the metabolite of creatinine is stronger than that of creatinine. The toxicity could be reversed by GSH.%目的:研究肌酐产物对红细胞的毒性作用.方法:用液相色谱仪分析尿毒症患者肠道细菌分解肌酐的产物.用分解肌酐能力最强的肺炎克雷伯菌与肌酐共同培养,取其培养液与健康红细胞孵化,观察溶血情况;并分别加入葡萄糖、ATP(三磷酸腺苷)、GSH(谷胱甘肽),了解以上物质对溶血的纠正情况;并测定红细胞内GSH的浓度.结果:肠道细菌分解肌酐产生甲胺.肌酐组溶血度1.52%,肌酐产物组3.52%,后者较前者的毒性强,加重红细胞溶血(P<0.05);加入葡萄糖、ATP溶血不纠正,加入GSH明显纠正(P<0.001);GSH组溶血度0.252%,正常对照组0.192%,二者差异无显著性.肌酐组红细胞内GSH含量2152.98μmol/L,肌酐产物组1047.96μmol/L,后者红细胞内GSH含量明显降低(P<0.001).结论:肌酐产物导致红细胞溶血,红细胞内GSH含量下降,补充GSH可纠正溶血.

  6. Volumetric measurement of tank volume

    Science.gov (United States)

    Walter, Richard T. (Inventor); Vanbuskirk, Paul D. (Inventor); Weber, William F. (Inventor); Froebel, Richard C. (Inventor)

    1991-01-01

    A method is disclosed for determining the volume of compressible gas in a system including incompressible substances in a zero-gravity environment consisting of measuring the change in pressure (delta P) for a known volume change rate (delta V/delta t) in the polytrophic region between isothermal and adiabatic conditions. The measurements are utilized in an idealized formula for determining the change in isothermal pressure (delta P sub iso) for the gas. From the isothermal pressure change (delta iso) the gas volume is obtained. The method is also applicable to determination of gas volume by utilizing work (W) in the compression process. In a passive system, the relationship of specific densities can be obtained.

  7. Impact of various body weights and serum creatinine concentrations on the bias and accuracy of the Cockcroft-Gault equation.

    Science.gov (United States)

    Winter, Mary A; Guhr, Kelly N; Berg, Gina M

    2012-07-01

    To evaluate the impact of various body weights and serum creatinine (S(c) (r) ) concentrations on the bias and accuracy of the Cockcroft-Gault creatinine clearance (C-G Cl(c) (r) ) equation compared with measured 24-hour Cl(c) (r) . Retrospective analysis. Tertiary care hospital. A total of 3678 patients with stable renal function and who underwent a 24-hour urine collection between July 1, 1996, and June 30, 2010. For each patient, C-G Cl(c) (r) was calculated and compared with a measured 24-hour Cl(c) (r) . Body weight adjustments to the calculation were performed based on the following weight classifications: underweight, normal weight, overweight, obese, and morbidly obese. In addition, C-G Cl(c) (r) was calculated by using rounded S(c) (r) values based on two S(c) (r) thresholds-0.8 mg/dl and 1 mg/dl-for patients with measured S(c) (r) values below those thresholds. Those patients were then evaluated after stratification into two age groups: all ages and a subgroup of patients aged 65 years or older. The S(c) (r) -rounded C-G Cl(c) (r) values were compared with the C-G Cl(c) (r) values using actual S(c) (r) values. Mean differences were calculated, and accuracy was evaluated. Use of actual body weight in the calculations for underweight patients resulted in an unbiased Cl(c) (r) of -0.22 ml/minute (p=0.898). Use of ideal body weight in the calculations of patients of normal weight returned an unbiased Cl(c) (r) of -1.3 ml/minute (p=0.544). An unbiased C-G Cl(c) (r) could not be calculated for other weight categories. In those patients, adjusted body weight using a factor of 0.4 (ABW(0.4) ) was the least biased and most accurate. In patients aged 65 years or older with an S(c) (r) less than 0.8 mg/dl and less than 1 mg/dl, actual S(c) (r) was unbiased (-3 ml/min [p=1] and -9 ml/min [p=0.279], respectively) and more accurate than rounded S(c) (r) . In patients of all ages with an S(c) (r) less than 0.8 mg/dl and less than 1 mg/dl, actual S(c) (r) proved less

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

    Science.gov (United States)

    Schwartz, Janice B

    2016-10-01

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

  9. Application of the Age, Creatinine, and Left Ventricular Ejection Fraction Score for Patients on Extracorporeal Membrane Oxygenation.

    Science.gov (United States)

    Tsai, Tsung-Yu; Tsai, Feng-Chun; Fan, Pei-Chun; Chang, Chih-Hsiang; Lin, Chan-Yu; Chang, Wei-Wen; Lee, Shen-Yang; Hsu, Hsiang-Hao; Tian, Ya-Chung; Fang, Ji-Tseng; Yang, Chih-Wei; Chen, Yung-Chang

    2017-02-01

    Patients on extracorporeal membrane oxygenation (ECMO) usually have high mortality rate and poor outcome. Age, Creatinine, and Left Ventricular Ejection Fraction (ACEF) score is an easy-calculating score and provides good performance on mortality prediction in patients undergoing cardiac operations or percutaneous coronary intervention, but it has not been applied to patients on ECMO before. In this study, we aimed to use ACEF score obtained within 1 week of ECMO support for in-hospital mortality prediction in patients on ECMO due to severe myocardial failure. This study reviewed the medical records of 306 patients on ECMO at a specialized intensive care unit (CVSICU) in a tertiary-care university hospital between March 2002 and December 2011, and 105 patients on veno-arterial ECMO due to severe myocardial failure were enrolled. Demographic, clinical, and laboratory variables were retrospectively collected as survival predictors. The overall mortality rate was 47.6%. The most frequent condition requiring ICU admission was postcardiotomy cardiogenic shock. Multiple logistic regression analysis indicated that post-ECMO ACEF score, Sequential Organ Failure Assessment score, and troponin I on day 1 of ECMO support were independent risk factors for in-hospital mortality. Using the area under the receiver operating characteristic curve (AUROC), the post-ECMO ACEF score indicated a good discriminative power (AUROC 0.801 ± 0.042). Finally, cumulative survival rates at 6-month follow-up differed significantly (P  2.22. After ECMO treatment due to severe myocardial failure, post-ECMO ACEF score provides an easy-calculating method with a reproducible evaluation tool with excellent prognostic abilities in these patients.

  10. 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.  

  11. The Expression of miR-192 and Its Significance in Diabetic Nephropathy Patients with Different Urine Albumin Creatinine Ratio

    Directory of Open Access Journals (Sweden)

    Xiaoyu Ma

    2016-01-01

    Full Text Available Objective. To investigate the expression of miR-192 and its significance in diabetic nephropathy (DN patients. Methods. 464 patients with type 2 diabetes mellitus (T2DM were divided into normal albuminuria group (NA, n=157, microalbuminuria group (MA, n=159, and large amount of albuminuria group (LA, n=148. 127 healthy persons were selected as the control group (NC, n=127. The serum miR-192 levels were detected by Real-Time PCR and transforming growth factor-β1 (TGF-β1 and fibronectin (FN were detected by enzyme-linked immunosorbent assay. The relationships among these parameters were analyzed by Pearson correlation analysis and multiple linear regression analysis. Results. The miR-192 in the LA group was significantly lower than other groups, which was lower in the MA group than in the NA group (P<0.01. The TGF-β1 and FN in the LA group were significantly higher than other groups, which were higher in the MA group than in the NA group (P<0.01. The expression of miR-192 was negatively correlated with TGF-β1, FN, and Ln (UACR and miR-192, TGF-β1, and FN were independent relevant factors affecting Ln (UACR in T2DM (P<0.01. Conclusions. These findings indicate that the levels of miR-192 were lower accompanied by the decrease of urine albumin creatinine ratio (UACR and the association between miR-192 and nephritic fibrosis in DN.

  12. 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

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

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    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.

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

    Science.gov (United States)

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

    2016-03-01

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

  15. 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.

  16. Specific Phobias

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    ... Mental Health This information in Spanish ( en español ) Specific phobias Treatment More information on specific phobias A specific ... targeted psychotherapy. Return to top More information on Specific phobias Explore other publications and websites Phobias (Copyright © American ...

  17. INCREASED URINARY NEOPTERIN: CREATININE RATIO AS A MARKER OF ACTIVATION OF CELL-MEDIATED IMMUNITY AND OXIDATIVE STRESS IN THE IRANIAN PATIENTS WITH MULTIPLE SCLEROSIS

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    H. Khorami

    2003-09-01

    Full Text Available Neopterin, apyrazinopyrimidine compound, is produced by macrophages after induction by interferon gamma (IFN-y and serves as a marker of cellular immune system activation followed by oxidative stress. The aim of this study was to determine urinary neopterin to creatinine ratio (UNCR as a surrogate marker of cell-mediated immune activation in multiple sclerosis (MS. Three weekly early morning urine samples were collected from 27 patients with MS and 31 age- and sex-matched apparently healthy subjects. Urinary neopterin and creatinine were determined using reversed phase high-performance liquid chromatography and Jaffe reaction, respectively. UNCR was significantly higher in patients than in healthy controls indicating IFN-y-induced cellular immunity activation and oxidative stress in multiple sclerosis. As a non-invasive method, UNCR determination may be helpful in monitoring disease progression and the effects of therapies, as well.

  18. Simultaneous determination of creatinine and acetate by capillary electrophoresis with contactless conductivity detector as a feasible approach for urinary tract infection diagnosis.

    Science.gov (United States)

    Grochocki, Wojciech; Markuszewski, Michał J; Quirino, Joselito P

    2017-04-15

    Urinary tract infection (UTI) is one of the most common bacterial infection in human but its diagnosis is difficult. Metabolomic studies with nuclear magnetic resonance of urine have shown that acetic acid/creatinine ratio may be used for early UTI diagnosis. Here, a method for simultaneous determination of acetate and creatinine by capillary zone electrophoresis with contactless conductivity detector was developed for the first time. The separation was with 40mM MES and 20mM l-histidine as a background solution. The total time of a single run, including capillary conditioning, was less than 12min. The method was successfully demonstrated for analysis of actual and fortified human urine samples after methanol dilution. Analytical figures of merit such as linearity, LOQ, and repeatability (intraday and interday) were studied.

  19. Urinary creatinine concentration is inversely related to glycaemic control and the presence of some diabetic complications in patients with newly diagnosed Type 2 diabetes

    DEFF Research Database (Denmark)

    Olivarius, Niels de Fine; Andreasen, Anne H; Vestbo, Else

    2006-01-01

    of Type 2 diabetic patients. METHODS: A freshly voided morning urine specimen was provided by 1,284 consecutive, newly diagnosed diabetic patients aged 40 years or over in general practice. Albumin was measured by a polyethyleneglycol radioimmunoassay and creatinine by a modified Jaffe method. RESULTS......BACKGROUND: The ratio between urinary albumin concentration (UAC) and urinary creatinine concentration (UCC) is widely used to estimate renal involvement. We examined how UAC and UCC associate with each other, with other risk factors, and with diabetic complications in a population-based sample......: In a multivariate model including UAC, UCC, age, sex, HbA1c, and urinary glucose concentration, UAC increased with both age (P=.042) and HbA1c (P=.014), while UCC decreased (Pdiabetic retinopathy (P

  20. Screening for renal insufficiency following ESUR (European Society of Urogenital Radiology) guidelines with on-site creatinine measurements in an outpatient setting

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    Ledermann, H.P.; Mengiardi, B.; Schmid, A. [IMAMED Radiologie Nordwest, Basel (Switzerland); Froehlich, J.M. [Guerbet AG, Medical Affairs, Zurich (Switzerland); University of Bern, Radiology Department, Bern (Switzerland)

    2010-08-15

    To report the results and implications for workflow following introduction of ESUR guidelines to screen for potential renal insufficiency (RI) in private practice with on-site creatinine measurements. A total of 1,766 consecutive outpatients scheduled for contrast-enhanced CT (CECT) completed the ESUR questionnaire enquiring about kidney disease, renal surgery, proteinuria, diabetes mellitus, hypertension, gout or use of nephrotoxic drugs. Patients with positive risk factors underwent on-site creatinine measurement and calculation of estimated glomerular filtration rate (eGFR). Attending radiologists adapted subsequent imaging depending on renal function and presence of risk factors. One or more ESUR risk factors were present in 796 (45.1%) patients, including hypertension (37.7%), nephrotoxic medication (21.3%), diabetes mellitus (8.0%), proteinuria (3.9%), renal disease (4.1%), gout (3.1%) and renal surgery (2.6%). Pre-procedural creatinine measurements revealed severe RI (eGFR < 30 ml min{sup -1} 1.73 m{sup -2}) in 10 (1.3%) and moderate RI (eGFR 30-59 ml min{sup -1} 1.73 m{sup -2}) in 106 (13.8%). Imaging work-up was adapted in 132 (16.6%) as follows: reduction of contrast material dose (n = 85), CT without contrast (n = 40), changeover to MRI (n = 3) or scintigraphy (n = 4). Screening for RI following ESUR guidelines requires creatinine measurements in nearly half of outpatients scheduled for CECT and reveals moderate to severe renal impairment in 6.6%. (orig.)

  1. 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

    Objective 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). Methods 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%. Results 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. Conclusions 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. PMID:25961558

  2. MELD vs Child-Pugh and creatinine-modified Child-Pugh score for predicting survival in patients with decompensated cirrhosis

    Institute of Scientific and Technical Information of China (English)

    George V. Papatheodoridis; Evangelos Cholongitas; Eleni Dimitriadou; Giota Touloumi; Vassilios Sevastianos; Athanasios J. Archimandritis

    2005-01-01

    AIM: Model of End-stage Liver Disease (MELD) score has recently gained wide acceptance over the old Child-Pugh score in predicting survival in patients with decompensated cirrhosis, although it is more sophisticated. We compared the predictive values of MELD, Child-Pugh and creatinine modified Child-Pugh scores in decompensated cirrhosis. METHODS: A cohort of 102 patients with decompensated cirrhosis followed-up for a median of 6 mo was studied.Two types of modified Child-Pugh scores estimated by adding 0-4 points to the original score using creatinine levels as a sixth categorical variable were evaluated.RESULTS: The areas under the receiver operating characteristic curves did not differ significantly among the four scores, but none had excellent diagnostic accuracy (areas:0.71-0.79). Child-Pugh score appeared to be the worst, while the accuracy of MELD was almost identical with that of modified Child-Pugh in predicting short-term and slightly better in predicting medium-term survival. In Cox regression analysis, all four scores were significantly associated with survival, while MELD and creatinine-modified Child-Pugh scores had better predictive values (c-statistics: 0.73 and 0.69-0.70) than Child-Pugh score (c-statistics: 0.65). Adjustment for gamma-glutamate transpeptidase levels increased the predictive values of all systems (c-statistics: 0.77-0.81). Analysis of the expected and observed survival curves in patients subgroups according to their prognosis showed that all models fit the data reasonably well with MELD probably discriminating better the subgroups with worse prognosis. CONCLUSION: MELD compared to the old Child-Pugh and particularly to creatinine-modified Child-Pugh scores does not appear to offer a clear advantage in predicting survival in patients with decompensated cirrhosis in daily clinical practice.

  3. 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 uric acid ( r = 0.005, p = 0.858). Moreover, multivariate analysis revealed that serum uric acid was not an independent risk factor for incident chronic kidney disease ( p = 0.055), whereas serum uric acid to creatinine ratio was significantly associated with incident chronic kidney disease independently of potential confounders including baseline estimated glomerular filtration rate. serum uric acid to creatinine ratio might be a better predictor of incident chronic kidney disease in type 2 diabetes mellitus patients.

  4. Study on discrepancy and correlation of urinary creatinine levels between enzyme method and Jaffe kinetic creatinine assay%酶法与碱性苦味酸法测定尿肌酐值的差异及相关性研究

    Institute of Scientific and Technical Information of China (English)

    史善富; 陶松宁

    2011-01-01

    目的 研究酶法和碱性苦味酸法测定尿肌酐值的差异及相关性,探讨酶法测定肌酐值用于职业接触汞的生物限值的报告.方法 将123名受检者尿液分为两组,分别用0.9%的生理盐水作1∶10及1∶20稀释,用肌氨酸氧化酶法和碱性苦味酸速率法测定两组尿肌酐值,分析两法测定尿肌酐值的差异及相关性.结果 1∶10稀释组尿液肌酐均值苦味酸法低于酶法(P<0.01),相关系数r=0.9955,回归方程Y苦味酸法=0.5726X酶法+392;1∶20稀释组尿液肌酐均值苦味酸法低于酶法(P<0.01),相关系数r=0.9977,回归方程Y苦味酸法=0.5723X酶法+602.结论 两种方法测定的尿液肌酐值差异有统计学意义但具有良好的相关性,可以酶法测定的尿肌酐值计算成苦味酸法测定的尿肌酐值用于职业接触汞的生物限值的报告.%Objective To compare the enzymic method and Jaffe kinetic ereatinine assay for the determination of creatinine in urine and discuss whether using the levels of creatinine by enzymic method to report on biological limits for occupational exposure to mercury. Methods A total of 123 conscript persons were selected as study subjects, they were further divided into two groups, their urine were diluted into 1: 10 and 1: 20 respectively by 0. 9% physiological saline. The levels of urine creatinine were determined by enzymic method and Jaffe kinetic creatinine assay, their differece and correlation were analyzed statistically. Results The creatinine concentrations in urine determined by the Jaffe kinetic creatinine assay were significantly lower than those by enzymic method in 1: 10 group (P < 0.01) and correlation coefficient r = 0.9955, regression equation J'jiiffe kinetic cre.tMm u?a, = 0. 5726 Xmzp^c method + 392; The creatinine concentrations in urine determined by the Jaffe kinetic creatinine assay were significantly lower than those by enzymic method in 1: 20 group ( P < 0. 01) and correlation coefficient r = 0

  5. Evaluation of Serumal Levels of AST, ALT, Total Bilirubin, Glucose, Urea and Creatinin in Mice after Administration of Tc-99m MIBI

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    Bahram Amouoghli Tabrizi

    2012-02-01

    Full Text Available Tc-99m MIBI methoxyisobutylisonitrile (MIBI is a lipophilic cationic agent which is widely used for myocardial perfusion imaging and also for the detection of various tumors. In present study, for evaluation of serum level of AST, ALT, Total bilirubin, FBC, Urea and Creatinin, 25 mice, respectively were selected and they were divided in 5 groups. 0.3 mC/kg of drug was injected to 4 groups via tail vein. In the control group, before beginning of the investigation bleeding was done. Twenty four hours after injection from the 2nd group, 48 h later from the 3rd group, one week later from the 4th group and two weeks later from the 5th group bleeding was done respectively and the levels of Glucose, Urea, creatinin, ALT, AST and T-bilirubin, respectively were measured using spectophotometr (Biowave S2100 made in England and diagnostic kits (made in bio-chemistry company, Iran. In Comparison to control group, results had significant differences in serum level of Urea, Creatinin and total bilirubin after 24 and 48 h of administration(p<0.05. Also there were insignificant differences in serum ALT and AST level and Glucose after 24 h of administration in all groups (p<0.05. Results shows that more care is needed for administration of drug in diabetic, renal and hepatic patients.

  6. Masked Hypertension Defined by Ambulatory Blood Pressure Monitoring Is Associated With an Increased Serum Glucose Level and Urinary Albumin-Creatinine Ratio

    Science.gov (United States)

    Ishikawa, Joji; Hoshide, Satoshi; Eguchi, Kazuo; Schwartz, Joseph E.; Pickering, Thomas G.; Shimada, Kazuyuki; Kario, Kazuomi

    2017-01-01

    The authors evaluated the relationship of hypertensive target organ damage to masked hypertension assessed by ambulatory blood pressure (BP) and home blood pressure (HBP) monitoring in 129 participants without taking antihypertensive medication. Masked hypertension was defined as office BP ≤140/90 mm Hg and 24-hour ambulatory BP ≥130/80 mm Hg. The masked hypertensive participants defined by 24-hour ambulatory BP (n=13) had a higher serum glucose level (126 vs 96 mg/dL, P=.001) and urinary albumin-creatinine ratio (38.0 vs 7.5 mg/gCr, P<.001) than the normotensive participants (n=74); however, these relationships were not observed when the authors defined groups using HBP (≥135/85 mm Hg). Masked hypertension by both 24-hour ambulatory BP and HBP had a higher urinary albumin-creatinine ratio than normotension by both 24-hour ambulatory BP and HBP (62.1 vs 7.4 mg/gCr, P=.001), and than masked hypertension by HBP alone (9.3 mg/gCr, P=.009). Masked hypertension defined by 24-hour ambulatory BP is associated with an increased serum glucose level and urinary albumin-creatinine ratio, but these relationships are not observed in masked hypertension defined by HBP. PMID:20695934

  7. Effect of Plectranthus amboinicus Extract on BUN and Creatinine Levels and Cellular Response Proinflammatory Factors TNF-α and IL-1β on Gout Arthritis Patients

    Directory of Open Access Journals (Sweden)

    Lailatul Muniroh

    2014-12-01

    Full Text Available The purpose of this research was to develop anti-cytokine-based treatment using extract of Plectranthus amboinicus applied to gout arthritis (GA patients. The research was quasi experimental, with a pretest-posttest randomized control group design. The samples were GA patientsin the Outpatient Installation of Internal Medicine in General Hospital Haji,Surabaya. The sample was comprised of 30 respondents. The respondents were divided into a treatment group and a control group. The treatment group was asked to take medicine from the hospital, coupled with Plectranthus amboinicus extract capsules, for 7 days, during which time patients’ joint inflammation was observed. The control group was provided with only medication from the hospital, and their joint inflammation was likewise observed. Blood samples were taken before and after treatment, to measure the levels of blood urea nitrogen (BUN and creatinine, as well as the concentrations of TNF-α and IL-1β. There was a decrease in BUN and creatinine levels in the control group, but it was not significant, decreasing by 3% and 8%, respectively. The treatment group also showed elevated levels of BUN and creatinine, which also was not significant at 3% and 7%, respectively. There was a decrease in the concentration of TNF-α in the control group by 9% and 22%. The concentration of IL-1β in the control group increased by 18%, whereas,in the treatment group,it decreased by3%; however,the decreases in bothgroups were not significant.

  8. 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

  9. Insular volume reduction in schizophrenia.

    Science.gov (United States)

    Saze, Teruyasu; Hirao, Kazuyuki; Namiki, Chihiro; Fukuyama, Hidenao; Hayashi, Takuji; Murai, Toshiya

    2007-12-01

    Structural and functional abnormalities of the insular cortex have been reported in patients with schizophrenia. Most studies have shown that the insular volumes in schizophrenia patients are smaller than those of healthy people. As the insular cortex is functio-anatomically divided into anterior and posterior subdivisons, recent research is focused on uncovering a specific subdivisional abnormality of the insula in patients with schizophrenia. A recent ROI-based volumetric MRI study demonstrated specific left anterior insular volume reduction in chronic schizophrenia patients (Makris N, Goldstein J, Kennedy D, Hodge S, Caviness V, Faraone S, Tsuang M, Seidman L (2006) Decreased volume of left and total anterior insular lobule in schizophrenia. Schizophr Res 83:155-171). On the other hand, our VBM-based volumetric study revealed a reduction in right posterior insular volume (Yamada M, Hirao K, Namiki C, Hanakawa T, Fukuyama H, Hayashi T, Murai T (2007) Social cognition and frontal lobe pathology in schizophrenia: a voxel-based morphometric study. NeuroImage 35:292-298). In order to address these controversial results, ROI-based subdivisional volumetry was performed using the MRI images from the same population we analyzed in our previous VBM-study. The sample group comprised 20 schizophrenia patients and 20 matched healthy controls. Patients with schizophrenia showed a global reduction in insular gray matter volumes relative to healthy comparison subjects. In a simple comparison of the volumes of each subdivision between the groups, a statistically significant volume reduction in patients with schizophrenia was demonstrated only in the right posterior insula. This study suggests that insular abnormalities in schizophrenia would include anterior as well as posterior parts. Each subdivisional abnormality may impact on different aspects of the pathophysiology and psychopathology of schizophrenia; these relationships should be the focus of future research.

  10. Industrial cogeneration optimization program. Volume II. Appendix A. Conceptual designs and preliminary equipment specifications. Appendix B. Characterization of cogeneration systems (near-term technology). Appendix C. Optimized cogeneration systems

    Energy Technology Data Exchange (ETDEWEB)

    1980-01-01

    This appendix to a report which evaluates the technical, economic, and institutional aspects of industrial cogeneration for conserving energy in the food, chemical, textile, paper, and petroleum industries contains data, descriptions, and diagrams on conceptual designs and preliminary equipment specifications for cogeneration facilities; characterization of cogeneration systems in terms of fuel utilization, performance, air pollution control, thermal energy storage systems, and capital equipment costs; and optimized cogeneration systems for specific industrial plants. (LCL)

  11. Variações diárias nas excreções de creatinina e derivados de purinas em novilhas Daily variation in the urinary excretion of creatinine and purine derivatives in heifers

    Directory of Open Access Journals (Sweden)

    Thalita Lázaro Leal

    2007-08-01

    Full Text Available Objetivou-se avaliar as variações nas excreções diárias de creatinina e de uréia na urina utilizando coletas durante seis dias consecutivos em novilhas de origem leiteira; avaliou-se também o efeito da duração do período de coleta sobre a estimativa da produção microbiana obtida a partir dos derivados de purinas na urina. Utilizaram-se onze novilhas de grau de sangue predominantemente Holandês, com 287 ± 49 kg, considerando o grupo de animais como amostra aleatória simples da população. Para comparação entre dias de coletas, empregou-se análise de variância como ferramenta para isolamento do erro puro, adotando-se modelo constituído pelo efeito aleatório de animal e pelo efeito fixo de dia de avaliação. O volumoso foi constituído de silagem de milho fornecida à vontade. Diariamente, foram fornecidos 2,0 kg de concentrado por animal. O período experimental teve duração de seis dias, pois os animais já estavam adaptados à dieta. As coletas de urina foram realizadas utilizando-se sondas de Folley nº 22 ou 26, sendo determinado o volume urinário diário. As excreções urinárias de creatinina, uréia, alantoína, ácido úrico e derivados de purinas totais não foram afetadas pelos dias de coleta de urina. Do mesmo modo, a quantidade estimada de proteína microbiana não diferiu entre os dias de coleta de urina. O valor médio para a excreção de creatinina foi de 30,5 mg/kgPV, 124,84 mg/kg0,75 ou 1,1 mmol/kg0,75. A ausência de efeito de número de dias sobre a excreção de creatinina tem grande aplicação prática, pois, além de reduzir o trabalho com tempos longos de coleta, permite a redução dos custos da pesquisa, podendo ser recomendadas coletas de urina com duração de 24 horas.The objective of this trial was to investigate the daily variation in the urinary excretions of creatinine and nitrogen compounds in dairy heifers. It was also of particular interest to determine whether or not estimation of

  12. USCIS National Processing Volumes and Trends

    Data.gov (United States)

    Department of Homeland Security — The dataset provides the public with a comparison of form processing volumes and trend data for specific form types and offices with national levels. This gives the...

  13. Ovarian volume throughout life

    DEFF Research Database (Denmark)

    Kelsey, Thomas W; Dodwell, Sarah K; Wilkinson, A Graham

    2013-01-01

    cancer. To date there is no normative model of ovarian volume throughout life. By searching the published literature for ovarian volume in healthy females, and using our own data from multiple sources (combined n=59,994) we have generated and robustly validated the first model of ovarian volume from...... to about 2.8 mL (95% CI 2.7-2.9 mL) at the menopause and smaller volumes thereafter. Our model allows us to generate normal values and ranges for ovarian volume throughout life. This is the first validated normative model of ovarian volume from conception to old age; it will be of use in the diagnosis...

  14. An estimate of global glacier volume

    Directory of Open Access Journals (Sweden)

    A. Grinsted

    2013-01-01

    Full Text Available I assess the feasibility of using multivariate scaling relationships to estimate glacier volume from glacier inventory data. Scaling laws are calibrated against volume observations optimized for the specific purpose of estimating total global glacier ice volume. I find that adjustments for continentality and elevation range improve skill of area–volume scaling. These scaling relationships are applied to each record in the Randolph Glacier Inventory, which is the first globally complete inventory of glaciers and ice caps. I estimate that the total volume of all glaciers in the world is 0.35 ± 0.07 m sea level equivalent, including ice sheet peripheral glaciers. This is substantially less than a recent state-of-the-art estimate. Area–volume scaling bias issues for large ice masses, and incomplete inventory data are offered as explanations for the difference.

  15. Control volume based hydrocephalus research

    Science.gov (United States)

    Cohen, Benjamin; Voorhees, Abram; Wei, Timothy

    2008-11-01

    Hydrocephalus is a disease involving excess amounts of cerebral spinal fluid (CSF) in the brain. Recent research has shown correlations to pulsatility of blood flow through the brain. However, the problem to date has presented as too complex for much more than statistical analysis and understanding. This talk will highlight progress on developing a fundamental control volume approach to studying hydrocephalus. The specific goals are to select physiologically control volume(s), develop conservation equations along with the experimental capabilities to accurately quantify terms in those equations. To this end, an in vitro phantom is used as a simplified model of the human brain. The phantom's design consists of a rigid container filled with a compressible gel. The gel has a hollow spherical cavity representing a ventricle and a cylindrical passage representing the aquaducts. A computer controlled piston pump supplies pulsatile volume fluctuations into and out of the flow phantom. MRI is used to measure fluid velocity, and volume change as functions of time. Independent pressure measurements and flow rate measurements are used to calibrate the MRI data. These data are used as a framework for future work with live patients.

  16. Effect of VCO to leucocyte differential count, glucose levels and blood creatinine of hyperglycemic and ovalbumin sensitized Mus musculus Balb/c

    Directory of Open Access Journals (Sweden)

    RUBEN DHARMAWAN

    2009-03-01

    Full Text Available Abstract. Handajani NS, Dharmawan R. 2009. Effect of VCO to leucocyte differential count, glucose levels and blood creatinine of hyperglycemic and ovalbumin sensitized Mus musculus Balb/c. Nusantara Bioscience 1: 1-8. Chemical medicines and insulin can decrease glucose blood level on hyperglycemic patients with macro vascular side effect. Diabetes and allergy incidences are influenced by quality and quantity of leucocytes. Lauric acid within VCO reports decreased glucose blood level of diabetes and some allergy incidents. The purpose of the study is to know the effect of VCO on glucose blood level, differential leucocytes count and creatinine blood level on hyperglycemic and normoglicemic ovalbumin sensitized mice. Forty five (45 male (mice of Mus musculus Balb/c with average weight of 35 g are divided into 9 groups with 5 repetitions, those are 4 non alloxan groups and 5 alloxan induced hyperglycemic groups. On 22nd day to 36th day they are sensitize to ovalbumin as allergen. Blood sample was obtained by orbital vena using heparin as anti coagulant in order measuring glucose blood level by GOD method to 6 times, on 1st, 4th, 18th, 22nd, 32nd and 37th days, then are tested by ANOVA followed by DMRT 0.05. On 37th day, differential leucocytes are determined, blood level are counted, and then compared to normal value. The result of this study were that within differential leucocytes count of hyperglycemic mice, neutrophile percentage were much lower than the normal value (3.22%, and lymphocyte percentage were much higher than the normal value (94.54%. Consumed 0.003 mL/35 g VCO more 18 days decreased glucose blood level on hyperglycemic mice, decreased basophile percentage of ovalbumin sensitized mice, normalized neutrophile percentage no increased creatinine blood level.

  17. [Quantification of separate renal function using Tc 99m DTPA and Tc 99m DMSA. Correlations between individual isotopic data and creatinine clearance].

    Science.gov (United States)

    Chevet, D; Moisan, A; Le Pogamp, P; Le Cloirec, J; Wehbe, B; Herry, J Y

    1984-01-01

    The purpose of this prospective study (30 controls and 100 renal patients) is to compare one to each other the values of renal function measured with: 1--the DTPA 99mTc , 2--the DMSA 99mTc , and 3--the creatinine clearance. After the control values being established, correlations are done for the whole group (n = 130) between the creatinine clearance, the DTPA 99mTc clearance and the fixation rate of the DMSA 99mTc . The correlations obtained are:--Clcr Versus Cldtpa = 0,91.--Clcr Versus % Dmsa = 0,90. - Cldtpa Versus % Dmsa = 0,93. and indicate the two isotopic tests performed give similar quantitative results than creatinine clearance. Camera and computer allow to measure the separate renal function one by one, the two isotopic test giving similar values for each kidney. The results of these studies give a good concordance with the observed diseases, except for partial renal artery stenosis. The pyelic retention of DMSA 99mTc product, in condition of ureteral compression, gives a potential overestimation of this test and is a matter to debate. The extreme simplicity and facility of DMSA 99mTc procedures make this investigation accessible to any patient and give excellent morphological and functional tests. DTPA 99mTc clearances--global and separate kidney--give a more sensitive approach than DMSA 99mTc does because vascular captation , elimination rates could be focused. DTPA 99mTc procedure is to be used in patients with transplanted kidney, silent IVP kidney, contrast media contraindication or for exploring glomerular clearance without urine collection.

  18. 宜昌地区血清肌酐酶法参考区间调查%Investigating of reference intervals of serum creatinine in Yichang

    Institute of Scientific and Technical Information of China (English)

    杨芳芳; 杨晓东

    2013-01-01

    Objective To investigate the normal reference limits of serum creatinine and establish reference interval of this lab.Methods 1 243 cases of healthy adults(more than 18 years old, 646 cases of male, 597 cases of female) were detected for serum creatinine,and the results of different age and gender groups were compared.Results The results were conformed not to be with normal distribution,with significant difference between men and women(P < 0.05).Adult male 95% reference interval was 55.6 -103.3 μmol/L, women reference interval was 42.0 - 81.9 μmol/L.Conclusion Serum creatinine reference interval should be set up for different areas and different detection systems.%目的 调查该地区血清肌酐的正常参考范围,建立该实验室肌酐酶法的参考区间.方法 对1 243例健康成年人(年龄大于18岁,其中男646例,女597例)进行血清肌酐的测定,并按性别和年龄组分别比较.结果 血清肌酐测定结果 不符合正态分布,成年人肌酐值男女间差异有统计学意义(P<0.05),成年男性95%参考区间为55.6~103.3 μmol/L,女性参考区间为42.0~81.9 μmol/L.结论 应该建立不同地区不同检测系统血清肌酐的参考区间.

  19. Integrating solid-state sensor and microfluidic devices for glucose, urea and creatinine detection based on enzyme-carrying alginate microbeads.

    Science.gov (United States)

    Lin, Yen-Heng; Wang, Shih-Hao; Wu, Min-Hsien; Pan, Tung-Ming; Lai, Chao-Sung; Luo, Ji-Dung; Chiou, Chiuan-Chian

    2013-05-15

    A solid-state sensor embedded microfluidic chip is demonstrated for the detection of glucose, urea and creatinine in human serum. In the presented device, magnetic powder-containing enzyme-carrying alginate microbeads are immobilized on the surface of an electrolyte-insulator-semiconductor (EIS) sensor by means of a step-like obstacle in the microchannel and an external magnetic force. The sample is injected into the microchannel and reacts with the enzyme contained within the alginate beads; prompting the release of hydrogen ions. The sample concentration is then evaluated by measuring the resulting change in the voltage signal of the EIS sensor. The reaction time and alginate bead size are optimized experimentally using a standard glucose solution. The experimental results show that the device has a detection range of 2-8mM, 1-16mM and 10(-2)-10mM for glucose, urea and creatinine, respectively. Furthermore, it is shown that the device is capable of sequentially measuring all three indicators in a human serum sample. Finally, it is shown that the measured values of the glucose, urea and creatinine concentrations obtained using the device deviate from those obtained using a commercial kit by just 5.17%, 6.22% and 13.53%, respectively. This method can be extended to sequentially measure multiple blood indicators in the sample chip by replacing different types of enzyme in alginate bead and can address the enzyme preservation issue in the microfluidic device. Overall, the results presented in this study indicate that the microfluidic chip has significant potential for blood monitoring in point-of-care applications.

  20. The diagnostic value of both troponin T and creatinine kinase isoenzyme (CK-MB in detecting combined renal and myocardial injuries in asphyxiated infants.