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Abstract Heart failure is a highly prevalent disease, which courses with frequent readmissions, mainly by Acute Heart Failure (AHF). Reduced renal function is associated with increased mortality in patients with HF. Therefore, an accurate and precise evaluation of renal function in patients with HF is crucial. The error of estimated GFR (eGFR) is wide and common, showing a ± 30% variability compared to measured GFR (mGFR). However, there is no evidence on the error of formulas in reflecting real renal function and particularly the consequences of this error in patients with AHF. This is a prospective study comparing the impact of mGFR versus eGFR in the onset of cardiovascular (CV) outcomes in patients with AHF. This was tested with cox survival analysis. Measured GFR was determined by the plasma clearance of iohexol-dbs and eGFR by Cockroft-Gould, MDRD, CKD-EPI creatinine, CKD-EPI cystatin-C and CKD-EPI creatinine + cystatin-C equations formulas. Also the agreement between mGFR and eGFR was analyzed. A total of 90 patients were included. Average age was 66 (± 12 years) and 52 (58%) were male. Of them 53 patients (59%) had a cardiovascular event during follow-up, 22 fatal (41%). The agreement between mGFR and eGFR indicated moderate precision and accuracy (concordance correlation coefficient of 0.77; CI = 0.73–0.82). In multiple cox survival analysis, mGFR was significantly associated with cardiovascular events together with NTproBNP, BMI, LVEF and previous coronary artery disease (p = 0.037; HR = 0.98, 95% CI = 0.95–0.99). Estimated GFR by formulas was not significant. In patients with AHF the error of formulas is large, frequent and random, also, mGFR and not eGFR predicted future CV events. The error of eGFR may have clinical consequences in specific subpopulations.

Aim. To study the features of lipid metabolism disorders in patients with acute coronary syndrome (ACS), depending on glomerular filtration rate (GFR) and smoking factor. Materials and methods. The study included 142 ACS patients (mean age – 59.66 ± 0.78 years). All the patients were divided into two groups according to GFR. Group I comprised 57 individuals with GFR

Abstract Fabry disease (FD) constitutes a rare, X-linked lysosomal storage disorder affecting multiple organ systems, most notably heart, kidneys, and the central nervous system. Neurofilament light chains (NfL) have emerged as a prime candidate for a body fluid biomarker reflecting neuro-axonal injury. We aimed to evaluate its addition to the diagnostic and monitoring armamentarium in FD. Serum NfL concentrations (sNfL) were measured in 50 people with FD (PwFD) and 30 healthy control subjects (HC) using the Simoa© technology, followed by calculation of Z-scores adjusted for age and body mass index. In addition, clinical disease severity in PwFD was measured using the FOS-MSSI (Fabry outcome study – Mainz severity score index), which comprises clinical and paraclinical parameters. PwFD show elevated sNfL Z-scores compared to HC (PwFD: 1.12 [SD 1.5], HC: 0.01 [SD 1.2], p

Aim – to develop an applied prognostic calculator for the rate of progression of CKD in elderly patients with type 2 diabetes, which makes it possible to identify a group of high rate of GFR reduction in conditions of routine outpatient admission. Material and methods. 69 clinical indicators were studied, the interrelationships and significance of differences in parameters in the groups identified according to the original diagnostic parameter, the glomerular filtration rate reduction index with a threshold value of 3.83 ml/min/1.73 m2 per year, above which the rate of progression of CKD was considered high. Results. By using regression analysis, significant factors for the prognostic calculator were identified: the duration of diabetes and insulin therapy, concomitant diagnosis of obesity, pulse in the ankle artery, severe stage of polyneuropathy, risk group IV of hypertension, treatment with sulfonylureas, the number of antihypertensive drugs taken. When evaluating the information capacity and predictive ability of the calculator, the area under the AUC ROC curve was 0.89 (0.80; 0.99) p 0.001, which characterizes the quality of the diagnostic technique as high. Conclusion. The presented calculator gives the doctor the opportunity to identify a group of patients with the risk of rapid progression of CKD directly on an outpatient basis.

Abstract Kidney diseases pose a global healthcare burden, with millions requiring renal replacement therapy. Ischemia/reperfusion injury (IRI) is a common pathology of acute kidney injury, causing hypoxia and subsequent inflammation-induced kidney damage. Accurate detection of acute kidney injury due to IRI is crucial for timely intervention. We used longitudinal, multi-parametric magnetic resonance imaging (MRI) employing arterial spin labelling (ASL), diffusion weighted imaging (DWI), and dynamic contrast enhanced (DCE)-MRI to assess IRI induced changes in both the injured and healthy contralateral kidney, in a unilateral IRI mouse model (n = 9). Multi-parametric MRI demonstrated significant differences in kidney volume (p = 0.001), blood flow (p = 0.002), filtration coefficient (p = 0.038), glomerular filtration rate (p = 0.005) and apparent diffusion coefficient (p = 0.048) between the injured kidney and contralateral kidney on day 1 post-IRI surgery. Identification of the injured kidney using principal component analysis including most of the imaging parameters demonstrated an area under the curve (AUC) of 0.97. These results point to the utility of multi-parametric MRI in early detection of IRI-induced kidney damage suggesting that the combination of various MRI parameters may be suitable for monitoring the extent of injury in this model.

Background: Diabetic kidney disease is a major contributor to end stage renal disease. A change in kidney oxygen homeostasis leading to decreased tissue oxygen tension is an important factor initiating alterations in kidney function in diabetes. However, the mechanism contributing to changed oxygen homeostasis is still unclear. Hyperglycemia-induced production of reactive oxygen species and an altered response to them have previously been demonstrated. In the present study, chronic treatment with DL-sulforaphane to induce nuclear factor erythroid 2-related factor 2 (Nrf2) expression, a master transcriptional regulator binding to antioxidant response elements inducing increased protection against reactive oxygen species, is studied. Methods: Sprague–Dawley rats were made diabetic using streptozotocin and either left untreated or received daily subcutaneous injections of DL-sulforaphane for 4 weeks. Age-matched non-diabetic rats served as controls. After 4 weeks of treatment, rats were anesthetized using thiobutabarbital, and kidney functions were studied in terms of glomerular filtration rate (GFR), renal blood flow (RBF), sodium transport, kidney oxygen consumption, and kidney oxygen tension. Mitochondria was isolated from kidney cortical tissue and investigated using high-resolution respirometry. Results: GFR was increased in diabetics but not RBF resulting in increased filtration fraction in diabetics. DL-sulforaphane treatment did not affect RBF and GFR in controls but decreased the same parameters in diabetics. Increased GFR resulted in increased sodium transport and oxygen consumption, hence decreased efficiency in diabetics compared to controls. Increased oxygen consumption in diabetics resulted in decreased cortical tissue oxygen tension. DL-sulforaphane treatment decreased oxygen consumption in diabetics, whereas transport efficiency was not significantly affected. DL-sulforaphane treatment increased cortical pO2 in diabetics. Conclusions: DL-sulforaphane treatment affects renal hemodynamics, improving cortical oxygen tension but not mitochondrial efficiency.

Aim – to develop and provide clinical substantiation of experimental mathematical models for the chronic kidney disease (CKD) progression rate in patients with type 2 diabetes mellitus (T2DM) using the glomerular filtration rate reduction index (RI_GFR) as original diagnostic parameter. Material and methods. A cross-sectional observational study of clinical status indices was performed in a sample of patients with type 2 diabetes. The significant predictors of a high rate of CKD progression were identified by regression analysis, three variants of experimental mathematical models were developed with different combinations of arguments with an emphasis on modifiable factors. Results. The method of one-dimensional logistic regression analysis revealed the indices of clinical status having a significant impact on the rate of CKD progression on the scale of changes in RI_GFR by 1 ml/min/1.73 m2 and on the binary classification of outcomes in the groups of "slow" and "fast" decrease in kidneys filtration function with a threshold value of RI_GFR of 4.21 ml/min/1.73 m2 per year. These indices were age, body mass index (BMI), glycemia and duration of diabetes at the time of visit, history of insulin therapy, acute myocardial infarction in the anamnesis, pulse on the popliteal artery, concomitant retinopathy, hypertension risk group, treatment with sulfonylureas and calcium antagonists. Using multidimensional logistic regression, three types of experimental mathematical models were developed, including various combinations of predictors that demonstrated high values of diagnostic significance. Conclusion. The mathematical modeling of CKD progression in patients with T2DM with the RI_GFR diagnostic index allows for better understanding of the pathology's development patterns. An experimental mathematical model using modifiable drug factors that a doctor can manage during the treatment (administration of sulfonylureas and calcium channel blockers) demonstrated 55.6% sensitivity, 85.3% specificity, AUC 0.76 (0.65; 0.86), which ensured high quality prediction with an accuracy of 77.5%.

Objective To analyze the factors influencing poor recovery of renal function in patients with severe unilateral hydronephrosis after relief of obstruction， providing evidence for predicting the recovery of renal function. Methods Clinical data of 55 patients with severe unilateral hydronephrosis and glomerular filtration rate （GFR） < 10 mL/min admitted to Tungwah Hospital from 2015 to 2022 were retrospectively analyzed. All patients underwent percutaneous nephrostomy for temporary relief of the obstruction. Based on the recovery of renal function， all patients were divided into the recovery group and non-recovery group， and the factors influencing renal function recovery after nephrostomy were collected and analyzed. Results Among 55 patients treated with percutaneous nephrostomy for severe hydronephrosis， renal function was recovered in 30 cases （54.5%）， and poor recovery in 25 cases （45.5%）. Univariate analysis showed no significant differences in terms of gender， side， body mass index （BMI）， history of diabetes mellitus， history of hypertension， pre-nephrostomy GFR， and urinary pH of the affected kidney between the recovery and non-recovery groups （all P > 0.05）. However， there were significant differences in age， renal parenchymal thickness， ratio of GFR of the affected kidney to total GFR， presence of renal infection， and post-nephrostomy urinary output of the affected kidney between two groups （all P < 0.05）. Further multivariate logistic regression analysis showed that a pre-nephrostomy ratio of GFR of the affected kidney to total GFR （OR=0.24， 95%CI 0.06-0.98） and a post-nephrostomy urinary output of the affected kidney （OR=0.04， 95%CI 0.01-0.25） were the independent influencing factors of poor recovery of renal function after nephrostomy. Conclusions Partial patients with severe unilateral hydronephrosis and a GFR

Background: The main difficulty with donation after circulatory death is the inevitable period of warm ischemia, which may adversely affect tissue viability and graft function after transplantation. The aim of this study was to evaluate dynamic changes in the functional parameters of the kidneys because of renal warm ischemia (RWI) in the experiment. Methods and Results: The experiments were carried out on 78 white male rats weighing 214.5±31.8g. To achieve the study's aim, we applied a method of modeling the intraoperative RWI by clamping renal arteries from both sides through a median laparotomy under ether anesthesia. Vascular clamping lasted 12, 24, 36, or 48 minutes in four experimental groups of rats, each containing 18 rats. The intact group of rats became the control group (n=6). In each of the 4 experimental groups, rats were euthanized by decapitation on Days 3, 7, and 14 of the experiment. Before euthanasia, a 24-hour urine collection was performed in metabolic chambers. Laboratory tests included the determination of blood urea nitrogen (BUN), serum creatinine (sCR), serum potassium (SP), and urinary creatinine (uCr); glomerular filtration rate (GFR) was calculated using the Rehberg-Tareev method. Warm ischemia time (WIT) for no more than 12 minutes did not lead to significant negative changes in most of the studied parameters of renal function at all time stages of the experiment, with the exception of a significant decrease in GFR, as well as an increase in SP levels on Days 3 and 7 of the experiment. The WIT up to 24 minutes led to a more pronounced drop in GFR at all time stages of the experiment (P

Background: An increased chance of developing chronic kidney disease (CKD), which has higher morbidity and mortality, exists among patients with Type 2 diabetes (T2D). Aims and Objectives: Our goal was to determine and classify the anthropometric, physiological, and demographic risk factors for CKD in individuals with T2D. Materials and Methods: A cross-sectional research study was conducted at a tertiary care hospital involving 218 participants. Data were collected on various parameters including age, gender, education level, employment status, height, weight, blood pressure, hemoglobin levels, and estimated glomerular filtration rates (eGFRs). Participants were selected based on specific inclusion and exclusion criteria, and rigorous statistical analyses were applied to the collected data. Using the SPSS program, we analyzed the data, and when the P

Background and Aim: Kidney dysfunction is reported in significant number of beta thalassemia major children. The aim of this study was to determine the prevalence of glomerular dysfunction in beta-thalassemia major children on regular blood transfusion (BT) and chelation therapy, and to find the correlation between glomerular filtration rate (GFR) estimated by Schwartz formula and Technetium 99m diethylenetriaminepentaacetic acid (99mTc-DTPA) renogram with ferritin level and cumulative transfusion load. Materials and Methods: An observational cross-sectional study conducted was done on 110 children diagnosed with beta-thalassemia major receiving regular BT and chelation therapy. Clinical examination, biochemical investigations (serum creatinine, ferritin) and DTPA renal scan were done. Estimated GFR calculation was done by Schwartz method and 99mTc-DTPA scan. The normal values of GFR were taken from the standard value as per KDIGO guidelines. P < 0.05 was considered statistically significant. Results: The prevalence of glomerular dysfunction by Schwartz formula and DTPA renogram was 44% and 24%, respectively. The GFR calculation (Schwartz formula and DTPA renogram) were weakly positively correlated (r = 0.126, P = 0.547). There was significant association between GFR Schwartz and duration of iron chelation, as children with abnormal GFR had significantly more duration of iron chelation >5 years (28% vs. 4%, P = 0.003). GFR (Schwartz formula and DTPA renogram) showed no association with cumulative transfusion load and disease duration (P > 0.05). GFR Schwartz formula and GFR–DTPA showed no correlation with serum ferritin with r = 0.179, (P = 0.392) and r = 0.278 (P = 0.178). Conclusion: There is a significant derangement in the renal function of children of beta-thalassemia major on chronic BT and iron chelation therapy. GFR holds a direct correlation with the increasing duration of iron chelation.

Background Aldosterone-producing adenoma (APA) is a common type of primary aldosteronism. For those with unilateral adrenocortical adenoma, although expert consensus recommends plasma aldosterone-to-renin ratio (ARR) as a screening indicator for APA, the range of ARR cut-off values varies widely due to the lack of unified detection method and diagnostic process. Therefore, there is a clinical need for a reliable and rapid predictive model to assist in identifying APA. Objective To explore the correlation between glomerular filtration rate (GFR) and APA, construct and validate the nomogram prediction model of APA. Methods A total of 493 patients with with pathologic results of unilateral adrenal mass who underwent surgical treatment after evaluation of adrenal endocrine hormones in the first affiliated hospital of Shihezi University from 2012 to 2022 were collected, 155 patients were ultimately included in the APA group and 113 patients in nonfunctioning adrenal adenoma combined with essential hypertension group according to the diagnostic criteria of APA and nonfunctioning adrenal adenoma. The patients' clinical data and biochemical data were collected. The patients were grouped according to GFR quartiles, and the correlation between GFR and APA was analyzed. The risk factors for APA were screened by multivariate Logistic regression analysis and a nomogram prediction model was constructed. Receiver operating characteristic (ROC) curve was used to analyze the discrimination of the prediction model, a consistency index (C-index) was used to evaluate the predictive accuracy of the model, Hosmer Lemeshow test was used to verify the fit of model, and the diagnostic efficacy of the model was evaluated using decision curve and clinical benefit curve. Results The patients were grouped according to GFR quartiles (Q1 to Q4 groups), Q1 group: ≥107.4 mL·min-1· (1.73 m2) -1 (n=67), Q2 group: 99.7-107.3 mL·min-1· (1.73 m2) -1 (n=67), Q3 group: 88.6-99.6 mL·min-1· (1.73 m2) -1 (n=67) and Q4 group: ≤88.5 mL·min-1· (1.73 m2) -1 (n=67), and the proportion of APA in each group was 47.8% (32/67), 53.7% (36/67), 58.2% (39/67) and 71.6% (48/67). Logistic regression trend test suggested that the risk of APA tended to increase as GFR levels decreased (P160 mmHg (OR=5.209, 95%CI=2.531-10.720), hypertension duration≥59 months (OR=4.326, 95%CI=1.950-9.595), blood potassium13.42 ng/dL (OR=8.756, 95%CI=4.320-17.749) were independent risk factors for the occurrence of APA (P

Abstract The incidence of post stroke cognitive impairment (PSCI) is high in patients with mild stroke (MIS), and the risk factors and mechanism are uncertain. Increased cystatin C (CysC) levels after stroke may reflect lower glomerular filtration rate (GFR) and renal impairment. Previous studies have suggested endothelial dysfunction (ED) is closely related to renal impairment and cognitive impairment, respectively. We aimed to observe whether lower GFR estimated by CysC after MIS leaded to a high incidence of PSCI, and the role of ED in this process. 256 patients were enrolled in this prospective observational study. Renal function was assessed using GFR estimated by serum CysC. Endothelial function was evaluated by reactive hyperemia index (RHI) which calculated automatically by peripheral arterial tonometry (PAT). The cognitive function at baseline and 3 months was evaluated by MoCA score, and MoCA score ≤ 26 indicates the presence of PSCI. Spearman correlation analysis and linear regression were conducted to explore the factors affecting ED. Univariate and multivariate analysis was used to identify the independent risk factors of PSCI. The receiver operating characteristic (ROC) curve was applied to explore the optimal cutoff value of the independent risk factors levels for predicting PSCI. A total of 141 patients (55.1%) suffered from ED. Multiple linear regression analysis showed that there was a strong linear correlation between eGFRcys and RHI (p

Introduction: Serum cystatin C has been proposed as a sensitive marker for detecting renal impairment. Renal impairment can often co-exist with liver cirrhosis, as decreased blood flow through the cirrhotic liver can lead to kidney dysfunction. However, its role in patients with liver cirrhosis has not been extensively studied, especially in the detection of early renal impairment. Aim: To investigate whether serum cystatin C could serve as a potential marker for detecting early renal dysfunction in patients with liver cirrhosis. Materials and Methods: This hospital-based cross-sectional study was conducted on 60 patients with liver cirrhosis at Assam Medical College and Hospital, Dibrugarh, Assam, India, from June 2019 to May 2020. All patients were assessed for clinical symptoms and laboratory parameters, focusing on renal function tests, measurement of serum cystatin C levels, and Glomerular Filtration Rate (GFR). A two-tailed p-value

Introduction The intricate relationship between obesity and chronic kidney disease (CKD) progression underscores a significant public health challenge. Obesity is strongly linked to the onset of several health conditions, including arterial hypertension (AHTN), metabolic syndrome, diabetes, dyslipidemia, and hyperuricemia. Understanding the connection between CKD and obesity is crucial for addressing their complex interplay in public health strategies. Objective This research aimed to determine the prevalence of CKD in a population with high obesity rates and evaluate the associated metabolic risk factors. Material and Methods In this cross-sectional study conducted from January 2017 to December 2019 we included 3,901 participants of both sexes aged ≥20 years who were selected from primary healthcare medical units of the Mexican Social Security Institute (IMSS) in Michoacan, Mexico. We measured the participants’ weight, height, systolic and diastolic blood pressure, glucose, creatinine, total cholesterol, triglycerides, HDL-c, LDL-c, and uric acid. We estimated the glomerular filtration rate using the Collaborative Chronic Kidney Disease Epidemiology (CKD-EPI) equation. Results Among the population studied, 50.6% were women and 49.4% were men, with a mean age of 49 years (range: 23–90). The prevalence of CKD was 21.9%. Factors significantly associated with an increased risk of CKD included age ≥60 years (OR = 11.70, 95% CI [9.83–15.93]), overweight (OR = 4.19, 95% CI [2.88–6.11]), obesity (OR = 13.31, 95% CI [11.12–15.93]), abdominal obesity (OR = 9.25, 95% CI [7.13–11.99]), AHTN (OR = 20.63, 95% CI [17.02–25.02]), impaired fasting glucose (IFG) (OR = 2.73, 95% CI [2.31–3.23]), type 2 diabetes (T2D) (OR = 14.30, 95% CI [11.14–18.37]), total cholesterol (TC) ≥200 mg/dL (OR = 6.04, 95% CI [5.11–7.14]), triglycerides (TG) ≥150 mg/dL (OR = 5.63, 95% CI 4.76-6.66), HDL-c

Background. Sympathetic outflow may be capable of selectively increasing or decreasing glomerular capillary pressure and hence glomerular filtration rate (GFR) by differentially activating separate populations of renal nerves. Sympathetic outflow to the kidney is regulated by major cortical, brainstem and medullary areas. The purpose of this study is to find out the relationship between GFR and HRV/EEG parameters as markers of the neural regulation of the kidney. Materials and Methods. The object of observations were 10 men aged 37-69 years without clinical diagnosis tested twice with 7-days interval. The rate of glomerular filtration was calculated according to endogenous creatinine clearance and the Cockcroft & Gault formula. The state of the autonomic nervous system was assessed by the HRV method. Simultaneosly qEEG recorded. Results. For the sample as a whole, a weak (r=0.396; p>0.05) correlation was found between HRV-marker of sympathetic tone and GFR. However, two clusters of individuals can be distinguished: with a strong correlation (r=0.852; n=12) and its complete absence (n=8). The qEEG method revealed neural structures generating delta and theta rhythms that upregulate GFR, and generating beta rhythm that downregulate GFR. The regression model, which includes 16 EEG parameters, allows estimating GFR with a standard error of 3,4 mL/min. Conclusion. Glomerular filtration rate is subject to the modulatory regulatory influence of the nervous system and can be estimated with high accuracy by EEG parameters.

Abstract Background Although simple renal cyst (SRC) is a kind of structural alterations of kidney with age, the relationship between SRC and renal function is still obscure. We investigated the relationship between SRC and renal function in Chinese population. Methods The medical records of 41,842 individuals who underwent physical examinations at the Health Check-up Center at our institution in 2018 were reviewed. According to whether with SRC, they were divided into no-SRC and SRC groups. SRCs were classified into subgroups based on number (

Introduction: Chronic Kidney Disease (CKD) is one of the fastest-growing causes of death worldwide. Monitoring biochemical parameters such as liver function tests, kidney function tests, and lipid profiles is crucial for early identification of health complications, prevention, and prompt management in CKD patients. Aim: To investigate the association of sociodemographic factors and serum biochemical indicators with Glomerular Filtration Rate (GFR) among CKD patients in rural Odisha, India. Materials and Methods: A cross-sectional study was conducted in a rural cohort of the Model Rural Health Research Unit (MRHRU) established in Cuttack district, Odisha, India, from March 2021 to April 2021. A total of 530 registered CKD patients were enrolled in the study. Sociodemographic data and blood samples were collected for lipid profile, kidney function, and liver function analysis. The data were analysed using STATA 15.1 and RStudio 2021.09.0+351. Results: The mean age of the study participants was 51.2±14.1 years, with 330 (62.26%) being male. A total of 74% of the participants showed abnormal Estimated Glomerular Filtration Rate (eGFR). Abnormal eGFR was found to be more common among the older age group (>45 years), those who were literate, and those in private jobs, compared to their counterparts. Both lipid profile and liver function abnormalities were significantly associated with individuals having normal eGFR. Conclusion: The positive association of eGFR with lipid profile and liver function enzymes highlights the importance of regular screening of these parameters among CKD patients for early prevention and control of future complications.

No consensus exists on whether acute aerobic exercise alters the glomerular filtration rate in older adults. Objective: To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Methods: Eighteen healthy, sedentary older adults (ten men and eight women) voluntarily participated in this study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerols, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. Results: eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R = −0.512, R = −0.582, R = −0.531; p < 0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. In addition, a negative correlation existed for age vs. eGFR at 60% of the maximal heart rate (R = −0.516; p < 0.05). Conclusions: Short-duration aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults. However, regular monitoring of kidney function in older people engaged in moderate- and high-intensity exercise is advised.

ABSTRACT BACKGROUND: Evidence on the effect of one-anastomosis gastric bypass (OAGB) on renal function is limited. OBJECTIVE: To compare the evolution of estimated renal function observed 1 year after OAGB and Roux-en-Y gastric bypass (RYGB) in individuals with obesity. DESIGN AND SETTING: Observational, analytical, and retrospective cohort study. Tertiary-level university hospital. METHODS: This study used a prospectively collected database of individuals who consecutively underwent bariatric surgery. Renal function was assessed by calculating the estimated glomerular filtration rate (eGFR), according to the Chronic Kidney Disease Epidemiology Collaboration. The one-year variation in the eGFR was compared between the procedures. RESULTS: No significant differences in age, sex, obesity-associated conditions, or body mass index were observed among individuals who underwent either OAGB or RYGB. OAGB led to a significantly higher percentage of total (P = 0.007) and excess weight loss (P = 0.026). Both OAGB and RYGB led to significantly higher values of eGFR (103.9 ± 22 versus 116.1 ± 13.3; P = 0.007, and 102.4 ± 19 versus 113.2 ± 13.3; P < 0.001, respectively). The one-year variation in eGFR was 11 ± 16.2% after OAGB and 16.7 ± 26.3% after RYGB (P = 0.3). Younger age and lower baseline eGFR were independently associated with greater postoperative improvement in renal function (P < 0.001). CONCLUSION: Compared with RYGB, OAGB led to an equivalent improvement in renal function 1 year after the procedure, along with greater weight loss.

This study examined 37 patients with hepatitis and cirrhosis of the liver and 30 healthy individuals, assessing liver function indicators and renal function under conditions of daily diuresis and after a load of drinking water and a 0.5% sodium chloride solution, at 0.5% of body weight. The study showed that hepatitis and cirrhosis of the liver lead to signs of hepatorenal syndrome development, particularly in patients with cirrhosis, primarily manifested by a reduction in glomerular filtration rate (GFR). The extent of reduction correlated with the severity of liver damage. Simultaneously, it was independent of blood pressure, plasma protein, and renal sodium exchange mechanisms. The primary dysfunction in hepatorenal syndrome was determined to be a reduction in GFR, evidenced by the rise in creatinine concentration, although urea increased only in cirrhosis, requiring further explanation. The results showed that liver diseases, especially cirrhosis, can lead to kidney problems, mainly by reducing the kidney's ability to filter blood, which was shown by higher creatinine levels in the blood.

Background. Existing methods for assessing glomerular filtration rate (GF) are invasive. Therefore, we set ourselves the goal of evaluating the rate of glomerular filtration by a non-invasive method. Materials and Methods. The object of observations were 10 men aged 37-69 years without clinical diagnosis tested twice with 7-days interval. The rate of glomerular filtration was calculated according to endogenous creatinine clearance and the Cockcroft & Gault formula. Systolic and diastolic blood pressure was measured three times in a row. The state of the autonomic nervous system was assessed by the HRV method. Results. We confirmed the significant correlation of GF with age and weight. The screening revealed a significant correlation of GF with a number of blood pressure and HRV parameters. If in the classic formula we replace creatinineemia with systolic blood pressure and HRV-markers of sympathetic tone, we get a formula for estimating the GF with a standard error of 10,9 mL/min vs 2,7 mL/min, but without blood sampling. The regression model, which includes HRV and blood pressure parameters, as well as urinary creatinine concentration, allows estimating GF with a standard error of 12 mL/min. Conclusion. The balneotherapy has a significant effect not only on blood creatinine level, but also on HRV and blood pressure parameters, and even more pronounced. Therefore, the estimation of GF based only on the Cockcroft & Gault formula is at least not much more accurate than the one proposed by us, besides, our method is completely non-invasive.

Background: Osteoporosis is characterized by low bone mass and deterioration of bone tissue, which is influenced by both environmental factors and nutritional metabolism. The relationship between biochemical indicators and bone mineral density (BMD) is intricate and involves complex mechanisms. Path analysis, a statistical method that investigates causal relationships and the strength of associations among multiple factors, can be valuable in elucidating the connection between biochemical indicators and BMD. Methods: In this study, we employed advanced statistical techniques, specifically structural equation modeling (SEM) to investigate the intricate interrelationships among a myriad of factors that exert influence on BMD. This analytical approach facilitated not only the identification of the direct relationships between specific variables and BMD but also the exploration of the intricate of indirect pathway through which other variables contribute to the oval impact on BMD. By delving into the direct and indirect effects, we aimed to unravel the complex influences that collectively shape the state of bone health, providing a nuanced understanding of the multifaceted nature of the factors affecting BMD. Results: Our findings revealed that lipid levels had a significant indirect influence on BMD, which was mediated by body mass index (BMI). BMI exhibited both direct and indirect effects on BMD. Uric acid (UA) exerted a significant direct and indirect influence on BMD, with glomerular filtration rate (GFR) acting as the mediator. However, the total effect of UA on BMD was not significant due to the cancellation of positive effect UA on BMD but negative indirect effects of UA through GFR. For females, albumin had a significant direct effect on BMD, whereas this effect was not observed in males. The path analysis models generated results that demonstrated an acceptable fit for both female data (χ2 = 9.63, df = 7, p = 0.21, comparative fit index (CFI) = 0.98, root mean square error of approximation (RMSEA) = 0.05) and male data (χ2 = 6.26, df = 4, p = 0.18, CFI = 0.97, RMSEA = 0.06). Conclusions: Nutritional metabolism plays a crucial role in maintaining BMD in elderly females and males.

Objectives: To evaluate the performance of measurement of glomerular filtration rate (GFR) using Modification of Diet in Renal Disease equations (MDRD186, MDRD175) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, in comparison with technetium-99m diethylenetriaminepentaacetic acid (99Tc-DTPA) renogram method, the gold standard. A related aim was to correlate the three equations to estimate GFR and their impact on reclassifying the stages of CKD in adult Omani patients. Methods: This cross-sectional study recruited two groups of patients diagnosed with CKD during a 10-month period from January to October 2021. The first group comprised 48 patients who underwent a 99Tc-DTPA renogram procedure for GFR measurement, and the second group comprised 30 348 adult patients who did not undergo the same procedure; estimated GFR was calculated using the three equations. Results: The median of the reference GFR was 106.0 mL/min/1.73 m2, whereas the median estimated GFR for the MDRD175, MDRD186, and CKD-EPI equations were 92.5, 98.3, and 102.1, respectively. All three equations correlated moderately with the reference GFR (0.428, 0.428, 0.523, respectively; p < 0.010). The CKD-EPI showed lesser bias (3.7 vs. 12.9 and 7.5 for MDRD175 and MDRD186, respectively) and more accuracy (95.8% vs. 91.7% and 93.8%); however, it was the least precise (25.1 vs. 22.3 and 23.8). The MDRD186 performed similarly to the CKD-EPI equation at CKD stages 3a–5 and differed significantly at stages 1–2. Whereas the MDRD175 differed significantly with both equations at stages 1–3b and was similar to them at stages 4–5. Conclusions: The CKD-EPI equation had the highest accuracy and the least bias and precision in the general population. The MDRD186 CKD classification differed significantly from the CKD-EPI equation at CKD-stages 1–2 only. The CKD-EPI equation is preferred to MDRD for the detection and classification of early CKD stages.

Background Hyperuricemia (HUA) caused by elevated serum uric acid (SUA) has been shown to be an independent risk factor for the development and progression of chronic kidney disease (CKD). However, there are few cohort studies on the correlation of SUA level with the development and progression of CKD in the elderly of China. Objective To explore the association of baseline SUA level and its changes with the risk of chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) in the elderly in longevity areas of China. Methods Based on the Healthy Aging and Biomarkers Cohort Study (HABCS), a sub cohort of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the older adults who received physical examination and with biomedical indicators in 2012 and 2014 were selected as the study subjects from December 2021 to May 2022. The age, gender, blood pressure, blood lipids, blood glucose and other biomedical indicators were collected at baseline and follow-up period. Cox proportional hazards regression model was used to analyze the association of different SUA levels with the risk of CKD. Spearman rank correlation and generalized linear model analysis were used to analyze the association between baseline SUA level and baseline eGFR level and the linear correlation between changes in SUA level and eGFR changes in the elderly, respectively. Results A total of 981 subjects were included in the study, with the median age of 79 (70, 88) years, the prevalence of HUA of 6.8% (67/981), the cumulative follow-up of 2 029 person-years and the median follow-up of 2.05 years, including 179 new cases of CKD, the cumulative incidence of CKD during the follow-up was 18.2%〔95%CI (15.9%, 20.8%) 〕, and the incidence density was 88.22/1 000 person-years〔95%CI (76.24/1 000 person-years, 101.41/1 000 person-years) 〕. Cox proportional hazards regression analysis with SUA quartile grouping as the independent variable showed that compared with the lowest quartile group of baseline SUA level (Q1), the HR value for the risk of CKD in the highest quartile group of baseline SUA level (Q4) was 2.08〔95%CI (1.27, 3.41), P=0.004〕. Cox proportional hazards regression analysis with SUA level as the independent variable showed that, for every 10 μmol/L increase in baseline SUA level, the risk of CKD in the elderly increased by 4% (P

In systemic sclersis (SSc), different types of renal involvement occur. Their severity can range from asymptomatic deterioration of renal function to life-threatening damage, which is a complex therapeutic problem. Rituximab (RTM) has been used in the treatment of SSc and other autoimmune diseases with promising results, but its effect on renal function has not been adequately studied. Objective: to evaluate the renal function during complex therapy, including RTM, in patients with SSc over a long-term follow-up (at least 1 year). Material and methods. The study included 90 patients with SSc who were examined at least twice – before and 1–3.5 years after initiation of RTM treatment. Renal function was assessed by glomerular filtration rate (GFR) calculated according to the CKD-EPI formula. The stages of chronic kidney disease (CKD), blood pressure, daily proteinuria, skin score, activity, and indicators of lung function – forced vital capacity and diffusing capacity of the lungs – were also determined. Results and discussion. Against the background of complex therapy with RTM, there was a statistically significant decrease in GFR in the entire group of patients at the end of observation. On the other hand, renal function remained stable in the majority of patients with initially preserved GFR and there was a 25 % decrease – from 20 to 15 patients – in the number of patients with CKD. In more than half of the patients who initially had CKD, GFR increased (n = 11) or stabilized (n = 2) after therapy, and it decreased in a statistically insignificant manner in only 7 patients, whereas the development of a more advanced stage of CKD was observed in only 2 cases. The results of the treatment of 2 patients who had previously experienced scleroderma renal crisis (SRC) are reviewed in detail. Conclusion. In this study, there was no significant effect of RTM treatment on GFR and grade of CKD. Most patients had stable renal function; patients with an initial low grade of CKD showed a tendency toward stabilization of renal function. A significant decrease in GFR during long-term therapy noted in the entire patient group appears to be explained by an increase in renal insufficiency in patients with initially severe scleroderma renal damage, particularly due to SRC. Further studies on the effects of RTM therapy on renal function in patients with SSc are needed.

Dear Editor, The article in your issue 2024 Jan; Vol 18(1): BC05-BC08, titled “Efficacy of Salivary Urea and Creatinine Compared to Serum Levels in Chronic Kidney Disease Patients: A Cross-sectional Study”. We read this article with great interest. In this study, the authors tried to explore the use of saliva as a non invasive tool for evaluation of Chronic Kidney Disease (CKD).

Introduction. Acute coronary artery disease is the leading cause of death in patients with chronic kidney disease (CKD). In addition, CKD itself is the initiator of acute coronary syndrome (ACS), the prevalence of which is greater, the more pronounced the impairment of kidney function and the more concomitant risk factors in the patient.Aim. To study the predictive value of various laboratory and instrumental markers in identifying the risk of developing ACS in patients with CKD.Materials and methods. A search was made for articles for the last 10 years in the databases: PubMed, Medline, Google Scholar and eLIBRARY by keywords in Russian and English, the articles were selected in accordance with the purpose of the study.Results. ACS manifests itself in CKD patients with an atypical picture, and in 3 % of cases it is generally asymptomatic. The risk of death from cardiovascular complications increases in proportion to the deterioration of the glomerular filtration rate (GFR). This progression also increases the risk of coronary artery calcification. At the same time, it was found that cystatin C is a more universal marker of a decrease in GFR than creatinine. Other laboratory markers that indicate the risk of ACS are inflammatory markers, albuminuria, troponins, natriuretic peptide.Conclusion. So far as ACS is atypical or asymptomatic, in addition to troponins and traditional instrumental diagnostic methods, markers such as GFR, albuminuria, an increase in serum cystatin C, phosphate, fibroblast growth factor-23, interleukin-6, tumor necrosis factor-alpha, total parathyroid hormone, fibrinogen, natriuretic peptide can help in its prediction.

Abstract Background Due to the asymptomatic nature of the early stages, chronic kidney disease (CKD) is usually diagnosed at late stages and lacks targeted therapy, highlighting the need for new biomarkers to better understand its pathophysiology and to be used for early diagnosis and therapeutic targets. Given the close relationship between CKD and cardiovascular disease (CVD), we investigated the associations of 233 CVD- and inflammation-related plasma proteins with kidney function decline and aimed to assess whether the observed associations are causal. Methods We included 1140 participants, aged 55–74 years at baseline, from the Cooperative Health Research in the Region of Augsburg (KORA) cohort study, with a median follow-up time of 13.4 years and 2 follow-up visits. We measured 233 plasma proteins using a proximity extension assay at baseline. In the discovery analysis, linear regression models were used to estimate the associations of 233 proteins with the annual rate of change in creatinine-based estimated glomerular filtration rate (eGFRcr). We further investigated the association of eGFRcr-associated proteins with the annual rate of change in cystatin C-based eGFR (eGFRcys) and eGFRcr-based incident CKD. Two-sample Mendelian randomization was used to infer causality. Results In the fully adjusted model, 66 out of 233 proteins were inversely associated with the annual rate of change in eGFRcr, indicating that higher baseline protein levels were associated with faster eGFRcr decline. Among these 66 proteins, 21 proteins were associated with both the annual rate of change in eGFRcys and incident CKD. Mendelian randomization analyses on these 21 proteins suggest a potential causal association of higher tumor necrosis factor receptor superfamily member 11A (TNFRSF11A) level with eGFR decline. Conclusions We reported 21 proteins associated with kidney function decline and incident CKD and provided preliminary evidence suggesting a potential causal association between TNFRSF11A and kidney function decline. Further Mendelian randomization studies are needed to establish a conclusive causal association.

Objectives. To determine the prevalence of kidney disease of unknown etiology in banana, melon, and tomato workers in north-eastern Guatemala, and to evaluate the usefulness of a cystatin C blood test for early detection of renal disease. Methods. This was a cross-sectional, farm-based study of 462 agricultural workers conducted from June to September 2021. Epidemiological and demographic characteristics of the workers were collected through a self-administered questionnaire. Blood samples were obtained to determine glucose, creatinine and cystatin C levels. Anthropometric and clinical data were also recorded. Results. The prevalence of kidney disease of unknown etiology was 3.03% (95% confidence interval (CI): 1.36–4.70%) based on glomerular filtration rate (GFR-EPI) < 60 mL/min/1.73 m2, with a significantly higher prevalence in banana workers (5.67%; 95% CI: 2.16–9.18%) than melon workers (p = 0.009) and tomato workers (p = 0.044). Ten workers (2.16%) had reduced kidney function (GFR-EPI 60–90 mL/min/1.73 m2). The levels of cystatin C showed less variability (coefficient of variation 46.4%) than those of creatinine (coefficient of variation 67.0%), and cystatin C levels in cases with abnormal and reduced kidney function were significantly different from cases with normal kidney function (p < 0.001). Conclusions. Surveillance of the health of active farm workers and improvement of working conditions, such as sun protection, adequate hydration, and sufficient breaks, are recommended. The significant differences in cystatin C levels between cases with abnormal and reduced kidney function and those with normal kidney function suggest that cystatin C could be a useful measure for early detection of renal disease.

Abstract Objective Glomerular filtration rate (GFR) is a key indicator of renal function. In both clinical practice and pre-clinical research, serum levels of endogenous filtration markers, such as creatinine, are often used to estimate GFR. However, these markers often do not reflect minor changes in renal function. In this study, we therefore set out to evaluate the applicability of transcutaneous GFR (tGFR) measurements to monitor the changes in renal function, as compared to plasma creatinine (pCreatinine), in two models of obstructive nephropathy, namely unilateral ureteral obstruction (UUO) or bilateral ureteral obstruction followed by release (BUO-R) in male Wistar rats. Results UUO animals showed a significant reduction in tGFR compared to baseline; whereas pCreatinine levels were not significantly changed. In BUO animals, tGFR drops 24 h post BUO and remains lower upon release of the obstruction until day 11. Concomitantly, pCreatinine levels were also increased 24 h after obstruction and 24 h post release, however after 4 days, pCreatinine returned to baseline levels. In conclusion, this study revealed that the tGFR method is superior at detecting minor changes in renal function as compared to pCreatinine measurements.

Pelviureteric Junction Obstruction (PUJO) can cause recurrent Urinary Tract Infections (UTIs), pain, and loss of renal unit function. Surgical intervention is often required, and numerous treatment strategies have been employed. Vertical flap pyeloplasty was initially described as the technique of choice in PUJO patients with the large box-shaped extra-renal pelvis and longer segment strictures (usually >2 cm). In the present case series, 11 patients underwent vertical flap pyeloplasty for PUJO with a large extrarenal box-shaped pelvis. Demographic, perioperative, and follow-up data were recorded. Success was defined as symptomatic improvement and an improvement in early Diethylenetriamine Pentaacetate (DTPA) renogram at six months. In the present series, all 11 patients showed an improvement in Glomerular Filtration Rate (GFR) with an average improvement of 11.9 mL. The procedure was technically easier, less time-consuming, and produced acceptable results. Vertical flap pyeloplasty could be considered as a practical, technically easier, and effective treatment option in PUJO with a large extrarenal pelvis and long segment strictures.

Aim to determine the factors associated with the risk of developing type 2 diabetes in patients with coronary artery disease (CAD). Material and methods.The retrospective data sample included 181 patients hospitalized in the cardiology department of the SamSMU clinics. The patients were divided into two groups: group 1 122 patients without type 2 diabetes (77 (63.1%) men, median age 66.0 (59.0;75.0) years) and group 2 59 patients with type 2 diabetes (29 (49.2%) men, median age 69.0 (63.0;73.5) years). Results.The statistically significant difference (p0.05) was registered in glomerular filtration rate (GFR); no significant differences were demonstrated in other clinical indicators, including age and gender. Expectedly, the patients with type 2 diabetes had higher glucose levels. The parameters of the lipid spectrum and creatinine did not differ between the groups. Conclusion.The factors associated with the risk of developing type 2 diabetes are high glucose concentration and reduced GFR. The application of the developed discriminant analysis model will allow to determine the risk group of type 2 diabetes in patients with coronary heart disease, which will ensure a timely control of the presented indicators.

Background Time in range (TIR) is a new indicator of glycemic management in diabetes mellitus which has been thriving in recent years. Studies have confirmed that TIR is closely associated with chronic complications of diabetes. Previous studies have confirmed a close association between TIR and chronic complications of diabetes. Current studies on TIR and diabetic kidney disease (DKD) mainly focus on proteinuria, however the role of glomerular filtration rate (eGFR) in it is often neglected, and there are few studies on the cut points of TIR in evaluating glycemic control. Objective To investigate the relationship between TIR and the development of DKD in type 2 diabetes mellitus (T2DM), so as to provide theoretical foundations for the timely clinical detection, diagnosis and treatment of DKD in patients with T2DM. Methods A total of 214 T2DM patients admitted to the Department of Endocrinology in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from July 2021 to December 2021 were included. The general data, laboratory indices and medication use were collected. The included patients were divided into group of DKD〔UACR ≥ 30 mg/g and/or eGFR < 60 ml·min-1 (1.73 m2) -1, n=58〕 and group of T2DM alone〔UACR85%, n=90), TIR2 group (70%

Background The ease of access to antiretroviral therapy (ART) has improved both survival rate and comorbidities in patients with human immunodeficiency virus (HIV) infection. Impaired kidney function is one of the most common comorbidities of HIV. CD4 and viral load can be used to monitor HIV progression and to determine the effectiveness of ART. The most commonly used estimated-glomerular filtration rate (e-GFR) technique is to use serum creatinine but often causes late detection of kidney dysfunction while serum cystatin increases at the beginning of the GFR decrease. This supports cystatin C serum as an early diagnostic tool to detect kidney function or biomarker early kidney disorders. Objective To evaluate a possible association between serum cystatin C as a marker of kidney function and HIV progression through CD4 levels and viral load. Methods This cross-sectional study was conducted through evaluation of secondary data from medical and laboratory records of pediatric patients who had routine visits to the HIV Clinic at Dr. Hasan Sadikin General Hospital, Bandung, West Java, in January-February 2020. Results Sixty subjects were reviewed in the study. Median cystatin C-based eGFR was 28.1mL/minute/1.73m2. Subjects were categorized by viral load result into 40 copies/mL viral load group than the

Objectives:This study aimed to evaluate changes in subfoveal choroidal thickness (SFCT), choroidal vascularity index (CVI), estimated glomerular filtration rate (GFR), mean arterial pressure (MAP), and intraocular pressure (IOP) after renal transplantation.Materials and Methods:A total of 49 renal transplantation patients were included in this prospective study. CVI and SFCT on enhanced-depth imaging optic coherence tomography (EDI-OCT), MAP at the cubital fossa, GFR, and IOP were measured preoperatively and at postoperative 1 week and 1 month. In the analysis of EDI-OCT images, luminal area (LA) and stromal area of the choroid were determined using the image binarization method. CVI was defined as the ratio of LA to total choroid area. The effects of GFR, IOP, and MAP on CVI and SFCT were investigated.Results:The study included 23 women (47%) and 26 men (53%) with a mean age of 26.28±8.25 years (range: 18-52). Changes between preoperative, postoperative 1-week, and postoperative 1-month GFR values, CVI, and SFCT measurements were evaluated. There were significant differences between preoperative and postoperative GFR and SFCT measurements (p

ABSTRACT BACKGROUND: Among the complications related to chronic kidney disease (CKD), those of a neurological nature stand out, and for a better quality of life for patients, the diagnosis and treatment of these complications is fundamental. OBJECTIVES: This study aimed to assess the effect of hemodialysis on intracranial pressure waveform (ICPw) in patients with chronic kidney disease undergoing hemodialysis and those who are not yet undergoing substitutive therapy. DESIGN AND SETTING: An observational study was conducted in two stages at a kidney replacement therapy center in Brazil. The first was a longitudinal study and the second was a cross-sectional study. METHODS: Forty-two patients on hemodialysis were included in the first stage of the study. In the second stage, 226 participants were included. Of these, 186 were individuals with chronic kidney disease (who were not undergoing substitutive therapy), and 40 did not have the disease (control group). The participants’ intracranial compliance was assessed using the non-invasive Brain4care method, and the results were compared between the groups. RESULTS: There was a significant difference between the hemodialysis and non-hemodialysis groups, with the former having better ICPw conditions. CONCLUSIONS: Hemodialysis influenced the improvement in ICPw, probably due to the decrease in the patients’ extra-and intracellular volumes. Furthermore, ICPw monitoring can be a new parameter to consider when defining the moment to start substitutive therapy.

Introduction: Diabetes mellitus (DM) prevalence rise worldwide, and it also increases the healthcare challenges. Diabetic kidney disease(DKD) is a major long-term complication of type 2 diabetes(T2DM) and the most common cause of chronic kidney disease(CKD) and end-stage kidney disease(ESKD) worldwide. The study aims to assess the prevalence of kidney involvement among T2DM patients, classify them according to glomerular filtration rate(GFR), and determine the predictive value of HbA1C and albumin-creatinine ratio(ACR) for declining GFR. Methodology: The study is a cross-sectional analysis of patients diagnosed with T2DM. The sample size 106 was determined based on the prevalence of DKD among T2DM. Data collection included medical record review, face-to-face interviews, blood and urine sample analysis, and calculation of eGFR. Patients were classified based on GFR and urinary ACR, and those with kidney involvement were identified. Statistical analyses were performed using SPSS, and significance was set at p ≤ 0.05. Result: The study included 106 T2DM patients, of which 46.2% had kidney involvement based on elevated ACR. Among these patients, 28.6% had a GFR

Objective To investigate the effect of the sodium-glucose cotransporter 2 (SGLT2) inhibitor dapagliflozin on renal function and renin-angiotensin-aldosterone system (RAAS) in elderly patients with early diabetic kidney disease (DKD). Methods A total of 97 elderly patients with type 2 diabetes mellitus (T2DM) who attended our hospital from September 1, 2019 to August 1, 2021 were enrolled, and according to urinary albumin-to-creatinine ratio (UACR), they were divided into normal UACR group and early DKD group. A random number table was further used to determine whether each patient in the above two groups was treated with dapagliflozin. Finally, all patients were divided into normal-UACR dapagliflozin group (group A), normal-UACR control group (group B), early-DKD dapagliflozin group (group C), and early-DKD control group (group D), and these four groups were compared in terms of the changes in related clinical indices at 1 year after treatment. Results After 1 year of treatment, group A had significant changes in body mass index (BMI), systolic blood pressure, diastolic blood pressure, UACR, annualized relapse rate (ARR), fasting blood glucose, and fasting insulin (t=2.098-7.122,P

Aim:Magnesium is associated with many chronic diseases, especially cardiovascular diseases. The purpose of this study is to evaluate the relationship between serum magnesium level, glomerular filtration rate (GFR) and atherogenic index of plasma (AIP).Materials and Methods:The data of 214 patients included in the study were analyzed retrospectively. Those with an estimated GFR of 60 mL/minute/1.73 m2 and above were grouped as the “high GFR group”, and those with an estimated GFR of less than 60 mL/minute/1.73 m2 were grouped as the “low GFR group”. AIP was calculated by taking the logarithm of the ratio of serum triglyceride level to serum high-density lipoprotein level.Results:There were 72 patients in the high GFR group and 142 patients in the low GFR group. There was no difference between the groups in terms of serum magnesium level and AIP. The factors related to serum magnesium level and AIP were investigated in the whole study population. A negative correlation was found between serum magnesium level and AIP [Odds ratio (OR): -0.212]. When the factors associated with AIP were examined, AIP was found to be negatively correlated with serum magnesium level (OR: -0.189) whereas positively correlated with body mass index, systolic blood pressure and serum uric acid level (OR: 0.154; 0.276; 0.165, respectively). There was no relationship between AIP and magnesium levels and GFR.Conclusion:The inverse relationship between serum magnesium level and AIP is consistent with the literature on the relationship between hypomagnesemia and atherogenicity. The lack of a relationship between AIP and serum magnesium level and GFR may be attributed to the small number of patients.

Objective: To determine the frequency of chronic kidney disease and its associated risk factors in patients with type 2 Diabetes Mellitus. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital Malir Cantt, Karachi, from Jan to Jun 2019. Methodology: A total of 203 adult patients with Type 2 Diabetes Mellitus were included in the study after taking informed consent on the justification of inclusion/exclusion criteria. The estimated Glomerular filtration rate was calculated for each patient using Creatinine based chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Chronic kidney disease was defined as decreased glomerular filtration rate of

Introduction: Renal length and volume are important indicators for the presence or progression of disease in urology and nephrology. Estimation of renal volume by Ultrasonography (USG) has clinical utility for the physician, nephrologist, and urologist. Aim: To measure individual renal volume by ultrasonography and determine its relationship with renal function as measured by the Diethylene Triamine Penta-acetic Acid (DTPA) in normal adults. Materials and Methods: It was a cross-sectional study conducted on fifty patients who underwent DTPA scans both in Outpatient (OPD) and In-Patient Department in the Department of Urology, of a tertiary care centre from January 2020 to December 2020. All the transplant donors who underwent donor nephrectomy were included in the study. A sonographic assessment was done and the Glomerular Filtration Rate (GFR) was calculated by Technetium (Tc)-154 DTPA. The primary outcome was to determine the relationship between renal volume with renal function in normal adults. The secondary outcome was to measure individual renal parameters sonographically. They were assessed for correlation between renal parameters (mainly renal volume) and DTPA using Pearson’s coefficient. Results: The age range of the subjects was 18-70 years. GFR calculated by DTPA for the right kidney had a better correlation with renal volume (r=0.241) on the right and 0.162 on the left, both with a p-value of 0.001). GFR of the left kidney had a better correlation with left kidney volume (r=0.184) than right kidney volume (r=0.130). No correlation was found between GFR with renal Anteroposterior (AP) dimension, renal width, and renal length. The kidney volume was more significant on the left-side (r=0.351) than on the right kidney (r=0.263). Conclusion: Renal volume correlated well with renal function. Sonographic assessment of renal volume rather than renal length would serve as a tool to evaluate renal status for evaluation and follow-up.

Cardiovascular disease is the leading cause of death in the world. The use of the coronary artery calcification score (CACS) allows to determine the risk of coronary artery disease (CAD). Chronic kidney disease (CKD) is a one of the major risk factors for coronary artery disease. With a decrease in renal function, impaired calcium-phosphorus metabolism leads to excessive tissue calcification. It is likely that patients with different kidney function experience different types of calcium deposition. The use of CACS is an opportunity to assess the condition of the coronary arteries without using a contrast agent, which is very important for patients with CKD. One of the most accessible and significant research methods for clinical screening use is computed tomography with non-invasive assessment of coronary calcium (quantitative analysis of the calcium index). To evaluate it, the method of A. Agatston is used, which allows to measure calcium in units. Our aim was to investigate the pattern of calcification of heart structures depending on renal function in patients with suspected coronary heart disease. The patients in the presented study had a high incidence of diabetes mellitus (49.4%) and arterial hypertension (83.1%). In patients with suspected coronary artery disease, borderline values of systolic and diastolic blood pressure and total cholesterol were found. In the majority of the patients CACS was 1-100 Agatston units (AU). After the distribution of patients into groups depending on glomerular filtration rate (GFR), it was found that the groups of patients with lower GFR, were of older age. The proportion of patients with total CACS >100 AU was the highest in the group of patients with GFR 30-59 ml/min. There were no significant differences in the structure of general and vascular CACS between patients with GFR 90-120 ml/min and GFR 60-89 ml/min. Valvular CACS was significantly lower in patients with GFR

Diabetes has reached epidemic proportions, both in Korea and worldwide and is associated with an increased risk of chronic kidney disease and kidney failure (KF). The natural course of kidney function among people with diabetes (especially type 2 diabetes) may be complex in real-world situations. Strong evidence from observational data and clinical trials has demonstrated a consistent association between decreased estimated glomerular filtration rate (eGFR) and subsequent development of hard renal endpoints (such as KF or renal death). The disadvantage of hard renal endpoints is that they require a long follow-up duration. In addition, there are many patients with diabetes whose renal function declines without the appearance of albuminuria, measurement of the eGFR is emphasized. Many studies have used GFR-related parameters, such as its change, decline, or slope, as clinical endpoints for kidney disease progression. In this respect, understanding the trends in GFR changes could be crucial for developing clinical management strategies for the prevention of diabetic complications. This review focuses on the clinical implication of the eGFR-related parameters that have been used so far in diabetic kidney disease. We also discuss the use of recently developed new antidiabetic drugs for kidney protection, with a focus on the GFR as clinical endpoints.

Aims:Not only severe but also mild to moderate chronic kidney disease (CKD) is an independent risk factor for peripheral artery disease (PAD). In this study, we examined the prevalence of PAD among older adults with mild-to-moderate CKD.Methods:The study was performed using the dataset of participants registered to a previous single-center, cross-sectional study that included non-institutionalized older adults aged 65 years or older in a geriatric outpatient setting. The subjects were patients with mild to moderate CKD. Ankle brachial index (ABI) was measured using a hand-held Doppler. PAD was diagnosed using an ABI value

Background and aim: Cigarette smoking is known to be associated with increased oxidative stress and renal function, both known to be associated with cardiovascular disease. The present study aimed to associate oxidative stress with kidney function in cigarette smokers. Material and methods: The present study was carried out in the department of biochemistry, Santosh medical college, Ghaziabad, National Capital Region (NCR), India. In this study, 280 subjects were enrolled, out of which 140 were smokers, and 140 were non-smokers healthy individuals. The subjects who had been smoking for two or more than two years were included. All the subjects were in 20 – 60 years of age. Results: The mean levels of blood urea (p=0.019), serum creatinine (p=0.013), urinary albumin (p

Abstract Background Data on the relations between kidney function abnormalities and stroke in type 2 diabetes are limited. We evaluated the associations of kidney function abnormalities and chronic kidney disease (CKD) stages with incident stroke in a large sample of adults with type 2 diabetes. Methods Participants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study without history of stroke at baseline were included. Urine albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) were assessed at baseline. CKD categories were defined according to the KDIGO (Kidney Disease: Improving Global Outcomes) guidelines. Cox proportional hazards regression models were used to compute hazard ratios (HR) and 95% confidence intervals (CI) for stroke in relation to measures of kidney function and CKD categories. Results A total of 9170 participants (mean age 62.8 [SD: 6.6] years, 38.2% women, 62.9% white) were included. Over a median follow-up of 4.9 years (interquartile range: 4.0–5.7), 156 participants developed a stroke (incidence rate 3.6/1000 person-years [95% CI 3.0–4.2]). After adjusting for relevant confounders, higher UACR and lower eGFR were each associated with increased risk of stroke. Compared to UACR

Background and purpose: Aminoglycosides (AG) such as Amikacin that are widely used to prevent and treat infections in neonates have nephrotoxic effects. The aim of this study was to evaluate the role of urinary index to Glomerular filtration rate (GFR) in diagnosis of tubular renal injury following administration of Amikacin in neonates admitted to neonatal intensive care unit (NICU). Materials and methods: In this descriptive cross-sectional study, 45 neonates admitted to NICU with confirmed sepsis undergone treatment with Amikacin and Ampicillin and 45 neonates were treated with Ampicillin and Cefotaxime. GFR was calculated using Schwartz's formula (serum creatinine/height * 0.45) and categorized based on Fanaroff table. In both groups, BUN, Cr, and GFR were measured at days one and seven. Data analysis was performed in SPSS. Results: Two (4.4%) patients in the group treated with Amikacin and Ampicillin and one (2.2%) in the group who received Ampicillin and Cefotaxime developed acute kidney injury (AKI). GFR changes and Cr levels at day seven were not found to be significantly different between septic neonates treated with Amikacin and Ampicillin and neonates treated with other non-aminoglycosidic antibiotics (P>0.05). Conclusion: There was no difference in incidence of AKI between neonates receiving Amikacin and Ampicillin and those who received Ampicillin and Cefotaxime. Hence, AKI in these neonates requires further evaluations.

Hematopoietic stem cell transplantation is a life-saving therapy in patients suffering from acute leukemia. However, kidney complications developed after performing hematopoietic stem cell transplantation can affect the course and prognosis of the disease in patients with acute leukemia. This study is aimed at assessing the functional status of the kidneys in patients with acute leukemia who have undergone hematopoietic stem cell transplantation. The study has observed a group of patients with acute lymphoblastic leukemia and acute myeloid leukemia who have undergone hematopoietic stem cell transplantation. It has been discovered that β2 microglobulin is a sensitive method of analyzing renal function, with the β2 microglobulin threshold urine level not exceeding 0.3 mg/L. The complex diagnostics of kidney function in hematopoietic stem cell transplantation recipients has given the opportunity to identify the relationship between increased β2 microglobulin levels and decreased glomerular filtration rate. It has been determined that β2 microglobulin is a biomarker of renal disorders. The obtained data have showed that β2 microglobulin can be used as a diagnostic marker of reduced kidney function.

Abstract Background and Aim Adipocytes secrete a peptide hormone called leptin, which plays a crucial role in controlling appetite and energy expenditure. Alterations in leptin concentrations are associated with CKD‐related cardiovascular problems such as hypertensive heart disease (HHD). Despite the link, data on the precise function of leptin in people with CKD and HHD is scant. Methods An observational cross‐sectional study involving a total of 108 participants (72 CKD patients with HHD and 36 healthy controls). Their demographic and anthropometric information was collected using a standardized questionnaire. Certain clinical measures such as blood pressure and body mass index (BMI) were assessed. Fasting blood samples were analyzed for levels of plasma glucose (FPG), lipids, creatinine, and leptin. Data were analyzed with SPSS v23. Results Leptin, FPG, creatinine and triglyceride levels were all significantly higher in CKD patients with HHD compared to controls (p