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

Objectives: Serum creatinine levels are often used to diagnose acute kidney injury (AKI), but may not necessarily accurately reflect changes in glomerular filtration rate (GFR). This study aimed to compare the prevalence of AKI in children with severe malaria using diagnostic criteria based on creatinine values in contrast to cystatin C. Methods: This prospective cross-sectional study was performed between June 2016 and May 2017 at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. A total of 170 children aged 0.5–14 years old with severe malaria were included. Serum cystatin C levels were determined using a particle-enhanced immunoturbidmetric assay method, while creatinine levels were measured using the Jaffe reaction. Renal function assessed using cystatin C-derived estimated GFR (eGFR) was compared to that measured using three sets of criteria based on creatinine values including the Kidney Disease: Improved Global Outcomes (KDIGO) and World Health Organization (WHO) criteria as well as an absolute creatinine cut-off value of >1.5 mg/dL. Results: Mean serum cystatin C and creatinine levels were 1.77 ± 1.37 mg/L and 1.23 ± 1.80 mg/dL, respectively (P = 0.002). According to the KDIGO, WHO and absolute creatinine criteria, the frequency of AKI was 32.4%, 7.6% and 16.5%, respectively. In contrast, the incidence of AKI based on cystatin C-derived eGFR was 51.8%. Overall, the rate of detection of AKI was significantly higher using cystatin C compared to the KDIGO, WHO and absolute creatinine criteria (P = 0.003, <0.001 and <0.001, respectively). Conclusion: Diagnostic criteria for AKI based on creatinine values may not indicate the actual burden of disease in children with severe malaria. Keywords: Biomarkers; Acute Kidney Injury; Renal Failure; Glomerular Filtration Rate; Cystatin C; Creatinine; Malaria; Nigeria.

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THE STUDY OF RENOPROTECTIVE PROPERTIES OF ERYTROPOETIN DERIVATIVES ON THE KIDNEY ISCHEMIA-REPERFUSION MODEL

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2018-25-6-73-77 ◽

2018 ◽

Vol 25 (6) ◽

pp. 73-77 ◽

Cited By ~ 1

Author(s):

V. V. Elagin ◽

D. A. Kostina ◽

O. I. Bratchikov ◽

M. V. Pokrovsky ◽

T. G. Pokrovskaya

Keyword(s):

Acute Kidney Injury ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Sodium Excretion ◽

Filtration Rate ◽

Ischemia Reperfusion ◽

Kidney Injury ◽

Fractional Sodium Excretion ◽

Male Wistar Rats ◽

Microcirculatory Disorders

Aim.The research was designed to study the renoprotective properties of erythropoietin derivatives on the kidney ischemiareperfusion experimental model.Materials and methods.The renoprotective properties of asialo erythropoietin (0.4 μg/kg and 2.4 μg/kg 30 minutes before the induction of ischemia) and carbamylated darbepoetin (50 μg/kg 24 hours before the ischemic stimulus) were studied in comparison with erythropoietin and darbepoetin in a series of experiments on male Wistar rats on a 40-minute bilateral model of renal ischemia-reperfusion. The renoprotective properties were evaluated by the results of biochemical markers of acute kidney injury, the dynamics of glomerular filtration rate and fractional sodium excretion, as well as the severity of microcirculatory disorders.Results.It was found that the prophylactic use of asialo erythropoietin (dose-dependent) and carbamylated darbepoetin leads to a decrease in the serum concentration of markers of acute renal damage, an increase in the glomerular filtration rate, a decrease in fractional sodium excretion, and a decrease in microcirculatory disorders.Conclusion.Asialo erythropoietin and carbamylated darbepoetin have the pronounced renoprotective properties and are the promising agents for the prevention and treatment of acute kidney injury.

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The Renal System

10.2310/7ccsp.2255 ◽

2017 ◽

Author(s):

Jayme E. Locke ◽

John T Killian Jr

Keyword(s):

Vitamin D ◽

Acute Kidney Injury ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Kidney Injury ◽

Donor Nephrectomy ◽

General Surgeon ◽

Ureteral Injuries ◽

Renal System

This updated review on the renal system provides a concise overview of the topics most important to the general surgeon. Anatomic topics have been expanded to also include variant anatomy and surgical approaches. There is a new focus on the accuracy and utility of equations for estimating the glomerular filtration rate, as well as supplementation and pharmacology for the general surgeon with discussions of vitamin D and erythropoietin. Acute kidney injury is defined; its pathophysiology is discussed; and its management is outlined, highlighting evidence-based practice. Finally, urologic surgery is addressed with a focus on donor nephrectomy and its consequences, as well as the management of iatrogenic ureteral injuries. Key words: acute kidney injury; contrast nephropathy; erythropoiesis-stimulating agents; estimated glomerular filtration rate; iatrogenic ureteral injury; laparoscopic donor nephrectomy; renal surgical anatomy; vitamin D supplementation

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KIM-1 level in urine with initial reduction of glomerular filtration rate in patients with various bronchial asthma variants

Nephrology (Saint-Petersburg) ◽

10.36485/1561-6274-2021-25-4-64-70 ◽

2021 ◽

Vol 25 (4) ◽

pp. 64-70

Author(s):

V. N. Mineev ◽

T. S. Vasilieva ◽

A. V. Smirnov ◽

O. V. Galkina ◽

V. I. Trofi mov

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Enzyme Immunoassay ◽

Bronchial Asthma ◽

Filtration Rate ◽

Kidney Injury ◽

Renal Tubules ◽

Disease Course ◽

Kidney Injury Molecule 1 ◽

Positive Factor

INTRODUCTION. Previously, we postulated the common pathogenetic mechanisms in bronchial asthma (BA) and chronic kidney disease (CKD). The kidney injury molecule-1 (KIM-1) is considered as an early biomarker of the proximal renal tubules damage. In the available literature, there is only one clinical study of KIM-1 in children BA.THE AIM of the study is to assess KIM-1 levels in different variants of BA.PATIENTS AND METHODS. The 24 BA patients were examined. Glomerular filtration rate (eGFR) by CKD-EPI was calculated. The concentration of the kidney injury molecule -1 (KIM-1) in urine was determined by enzyme immunoassay. Urinary albumin was determined by the immunoturbidimetric method. VEGF-A in serum was determined by enzyme immunoassay (sandwich variant).RESULTS. In the urine of BA patients, KIM-1 was detected, and its level in patients with a non-allergic variant is significantly higher than in patients with an allergic variant of the disease. Factor analysis was carried out, the following was revealed: the KIM-1 component with a high positive factor load is associated with a key characteristic of BA such as the severity of the disease course, as well as with a high negative factor load – with a component of the glomerular filtration rate; the KIM-1 component with a high positive factor load is associated with the presence of drug intolerance in BA patients; the microalbuminuria component is negatively associated with the severity of BA disease course, as well as with the components KIM-1, VEGF-A, which seems to be associated with the use of systemic glucocorticoids in severe BA disease course; the KIM-1 component is positively associated with the VEGF-A component, which may indicate possible KIM-1 involvement in hypoxic kidney injury in BA. CONCLUSION. The obtained data suggest that in BA, first of all, in a non-allergic variant of the disease and in a severe course of BA, kidney injure is formed, detected using kidney injure molecule-1 KIM-1.

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The Renal System

DeckerMed Surgery ◽

10.2310/surg.2255 ◽

2017 ◽

Author(s):

Jayme E. Locke ◽

John T Killian Jr

Keyword(s):

Vitamin D ◽

Acute Kidney Injury ◽

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Filtration Rate ◽

Kidney Injury ◽

Donor Nephrectomy ◽

General Surgeon ◽

Ureteral Injuries ◽

Renal System

This updated review on the renal system provides a concise overview of the topics most important to the general surgeon. Anatomic topics have been expanded to also include variant anatomy and surgical approaches. There is a new focus on the accuracy and utility of equations for estimating the glomerular filtration rate, as well as supplementation and pharmacology for the general surgeon with discussions of vitamin D and erythropoietin. Acute kidney injury is defined; its pathophysiology is discussed; and its management is outlined, highlighting evidence-based practice. Finally, urologic surgery is addressed with a focus on donor nephrectomy and its consequences, as well as the management of iatrogenic ureteral injuries. Key words: acute kidney injury; contrast nephropathy; erythropoiesis-stimulating agents; estimated glomerular filtration rate; iatrogenic ureteral injury; laparoscopic donor nephrectomy; renal surgical anatomy; vitamin D supplementation

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