scholarly journals ALBUMIN CREATININE RATIO AS AN INDICATOR OF NON-HEALING FOOT WOUND FORMATION IN DIABETES

2021 ◽  
Author(s):  
André Greenidge ◽  
Kim R Quimby ◽  
Amy P Speede ◽  
Ian R Hambleton ◽  
Simon G Anderson ◽  
...  
Keyword(s):  
Diabetic Foot ◽  
Kidney Injury ◽  
Queen Elizabeth Hospital ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Significant Difference ◽  
Potential Risk Factors ◽  
History Of ◽  
Identification Of Persons ◽  
Matching Criteria

Aims: To investigate whether kidney injury, determined by albumin creatinine ratio, was associated with current non-healing foot wounds in type 2 diabetes. Materials and Methods: Eighty–nine Barbadians with diabetes were recruited. Cases had a current foot wound and controls had no current foot wound and no history of a non-healing foot wound. Cases were matched to controls using sex, age and duration of diabetes. Participants were from wound dressing and diabetes clinics at the Queen Elizabeth Hospital and Polyclinics, and from private healthcare practitioners. The relationship between albumin creatinine ratio and foot ulceration, adjusting for selected potential risk factors, was analyzed using logistic regression and presented as odds ratios. Results: Forty–four cases and 45 controls were matched, with no statistically significant difference in matching criteria. There were statistically important differences in measures of neuropathy, blood glucose, HbA1c and Albumin:creatinine ratio between cases and controls. Cases were 3 times more likely than controls to have microalbuminuria (95% CI 0.9 – 10.2; p=0.08). Cases were 7.4 times more likely than controls to have macroalbuminuria (95% CI 1.2 – 47.5; p=0.04). Conclusions: The possible association of albumin:creatinine ratio with diabetic foot wounds raises the possibility of its use in earlier identification of persons on the pathway to developing diabetic foot.

scholarly journals Is there a relationship between sleep apnoea and microalbuminuria?

2021 ◽  
Author(s):  
Melek Cihanbeylerden ◽  
Melike Bağnu Yüceege
Keyword(s):  
Microvascular Complications ◽  
Sleep Apnoea ◽  
Urinary Albumin ◽  
Control Group ◽  
Creatinine Ratio ◽  
Microvascular Damage ◽  
Metabolic Complications ◽  
Albumin Creatinine Ratio ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Introduction Obstructive sleep apnoea (OSA) is a cause of hypoxia, and the correlation between hypoxia and microvascular complications is well known. Microalbuminuria (MAU) is a marker for endovascular dysfunction and an indicator of cardiovascular events and all-cause mortality in the general population. The aim of this study was to investigate the relationship between microvascular damage and the metabolic complications of OSA based on the presence of MAU. Material and method Urinary albumin/creatinine ratio (ACR) and microalbumin level were examined in patients with an apnoea-hypopnoea index (AHI) greater than 5/h (study group) and in patients with an AHI less than 5/h (control group). The exclusion criteria were other possible causes of MAU (hypertension, nephropathy, coronary artery disease, and severe thyroid dysfunction). Results Of 103 patients enrolled, 80 formed the group with OSA and 23 served as controls. According to the AHI values, the patients were divided into four groups as normal, mild, moderate and severe. There was no significant difference between the four groups in terms of the microalbumin level and urinary albumin/creatinine ratio. Conclusion In this study, no significant relationship was found between MAU and sleep apnoea.

Acute kidney injury and major outcomes in cancer patients with no history of chronic kidney disease (CKD) with coronavirus 2019 (COVID-19) infection.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18816-e18816
Author(s):  
Cesar Simbaqueba ◽  
Omar Mamlouk ◽  
Kodwo Dickson ◽  
Josiah Halm ◽  
Sreedhar Mandayam ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Kidney Injury ◽  
Hazard Model ◽  
Cancer Center ◽  
Icu Admission ◽  
Significant Difference ◽  
History Of

e18816 Background: Acute Kidney Injury (AKI) in patients with COVID-19 infection is associated with poor clinical outcomes. We examined outcomes (hemodialysis, mechanical ventilation, ICU admission and death) in cancer patients with normal estimated glomerular filtration rate (eGFR) treated in a tertiary referral center with COVID-19 infection, who developed AKI within 30 days of diagnosis. Methods: All patient data — demographics, labs, comorbidities and outcomes — were aggregated and analyzed in the Syntropy platform, Palantir Foundry (“Foundry”), as part of the Data-Driven Determinants of COVID-19 Oncology Discovery Effort (D3CODE) protocol at MD Anderson. The cohort was defined by the following: (1) positive COVID-19 test; (2) baseline eGFR >60 ml/min/1.73m2most temporally proximal lab results within 30 days prior to the patient’s infection. AKI was defined by an absolute change of creatinine ≥0.3 within 30 days after the positive COVID-19 test. Kaplan-Meier analysis was used for survival estimates at specific time periods and multivariate Cox Proportional cause-specific Hazard model regression to determine hazard ratios with 95% confidence intervals for major outcomes. Results: 635 patients with Covid-19 infection had a baseline eGFR >60 ml/min/1.73m2. Of these patients, 124 (19.5%) developed AKI. Patients with AKI were older, mean age of 61+/-13.2 vs 56.9+/- 14.3 years (p=0.002) and more Hypertensive (69.4% vs 56.4%, p=0.011). AKI patients were more likely to have pneumonia (63.7% vs 37%, p<0.001), cardiac arrhythmias (39.5% vs 20.7%, p<0.001) and myocardial infarction (15.3% vs 8.8%, p=0.046). These patients had more hematologic malignancies (35.1% vs 19%, p=0.005), with no difference between non metastatic vs metastatic disease (p=0.284). There was no significant difference in other comorbidities including smoking, diabetes, hypothyroidism and liver disease. AKI patients were more likely to require dialysis (2.4% vs 0.2%, p=0.025), mechanical ventilation (16.1% vs 1.8%, p<0.001), ICU admission (43.5% vs 11.5%, p<0.001) within 30 days, and had a higher mortality at 90 days of admission (20.2% vs 3.7%, p<0.001). Multivariate Cox Proportional cause-specific Hazard model regression analysis identified history of Diabetes Mellitus (HR 10.8, CI 2.42 - 48.4, p=0.001) as an independent risk factor associated with worse outcomes. Mortality was higher in patients with COVID-19 infection that developed AKI compared with those who did not developed AKI (survival estimate 150 days vs 240 days, p=0.0076). Conclusions: In cancer patients treated at a tertiary cancer center with COVID-19 infection and no history of CKD, the presence of AKI is associated with worse outcomes including higher 90 day mortality, ICU stay and mechanical ventilation. Older age and hypertension are major risk factors, where being diabetic was associated with worse clinical outcomes.

scholarly journals MICROALBUMINURIA;

2017 ◽  
Vol 24 (02) ◽  
pp. 221-227
Author(s):  
Ghazanfar Ali Sandhu ◽  
Ghulam Abbas Tahir ◽  
Zaheer Ahmad ◽  
Aqeel Maqsood Anjum
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
T Test ◽  
Losartan Potassium ◽  
P Value ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Significant Difference

Diabetes Mellitus is a rapidly increasing problem which is contributing tochronic illnesses like Cerebrovascular, Cardiovascular, Diabetic Retinopathy and End StageKidney Disease. These dreaded complications can be prevented if treated early. In patientswith diabetes mellitus type 2, microalbuminuria is an independent and strong risk factor forcardiovascular mortality & morbidity and diabetic nephropathy. If diagnosed early, diabeticnephropathy can be treated at this stage. Angiotensin converting enzyme inhibitors (ACEInhibitors) and Angiotensin Receptor Blockers (ARBs) are effective in prevention and treatmentof microalbuminuria. Material & Methods: Study Design: randomized controlled trial. Setting:medical department, allied hospital, Faisalabad. Duration of study: Feb 2013 to July 2013.Sample size: 60 (30 in each group). Sampling technique: Non-probability consecutivesampling. Results: 60 patients were included in the study. 28(46.7%) were males and 32(53.3%)were females. Mean age of study population was 50.15±7.27 years. Albumin creatinine ratio(mcg/mg) at start of study was 193±67.5 in Losartan potassium group and 209.5±72.00 inlisinopril group (independent sample t-test p value=0.302). Albumin creatinine ratio (mcg/mg) at 12 weeks of study was 36.33±54.68 in Losartan potassium group and 72±83.42 inlisinopril group (independent sample t-test p value = 0.056). Paired sample t test applied toboth treatment groups and p value was found to be 0.0001 which is highly significant for bothgroups and shows that both drugs are effective in reducing microalbuminuria in both groups.Microalbuminuria was reduced significantly in 26 patients (86.7%) in Losartan potassiumgroup and 20 patients (66.7%) in lisinopril group (p-value=0.067). Conclusion: It has beenconcluded from this study that lisinopril and Losartan potassium, both significantly reducemicroalbuminuria in type 2 diabetes mellitus and there is no statistically significant difference inefficacy of these two drugs in reducing microalbuminuria in type 2 diabetes mellitus.

scholarly journals Altered kidney function and acute kidney damage markers predict survival outcomes of COVID-19 patients: A prospective pilot study

2021 ◽  
Author(s):  
Mustafa Zafer Temiz ◽  
Ibrahim Hacibey ◽  
Ramazan Omer Yazar ◽  
Mehmet Salih Sevdi ◽  
Suat Hayri Kucuk ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Cystatin C ◽  
Urine Analysis ◽  
Kidney Injury ◽  
Kidney Damage ◽  
Creatinine Ratio ◽  
Serum Cystatin C ◽  
Significant Difference

AbstractBackgroundThe central role in the pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), called as coronavirus disease 2019 (COVID-19), infection is attributed to angiotensin-converting enzyme 2 (ACE-2). ACE-2 expressing respiratory system involvement is the main clinical manifestation of the infection. However, literature about the association between the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and higher ACE-2 expressing kidney is very limited. In this study, we primarily aimed to investigate whether there is a kidney injury during the course of SARS-CoV-2 infection. The predictive value of kidney injury for survival was also determined.MethodsA total of 47 participants who met the inclusion criteria were included in the study. The participants were classified as ‘‘COVID-19 patients before treatment’’ ‘‘COVID-19 patients after treatment’’, ‘‘COVID-19 patients under treatment in ICU’’ and ‘‘controls’’. The parameters comorbidity, serum creatinine and cystatin C levels, CKD-EPI eGFR levels, KIM-1 and NGAL levels, urine KIM-1/creatinine and NGAL/creatinine ratios were statistically compared between the groups. The associations between covariates including kidney disease indicators and death from COVID-19 were examined using Cox proportional hazard regression analysis.ResultsSerum creatinine and cystatin C levels, urine KIM-1/creatinine levels, and CKD-EPI, CKD-EPI cystatin C and CKD-EPI creatinine-cystatin C eGFR levels exhibited significant difference in the groups. The causes of the difference were more altered kidney function and increased acute kidney damage in COVID-19 patients before treatment and under treatment in ICU. Additionally, incidences of comorbidity and proteinuria in the urine analysis were higher in the COVID-19 patients under treatment in ICU group. Urine KIM-1/creatinine ratio and proteinuria were associated with COVID-19 specific death.ConclusionsWe found that COVID-19 patients under treatment in ICU exhibited extremely higher levels of serum cystatin C, and urine KIM-1/creatinine and urine NGAL/creatinine ratios. These results clearly described the acute kidney damage by COVID-19 using molecular kidney damage markers for the first time in the literature. Lowered CKD-EPI, CKD-EPI cystatin C and CKD-EPI creatinine-cystatin C eGFR levels were determined in them, as well. Urine KIM-1/creatinine ratio and proteinuria were associated with COVID-19 specific death. In this regard, considering kidney function and kidney damage markers must not be ignored in the COVID-19 patients, and serial monitoring of them should be considered.

Abstract P297: Repeated Measures of Albuminuria in the Rancho Bernardo Study: 1992-2005

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Simerjot K Jassal ◽  
Jaclyn Bergstrom ◽  
Joachim Ix ◽  
Dena Rifkin ◽  
Elizabeth Barrett-Connor
Keyword(s):  
Repeated Measures ◽  
Kidney Injury ◽  
Community Dwelling ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Spot Urine ◽  
Non Invasive ◽  
Urine Albumin ◽  
Baseline Characteristics ◽  
Median Change

Albuminuria is an early, non-invasive marker of kidney injury, and an independent, potentially modifiable, risk factor for cardiovascular disease. Between 1992-96, 1764 community-dwelling men and women 31-98 (mean 71) years old were assessed for albuminuria using spot urine albumin/creatinine ratio (ACR). Median (interquartile range) ACR was 12 (7-20) mg/g. ACR was repeated in 1997-99 (n=926; ACR 12 [7-20]), 1999-2002 (n=977; ACR 16 [9-32]) and 2003-05 (n=755; ACR 11 [6-20]) (Figure). In analyses limited to 977 participants with ACR measured at 1992-96 and 1999-2002 visits, mean 6.6 (range 4.5-9.5) years later, median change in ACR was 4 (-1-17) mg/g; ACR doubled or greater in 36%, halved or less in 10%, and was unchanged in 54%. Table shows change in ACR by baseline characteristics. Using logistic regression, only sex was associated with doubling of ACR (vs. less than doubling); OR 1.42 (95% CI 1.08-1.87, p=0.01) for women; age, blood pressure, and diabetes were not; none of these were associated with halving of ACR. Further studies of predictors of albuminuria may inform future interventions to modify albuminuria and mitigate kidney and cardiovascular risk.

Novel kidney injury biomarkers in a large cohort of children with sickle cell anemia

2021 ◽  
Author(s):  
André R Belisário ◽  
Roberta da S Filha ◽  
Jéssica A de Almeida ◽  
Fabíola G Mendes ◽  
Paulo V Rezende ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Estimated Glomerular Filtration Rate ◽  
Kidney Injury ◽  
Glomerular Hyperfiltration ◽  
Creatinine Ratio ◽  
Albumin Creatinine Ratio ◽  
Urine Albumin ◽  
Urinary Levels ◽  
Brazilian Children

Aim: The aim of this study was to compare novel kidney injury biomarkers in sickle cell anemia (SCA) children with and without albuminuria or glomerular hyperfiltration. Materials & methods: A total of 358 Brazilian children with SCA were studied. Fifteen kidney injury biomarkers in urine were measured. Albuminuria was defined as urine albumin/creatinine ratio >100 mg/g. Glomerular hyperfiltration was defined as estimated glomerular filtration rate ≥140 ml/min/1.73 m2. Results: After adjustment for age, sex and modifying therapies in use, EGF and collagen IV urinary levels were associated with albuminuria. Renin and clusterin levels were associated with hyperfiltration. Conclusion: Levels of novel kidney injury biomarkers were associated with albuminuria and hyperfiltration in Brazilian children with SCA, suggesting concomitant structural and functional abnormalities.

scholarly journals Values of Alpha 1 Microglobulin Does Not Differ between Individuals with and without Family History of Balkan Endemic Nephropathy

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Mirna Aleckovic-Halilovic ◽  
Enisa Mesic ◽  
Senaid Trnacevic ◽  
Emir Hodzic ◽  
Vildana Habul ◽  
...  
Keyword(s):  
Family History ◽  
Family Burden ◽  
Balkan Endemic Nephropathy ◽  
Creatinine Ratio ◽  
Healthy Individuals ◽  
Average Value ◽  
Urine Creatinine ◽  
Significant Difference ◽  
Endemic Nephropathy ◽  
History Of

Aim. The aim of this study was to compare urinary alpha 1 microglobulin (A1MG) in healthy individuals with and without family burden for Balkan endemic nephropathy (BEN) in an endemic village.Methods. Otherwise healthy inhabitants with microalbuminuria or proteinuria were divided into two groups: with (n=24) and without (n=32) family BEN burden and screened for urinary A1MG and A1MG/urine creatinine ratio.Results. Average value of urinary A1MG was10.35±7.01 mg/L in group with and10.79±8.27 mg/L in group without family history for BEN (NS,P=0.87). A1MG was higher than 10 mg/L in eight (33.33%) inhabitants with family history and in 12 (37.5%) without (NS,P=0.187). Average values of urinary A1MG/creatinine ratio were1.30±1.59and0.94±0.78in group with and group without family BEN history (NS,P=0.39, resp.). Elevated values of this ratio were found in 13 (54.17%) inhabitants with and 14 (43.75%) without family history for BEN (NS,P=0.415).Conclusion. We did not find statistically significant difference in the examined markers between healthy individuals with and without family burden for BEN. We concluded that these markers are not predictive of risk for BEN.

scholarly journals Stage 1-Biomarkers of Kidney Injury in Dogs Undergoing Constant Rate Infusion of Hydroxyethyl Starch 130/0.4

Animals ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 2555
Author(s):  
Barbara Bruno ◽  
Roberta Troìa ◽  
Francesco Dondi ◽  
Cristiana Maurella ◽  
Paola Gianella ◽  
...  
Keyword(s):  
Hydroxyethyl Starch ◽  
Kidney Injury ◽  
Fractional Excretion ◽  
Creatinine Ratio ◽  
Constant Rate Infusion ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Constant Rate ◽  
Significant Difference ◽  
Stage 1 ◽  
Rate Infusion

In veterinary medicine, investigations relating the effects of hydroxyethyl starch (HES) on renal function report contrasting results. This study aimed to assess the changes in the selected biomarkers of kidney injury in dogs after the administration of HES 130/0.4 as a constant rate infusion (CRI) for 24 h. Ten adult client-owned dogs with hypoalbuminemia (albumin < 2 g/dL) and ongoing fluid losses were included. Enrolled dogs received intravenous fluid therapy with crystalloids and a CRI of HES 130/0.4 at a dose of 2 mL/kg/h for 24 h. Serum creatinine (sCr), fractional excretion (FE) of electrolytes, urinary protein to creatinine ratio (UPC), urinary albumin to creatinine ratio (UAC), SDS-page, and urinary neutrophil gelatinase-associated lipocalin (uNGAL) were measured at the baseline before HES infusion, and after 24 h (T24) and 48 h (T48) from the baseline. No statistically significant difference was found between the baseline value vs. T24 and the baseline vs. T48 for sCr, UAC, UPC, FE of sodium, chloride and calcium, and uNGAL. A significant increase in FEK (p = 0.04) was noticed between the baseline and T48. In this study sample of hypoalbuminemic dogs, HES 130/0.4 at the dose and rate of infusion applied did not cause any significant changes in the investigated biomarkers of kidney injury.

Significance of urine albumin / creatinine ratio (UACR) and uric acid in women with preeclampsia and its comparison with healthy normotensive pregnant women in their third trimester

2014 ◽  
Vol 21 (1) ◽  
pp. 9-15
Author(s):  
Sonal Sogani ◽  
Vandana Varma ◽  
Purnima Dey Sarkar
Keyword(s):  
Uric Acid ◽  
Pregnant Women ◽  
Creatinine Ratio ◽  
Third Trimester ◽  
Albumin Creatinine Ratio ◽  
Mean Values ◽  
Urine Albumin ◽  
Significant Difference ◽  
Urine Albumin Creatinine Ratio ◽  
New Onset

Objective. To determine the significance of urine albumin / creatinine ratio (UACR) as to predict proteinuria in new-onset hypertension and uric acid in women with preeclampsia and its comparison with healthy normotensive pregnant women. Methods. Healthy normotensive pregnant women (n = 45), women with preeclampsia (n = 36) were included in the study. The preeclamptic group was further divided into two subgroups: mild (n  =  25) and severe preeclampsia (n = 11). Results. Higher mean values of urine albumin / creatinine ratio (UACR) and uric acid were found in preeclamptic pregnant women (319.05 ± 247.56 mg/g, 5.98  ±  2.1  mg/dl) as compared to healthy normotensive pregnant women (22.15  ±  8.1  mg/g, 4.07  ±  0.91  mg/dl) in the third trimester with highly significant difference (p 

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