Pilot study of side effects and serum and urine concentrations of amoxicillin–clavulanic acid in azotemic and non-azotemic cats

2019 ◽  
Vol 22 (8) ◽  
pp. 729-735 ◽  
Author(s):  
Kellyi K Benson ◽  
Jessica M Quimby ◽  
Kristy L Dowers ◽  
Liberty G Sieberg ◽  
Joshua B Daniels ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Side Effects ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Clavulanic Acid ◽  
Serum Creatinine Concentration ◽  
Creatinine Concentration ◽  
Drug Concentrations ◽  
Amoxicillin Clavulanic Acid ◽  
Serum And Urine

Objectives The aims of this study were to determine the side effect frequency and serum and urine drug concentrations of amoxicillin–clavulanic acid in cats with and without azotemic chronic kidney disease (azCKD). Methods Owners whose cats had been prescribed amoxicillin–clavulanic acid completed a survey regarding the occurrence and type of side effects, and whether treatment was altered as a result. Cats were defined as azCKD (serum creatinine concentration >2.0 mg/dl, urine specific gravity [USG] <1.035 with a clinical diagnosis of chronic kidney disease) and without azCKD (serum creatinine concentration <2.0 mg/dl). Data were assessed with Fisher’s exact test. Serum and urine samples were obtained from client-owned cats with azCKD (n = 6) and without azCKD (n = 6, serum creatinine concentration <1.8 mg/dl, USG >1.035) that were receiving amoxicillin–clavulanic acid. Amoxicillin and clavulanic acid were measured with liquid chromatography coupled to tandem mass spectrometry and compared between groups with a Mann–Whitney test. Correlation between serum creatinine and drug concentrations in urine and serum was determined using Spearman’s rank test. Results Sixty-one surveys were returned (11 azCKD cats and 50 without azCKD cats). No significant difference in the presence of side effects or type of side effects was seen between groups; however, significantly more azCKD cats had more than one side effect ( P = 0.02). More owners of azCKD cats reported that an alteration in treatment plan was necessitated by side effects (55% vs 12%; P = 0.008). Urine amoxicillin was significantly lower in cats with azCKD ( P = 0.01) and serum amoxicillin trended toward significance ( P = 0.07). Serum amoxicillin concentration was positively correlated with serum creatinine ( P = 0.02; r = 0.62) and urine amoxicillin concentration was negatively correlated with serum creatinine ( P = 0.01; r = –0.65). Conclusions and relevance The data suggest that cats with azCKD have altered pharmacokinetics of amoxicillin, which may contribute to an increased incidence of multiple side effects.

ASYMMETRIC DIMETHYLARGININE PLASMA IN END STAGE CHRONIC KIDNEY DISEASE

2016 ◽  
pp. 72-77
Author(s):  
Trong Ai Quoc Hoang ◽  
Tam Vo ◽  
Viet Thang Hoang
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Asymmetric Dimethylarginine ◽  
Healthy People ◽  
Serum Creatinine Concentration ◽  
Creatinine Concentration ◽  
Plasma Adma ◽  
End Stage ◽  
Adma Concentration

Objectives: we aimed to assess the levels of plasma ADMA in healthy people and in reserved patients with end stage renal disease (ESRD), the association between plasma ADMA with serum creatinine concentration and with eGFR. Materials and Methods: This is a controlled cross sectional study. Plasma ADMA and other variables were measured in 27 patients with ESRD and in 21 controls. Plasma ADMA levels were determined by enzyme linked immunosorbent assay (ELISA) using kits provided from immunodiagnostic AG, Germany. Data was analyzed by SPSS 19.0. Results: Mean ADMA in men- women was 0.69 ± 0.19 µmol/L and 0.61 ± 0.20 µmol/L, respectively, (p>0.05), mean ADMA in control and disease were 0.48 ± 0.17 µmol/L and 0.77± 0.12µmol/L; respectively, (p <0.001). No correlation between ADMA and age (r=-0.059, p=0.691); correlation between ADMA with serum creatinine (r=0.459, p<0.001) with eGFR r=-0.596, p<0.001). Conclusion: ADMA concentration in healthy people: 0.48 ± 0.17 µmol/L. ADMA concentration in ESRD: 0.77± 0.12 µmol/L. There is a correlation between ADMA concentration with eGFR and with serum creatinine concentration. Key words: Asymmetric dimethylarginine, end stage chronic kidney disease

scholarly journals Evaluation of Urinary Big Endothelin-1 in Feline Spontaneous CKD

Animals ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 2144
Author(s):  
Marco Giraldi ◽  
Saverio Paltrinieri ◽  
Camilla Piazza ◽  
Paola Scarpa
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Urine Samples ◽  
Ckd Progression ◽  
Creatinine Concentration ◽  
Endothelin 1 ◽  
Urine Creatinine ◽  
Advanced Stages

The endothelin-1 (ET-1) system has been implicated in the development and progression of chronic kidney disease (CKD). No information on big ET-1 in feline urine is available. The purpose of this study was to evaluate if urinary big endothelin-1 (bigET-1) is associated with feline CKD. Sixty urine samples were prospectively collected from 13 healthy cats at risk of developing CKD and 22 cats with CKD of different International Renal Interest Society (IRIS) stages (1–4). Urinary bigET-1 was measured using a commercially available ELISA. BigET-1 normalized to urine creatinine (bigET-1:UC) was compared amongst stages and substages, as proposed by IRIS, and correlated with serum creatinine concentration, proteinuria and blood pressure. BigET-1:UC at the time of inclusion was compared between cats that remained stable and cats that progressed after 12 months. BigET-1:UC was significantly higher (p = 0.002) in cats at IRIS stages 3–4 (median: 21.9; range: 1.88–55.6), compared to all other stages, and in proteinuric (n = 8, median: 11.0; range: 0.00–46.4) compared with nonproteinuric cats (n = 38 median: 0.33; range: 0.00–55.6) (p = 0.029). BigET-1:UC was not associated with CKD progression. Urinary bigET-1 increased in advanced stages of CKD and in proteinuric patients, suggesting that ET-1 may be indicative of the severity of feline CKD.

THE STUDY ON SERUM WITH eGFR IN PATIENTS OF CHRONIC KIDNEY DISEASE

2021 ◽  
pp. 23-25
Author(s):  
Brahmarshi Das ◽  
Narendranath Hait ◽  
Titol Biswas ◽  
Debarshi Jana
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Cross Sectional Study ◽  
Newly Diagnosed ◽  
Creatinine Concentration ◽  
Cross Sectional ◽  
Ckd Stage ◽  
The Mean ◽  
Stage 1

INTRODUCTION: Chronic Kidney Disease (CKD) is dened as a disease characterized by alterations in either kidney structure or function or both for a minimum of 3 months duration. According to the National Kidney Foundation criteria, 1 CKD has been classied into ve stages with stage 1 being the earliest or mildest CKD state and stage 5 being the most severe CKD stage. To stage CKD, it is necessary to estimate the GFR rather than relying on serum creatinine concentration. Glomerular ltration rate (GFR), either directly measured by computing urinary clearance of ltration marker such as inulin or estimated by calculating from different equations using serum creatinine. is the most commonly used parameter to assess kidney function. AIM AND OBJECTIVES: a) Establish relationship between serum CKD and eGFR MATERIAL AND METHOD: A Cross-sectional study on 100 cases of newly diagnosed Chronic Kidney Disease patients and matched control subjects is undertaken to study.100 Patients who are newly diagnosed as CKD are selected after proper initial screening. RESULT AND ANALYSIS: In case, the mean eGFR (mean± s.d.) of patients was 25.1500 ± 11.8929. In control, the mean eGFR (mean± s.d.) of patients was 87.2200 ± 17.8295. Difference of mean eGFR in two groups was statistically signicant (p<0.0001). In case, the mean creatinine (mean± s.d.) of patients was 3.6350 ± 2.4419 mg/dl. In control, the mean creatinine (mean± s.d.) of patients was .9435 ± .1317 mg/dl. Difference of mean creatinine in two groups was statistically signicant (p<0.0001). CONCLUSION: eGFR was strongly associated with CKD that also statistically signicant. The positive correlation was found in eGFR.

P0712TRANSGELIN AS A POTENTIAL MARKER OF RENAL IMPAIRMENT IN MULTIPLE MYELOMA PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Karolina Woziwodzka ◽  
Jolanta Malyszko ◽  
Małgorzata Banaszkiewicz ◽  
Ewa Koc- Żorawska ◽  
Paulina Dumnicka ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Multiple Myeloma ◽  
Renal Failure ◽  
Kidney Disease ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Renal Damage ◽  
Light Chains ◽  
Serum And Urine

Abstract Background and Aims Transgelin (SM22) is a cytoskeletal actin-binding protein involved in differentiation of smooth muscle cells, osteoblasts and adipocytes. It is present in fibroblasts, some epithelium, immune cells and acts as a tumor suppressor. It was found as a marker of interstitial fibrosis and glomerulosclerosis. Transgelin upregulation depends on the etiology of the disease in various cells (glomerular parietal or visceral, or tubular interstitial cells). Elevated SM22 expression was detected in glomerular and in tubulointerstitial injury. Among patients with multiple myeloma (MM) up to 50% suffer from renal insufficiency (RI) in early stages. Free light chains (FLCs), potential nephrotoxic substances, where lambda light chains are more commonly associated with renal damage, appear to have a prognostic value in MM and indicate the stages of MM. The aim of the study was to analyse the utility of transgelin in case of renal impairment in MM patients and investigate its relationship with acclaimed parameters of renal failure and markers of MM stages. Method The analysis included 126 patients (73 women and 53 men) in mean age 66 ± 10 years. Symptomatic MM was diagnosed in 119 patients, including 84 (67%) with ISS stage 1, 20 (16%) with stage 2 and 15 (12%) with stage 3; 7 (6%) patients had smoldering MM. Mean baseline eGFR (CKD-EPICr) was 74 ± 24 ml/min/1.73 m2 and 31 (25%) patients had eGFR &lt;60 ml/min/1.73 m2. The examined parameters included creatinine, urea, NGAL urine, serum and urine cystatin C, periostin, FLC kappa and lambda in serum and urine. The association between transgelin, markers of renal failure, MM were determined by the Pearson's test and multivariate stepwise regression analysis. The p-value &lt;0.05 was considered statistically significant. Results Median serum transgelin in the whole studied group was 84.1 (IQR: 65.4; 116.4) ng/ml. Transgelin concentrations were higher in men (median 96.2 versus 78.8 ng/ml; p=0.022) and in patients with smoldering MM (median 149.2 versus 82.4 ng/ml; p=0.003). Transgelin did not differ according to ISS stage (p=0.3) or disease state (regression, stable disease or progression) (p=0.3). Significant correlations were detected between transgelin and serum creatinine (R=0.29; p=0.001), eGFR (CKD-EPICr) (R=-0.25; p=0.007), uric acid (R=0.19; p=0.036), alanine (R=0.18; p=0.048) and aspartate (R=0.26; p=0.003) aminotransferases, ferritin (R=-0.22; p=0.049), hepcidin (R=-0.25; p=0.033), and urine cystatin C (R=0.19; p=0.042). Moreover, after exclusion of patients with smoldering MM, transgelin significantly correlated with serum FLC lambda (R=0.18; p=0.047) and serum periostin (R=-0.22; p=0.013). After median follow-up of 21 (IQR: 15; 24) months, eGFR decreased in 47 (37%) of patients and increased in 71 (56%) patients (no follow-up data were available in 8, i.e. 6% of patients). Patients in whom eGFR decreased had higher transgelin (median 106.6 versus 83.9 ng/ml), although the difference was marginally significant (p=0.05). However, baseline transgelin positively correlated with serum creatinine after follow-up (R=0.37; p&lt;0.001) and negatively correlated with eGFR after follow-up (R=-0.33; p&lt;0.001). Moreover, higher baseline serum transgelin (beta=-0.11 ± 0.05; p=0.032) significantly predicted lower eGFR values after the follow-up, independently of baseline eGFR and the duration of follow-up. Conclusion Transgelin may be useful in investigating renal damage because of its proven role in regulation of fibrosis, especially in kidney. As a biomarker it may indicate diagnosis and etiology of MM-related chronic kidney disease, which can lead to beginning of early therapeutic interventions and improved overall survival and quality of life in patients with MM. Moreover, elevated transgelin at the beginning of the disease may induce future development of chronic kidney disease.

scholarly journals Abnormal Expression of miR-21 in Kidney Tissue of Dogs With X-Linked Hereditary Nephropathy: A Canine Model of Chronic Kidney Disease

2018 ◽  
Vol 56 (1) ◽  
pp. 93-105 ◽  
Author(s):  
Sabrina D. Clark ◽  
Wenping Song ◽  
Rachel Cianciolo ◽  
George Lees ◽  
Mary Nabity ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Kidney Tissue ◽  
Canine Model ◽  
Renal Tissue ◽  
Tubular Damage ◽  
Creatinine Concentration ◽  
Hereditary Nephropathy ◽  
End Stage

MicroRNAs (miRNAs) are a group of small noncoding RNAs that act as regulators of posttranslational gene/protein expression and are known to play a key role in physiological and pathological processes. The objective of our study was to compare expression of miR-21 in renal tissue from dogs affected with chronic kidney disease (CKD) caused by X-linked hereditary nephropathy (XLHN), a disease equivalent to human Alport syndrome, to that from unaffected dogs. Additionally, we sought to characterize changes in relative mRNA expression of various genes associated with miR-21 function. miRNA was isolated from kidney tissue collected from both affected dogs and unaffected, age-matched littermates at defined milestones of disease progression, including end-stage renal disease (ESRD). Additionally, autopsy samples from affected dogs at ESRD and corresponding unaffected dogs were evaluated. Samples were scored based on histological changes, and relative expression of miR-21 and kidney disease-related genes was determined using quantitative real-time polymerase chain reaction. In affected dogs, significant upregulation of kidney miR-21 was first detected at the milestone corresponding with increased serum creatinine. Furthermore, miR-21 expression correlated significantly with urine protein: urine creatinine ratio, serum creatinine concentration, glomerular filtration rate, and histologic lesions (glomerular damage, tubular damage, chronic inflammation, and fibrosis). At end-stage disease, COL1A1, TGFB1 and its receptor, TGFB2, and Serpine1 were upregulated, while PPARA, PPARGC1A, ACADM, SOD1, and EGF were downregulated. In conclusion, miR-21 is abnormally upregulated in the kidneys of dogs with CKD caused by XLHN, which may play an important pathologic role in the progression of disease by dysregulating multiple pathways.

Two-year Longitudinal Evaluation of Amphotericin B Lipid Complex Injection in a Tertiary Care Medical Center

2000 ◽  
Vol 35 (2) ◽  
pp. 176-181 ◽  
Author(s):  
Leanne D. Kennedy ◽  
Julie F. Connelly ◽  
Kevin M. Kuzma
Keyword(s):  
Serum Creatinine ◽  
Amphotericin B ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Serum Creatinine Concentration ◽  
Creatinine Concentration ◽  
Lipid Complex ◽  
Tertiary Care Medical Center ◽  
Amphotericin B Lipid Complex ◽  
The Mean

A 2-year concurrent drug use evaluation was conducted in 156 patients to determine whether Abelcet (amphotericin B lipid complex injection) was being prescribed according to institution-approved guidelines and to characterize the patient population receiving Abelcet. Eighty-nine patients (57%) had fungal infections documented by chest x-ray, computed tomography, or fungal cultures. Sixty-seven (43%) had clinically suspected fungal infections. The Abelcet mean dose by weight was 5 mg/kg/day (actual body weight). Seventy-one patients (46%) met the established guidelines for use; 85 (54%) did not. Premedication was given to 64% of the patients; only 15 patients (10%) experienced documented fever and chills. A total of 72 patients (46%) died during therapy. Of the 75 patients who completed therapy in the hospital, 41 were switched to conventional amphotericin B, fluconazole, or itraconazole following a decrease in serum creatinine concentration, and 34 did not receive further antifungal therapy. The mean length of Abelcet therapy was 11 days. The mean increase in serum creatinine concentration at discontinuation of therapy was 0.2 mg/dL. Continued monitoring of Abelcet use was recommended and established guidelines were reaffirmed. Hydration with normal saline before and after dosing was suggested to help improve renal function, and dopamine was recommended to increase renal blood flow.

scholarly journals MicroRNA-451 as an Early Predictor of Chronic Kidney Disease in Diabetic Nephropathy

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mostafa Abdelsalam ◽  
A. M. Wahab ◽  
Maysaa El Sayed Zaki ◽  
Mohamad Motawea
Keyword(s):  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Early Diagnosis ◽  
Serum Creatinine ◽  
High Sensitivity ◽  
Urinary Albumin ◽  
Significant Difference ◽  
Plasma Microrna ◽  
Stage Renal Disease

Background. Diabetes mellitus is the leading cause of end-stage renal disease worldwide. Microalbuminuria is the cornerstone for the diagnosis of diabetic nephropathy. However, it is an inadequate marker for early diagnosis. MicroRNAs are not only new and promising markers for early diagnosis but also, but they may also play a role in the prevention of disease progression. Methods. This study included ninety patients with type 2 DM in addition to 30 control subjects. MicroRNA-451 expression in blood and plasma using real-time PCR was evaluated in addition to the classic diabetic nephropathy markers (serum creatinine, urinary albumin, and eGFR). Results. There was a significant difference between the studied groups versus control regarding serum creatinine, eGFR, urinary, and plasma microRNA-451 with p=0.0001. Patients with eGFR 60 ml/min/1.73 m2 showed a significantly higher plasma microRNA-451 (29.6 ± 1.6) and significantly lower urinary microRNA-451 (21 ± 0.9) in comparison to patients with eGFR >60 ml/min/1.73 m2 and p=0.0001. eGFR showed a positive correlation with urinary microRNA-451 and negative correlation with both plasma microRNA-451 and urinary albumin. Both plasma and urinary microRNA-451 are highly sensitive and specific markers for chronicity in diabetic nephropathy patients with sensitivity of 90.9% and 95.5% and specificity of 67.6% and 95.6%, respectively. Conclusion. MicroRNA-451 is a promising early biomarker for chronic kidney disease in diabetic nephropathy with high sensitivity and specificity.

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