scholarly journals Relation between Renal Resistive Index and Serum Albumin in Nephrotic Syndrome

2021 ◽  
Vol 10 (30) ◽  
pp. 2228-2232
Author(s):  
Pranoy Dey ◽  
Niku Hage

BACKGROUND Renal resistive index (RRI) is a non-invasive marker of renal function, which can be measured by renal USG Doppler. High RI indicates poor prognosis, which has been associated with conditions such as proteinuria, hypertension, chronic kidney disease and renal failure. As nephrotic syndrome is characterised by significant proteinuria and hypoalbuminemia, which may progress to renal failure, it is important to see the correlation of RRI with serum albumin level. The purpose of this study was to assess the relation between renal resistive index and serum albumin in nephrotic syndrome. METHODS USG renal Doppler was done for all the children with nephrotic syndrome and RRI was calculated as [(peak - systolic velocity − end - diastolic velocity) / peak - systolic velocity]. Blood investigations were also done, from which serum albumin values were obtained. RRI was compared with mean serum albumin level. Statistical analysis of data was performed using the computer programme, Statistical Package for Social Sciences (SPSS for windows, version 21.01, Chicago, SPSS Inc.) and Microsoft excel 2010. Results on continuous measurement were presented as mean ± standard deviation and compared using Analysis of Variance (ANOVA). RESULTS The mean serum albumin in the children with nephrotic syndrome in our study was 1.82 ± 0.32 gm / dl. The mean RI value was 0.66 ± 0.14 SD, 0.64 ± 0.15 SD and 0.66 ± 0.12 SD as well as 0.63 ± 0.12 SD, 0.67 ± 0.16 SD and 0.71 ± 0.13 SD on the right and left kidney respectively for each of upper, middle, and lower pole. P value of left kidney and right kidney was 0.0057 and 0.6409 respectively. CONCLUSIONS Lower the mean serum albumin level, higher the range of RRI. KEY WORDS Serum Albumin, Renal Resistive Index, Nephrotic Syndrome, USG Renal Doppler

2011 ◽  
Vol 16 (3) ◽  
pp. 411-414 ◽  
Author(s):  
Kazunari Kaneko ◽  
Takahisa Kimata ◽  
Shoji Tsuji ◽  
Tomohiko Shimo ◽  
Masaya Takahashi ◽  
...  

2017 ◽  
Vol 89 (4) ◽  
pp. 305
Author(s):  
Simone Brardi ◽  
Gabriele Cevenini ◽  
Vanni Giovannelli ◽  
Giuseppe Romano

Objective: This longitudinal prospective observational type study was conceived with the aim to examine the impact on renal resistive index (RRI) of the variables that we can manipulate with therapeutic and or dietetic interventions in a chronic kidney disease population in order to known which of these variables was statistically related to changes in RRI and therefore could become the object of the greatest therapeutic effort. Material and methods: This study was undertaken between May 2016 to May 2017 in the outpatient nephrology and urology clinic of San Donato Hospital in Arezzo. The study population (84 patients: 47 males and 37 females) was randomly selected among the chronic kidney patients (with various degrees of renal impairment) affected by hypertension and or diabetes mellitus. After a comprehensive medical examination these patients were submitted to determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and finally renal Doppler ultrasonography. Then the patients were submitted to a full therapeutic and dietetic intervention to ameliorate the renal impairment by a wide range of actions and after on average a one-year interval were submitted again to a new medical examination and a second determination of serum creatinine, glycated hemoglobin, 24-hour urinary albumin excretion and a new renal Doppler ultrasonography too. Results: The comparison between basal and final data revealed a slight reduction in the mean of bilateral renal resistance indices (Delta RRI: -0.0182 ± 0.08), associated to a slight increase in the mean glomerular filtration rate (Delta GFR: 0.8738 ± 10.95 ml/min/1.73 m2), a reduction in mean body weight (Delta weight: -1.9548 ± 5.26 Kg) and mean BMI (Delta BMI: -0.7643 ± 2.10 Kg/m2) as well as a reduction in the mean systolic blood pressure (Delta systolic blood pressure: -8.8333 ± 25.19 mmHg). Statistical analysis showed statistically significant correlations (p < 0.05) between Delta RRI and Delta weight (p < 0.03), Delta BMI (p < 0.02) and Delta systolic blood pressure (p < 0.05). Conclusion: Despite the many limitations the our study clearly identifies the targets (yet widely known) to act on to prevent kidney alterations related to RRI and provides further evidence, if any, of the utility of RRI as a key parameter in monitoring patients with chronic renal failure and as a valuable tool to drive the clinical efforts to contrast the kidney disease.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ngoc Nguyen Thi ◽  
Dien Tran Minh ◽  
Huong Nguyen Thu ◽  
Phuong Luong Thi ◽  
Nam Thai Thien ◽  
...  

Background: The current study intended to determine whether serum albumin level and urine protein/creatinine rate (uPCR) are appropriate predictors of severe lupus nephritis in childhood-onset SLE. Objectives: Following a cross-sectional single-center design, 85 LN children referred to the National Children Hospital, Ha Noi, Viet Nam, from 6/2019 to 6/2020 were recruited. Renal biopsy was performed for all participants. Methods: Following a cross-sectional single-center design, 85 LN children referred to the National Children Hospital, Ha Noi, Viet Nam, from 6/2019 to 6/2020 were recruited. Renal biopsy was performed for all participants. Results: The mean SLEDAI score of all patients was 14.69. The proportion of patients with high and very high SLEDAI was 61.2 and 17.6%, respectively. The mean concentration of serum albumin was 28.55 g/L, and the proportion of decreased albumin concentration was 55.3%. The median uPCR was 446.6 mg/mmol in which 76.5% of values were ≥ 200 mg/mmol. Pathological morphology of LN class from I to VI was observed in 0%, 17.6%, 37.6 %, 37.6%, 7.1%, and 0%, respectively. Serum albumin level and uPCR presented the predictive value for severe and active LN (class IV and V); (AUC: 0.725 P < 0.001 for both). Conclusions: Serum albumin and uPCR were appropriate predictors for severe and active LN in Vietnamese children.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed Saad El-Din Mahmud ◽  
Hala Mahmoud EL-Khawas ◽  
Hossam El Din Mahmoud Afify ◽  
Mohamed Mohamed Tawfik

Abstract Objectives We aimed to Detect if there is association between serum albumin level in acute ischemic stroke patients and its short term neurological and functional outcome in a tertiary care hospital in Cairo. Methods The study was carried out as descriptive (cross-sectional) study conducted on 50 cases first-ever acute ischemic stroke patients were enrolled between June 2018 to December 2018 with follow up after 30 days of discharge from hospital. Inclusion and exclusion criteria were strictly exercised. National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) score was noted. Serum albumin (SA) was estimated from blood Clinical, functional, and radiological evaluation was done for the patients. Statistical SPSS 20.0 software and Microsoft excel were used for statistical analysis (P ≤ 0.05).Relationship between serum albumin and stroke outcome was determined. Results A total of 50 stroke cases were thus included in the study comprising 34 males and 16 females. The mean age of patients was 40-65 [59.26±6.25] years, we found the most prevalent risk factors in the present study results were hypertension 36 (72.0%). The mean serum level of albumin were (3.73±0.63) on day o of onset and (3.72±0.63) after 30 days of discharge from hospital. Bivariate analysis shows serum albumin was inversely associated with NIHS score and mRS on day o of onset and after 30 days of discharge from hospital which were NIHSS(r= -0.264, P = 0.044) (r= -0.645, P = &lt;0.001) and mrs (r= -0.321, P = 0.031) (r= -0.587, P = &lt;0.001) respectively. Conclusion Hypoalbuminemia had influence to degree of stroke severity, degree of disability and functional outcome. Serum albumin levels had a negatively correlation with NIHSS score and modified Rankin scale. Low serum albumin levels associated with poor prognosis in acute ischemic stroke patients.


2020 ◽  
Vol 17 (01) ◽  
pp. 24-27
Author(s):  
Raghavendra Nayak ◽  
Nitin Jagdhane ◽  
Sanjeev Attry ◽  
Samarendranath Ghosh

Abstract Background Serum albumin has long been considered as an outcome marker in various critical illnesses. The aim of our study is to ascertain the role of serum albumin as a predictor of outcome in severe head injury patients. Materials and Methods This is a prospective observational study of patients with severe traumatic brain injury (TBI). Depending on the serum albumin level at admission, patients were dichotomized into two groups: one with normal serum albumin and other with hypoalbuminemia. Their outcomes at 6-month follow-up were assessed by the modified Glasgow Outcome Score. Result Eighty patients (57 males and 23 females) with severe TBI were included in the study. The mean age of the study patients was 39.6 + 13.1 years and the mean serum albumin level at admission was 3.7 + 1.2 g/dL with lowest being 2.2 mmol/L and highest being 6.1 mmol/L. Thirty-four patients (42.5%) had low serum albumin level (< 3.5 g/dL) at admission. At 6-month follow-up, 58 (72.5%) patients had a good neurological outcome and 22 (27.5%) had a poor outcome. The group with normal serum albumin levels showed a significantly better outcome compared with the hypoalbuminemia group (p = 0.01). On multiple regression analysis, low serum albumin emerged as the only predictor of the poor outcome in severe head injury patients. Conclusion Serum albumin at admission is an independent predictor of outcome in severe TBI patients. Larger prospective studies are required to confirm these findings.


2000 ◽  
Vol 20 (4) ◽  
pp. 439-444 ◽  
Author(s):  
Douglas Shemin ◽  
Andrew G. Bostom ◽  
Cynthia Lambert ◽  
Connie Hill ◽  
Jenny Kitsen ◽  
...  

Objective Residual renal function contributes importantly to total solute clearance in peritoneal dialysis (PD) patients. This study was designed to examine the progression of residual renal function over time and its impact on nutrition and mortality in PD patients in the six New England states (ME, NH, VT, CT, MA, RI) comprising End Stage Renal Disease (ESRD) Network 1. Design As part of the ESRD Clinical Indicators Project, data on 990 PD patients in Network 1 were abstracted from data supplied by dialysis units in the fourth quarter of 1997. This included demographic information; dose of PD in L/day; weekly renal, dialysis, and total Kt/V urea; weekly renal, dialysis, and total creatinine clearance (CCr); serum albumin level; and mortality and transplantation information. Data collection was repeated in the second and fourth quarters of 1998 and in the second quarter of 1999. Patients 990 PD patients in Network 1. Outcome Measures The change in total and renal solute clearances over time, the relationship between renal clearance and mortality, and the relationship between renal clearance and nutritional status, as represented by serum albumin. Results Over the 2-year period, mean weekly renal Kt/V urea and weekly renal CCr dropped significantly. To examine the effect of residual renal function on mortality, patients were divided into high and low (above and below the median) weekly renal Kt/V urea and weekly renal CCr groups. Patients above the median levels of both weekly renal Kt/V urea and weekly renal CCr had a significantly decreased risk of dying during the observation period, after controlling for age, gender, serum albumin level, and diabetic status [OR for high vs low renal Kt/V urea 0.54 (CI 0.34 – 0.84), OR for high vs low renal CCr 0.61 (CI 0.40 – 0.94)]. The mean weekly renal Kt/V urea was significantly and directly correlated with the mean serum albumin level by Spearman rank correlation ( R = 0.133, p < 0.001), as was the mean weekly renal CCr ( R = 0.115, p < 0.001). Conclusions Residual renal function is an important contributor to total solute clearance in PD patients. Even at low levels it is linked to decreased mortality and better nutritional status.


2019 ◽  
Vol 59 (1) ◽  
pp. 7-12
Author(s):  
Andar Laura Nainggolan ◽  
Sri Sudarwati ◽  
Dany Hilmanto

Background Nephrotic syndrome (NS) is the most common renal disease among children, and contributes to life-threatening complications such as thromboembolic disease. Platelets are considered to be important agents in thrombotic events among NS patients. The gold standard assessment for platelet aggregation is the use of adenosine diphosphate (ADP) agonist, however, it is expensive and not accessible in smaller health facilities. Thus, other thrombosis parameters are needed. Previous studies suggested that low albumin increased the risk of thrombosis in NS patients. Objective To assess for a possible correlation between albumin level and platelet count as well as platelet aggregation. Methods This cross-sectional study was conducted in children with nephrotic syndrome who were admitted to the Pediatric Nephrology Department in Dr. Hasan Sadikin General Hospital, Bandung, West Java, from November 2017 to March 2018. Subjects were selected by consecutive sampling. Serum albumin, platelet count, and platelet aggregation were measured. Statistical analysis was conducted by Spearman’s test. Results A total of 32 patients participated in the study, with mean age of 109 (SD 7.4) months. Most subjects were male (56%). Subjects’ mean serum albumin level was 2.06 (SD 1.23) g/dL; mean platelet count was 453,062.5 (SD 187,443.90)/mm3; and mean platelet aggregation values for ADP agonist concentrations of 10, 5, 2.5, and 1 mM were 86.8 (SD 8.63)%, 82.4 (SD 15.33)%, 66.6 (SD 24.90)%, 34.95 (SD 31.69)%, respectively. Partial correlation analysis revealed significant negative associations between albumin and platelet count as well as platelet aggregation assessed with 1 mM of ADP concentration (P<0.001), with Spearman correlation coefficients of -0.641 and -0.634, respectively. Conclusion Serum albumin level had a moderately negative correlation with platelet count and platelet aggregation value.


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