Assessment of renal functions with different glomerular filtration rate formulas in children with acute exposure of mercury

2015 ◽  
Vol 40 (3) ◽  
Author(s):  
Ceylan Bal ◽  
Oya Torun Güngör ◽  
Hüseyin Tuğrul Çelik ◽  
Sedat Abuşoğlu ◽  
Nihal Uğuz ◽  
...  

AbstractObjective: Our aim was to determine whether cystatin C level has a superiority to creatinine to assess kidney functions in rapid decreases of glomerular filtration rate due to acute mercury exposure in children. Eight different glomerular filtration rate calculation formulas which have been used creatinine and/or cystatin C were also compared.Methods: Serum urea, creatinine and cystatin C values of 39 mercury exposed children were measured. Glomerular filtration rates were calculated by eight different formulas. Patient group was divided into three subgroups according to mercury levels.Results: Cystatin C and mercury levels of the patients were found significantly different from control group (p<0.001). There was not a significant difference in creatinine and urea values between two groups (p=0.913, p=0.236). There was not a significant difference between patient and control groups in GFR calculations which have been used serum creatinine and height or which have been used urea additional to them (p=0.069, p=0.559, p=0.424, p=0.945, respectively), but there was a significant difference between patient and control groups in GFR calculations which have been used cystatin C only or creatinine, urea and height in addition to this (p<0.001, p<0.001, p=0.042, p<0.001, respectively). In sugroup analysis, cystatin C results and the results of three GFR calculations of four GFR calculations which were used cystatin C were found different in control group according to subgroups but there was not a difference between subgroups.Conclusion: Cystatin C level is a better indicator than creatinine to assess kidney functions in rapid decreases of glomerular filtration rate due to acute exposure of mercury. Formulas using cystatin C gave better results than formulas using creatinine and height in estimation of glomerular filtration rate.

Author(s):  
Mang Ngaih Ciin ◽  
Tanakorn Proungvitaya ◽  
Tanakorn Proungvitaya ◽  
Temduang Limpaiboon ◽  
Sittiruk Roytrakul ◽  
...  

Background: Cholangiocarcinoma (CCA) is the second most common primary hepatobiliary cancer. These patients have meager prognosis and short-term survival. Precise assessment of glomerular filtration rate is a fundamental aspect of clinical care in cancer patients. Cystatin C has been proposed to be superior to creatinine, a well-known marker of renal function. This study aimed to evaluate cystatin C as a marker of GFR calculation in CCA patients. Materials and Methods: One hundred thirty serum samples from CCA patients and 32 from controls were included in this study. Serum cystatin C was measured using immunoturbidity assay. Estimated glomerular filtration rate was calculated by three equations established by chronic kidney disease epidemiology collaboration (based on creatinine and/or cystatin C). Results: Serum cystatin C in CCA patients was higher than that of controls (p=0.0002). Cystatin C was positively correlated with BUN in CCA group (p=0.019). eGFR based on cystatin C and based on both cystatin C and creatinine in CCA was low with significantly different from those of control (p<0.001). Although there was no difference in eGFR using three equations in control, creatinine based eGFR was high with significantly different from eGFR based on cystatin C and on both creatinine and cystatin C in CCA (P=0.000). Proportion in each eGFR stage by three equations showed a high sensitivity with significantly different in CCA (p<0.05). Conclusion: There was a high sensitivity of cys C with significant difference between creatinine and/or cystatin C based eGFR in CCA patients. It should be taken into consideration of mild changes in eGFR by cystatin C which is important in managing drug dosage for CCA patients.


2020 ◽  
Vol 65 (10) ◽  
pp. 602-606
Author(s):  
V. Yu. Kopylov

To assess the change in the functional state of the proximal renal tubule epithelium in patients with dyslipidemia on the background of obesity, by determining the concentration in the urine of the examined level of cystatin C and the degree of activity of the renal organ-specific enzymes neutral α-glucosidase (NAG) and L-alaninaminopeptidase (laap) during simvastatin therapy at a daily dose of 20 mg for 6 months. The study involved 88 people who were divided into three groups: control, comparison and main. The control group is a group of practically healthy individuals: 30 people, average age 20.67 ± 0.18 years, body mass index (BMI) 21.36 ± 0.4 kg/m2. Comparison group (obese): 27 people, average age 22.38 ± 0.76 years, BMI 31.48 ± 0.56 kg / m2. Patients of the main group were divided into 2 subgroups. The first main subgroup of persons with chronic heart failure stage I (CHF I) without type 2 diabetes mellitus (DM 2)) - 15 observed: average age 56.8 ± 1.8 years, BMI 30.28 ± 1.11 kg / m2. The second main subgroup (CHF I with DM 2) - 16 observed: average age 48.25 ± 2.45 years, BMI 30.37 ± 1.11 kg/m2. The study found that simvastatin therapy does not affect glomerular filtration rate in patients with asymptomatic heart dysfunction. There was an increased level of cystatin C in the urine of the comparison group compared to the control group, the concentration of cystatin C in the main subgroups was statistically significantly higher than the control group. On the background of simvastatin therapy for 6 months, the level of this analyte is statistically significantly increased. The activity of LAAP and NAG during simvastatin therapy during the follow-up period in the CHF I subgroup without DM2 significantly decreased. In the subgroup of CHF I + DM2, a decrease in the concentration of LAAP and an increase in the activity of NAG was revealed, which may indicate that the brush border epithelium dystrophy occurred during simvastatin therapy. Simvastatin therapy for 6 months in patients with the initial stage of heart failure at a daily dosage of 20 mg does not impair glomerular function in the form of reduced glomerular filtration rate (GFR). Cystatin C levels are higher in obese individuals without heart failure and significantly higher in those with asymptomatic heart failure. When treating dyslipidemia with simvastatin at a dose of 20 mg / day, there is a decrease in the activity of NAG and laap in patients with CHF I without DM2. In the result of lipid-lowering therapy with simvastatin in a daily dosage of 20 mg in patients with CHF I+D2M there is increased activity of NAG while reducing the concentration of the LAAP, which may be due to degeneration of the proximal tubular epithelium, amid additional load on a partially renal route of metabolism of simvastatin.


2008 ◽  
Vol 27 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Velibor Čabarkapa ◽  
Zoran Stošić ◽  
Mirjana Đerić ◽  
Ljiljana Vučurević-Ristić ◽  
Radmila Žeravica ◽  
...  

Serum Cystatin C in Estimating Glomerular Filtration RateUsing serum cystatin C in estimating glomerular filtration rate (GFR) has in recent times been recommended. A number of simple formulas for calculating GFR have been derived specifically from serum cystatin C concentrations. The purpose of this study was to assess the significance of cystatin C and of the two most frequently applied of these formulas in estimating glomerular filtration rate compared to serum creatinine and its derived formulas for estimating glomerular filtration rate from creatinine concentrations. The study included 74 patients: 59 were in various stages of chronic renal insufficiency (divided into two subgroups: I with GFR ≥ 60 mL/min/1.73m2and II with GFR<60 mL/min/1.73m2) and 15 on hemodialysis. A control group of 30 healthy participants was also included in the study. Serum values of cystatin C ranged from: 0.86 ± 0.16 mg/L in subgroup I, and 1.77 ± 0.79 mg/L in subgroup II, to 6.9 ± 1.83 mg/L in patients on hemodialysis. The correlation between the two formulas derived from cystatin C and the clearance of creatinine, as well as the Cockcroft and Gault's formula, was significant, while one of the formulas derived from cystatin C did not show a significant correlation with MDRD. It was concluded that serum cystatin C is a significant marker in estimating glomerular filtration rate, especially in the advanced stages of chronic renal insufficiency.


2021 ◽  
Vol 67 (3) ◽  
pp. 411-415
Author(s):  
Hayk Petrosyan ◽  
Mikhail Sckolnik ◽  
Artem Keln ◽  
Alexander Lykov ◽  
Alexander Kupchin ◽  
...  

Relevance. Chronic renal failure in patients undergoing radical cystoprostatectomy (RCPE) with various variants of urine derivation is one of the significant problems that requires an interdisciplinary approach. To date, there is an insufficient number of studies comparing a significant decrease in glomerular filtration rate (GFR) between different types of urine diversion after radical cystectomy. Purpose of research. To study glomerular filtration rate (GFR) indicators in patients who underwent radical cystectomy with a heterotopic Bricker reservoir and compare them with similar indicators in patients who underwent radical cystectomy with a « V « shaped heterotopic reservoir. To compare early postoperative complications in patients who underwent radical cystoprostatectomy with the formation of a heterotopic Bricker reservoir and with a modified V-shaped heterotopic reservoir. Materials and methods. To study and compare the dynamics of glomerular filtration rate (GFR), we retrospectively selected patients after radical cystoprostatectomy with heterotypic ileocystoplasty. Patients were divided into two groups: the control group — patients with radical cystoprostatectomy and Bricker ileocystoplasty (n=46), the study group — patients with radical cystoprostatectomy and modified V-shaped heterotopic ileocystoplasty (n=49). Results. At the stage of discharge of patients from the hospital after radical cystoprostatectomy, the level of glomerular filtration rate (GFR) was not statistically significant differences between the study and control group (P=0.3791), including patients with the presence of hydronephrosis (P=0.4664). The difference in glomerular filtration rate (GFR) between the study group and the control group was statistically significant after 6 years of dynamic follow-up. As a result, it can be argued that the dynamics of glomerular filtration rate (GFR) reduction in the study group is lower than in the control group. A particularly significant difference in glomerular filtration rate (GFR) was observed in patients with existing hydronephrosis at the preoperative stage. Conclusion. Modified «V» — shaped heterotopic urine derivation can be recommended for patients who have undergone radical cystoprostatectomy, especially with existing hydronephrosis at the preoperative stage. This method should be used in patients with chronic pyelonephritis against the background of previously diagnosed ureterohydronephrosis, which is a fairly frequent consequence of the invasive nature of the growth of bladder cancer with ureteral obstruction.  


Author(s):  
Balkar Chand ◽  
Lovleen Bhatia ◽  
Kanchan Vohra

Background: Estimated glomerular filtration rate (eGFR) is accepted as the best indicator of kidney function and commonly assessed from serum creatinine (Cr) and cystatin C (Cys-C) based equations. The present cross-sectional, observational study aimed to assess eGFR using a new and validated Full Age Spectrum (FAS) equation and compared with eGFR assessed using old and established equations in hypertensive patients. Materials and Methods: Overall, 60 subjects were recruited for the study, including 30 hypertensive patients and 30 age and sex matched healthy subjects. Serum creatinine and cystatin C were measured using commercial biochemical kits. These levels were used to derive and compare eGFR using our different equations, namely, Cockcroft and Gault (CG), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease-epidemiology collaboration (CKD-EPI), and FAS equation. Student t-test was used for comparison between two groups and One-way ANOVA test was used to find multiple comparison with-in the hypertensive and control group. Pearson’s Univariate correlation followed by multiple linear regression analysis was applied to find independent predictors of eGFR. All data were analyzed using Sigma-Stat. Results: There was significant difference found in the eGFR levels using different equations in hypertensive subjects as compared to healthy subjects (P<0.01). With–in hypertensive subjects and with-in heathy subjects, a significant difference was also reported (both P<0.01). For FAS-based GFR, age was found as independent predictor of eGFR by all FAS equations. eGFR estimated using Cr based equations resulted in significant difference in categorizing number of subjects into CKD v/s non-CKD depending on their eGFR levels. But there was no difference found for the above in serum cystatin C based equations (P=0.26). Conclusion: Present data showed that eGFR derived using all set of equations resulted in variable eGFR levels. But, use of Cr based equations instead of Cys-C or combine Cr-Cys based equations resulted in wide variation i.e. change in GFR due to change in marker.


2001 ◽  
Vol 41 (4) ◽  
pp. 175
Author(s):  
Elly Nova Lubis ◽  
Srie Yanda ◽  
Khainir Akbar ◽  
Guslihan Dasa Tjipta ◽  
Dachrul Aldy

Neonatal asphyxia can cause renal perfusion and dilution disorders and also glomerular filtration abnormality. The purpose of this study was to find renal dysfunction, which caused by neonatal asphyxia. The study was performed by cross sectional for newborn babies with asphyxia based on Apgar score in the first minute. Newborn babies without asphyxia were as control. In both group, the first micturition times were recorded, total urine output in 24 hours were counted, the mean of blood urea and creatinine serum level value examined and also glomerular filtration rate. Statistical analysis has been performed by using Fisher Exact test, Student t test and Wilcoxon Rank Sum test. All of babies in the asphyxiated and non asphyxiated group had the first micturition in 24 hours after delivery. Significant difference of oliguria incidence was found in the asphyxiated group compared to the control group (p<0,05). The mean of blood urea and creatinine serum level was significantly higher in asphyxiated (p<0,05). The mean of glomerular filtration rate in the asphyxiated group was not significantly different to the control group (p>0,05). According to the degree of asphyxia we found significantly different of renal dysfunction (p<0,05). It was concluded that the asphyxia could cause the occurrence of renal dysfunction. 


2019 ◽  
Vol 2 (3) ◽  
pp. 186-196
Author(s):  
Ahadi Aulia Rahman ◽  
Rachmat Hidayat ◽  
Sri Nita

Acute Kidney Injury (AKI) merupakan penurunan fungsi ginjal secara cepat. Penyebab AKI terbesar adalah iskemia/reperfusi yang memicu respon inflamasi dan menyebabkan kerusakan ginjal. Inflamasi merupakan respon proteksi dan perbaikan jaringan, namun dapat menyebabkan fibrosis yaitu jaringan normal digantikan oleh matriks ektraseluler seperti kolagen. Kerusakan yang terjadi pada bagian tubulointerstisial berpengaruh besar terhadap fungsi ginjal yang dapat diukur dengan GFR menggunakan cystatin C. Tujuan penelitian ini adalah untuk mengetahui pengaruh durasi iskemia-reperfusi terhadap gambaran seluler tubulointerstisial, kadar cystatin C dan GFR pada tikus Wistar serta korelasi antara gambaran seluler tubulointerstisial, kadar cystatin C dan GFR. Penelitian ini adalah penelitian eksperimental dengan desain posttest only with control group. Penelitian menggunakan 30 ekor tikus Wistar yang dilakukan di animal house dan laboratorium biomolekuler Fakultas Kedokteran Universitas Sriwijaya. Gambaran seluler tubulointerstisial, kadar cystatin C dan GFR dinilai dengan persentase fraksi area kolagen, ELISA dan rumus Larsson. Iskemia 30 menit dan reperfusi 14 hari 99,1% berpengaruh terhadap persentase fraksi area kolagen, iskemia 120 menit dan reperfusi 14 hari 98,8% berpengaruh terhadap kadar cystatin C serta 99,5% berpengaruh terhadap GFR. Terdapat korelasi yang signifikan antara persentase fraksi area kolagen dan kadar cystatin C (p=0,0001, r=0,901), serta GFR (p=0,0001, r=-0,834), lalu antara kadar cystatin C dan GFR (p=0,0001, r=-915). Durasi iskemia-reperfusi berpengaruh terhadap gambaran seluler tubulointerstisial, kadar cystatin C dan GFR serta terdapat korelasi antara gambaran seluler tubulointerstisial, kadar cystatin C dan GFR pada tikus Wistar.


2011 ◽  
Vol 32 (2) ◽  
pp. 97 ◽  
Author(s):  
Eun-Jin Bae ◽  
Ju-Seong Park ◽  
Seong-Ho Han ◽  
Young-Jin Park ◽  
You-Ri Kim ◽  
...  

2021 ◽  
Vol 9 (B) ◽  
pp. 1453-1457
Author(s):  
Azza Abd El-Shaheed ◽  
Nermine N. Mahfouz ◽  
Reham F. Fahmy ◽  
Mona A. Elabd ◽  
Hiba Sibaii ◽  
...  

Background: Obesity is well known as an independent risk factor for chronic kidney disease. Thus meticulous assessment of renal function is more essential in obese individuals. Glomerular filtration rate (GFR) is commonly estimated based on serum creatinine (Cr).  However, using Cr as marker of kidney function has some limitations and Cystatin C has been reported as an alternative marker. Aim of work: This study was designed to assess renal function using both GFR and cystatin in obese adolescents. Methods: This case-control study enrolled ninety Egyptian adolescents aged between 10 and 18 years old who were divided equally into two groups according to body mass index (obese and non-obese).  Each participant was subjected to full medical history taking, anthropometric measures, and Laboratory investigation including CBC, serum Cr, estimated GFR and cystatin C. Results:  Serum Cr level was significantly higher in obese adolescents compared to non-obese mean value (0.94) and (0.79) resepectively. Also, eGFR based on Cr was significantly lower in obese group compared to controls (73.1) and ( (85.30)respectively. Cystatin C showed non-significant higher levels in obese group versus controls with mean value (2.28) and (1.85)respectively. Cystatin C at Cut-off value of 1.525 and 95% CI showed sensitivity of 47.2% and specificity of 63.9% for evaluation of kidney affection in obese children and adolescences. Conclusion: GFR is affected in obese adolescence with elevation of serum creatinine and unexpected non significant elevation of cystatin C in obese adolescence when compared by control group. Keywords: Cystatin, Creatinine, Pediatric obesity, GFR, renal function.


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