scholarly journals Albuminuria and glomerular filtration rate in obese children and adolescents

2019 ◽  
Vol 41 (2) ◽  
pp. 193-199
Author(s):  
Luciana Satiko Sawamura ◽  
Gabrielle Gomes de Souza ◽  
Juliana Dias Gonçalves dos Santos ◽  
Fabíola Isabel Suano-Souza ◽  
Anelise Del Vecchio Gessullo ◽  
...  

Abstract Objective: To describe the frequency of albuminuria in overweight and obese children and adolescents and to relate it to the severity of obesity, pubertal staging, associated morbidities and the glomerular filtration rate. Method: Cross-sectional study including 64 overweight and obese children and adolescents between 5 and 19 years of age. Data collected: weight, height, waist circumference and systemic arterial pressure. Laboratory tests: lipid profile; glycemia and insulin, used to calculate the Homeostasis Model Assessment (HOMA-IR); C-reactive protein; glutamic-pyruvic transaminase and albuminuria in an isolated urine sample (cutoff <30 mg/g). Creatinine was used to calculate the estimated glomerular filtration rate (eGFR, mL/min/1.73 m2). Results: The mean age was 11.6 ± 3.4 years, 32 (50%) and 29 (45.3%) were male and prepubertal. Forty-six (71.9%) had severe obesity. The frequency and median (min/max) of the observed values for albuminuria (> 30 mg/g) were 14 (21.9%) and 9.4 mg/g (0.70, -300.7 mg/g). The mean eGFR was 122.9 ± 24.7 mL/min/1.73 m2. There was no significant correlation between body mass index, pubertal staging, insulin and HOMA-IR with albuminuria values and neither with eGFR. Children with albuminuria tended to have higher values of diastolic blood pressure (75.0 ± 12.2 vs. 68.1 ± 12.4, p = 0.071). Conclusion: Albuminuria, although frequent in children and adolescents with obesity, was not associated with other morbidities and the glomerular filtration rate in these patients.

2017 ◽  
Vol 50 (2) ◽  
pp. 82-89 ◽  
Author(s):  
Flávio Augusto Teixeira Ronzani ◽  
Filomena Maria Kirchmaier ◽  
Nathália Mussi Monteze ◽  
Edson José de Carvalho Magacho ◽  
Marcus Gomes Bastos ◽  
...  

Abstract Objective: The aim of this study was to evaluate breast arterial calcification (BAC) detected on routine mammography, analyzing its association with chronic degenerative disease. Materials and Methods: This was a cross-sectional study involving women treated at a specialized outpatient clinic for high-risk hypertension, diabetes, or chronic kidney disease, as well as volunteers who participated in a study to validate a method of screening for occult renal disease. A total of 312 patients between 40 and 69 years of age, with no history of breast cancer, all of whom had undergone routine mammography in the last two years, were included. The mammograms were analyzed by researchers who were unaware of the risk factors for BAC in each case. Results: The mean age was 55.9 ± 7.4 years, and 64.3% of the patients were white. The mean glomerular filtration rate was 41.87 ± 6.23 mL/min/1.73 m2. Seventy-one patients (22.8%) had BAC. We found that BAC was associated with advanced age, hypertension, diabetes, chronic kidney disease, and low glomerular filtration rate. In the multivariate analysis, advanced age and diabetes continued to be associated with BAC. The odds ratio for BAC was higher for all chronic diseases. Conclusion: The association of BAC with advanced age, hypertension, diabetes, chronic kidney disease, and low glomerular filtration rate should call the attention of radiologists. Therefore, the presence of BAC should be reported, and patients with BAC should be screened for those diseases.


2019 ◽  
Vol 6 (5) ◽  
pp. 1931
Author(s):  
Gabriel O. Ezeh ◽  
Oluseyi Oniyangi ◽  
Iretiola B. Babaniyi ◽  
Vincent E. Nwatah ◽  
Felicia U. Eke

Background: Kidney disease is more common in people of African descent in developed countries. Studies reporting estimate Glomerular Filtration Rate (eGFR) in African populations and people living with HIV have been carried more frequently on adults than children. The study aimed to assess eGFR by use of the SCHWARTZ formula in HIV infected children seen at tertiary hospital.Methods: A descriptive, prospective and cross sectional study of 221 children with HIV infection. Schwartz formula was used to determine eGFR. The main outcome measures were eGFR. The study population comprised HIV infected children attending Paediatric out-patients’ clinic and those admitted into the Paediatric wards, aged between 6 months and 15 years. Data was analysed using SPSS version 20 and results presented in tables and figures. Results: The age range of the study subjects was 12 months to 15 years with the mean age and SD of 8.21±3.61 years. There were 129 (58.4%) male and 92 (41.6%) female children with male to female ratio 1: 0.7.  The mean age for males was 7.87±3.49 years while that for females was 8.70±3.71 years. The eGFR for the study as determined by Schwartz formula had a range of 49.21 to 463.67 ml/ min/ 1.73m2 with the mean of 159.56±59.04 ml/min. The mean eGFR for the males and females were 166.39±63.54ml/ min and 149.99±45.01 ml/ min respectively. Conclusion: The study, in comparison with other studies, observed a lower prevalence of CKD in HIV infected children. Detection of CKD in HIV infection children may be more optimal if combined methods are employed.


2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Naowanit Nata ◽  
Ram Rangsin ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj

Background. Type 2 diabetic mellitus (T2DM) patients with impaired renal function have a higher risk of mortality, and often progress to end-stage renal disease. The study aims to determine the prevalence of kidney disease and investigate the relationship between various factors and impaired renal function in a large population of patients with T2DM. Methods. We conducted a cross-sectional study among 30,377 patients from a nationwide diabetes study involving 602 Thai hospitals. Impaired glomerular filtration rate (GFR) was defined as <60 mL/min per 1.73 m2. Multivariate logistic regression was used to determine the association between standard risk factors and impaired GFR. Results. The prevalence of impaired GFR in a T2DM population was 39.2%. After adjusting for multiple risk factors, advanced age (adjusted OR 11.69 (95%CI=3.13 to 43.61)), macroalbuminuria (adjusted OR 3.54 (95%CI=1.50 to 8.40)), high serum uric acid (adjusted OR 2.06 (95%CI=1.73 to 2.46)), systolic BP 130-139 mmHg (adjusted OR 3.21 (95%CI=1.30 to 7.96)), hemoglobinA1C (HA1C) <6% (adjusted OR 3.71 (95%CI=1.65 to 8.32)), and HA1C >7% (adjusted OR 2.53 (95%CI=1.38 to 4.63)) were found to be associated with a significantly increased risk of impaired GFR among T2DM patients. Conclusion. Almost 40% of patients with T2DM in a nationwide cross-sectional study in Thailand had impaired GFR. Advanced age, albuminuria, hyperuricemia, hypertension, HA1C <6%, and HA1C >7% were independently associated with increased prevalence of impaired GFR.


2020 ◽  
Vol 7 ◽  
pp. 205435811989931 ◽  
Author(s):  
Andrea Wallace ◽  
April Price ◽  
Erin Fleischer ◽  
Michael Khoury ◽  
Guido Filler

Background: Patients with cystic fibrosis (CF) have frequent infectious complications requiring nephrotoxic medications, necessitating monitoring of renal function. Although adult studies have suggested that cystatin C (CysC)-based estimated glomerular filtration rate (eGFR) may be preferable due to reduced muscle mass of patients with CF, pediatric patients remain understudied. Objective: Our objective was to determine which eGFR formula is best for estimating glomerular filtration rate (GFR) in pediatric patients with CF. Methods: A total of 17 patients with CF treated with nephrotoxic antibiotics were recruited from the Children’s Hospital at London Health Sciences Centre, London, Ontario, Canada. 99Tc DTPA GFR (measured GFR [mGFR]) was measured with 4-point measurements starting at 120 minutes using a 2-compartmental model with Brøchner-Mortensen correction, with simultaneous measurement of creatinine, urea, and CysC. The eGFR was calculated using 16 known equations based on creatinine, urea, CysC, or combinations of these. Primary outcome measures were correlation with mGFR, and agreement within 10% for various eGFR equations. Results: Mean mGFR was 136 ± 21 mL/min/1.73 m2. Mean creatinine, CysC, and urea were 38 ± 10 μmol/L, 0.72 ± 0.08 mg/L, and 3.9 ± 1.4 mmol/L, respectively. The 2014 Grubb CysC eGFR had the best correlation coefficient ( r = 0.75, P = .0004); however, only 35% were within 10%. The new Schwartz formula with creatinine and urea had the best agreement within 10%, but a relatively low correlation coefficient ( r = 0.63, P = .0065, 64% within 10%). Conclusions: Our study suggests that none of the eGFR formulae work well in this small cohort of pediatric patients with CF with preserved body composition, possibly due to inflammation causing false elevations of CysC. Based on the small numbers, we cannot conclude which eGFR formula is best.


2012 ◽  
Vol 5 (1) ◽  
Author(s):  
Elisabet Nerpin ◽  
Johanna Helmersson-Karlqvist ◽  
Ulf Risérus ◽  
Johan Sundström ◽  
Anders Larsson ◽  
...  

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