scholarly journals Antiproteinuric effects of cilnidipine and amlodipine as add on therapy in hypertensive patients with chronic renal disease: a comparative study

2017 ◽  
Vol 6 (10) ◽  
pp. 2482
Author(s):  
Y. Nisha Maheswari ◽  
B. Meenakshi ◽  
V. Ramasubramanian D. M. ◽  
J. Ezhil Ramya
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Renal Disease ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Open Label ◽  
Hypertensive Patients ◽  
Spot Urine ◽  
Amlodipine Group ◽  
Group B

Background: Cilnidipine is a dual blocker of L type and N type calcium channel and dilates both afferent and efferent arterioles. Hence it increases renal blood flow and reduces glomerular pressure ultimately reducing proteinuria. Thus, it may exert renoprotective effects. The present study was designed to compare the antiproteinuric effects of cilnidipine and amlodipine in hypertensive patients with chronic kidney disease as add on therapy to patients on losartan.Methods: This is a randomized, open label, prospective, parallel group study conducted in the out patient Department of Nephrology. The trial enrolled Diabetic CKD patients with hypertension and with spot urine protein creatinine ratio (PCR) ≥0.2 who were being treated with T. Losartan 50mg/day for >2 months. The subjects were then randomly assigned to 2 groups to receive either cilnidipine 10-20mg/day (Group A-46) or amlodipine 5-10mg/day (Group B- 50). The drugs were given for a duration of 6 months for each patient. The dose of losartan (50mg/day) was not adjusted throughout the study.Results: After 6 months, a significant reduction in systolic and diastolic blood pressure was seen in both the groups. The decrease in urinary protein creatinine ratio was significantly higher in cilnidipine group rather than amlodipine group. Thus, cilnidipine exerted greater antiproteinuric effect than amlodipine.Conclusions: Cilnidipine has antihypertensive effect equivalent to amlodipine but addition of cilnidipine rather than amlodipine to losartan decreased urine protein excretion in diabetic chronic kidney disease patients.

scholarly journals Accuracy of spot urine protein creatinine ratio in measuring proteinuria in chronic kidney disease stage 3 and 4

2013 ◽  
Vol 23 (6) ◽  
pp. 428 ◽  
Author(s):  
RA Annigeri ◽  
V Vadamalai ◽  
R Seshadri ◽  
S Balasubramanian ◽  
BS Rao ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Chronic Kidney Disease Stage ◽  
Disease Stage ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine

Spot urine protein creatinine ratio compared with dipstick proteinuria as a primary screening tool for renal disease in a community setting

2021 ◽  
Author(s):  
Michael Abel Alao ◽  
Asinobi OA ◽  
Ibrahim OR ◽  
Lagunju IA
Keyword(s):  
High Risk ◽  
Kidney Disease ◽  
Renal Disease ◽  
Screening Tool ◽  
Healthy Children ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine ◽  
Primary Screening ◽  
Dipstick Urinalysis

Abstract Background Although, the use of manual dipstick urinalysis for proteinuria has been a common practice, the Kidney Disease Improving Global Outcomes (KDIGO) guideline on screening for chronic renal disease least advocate it use. Besides, several studies have assessed the performance of dipstick urinary in screening for proteinuria to be inaccurate, unreliable with a poor predictive values. The goal of this study was to determine and compare the presence of significant proteinuria (SP) in high-risk African children using the spot urine protein creatinine ratio (UPr/UCr) as a primary screening tool besides dipstick proteinuria screening. Methods This cross-sectional study involved 1,316 apparently healthy children recruited through a multi-stage sampling technique in Ogbomoso land, Nigeria. We performed a dipstick urinalysis on early-morning urine samples. Urinary protein content was determined using a turbidimetric method and Jaffe’s reaction to measure the urinary creatinine concentration. Statistical analysis was performed using the IBM Statistical Package for Social Sciences (SPSS)TM, Version 23.0 for Windows. Results The prevalence of SP using spot UPr/UCr (≥ 0.2) and dipstick proteinuria screening (≥1+) were 18% and 0.8%, respectively (p<0.001). Of the 224 subjects determined to have SP using UPr/UCr, the females (140; 20.1%) had a higher proportion compared to males (84; 15.4% -p=0.032). Nephrotic range proteinuria was detected in nine out of 10 subjects (90%) using UPr/UCr but in only three out of ten (30%) using the urinary dipstick method. The biserial correlation coefficient (r= 0.092; p=0.001) and inter-rater-agreement (Cohen’s Kappa = 0.01) were poor, and the McNemar’s test result was (p<0.001). Conclusion The UPr/UCr ratio technique appeared to perform better than dipstick urinalysis as a primary screening tool for renal disease. Hence, it may be adopted for early detection of SP as a kidney disease marker especially among the high risk population.

scholarly journals Serum Carnosinase-1 and Albuminuria Rather than the CNDP1 Genotype Correlate with Urinary Carnosinase-1 in Diabetic and Nondiabetic Patients with Chronic Kidney Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Angelica Rodriguez-Niño ◽  
Sibylle J. Hauske ◽  
Anna Herold ◽  
Jiedong Qiu ◽  
Jacob van den Born ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Healthy Subjects ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Creatinine Ratio ◽  
Healthy Individuals ◽  
Albumin Creatinine Ratio ◽  
Spot Urine

Background. Carnosinase-1 (CN-1) can be detected in 24 h urine of healthy individuals and patients with type 2 diabetes (T2DM). We aimed to assess whether urinary CN-1 is also reliably measured in spot urine and investigated its association with renal function and the albumin/creatinine ratio (ACR). We also assessed associations between the CNDP1 (CTG)n genotype and CN-1 concentrations in serum and urine. Methods. Patients with T2DM (n=85) and nondiabetic patients with chronic kidney disease (CKD) (n=26) stratified by albuminuria (ACR≤300 mg/g or ACR>300 mg/g) recruited from the nephrology clinic and healthy subjects (n=24) were studied. Results. Urinary CN-1 was more frequently detected and displayed higher concentrations in patients with ACR>300 mg/g as compared to those with ACR≤300 mg/g irrespective of the baseline disease (T2DM: 554 ng/ml [IQR 212-934 ng/ml] vs. 31 ng/ml [IQR 31-63 ng/ml] (p<0.0001) and nondiabetic CKD: 197 ng/ml [IQR 112-739] vs. 31 ng/ml [IQR 31-226 ng/ml] (p=0.015)). A positive correlation between urinary CN-1 and ACR was found (r=0.68, p<0.0001). Multivariate linear regression analysis revealed that ACR and serum CN-1 concentrations but not eGFR or the CNDP1 genotype are independent predictors of urinary CN-1, explaining 47% of variation of urinary CN-1 concentrations (R2=0.47, p<0.0001). Conclusion. These results confirm and extend previous findings on urinary CN-1 concentrations, suggesting that assessment of CN-1 in spot urine is as reliable as in 24 h urine and may indicate that urinary CN-1 in macroalbuminuric patients is primarily serum-derived and not locally produced.

scholarly journals Association of uric acid and uric acid to creatinine ratio with chronic kidney disease in hypertensive patients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Nathalia Rabello Silva ◽  
Camila Evangelista Torres Gonçalves ◽  
Danilo Lemes Naves Gonçalves ◽  
Rosângela Minardi Mitre Cotta ◽  
Luciana Saraiva da Silva
Keyword(s):  
Chronic Kidney Disease ◽  
Uric Acid ◽  
Kidney Disease ◽  
Serum Uric Acid ◽  
Roc Curve ◽  
Care Service ◽  
Health Care Service ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Hypertensive Patients

Abstract Background Recent studies have shown that the serum uric acid/creatinine ratio (SUA/SCr) is a better predictor of chronic kidney disease (CKD) than serum uric acid (SUA) isolated. The aim of the present study was to evaluate the association of isolated SUA and the SUA/SCr with CKD in hypertensive patients. Methods Cross-sectional study conducted with hypertensive patients followed-up by the Primary Health Care Service (PHC). Sociodemographic, economic, lifestyle, clinical, anthropometric, and biochemical variables were evaluated. The association between SUA parameters (quartiles of SUA and quartiles of SUA/SCr) and CKD was evaluated by bivariate and multivariate logistic regression. The association between SUA parameters (SUA and SUA/SCr) and estimated glomerular filtration rate (eGFR) was evaluated by linear regression. The analyses were performed considering four adjustment models. SUA and SUA/SCr were compared by receiver operating characteristic (ROC) curve. Results In the fully adjusted model, SUA was positively associated with the presence of CKD (OR = 6.72 [95 % CI 1.96–22.96]) and inversely associated with eGFR (β Coef. = -2.41 [95 % CI -3.44; -1.39]). SUA/SCr was positively associated with eGFR (β Coef. = 2.39 [1.42; 3.36]). According to the ROC curve, the SUA is a better predictor of CKD than the SUA/SCr. Conclusions Elevated levels of isolated SUA were associated with CKD and eGFR. However, the SUA/SCr was not associated with CKD. We do not recommend using the SUA/SCr to predict CKD in hypertensive patients.

Proteinuria in HIV-infected Indian children

2016 ◽  
Vol 47 (3) ◽  
pp. 230-233 ◽  
Author(s):  
Gopila Gupta ◽  
Alok Hemal ◽  
Abhijeet Saha ◽  
Kanika Kapoor ◽  
Parul Goyal ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Creatinine Ratio ◽  
End Stage Kidney Disease ◽  
Urine Protein ◽  
Indian Children ◽  
Spot Urine ◽  
Advanced Stages ◽  
Study Population ◽  
End Stage ◽  
Stage 1

Chronic kidney disease (CKD) is a major cause of morbidity and mortality among individuals with HIV infection. Screening for proteinuria in HIV-infected children will help in early detection and treatment, and thus prevention and progression to CKD to end-stage kidney disease (ESRD). We screened 139 HIV-infected children aged 18 months to 18 years for proteinuria by urinary dipstick and confirmed by spot urine protein-to-creatinine ratio. If proteinuria was absent by the above methods, patients were screened for microalbuminuria by urinary albumin to creatinine ratio. We found proteinuria in 11.5% and microalbuminuria in 10.6% of our study population. The prevalence of proteinuria was higher in the advanced stages; 8.05% in stage 1, 12.12% in stage 2 and 26.32% in stages 3 + 4.

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