scholarly journals Profile of estimated glomerular filtration rate of children with Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome

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.

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.


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.


2017 ◽  
Vol 5 (4) ◽  
pp. 315-322
Author(s):  
Mark Fernandez Bedoya ◽  
Maria A. Hegeman

Continued progression of kidney disease will lead to renal function too low to sustain healthy life. In developed countries, such people will be offered renal replacement therapy in the form of dialysis or renal transplantation. Estimates of glomerular filtration rate (GFR) that are based on serum creatinine are routinely used; however, they are imprecise, potentially leading to the overdiagnosis of chronic kidney disease. The purpose of this study is to evaluate the glomerular filtration rate from serum creatinine in Brazil patients with chronic kidney disease (CKD). Multiple equations exist to estimate glomerular filtration rate (GFR); however, there is no consensus on which is superior for risk classification in patients with chronic kidney disease (CKD). Renal function was analyzed through serum creatinine and glomerular filtration rate (GFR) estimated according to the CG, MDRD and CKD-EPI equations, available on the websites of the Brazilian Nephrology Society (SBN) and the (NKF) by using cross-sectional analyses in diverse populations totaling 3949 participants.


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.


2014 ◽  
pp. 73-77
Author(s):  
Van Chuong Nguyen ◽  
Thi Kim Anh Nguyen

Background: A Research glomerular filtration rate (GFR) of 61 patients with type 2 diabetes mellitus with renal scanning 99mTc-DTPA glomerular filtration rate at the hospital 175. Objective: (1) To study characteristics of imaging of renal function. (2) Understanding the relationship between GFR with blood sugar, HbA1c, blood pressure and albuminuria in patients with type 2 diabetes. Methods: Descriptive, prospective, cross-sectional study. Clinical examination, Clinical tests and 99mTc-DTPA GFR gamma - camera renography for patients. Result: GFR of the study group was 75,4 ± 22,3 ml/phut/1,73m2, the left kidney was 35,0 ± 13,0 is lower than the right kidney and 39,8 ± 11,9; p <0,01. There is no correlation between GFR with blood glucose and HbA1c, the risk of reduced GFR in hypertensive group associated is OR = 6,5 with p<0,01; albuminuria (+) is OR = 4,2 with p <0,01; and disease duration > 10 years is OR = 3,5 with p <0.01. Conclusion: GFR of the left kidneys is lower than the right kidney; correlation decreased GFR associated with hypertension, albuminuria and disease duration. Keywords: GFR, diabetes, albuminuria


1983 ◽  
Vol 245 (5) ◽  
pp. R743-R748 ◽  
Author(s):  
R. W. Davis ◽  
M. A. Castellini ◽  
G. L. Kooyman ◽  
R. Maue

Renal and hepatic function were studied during voluntary dives in Weddell seals by measuring the clearance rate of inulin and indocyanine green (ICG). Inulin is cleared exclusively by the kidneys and measures renal glomerular filtration rate (GFR). ICG is cleared by the liver and is blood flow dependent at concentrations used. Studies were conducted from a portable hut with a trapdoor placed over an isolated hole in the sea ice near McMurdo Station, Antarctica. An intravertebral extradural catheter was inserted percutaneously under light anesthesia in subadult seals weighing 130-200 kg. When released into the ice hole, the seals made voluntary dives, but always had to return to breathe. Serial blood samples were taken after single injections of inulin and ICG and analyzed within 24 h. The mean half time (t 1/2) for inulin clearance while resting at the surface was 27.3 +/- 13.0 min (n = 43) and the mean t 1/2 for ICG clearance was 18.3 +/- 7.3 min (n = 23). The mean resting GFR was 3.6 ml X min-1 X kg-1 (range 3.2-3.9, n = 3). Inulin and ICG clearance rates did not change from resting levels during dives shorter than the seal's aerobic dive limit (ADL). Inulin clearance decreased over 90% during dives longer than the ADL, but there was no significant reduction in ICG clearance during dives lasting up to 23 min. It appears that normal renal GFR and hepatic blood flow continue during natural aerobic dives. During dives that exceed the ADL, GFR is reduced but hepatic blood flow may be maintained.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Negreanu ◽  
Michael Gagnon ◽  
anh nguyen ◽  
Samer Mansour ◽  
Michel T Nguyen ◽  
...  

Background: The incidence and predictors of contrast-induced nephropathy (CIN) in patients with normal glomerular filtration rate (GFR) are not well ascertained. We aim to determine the incidence and predictors for CIN after coronary catheterization (CATH) for acute coronary syndromes (ACS). Methods: We combined the datasets of two studies. The AMI-QUEBEC was an observational cohort of patients with ST-segment elevation myocardial infarctions in 2003. The AMI-OPTIMA was a study of patients hospitalized with ACS in 2009 and 2012. For this analysis, we retained only patients with GFR > 60 ml/min who underwent CATH. We defined “hyperfiltrators” as patients with GFR above the 95th percentile age and sex-adjusted value. CIN was defined as an increase in serum creatinine >0.5 mg/dL (44.2 μmols/L) or > 50% from baseline serum creatinine. Results: There were 3,188 patients with GFR > 60 ml/min : 39 hyperfiltrators and 3,149 without hyperfiltration. The mean age was similar between the two groups of patients (62 years); 21% and 27% females in hyperfiltrators and non-hyperfiltrators (p<0.0001). The prevalences of diabetes mellitus and hypertension were 36% and 64%, respectively in hyperfiltrators compared to 20% and 46%, respectively in non-hyperfiltrators. The mean baseline GFR and creatinine were 112 ml/min and 50 μmols/L, respectively in hyperfiltrators; 84.2 ml/min and 80 μmols/L in non-hyperfiltrators. There were 225 CIN following CATH; 7.1% of the whole cohort with 35.9% in the hyperfiltrators and 6.7% in non-hyperfiltrators. Hyperfiltration was independently associated with a 13-fold increase in the risk of CIN (Table 1). Each year of increase in age was associated with a 5% increase in the risk of CIN. Shock was also associated with an 11-fold increase in the risk of CIN. Conclusion: Hyperfiltrators may be at high risk of CIN following CATH in ACS. The risk of CIN associated with hyperfiltration should be evaluated in other populations.


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