scholarly journals Obesity Facts and Their Influence on Renal Function Across the Life Span

2021 ◽  
Vol 8 ◽  
Author(s):  
Vera H. Koch
Keyword(s):  
Cystatin C ◽  
Plasma Levels ◽  
Filtration Rate ◽  
Population Level ◽  
Overweight And Obesity ◽  
Systemic Arterial Hypertension ◽  
Single Nephron ◽  
Definition Of ◽  
Laboratory Assay ◽  
The Ideal

Obesity is a chronic disease, with a rapidly increasing prevalence worldwide. Body mass index (BMI) provides the most useful population-level measure of overweight and obesity. For adults, overweight is defined as a BMI (Kg/m2) ≥ 25, and obesity as a BMI ≥ 30, for non-Asians and ≥ 27.5 for Asians. Abdominal obesity can be defined as a waist circumference equal to or higher than 102 cm for men and ≥88 cm for women. The definition of children and adolescents BMI changes with age and sex. Obesity may be exogenous or endogenous obesity, the latter is multifactorial and predominantly manifested during childhood. Presently, overweight and obesity are linked to more deaths worldwide than underweight. The total kidney glomerular filtration rate (GFR) is determined by the sum of nephrons and the GFR within each nephron or single nephron GFR. In clinical practice, GFR is more frequently calculated by GFR estimating equations based upon the plasma levels of creatinine, cystatin C, or both. The measured value of plasma creatinine is strongly influenced by non-GFR factors, by its tubular and gastrointestinal secretion, and by the problems associated with the lack of standardization of creatinine's laboratory assay discrediting it as an ideal GFR biomarker. Unlike creatinine, cystatin C plasma levels are mainly determined by GFR. Obesity may affect the kidney, via development of systemic arterial hypertension and/or diabetes mellitus, or directly, by ectopic accumulation of adipose tissue in the kidney. As obesity is a clinical condition associated with altered body composition, creatinine may not be the ideal biomarker for GFR measurement in obese individuals.

scholarly journals Plasma Cystatin C and Estimates of Glomerular Filtration Rate Using Cystatin C Independently Diagnose Acute Kidney Injury in Critically Ill Patients with Sepsis

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Azrina Md Ralib ◽  
Iqbalmunawwir Ab Rashid ◽  
Nur Aisyah Ishak ◽  
Suhaila Nanyan ◽  
Nur Fariza Ramly ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Critically Ill ◽  
Cystatin C ◽  
Clinical Setting ◽  
Critically Ill Patients ◽  
Filtration Rate ◽  
Kidney Injury ◽  
The Ideal

Introduction: Plasma Cystatin C (CysC) is as an early functional marker for acute kidney injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing acute kidney injury (AKI) and predicting death in critically ill patients with sepsis.  Materials and method: This is an interim analysis of single centre, prospective observational study of critically ill patients. Inclusion criteria were patients older than 18 years old with sepsis and procalcitonin > 0.5ng/ml. Plasma creatinine and CysC were measured on admission, and eGFRCysC. AKI was defined based on the plasma creatinine criteria of the KDIGO guideline.  Results: Thirty one patients were recruited so far, of which 13 (41.9%) had AKI and six died. CysC were higher in patients with AKI versus No AKI (p<0.001), and corresponding eGFRCysC were lower (p=0.006). CysC and eGFRCysC on ICU admission diagnosed AKI with an AUC of 0.88(0.72 to 1.00), and 0.79 (0.62 to 0.96), respectively. Both did not predict death (AUC 0.59 (0.31 to 0.87) and 0.59 (0.31 to 0.86), respectively). After adjusting for age and SOFA score, both CysC and eGFRCysC independently diagnosed AKI (OR 13 (1.5 to 115) and 1.03 (1.01 to 1.06), respectively). The ideal cut-off point for diagnosing AKI for CysC is 1.5 mg/dl (84% sensitivity and 89% specificity) and for eGFRCysC as 77 ml/min (72% sensitivity and 84% specificity).  Conclusion: Plasma CysC and its estimated GFR independently diagnosed AKI in critically ill patients with sepsis. We suggest the ideal cut-off points of 1.5 mg/dl and 77 ml/min which can be used in the clinical setting in this cohort of patients.

Features of glomerular filtration rate evaluation for kidney function assessment in patients with rheumatoid arthritis

2020 ◽  
pp. 44-48
Author(s):  
V. A. Aleksandrov ◽  
L. N. Shilova ◽  
A. V. Aleksandrov
Keyword(s):  
Rheumatoid Arthritis ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Initial Assessment ◽  
Serum Cystatin C ◽  
Creatinine Concentration

The development of renal dysfunction in patients with rheumatoid arthritis (RA) is due to the presence and severity of autoimmune disorders, chronic systemic inflammation, a multiplicity of comorbid conditions, and pharmacotherapy features. The most important parameter that describes the general condition of the kidneys is glomerular filtration rate (GFR). This review presents the data on the possibilities of modern methods for determining estimated GFR (e-GFR) and the specificity of their use in various clinical situations that accompany the course of RA. For the initial assessment of GFR in patients with RA it is advisable to use the measurement of e-GFR based on serum creatinine concentration using the CKD-EPI equation (2009) (with or without indexing by body surface area). In cases where the e-GFR equations are not reliable enough or the results of this test are insufficient for clinical decision making, the serum cystatin C level should be measured and the combined GFR calculation based on creatinine and cystatin C should be used.

scholarly journals Divergence between serum creatine and cystatin C in estimating glomerular filtration rate of critically ill COVID-19 patients

Renal Failure ◽  
2021 ◽  
Vol 43 (1) ◽  
pp. 1104-1114
Author(s):  
Yanan Liu ◽  
Peng Xia ◽  
Wei Cao ◽  
Zhengyin Liu ◽  
Jie Ma ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Critically Ill ◽  
Cystatin C ◽  
Filtration Rate

scholarly journals Serum NGAL, BNP, PTH, and albumin do not improve glomerular filtration rate estimating formulas in children

2021 ◽  
Author(s):  
Julie Mouron-Hryciuk ◽  
François Cachat ◽  
Paloma Parvex ◽  
Thomas Perneger ◽  
Hassib Chehade
Keyword(s):  
Glomerular Filtration Rate ◽  
Parathyroid Hormone ◽  
Serum Creatinine ◽  
Brain Natriuretic Peptide ◽  
Glomerular Filtration ◽  
Natriuretic Peptide ◽  
Cystatin C ◽  
Filtration Rate ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Neutrophil Gelatinase

AbstractGlomerular filtration rate (GFR) is difficult to measure, and estimating formulas are notorious for lacking precision. This study aims to assess if the inclusion of additional biomarkers improves the performance of eGFR formulas. A hundred and sixteen children with renal diseases were enrolled. Data for age, weight, height, inulin clearance (iGFR), serum creatinine, cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), parathyroid hormone (PTH), albumin, and brain natriuretic peptide (BNP) were collected. These variables were added to the revised and combined (serum creatinine and cystatin C) Schwartz formulas, and the quadratic and combined quadratic formulas. We calculated the adjusted r-square (r2) in relation to iGFR and tested the improvement in variance explained by means of the likelihood ratio test. The combined Schwartz and the combined quadratic formulas yielded best results with an r2 of 0.676 and 0.730, respectively. The addition of BNP and PTH to the combined Schwartz and quadratic formulas improved the variance slightly. NGAL and albumin failed to improve the prediction of GFR further. These study results also confirm that the addition of cystatin C improves the performance of estimating GFR formulas, in particular the Schwartz formula.Conclusion: The addition of serum NGAL, BNP, PTH, and albumin to the combined Schwartz and quadratic formulas for estimating GFR did not improve GFR prediction in our population. What is Known:• Estimating glomerular filtration rate (GFR) formulas include serum creatinine and/or cystatin C but lack precision when compared to measured GFR.• The serum concentrations of some biological parameters such as neutrophil gelatinase-associated lipocalin (NGAL), parathyroid hormone (PTH), albumin, and brain natriuretic peptide (BNP) vary with the level of renal function. What is New:• The addition of BNP and PTH to the combined quadratic formula improved its performance only slightly. NGAL and albumin failed to improve the prediction of GFR further.

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