scholarly journals Childhood Idiopathic Nephrotic Syndrome: Does the Initial Steroid Treatment Modify the Outcome? A Multicentre, Prospective Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Andrea Pasini ◽  
Cristina Bertulli ◽  
Luca Casadio ◽  
Ciro Corrado ◽  
Alberto Edefonti ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Protein ◽  
Idiopathic Nephrotic Syndrome ◽  
Age At Onset ◽  
Total Serum Protein ◽  
Total Serum ◽  
Prednisone Dose ◽  
Steroid Dependent ◽  
Prospective Cohorts ◽  
Frequent Relapsers

Background: A great majority of children with idiopathic nephrotic syndrome will relapse after successful treatment of the initial episode. The possibility that different steroid dosing regimens at onset, adjusted for risk factors, can reduce the rate of relapse represents an interesting option to investigate.Objectives: To evaluate the effect of the initial steroid regimen, adjusted for time to remission (TTR), on the frequency of relapses and steroid dependence, and to verify the influence of prognostic factors on disease course.Methods: A multicentre, prospective, cohort study. Children with nephrotic syndrome, with TTR ≤ 10 days (Group A), were given a 20-week prednisone regimen (2,828 mg/m2) and those with a TTR >10 days, a 22-week regimen (3,668 mg/m2) (Group B). Previously published retrospective data from the same centers were also evaluated. Main outcomes were: relapse rate, number of frequent relapsers + steroid dependent children and total prednisone dose after induction.Results: 143 children were enrolled. Rate of relapsed subjects (77 vs. 79%) and frequent relapsers + steroid dependent subjects (40 vs. 53%) did not differ between Groups A and B, or between the retrospective and prospective cohorts. The cumulative prednisone dose taken after the induction treatment was similar in both groups and in the retrospective and prospective cohorts. TTR was not associated with relapse risk. Age at onset and total serum protein were significantly lower in relapsing patients. At ROC analysis, the best cut-off was 5.3 years for age at onset and 4.2 g/dL for total serum protein. According to these cut-offs, older children with higher total serum protein had a higher relapse free survival rate (58%) than younger children with lower total serum protein (17%).Conclusions: TTR was not found to be a prognostic factor of relapse; because of this, different steroid regimens, adjusted for TTR, did not modify the relapse rate in any relevant measure. Conversely, younger age and low total serum protein were independent predictors of relapse risk, however this outcome was not modified by higher prednisone regimens.Clinical Trial Registration:https://www.ClinicalTrials.gov/, identifier: NCT01386957 (www.nefrokid.it).

MO317DETERMINANTS OF LENGHT OF HOSPITAL STAY  (LOS) IN NEPHROTIC SYNDROME PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Simone Accarino ◽  
Marco Colucci ◽  
Ettore Pasquinucci ◽  
Giuseppe Sileno ◽  
Vittoria Esposito ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Length Of Stay ◽  
Serum Creatinine ◽  
Serum Protein ◽  
Protein Concentration ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Total Serum Protein ◽  
Total Serum ◽  
Serum Protein Concentration

Abstract Background and Aims Generalized edema, non responsive to oral diuretics, is one of the main causes of hospital admission for nephrotic syndrome patients. Although hospital length of stay (LOS) may vary widely, in 2017 the average LOS in acute-care hospitals was lower than 8 days in OECD countries. The aim of the present study was to determine the factors commonly associated with a longer LOS in patients admitted for edema due to nephrotic syndrome in the Nephrology Unit of ICS Maugeri, Pavia, Italy Method In this retrospective study we reviewed the medical records of all patients admitted for nephrotic syndrome between 2012-2020 in the Nephrology Unit of ICS Maugeri. Inclusion criteria were the following: age between 18-85 years of age; severe edema non responsive to oral, low dose diuretics; patients with heart failure, serum creatinine > 3.5 g/dl or on dialysis treatment were excluded from the study. Patients were divided into two groups according to the length of stay: ≤ 7 days or ≥ 8 days. Age, gender, serum protein concentration, creatinine, and hemoglobin; serum cholesterol and tryglicerides, urinary protein excretion rate; types of glomerular disease, weight loss were recorded. Student T tests and one-way Anova were performed to evaluate the differences between the means. Results 60 patients (42 male, 18 female) with a total number of hospital accesses of 93 were enrolled in the study. Mean age was 66.8 ± 13.07 years. Average LOS was 9.02 ± 7.4 days. Protein excretion rate was 6.7 ± 3.6 g/24 hours at the admission and was not statistically changed at discharge. Mean total serum protein and creatinine concentration at the admission were 4.7 ± 0.8 g/dl and 1.8 ± 1.1 mg/dl respectively. Patients with LOS < 7 days were younger (64 ± 11.9 vs 69 ± 13.6 years, p <0.05), had a lower serum creatinine (1.55 ± 0.92 vs 2.08 ± 1.2 mg/dl, p>0.001) and a significantly higher total serum protein concentration (5.02 ± 0.77 vs 4.65 ± 0.76 g/dl, p< 0.001) and haemoglobin (12.6 ± 1.8 vs 11.4 ± 1.8 g/dl, p< 0.05) compared to patients with longer LOS. Proteinuria was not significantly different between the two groups (6.27 ± 3.36 vs 7.1 ± 3.9 g/24 hours, p= NS). While serum cholesterol and tryglicerides were higher in the group of patients with longer LOS, weight loss was similar in the two groups at discharge. Although the difference was not significant, the group with longer hospitalization had a greater number of patients with a diagnosis of focal segmental glomerulosclerosis (FSGS) Conclusion Our results demonstrate that age, total serum protein concentration, serum creatinine, higher lipids and probably the diagnosis of FSGS may affect the hospital length of stay of patients with nephrotic syndrome admitted for severe edema. A more aggressive diuretic treatment may be needed in elderly nephrotic syndrome patients with lower GFR and total serum protein concentration.

scholarly journals Association between Immunoglobulin M and steroid resistance in children with nephrotic syndrome: A retrospective multicenter study in Japan

Kidney360 ◽  
2021 ◽  
pp. 10.34067/KID.0004432020
Author(s):  
Tomohiro Udagawa ◽  
Yusuke Matsuyama ◽  
Mika Okutsu ◽  
Yaeko Motoyoshi ◽  
Mari Okada ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Serum Protein ◽  
Albumin Level ◽  
Initial Diagnosis ◽  
Immunoglobulin M ◽  
Steroid Resistance ◽  
Total Serum Protein ◽  
Total Serum ◽  
Steroid Resistant ◽  
Low Levels

Background: The prognosis of steroid resistant nephrotic syndrome (SRNS) in children is poorer than steroid-sensitive cases. The diagnosis is made following the response to the initial 4-week corticosteroid therapy, which might be accompanied by side effects. However, predictive indicators at initial diagnosis remain unknown. We aimed to investigate whether selectivity index (SI) and other indicators at initial diagnosis, for example, serum immunoglobulin M (IgM) and total serum protein albumin ratio (TA ratio, total serum protein level over albumin level), can predict SRNS. Methods: Eighty children were enrolled from seven hospitals in Japan between January 2008 and December 2019 (mean age 4.7; male 65.0 %). Of the enrolled 80 children, 13 (16.3 %, M:F = 5:8) had been diagnosed as steroid-resistant after the initial treatment with steroids. The association between serum IgM (tertile categories; low: 24-133; middle: 134-169; and high: 169.1-510 mg/dl), SI (<0.2 or ≥0.2), and TA ratio (tertile categories; low: 1.8-2.6; middle: 2.62-3.75; and high: 3.8-15.3) at initial diagnosis and steroid resistance was evaluated with logistic regression adjusting for age and sex. Results: Low levels of serum IgM were significantly associated with steroid resistance (adjusted odds ratio (aOR) = 6.94; 95% confidence interval (CI): 1.12-43.11). TA ratio and SI were not significantly associated with steroid resistance. Conclusions: Low levels of serum IgM at initial diagnosis might predict steroid resistance among Japanese children with idiopathic nephrotic syndrome.

PARALLEL STUDIES OF COMPLEMENT AND COAGULATION IV. EFFECT OF CARBON TETRACHLORIDE

1951 ◽  
Vol 29 (2) ◽  
pp. 48-58
Author(s):  
Christine E. Rice ◽  
Paul Boulanger ◽  
P. J. G. Plummer
Keyword(s):  
Carbon Tetrachloride ◽  
Liver Injury ◽  
Serum Protein ◽  
Guinea Pigs ◽  
Fatty Degeneration ◽  
Blood Groups ◽  
Total Serum Protein ◽  
Total Serum ◽  
Coagulation Time ◽  
Complement Activity

To determine whether liver injury would result in a parallel decline in the complement titer and coagulative properties of the blood, groups of guinea pigs were given series of injections of the liver poison, carbon tetrachloride. Marked fatty degeneration of the liver, a decline in total serum protein and albumin, a decrease in complement activity, and a prolongation of coagulation time was observed in the treated animals. A general relationship was noted between the albumin-globulin ratio and the complement titer of the serum and between the complement titer and the coagulation time of the plasma.

Muscle Weight Relationship to Serum Proteins, Hemocytes, and Hepatopancreas in the Lobster, Homarus americanus

1967 ◽  
Vol 24 (11) ◽  
pp. 2339-2354 ◽  
Author(s):  
James E. Stewart ◽  
John W. Cornick ◽  
Diane M. Foley ◽  
M. F. Li ◽  
C. M. Bishop
Keyword(s):  
Serum Protein ◽  
Physiological Condition ◽  
Serum Proteins ◽  
Homarus Americanus ◽  
Total Serum Protein ◽  
Total Serum ◽  
Experimental Conditions ◽  
Muscle Weight ◽  
Beef Liver ◽  
The Relationship

Total serum protein values, hemocyte numbers, and muscle weights were determined for 216 intermolt lobsters immediately after their capture, and for 230 others held captive under a variety of dietary and environmental conditions. Average muscle values ranged from approximately 13% to the more normal 20–25% of the live animals' weight, depending upon experimental conditions. The total serum protein up to a level of 55 mg/ml was shown to be a reliable indicator of muscle weights, although the relationship was not identical for all lobster groups. It appeared to be modified chiefly by the areas from which the different groups were taken. Diet was more important than the temperatures (5 to 14 C) in affecting changes in muscle and serum protein values. Starvation caused a greater reduction (50 to 70%) in the size of the hepatopancreas than in the muscle. Histological examination of the hepatopancreatic tissue showed that the lipid content was markedly reduced upon starvation and that a degeneration of this organ was apparent for lobsters fed a beef liver and herring diet. Measurement of serum proteins would appear to be a useful technique in experiments on lobster nutrition and have value, within specified limits, for assessing the physiological condition of wild lobsters.

THE EFFECT OF REPEATED HEAT AND COLD EXPOSURE ON SERUM PROTEIN COMPOSITION IN MAN

1967 ◽  
Vol 45 (4) ◽  
pp. 571-575 ◽  
Author(s):  
W. F. Blatt ◽  
J. Kerkay
Keyword(s):  
Serum Protein ◽  
Cold Exposure ◽  
Total Protein ◽  
Protein Composition ◽  
Total Serum Protein ◽  
Total Serum ◽  
Heat Acclimatization ◽  
Albumin Content ◽  
Protein Serum ◽  
Lipoprotein Distribution

Total protein, serum protein, and lipoprotein electrophoretic distribution and hematocrit values were determined in two groups of men during acclimatization to 6 weeks of cold and 11 days of heat respectively. After 3 weeks of cold exposure total serum protein and albumin content decreased, while the globulin fractions increased; thus, the calculated albumin/globulin ratio was significantly depressed. During the last 2 weeks, these parameters gradually returned to control values. Overall, the protein changes during heat acclimatization were minimal, although the globulins decreased slightly, yielding a small increase in the albumin/globulin ratio. The hematocrit levels were significantly lowered during both environmental exposures, whereas the lipoprotein distribution remained essentially unchanged.

scholarly journals Serum proteinogram of the Campeiro horse

2019 ◽  
Vol 71 (2) ◽  
pp. 363-368
Author(s):  
A.F. Souza ◽  
J. Schade ◽  
A.F. Ramos ◽  
M.S.M. Albuquerque ◽  
G.V. Fonteque ◽  
...  
Keyword(s):  
Serum Protein ◽  
Serum Proteins ◽  
Reference Interval ◽  
Total Serum Protein ◽  
Total Serum ◽  
Serum Concentrations ◽  
Reproductive Condition ◽  
Serum Fractions ◽  
Pregnancy Status ◽  
Biuret Method

ABSTRACT The aim of this study to measure the fractions of the total serum proteins of the Campeiro horse and identify the influences of biological variants. Blood samples were taken in 138 horses of the breed Campeiro for measuring the concentration of total serum protein by the biuret method. Serum concentrations of protein fractions were measured by electrophoresis using agarose gel. Groups were formed according to age, sex and reproductive condition. The average values of serum fractions: albumin (2.85±0.36g/dl), alpha 1 (0.28±0.11g/dl), alpha 2 (0.26±0.08g/dL) beta 1 (0.57±0.15g/dl), beta 2 (0.89±0.28g/dL), gamaglobulinas (1.86±0.34g/dL), albumin/globulin ratio (0.75±0.18) and 2.5% percentile and 97.5% had slight differences in relation to the reference interval proposed for the species. They observed higher values of alpha 1 and 2 globulins in the group from that had six to eight years old and gammaglobulins in group above 13 years old. Serum protein concentrations were similar in horses and mares and between non-pregnant and pregnant. Sex and pregnancy status did not affect serum proteinogram. Alpha and gammaglobulins have higher values as the age increases. Serum proteinogram of Campeiro horses shows variations that have to be considered in the interpretation of laboratory tests.

Automated Procedure for Simultaneously Measuring Total Globulin and Total Protein in Serum

1971 ◽  
Vol 17 (4) ◽  
pp. 301-306 ◽  
Author(s):  
John Savory ◽  
M Geraldine Heintges ◽  
Robert E Sobel
Keyword(s):  
Serum Protein ◽  
Total Protein ◽  
Continuous Flow ◽  
Gamma Globulin ◽  
Glyoxylic Acid ◽  
Total Serum Protein ◽  
Total Serum ◽  
Serum Globulin ◽  
Automated Method ◽  
A Minor

Abstract An automated continuous-flow procedure has been developed for simultaneously measuring total serum protein and globulin. The method for total protein is a minor modification of an existing automated method in which the biuret reagent is used. Total globulin is measured by reaction with glyoxylic acid, and standardized with N-acetyltryptophan. An empirical factor relating concentration of N-acetyltryptophan to human globulin has been derived. Values for total serum globulin obtained by this new automated procedure correlate closely with values obtained by electrophoresis, but do not agree with values obtained by use of procedures involving binding of anionic dye. Recovery of gamma globulin added to serum is essentially quantitative; the day-to-day precision (CV) is 4.31%.

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