Dehydration Status Aggravates Early Renal Impairment in Children: A Longitudinal Study

Dehydration is common in children for physiological and behavioral reasons. The objective of this study was to assess changes in hydration status and renal impairment across school weekdays. We conducted a longitudinal study of three repeated measures of urinalysis within one week in November 2019 in a child cohort in Beijing, China. We measured urine specific gravity (USG) to determine the dehydration status, and the concentration of β2-microglobulin (β2-MG) and microalbumin (MA) to assess renal function impairment among 1885 children with a mean age of 7.7 years old. The prevalence of dehydration was 61.9%, which was significantly higher in boys (64.3%). Using chi-square tests and linear mixed-effects regression models, we documented the trends of the renal indicators’ change over time among different hydration statuses. Compared to Mondays, there were apparent increases of β2-MG concentrations on Wednesdays (β = 0.029, p < 0.001) and Fridays (β = 0.035, p < 0.001) in the dehydrated group, but not in the euhydrated group. As for the MA concentrations, only the decrease on Fridays (β = −1.822, p = 0.01) was significant in the euhydrated group. An increased trend of elevated β2-MG concentration was shown in both the euhydrated group (Z = −3.33, p < 0.001) and the dehydrated group (Z = −8.82, p < 0.001). By contrast, there was a decreased trend of elevated MA concentrations in the euhydrated group (Z = 3.59, p < 0.001) but not in the dehydrated group. A new indicator ratio, β2-MG/MA, validated the consistent trends of renal function impairment in children with dehydration. Renal impairment trends worsened as a function of school days during the week and the dehydration status aggravated renal impairment during childhood across school weekdays, especially tubular abnormalities in children.

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Renal function impairment in cervical cancer patients treated with cisplatin-based chemoradiation: A review of medical records in a Zimbabwean outpatient department

PLoS ONE ◽

10.1371/journal.pone.0245383 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0245383

Author(s):

Pinky M. C. Manyau ◽

Mensil Mabeka ◽

Tinashe Mudzviti ◽

Webster Kadzatsa ◽

Albert Nyamhunga

Keyword(s):

Cervical Cancer ◽

Renal Function ◽

Renal Impairment ◽

Hiv Infection ◽

Statistical Tests ◽

Invasive Cervical Cancer ◽

Hiv Positive ◽

Treatment Protocols ◽

Renal Function Impairment ◽

Function Impairment

Background There is a potential increase in risk of renal function impairment among patients with invasive cervical cancer (ICC) who are HIV-positive and treated with cisplatin-based concurrent chemoradiation (CCRT). This concern is due to overlapping nephrotoxicity of the drugs, and nephropathy from the diseases themselves. There is limited literature available for the short-term renal outcomes for HIV-positive patients with ICC during routine clinical management. This study aimed to assess if HIV-infection increased the risk of renal impairment in ICC patients treated with CCRT, and explore the respective risk factors. Materials and methods This was a retrospective review of records of ICC patients treated with at least one cycle of weekly cisplatin during CCRT at the Parirenyatwa Radiotherapy Center from January 2017-December 2018. The RIFLE criteria were used to classify renal impairment. Analyses were performed with Fisher’s Exact tests, Wilcoxon rank sum tests. Odds ratios (OR) were generated using logistic regression. All statistical tests were 2-sided at a 5% level of significance. Results Seventy-two eligible patients were identified, 32 (44.44%) were HIV-positive. HIV-positive patients were younger (p = 0.002), had lower albumin levels (p = 0.014) and received lower cisplatin doses (p = 0.044). The mean percent reduction in estimated glomerular filtration rate (eGFR) from baseline was -19% (95% CI: -25.9% to -13.2%) for all patients. Thirty-one (43.1%) patients experienced renal impairment, 50% and 37.5% of HIV-positive and -negative patients respectively (p = 0.287). HIV-infection was associated with an adjusted OR of 1.16 (95% CI 0.35–3.43, p = 0.769). Baseline eGFR< 60ml/min was the only independent predictor of renal impairment, OR 0.25 (95% CI: 0.07–0.85). Baseline eGFR<60ml/min was also associated with receipt of lower cisplatin doses (p = 0.044). Conclusion HIV-infection was not associated with elevated risk of renal impairment. Patients with an eGFR<60ml/min appear to be managed more cautiously reducing their risk for renal impairment during cisplatin therapy. The high prevalence of renal impairment in this population suggests the need for optimization of pre-treatment protocols.

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Sodium–glucose cotransporter 2 inhibitors in type 2 diabetes patients with renal function impairment slow the annual renal function decline, in a real clinical practice

Journal of Diabetes Investigation ◽

10.1111/jdi.13502 ◽

2021 ◽

Cited By ~ 1

Author(s):

Taro Hirai ◽

Munehiro Kitada ◽

Itaru Monno ◽

Erina Oda ◽

Yoshihiro Hayashi ◽

...

Keyword(s):

Type 2 Diabetes ◽

Renal Function ◽

Clinical Practice ◽

Renal Function Decline ◽

Renal Function Impairment ◽

Sodium Glucose Cotransporter ◽

Function Impairment ◽

Real Clinical Practice ◽

Diabetes Patients

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Impact of renal function impairment assessed by CKDEPI estimated glomerular filtration rate on early and late outcomes after coronary artery bypass grafting

International Journal of Cardiology ◽

10.1016/j.ijcard.2016.10.059 ◽

2017 ◽

Vol 227 ◽

pp. 778-787 ◽

Cited By ~ 6

Author(s):

Sandro Gelsomino ◽

Stefano Del Pace ◽

Orlando Parise ◽

Sabina Caciolli ◽

Francesco Matteucci ◽

...

Keyword(s):

Renal Function ◽

Glomerular Filtration Rate ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Artery Bypass ◽

Bypass Grafting ◽

Renal Function Impairment ◽

Function Impairment

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Rhabdomyolysis and renal function impairment after isolated limb perfusion—Comparison between the effects of perfusion with rhTNFα and a ‘triple-drug’ regimen

European Journal of Cancer ◽

10.1016/s0959-8049(97)00013-0 ◽

1997 ◽

Vol 33 (4) ◽

pp. 596-601 ◽

Cited By ~ 20

Author(s):

P. Hohenberger ◽

J. Haier ◽

P.M. Schlag

Keyword(s):

Renal Function ◽

Drug Regimen ◽

Isolated Limb Perfusion ◽

Renal Function Impairment ◽

Limb Perfusion ◽

Function Impairment

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Predictors for Clinical Success at One Year following Renal Artery Stent Placement

Journal of Endovascular Therapy ◽

10.1177/152660280200900419 ◽

2002 ◽

Vol 9 (4) ◽

pp. 495-502 ◽

Cited By ~ 6

Author(s):

Trude C. Gill-Leertouwer ◽

Elma J. Gussenhoven ◽

Johanna L. Bosch ◽

Jaap Deinum ◽

Hans van Overhagen ◽

...

Keyword(s):

Renal Function ◽

Serum Creatinine ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Stent Placement ◽

Clinical Success ◽

Artery Stenosis ◽

Renal Function Impairment ◽

Function Impairment ◽

Renal Artery Stent

Purpose: To determine pretreatment variables that may predict 1-year clinical outcome of stent placement for renal artery stenosis. Methods: In a prospective study, 40 consecutive patients (29 men; mean age 60 ± 9.1 years) with angiographically proven atherosclerotic renal artery stenosis were treated with stent placement because of drug resistant hypertension (n=14), renal function impairment (n=14), or both (n=12). Clinical success at 1 year was defined as a decrease of diastolic blood pressure ≥10 mmHg or a decrease in serum creatinine ≥20%, depending on the indication for treatment. Regression analysis was performed using anatomical parameters from angiography and intravascular ultrasound, estimates of renal blood flow from renal scintigraphy, and single-kidney renal function measurements. Results: Patients treated for hypertension had better outcome than those treated for renal function impairment, with clinical success rates of 85% and 35%, respectively. Preserved renal function, with low serum creatinine and high 2-kidney glomerular filtration rate at baseline, was associated with clinical success in the entire patient group at follow-up (p=0.02 and p=0.03, respectively). An elevated vein-to-artery renin ratio on the affected side was borderline predictive (p=0.06). In patients treated for renal impairment, lateralization to the affected kidney (affected kidney—to–2-kidney count ratio ≤0.45) on the scintigram emerged as a significant predictor for clinical success, with an odds ratio of 15 (p=0.048). Conclusions: Clinical success of renal artery stent placement is better for the treatment of hypertension than for preserving renal function. In patients with renal function impairment, lateralization to the affected kidney on the scintigram appears to be a predictor of clinical success.

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