Prognostic value of endotoxicosis criteria in the diagnosis of acute renal injury

2021 ◽  
Author(s):  
A.P. Vlasov ◽  
V.E. Ryazantsev ◽  
T.A. Muratova ◽  
M.V. Volkova ◽  
N.Yu. Stepanov ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Renal Injury ◽  
Prognostic Value ◽  
Filtration Rate ◽  
Initial Level ◽  
Biochemical Study ◽  
Antioxidant Protection ◽  
Acute Renal Injury ◽  
Functional Changes

In order to find informative statically significant laboratory criteria for endotoxicosis in the diagnosis of acute renal injury, a clinical and biochemical study of 40 patients with acute renal injury developed against the background of renal urological and extrarenal surgical pathology was conducted. The results of the study demonstrate pronounced changes in the mechanisms of antioxidant protection that develop in patients with acute renal injury. Deviations from the initial level of the studied criteria are interrelated with many links of pathogenesis, where one of the central links is ischemia of the renal parenchyma. The progression of endogenous intoxication, taking into account the data obtained, confirmed by a decrease in prooxidant protection contributes to the progression of intrarenal changes, aggravating functional changes in renal and extrarenal injuries. Key words: significance of endotoxicosis criteria, acute renal injury, endotoxicosis, serum creatinine, glomerular filtration rate.

Renal Insufficiency and Failure

Hematology ◽  
2010 ◽  
Vol 2010 (1) ◽  
pp. 431-436 ◽  
Author(s):  
Meletios A. Dimopoulos ◽  
Evangelos Terpos
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Renal Impairment ◽  
Renal Disease ◽  
Renal Injury ◽  
Filtration Rate ◽  
Acute Renal Injury ◽  
Sustained Improvement ◽  
Definition Of

Abstract Renal impairment is a common complication of multiple myeloma. Chronic renal failure is classified according to glomerular filtration rate as estimated by the MDRD (modification of diet in renal disease) formula, while RIFLE (risk, injury, failure, loss and end-stage renal disease) and AKIN (acute renal injury network) criteria may be used for the definition of the severity of acute renal injury. Novel criteria based on estimated glomerular filtration rate measurements are proposed for the definition of the reversibility of renal impairment. Renal complete response (CRrenal) is defined as sustained (i.e., lasting at least 2 months) improvement of creatinine clearance (CRCL) from under 50 mL/min at baseline to 60 mL/min or above. Renal partial response (PRrenal) is defined as sustained improvement of CRCL from under 15 mL/min at baseline to 30 to 59 mL/min. Renal minor response (MRrenal) is defined as sustained improvement of the baseline CRCL of under 15 mL/min to 15 to 29 mL/min or, if baseline CRCL was 15 to 29 mL/min, improvement to 30 to 59 mL/min. Bortezomib with high-dose dexamethasone is considered the treatment of choice for myeloma patients with renal impairment and improves renal function in most patients. Although there is limited experience with thalidomide, this agent can be administered at the standard dosage to patients with renal failure. Lenalidomide, when administered at reduced doses according to renal function, is effective and can reverse renal impairment in a subset of myeloma patients.

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.

Pathogenesis and Assessment of Renal Function in Patients With Liver Cirrhosis

Folia Medica ◽  
2012 ◽  
Vol 54 (4) ◽  
pp. 5-13 ◽  
Author(s):  
Bilyana H. Teneva
Keyword(s):  
Renal Function ◽  
Liver Cirrhosis ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Serum Markers ◽  
Meld Score ◽  
Kidney Damage ◽  
Early Assessment

Abstract In liver cirrhosis patients awaiting liver transplantation, it is prognostically equally important to assess the renal function before and after transplantation. This is evidenced by the inclusion of serum creatinine in the Model for End-Stage Liver Disease (MELD) score. Most of the causes of renal failure in liver cirrhosis are functional, the acute kidney damage including prerenal azotemia, acute tubular necrosis and hepatorenal syndrome. A major index of the renal function, the glomerular filtration rate (GFR) is determined in a specific way in patients with liver cirrhosis. Clinically, serum creatinine is considered the best indicator of kidney function, although it is rather unreliable when it comes to early assessment of renal dysfunction. Most of the patients with liver cirrhosis have several concomitant conditions, which are the reason for the false low creatinine levels, even in the presence of moderate to severe kidney damage. This also holds for the creatinine clearance and creatinine-based estimation equations for assessment of the glomerular filtration rate (the Cockroft-Gault and MDRD formulas), which overestimate the real glomerular filtration. Clearance of exogenous markers is considered a gold standard, but the methods for their determination are rather costly and hard to apply. Alternative serum markers (e.g., cystatin C) have been used, but they should be better studied in cases of liver cirrhosis assessment.

MO190NORMATIVE DATA FOR GLOMERULAR FILTRATION RATE IN HEALTHY KIDNEY DONOR POPULATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ashish Bhoyar ◽  
Vinant Bhargava ◽  
Ashwani Gupta ◽  
Anurag Gupta ◽  
Vaibhav Tiwari ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Filtration Rate ◽  
Age Groups ◽  
Kidney Donor ◽  
Urinary Creatinine ◽  
Donor Population ◽  
Sample Method ◽  
Clearance Methods

Abstract Background and Aims Glomerular filtration rate (GFR) is estimated traditionally from 24-hour urinary creatinine clearance. Creatinine is mainly filtered by glomerulus. The collection of 24-hour urinary sample is a difficult task with many patients fail to collect all the urine samples. As measuring GFR is cumbersome, expensive, and not easily available in all centers, various equations are developed for estimating GFR from creatinine like MDRD, CKD EPI creatinine. GFR obtained from serum creatinine shows wide variation as muscle mass and dietary protein intake are important determinants of serum creatinine concentration. Literature shows very few studies with GFR estimation with reference to age in Indian population. Hence, this study is planned to develop age specific nomogram for GFR in healthy kidney donor population as well as to study agreement between GFR obtained by 99m Tc DTPA three sample method and GFR estimated by 24-hour urinary creatinine. The aim of this stidy was to develop age-specific nomogram GFR in healthy kidney donor population and to study the agreement between the GFR measured by Technetium-99m diethylene triamine pentaacetic acid (99m Tc DTPA) and 24-hour urinary creatinine method. Method This study was conducted at Sir Ganga Ram hospital, New Delhi. All healthy individuals aged more than 20 years and less than 65 years, undergoing evaluation as prospective kidney donor at our hospital were the part of this study. GFR was measured by 99m Tc DTPA clearance using 3 sample method. GFR measured by DTPA method was used to develop nomogram. Creatinine Clearance was calculated from 24-hour urinary creatinine by formula U x V/P where, U is urinary creatinine level, P is plasma creatinine level and V is total volume of urine. Nomogram was developed with respect to these 3 Age groups; namely, 20 to 40 years, 40 to 50 years and 50 to 65 years Results Total 100 kidney donors were included in this study. Enrolled subjects were divided into 3 age groups; 20 to 40 years (n=28), 40 to 50 years (n=46) and 50 to 65 years (n=26). Majority of the donors were females (n=80). The agreement between GFR obtained by 99m Tc DTPA and 24-hour urinary creatinine clearance methods was 92.6 vs. 94 ml/min, 80.4 vs. 76 ml/min and 76.3 vs. 70 ml/min in respective age groups. Conclusion In the younger age group (20 to 40 years), there is better agreement in GFR measured by 99m Tc DTPA method and 24-hour urinary creatinine clearance methods.

In-Hospital Prognostic Value of Glomerular Filtration Rate in Patients With Acute Coronary Syndrome and a Normal Creatinine Level

2007 ◽  
Vol 60 (7) ◽  
pp. 714-719 ◽  
Author(s):  
Rocío Carda Barrio ◽  
José A. de Agustín ◽  
María C. Manzano ◽  
Juan C. García-Rubira ◽  
Antonio Fernández-Ortiz ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Creatinine Level ◽  
Prognostic Value ◽  
Filtration Rate ◽  
Coronary Syndrome

scholarly journals Incidence of Acute Renal Failure in Full Term Neonates with Birth Asphyxia

2019 ◽  
Vol 4 (1) ◽  
pp. 671-674
Author(s):  
Chandra Bhushan Jha ◽  
Akhil Tamrakar
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Renal Injury ◽  
Urine Output ◽  
Birth Asphyxia ◽  
Full Term ◽  
Acute Renal Injury ◽  
Term Neonates ◽  
Oliguric Renal Failure

Introduction: Birth asphyxia is an eventuality having far reaching consequences in the neonatal period. Hypoxia and ischemia can cause damage to almost every tissue and organ in the body and various target organs involved. Renal insult is a recognized complication of birth asphyxia and carries a poor prognosis. Timely detection of renal dysfunction and appropriate management may favorably alter the prognosis in many neonates with birth asphyxia. Objective: The present study was done to find out the incidence of acute renal failure in the full term neonates with birth asphyxia. Methodology: A cross sectional study was conducted at Birat Medical College Teaching Hospital, Morang, Nepal from 1st September 2017 to 28th February 2018. Fifty full term neonates born with Apgar score of <6 at 5 minutes and fulfilling inclusion criteria were enrolled in the study. Asphyxiated neonates having Serum creatinine >1.5gm/dl or urine output<1ml/kg/hr were labeled as cases of Acute Renal Failure. Blood sample for serum creatinine was collected at 24hrs, 48 hrs and 72 hrs of life. Results A total of 50 term asphyxiated neonates were enrolled in the present study. Among them 54% and 46% were males and females respectively with male to female ratio of 1.2:1. In the present study 62% of cases developed acute renal failure in either of the first three days of life with mean urine output 1.02±0.27ml/kg/hr and mean serum creatinine of 1.49±0.32 mg/dL. The incidence of oliguric renal failure was 52% and non oliguric renal failure was 48%.The association between serum creatinine and urine output was statistically significant. Conclusion: In the present study birth asphyxia has been an important cause of neonatal acute renal injury, revealing 31 (62%) cases. Monitoring urine output and serum creatinine has helped in detecting the asphyxiated neonates with acute renal injury in the early stage.

Abstract 13433: Predictors of Contrast Induced Nephropathy in Patients With Acute Coronary Syndromes and Normal Baseline Glomerular Filtration Rate

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Daniel Negreanu ◽  
Michael Gagnon ◽  
anh nguyen ◽  
Samer Mansour ◽  
Michel T Nguyen ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Acute Coronary Syndromes ◽  
Filtration Rate ◽  
Fold Increase ◽  
Contrast Induced Nephropathy ◽  
Baseline Serum ◽  
Coronary Syndromes ◽  
The Mean

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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