THE EFFECT OF SPIRONOLACTONE ON SERUM ELECTROLYTES AND RENAL FUNCTION TESTS IN PATIENTS WITH SEVERE CHRONIC HEART FAILURE

2021 ◽  
Vol 74 (10) ◽  
pp. 2460-2462
Author(s):  
Seher Abdurasool Almedeny ◽  
Jabbar Yasir AL- Mayah ◽  
Mohanmed S. Abdulzahra ◽  
Najah R. Hadi
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Kidney Function ◽  
Serum Potassium ◽  
Control Group ◽  
Kidney Function Tests ◽  
Serum Electrolytes ◽  
Function Tests ◽  
Renal Function Tests

The aim: To evaluate the effect of single daily 25 mg of spironolactone on serum electrolytes and kidney function tests in patients with severe chronic left sided heart failure. Materials and methods: 60 patients with severe chronic left sided heart failure were enrolled in this study and they were divided in to 2 equal groups’ one group with standard therapy of HF and the other with spironolactone in a dose of 25 mg / day, as an additive therapy to the standard one. Serum electrolytes and kidney function tests were assessed at the beginning of the study and after 3 months. Results: A significant increment in serum potassium (p<0.05) was observed in the spironolactone group after 3 months treatment, while no significant reduction in serum sodium (p>0.05) and no significant increase in serum creatinine and blood urea (p>0.05) was noticed in the same group, control group showed no significant changes (p>0.05), in both serum electrolytes (S.K and S.Na) and renal function tests (S.C and B.U). Conclusions: Spironolactone caused a significant elevation of serum potassium level but this elevation is still with the clinically accepted ranges when low dose of spironolactone is used and with intact renal function. Serum creatinine level was not significantly increased with 25 mgl day of spironolactone. We conclude that Renal function tests namely blood urea and serum Creatinine, and serum potassium should be closely monitored in patients on spironolactone therapy especially those patients who use ACEI and ARBs in addition.

Effects of angiotensin receptor neprilysin inhibitor on renal function in patients with heart failure: a systematic review and meta-analysis

2021 ◽  
pp. postgradmedj-2021-140132
Author(s):  
Yuwu Shi ◽  
Yiwen Wang ◽  
Junhong Chen ◽  
Chi Lu ◽  
Haochen Xuan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Ejection Fraction ◽  
Serum Potassium ◽  
Cochrane Library ◽  
Control Group ◽  
Angiotensin Receptor ◽  
Neprilysin Inhibitor ◽  
Patients With Heart Failure ◽  
Angiotensin Receptor Neprilysin Inhibitor

The angiotensin receptor neprilysin inhibitor (ARNI) has been recommended as a first-line treatment in patients with heart failure (HF). However, the effects of ARNI on renal function remain controversial.The PubMed, Embase, the Cochrane Library of Trials and Web of Science were searched in the period from inception to 31 January 2021. Randomised controlled trial, cohort studies and observational studies reporting at least one of renal function indicators were included.In patients with HF with reduced ejection fraction (HFrEF), ARNI did not lead to a significant decrease in estimated glomerular filtration rate (eGFR, p=0.87), and the risk of worsening renal function (WRF) dropped by 11% compared with control group. Though the level of serum creatinine (SCr) and serum potassium had a slight increase (p=0.01; p=0.02), in contrast to the baseline level, but without clinical significance. In patients with HF with preserved ejection fraction (HFpEF), the level of SCr and serum potassium did not have a significant change, and patients with HFpEF assigned to ARNI had a much lower rate of WRF (p=0.0007). In contrast to control group, both patients with HFrEF and HFpEF had a less decrease in eGFR and a lower rate of hyperkalaemia in ARNI group.ARNI did not lead to a significant decrease in eGFR in HFrEF. Compared with control group, ARNI could delay the progression of decrease in eGFR and result in less events of hyperkalaemia in patients with HF. Besides, patients with HFpEF had a lower rate in the events of WRF.

scholarly journals Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies

2016 ◽  
Vol 20 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Rajeev Ranjan ◽  
Anjana Singh
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Cystatin C ◽  
Normal Pregnancy ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Function Tests ◽  
Renal Function Tests

ABSTRACT Background Glomerular endotheliosis is an essential component in the pathophysiology of gestational hypertension (GH) and preeclampsia (PE) which results in renal dysfunction. This is not always detected by routine renal function tests, such as serum creatinine, urea, and uric acid. Cystatin C, an endogenous cysteine protease inhibitor, is completely absorbed by renal tubules and has been shown to be an ideal marker of glomerular filtration rate (GFR), which needs to be evaluated in assessing renal dysfunction occurring in GH and PE. Aims The present study is designed to evaluate serum cystatin C levels in normal pregnancy, GH, and PE and compare its efficacy with traditional renal function tests. Materials and methods In this prospective cross-sectional study, 75 subjects enrolled, comprised of 25 subjects each of normal pregnancy, GH, and PE. Serum cystatin C, blood urea, serum creatinine, serum uric acid, and urinary protein/creatinine ratio were estimated in all subjects prior to delivery. Results All renal parameters including cystatin C were significantly raised in GH and PE compared with control group. However, only serum cystatin C level (and no other renal parameters) was significantly higher in PE group compared with GH group. Area under the curve for cystatin C was maximum (0.917) compared with other parameters. Cystatin C had a higher sensitivity and specificity than other conventional markers. Conclusion Serum cystatin C is a better marker of renal dysfunction in hypertensive pregnancies. How to cite this article Singh A, Gupta M, Ranjan R, Saini V, Gupta SK. Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies. Indian J Med Biochem 2016; 20(1):21-27.

Renal Function Tests Predictors in Asthmatic Patients

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Shahlaa Kh. Chabuk
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Creatinine Clearance ◽  
Bronchial Asthma ◽  
Asthmatic Patients ◽  
Function Tests ◽  
Significant Difference ◽  
The Impact ◽  
Renal Function Tests ◽  
Hypoxic Group

Background: Bronchial asthma can cause many morbidities such as heart disease, diabetes mellitus, and hypertension, but the impact of asthma on renal function is not yet verified. This study aims to clarify the association between bronchial asthma and the risk of developing renal dysfunction. Methods: The study was conducted in Merjan Medical City in the period from April 2015 to August 2016, it included 75 patients with asthma and 70 control healthy subjects who completed medical questionnaires, pulmonary function tests, measurement of blood urea, serum creatinine, and creatinine clearance in addition to measurement of oxygen saturation (SPO2) by oximeter. Hypoxic patient has level of SPO2 less than 95%. Statistical analysis was done, P values ≤0.05 were considered to be clinically significant. Results: There was no significant difference in mean age and gender between both groups. There was significant difference in the mean values of blood urea (Bur), serum creatinine (Scr) and creatinine clearance (Ccr) before and after treatment for all patients, Bur increased and Scr decreased significantly in hypoxic group in comparison with non-hypoxic group (P ˂ 0.05). In addition, the study showed a significant correlation between blood urea and creatinine clearance (Ccr) with SPO2 (before treatment) (p less than 0.05), while non-significant negative correlation between serum creatinine and SPO2 (before treatment) (r = 0.1, P > 0.05). The results revealed that while Ccr decreased while the Bur and Scr increased significantly in male group in comparison to female group (P˂0.05). Also there was no significant correlation between blood urea, creatinine clearance (Ccr) and serum creatinine with forced expiratory volume in first second (FEV1) (before treatment) (P > 0.05). Conclusions: The study showed high percentage of asthmatic patients admitting in the hospital wards had abnormalities of renal function tests at the first days of admission to hospital, but most patients return to normal state gradually after getting treatment. The mechanisms and clinical implications of kidney dysfunction in patients with asthma need further investigation in addition to follow up for those patients to determine who of them will get chronic renal failure at future.

scholarly journals Levels of Serum Lipid profile and Kidney Function Tests in Iraqi Hypertensive Patients: Duration Effect Study

2017 ◽  
Vol 14 (2) ◽  
pp. 363-370
Author(s):  
Baghdad Science Journal
Keyword(s):  
Uric Acid ◽  
Lipid Profile ◽  
Kidney Function ◽  
Control Group ◽  
Kidney Function Tests ◽  
Hypertensive Patients ◽  
Function Tests ◽  
Duration Of Disease ◽  
Group 2 ◽  
Group 1

Hypertension is one of the leading causes of the global burden of disease, which causes serious health problems. The aim of this study is to investigate the lipid profile levels in sera of Iraqi hypertensive patients by measuring Total cholesterol (TC), triglyceride (TG) and low density lipoproteins (LDL) and kidney function levels by measuring uric acid, urea and creatinine. Seventy five individuals of Iraqi adults (Males) were divided into three groups: 25 hypertensive patients with duration of disease (1-10) year (group 1), 25 hypertensive patients with duration of disease (11-30) year (group 2) and 25 normal individuals as control group (group3). The findings indicate that serum (TC, TG and LDL) levels were significantly elevated (p ? 0.05) compared with healthy group and the values of them were significantly higher in group 2 than in group 1.This study also shows significant positive correlations between TC and TG, LDL (p ?0.01), (p ? 0.05)respectively. From collected data, a significant increase was found in the mean value of serum uric acid, urea and creatinine in hypertensive patients in two groups (1, 2) compared with control group and the levels of them were significantly higher in group2 than in group1 (p?0.01).The results also indicate strong correlations between parameters studied of kidney function tests ( p? 0.01). This study has shown that lipid profile and renal function levels abnormalities are highly prevalent among Iraqi hypertensive patients and also the effect of duration of disease on parameters was studied.

scholarly journals Correlation of renal function tests with early onset neonatal sepsis.

2020 ◽  
Vol 27 (02) ◽  
pp. 317-323
Author(s):  
Amna Iqtidar ◽  
Imran Ali ◽  
Aamer Naseer ◽  
Fouzia Aamer ◽  
Kiran Namoos ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Serum Creatinine ◽  
Serum Creatinine Level ◽  
Creatinine Level ◽  
Neonatal Sepsis ◽  
Early Onset ◽  
Function Tests ◽  
Renal Function Tests

Early onset neonatal sepsis is invariably very common and serious problem worldwide, especially it is one of the important etiological factor for deaths of neonates in Pakistan. Acute renal failure is frequently seen in neonates with sepsis. Objectives: The aim of present study was to determine the correlation of renal function tests (Blood Urea and creatinine) with early onset neonatal sepsis. Study Design: Descriptive study. Setting: Department of Paediatric Medicine Sir Ganga Ram hospital, Lahore. Period: Six months from 20th March to 20th September 2018. Material & Methods: Total 300 cases of neonatal sepsis with acute renal failure were included in this study after taking informed consent from the parents. Cases selection was done with help of a predefined inclusion and exclusion criteria. Daily blood urea and serum creatinine were calculated from birth to first 7 days of life. If any of blood urea or serum creatinine was deranged, the neonate was labelled as having acute renal failure. Data was entered and analysed using SPSS software version 21. Results: Mean age of all cases was 2.82±1.56 days. The minimum and maximum age limits of the neonates were 1 and 7 days respectively. Gender distribution of neonate showed that 57% of the neonates were male and 43% were females. At the 2nd day of life, mean serum creatinine level was 1.12±0.39, at 3rd day 1.19±0.51, at 4th day 1.41±0.38, at 5th day 1.33±0.39, at 6th day 1.19±0.39, and at 7th day mean serum creatinine level was 1.09±0.31 respectively. At 2nd day of birth mean blood urea was 54.82±34.77, at 3rd day59.50±28.22 at 4th day 74.94±30.37, at 5th day 67.09±26.94, at 6th day 56.09±25.76, at 7th day mean blood urea level was 47.66±22.47 respectively. Frequency of acute renal failure was observed in 28.3% of the neonates while the remaining 71.7% of neonates did not suffer from acute renal failure. Conclusion: Early onset neonatal sepsis contributes significantly to development of acute renal failure in neonates.

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