Serum and Salivary Levels of Glucose and Urea in Pregnant and Non-pregnant Women: A Comparative Study

Background: Pregnancy is one of the most critical periods in the life of most women. Since it is necessary to be aware of the health of the mother and fetus, serum markers (i.e., glucose and urea) need to be monitored during pregnancy. A routine strategy in this area is venipuncture which is applied to measure the level of these markers. It is also a stressful procedure for pregnant women. The purpose of this study was to determine the salivary level of these markers as a stress-free method in pregnant women. Materials and Methods: The samples were collected from 30 pregnant and 30 non-pregnant fasting women. Then, the serum and salivary levels of glucose and urea were measured, analyzed, and compared by photometry. Results: Results indicated that the mean salivary glucose level was 10.2±1.4 mg/dL and 6.4±0.9 mg/ dL in non-pregnant and pregnant women, respectively. In addition, the mean serum glucose level was 106.5±5.3 mg/dL and 82.9±4.5 mg/dL in non-pregnant and pregnant women, respectively. Further, the mean salivary urea level was 37.1±3.3 mg/dL in non-pregnant women and 27.1±1.9 mg/dL in pregnant women. Moreover, the mean serum urea level was 26.9±1.9 mg/dL and 19.5±2.3 mg/dL in non-pregnant and pregnant women, respectively. Conclusion: Serum and salivary levels of glucose and urea in pregnant women were lower than those in non-pregnant women, and there was a positive correlation between serum and salivary levels. Therefore, it seems that saliva can be a substitute for serum regarding the measurement of glucose and urea levels.

KIM-1 and GADDI-153 gene expression in paracetamol-induced acute kidney injury: effects of N-acetylcysteine, N-acetylmethionine, and N-acetylglucosamine

Objectives Acute kidney injury (AKI) is a critical clinical event characterized by a reduction in the excretory function of the kidneys. N-acetylcysteine (NAC), N-acetylmethionine (NAM) and N-acetylglucosamine (NAG) are antioxidants with scanty known genetic mechanisms. We aimed to assess both kidney injury molecule-1 (KIM-1) and growth-arrested DNA damage-inducible gene-153 (GADD-153) genes expression in paracetamol (PA) induced AKI. Also, to recognize whether NAC, NAM and/or NAG have roles in altering the expression of these genes for ameliorating the AKI induced by PA. Methods The present preliminary study achieved the AKI model by oral administration of PA therapeutic dose for 15 days in experimental male rats. Serum urea, creatinine, and renal oxidative stress parameters were analyzed. Genetic expression of KIM-1 and GADD-153 were determined using real time-PCR. Results Significant elevations of serum urea, creatinine and nitric oxide in renal tissue after PA administration; however, total thiol content was reduced. In addition, both KIM-1 and GADD-153 were upregulated. These biochemical alterations were improved after using NAC and partially after NAM; however, NAG had little effect. Conclusions Up-regulation of both KIM-1 and GADD-153 occur in AKI induced by PA, which was significantly reversed by NAC.

Assessment of measurement of salivary urea by ATR-FTIR spectroscopy to screen for chronic kidney disease

Stages of chronic kidney disease (CKD) are currently defined by estimated glomerular filtration rates (eGFR) and require measurement of serum creatinine concentrations. Previous studies have shown a good correlation between salivary and serum urea levels and the stage of CKD. However, quantitative salivary urea assays in current clinical use require costly and labour-intensive commercial kits which restricts the advantage of using saliva and limits wider applicability as a quick and easy means of assessing renal function. Attenuated total reflection Fourier-transform infrared (ATR-FTIR) spectroscopy has been shown to provide a potentially straightforward, reagent-free method for the identification of a range of disease-related biomarkers and is in current clinical use for analyses of the chemical composition of kidney stones. We assessed the feasibility of ATR-FTIR spectroscopy as an alternative method to measure salivary urea in patients with different stages of CKD. The ATR-FTIR spectra of dried saliva samples from 6 healthy controls and 20 CKD patients (stages 1-5) were analysed to provide their urea concentrations. The lower limit of detection of salivary urea by the ATR-FTIR spectroscopy method was 1-2 mM, at the lower end of the clinically-relevant range. Statistically significant differences in salivary urea concentrations were demonstrated between healthy subjects (4.1±0.5 mM) and patients with CKD stages 3-5 (CKD stage 3: 6.8±0.7 mM; CKD stage 4: 9.1±1 mM; CKD stage 5: 14.8±1.6 mM). These salivary urea concentrations correlated well with serum urea levels in the same patients measured by an automated analyser (Spearman's rank correlation coefficient of 0.71; p<0.001). The ability of the method to detect and stage CKD was assessed from the sensitivity and specificity parameters of a receiver operating characteristics (ROC) curve analysis. This proof-of-concept study demonstrates that quantitation of salivary urea by ATR-FTIR spectroscopy could provide a viable tool for rapid and cost-effective diagnosis of stages 3-5 CKD.

Effect of Ethanolic Extract of Carica Papaya seeds in Drug-Induced Acute Nephrotoxicity

Background: Nephrotoxicity is characterized by raised serum urea and creatinine levels and kidneys being one of the primary organs of drug concentration and excretion are vulnerable to many widely used marketed drugs, including anti-cancer drugs, antibiotics, immunosuppressants, and radio contrast agents, are nephrotoxic. Aim: To determine the nephroprotective effect of ethanolic extract of Carica papaya seeds in Aminoglycoside induced acute nephrotoxicity. Study design: Quasi Experimental study. Methodology: Thirty Sprague Dawley rats were sub divided into 3 groups i.e., I, II and III with 10 rats in each group. Group II and III were administered Aminoglycoside drug; Gentamycin in 80 mg/kg) via intraperitoneal route once daily for 5 consecutive days to induce acute nephrotoxicity. At day 6, nephrotoxicity was confirmed by measuring serum urea and creatinine. Ethanolic extract of Carica papaya seeds (1000 mg/kg) was started once daily through oral route in group III for 5 consecutive days to see the nephroprotective effects of seed extract after causing acute kidney injury. All animals were given standard diet pellets manufactured at NIH. Results: Mean serum urea and creatinine for Group I (Control Group) at day 0 were 24.90 mg/dL ± 1.633 and .750 mg/dL ± .0619 respectively. Mean serum urea and creatinine for Group II (Disease Control Group) was 81.00 mg/dL ± 1.247 and 1.980mg/dL ± .0467 at day 6th. This suggested induction of nephrotoxicity by Gentamycin. Mean serum urea and creatinine for Group III (Ethanolic Extract Treated Group) at 11 day was 72.40mg/dL± .991 and 1.680 mg/dL± .0467 after 5 days treatment with ethanolic extract of Carica papaya seeds. Conclusion: We concluded that ethanolic extract of Carica papaya seeds has significant nephroprotective effects on Aminoglycoside induced acute nephrotoxicity in rats. Keywords: COVID-19, Vaccination, Awareness and Adverse Effects

The Effects of Two Different Dietary Regimens During Exercise On Outcome of Experimental Acute Kidney Injury

Introduction: Acute kidney injury (AKI) is a syndrome characterized by rapid loss of excretory function of kidney. One of the molecules considered in the treatment of renal failure is the silent information regulator (SIRT1). In this study, the effect of two different diets during exercise on AKI was investigated. Materials and Methods: A number of rats were randomly divided into four groups; control without exercise, control with exercise, exercise + calorie restriction (CR), and exercise + time restriction (TR). Each group was divided into two subgroups of without AKI and with AKI (six rats in each group). Endurance exercise and diets were implemented before AKI. Serum urea and creatinine, urinary albumin, kidney malondialdehyde (MDA), total antioxidant capacity (TAC), transforming growth factor (TGF-β1), and SIRT1 levels, glomerular filtration rate (GFR) and relative kidney weight were measured before and 48 h after AKI induction.Results: After induction of kidney injury, serum urea and creatinine, urinary albumin, kidney MDA and TGF-β1 levels and relative kidney weight increased in rats with both previous exercise and no previous exercise (p <0.001), while GFR, and kidney TAC and SIRT1 levels decreased (p <0.001). These changes after AKI were less in the group with previous exercise than in the group that had no exercise (p <0.001). The TR diet during exercise caused a less increase in serum urea (p <0.001) and creatinine (p <0.05), and urinary albumin (p <0.01) levels after injury compared to the just exercise group. Also, both CR and TR diets during exercise caused less change in MDA (p <0.01, p <0.05, respectively) and TAC (p <0.001, p <0.05, respectively) levels compared to just exercise group. Conclusion: The results showed that exercise alone had no effect on preventing function impairment of kidney, oxidative stress, inflammation and also SIRT1 alteration following AKI in athletes, although these indexes were less among those with exercise than those without exercise. However, when the CR and TR diets were implemented during exercise, strong renoprotective effects appeared, and the protective effect of TR diet was greater.

Alcohol dehydrogenase 1C (ADH1C) polymorphism is significantly associated with kidney function status in Nusa Tenggara Timur ethnicity: A cross-sectional study

Excessive alcohol consumption is harmful to many human organs, but the association with kidney function is still controversial. The disagreement in findings might be caused by ADH1C polymorphism's influence on alcohol metabolism rate. This study aims to determine the correlation between ADH1C polymorphism and kidney function status in Nusa Tenggara Timur (NTT) ethnicity, a population with highly prevalent alcohol consumption in Indonesia. We conducted a cross-sectional study of 76 subjects, who are natives of NTT, Indonesia. The genotyping of extracted DNA for ADH1C was done by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using restriction endonuclease SspI. Kidney function status was defined by serum urea level and estimated glomerular filtration rate (eGFR) that had been categorized according to percentiles. The correlation with the ADH1C allele was analyzed using chi-square tests. The genotype of ADH1C in NTT ethnicity was ADH1C*1/*2 (51.3%), ADH1C*2/*2 (47.4%), and ADH1C*1/*1 (1.3%). The results showed that the population had the ADH1C*2 (73.03%) and the ADH1C*1 (26.97%) allele. There was a significant association between ADH1C polymorphism and eGFR among NTT ethnicity (p=0.005) when eGFR was analyzed at the 25th percentile (74.75 mL/minute/1.73m2). However, we found no associations when eGFR was analyzed at 50th (p=0.571) and 75th (p=0.335) percentiles. The odds ratio shows that having the ADH1C*1/*2 genotype escalates the probability of declining eGFR 6.620 times compared to ADH1C*2/*2 (95% CI: 1.539-28.478), after adjusted for smoking behavior. We found no association between ADH1C polymorphism and serum urea level (p=0.123, 0.421, and 0.335). The majority of NTT ethnicity have the ADH1C*1/*2 genotype. Populations with ADH1C*1/*2 have higher odds ratio for eGFR below 74.75 mL/minute/1.73m2 than those with ADH1C*2/*2 genotype. There was no association between ADH1C polymorphism and serum urea levels.

Synergistic effects of sinapic acid and ellagic acid ameliorate streptozotocin-induced diabetic nephropathy by inhibiting apoptosis, DNA damage, and structural deterioration in rats

Introduction Diabetic nephropathy (DN), a global problem that threatens human health, is an important reason for chronic kidney disease and kidney failure. In our study, it was aimed to investigate the individual and combined effects of SA and EA in streptozotocin (STZ)-induced rats. Methods The groups are as follows: Control, untreated diabetic, diabetic treated with Sinapic acid (SA), diabetic treated with Ellagic acid (EA), diabetic treated with SA and EA, treated with SA, treated with EA, and treated with SA and EA. Total kidney volume, total glomerulus volume, total filtration space volume, caspase-3, and 8-OHdG immunoreactivity, Malondialdehyde (MDA), Glutathione (GSH), Catalase (CAT), serum urea, and creatinine levels were evaluated by stereological, immunohistochemical, and biochemical methods. Results The findings of the study showed that total kidney volume, total glomerulus volume, total filtration gap volume, caspase-3, and 8-OHdG immunoreactivity, MDA, serum urea, and creatinine levels significantly increased in the untreated diabetic group compared to the control group. Also, severe mesangial and glomerular enlargement, extracellular matrix accumulation, and glomerular and tubular basal membrane thickness were observed in the tubulointerstitial and glomerular of the diabetic rats. However, individual and combined treatments of SA and EA ameliorated these histological changes. Additionally, decreased GSH and CAT in the untreated diabetic group increased by SA and EA treatment. Conclusions The findings suggest that treatment of SA and EA prevent apoptosis and DNA damage and structural changes in STZ-induced DN. However, the combined treatment of SA and EA were more effective than their individual treatments in all parameters except serum urea and creatinine.

Description of Serum Urea and Creatinine Levels Pre Hemodialysis and Post Hemodialysis at Royal Prima Hospital in Chronic Kidney Disease

Chronic Kidney Failure describes as the gradual loss of kidney functionand it is irreversible, to replace the loss of kidney function a therapy tokidney function is needed, which is hemodialysis. The objective of thisresearch is to know the levels of ureu and creatinine serum for prehemodialysis and post hemodialysis at RSU Royal Prima Medan. Themethods that are being used for this research is descriptive with 54 patientsas samples. The results of this research is loss of urea and creatinine serumlevel, with the average of urea level for pre hemodialysis is 128.11 mg/dL,and the average of urea level for post hemodialysis is 43.26 mg/dL with1,8% patient with low urea level, 50% with normal urea level, and 48.2%with high urea level. The average of creatine level for pre hemodialysis is11.56 mg/dL, and the average of creatine levels is 4.3 mg/dL, with all of thepatient still have a high creatinine levels. The conclusion is there is drop forboth urea and creatinen serum level, but the urea level for half of the patientdid not go down to normal, and for the creatinine level there is none of thepatient creatinine level that go down to normal.

Effects of prebiotic oligofructose-enriched inulin on gut-derived uremic toxins and disease progression in rats with adenine-induced chronic kidney disease

Recent studies suggest that dysbiosis in chronic kidney disease (CKD) increases gut-derived uremic toxins (GDUT) generation, leads to systemic inflammation, reactive oxygen species generation, and poor prognosis. This study aimed to investigate the effect of oligofructose-enriched inulin supplementation on GDUT levels, inflammatory and antioxidant parameters, renal damage, and intestinal barrier function in adenine-induced CKD rats. Male Sprague-Dawley rats were divided into control group (CTL, n = 12) fed with standard diet; and CKD group (n = 16) given adenine (200 mg/kg/day) by oral gavage for 3-weeks to induce CKD. At the 4th week, CKD rats were subdivided into prebiotic supplementation (5g/kg/day) for four consecutive weeks (CKD-Pre, n = 8). Also, the control group was subdivided into two subgroups; prebiotic supplemented (CTL-Pre, n = 6) and non-supplemented group (CTL, n = 6). Results showed that prebiotic oligofructose-enriched inulin supplementation did not significantly reduce serum indoxyl sulfate (IS) but did significantly reduce serum p-Cresyl sulfate (PCS) (p = 0.002) in CKD rats. Prebiotic supplementation also reduced serum urea (p = 0.008) and interleukin (IL)-6 levels (p = 0.001), ameliorated renal injury, and enhanced antioxidant enzyme activity of glutathione peroxidase (GPx) (p = 0.002) and superoxide dismutase (SOD) (p = 0.001) in renal tissues of CKD rats. No significant changes were observed in colonic epithelial tight junction proteins claudin-1 and occludin in the CKD-Pre group. In adenine-induced CKD rats, oligofructose-enriched inulin supplementation resulted in a reduction in serum urea and PCS levels, enhancement of the antioxidant activity in the renal tissues, and retardation of the disease progression.

Blood Serum Metabolite and Volatile Fatty Acid Profiles of Finishing Pigs Fed Diets with High and Low Levels of Energy and Crude Protein

Background: Studying how dietary imbalances affect blood serum metabolite (BSM) and faecal volatile fatty acids (VFA) profiles may help to understand whether pigs are fed adequate diets in commercial farms. The present study aimed to evaluate the effect of high and low net energy (NE) and crude protein (CP) diets on performance, BSM and VFA profiles on finishing pigs.Results: Twenty pens of 11 pigs (87.0 ± 4.10 kg; 18 weeks old) were assigned to 1 out of 5 dietary treatments (DT): control (C; 10.03 MJ/kg NE, 160.0 g/kg CP, and 9.5 g/kg SID Lys), low CP (LCP; 10.03 MJ/kg NE, 132.0 g/kg CP, 7.5 g/kg SID Lys), high CP (HCP; 10.03 MJ/kg NE, 188.0 g/kg CP, 11.5 g/kg SID Lys), low NE (LNE; 9.61 MJ/kg NE, 160.0 g/kg CP, 9.5 g/kg SID Lys) and high NE (HNE; 10.45 MJ/kg NE, 160.0 g/kg CP, 9.5 g/kg SID Lys). Pigs were followed for 10 days and blood and faecal samples were collected at the end of the trial. Performance was not affected by DT (P > 0.05). Albumin and glucose did not differ between DT (P > 0.05). HNE pigs had higher triglycerides (0.42 ± 0.03 mmol/L) and creatinine (133.8 ± 3.97 µmol/L) than LNE pigs (0.28 ± 0.03; 117.2 ± 3.97; P < 0.05); however, HNE pigs had lower total protein (60.9 ± 1.51 g/L) than C pigs (67.4 ± 1.51; P = 0.033). LCP pigs had higher cholesterol (2.4 ± 0.08 mmol/L) than LNE pigs (2.0 ± 0.08; P = 0.015); while HCP pigs had higher serum urea nitrogen (13.6 ± 0.95 mg/dL) than the other DT (7.5 ± 0.95; P < 0.001). Total VFA (mmol/kg) did not differ among DT (P > 0.05), but C and HNE pigs had higher branched-chain fatty acids (6.3 ± 0.38% of total VFA) than LNE pigs (4.4 ± 0.38; P < 0.05).Conclusions: Dietary imbalances in energy and protein affect BSM and VFA profile. BSM and VFA analysis may be good indicators to detect unbalanced diets in pig farms, especially serum urea nitrogen, to detect an excess of protein.