Average Creatinine Level Research Articles

The Relationship of Protein Intake to Creatinine Levels and Blood Pressure in Fitness Member

Background: Fitness center members generally eat foods high in protein, reaching 2 grams/kg body weight or more, and are often accompanied by supplements such as creatinine. High protein intake in the long term will produce a metabolic load that can cause impaired kidney function. In addition to creatinine, the influence of high protein intake that individuals with high activity directly feel is Blood Pressure. Objective: This study aims to determine the relationship between protein intake, creatinine levels, and blood pressure in fitness members at Osbond Gym Cempaka Putih. Method: This type of quantitative research uses a cross-sectional design, with a sample of 22 respondents, namely fitness members at Osbond Gym Cempaka Putih. Data analysis was performed using the Pearson correlation test for normally distributed data and the Spearman correlation test for abnormally distributed data. The test criteria are seen if the p-value < 0.05, then Ha is accepted, and Ho is rejected. Test Results in Normality Variables Protein Intake and Type of Exercise are abnormal, and other variables are normal. Results: All respondents (100%) in this study had been on a high-protein diet for over one year. Most respondents were between 26 and 35 (40.9%) and 36-45 years (40.9%). More respondents were men (68.2%). Most respondents did this weight training (81.8%), with an average exercise frequency of 367.73 minutes/week. The average protein intake of respondents was 212.7736 grams/day, the average body mass index was 25.33 kg / m2, and the average creatinine levels of respondents were 1.01 mg / dL. Most respondents had normal systolic (72.7%) and diastolic (68.2%) blood pressures. Conclusions: There was no association between protein intake, BMI, exercise, and creatinine levels. There is a relationship between sex and creatinine levels. There was no association between protein intake, sex, BMI, and exercise with systolic and diastolic blood pressure.

Pain relief after abdominal oncologic surgery. Evaluation of the effectiveness and safety of a fixed combination of diclofenac and orphenadrine

Evaluation of the analgesic, opioid-sparing, anti-inflammatory and adverse effects of the diclofenac and orphenadrine (Neodolpasse) fixed combination for analgesia in the postoperative period of surgical cancer patients. A randomized, single-center, prospective, comparative study evaluated two analgesic regimens in 40 cancer patients undergoing various open cavity surgeries, including extensive combined interventions associated with the resection of 3 or more organs. The study was conducted following the transfer from the ICU to the surgical department during the early activation period, within the first two postoperative days. In the first group N (n=20), "Neodolpasse" (a fixed combination of 75 mg Diclofenac and 30 mg Orphenadrine) was administered as an infusion, twice daily. In the second group K (n=20) analgesia was performed with ketoprofen as an intravenous infusion at a daily dose of 200 mg. Patients in both groups received scheduled prolonged epidural analgesia with 0.2% ropivacaine, and when the severity of pain in a visual analogue scale (VAS) increased to more than 40 mm, so an additional dose of 100 mg tramadol was administered intramuscularly. Daily measurments of blood creatinine level and C-reactive protein were taken, postoperative blood loss was accounted for, as well as postoperative complications according to the Clavien-Dindo classification. The comparative analysis of the indicators of pain syndrome severity showed that the patients in group N exhibited a more pronounced analgesic effect, so on the second postoperative day 30% of patients reported moderate pain (from 50 to 60 mm on the pain scale), on the third day - 15%, and by the fourth day - all 100% of patients experienced pain of low intensity. The additional analgesia with tramadol in group N was required twice less than in the comparison group, and such adverse effects as nausea, drowsiness, and weakness were significantly more common in the ketoprofen group. In both groups, the average blood creatinine level did not exceed permissible values, and the C-reactive protein was elevated at all stages of the study but tended to decrease by the fourth day. The analysis of postoperative complications according to the Clavien-Dindo scale at the time of discharge did not reveal a direct correlation between the occurred complications and the use of NSAIDs. Adverse effects such as anastomotic failure, gastrointestinal complications, or other hemorrhagic manifestations were not recorded. The inclusion of Neodolpasse into multimodal analgesic regimens resulted in the most pronounced analgesic and opioid-sparing effects in surgical cancer patients using laparotomy access. Additionally, the application of short courses of nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with a favorable safety profile.

Acute kidney injury in burn patients: A year findings from a topmost referral burn center in West Java, Indonesia

BackgroundBurn injuries, which affect two layers of the skin, are commonly quantified as a percentage of the total body surface area involved (%TBSA). Acute Kidney Injury (AKI) represents a rapid and typically reversible decrease in kidney function, as indicated by the glomerular filtration rate (GFR). In the context of burn injuries, AKI can be categorized as either early or late onset, each having distinct causes. Neglecting to identify and manage AKI can significantly impact the prognosis of burn injuries. MethodsThis research was an analytical observational study employing a cross-sectional design and subsequent correlation analysis. Data was collected from medical records during the year 2022. Out of a total of 171 cases, only 71 were suitable for evaluation. The statistical analysis of categorical data involved the use of the chi-square test. ResultIn this study, 62.7 % of male participants had burn injuries with a Total Body Surface Area (%TBSA) greater than 20 %, compared to 64.2 % with %TBSA less than 20 %. The average age for patients with %TBSA greater than 20 % was 37.4 years, while for those with %TBSA less than 20 %, it was 42.5 years. The average body weight for these groups was 64 kg and 65 kg, respectively. In terms of kidney function, patients with %TBSA greater than 20 % had an average creatinine level of 1.41 mg/dL and an estimated Glomerular Filtration Rate (eGFR) of 95.79 mL/min/1.73 m2. In contrast, those with %TBSA less than 20 % had average values of 0.86 mg/dL for creatinine and 115.12 mL/min/1.73 m2 for eGFR. Regarding Acute Kidney Injury (AKI), 7 % of patients with burn injuries of %TBSA less than 20 % suffered from AKI, compared to 53.5 % who did not. Among patients with %TBSA greater than 20 %, 25.4 % experienced AKI, while 14.1 % did not. ConclusionThe study reveals a significant correlation between the severity of burn injuries and the occurrence of Acute Kidney Injury (AKI). Specifically, patients with burn injuries affecting over 20% of their Total Body Surface Area (TBSA) are 13.6 times more likely to develop AKI compared to those with less extensive burns, covering less than 20% of TBSA.

The correlation between creatinine levels and estimated glomerular filtration rate (GFR) with blood glucose levels in diabetes mellitus type 2 patients

Diabetes mellitus (DM) was a group of metabolic diseases characterized by hyperglycemia. Measuring the blood creatinine level and calculating the estimated glomerular filtration rate (GFR) was crucial in determining if a person had impaired kidney function. These tests provided valuable insights into the progression of type 2 diabetes mellitus and its associated risk of kidney failure. The objective of this study was to investigate the correlation between average creatinine levels and GFR with blood glucose levels in type 2 DM patients. This correlative research used a cross-sectional approach and included samples from 30 patients with type 2 DM at a hospital in Bandung, Indonesia. The patients' blood glucose and blood creatinine levels were measured using GFR calculations and a Kenza Max photometer, respectively. The sampling method used was accidental sampling, with the sample criteria being type 2 DM patients who were willing to be respondents and did not have hypertension. The average creatinine levels and estimated GFR values were 0.97 mg/dL and 84.971 mL/min/1.73m². The results of the Pearson correlation test indicated non-significant correlations (p > 0.05, p = 0.703 and 0.819). This suggested that there was no significant relationship between creatinine levels and estimated GFR and blood glucose levels in type 2 DM patients. This study provided a foundational exploration of the link between blood glucose levels and kidney function, which could contribute to developing methods for examining kidney diseases in type 2 DM patients. This study's findings underscore the complexity of the relationship between metabolic control and renal function in type 2 diabetes mellitus patients, highlighting the need for individualized patient assessment and management strategies.

The use of intra-articular vancomycin is safe in primary hip and knee arthroplasty

BackgroundThe use of a single dose of intra-articular antibiotic (IAA) has been reported in reducing the rate of prosthetic joint injection after total hip and knee arthroplasty. We examine the safety of IAA in primary hip and knee replacement surgery and the blood levels and joint fluid levels of vancomycin utilising this technique. MethodsFrom August to October 2021, 68 patients undergoing primary total joint arthroplasty (THA & TKA) were given 1g vancomycin intra-articularly (IA)after closure of the fascia. All patients received 2g cefazolin intravenously (IV) 30 min prior to the procedure as is our standard prophylaxis, and 21 of the patients (IA + IV) were also administered an additional 1 gm vancomycin IV. Post-operative blood vancomycin, creatinine land eGFR level monitoring was performed d1 and d3. To determine the post-operative intra-articular vancomycin levels, surgical drain fluid was sampled at day 1 and 2, in 10 patients. ResultsAll patients had serum vancomycin levels measured on day 1 and 3. In the group where vancomycin was injected after fascial closure, the average blood vancomycin level day 1 was 5.2 μg/ml (range 2.0–10.9) and day 3 was <1.4 μg/ml. The average pre-op creatinine levels were 69.4 μmol/L (56.1–82.6) compared to 70.2 μmol/L (57.0–83.4) on day 1 and 66.1 μmol/L (52.6–79.6) on day 3, (p = 0.663). The average pre-op eGFR levels (ml/min/1.73 m2) were 82.2 (76.0–88.3) compared to 81.7 (75.6–87.8) on day 1 and 83.0 (76.8–89.2) on day 3 (p = 0.736). Samples of joint fluid aspirated from surgical drains on day 1 and day 2 showed average vancomycin levels of 224 μg/ml and 51 μg/ml respectively, significantly higher than the MIC for Staph aureus. ConclusionsThe use of intra-articular vancomycin is safe in primary TJA, with no renal damage and delivers levels within the joint which are highly therapeutic for at least 48 h post injection.

Ureum and Creatinine Levels of Kidney Failure Patients Pra and Post Hemodialysis in Jayapura General Hospital Papua

Kidney failure is a worldwide health problem seen from the increase in incidence, prevalence, and the level of morbidity. Indonesia is one country with high rates of kidney failure. The purpose of this research was to determine the description of the results of urea and creatinine levels in patients with kidney failure before and after hemodialysis. The population used in this study was all renal failure patients who would carry out hemodialysis at the Jayapura Regional General Hospital (RSUD). The number of samples in this research is 30. The method of examining urea and creatinine used is the photometry method. This research was conducted from 10 May to 10 June 2018. To determine the levels of urea and creatinine before and after hemodialysis, the average value of the results of the examination was calculated and the results of the average urea level before hemodialysis 53.37 mg/dl and the average yield were obtained. Average after hemodialysis 18.83 mg/dl. The results of the average creatinine level of patients before 12.25 mg/dl and the average results after hemodialysis were 43.63 mg/dl. The results of the examination showed that there were no significant differences and that the results remained high. This research concluded that there was no significant difference between the examination of urea and creatinine levels before hemodialysis and after hemodialysis.

УРОВЕНЬ КРЕАТИНИНА СЫВОРОТКИ КРОВИ ПОЗДНИХ НЕДОНОШЕННЫХ ДЕТЕЙ В РАННЕМ НЕОНАТАЛЬНОМ ПЕРИОДЕ

In accordance with the criteria for assessing the quality of medical care for prematurely born children, a study of serum creatinine is carried out on the first day of life. Elevated levels of the metabolite raise doubts about the advisability of prescribing a control analysis. The purpose of the study was to assess the level of serum creatinine in late preterm infants (34 to 36 weeks of gestation) in the early neonatal period for the correct interpretation of physiological changes in the blood. A retrospective cohort study of medical records was carried out, including an assessment of serum creatinine in late preterm infants on the first and on the 4th to 6th days of life. Two groups of participants were formed from 117 children: group 1 consisted of 62 premature babies with intrauterine growth restriction; group 2 included 55 premature babies with average physical development. The average creatinine level in late preterm infants varied from 85.0 (75.8; 101.6) µmol/l on the first day of life to 43.9 (28.8; 56.0) µmol/l on days 4th to 6th of life (p=0.001). Difference in creatinine level in children from G1 and G2 on the first day of life and at the end of the early neonatal period was not detected (p=0.864, p=0.104, respectively). A significant correlation was noted between the serum creatinine level in mother and child (p=0.001). The serum creatinine level in children in the first day of life is affected by the time of the day the blood sampling for analysis was taken. Thus, the average creatinine level in children at the beginning of the first day of life was 76.0 (68.4; 81.8) µmol/l and 101.6 (93.4; 110.9) µmol/l at the end of the first day of life (p=0.001). The high creatinine level in the first day of life reflects the maternal serum index with its subsequent decrease by the end of the early neonatal period which should be taken into account when assessing the postnatal adaptation of late preterm infants.

Lean muscle mass, not aggression, mediates a link between dominance rank and testosterone in wild male chimpanzees

Testosterone promotes mating effort, which involves intraspecific aggression for males of many species. Therefore, males with higher testosterone levels are often thought to be more aggressive. For mammals living in multimale groups, aggression is hypothesized to link male social status (i.e. dominance rank) and testosterone levels, given that high status predicts mating success and is acquired partly through aggressive intragroup competition. In male chimpanzees, Pan troglodytes, dominance rank has been repeatedly linked to interindividual variation in testosterone levels, but evidence directly linking interindividual variation in testosterone and aggression is lacking. In the present study, we test both aggression levels and lean muscle mass, as measured by urinary creatinine, as links between dominance rank and testosterone levels in a large sample of wild male chimpanzees. Multivariate analyses indicated that dominance rank was positively associated with total rates of intragroup aggression, average urinary testosterone levels and average urinary creatinine levels. Testosterone was positively associated with creatinine levels but negatively associated with total aggression rates. Furthermore, mediation analyses showed that testosterone levels facilitated an association between dominance rank and creatinine levels. Our results indicate that (1) adult male chimpanzees with higher average testosterone levels are often higher ranking but not more aggressive than males with lower testosterone and (2) lean muscle mass links dominance rank and testosterone levels in Ngogo males. We assert that aggression rates are insufficient to explain links between dominance rank and testosterone levels in male chimpanzees and that other social variables (e.g. male-male relationship quality) may regulate testosterone's links to aggression.

#5848 ROLE OF STATINS IN THE CONTRAST-INDUCED ACUTE KIDNEY INJURY PREVENTION AFTER COMPUTED TOMOGRAPHY WITH CONTRAST MEDIA

Abstract Background and Aims Contrast-induced acute kidney injury (CI-AKI) is a serious complication of the use of iodinated contrast media (CM). A number of researches have shown that statins have a protective role in the prevention of CI-AKI due to their pleiotropic effects. The aim of the study was to assess the influence of statins on the incidence of CI-AKI after intravenous CM administration. Method A randomized controlled open-label prospective study was conducted. Statin naive patients with cardiovascular diseases referred for contrast-enhanced computed tomography (CT) were included. Exclusion criteria were the use of statins and chronic kidney disease (CKD) stages 4-5. Acute kidney injury was defined as an increase in serum creatinine level by more than 44 μmol/L (0.5 mg/dL) or 25% from baseline within 48 hours after CM administration according to KDIGO guidelines. Glomerular filtration rate was calculated using the CKD-EPI formula. Overall, 181 patients were included in the study and divided into two groups. The first group (120 people) received high doses of atorvastatin (80mg or 40mg) 24 hours after and before the CM administration, while the second group (61 people), the control group, did not receive any statin therapy. Low-osmolar solutions in an amount of 100 ml were used. All patients were given intravenous hydration with saline before the study and 24 hours later. The statistical analysis was done using IBM SPSS Statistics v26.0. Results The patients in both groups did not significantly differ in age, BMI, coexisting conditions, and medications taken (Table 1). Both groups showed an increase in average creatinine levels after CT with intravenous CM administration, however, in the group of patients receiving high doses of statins, the average level increased less, p = 0.092 (Table 2). AKI developed in 12 individuals (6.7%), 9 of them were in the control group, and 3 were in the group receiving high doses of statins, p = 0.003. The chances of AKI development in the group receiving high doses of statins were 6.95 times lower compared to the control group (OR = 6.05, 95% CI: 1.7-21.5). Most of the patients had preserved kidney function and did not suffer from diabetes mellitus. There were statistically significantly more patients with preserved kidney function in the statin group, p = 0,007, OR: 2,374 (CI 95% 1,258 - 4,479), and fewer patients with CKD 3a stage, p = 0,05, OR: 0,406 (CI 95% 0,195 – 0,844). Conclusion Despite the presence of patients at risk, the incidence of CI-AKI was 6.7%, possibly due to additional prevention of this complication with intravenous saline before and after administration of the CM. In this trial, we observed that periprocedural administration of atorvastatin in high doses for a short duration, reduced the incidence of CI-AKI.

Analyses of Kidney Biomarkers in Patients With SARS-CoV-2 (COVID-19)

The new coronavirus was first reported in China and caused a widespread global outbreak of pneumonia that spread rapidly across this country and many other countries. Acute kidney injury is one of the important complications of COVID-19, which has been shown in some cases. Exploring the diagnostic features of biomarkers of kidney function in COVID-19 patients may lead to better patient management. We collected laboratory data from 206 people with confirmed COVID-19 disease and evaluated their renal biomarkers, Blood Urea Nitrogen (BUN), and creatinine. The age range of the patients was almost 62 years old. The mean age in the dead patients and recovered patients was 71 and 54 years old, respectively. The average LDH value was 755 U/L, and creatine phosphokinase (CPK) was 267 U/L in the patients. The average BUN was 59.1 U/L, and creatinine was 1.5 U/L in COVID-2019 patients. Among all 193 patients, laboratory results revealed that 163 (85.4 %) patients had an elevated BUN level. Based on creatinine levels for total patients, laboratory results revealed that 49 (25.4 %) patients had an elevated value. The average BUN value in dead patients was 85 mg/dL, while in recovered patients was 40.5 mg/dL (P&lt;0.0001). Also, the average creatinine level in dead patients was 1.86 mg/dL, while in recovered patients was 1.24 mg/dL (P=0.0004). Inflammation following COVID-19 disease causes kidney damage and elevated urea and creatinine levels, which may increase the risk of death in these patients.

Pregnancy after kidney transplantation: Ibn Sina Rabat University hospital experience

Kidney transplantation (KT) restores the fertility of women with end-stage kidney disease (ESKD), thus offering them the possibility of having children. However, pregnancy after kidney transplantation is associated with high maternal-fetal morbidity. The purpose of this work is to report the experience of our service in pregnancies in kidney transplant recipients. We retrospectively studied the records of transplant recipients who had one or more pregnancies after KT. We analyzed clinical (blood pressure, weight gain, oedema, duration of pregnancy, obstetric complication) and biological (creatinine, urinary albumin excretion) parameters. Between 1998 and 2020, twenty-one pregnancies occurred in 12 transplant recipients. The average age of patients at the time of conception was 29 ± 5 years with a delay between KT and pregnancy of 43 ± 29 months. Seven pregnancies began with arterial hypertension (HTA) controlled under treatment, proteinuria before conception was negative in all pregnancies and renal function was normal with an average creatinine level of 10.1 ± 1,27 mg/L. Prior to pregnancy, immunosuppression regimens were based on anticalcineurin (n = 21) combined either with mycophenolate mofetil (MMF) (n = 10) or azathioprine (n = 8) or alone (n = 3). Immunosuppression regimens were all associated with corticosteroid therapy. Three months before conception, MMF was relayed by azathioprine in seven pregnancies, on the other hand three other unplanned pregnancies, started under MMF. During pregnancy, the appearance of proteinuria greater than 0,5 g/24 h was noted in three pregnancies in the third trimester. Pregnancy hypertension was found in three pregnancies, one of which progressed to pre-eclampsia. As for renal function, it remained stable with an average creatinine level of 10,3 mg/l in the 3rdtrimester. Two cases of acute pyelonephritis were noted. No episode of acute rejection was noted during and 3 months after pregnancy. The delivery was performed by caesarean section in 44.4%, after an average term of 37 week of amenorrhea ± 2.04 with three cases of prematurity. The average birth weight was 3 110 g ± 450 g. There was one case of spontaneous abortion and two cases of fetal death in utero. After post-partum, renal function remained stable in five patients. In six cases, there was impaired renal function either by acute rejection or secondary to chronic allograft nephropathy. In our department, a quarter of transplant recipients were able to carry a pregnancy with a rate of 89% of successful pregnancies. Pregnancy after KT requires special planning and monitoring. A multidisciplinary collaboration between transplant nephrologist, gynecologist and pediatrician is necessary by referring to the recommendations.

Evaluating the iatrogenic effects of polypharmacy and drug interactions in HIV-positive patients admitted to the intensive care unit: a single-center retrospective study

Background. Polypharmacy and drug interactions are of particular concern in people living with HIV/AIDS, especially those who receive antiretroviral therapy (ARVs). Polypharmacy and drug-drug interactions (DDIs) can impact the efficacy and toxicity of HIV treatment. ARVs used in HIV treatment are often prone to drug interactions if administered with other non-ARV drugs because many of them are metabolized through the cytochrome P450 system. The pharmacological management of HIV patients in the intensive care unit (ICU) is usually complex and typically involves the administration of several classes of drugs. This patient group may be at higher risk for potential DDIs due to polypharmacy in the ICU. The main objective of this study was to assess the iatrogenic effects of polypharmacy in HIV patients treated in the ICU and to describe the DDI profile between ARVs and other non-ARV medications prescribed in the ICU. Methods and materials. Between 2018 and 2020, we conducted a single-center, retrospective study evaluating the medical records of 59 HIV patients admitted to the ICU for more than 24 hours at the Infectious Disease Clinical Hospital No. 2, Moscow, Russia. We evaluated the impact of polypharmacy on renal, hepatic and haemopoietic function. The Liverpool HIV Drug Interaction database was used to identify DDIs in ART-treated HIV patients. Results. All patients received more than 5 different medications matching the definition of polypharmacy. The average number of concurrent medications prescribed was 156.713 (maximum 40, minimum 6). All drug interactions recorded were between ARVs and antibiotics: 30 cases of potential interactions in 65.5% patients who received ARV. Of such patients, 94% were exposed to at least two potential interactions. Tenofovir (TDF) and the antibiotic vancomycin underlaid the most common potential interaction (49.2%), followed by lopinavir ritonavir (LPV/RTV) and ciprofloxacin (30.3%). A significant difference in average creatinine levels was found in patients with TDF/vancomycin potential interactions (p 0.05). Conclusion. This study demonstrated that potential DDIs frequently occur in ICU patients in line with previous investigations. It is necessary to implement collaborations among clinical pharmacologists and infectious disease/HIV specialists, as well as frequent clinical and laboratory monitoring, aimed at developing effective and actionable strategies that could reduce potential DDIs in HIV patients in the ICU.

P9.07: Post Liver Transplantation Renal Impairment: Experience With the First 100 Cases in a Single Center in Mongolia

Introduction: Renal impairment is multifactorial complication of liver transplantation (LT) with a variable prevalence that depends on pretransplant comorbidities, degree and cause of ESLD, intra and postoperative variables. Predisposing factors and incidence haven’t been studied in emerging transplant centers. In this study we aimed to identify risk factors and incidence of post-LT renal impairment in the first 100 LT cases in an emerging transplant center. Methods: This was a single center retrospective case-control study of 100 adult patients who underwent LT from September 2011 to September 2020. Renal impairment was defined as a KDIGO stage III or IV. Creatinine and GFR were measured pre-transplantation, intraoperatively and post LT. Cases and controls were compared to identify risk factors. Evaluated variables included demographics, etiology of liver disease, MELD preexisting HTN and DM, ischemic time, donor/graft type, intraoperative hemodynamics, use of blood products and postoperative outcomes. Data was collected by survey and statistical processing and analysis was done with Microsoft Excel, SPSS 15.0 software. Results: Thirty-nine patients in the study had renal impairment, 28 were males (72%) with a mean age of 43y (35-52) with a BMI of 24.7, mean MELD of 14.2 and a class B CPT score in (53.8%). The most common etiology in this group was viral (67%) 10.8% had HTN and preTx diagnosis of DM (compared with 3.7% and 7.4% of the control group). 91% of the total study group were RL LDLT with GRWR, median (IQR) of 1.04 % (0.92-1.21). Tacrolimus+MMF was used in 92% of all cases. (94.8% of study group NS p=0.253). The mean serum creatinine level before liver transplantation was 0.70 ± 0.27 mg/dl, and glomerular filtration rate was 121.6 ± 61.3 ml/min/m2. Average creatinine level of recipients who had renal impairment after liver transplantation was 0.825 ± 0.24 (p= <0.001), and glomerular filtration rate was 111 ± 36.3 ml/min/m2 (p=<0.001). Other variables, like diagnosis, degree of disease, preexisting comorbidities, donor/graft type, intraoperative hemodynamics immunosuppression and postoperative outcomes were not statistically significant. Conclusions: Our data shows that there is a statistically significant correlation between high pre-transplant serum creatinine levels, low glomerular filtration rate and post-transplant renal impairment. This correlates with experienced centers results, showing that emerging transplant centers have similar rates, understanding that our MELD scores are on average lower than larger series. There was a higher number of patients in the study group with HTN and DM, that said this was not statistically significant. The main limitation of the study is related to sample size but as our rate of LT continues to grow significantly every year, we will continue to asses variables and modify these factors to improve the rate of kidney dysfunction.

Influence of the Consumption of Four Diets on the Biological Blood Parameters of Japanese Quail (Coturnix japonica) Farmed in Côte D’ivoire

To ensure that newly formulated food (A1, A2 and A3) based on local products and commercial love (AT), fed to quail reared in captivity for 9 weeks, did not affect their health biologicaly, biochemical blood analysis were carried out on them at the end of the experiment. The results obtained show that the quails fed with A3 and AT foods have the highest respective crude protein levels (55.67 ± 1.70 and 55 ± 0.82 g/l). In addition, the blood Ca/P ratio which represents the index of a good metabolism of these electrolytes, between 1 and 2, is in accordance with the recommendations in force. In addition, the average urea and creatinine levels of all the quails studied are identical to those of the control quails. Similarly, in quail fed with commercial food AT, uricemia is the highest (66 ± 0.82 mg/l) in this study. Quails fed with commercial food AT have the highest cholesterol level (2.24 ± 0.04 g/l). However, quails fed with feed A3 are those with the lowest level of triglycerides (6.80 ± 0.02 g/l). Thus, consumption of the newly formulated feeds A1, A2 and A3 by quails did not affect their renal, hepatic, pancreatic and heart health like that of quails fed the commercial feed AT.

POS-513 PLASMA EXCHANGE IN NEPHROLOGY

Plasma exchange is a therapeutic tool with broad indications in different diseases. The aim of this study was to determine its indications and possible complications in the nephrology setting. This is a retrospective study of therapeutic plasma exchange performed in our department over 15 years [2006 to 2021]. Our study included 20 patients with an average age of 46.45 years [18-77] and a sex ratio of 0.66. The initial symptomatology was variable. A glomerular syndrome was present in all patients associated with rapidly progressive renal failure in 15 cases with an average blood creatinine level of 645.05 µmol/L [144-2017], 12 cases of Haemoptysis on chest CT scan or bronchoalveolar lavage and one case of cerebellar syndrome. Immunologically, 7 cases were positive for antiGBM antibodies, 4 cases positive for anti-MPO antibodies, 3 cases positive for antiPR3 antibodies, and serum complement was consumed in 3 patients. Renal biopsy performed in 10 patients revealed 1 case of myeloma nephropathy, 2 cases of lupus nephropathy, 3 cases of vasculitis, and 4 cases of Goodpasture's disease. Indications were diverse and included rapidly progressive glomerulonephritis, acute humoral rejection in a renal transplant patient, hyperviscosity syndrome in a myeloma patient, and a case of acute polyradiculoneuritis. The products used were albumin with fresh frozen plasma in all patients and albumin alone for the renal transplant patient, with an exchange volume of 50cc/kg. The average number of sessions was 6.3 [1-16] with a frequency of 1 to 3 sessions per week. Complications ranged from 2 episodes of circuit clotting to 2 episodes of low blood pressure, one case of acute coronary syndrome, one case of seizure followed by cardiac arrest and death. The progression was marked by an improvement of the renal function in 8 patients, the use of extrarenal purification in 9 patients, and the death of 2 patients. The indications for therapeutic plasma exchange are increasingly broad in the nephrology setting, including neurological and hematological disorders in patients with various kidney diseases.

Renal Dysfunction After Liver Transplantation: a Single Center Study

Objectives: Mongolia is known as one of the countries with a high prevalence of viral hepatitis infection and its related liver cirrhosis and HCC. Therefor, liver transplantation (LT) surgery increases from year to year in Mongolia. Our goal was to evaluate post-transplant renal dysfunction (PTRD) and to investigate the predicting factors for renal dysfunction after LT. Methods: The impact of graft ischemic time, peri- and postoperative blood product transfusion, perioperative hemodynamics, time to extubating, intensive care length of stay, incidence of chronic renal failure, and mortality and morbidity were examined alone and then as a combined outcome. Results: Early renal dysfunction was identified by measuring serum creatinine and glomerular filtration rate. In our investigation which was a study group of patients following liver transplantation (LT), the following renal dysfunctions were found: 39% of recipients in the study had renal dysfunction, while the rest had no renal dysfunction. The average creatinine level of the recipients who had a renal dysfunction after LT, was 0.825 ± 0.24 mg/dl and the glomerular filtration rate was 111 ± 36.3 ml/min, and statistically significant. Conclusion: Preoperative kidney function plays a crucial role for postoperative renal dysfunction.

Overview of Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients at Royal Prima Hospital Medan Indonesia

Diabetes Mellitus (DM) is a chronic disease characterized by blood glucose (blood sugar) levels exceeding normal. Diabetic nephropathy is a chronic microvascular complication that often occurs in diabetics. This study presents a picture of diabetic nephropathy in type 2 DM patients at the Royal Prima Hospital in Medan. This research is a type of descriptive research. The sample from this study was the total data of patients suffering from diabetic nephropathy who met the inclusion and exclusion criteria at Royal Prima Hospital from January 1, 2020 – to December 31, 2020. The inclusion criteria for the subjects of this study were complete patient medical records, type 2 diabetes patients, urinalysis tests. (proteinuria ≥ +2), renal function examination exceeds normal values, blood urea, and creatinine. The mean age of diabetic nephropathy patients was 57.52 years and the majority were 62 men (50.8%). The average picture of urea levels in diabetic nephropathy patients is 51.8 and the average creatinine level is 1.48. The majority of patients with diabetic nephropathy do not have proteinuria. And the average blood sugar level is 267 mg/dL. In conclusion, the incidence of diabetic nephropathy is highest in patients aged 57 years. The mean value of urea level is 51.80 mg/dl, creatinine value is 1.48 mg/dl, and the average blood sugar level is 267 mg/dl. Most proteinuria was in the negative category of as many as 107 people (87%).

The role of calcium metabolism disorders in the formation of different density calculi with calcium oxalate nephrolithiasis

Objective To investigate the relationship between calcium metabolism disorders, stone formation inhibitor levels and stone density in primary and recurrent calcium-oxalate nephrolithiasis.Material and Methods Sixty nine patients with urolithiasis were examined, their average age was 41,4 ± 9,5 years. Two main groups were distinguished: Group 1 – primary calcium-oxalate nephrolithiasis (PN), Group 2 – recurrent calcium-oxalate nephrolithiasis (RN). Then each group was divided into two subgroups – A and B according to stone density: 500–1000 HU and from 1000–1500 HU, respectively. Stone density was determined by computed tomography (CT). PTH (parathormone), PTHrP (parathyroid hormone related protein), vitamin D, total blood calcium (Ca), ionized blood Ca, total blood protein, Ca and urine pH were also examined. After the examination, patients underwent surgical removal of the stones.Results It was found that 41.9% of group 1 and 46.9% of group 2 patients had grade I obesity. Average creatinine level in group 2 was 9.7% higher than in group 1 (p &lt; 0.05). Urea level in both groups was not statistically significantly different. Glomerular filtration rate (GFR) was comparable. Groups 2A and 2B had higher PTHrP values (77.61 and 76.98 pg/mL, respectively) combined with relatively high PTH levels (2A – 4.4 pg/mL and 2B – 5.1 pg/mL), relatively low osteopontin concentration (2A – 0.044 pg/ mL, 2B – 1.106 pg/mL), compared to those in group 1 (p &lt; 0.05). Pairwise unidirectional differences between groups 1A and 2A, 1B and 2B were found to correlate positively with density values: for osteopontin: r = 0.992 (p &lt; 0.05); for vitamin D: r = 0.831 (p &lt; 0.05); for blood Ca2+ ions: r = 0.836 (p &lt; 0.05); for urine pH: r = 0.863 (p &lt; 0.05). There was a negative correlation with the daily concentration of urinary calcium ions with the density of concrements: r = -0.663; p &lt; 0.05. The concentration of osteopontin was significantly higher in Group 1B and 2B patients, and it was significantly lower in patients with stones of &lt; 1000 HU density. Higher values of osteopontin concentration were noted in groups 1B and 2B in relation to groups 1A (p &lt; 0.05) and 2A (p &lt; 0.05). The increase of blood Ca2+ ions in patients in groups 1B and 2B in relation to groups 1A (p &lt; 0.05) and 2A (p &lt; 0.05) was also accompanied by higher values of vitamin D.Conclusion Patients with denser stones showed high values of osteopontin and PTHrP in serum and low values of urinary calcium ions, which may lead to the formation of concrements on the matrix with an organic base. Determination of calcium metabolism makes it possible to predict recurrence of KSD in primary calcium oxalate nephrolithiasis and assess the severity of mineral metabolism disorders in recurrent calcium oxalate nephrolithiasis.

MO402ACUTE OBSTRUCTIVE RENAL FAILURE IN URGENT HEMODIALYSIS

Abstract Background and Aims Acute obstructive renal failure is secondary to obstruction of the upper excretory tract occurring bilaterally or in a single anatomical or functional kidney. It accounts for 8 to 14% of all acute renal failure in Morocco. They constitute serious conditions which can jeopardize the functional prognosis of the kidney . The objective of our study is to describe the profile of patients on emergency hemodialysis for acute obstructive renal failure (AKI), the main indications for hemodialysis and to assess the risk factors for mortality. Method It was a 2-year retrospective and descriptive study from January 2018 to December 2019; performed in the nephrology and hemodialysis department CHU IBN ROCHD CASABLANCA. Results A total of 118 patients were counted: 43 women, 75 men or 36.4%, 63.5%, with an average age of 54.3 years "+/- 10.3". The circumstances of discovery were: Oligo anuria 51.5%, hematuria 25%, AEG 24%. The obstacle was neoplastic in 67.79%; lithiasis 26.27%; on pregnancy in 0.84%; bladder malformation 0.84%, and unknown etiologies in 4.2%. The neoplastic origin was cancer of the cervix, followed by the bladder and then the prostate. The average creatinine level was 89.7mg / l. The indication for hemodialysis was: threatening hyperkalemia, uremic syndrome, acidosis and acute pulmonary edema in 56%, 25.8%, 9.6% and 10% of cases, respectively The total number of hemodialysis sessions was 227 hemodialysis sessions with an average number of 1.91. Obstacle removal was performed by percutaneous nephrostomy in 70.8% of cases, by mounting a double J probe in 10% of cases and by ureterostomy in 4.2% of cases. The course was good in 77.9% of the cases, 13.5% progressed to the IRCT. Mortality was 8.4%. Risk factors for mortality were: age, etiology of neoplasia. Conclusion A total of 118 patients were counted: 43 women, 75 men or 36.4%, 63.5%, with an average age of 54.3 years "+/- 10.3". The circumstances of discovery were: Oligo anuria 51.5%, hematuria 25%, AEG 24%. The obstacle was neoplastic in 67.79%; lithiasis 26.27%; on pregnancy in 0.84%; bladder malformation 0.84%, and unknown etiologies in 4.2%. The neoplastic origin was cancer of the cervix, followed by the bladder and then the prostate. The average creatinine level was 89.7mg / l. The indication for hemodialysis was: threatening hyperkalemia, uremic syndrome, acidosis and acute pulmonary edema in 56%, 25.8%, 9.6% and 10% of cases, respectively The total number of hemodialysis sessions was 227 hemodialysis sessions with an average number of 1.91. Obstacle removal was performed by percutaneous nephrostomy in 70.8% of cases, by mounting a double J probe in 10% of cases and by ureterostomy in 4.2% of cases. The course was good in 77.9% of the cases, 13.5% progressed to the IRCT. Mortality was 8.4%. Risk factors for mortality were: age, etiology of neoplasia.

THE RENAL FUNCTION STATUS OF METAL ELECTROPLATING WORKERS EXPOSED TO CHROMIUM VI

Chromium (Cr) is commonly used as an anti-corrosive agent. Due to its unique nature, Cr is used to coat metal in order to make it looks shiny and attractive. However, hexavalent chromium (Cr (VI)), a form of chromium used in electroplating, is classified as carcinogenic substance. Its portal of entry into the human body can be through inhalation, ingestion, and dermal absorption. Talang District in central-Java, Indonesia is a center of informal sector’s metal electroplating industry. Electroplating workers in the informal sector rarely wear personal protective equipment (PPE) while working. This research analyzed the relation between chromium exposure, age, length of employment, and nutritional status with renal function of metal electroplaters. The subjects of this study involved 35 electroplaters from Talang with working experience ranging between 6 and 40 years. The independent variables were age, length of employment, nutritional status and exposure to chromium. Dependent variable was workers’ renal function. Urine samples were collected to determine chromium exposure and renal function based on urinary chromium and creatinine levels. Data was analyzed using chi-square test with SPSS Statistics software. The average urinary chromium and creatinine levels were 21.16 μg/L and 209.75 mg/dL respectively. This study found no relation between age and chromium levels in urine and renal function. However, length of employment and nutritional status were found to be significantly related to renal function. Although chromium exposure does not appear significantly associate with renal function, the average urinary chromium levels of metal electroplaters did exceed threshold values.