Changes In Kidney Function Research Articles

Azvudine versus paxlovid for oral treatment of COVID-19 in Chinese patients

PurposeTo explore the effect of azvudine as compared to paxlovid for oral treatment of hospitalized patients with SARS-CoV-2 infection.MethodsWe analyzed data from a cohort of patients with SARS-CoV-2 infection in Shandong provincial hospital between February 15 and March 15, 2023. The primary outcome was time to sustained clinical recovery through Day 28 and secondary outcomes included the percentage of participants who died from any cause by Day 28, the average hospitilization time and expenses, the changes in liver and kidney function and adverse events. The Kaplan–Meier method and Cox regression model was used for statistical analysis.ResultsThere was no significant difference between azvudine and paxlovid in terms of time to sustained clinical recovery (p = 0.429) and death rates (p = 0.687). As for hospitalization time and fee, no significant differences were observed between azvudine group and paxlovid group (Hospitalization time: p = 0.633; Hospitalization fee: p = 0.820). In addition, there were no significant differences in the effects of the two drugs on liver and kidney function (p > 0.05).ConclusionAmong adults who were hospitalised with SARS-CoV-2 infection, azvudine was noninferior to paxlovid in terms of time to sustained clinical recovery, death rates, hospitalization time and cost, with few safety concerns.Trial registrationChiCTR2300071309; Registered 11 May 2023.Level of evidenceLevel III; Retrospective cohort study.

Impact of Omicron variant infection on the liver, kidney, and coagulation system in patients undergoing elective surgery: a retrospective case-control study.

Purpose: We aimed to investigate the impact of Omicron variant infection on the perioperative organ function in patients undergoing elective surgery. Methods: A total of 5029 patients who underwent elective surgery between October 2022 and January 2023 at our hospital were enrolled. Among them, the patients who underwent elective surgery between October 2022 and November 2022 composed Group 1 (not infected with the Omicron variant) the control group; those who underwent elective surgery between December 2022 and January 2023 composed Group 2 (one month after Omicron variant infection) the experimental group. We further divided the patients into two subgroups for analysis: the tumor subgroup and the nontumor subgroup. Data on organ system function indicators, including coagulation parameters, liver function, complete blood count (CBC), and kidney function, were collected before and after surgery. Differences between the two groups were subsequently analyzed via binary logistic regression analysis. Results: Compared with those in the uninfected patient group, the following changes were observed in patients with Omicron variant infection who underwent elective surgery one month after infection: prothrombin activity (PTa), prothrombin time (PT), fibrinogen, albumin/globulin, alanine aminotransferase (ALT), mean corpuscular hemoglobin concentration (MCHC), platelet (PLT), and anemia were increased AST/ALT, indirect bilirubin (IBILI), eosinophils, and uric acid were decreased before surgery; and lung infection/pneumonia and fibrinogen were increased, while AST/ALT, globulin, total bilirubin (TBIL), white blood cell count (WBC), and uric acid were decreased after surgery. There was no significant difference in the mortality rate or length of hospital stay (LOS) between the two groups. Subgroup analysis revealed elevated monocyte, PLT, and fibrinogen classification, levels and decreased globulin, prealbumin (PBA), eosinophil, and uric acid levels in the tumor subgroup of patients who underwent elective surgery one month after Omicron infection compared with those in the uninfected patients. Compared with the nontumor subgroup, fibrinogen levels, lung infection/pneumonia, TBIL, and PLT count were increased in the uninfected patients, while the globulin and eosinophil levels were decreased. Conclusion: Compared with uninfected patients, patients who underwent elective surgery one month after Omicron variant infection exhibited minimal changes in perioperative coagulation parameters, liver function, CBC counts, and kidney function. Additionally, no significant differences in postoperative mortality or LOS were observed between the two groups.

Analysis of Biodistribution and in vivo Toxicity of Varying Sized Polystyrene Micro and Nanoplastics in Mice.

Studies have shown that microplastics (MPs) and nanoplastics (NPs) could accumulate in the human body and pose a potential threat to human health. The purpose of this study is to evaluate the biodistribution and toxicity of MPs/NPs with different particle sizes comprehensively and thoroughly. The purpose of this study was to investigate the biodistribution and in vivo toxicity of polystyrene (PS) MPs/NPs with different sizes (50 nm, 100 nm, and 500 nm). The BALB/c mice were given 100 μL of PS50, PS100 and PS500 at the dosage of 1 mg/kg BW or 10 mg/kg BW, respectively, by gavage once a day. After 28 consecutive days of treatment, the biodistribution of differently sized PS MPs/NPs was determined through cryosection fluorescence microscopy and fluorescent microplate reader analysis, and the subsequent effects of differently sized PS MPs/NPs on histopathology, hematology and blood biochemistry were also evaluated. The results showed that the three different sizes of PS MPs/NPs were distributed in the organs of mice, mainly in the liver, spleen, and intestine. At the same time, the smaller the particle size, the more they accumulate in the body and more easily penetrate the tissue. During the whole observation period, no abnormal behavior and weight change were observed. The results of H&E staining showed that no severe histopathological abnormalities were observed in the main organs in the low-dose exposure group, while. Exposure of three sizes of PS MPs/NPs could cause some changes in hematological parameters or biochemical parameters related to heart, liver, and kidney function; meanwhile, there were size- and dose-dependencies. The biological distribution and toxicity of plastic particles in mice were more obvious with the decrease of particle size and the increase of concentration of plastic particles. Compared with MPs, NPs were easier to enter the tissues and produce changes in liver, kidney, and heart functions. Therefore, more attention should be paid to the toxicity of NPs.

Assessment of pharmacologically induced changes in canine kidney function by multiparametric magnetic resonance imaging and contrast enhanced ultrasound.

Assessment of pharmacologically induced changes in canine kidney function by multiparametric magnetic resonance imaging and contrast enhanced ultrasound.

Alterations of serum biochemical parameters and tyrosine phosphorylation in kidney and liver of chronic stress-induced rats

Abstract Chronic stress (CS) can contribute to dysfunction in several organs including liver and kidney. This study was performed to investigate the changes in serum biochemistry, histological structure, as well as in localization of tyrosine phosphorylated proteins (TyrPho) and Heat shock protein 70 (Hsp-70) in liver and kidney tissues of CS rats induced by two stressors (restrained and force swimming) for 60 consecutive days. Samples of blood, liver, and kidney were collected from adult male Sprague–Dawley rats in each group. Our results showed that serum biochemical parameters including corticosterone, blood sugar, urea nitrogen, creatinine, cholesterol, triglyceride, HDL-C, LDL-C, ALT, AST, alkaline phosphatase in CS group were significantly different from that in normal group in both liver and kidney tissues. Although histological structure was not changed. TyrPho expression was significantly increased in liver lysate but significantly decreased in kidney. Hsp-70 expression in liver increased whereas in kidney decreased. In conclusion, CS can induce changes in liver and kidney functions.

Efficacy of 1060 nm Diode Laser for Non-Invasive Subcutaneous Fat Reduction in Mini-Pigs.

To evaluate the efficacy and safety of abdominal fat reduction in mini-pigs, utilizing at 1060 nm diode laser with a wavelength of 1060nm. The laser system non-invasively disrupts adipose tissue; its effectiveness and safety were evaluated by ultrasound imaging and histological analysis. Laser irradiation was performed with various powers, and the cooling function was activated to prevent skin surface damage. The dermal tissue temperature increased to at least 43°C during laser exposure, leading to a decrease in abdominal fat thickness after 30days. Blood tests revealed no significant changes in kidney and liver function but showed increased blood levels of nonessential free acids (NEFAs), likely due to the release of fatty tissue-derived free fatty acids. Histological evaluation demonstrated rapid transformation of adipose tissue into collagen, muscle fibers, and intracellular fibrous tissue. The 1060nm laser showed promise as a non-invasive and safe tool for reducing abdominal fat.

Imperatorin ameliorates kidney injury in diabetic mice by regulating the TGF-β/Smad2/3 signaling axis, epithelial-to-mesenchymal transition, and renal inflammation

Diabetic nephropathy (DN) is a serious concern in patients with diabetes mellitus. Prolonged hyperglycemia induces oxidative damage, chronic inflammation, and build-up of extracellular matrix (ECM) components in the renal cells, leading to kidney structural and functional changes. Imperatorin (IMP) is a naturally occurring furanocoumarin derivative with proven antioxidative and anti-inflammatory properties. We investigated whether IMP could improve DN and employed high glucose (HG)-induced HK-2 cells and high-fat diet-fed streptozotocin (HFD/STZ)-generated DN experimental model in C57BL/6 J mice. In vitro, IMP effectively reduced the HG-activated reactive oxygen species generation, disturbance in the mitochondrial membrane potential (MMP) and epithelial-to-mesenchymal transition (EMT)-related markers, and the transforming growth factor (TGF)-β and collagen 1 expression in HK-2 cells. In vivo, we found an elevation of serum creatinine, kidney histology alterations, and collagen build-up in the kidneys of the DN control group. Also, we found that altered expression of EMT-related markers, upregulation of the TGF-β/Smad2/3 axis, and elevated pro-inflammatory molecules, TNF-α, IL-1β, IL-18 and phospho–NF–kB (p65) in the DN control group. IMP treatment did not significantly reduce the blood glucose level compared to the DN control group. However, IMP treatment effectively improved renal damage by ameliorating kidney histological changes and serum renal injury markers. IMP treatment restored renal antioxidants and exhibited anti-inflammatory effects in the kidneys. Moreover, the abnormal manifestation of EMT-related attributes and elevated levels of TGF-β, phospho-Smad2/3, and collagen 1 were also normalized in the IMP treatment group. Our findings highlight that IMP may be a potential candidate for treating DN.

The Effectiveness Of Atorvastatin On Kidney Function In Outpatient Diabetic Nephrophaty Patients

Introduction: Dyslipidemia can damage the kidneys through increased oxidative stress. Statins can be used as adjunctive therapy to standard treatment with Angiotensin Converting Enzym Inhibitor (ACEIs) or Angiotensin II Receptor Blocker (ARBs) to improve renoprotection. Objective: The study is that to analyze the effectiveness atorvastatin on changes in kidney function in patients diabetic nephropathy. Methods: It was observational study. Samples were taken prospectively from diabetic nephropathy patients receiving atorvastatin at the Interna Polyclinic of the Bhayangkara Hospital Surabaya namely November 2021 – January 2022. Patients aged 18 – 80 years received atorvastatin for ≤3 months before the study was conducted, with Glomerulo Filtration Rate (GFR) stages 3A, 3B, and 4, with mild, moderate, and severe albuminuria degrees. Results: There are several patients which receive ARBs, namely candesartan and ketoacid which can affect the results of the analysis so that different tests are conducted in the three groups, the result shows a significant decrease in Blood Urea Nitrogen (BUN) values in the sample group which receives additional ketoacid therapy (p <0.05); besides, a decrease in parameters albuminuria in the group with additional 16 mg candesartan therapy which is not significant. Conclusion: The administration atorvastatin alone 20 mg or in combination with candesartan 16 mg and ketoacid on kidney function after 3 months of use can prevent the progression of diabetic nephropathy. Key words: Atorvastatin; Diabetic Nephropathy; Kidney Function

Експериментальна патологія нирок: моделі токсичних нефропатій

When conducting experimental studies, the question of an adequate model of renal pathology is problematic, therefore, the range of choice of methods of reproduction is extremely wide. The paper highlights the main modern methods of modeling and the principles of choosing a model of nephropathy for the study of changes in kidney functions and processes. It also investigates the effectiveness of pharmacological correction under the conditions of exposure to exotoxins. Attention is focused on models with predominant damage to nephron sections with established pathogenetic features of the course of acute and chronic toxic nephropathy. Aim of research is elucidation of methods of modeling toxic nephropathies, using the results of our research laboratories and modern data from the literature on experimental nephrology. Materials and Methods. Analytical methods are used in the work: collection of scientific information on the problem, data analysis and scientific generalization of results. Results and Conclusions. Experimental models of kidney diseases are diverse, which allows to carefully study the pathogenesis of renal pathology and to develop effective therapeutic strategies. At the same time, in experimental studies, in a number of cases, it is necessary to simulate kidney disease with differentiated damage to the glomerular or tubular part of the nephron. The development of effective medical interventions to reduce exotoxin-induced nephrotoxicity largely depends on the chosen experimental model, respectively, on the understanding of the pathophysiology of toxic nephropathies. Keywords: experimental nephrology, differentiated damage of the nephron, toxic nephropathies.

Statin therapy in patients with early-stage autosomal dominant polycystic kidney disease: Design and baseline characteristics

BackgroundAutosomal dominant polycystic kidney disease (ADPKD) is characterized by the development and continued growth of multiple cysts in the kidneys leading to ultimate loss of kidney function in most patients. Currently, tolvaptan is the only agency approved therapy to slow kidney disease advancement in patients with faster progressing disease underscoring the need for additional ADPKD therapies suitable for all patients. We previously showed that pravastatin slowed kidney disease progression in children and young adults with ADPKD. However, the intervention has not been tested in an adult cohort. AimsThe aim of the study is to conduct a single center, randomized, placebo-controlled double-blinded clinical trial to determine the efficacy of pravastatin on slowing kidney disease progression in adult patients with early stage ADPKD. MethodsOne hundred and fifty adult patients with ADPKD and eGFR ≥60 ml/min/1.73m2 will be enrolled in the study and randomized to receive 40 mg/day pravastatin or placebo for a period of 2-years. OutcomesThe primary outcome of the trial is change in total kidney volume assessed by magnetic resonance imaging (MRI). Secondary outcomes include change in kidney function by iothalamate GFR and renal blood flow and markers of inflammation and oxidative stress. ConclusionThis study will assess the kidney therapeutic benefits of pravastatin in adult patients with ADPKD. The recruitment goal of 150 subjects was attained and the study is ongoing.Registration: This study is registered on Clinicaltrials.gov # NCT03273413

Age-related changes in hematological biomarkers in common marmosets.

Researchers and veterinarians often use hematology and clinical chemistry to evaluate animal health. These biomarkers are relatively easy to obtain, and understanding how they change across healthy aging is critical to clinical care and diagnostics for these animals. We aimed to evaluate how clinical biomarkers from a chemistry profile and complete blood count (CBC)change with age in common marmosets (Callithrix jacchus). We assessed blood samples collected during routine physical exams at the Southwest National Primate Research Center and the University of Texas Health San Antonio marmoset colonies from November 2020-November 2021. We found that chemistry and CBC profiles varied based on facility, sex, and age. Significant changes in albumin, phosphorus/creatinine ratio, albumin/globulin ratio, amylase, creatinine, lymphocyte percent, hematocrit, granulocytes percent, lymphocytes, hemoglobin, red cell distribution width,and platelet distribution widthwere all reported with advancing age. Aged individuals also demonstrated evidence for changes in liver, kidney, and immune system function compared with younger individuals. Our results suggest there may be regular changes associated with healthy aging in marmosets that are outside of the range typically considered as normal values for healthy young individuals, indicating the potential need for redefined healthy ranges for clinical biomarkers in aged animals. Identifying animals that exhibit values outside of this defined healthy aging reference will allow more accurate diagnostics and treatments for aging colonies.

Protective effect of pomegranate seed oil against salt toxicity in rat kidneys

Consuming too much salt can have a negative impact on your kidneys. The kidneys play an important role in regulating sodium levels in the body, and excess salt can lead to water retention and increased blood pressure, which in turn can have a negative impact on the kidneys. Excess salt in the diet can contribute to the formation of kidney stones. This is because excess sodium can lead to increased calcium excretion in the urine, which in turn increases the risk of stone formation. An experiment was conducted on rats to study the effect of salt on kidney function. During the experiment, a group of rats received a high dose of salt for a certain period of time, while another group received a regular amount of salt. The results showed that rats that consumed more salt had increased blood pressure and negative changes in kidney function. They also faced problems with fluid retention and the formation of kidney stones. This experiment confirmed that excess salt consumption can negatively affect kidney function and lead to the development of various diseases. Therefore, controlling your salt intake is an important aspect of maintaining a healthy kidney system. Kidney contamination from salt can lead to various diseases such as kidney stones, kidney failure and other genitourinary problems. One way to correct this problem may be to use pomegranate oil. Pomegranate oil contains antioxidants that help reduce inflammation and protect kidney cells from damage. It also improves blood circulation and helps cleanse the kidneys of toxins and waste. Research has shown that consuming pomegranate oil may help improve kidney function, reduce inflammation, and prevent the formation of kidney stones. It can also help lower blood pressure and improve the overall health of the kidney system.

Efficacy and safety of losartan in childhood immunoglobulin A nephropathy: a prospective multicenter study

Purpose: Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers (ARBs) are frequently employed to counteract the detrimental effects of proteinuria on glomerular diseases. However, the effects of ARBs remain poorly examined in pediatric patients with immunoglobulin A (IgA) nephropathy. Herein, we evaluated the efficacy and safety of losartan, an ARB, in pediatric IgA nephropathy with proteinuria.Methods: This prospective, single-arm, multicenter study included children with IgA nephropathy exhibiting proteinuria. Changes in proteinuria, blood pressure, and kidney function were prospectively evaluated before and 4 and 24 weeks after losartan administration. The primary endpoint was the difference in proteinuria between baseline and 24 weeks.Results: In total, 29 patients were enrolled and received losartan treatment. The full analysis set included 28 patients who received losartan at least once and had pre- and post-urinary protein to creatinine ratio measurements (n=28). The per-protocol analysis group included 22 patients who completed all scheduled visits without any serious violations during the study period. In both groups, the mean log (urine protein to creatinine ratio) value decreased significantly at 6 months. After 24 weeks, the urinary protein to creatinine ratio decreased by more than 50% in approximately 40% of the patients. The glomerular filtration rate was not significantly altered during the observation period.Conclusions: Losartan decreased proteinuria without decreasing kidney function in patients with IgA nephropathy over 24 weeks. Losartan could be safely employed to reduce proteinuria in this patient population. <i>ClinicalTrials.gov trial registration (NCT0223277)</i>

Protein extracted from Moringa oleifera Lam. Leaves: Bio-evaluation and characterization as suitable plant-based meat-protein alternative

This study aimed to isolate and characterize moringa leaf protein (MLP) via HPLC and evaluate its consumption's effects through rat model. Four groups of Albino Wistar rats (n = 25 each) along with a control group (n = 25) were acclimatized. The isolated MLP was added to the basal diet (casein; control) in various percentages (25, 50, 75, 100%) for a 21-day experimental period. On three intervals (1st, 11th, 21st days), blood samples were collected and subjected for hematological and biochemical examination (Renal Function Test (RFT), Liver Function Test (LFT)). MLP contained a variety of essential and non-essential amino acids in substantial amounts. The Protein Efficiency Ratio (PER) of 50% MLP-treated group was the highest (1.72) among MLP treatments. Increases in feed intake and weight were observed in treated rats compared to the control. The hematological profile of the rats revealed increases in Hemoglobin (Hb) (7.9–14.0%), White Blood Cell (WBC) (35.9–51.5%), Red Blood Cell (RBC) (17.1–22.2%), Hematocrit (HCT) (13.1–22.9%), and platelets levels (36.5–40.6%) from day 1. Protein isolates decreased liver parameters but resulted in non-significant changes in liver and kidney functions in rats. Further investigation is needed to determine the safe daily intake of MLP.

Minor age difference substantially affects renal function in conscious and anaesthetized rats*

Abstract In this study we re-examined the postulate that in the rat age-related body metabolism and kidney function changes progress only slowly. Thus we checked whether a moderate between-animal age distance may cause any marked difference, which could affect interpretation of experimental results. Food and water consumption, renal sodium and potassium excretion and haemodynamics were lower in rats aged 15 versus 9 weeks. In turn, hematocrit, mean arterial pressure, and renal vascular resistance were significantly higher in older animals, whereas renal excretion of NO3-/NO2- and vascular endothelial growth factor A and in situ renal tissue NO signal did not differ. Evidently, an age older by 6 weeks was associated with decreased hydration, tone of systemic and renal blood vessels, and renal excretion. In conclusion, since the actual age is an important determinant of the animal’s functional status, accurate age-matching of experimental groups is a necessary pre-condition for correct data interpretation.

Prospective affirmative therapeutics of cannabidiol oil mitigates doxorubicin-induced abnormalities in kidney function, inflammation, and renal tissue changes

Nephropathy is the decline in kidney function. A promising treatment for numerous types of illness is using natural materials as natural chemical compounds. The inquiry was conducted to investigate cannabidiol (CBD) potential for renal syndrome protection. The five equal groups of fifty male Sprague-Dawley rats weighing 150 ± 25 g each were designed; group I received distilled water orally, while group II got an intraperitoneal injection of doxorubicin (18 mg/kg bwt). Group III received CBD (26 mg/kg bwt) orally, while group IV received 1 ml of CBD (26 mg/kg bwt) and group V received trimetazidine (10 mg/kg bwt), in addition to a single intraperitoneal dose of doxorubicin (18 mg/kg bwt) on the 11th day for both groups (IV, V). The administration of CBD (26 mg/kg bwt) led to a noticeable improvement in oxidative stress parameters (SOD and GSH) in rats by significantly lowering enzyme activity (ALT and AST), as well as serum creatinine and urea, IL-6, and MDA, confirming the anti-inflammatory accuracy of CBD linked to significant lowering to IL6R DNA frequency concentration in line with histopathology results. As a result of its anti-inflammatory and antioxidant capabilities, cannabidiol may have protective quality, and CBD medication could be related to controlling renal problems.

Changes in medical therapy after cardiac resynchronization in patients with heart failure: insights from the U.S. Veterans Affairs healthcare system

Abstract Background Patients with heart failure with reduced ejection fraction (HFrEF) are often not treated with comprehensive guideline directed medical therapy (GDMT) due to hemodynamic and renal limitations. Cardiac resynchronization therapy (CRT) improves hemodynamics in patients with HFrEF and ventricular dyssynchrony. Whether CRT facilitates intensification of GDMT in patients with HFrEF has not been well-studied. Purpose To assess pre-procedure GDMT (B-blocker, ACEI [angiotensin converting enzyme inhibitor]/ARB [angiotensin receptor blocker], ARNI [angiotensin receptor neprilysin inhibitor], MRA [mineralocorticoid receptor antagonist], SGLT2i [sodium-glucose cotransporter-2 inhibitor]) utilization in HFrEF patients who received CRT and to compare changes in GDMT in patients who received CRT with patients who received implantable cardioverter-defibrillator (ICD). Methods Veterans with left ventricular ejection fraction (LVEF) 35% who received CRT or ICD from Feb 22, 2000 – Jul 28, 2022 were identified. Patients with end-stage renal disease were excluded. Changes in GDMT 12-months following device implant were characterized and compared between CRT and ICD recipients. Mixed effects logistic regression models were generated to evaluate associations between receipt of CRT and the composite of therapy initiation, dose increase, or target dose achievement compared with ICD. Models were adjusted for clinical characteristics and pre-implant GDMT utilization. Similar models were developed to evaluate the adjusted associations between CRT and changes in estimated glomerular filtration rate (eGFR) and blood pressure (BP) compared with ICD. Results A total of 2,082 CRT recipients and 7,263 ICD recipients were identified. Pre-procedure heart rate, BP, serum potassium, and eGFR were within normal ranges and similar between groups. Prior to device implant, ACEI/ARB/ARNI were most frequently prescribed (91%), followed by -blockers (88%), MRA (46%), and SGLT2i (33% in post-SGLT2i era). Pre-procedure GDMT was similar between CRT and ICD recipients. At 12 months follow-up, CRT was independently associated with increased odds of therapy initiation, dose increase, or target dose achievement for ACEI/ARB/ARNI, ARNI, B-blockers, and MRA (Figure 1). ICD was associated with a decline in eGFR while CRT was associated with an increase in eGFR (mean [standard deviation]: -0.95 [0.17] vs. +0.6 [0.29]; p<0.01), while no differences were observed in BP or LVEF at 12 months. Conclusions In a large, contemporary cohort of patients with HFrEF, most patients were not prescribed MRA or SGLT2i prior to receiving CRT or ICD despite no apparent renal or blood pressure-related contraindications. CRT is associated with increased odds of the composite of initiation, dose increase, or target dose achievement for ACEI/ARB/ARNI, ARNI, B-blockers, and MRA compared with ICD. GDMT intensification may be mediated by beneficial changes in kidney function in CRT recipients.Figure 1

Abstract 14276: Using Artificial Intelligence and Natural Language Processing on Electronic Health Records of Heart Failure Patients to Examine the Impact of Estimated Glomerular Filtration Rate Trend on Mortality

Introduction and Hypothesis: Heart failure (HF) often leads to an imbalance between heart and kidney function, with a poor prognosis in HF patients linked to dynamic changes in renal function as well as chronic kidney disease (CKD). This study aimed to determine the incidence of reduced renal function upon HF diagnosis and to explore the potential for dynamic changes in kidney function to predict short- and long-term outcomes in a real-world cohort of HF patients. Methods: Clinical data of patients with a diagnosis of HF (index event) were gathered retrospectively using natural language processing. Patients were classified as having CKD based on their eGFR (<60 mL/min/1.73m2) and a history of CKD and/or dialysis. eGFR trajectories were analyzed using linear mixed effects models. Cox proportional hazard models were used to analyze the relationship between baseline variables and mortality. Joint modeling was employed to assess the relationship between the eGFR trend and mortality. Results: There were 1986 patients in the study population, with a mean (SD) age of 74.8 ± 11.7 years and 58% of males. At the index event, 58% (n = 1156) had CKD, and 17% (n = 339) had HF with preserved ejection fraction (HFpEF). Median follow-up was 3.16 years. After 2 years, 10% (n = 198) of the patients had passed away. The proportion of CKD at index was considerably lower in the 2-year survivors group (55% vs 76%, p < 0.001) in this group. The calculated mean annual eGFR reduction was 4.2 mL/min/1.73m 2 . Age, CVA, diastolic blood pressure, hemoglobin, HDL, potassium, and NT-proBNP levels in blood serum were found to be the primary predictors of mortality in multivariate Cox PH model. Joint modeling revealed that a current eGFR value that was 10 mL/min/1.73m 2 lower between patients corresponded with a higher mortality hazard of 1.22 ± 0.05 (p < 0.001). In addition, a drop in eGFR of 10 mL/min/1.73m 2 over the previous year showed an the elevated mortality hazard of 1.97 ± 0.16 (p < 0.001). Conclusions: We show that the prevalence of CKD is significant in a real-world population of HF patients, and CKD is a standalone predictor of mortality. Current eGFR value and the eGFR slope from the previous year have a potential to be used for individual mortality hazard assessment in the clinical follow-up of HF patients.

Investigating kidney function changes in young adults with COVID-19: Serum creatinine level, glomerular filtration rate, and biochemical profile analysis

The study’s objective was to comprehensively assess kidney function alterations in patients with COVID-19. The study was carried out in Moscow (Russia) in 2021. 100 patients of 19-30 years old (51 females and 49 males) took part in the survey. The study collected participant data on basal urine, serum creatinine, and estimated glomerular filtration rate from medical histories before COVID-19 infection. COVID-19 diagnosis (delta strain) was confirmed by polymerase chain reaction test. Serum creatinine was measured, considering age and race. Micro-albuminuria levels from daily urine samples were established. Laboratory blood tests included quantitative indices of blood-forming elements, hemoglobin levels, and biochemical parameters. Based on the results, the study observed a slight increase in serum creatinine levels after COVID-19 infection, with concentrations of 78.4±6.4 mmol/L before infection and 87.5±7.7 mmol/L after the disease (p≥0.05). The microalbuminuria-creatinine ratio also showed an increase. The glomerular filtration rate in renal glomeruli declined from 93.3±10.1 mL/min/1.73 m<sup>2</sup> before infection to 78.9±8.7 mL/min/1.73 m<sup>2</sup> after the disease (p≥0.05). These findings suggest a trend towards decreased kidney function in young patients with moderate COVID-19 severity. However, normoalbuminuric compared to creatinine was significantly higher than normal after COVID-19. Urine tests indicated a trend of decreased renal glomerular filtration rate. Clinical symptoms included high temperature, weakness, cough, and, in some cases, liquid stools. Laboratory findings revealed significant deviations in hematocrit, neutrophil, and eosinophil concentrations. Parallel tests focusing on cystatin C and beta-2 macroglobulin are recommended to assess kidney function and identify potential dysfunction.

Comparison Between Longitudinal Kidney Function and Volume Changes in Association with Heart Failure Outcomes Among Discharged Patients in EVEREST

Comparison Between Longitudinal Kidney Function and Volume Changes in Association with Heart Failure Outcomes Among Discharged Patients in EVEREST