Blood Creatinine Concentrations Research Articles

Quality of life and its related-influencing factors in patients with cervical cancer based on the scale QLICP-CE(V2.0)

BackgroundQuality of life research can guide clinical workers to adopt more targeted treatment and intervention measures, so as to achieve the purpose of improving patients’ quality of life. The objective of this study was to evaluate health-related quality of life in Chinese patients with cervical cancer and to explore its influencing factors.MethodsA total of 186 patients with cervical cancer were investigated by using the QLICP-CE (V2.0) scale (Quality of Life Instruments for Cancer Patients-Cervical Cancer) developed by our group in China. The data were analyzed by t-test, one-way ANOVA, univariate analysis, and multivariate linear regression.ResultsThe total score of quality of life scale for cervical cancer patients was (62.58 ± 12.69), Univariate analysis of objective clinical indexes showed that creatinine concentration was a negative influence factor in the psychological domain, potassium ion concentration was a negative influence factor in the common symptoms and side effect domain, erythrocyte content was a positive influence factor physical domain and common general domain. Multiple linear regression results suggested that clinical staging was the influencing factor of common symptom and side effect domain, common general module and total score of scale. Marital status has different degrees of influence on the psychological, social, and common general domains. The level of education also influenced scores in the social domain.ConclusionThe total score of quality of life in patients with cervical cancer who received active treatment was acceptable. Marital status, clinical staging, and educational level are the factors that affect the quality of life of patients with cervical cancer. At the same time, potassium ion concentration, red blood cell count and creatinine concentration also have important effects on quality of life in patients with cervical cancer. Therefore, it is very important to give personalized treatment and nursing to patients based on various factors.

The clinical effectiveness and safety of Zone III REBOA for resection of sacropelvic tumors in patients older than 70 years

BackgroundREBOA is a method used to manage bleeding during surgery involving sacropelvic tumors. Nevertheless, studies on the use of REBOA among elderly people are lacking. The aim of this research was to investigate the efficacy and safety of Zone III REBOA in patients aged more than 70 years.MethodsA comparative study was conducted using case-control methods. A group of patients, referred to as Group A, who were younger than 70 years was identified and paired with a comparable group of patients, known as Group B, who were older than 70 years. Continuous monitoring of physiological parameters was conducted, and blood samples were collected at consistent intervals.ResultsTotally, 188 participants were enrolled and received REBOA. Among the 188 patients, seventeen were aged more than 70 years. By implementing REBOA, the average amount of blood loss was only 1427 ml. Experiments were also conducted to compare Group A and Group B. No notable differences were observed in terms of demographic variables, systolic blood pressure (SBP), arterial pH, lactate levels, blood creatinine levels, potassium levels, or calcium levels at baseline. Additionally, after the deflation of the REBOA, laboratory test results, which included arterial pH, lactate, potassium concentration, calcium concentration, and blood creatinine concentration, were not significantly different (P > 0.05).ConclusionThis study indicated that in selected patients aged more than 70 years can achieve satisfactory hemodynamic and metabolic stability with Zone III REBOA.Level of evidenceTherapeutic study, Level III.

Microbial imidazole propionate affects glomerular filtration rate in patients with diabetic nephropathy through association with HSP90α

Imidazole propionate (ImP) is a detrimental metabolite produced by the fermentation of histidine intermediates via the intestinal flora. Here, the untargeted metabolite analysis of plasma metabolites from patients with diabetic nephropathy (DN), in combination with the Human Metabolome Database, revealed significantly increased levels of ImP in patients with DN, with a positive correlation with patients' blood creatinine concentration and urinary albumin-to-creatinine ratio, and a negative correlation with the glomerular filtration rate. RNA-seq was applied to detect the effects of ImP on renal tissue transcriptome in mice with DN. It demonstrated that ImP exacerbated renal injury in mice with DN and promoted renal tubular epithelial-mesenchymal transition (EMT), leading to renal mesenchymal fibrosis and renal impairment. Furthermore, ImP was found to directly target HAP90α and activate the PI3K-Akt signalling pathway, which is involved in EMT, by the drug affinity response target stability method. The findings showed that ImP may provide a novel target for DN quality, as it can directly bind to and activate HSP90, thereby facilitating the development of DN while acting as a potential indicator for the clinical diagnosis of DN.

Discolored urine in sheep and goats: Clinical, etiological, hematobiochemical, sonographic and postmortem findings.

Bloody urine is classified in farm animals as hematuria, hemoglobinuria, and myoglobinuria. In small ruminants, discolored urine is reported due to several etiologies which is sometimes fatal. Of these causes are babesiosis, bacillary hemoglobinuria, copper toxicity, and hypophosphatemia. This study was designed to investigate the clinical, etiological, hematobiochemical, ultrasonographic, and pathological findings in rams and bucks with red urine syndrome. Eighteen male animals (nine rams and nine bucks) of 6 months to 3 years were examined. Parallel, 10 healthy controls were used. They were admitted due to red urine, voiding of only urine drops, straining during the act of urination, grunting during urination, ventral abdominal edema, and abdominal distension. The duration of the disease ranged from 2 to 30 days. A history of chronic copper toxicosis was informed in two bucks and a ram. Two blood samples were collected from diseased as well as from controls in EDTA tubes (for complete blood count testing) and in plain tubes (for serum collection). Hematuria was found in 11 animals (seven bucks and four rams) while hemoglobinuria was detected in seven animals (five bucks and two rams). Sonographic findings in diseased animals included ruptured urinary bladder in 3, ruptured urethra in 5, penile calculi, uroperitoneum in 6, distended urinary bladder in 7, hydronephrosis in 5, echogenic deposits in the bladder in 3, and ventral urine accumulation in four animals. Laboratory evaluation of a Geimsa-stained blood smear confirmed the infection with Babesia in three bucks and a ram. Hemolytic anemia was marked in two bucks and a ram due to chronic copper toxicity. Biochemical abnormalities included hypoalbuminemia, hyperglobulinemia, increased blood urea nitrogen and creatinine concentration, and hyperglycemia. Postmortem examination was carried out on six animals (four rams and two bucks). Discolored urine in rams and bucks in this study resulted from hematuria due to urinary calculi and pelvic abscessation or from hemoglobinuria due to Babesia infection or due to copper toxicity. Hemolytic anemia was the outstanding hematological finding and hypoalbuminemia, hyperglobulinemia, increased blood urea nitrogen (BUN) and creatinine, and hyperglycemia were the characteristic biochemical findings. Sonography of the urinary tract was very helpful in assessing the renal parenchyma, urinary bladder, and abdominal cavity for the verification of urolithiasis, hydronephrosis, intact or ruptured urinary bladder, uroperitoneum, and perforated urethra.

KIDNEY ULTRASOUND PARAMETERS AND RENAL BLOOD BIOCHEMISTRY MARKERS IN POST-HEMORRHAGIC STROKE HYPERTENSIVE SURVIVORS

Introduction. Hemorrhagic stroke is a serious and devastating complication of arterial hypertension, which leads to increased mortality in survivors even after the early recovery period. Being other target organs for arterial hypertension, kidneys take part in blood pressure regulation. Investigation of their peculiarities in such patients may provide valuable data on possible reasons of poor long-term prognosis in this category of patients.
 The aim of the study: to compare kidney ultrasound parameters and renal blood biochemistry tests between the post-hemorrhagic stroke hypertensive subjects in a stable phase of recovery period and the patients with arterial hypertension who had no cerebrovascular and cardiovascular events.
 Materials and methods. There were 100 subjects enrolled into the study. They formed two investigatory groups: the main (n=64; age – 52,2±8,41 years, M±SD years) and the control (n=36; age – 51,8±5,92 years) one. Hypertensive patients of the main group developed hemorrhagic stroke – subarachnoid hemorrhage (SAH) (n=42) or intracerebral hemorrhage (ICH) (n=22) – ≥6 months prior to the examination conducted at this study. The control group consisted of patients with non-complicated arterial hypertension. In both groups of patients, the kidney ultrasound parameters and blood plasma urea, creatinine and uric acid concentration levels were determined. Estimated glomerular filtration rate (eGFR) was calculated.
 Results. The indices of kidney ultrasound parameters in the main group and the control group were the following ones, respectively: the pole-to-pole size of the right kidney was 9,96±1,05 and 11,63±1,26 cm, the same size of the left kidney – 10,39±0,93 and 11,95±1,23 cm, p<0,01 for both pairs. Among the biochemistry blood plasma indices, uric acid concentration reached significant difference as well – 411,21±60,36 and 360,91±75,3 µmol/L in the relevant groups, respectively (p=0,04). On the other hand, eGFR did not show the difference between the study groups. The main group was characterized by a higher prevalence of kidney stone formation – OR 5,00 (95% CI, 1,83-13,65). The statistically significant higher incidence rate of calculus development was identified in two subgroups of the main group as well: for SAH – OR 3,08 (95% CI, 1,05-9,02), for ICH – OR 13,33 (95% CI, 3,69-48,15). When comparing to the control group, kidney cyst identification rate in the SAH subgroup referred to OR 3,08 (95% CI, 1,05-9,02), while kidney pelvis/calyces enlargement incidence rate was higher in the ICH subgroup OR 9,17 (95% CI, 2,15-39,06).
 Conclusions. The obtained data indicate the smaller pole-to-pole dimension of both kidneys in hypertensive subjects who suffered hemorrhagic stroke, accompanying higher incidence rate of kidney calculus formation in view of the increased blood plasma uric acid concentration. The same is typical for the SAH individuals subgroup but with the addition of prevalence of kidney cysts incidence rate. As for the ICH subgroup, in addition to the main group findings, pelvis/calyces enlargement is observed more frequently when comparing to the hypertensive only subjects.

ANTICALCIURIA EFFECT OF METHANOLIC ROOT EXTRACT OF LAGERSTROEMIA SPECIOSA (L). PERS (LYTHRACEAE) AGAINST HIGH PROTEIN DIET INGESTED IN ALBINO RATS

Nephrolithiasis, commonly known as kidney stone disease or urolithiasis, is a crystallopathy in which a solid mass forms in the urinary tract. The aim of the present research is to evaluate the way that albino rats administered with a high-protein diet, react to methanolic root extracts of Lagerstroemia speciosa anticalciuric properties. Medicinal plants are frequently utilised in folk medicine to treat a wide range of illnesses. Banaba is the common name for L. speciosa, a member of the Lythraceae family; Poomaruthu is its Tamil name. The test animals were given a diet high in protein and low in protein as well as 45 days of treatment with methanolic root extracts of L. speciosa. The experiment was scheduled with a sample collection, biochemical inquiries, and histopathological exams. The experiment had been scheduled with a sample collection, biochemical investigations, and histopathological evaluations. The biochemical data reveal that as compared to the control, III, and V groups, the low-protein diet groups II and IV had greater blood urea concentrations. The low-protein diet groups II and IV exhibited an increased blood creatinine concentration in contrast to the control, III, and V groups, while group V (H.P+MRE 500 mg/kg) demonstrated a nearly identical outcome to that of the control groups. L. speciosa root extracts in methanol are given to groups to control creatinine concentration. The normal control group's histopathological analysis revealed tubules with a single epithelial lining along the outermost layer that were normal in size.

32 Effect of Probiotics Supplementation Level on Growth Performance, Blood Parameters and Fecal Metabolites in Nursery Pigs

Abstract This experiment was conducted to evaluate the effects of dietary supplementation level of probiotics on growth performance, blood variables, and fecal metabolites in nursery pigs. Certain strains of Bacillus subtilis have been shown to reduce the incidence and severity of diarrhea and therefore improve growth performance of nursery pigs. A total of 54 newly weaned piglets were allotted to 3 treatments in 3 replicates with 6 pigs per pen based on body weight, gender, and breed for a 28-d feeding trial. Treatments were: 1) Control: no probiotics supplementation, 2) CERTILLUS 1x: probiotics supplementation at the recommended level, and 3) CERTILLUS 10x: probiotics supplementation at 10 times the recommended level. The CERTILLUS products consisted of two strains of Bacillus subtilis at a low and a high dose of 3.75 × 108 CFU/g and 3.75 × 109 CFU/g supplemented at 0.05% resulting in 1.875 × 105 CFU/g diet and 1.875 × 106 CFU/g diet for the 1x and 10x treatments, respectively. Corn-soybean meal-based diets were used for d 0-14 (Phase 1) and d 14-28 (Phase 2) postweaning. Body weight, blood glucose and creatinine, fecal short chain fatty acid (SCFA) and bile acid concentrations were measured at d 14 and 28 postweaning. Body weight at d 14 postweaning (P = 0.06; 11.98, 12.73, and 12.21 kg for the control, 1x, and 10x treatments, respectively) and average daily gain for d 0 to 14 postweaning (P < 0.05; 0.206, 0.259, and 0.222 kg/d, respectively) were greater in the 1x treatment than the control and 10x treatments although there was no significant difference in growth performance at d 28 postweaning. Blood glucose concentrations were greater in both probiotic treatments than the control treatment at d 14 postweaning (P < 0.05; 95.2, 111.7 and 114.3 mg/dL for the control, 1x, and 10x treatments, respectively). In the fecal SCFA concentrations, the butyrate concentrations were greater in the 1x treatment than the control and 10x treatments (P < 0.05; 36.17, 47.57, and 33.23 µmol/g feces for the control, 1x, and 10x treatments, respectively) and the acetate (120.02, 141.87, and 101.17 µmol/g feces, respectively), propionate (62.95, 71.42 and 55.27 µmol/g feces, respectively), and total SCFA (236.72, 282.23, and 205.80 µmol/g feces, respectively) concentrations were greater in the 1x treatment than the 10x treatment with the intermediate value in the control treatment (P < 0.05). There were no significant differences in fecal bile acid concentrations and blood creatinine concentrations at both d 14 and 28 postweaning. In conclusion, dietary probiotics supplementation to nursery diets at the recommended level could improve growth rate in the early postweaning period and increase fecal SCFA concentrations but not at a high level of supplementation.

B-203 Development and Validation of an LC/MS/MS Method to Quantify Creatinine in Dried Blood Spots

Abstract Background Health disparities in diagnosis and treatment of chronic kidney disease (CKD) are apparent with Black, Brown, and socially disadvantaged people experiencing worse outcomes. Improving access to CKD screening may decrease disparities. Blood creatinine concentrations are a mainstay in CKD screening, as it is commonly used to estimate glomerular filtration rate. Creatinine is classically measured in serum/plasma using high-throughput chemistry analyzers. Dried blood spots (DBS) could offer a solution to under-screening, but require an alternative method since extraction from DBS retrieves minimal sample volume and is difficult to scale using conventional automation. The purpose of this study was to develop an LC/MS/MS DBS method to quantify creatinine and ultimately to increase screening access for underprivileged communities. Methods Creatinine was measured using a 100 × 2.1 mm Hypersil Silica column with an ABSciex API4000 MS/MS detector. A 5-point calibration curve was made using creatinine certified reference material (Cerilliant) and blank whole blood (UTAK) (target concentrations: 0.575, 0.975, 4.575, 10.575, 20.575 mg/dL). Calibrators were spotted onto Whatman903 cards and allowed to dry for at least 24-hours. A 6 mm punch was used for analysis of calibration points and patient samples. Once punched, water (50 ul) was added and the samples were incubated at 60°C for 15 min before shaking at 800 RPM. Acetonitrile with 2H-creatinine internal standard (IS; .06 mg/dL) was added and the mixture was shaken and centrifuged. The resulting supernatant was diluted to contain 20% water before injecting 10 uL. Creatinine was separated using an isocratic mobile phase (80% Acetonitrile, 20% DI water, 10 mM Ammonium Formate) and detected using MRM mode (Q1 114.0 m/z; Q3 86.8 m/z (quantifier) and 44.5 m/z (qualifier)). For the IS a Q1 of 117.0 m/z and Q3 of 89.9 m/z was applied and the extraction ratio of endogenous creatinine to IS was calculated to determine the concentration. Linearity was confirmed by running five levels of DBS calibration standards for five days. Imprecision was established by running 3 control levels five times for five consecutive days. Control material was purchased from BioRad and run as liquid. Accuracy was assessed using residual liquid CAP serum creatinine proficiency testing (PT) material in triplicate. DBS creatinine concentration determined by LC/MS/MS was compared to paired venous serum creatinine concentration determined by the Roche Cobas enzymatic creatinine assay (n = 63). Results Creatinine concentrations from 0.2–20 mg/dL were within the allowable nonlinearity of 0.075 mg/dL or 5.0% (y = 1.00x−0.010;R = 0.999). Intraday and interday precision was <2%and <3%, respectively for all levels (mean concentrations 1.00, 2.02, and 7.05 mg/dL). Residual CAP PT samples (n = 4) were within 2.5% of the peer group mean. Compared to venous results, DBS had a bias of −0.03 mg/dL (−3.573%) and a linear equation of (y = .904x +0.049; R = 0.83). Conclusion Preliminary results indicate that DBS are a viable sample source for measuring creatinine. Creatinine concentrations measured by DBS compared favorably with CAP PT. A clinically insignificant negative bias was seen when DBS creatinine concentration was compared to venous blood.

Preventive Action of Beta-Carotene against the Indoxyl Sulfate-Induced Renal Dysfunction in Male Adult Zebrafish via Regulations of Mitochondrial Inflammatory and β-Carotene Oxygenase-2 Actions.

Indoxyl sulfate (IS) is a metabolic byproduct of indole metabolism. IS readily interacts with the mitochondrial redox metabolism, leading to altered renal function. The β-carotene oxygenase-2 (BCO2) enzyme converts carotenoids to intermediate products. However, the role of β-carotene (BC) in IS-induced renal dysfunction in zebrafish and their modulatory action on BCO2 and mitochondrial inflammations have not been explored yet. Hence, the present study is designed to investigate the role of BC in the attenuation of IS-induced renal dysfunction via regulations of mitochondrial redox balance by BCO2 actions. Renal dysfunction was induced by exposure to IS (10 mg/L/hour/day) for 4 weeks. BC (50 and 100 mg/L/hour/day) and coenzyme Q10 (CoQ10; 20 mg/L/hour/day) were added before IS exposure. BC attenuated the IS-induced increase in blood urea nitrogen (BUN) and creatinine concentrations, adenosine triphosphate (ATP), and complex I activity levels, and the reduction of renal mitochondrial biomarkers, i.e., BCO2, superoxide dismutase-2 (SOD2), glutathione peroxidase-1 (GPX1), reduced and oxidized glutathione (GSH/GSSG) ratio, and carbonylated proteins. Moreover, renal histopathological changes were analyzed by the eosin and hematoxylin staining method. As a result, the administration of BC attenuated the IS-induced renal damage via the regulation of mitochondrial function.

Importance of blood biomarker determination in the selection of patients with heart failure for cardioverterdefibrillator implantation

Aim. To conduct a comparative analysis of blood biomarker concentrations, to study their prognostic role in the occurrence of sustained ventricular tachyarrhythmia (VT) or VT episodes requiring electrotherapy in patients with heart failure (HF) and left ventricular ejection fraction (LVEF) ≤35% without prior syncope or sustained ventricular arrhythmias.Material and methods. This single-center prospective clinical study included 319 patients (men, 83%) aged 57 (51-63) years with LVEF of 29 (24-33)% receiving optimal therapy for HF, hospitalized for cardioverterdefibrillator implantation for the purpose of primary prevention of sudden cardiac death. Before the procedure, the concentration of blood biomarkers (blood electrolytes, C-reactive protein, creatinine, Soluble suppression of tumorigenicity 2 (sST2), N-terminal pro-brain natriuretic peptide (NT-proBNP), galectin-3) was determined. Based on blood creatinine concentration, glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Patients underwent a two-year prospective follow-up to record the end point of newly occurring clinically significant VT episodes detected by an implantable cardioverter-defibrillator.Results. The studied arrhythmic endpoint occurred in 84 (26,3%) patients. The multivariate analysis revealed three blood biomarkers, the concentration of which was associated with the first manifestation of VT. With sST-2 >35 ng/ml, this risk increased by ~3 times (odds ratio (OR)=2,86; 95% confidence interval (CI): 1,23-6,64 (p=0,013)). Galectin-3 level >12 ng/ml had a comparable prognostic value (OR=2,64; 95% CI: 1,06-6,53 (p=0,032)). In case of an increase in NT-proBNP >2000 pg/ml, the risk of the same outcome was 2,2 times lower (OR=0,46; 95% CI: 0,22-0,95 (p=0,034)).Conclusion. Pre-implantation laboratory screening of NT-proBNP, sST-2 and galectin-3 concentrations can help in personalized assessment of arrhythmic risk in patients with HF and LVEF ≤35% referred for interventional primary prevention of sudden cardiac death.

Comparability and Stability of Serum Creatinine Concentration in Capillary and Venous Blood.

Background: The use of self-collected capillary blood has several advantages over phlebotomy, as such finger-prick testing is rapidly becoming accepted as a routine sample type for adults. However, there is limited evidence that venous and capillary serum is comparable for many analytes. This study aimed to determine whether capillary samples could offer an alternative sampling method to venous samples for the assessment of serum creatinine using the enzymatic method and if this analyte was stable in unspun capillary blood for 3days. Methods: Matched capillary and venous blood samples were collected from 48 patients for the determination of serum creatinine, one set being processed on day zero, the other set being stored at ambient temperature and then processed on day three. Self-collected capillary blood was compared with phlebotomist-collected venous samples. Results: Serum creatinine concentrations from venous and capillary blood samples taken on day zero were compared to concentrations in capillary blood from day three. Data produced showed serum creatinine concentrations from capillary and venous serum to be comparable. Conclusion: It is believed that this is the first published study to determine if self-collected capillary blood sampling is an acceptable alternative to venous sampling for the measurement of serum creatinine concentration; our data indicates that there is no significant difference in results from unspun venous and capillary blood stored at room temperature for at least 3days compared to venous blood tested on the same day of collection.

Acute kidney injury is common in dogs with septic peritonitis and is associated with increased mortality.

To identify the frequency of and risk factors for acute kidney injury (AKI) in dogs undergoing abdominal surgery for septic peritonitis, and to evaluate outcome and kidney-related risk factors for survival to discharge in those dogs. 77 dogs that underwent abdominal surgery for septic peritonitis. Medical records of dogs that underwent surgery for septic peritonitis from 2012 through 2022 were reviewed. Data regarding signalment, clinical and biochemical findings at presentation, blood creatinine concentration throughout hospitalization, surgery characteristics, postoperative monitoring, and outcome were collected. Dogs were classified based on occurrence of AKI and whether they presented with or developed AKI in-hospital. Perioperative risk factors were evaluated, and outcomes were compared with univariable logistic regression. 31 dogs (40.3%) had AKI diagnosed; 18/77 (23.4%) dogs presented with AKI, 11 (61.1%) of which had it postoperatively, and 13/77 (16.9%) dogs developed AKI postoperatively. Significant factors for presenting with AKI included increasing baseline respiratory rate (OR 2.5 for every 10 beats per minute higher), decreasing systolic blood pressure (OR 0.8 for every 10 mm Hg higher), and increasing body condition score (OR 2.2 for every score greater). No significant factors for developing AKI postoperatively were identified after multiple comparisons adjustment. Sixteen dogs (20.8%) did not survive to discharge; 12 (75.0%) had AKI and 4 (25.0%) did not. Dogs with AKI had decreased odds of survival to discharge (OR 0.2). AKI was common in dogs with septic peritonitis and was a significant risk factor for survival to discharge. Clinical surveillance of AKI is critical in this population.

AACC/NKF Guidance Document on Improving Equity in Chronic Kidney Disease Care.

Kidney disease (KD) is an important health equity issue with Black, Hispanic, and socioeconomically disadvantaged individuals experiencing a disproportionate disease burden. Prior to 2021, the commonly used estimated glomerular filtration rate (eGFR) equations incorporated coefficients for Black race that conferred higher GFR estimates for Black individuals compared to non-Black individuals of the same sex, age, and blood creatinine concentration. With a recognition that race does not delineate distinct biological categories, a joint task force of the National Kidney Foundation and the American Society of Nephrology recommended the adoption of the CKD-EPI 2021 race-agnostic equations. This document provides guidance on implementation of the CKD-EPI 2021 equations. It describes recommendations for KD biomarker testing, and opportunities for collaboration between clinical laboratories and providers to improve KD detection in high-risk populations. Further, the document provides guidance on the use of cystatin C, and eGFR reporting and interpretation in gender-diverse populations. Implementation of the CKD-EPI 2021 eGFR equations represents progress toward health equity in the management of KD. Ongoing efforts by multidisciplinary teams, including clinical laboratorians, should focus on improved disease detection in clinically and socially high-risk populations. Routine use of cystatin C is recommended to improve the accuracy of eGFR, particularly in patients whose blood creatinine concentrations are confounded by processes other than glomerular filtration. When managing gender-diverse individuals, eGFR should be calculated and reported with both male and female coefficients. Gender-diverse individuals can benefit from a more holistic management approach, particularly at important clinical decision points.

Extravesicular, two-layer, side-to-side ureteroneocystostomy combined with tension-relieving techniques for feline proximal ureteral obstruction: A retrospective study.

To describe the surgical technique for extravesicular, two-layer, side-to-side ureteroneocystostomy combined with tension-relieving techniques (ETSUTT) for feline proximal ureteral obstruction and report clinical outcomes. Retrospective case series. Ten privately-owned cats with ureteral obstruction near the ureteropelvic junction (UPJ). Medical records were retrospectively reviewed for cats with ureteral obstruction close to the UPJ that underwent ETSUTT (2018-2021). The ETSUTT procedure consisted of a modified extravesicular technique (two-layer, side-to-side ureteroneocystostomy) and tension-relieving techniques (renal descensus, ureterocystopexy, and nephrocystopexy). All cats survived through discharge. In all cats, postoperative blood urea nitrogen and creatinine concentrations were decreased, compared with preoperative concentrations. Perioperative complications included ureteral catheter dislodgement (3), transient pollakiuria (2), and dysuria (1), but no specific treatments were required. Urinary tract infection was observed postoperatively in three of the 10 cats. The median follow-up was 648 days (min-max: 86-1229 days). Seven of the 10 cats were alive without recurrent ureteral obstruction at the end of this retrospective study. The ETSUTT procedure was successfully performed without major complications in cats with ureteral obstruction occurring near the UPJ. Use of ETSUTT provided a fair-to-good, long-term prognosis in cats that were otherwise difficult to manage. This novel procedure, ETSUTT, was feasible, safe, and could be a viable treatment option for feline proximal ureteral obstruction, including the UPJ, especially for obstructions caused by stricture.

600-P: Higher Hydration Status Is Indicative of Better Glucose Tolerance

Introduction: Water intake is an important dietary behavior to replace high-caloric beverages and to enhance metabolic health. Type 2 diabetes is a metabolic disorder that has been shown to be more prevalent in Hispanics, a population shown to consume relatively less water compared to non-Hispanic Whites. The underlying cause of type 2 diabetes is insulin resistance, characterized by hyperglycemia and impaired glycemic control. However, whether a relationship exists between dehydration and the development of diabetes remains to be elucidated. Purpose: To evaluate if hydration status indicates glucose tolerance among a dominant Mexican American population. Methods: Sixty-one participants without diabetes (Age: 26.5 ± 9.1 years; BMI: 27.5 ± 6.0 kg/m2) participated in the study. Fasting blood glucose level was determined, and a 2-hour glucose tolerance test was performed following the ingestion of a 75g glucose drink. Blood glucose concentration levels were determined at 15−, 30−, 60−, 90−, and 120-minute time intervals post ingestion and glucose area under the curve was analyzed as well. Blood works were performed to determine blood urea nitrogen (BUN) and creatinine concentrations. Hydration status was estimated using the ratio of BUN to creatinine values. Results: Hydration status measured by BUN/Creatinine was positively associated with glucose intolerance measured at 15−, 30−, 60−, and 90-minute post glucose load and by glucose area under the curve (r=0.33; r=0.43; r=0.37; r=0.27; and r=0.41 respectively; p<0.05). Conclusion: Adequate fluid consumption should be encouraged for glycemic control, especially among people with high diabetes risks. Disclosure J.Apaflo: None. J.Labadah: None. G.Narvaez: None. V.M.Rocha: None. A.Mossayebi: None. S.Bajpeyi: None.

#5423 THE FUNCTIONAL STATE OF THE KIDNEYS IN PATIENTS WITH CHRONIC ISCHEMIA OF THE RENAL AND PERIPHERAL ARTERIES

Abstract Background and Aims to study the functional state of the kidneys in patients with chronic ischemia of the renal and peripheral arteries. Methods We examined 120 patients with chronic lower limb ischemia (CLLI) on the background of coronary heart disease and type 2 diabetes mellitus. All examined patients were hospitalized in the department of Interventional Cardiology of the Republican Specialized Scientific and Practical Medical Center for Therapy and Medical Rehabilitation. Inclusion criteria for the study was the presence of intermittent claudication in the patient of II A-II B degree of CLLI, while the walking distance without pain in these patients was 50-1000 meters. Assessment of the functional state of the kidneys was carried out on the basis of determining the level of serum creatinine (Cr), glomerular filtration rate (GFR), calculated according to the EPI GFR formula, which takes into account race, gender, age, and serum creatinine level. To calculate GFR using the CKD-EPI formula, can be used special applications for mobile devices (QxMDCalculator) (based on the criteria of the clinical guidelines for the diagnosis, classification and treatment of CKD KDIGO - 2013). Results Analysis of the functional state of the kidneys depending on the severity of CKD and the level of GFR in accordance with the KDIGO classification (2013) showed that all 100% of patients with CLLI belonged to CKD categories: CKD C2 - 62 (51.7%), CKD with 3a-b - 51 (42.5%) and CKD with 4 - 7 (5.83%). In other words, there was not a single patient with CLLI with normal GFR values. We have revealed a significant increase in the concentration of blood creatinine by 2.1 times, blood urea by 77.9%, and a decrease in GFR by 64.3% (p<0.001). The mean value of the concentration of total protein in the blood serum was 58.4±3.72 mmol/l. The concentration of urea in the blood serum was 12.1±2.47 mmol/l in the CLLI group versus 6.8±0.33 mmol /l in the control group. The parameters of the functional state of the kidneys depending on the severity of CLLI showed that in the group of patients with stage IIB was an increase in serum creatinine clearance by 47.2%, amounting to 179.2 ± 15.5 μmol / l versus the data of IIA 121, 2±13.3 µmol/l (p<0.01). There was also a decrease in the level of GFR in patients with stage IIB by 29.1% (p<0.01) in relation to the data of stage IIA. Conclusion In all patients with CLLI, there was deterioration in the functional state of the kidneys, which was manifested by an increase in the concentration of blood creatinine, a decrease in GFR and the severity of albuminuria.

Blood biochemical parameters in mice under the action of polyphosphate esters and their complexes with antibiotics

Complexes of polyphosphate esters with antibiotics were developed in Lviv Polytechnic National University together with scientists of Institute of Animal Biology NAAS to reduce the negative impact of antibiotics on the animal body. The conducted experiments allow assessing the effect of antibiotics, polyphosphate esters and complexes of polyphosphate esters with antibiotics on the body of laboratory animals based on biochemical markers of hepato- and nephrotoxicity. The antibiotics were administered in average daily therapeutic doses. It was found that the physiological state of mice and their blood biochemical indicators were within physiological normal values after the administration of polyphosphate ester P4 and complexes of polyphosphate ester P4+antibiotics (amoxicillin, oxytetracycline, and doxycycline). At the same time, intramuscular administration of polyphosphate ester P6 and complexes of P6+antibiotics have a certain negative effect on mice, which is manifested by changes in the activity of marker enzymes: aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP). We found an increase in AST and ALT activities. P6+amoxicillin and P6+oxytetracycline complexes increased ALP activity. Complexes P4+antibiotics decreased ALP. Blood urea content decreased after the administration of polyphosphate ester P6 by 38.5%, P6+oxytetracycline by 26.9%, P6+doxycillin by 21.8%. P6+amoxicillin complex caused a significant increase by 237% in the concentration of creatinine in the blood of mice. The changes of blood creatinine concentration of other experimental groups fell within normal physiological range. Conducted studies of blood biochemical characteristics of mice under the action of new complexes of nanobiopolymer transporters with antibiotics ensured the selection of antibacterial drugs with low toxicity.

Development and evaluation of an electrochemical biosensor for creatinine quantification in a drop of whole human blood

An electrochemical biosensor for creatinine determination in a drop of whole human blood was developed and applied to the determination of creatinine in real clinical samples. It is based on the modification of a dual carbon working electrode with a combination of three enzymes: creatinine amidohydrolase (CNN), creatine amidinohydrolase (CRN) and sarcosine oxidase (SOX). Electrochemical transduction is performed using horseradish peroxidase (HRP) and potassium hexacyanoferrate(II) as mediator. A drop of human blood is enough to carry out the measurements by differential chronoamperometry where one carbon electrode detects creatine and the other both creatine and creatinine. The integrated differential signal obtained in the biosensor is linear with the concentration of creatinine in blood in the range 0.5–15 mg/dL and the enzyme-modified electrodes are stable for at least 3 months at 4 °C. The biosensor was lined to a reference method based on Isotope Dilution Mass Spectrometry (IDMS) with 50 real human blood samples and the results compared with those obtained by alternative routine techniques based on Jaffé method and an enzymatic method (Cobas 8000 Roche®, Crep2 Roche®). There were no significant differences between the creatinine concentrations found by the routine techniques and the developed biosensor.

Prognostic value of serum cystatin C concentration in dogs with myxomatous mitral valve disease.

Impaired renal function is 1 of the poor prognostic factors in dogs with myxomatous mitral valve disease (MMVD). However, the value of cystatin C (Cys-C), a marker of renal function, as a prognostic marker for MMVD in dogs has not yet been explored. This study aims to investigate the prognostic value of Cys-C in dogs with MMVD. Fifty client-owned small-breed dogs with MMVD were included in this study. This is a retrospective, cross-sectional study. The prognostic value of serum Cys-C concentration was assessed using univariable and multivariable Cox hazard regression analyses. Kaplan-Meier survival curves for MMVD-specific survival in dogs stratified into high and low Cys-C groups were generated and analyzed using the log-rank test. Serum Cys-C concentrations were significantly associated with MMVD-related death (P < .01) in both univariable (hazard ratio [HR], 5.086; 95% confidence interval [CI], 1.950-13.270) and multivariable Cox hazard regression analysis (HR, 4.657; 95% CI, 1.767-12.270). The high Cys-C group (n=14) had a significantly shorter MMVD-specific survival time than the low Cys-C group (n=36; P < .01). In dogs with normal blood creatinine concentrations, the high Cys-C group (n=10) had a significantly shorter MMVD-specific survival time than the low Cys-C group (n=36; P < .01). High serum Cys-C concentrations were associated with a worse prognosis of MMVD. Furthermore, serum Cys-C could be a predictor of MMVD prognosis even in dogs with normal blood creatinineconcentration.

Влияние пероксиредоксина 6 на нефроны в ранний реперфузионный период после ренальной ишемии у крыс

Renal reperfusion injury develops rapidly after ischemia relief. It is with the onset of reperfusion that a cascade of pathological processes is launched, which means that measures to protect the kidney have to be taken as early as in this period. The aim of the paper was to study the effect of exogenous peroxiredoxin 6 (Prx6) on the morphofunctional state of nephrons in the initial reperfusion period following ischemia. Materials and methods. The right kidney of rats was subjected to 45-minute ischemia with prior left-sided nephrectomy and examined after 2, 5 and 24 hours of reperfusion. Exogenous Prx6 was administered intravenously 15 minutes before ischemia. Results. The research showed that nephrectomy has no effect on the morphology of a single kidney, but leads to an increase in urea and creatinine in the blood within 24 hours. We noted signs of morphological and functional damage to nephrons after 2 hours of reperfusion, which tend to increase in the course of 24 hours. In addition, we observed a rise in blood creatinine and urea concentrations, an increase in the areas of renal corpuscles, glomeruli, and Bowman’s capsule, as well as dystrophic changes in nephrocytes and an increase in the immunosignal area of the kidney injury molecule-1 (KIM-1). When exogenous Prx6 was used, we observed normalization of the size of nephron components, a decrease in KIM-1 immunosignal and an improvement in the kidney’s excretory function both in the early reperfusion period and after 24 hours. Thus, exogenous Prx6 reduces damage to nephrons during the early reperfusion period, which improves their compensatory and adaptive properties in ischemia-reperfusion injury.