Early Detection Of Renal Impairment Research Articles

Association between proteinuria and adverse pregnancy outcomes: a retrospective cohort study

Proteinuria during pregnancy is closely related to the occurrence of adverse pregnancy outcomes. One hundred and forty-two women with proteinuria during pregnancy and followed between January 2018 and December 2020 were evaluated. Based on the 24-h proteinuria value, they were divided as mild (n = 76, 300–1000 mg/day), moderate (n = 39, 1000–3500 mg/day) and severe (n = 27, >3500 mg/day) proteinuria. The rates of prematurity, low birth weight and neonatal asphyxia were significantly higher in the severe proteinuria group than in the mild and moderate groups, while the rates of foetal growth restriction and neonatal intensive care unit admission were significantly higher in the severe compared with the mild proteinuria group (all p < .05). Logistic regression analysis showed that moderate proteinuria (OR = 97.2, 95%CI: 7.1–1334.2, p = .001) and severe proteinuria (OR = 34.0, 95%CI: 1.6–711.0, p = .023) were associated with adverse perinatal outcomes. Compared with mild proteinuria, moderate and severe proteinuria are associated with adverse pregnancy outcomes in perinatal infants. Impact Statement What is already known on this subject? The production of proteinuria is closely related to the filtration function of the glomerulus, the reabsorption and secretion function of the renal tubules. For women with normal renal function before pregnancy, such physiological changes are less likely to cause adverse symptoms; however, for women with chronic kidney disease before pregnancy, especially those with significantly impaired renal function, the kidneys often cannot compensate for these physiological changes, which can lead to serious complications for both mother and infant. What do the results of this study add? In our study, logistic regression analysis showed that the severity of proteinuria was independently associated with adverse perinatal outcomes. The ROC curve showed that 24-h proteinuria had a predictive value for adverse perinatal outcomes. Therefore, for patients with urine protein quantification ≥0.3 g/24 h, regular 24-h urine protein quantification during pregnancy could help predict adverse perinatal outcomes and improve prognosis. What are the implications of these findings for clinical practice and/or further research? Proteinuria quantification can be used as one of the factors predicting adverse pregnancy outcomes. Thus, monitoring of urinary protein quantification in women during pregnancy should be strengthened for early detection of renal impairment, then interventions be used to improve maternal and infant outcomes.

A Retrospective Comparative Study of Urine Albumin Creatinine Ratio over 24 Hour Urine Albumin in Early Detection of complications in Subjects with Type 2 Diabetes Mellitus

Background: Measurement of urinary protein is one of the important markers used for assessing the degree of renal impairment. Early detection of renal impairment is important to give appropriate treatment before it progresses to irreversible stage. Material and Methods: Study design: This was retrospective, comparative study done on 70 patients with type 2 diabetes mellitus in a tertiary care hospital over period of 18 months from October 2019 to March 2021. Enrolled patients underwent fasting blood sugar, postprandial blood sugar, glycosylated HbA1c, Albumin Creatinine ratio in a spot urine sample, 24 hour urinary albumin. Results: The mean age of the subjects was 68.75 ±10.22 years The majority of subjects were males (60%) and females were 40%.The majority of subjects were with Diabetes duration of 6-10 years (44.29%) and the mean duration of diabetes was 8.63 ±3.45 years . The fundoscopy findings of diabetic retinopathy among subjects showed that majority of subjects presented with moderate DR (32.86%) followed by mild DR (28.57%) The proliferative DR was seen in 5 (7.14%) subjects. The mean blood urea of the subjects was 44.43 mg/dl while mean serum creatinine among subjects was 1.44 mg/dl. Mean HbA1c was 7.95% among subjects. The mean 24 hour urine albumin and UACR of the subjects was 252.83mg and 232.71 mg/dl respectively. We observed that majority of subjects presented with value between 30-300 mg (35.71%) with 24 hour urine albumin method. The 24 hour urine albumin value&gt;300 mg was seen in 21 (30%) subjects. Majority of subjects showing Urine albumin to creatinine ratio between 30-300 mg (60%), while value&gt;300 mg was seen in 20 (28.57%) subjects. We observed that 24 hour urine albumin and duration of diabetes mellitus showed statistically significant correlation (p&lt;0.001). With respect to the correlation of Urine albumin to creatinine ratio, various study parameters observed that Urine albumin to creatinine ratio showed significant correlation with HbA1c, FBS, PPBS, diabetes duration and Fundoscopy with statistical significance. (p&lt;0.05).It was observed that 24 Hr Urine Albumin showed significant correlation with HbA1c, FBS, PPBS and diabetes duration with statistical significance (‘p’&lt;0.05). Conclusion: The present study was conducted to find out early diagnosis of renal complications of type 2 diabetes mellitus in the form of diabetic nephropathy. The study was predominated by male gender with a ratio of 3:2 and included 2/3rd subjects in age group 61-80 years. It was found that Urine albumin to creatinine ratio (UACR) was better parameter than 24 hour urine albumin to detect proteinuria in subjects with type 2 diabetes mellitus. There was a positive correlation of Urine albumin to creatinine ratio with duration of diabetes, HbA1c levels, and diabetic retinopathy; indicating the role of early detection of proteinuria and strict glycemic control, to halt the disease progression in subjects with type 2 diabetes mellitus. Keywords: Urine albumin to creatinine ratio (UACR), HbA1c, 24 hour urine albumin.

Role of urinary NAG enzyme in early detection of renal impairment in cystic fibrosis patients

BackgroundCystic fibrosis (CF) is the most common life-limiting autosomal recessive disease among people in the USA and Europe with increased prevalence in Egypt. Affected children are in danger of acute kidney injury and the development of chronic renal disease through exposure to multiple nephrotoxic agents. N-acetyl beta-D-glucosaminidase (NAG) is a lysosomal enzyme present in high concentrations in the proximal tubular cells, thus raising urinary NAG levels to reflect tubular dysfunction. The aim of our study is to detect the role of the urinary NAG enzyme in the early detection of renal impairment in CF patients. This cross-sectional study enrolled 40 CF patients diagnosed in the CF Clinic in Children’s Hospital of Cairo University. They were age- and sex-matched to 40 healthy controls. All patients had glomerular filtration rate (GFR), serum creatinine, blood urea nitrogen (BUN), albumin/creatinine (A/C) ratio measured, urine analysis, urinary NAG enzyme using enzyme-linked immunosorbent assay (ELISA), and renal ultrasound (U/S) were done.ResultsOur study showed high levels of urinary NAG in cases with a significant difference between cases and controls (P value < 0.001). There was a significant correlation between urinary NAG enzyme elevation and A/C ratio in urine, nephrotoxic drugs administration, and duration of disease (P value = 0.002, 0.005, 0.019), respectively.ConclusionOur study suggested that the NAG enzyme is a good early detector of renal impairment in CF patients before the conventional laboratory assays become deranged.

Prescription Drug Overdose, Depression, and Other Mental Disorders in the Context of Kidney Disease.

Clinical Background: Mental disorders, especially depression, are associated with several comorbidities in the kidneys. Depression is the psychiatric disorder that mostly affects individuals with chronic kidney disease (CKD) and end-stage kidney disease. Epidemiology: The mainly prescribed drugs involved in overdose cases are opioids, benzodiazepines, and antidepressants. Antidepressants are the main psychiatric drugs that lead to kidney injury, mainly the second-generation ones. However, the prevalence of depression in dialysis patients varies from 22.8 to 39.3%. Therefore, psychiatric patients have 1.5-3 times more hospitalization compared to patients having only CKD. Challenges: Randomized clinical studies should be encouraged. Studies have shown an association between depression and progression of kidney disease. The mechanisms are not completely clear, but changes on neurotransmitter release and endocrine functions appear to be related to it. Additionally, the use of antidepressant and other psychoactive drugs can induce kidney injury. Hyponatremia induced by second-generation antidepressant drugs is an important feature and can be a risk factor for elderly or patients with comorbidities such as cerebral edema, brain damage or coma. Besides this class, drugs used for anxiety and bipolar disorders or sympathomimetic drugs of abuse can trigger acute kidney injury, possibly due to endothelial dysfunction and thromboembolic and ischemic events. Prevention and Treatment: The early detection of renal impairment and the prescription of nephroprotective strategies has been a clinical challenge. Some studies aim to describe the biochemical mechanisms involved and develop clinical management strategies for these patients. This chapter brings attention to this topic, discussing the major mechanisms and clinical features of kidney injury associated with mental illness, and the most relevant clinical strategies.

Early Detection of Renal Impairment Among Patients with Type 2 Diabetes Mellitus Through Evaluation of Serum Cystatin C in Comparison with Serum Creatinine Levels: A Cross-Sectional Study.

BackgroundThe proportion of patients with end-stage renal disease caused by diabetes has progressively increased during the last few decades. Serum creatinine level is the most commonly used biochemical parameter to estimate GFR in routine practice. However, 50% of GFR can be lost before significant elevation of serum creatinine. Cystatin C is found to be a new promising marker for early detection of renal diseases.Objective of the StudyThe aim of this study was to determine the value of serum cystatin C and serum creatinine levels for early detection of renal disease in patients with type 2 diabetes mellitus.MethodologyA hospital-based comparative cross-sectional study was conducted with a sample size of 120. For early detection of renal disease in patients with type 2 diabetes mellitus, serum creatinine and cystatin C levels were measured and compared.Result and DiscussionSerum creatinine and cystatin C levels were significantly increased in patients with type 2 diabetes mellitus compared to healthy controls. The mean±SD value of serum creatinine was found to be 0.87±0.44 mg/dL in patients and 0.63±0.27 mg/dL in control. Serum cystatin C level was also found to be significantly (P=0.0001) higher in patients (0.92±0.38 mg/L) compared to controls (0.52±0.20 mg/L). The mean±SD of eGFR in three equations (Creatinine Equation, Cystatin C Equation, and Creatinine–Cystatin C Equation) were 105.7±27.5 mL/min/m2, 90.4±28.2 mL/min/m2, and 100±29.5 mL/min/m2, respectively.ConclusionCystatin C-based GFR estimation equations detect renal impairment in patients with type 2 diabetes mellitus earlier than creatinine-based GFR estimation equations.

Sickle Cell Nephropathy and Associated Factors among Asymptomatic Children with Sickle Cell Anaemia.

Background Sickle cell nephropathy (SCN) is a serious complication of sickle cell anaemia (SCA) with asymptomatic onset in childhood and possible progression to chronic kidney disease (CKD). In Southeast Nigeria, few studies have evaluated renal function in paediatric SCA patients for early detection of renal impairment and early intervention to reduce morbidity and mortality. Therefore, this study evaluated the renal function of paediatric SCA patients in a steady state based on glomerular filtration rate and urinalysis findings (proteinuria and haematuria). Methods A cross-sectional study of consecutively recruited sixty haemoglobin SS (HbSS) children in a steady state and sixty age- and sex-matched haemoglobin AA (HbAA) controls aged 2–18 years was done. Renal function of HbSS subjects was evaluated using estimated glomerular filtration rate (eGFR) which was compared with healthy HbAA subjects. The prevalence of significant proteinuria and haematuria, its association with eGFR, and the effect of past sickle cell crisis (in the preceding 24 months) on renal function were also evaluated. Results Mean eGFR was significantly higher in HbSS subjects than in the HbAA subjects (p = 0.001) and decreased with age. Significant proteinuria and haematuria were more prevalent in the HbSS group (3.4% and 6.7%, respectively) compared to the HbAA subjects (0% and 0%, respectively) (p = 0.496 and 0.119, respectively). No significant association was observed between eGFR and proteinuria (p = 1.000) or haematuria (p = 1.000). There was a positive correlation between eGFR and frequency of past painful crisis that required hospitalization (r = 0.138, p = 0.295) and between eGFR and frequency of blood transfusion (r = 0.679, p ≤ 0.001). Conclusions Asymptomatic paediatric HbSS (SCA) patients had higher mean eGFR indicating an increased risk of nephropathy. There was no association between eGFR and proteinuria or haematuria. Frequent sickle cell crises especially one requiring transfusion were positively correlated with hyperfiltration.

Study of Cystatin C in Early Detection of Renal Impairment in Patient with HIV/AIDS

Study of Cystatin C in Early Detection of Renal Impairment in Patient with HIV/AIDS

Urinary Cytochrome C and Caspase-3 as Novel Biomarker of Renal Function Impairment in Unilateral Ureteropelvic Junction Obstruction Model of Wistar Rats.

IntroductionProlonged obstruction in UPJO would lead to kidney destruction. It is important to find a non-invasive biomarker for early detection of renal impairment before definitive treatment for UPJO. In this study, we aim to evaluate the role of urinary cytochrome c and caspase-3 as a novel biomarker to predict renal function impairment in a UPJO model in Wistar rats.MethodsTwenty-five male Wistar rats were separated into 3 groups. Group I consists of 5 rats without any treatment or model, group II consists of 5 rats (sham group), and group III consists of 15 rats with the unilateral partial ureteral obstruction model. After 4, 15, and 21 days of observation, the urine was collected and rats were sacrificed to collect the glomerular count in the kidney. Measurement of cytochrome c and caspase-3 was done using the ELISA method, while the glomerular count was done using a light microscope. Data were analyzed using factorial repeated measures ANOVA test and correlation test with Pearson and processed using SPSS version 20.0.ResultsThe UPJO group has a significant increase in cytochrome c concentration and caspase-3 concentration compared to the control group and sham group (p<0.05). There was a significant decrease in the normal glomerulus count of the UPJO group (p<0.05). There was a significant relationship between the decrease in glomerulus count with the concentration of cytochrome c and caspase-3 in the UPJO group.ConclusionThere was a significant relationship between the decrease in glomerulus count with the increase in the concentration of cytochrome c and caspase-3 in the UPJO group.

Assessment of Urinary Kidney Injury Molecule-1 as an Indicator of Early Renal Insult in Children with Cystic Fibrosis

BACKGROUND: The risk of acute kidney injury in cystic fibrosis (CF) patients is due to renal tubular affection by CFTR gene.&#x0D; AIM: Our study aimed at early detection of renal impairment in CF patients, to enable careful monitoring and adjustment of nephrotoxic medications.&#x0D; METHODS: Fifty patients with CF were enrolled in our study; they were age- and sex-matched to 40 healthy control children. All subjects were screened by urine analysis, measurements of kidney function tests, fractional excretion of sodium, β2-microglobulin (beta-2-M) excretion, and renal ultrasound examination. Urinary kidney injury molecule-1 (KIM-1) was assayed using ELISA technique.&#x0D; RESULTS: Both urinary beta-2-M and KIM-1 concentrations were significantly higher in CF patients compared to the control group (p &lt; 0.001). The duration of the disease was significantly positively correlated with the urinary beta-2-M and KIM-1 levels (r = 0.6 and 0.7, respectively; p &lt; 0.01).&#x0D; CONCLUSIONS: Our results showed that urinary KIM-1 can be considered as a sensitive early indicator of acute renal injury.

Incidence of heart failure in patients of acute ST elevation myocardial infarction with impaired renal function

Ischemic heart disease is a common cardiac disorder and significant cause of mortality and morbidity worldwide. Effective risk stratification is integral to the management of patients with acute coronary syndromes and associated chronic kidney disease may adversely affect acute ST elevation myocardial infarction (STEMI) outcome. This prospective study was conducted in the Department of Cardiology, Chittagong Medical College Hospital after approval of the protocol for the study with duration of one year. For these purpose 100 patients of STEMI diagnosed by clinical, biochemical and ECG criteria were included in the study. After getting serum creatinine level, estimated glomerular filtration rate was calculated and if it is &lt;60 ml/min then the patient was selected for the study. Among the 100 patients inferior MI was 34%, anterior MI was 20%, extensive anterior MI was 12%, antero-septal MI was 18%, infero-lateral MI was 10%, lateral MI was 2%, high lateral MI was 3% and antero-inferior was 1%. Of these patients heart failure was found in 21% of the patients. The association between incidence of heart failure patients and eGFR was statistically significant (p &lt; 0.05). From this study, it was concluded that impaired renal function among MI patients plays a role for an adverse outcome. Early detection of renal impairment is necessary to avoid increased morbidity and mortality.&#x0D; Mediscope Vol. 6, No. 1: Jan 2019, Page 7-11

CKD-EPI is a Better Tool for Detecting Renal Dysfunction in Hypertensive Pregnancy: A Case-Control Study in Ghana

Background: Pregnant women with hypertension are at an increased risk of renal impairment. This study assessed the use of CKD-EPI and 4v-MDRD for early diagnosis of renal impairment in pregnant women with hypertension. Methods: This case-control study was conducted at Suntreso Government Hospital Kumasi, Ghana. In all, 220 pregnant women were recruited, 84 had Gestational Hypertension, 36 had Preeclampsia, with 100 normotensive pregnant women as controls. Structured Questionnaires were used to obtain socio-demographic and clinical information. 4 mL of venous blood was collected for estimation of electrolytes, urea, creatinine and uric acid; urine was collected for estimation of protein using dipstick. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease (MDRD-4) equations were used to assess and classify renal impairments. Results: Prevalence of renal impairment using CKD-EPI and MDRD-4 was 4.1% and 0.5% respectively. CKDEPI identified 22.2% of women with preeclampsia as having renal impairment whereas MDRD-4 identified 2.8%. Using CKD-EPI and MDRD-4, eGFR was significantly higher in the controls compared to the cases, (p<0.001). Sodium, chloride, urea, creatinine, uric acid was significantly increased in the hypertensive women. Conclusion: Renal impairment is common in hypertensive pregnant women. CKD-EPI is better equation in early detection of renal impairment in pregnant women and should be adopted as the tool for assessing renal dysfunction during routine antenatal examinations to prevent end-stage renal diseases.

Early Detection of Renal Impairment by Biomarkers Serum Cystatin C and Creatinine in Saudi Arabia

Early Detection of Renal Impairment by Biomarkers Serum Cystatin C and Creatinine in Saudi Arabia

Elevated cystatin C: is it a reflection for kidney or liver impairment in hepatic children?

Aim of the studyTo assess if elevated serum cystatin C (Cyst-C) is an indicator for renal or hepatic dysfunction in presence of liver fibrosis.Material and methodsData of 50 children with chronic liver diseases (CLDs), out of which 25 were without renal impairment, and 25 with renal impairment were analyzed. Twenty healthy children served as a healthy control group. Routine investigations, creatinine clearance, hepatitis viral markers, abdominal ultrasonography, and liver biopsy were performed for patients with CLDs. Measurement of serum Cyst-C concentration by particle induced immunonephelometry were completed for both patients and control group.ResultsResults showed that serum Cyst-C is not correlated with the degree of hepatic impairment (p > 0.05). Cyst-C levels were significantly higher in patients with renal impairment (3.66 ± 0.85) than those without (0.71 ± 0.12), and healthy control group (0.63 ± 0.85). Cystatin-C showed significant elevation in patients with severe fibrosis with renal impairment (3.66 ± 0.85) than those without (0.76 ± 0.04) (p < 0.0001). Cyst-C at cutoff levels of 1.65 mg/l showed 100% accuracy in discrimination between those with and those without renal impairment. Cyst-C > 2.34 mg/l predicting GFR < 40 ml/min with accuracy of 90%. Cyst-C > 2.73 mg/l predicting GFR < 20 ml/min with accuracy of 81.5%.ConclusionsSerum Cyst-C is a promising marker to estimate renal impairment in children with CLDs. Further studies are needed to estimate the accuracy of serum Cyst-C for early detection of renal impairment and close monitoring of the hepatic children.

Evaluation of serum cystatin-C and symmetric dimethylarginine concentrations in dogs with heart failure from chronic mitral valvular insufficiency.

Reduction in glomerular filtration rate (GFR) is a common complication in advanced stages of heart failure (HF). The convenient and precise assessment for GFR would be useful for early detection of renal impairment in HF dogs. Our hypothesis of this study was the GFR would be reduced in advanced stages of HF from chronic mitral valvular insufficiency (CMVI), as indicated by renal markers including serum cystatin-C (Cys-C) and symmetric dimethylarginine (SDMA) concentrations. Forty-three client-owned dogs consisting of 33 dogs with different stages of HF from CMVI and 10 age-matched healthy dogs were enrolled in this study. Serum Cys-C and SDMA concentrations along with other renal (i.e., urea nitrogen and creatinine) and echocardiographic markers were evaluated in healthy and CMVI dogs. Serum Cys-C concentrations were 1.4 ± 0.4 mg/l in control, 2.1 ± 0.9 mg/l in ISACHC I, 2.9 ± 0.8 mg/l in ISACHC II and 3.6 ± 0.6 mg/l in ISACHC III dogs, whereas serum SDMA concentrations were 8 ± 2 µg/dl in control, 14 ± 3 µg/dl in ISACHC I, 18 ± 6 µg/dl in ISACHC II and 22 ± 7 µg/dl in ISACHC III dogs. There was close correlation of serum Cys-C and SDMA concentrations to serum creatinine, urea nitrogen and the severity of HF. Our study demonstrated that the GFR was decreased in dogs with CMVI having earlier stages of HF.

Evaluation of Serum Creatinine and Cockcroft-Gault Estimated GFR as an Early Biomarker of Renal Impairment in Patients with Type 2 Diabetes Mellitus

Background: Control of blood sugar level in Type 2 Diabetes Mellitus (DM) cases is of utmost importance in prevention of long term complications like chronic kidney disease (CKD). With an alarming increase of the incidence of Type 2 DM cases the early detection of renal impairment becomes more important. The study therefore was carried out to evaluate whether conventional biomarker like creatinine and creatinine based GFR has any implication or not for diagnosing early renal impairment in such cases. Materials and Methods: 60 Type 2 Diabetes Mellitus patients and 60, age and sex matched healthy controls were included in the study. Routine biochemical markers like FBS, PPBS, Serum urea creatinine, Lipid profile and special parameters like HbA1c and Urine microalbumin level was measured in all of them. Results: We have found out that serum urea and creatinine were not significantly raised in normoalbuminuric and microalbuminuric cases as compared to controls. But creatinine based GFR was significantly reduced in microalbuminuric cases when compared to controls but not significantly reduced (p=0.09) in normoalbuminuric diabetics when compared with controls. Conclusion: Creatinine based GFR can help us to diagnose early renal impairment in Type 2 Diabetes Mellitus cases.

Urinary Neutrophil Gelatinase Associated Lipocalin and Interleukin-18 as Early Predictors of Kidney Injury in Neonates

Background: Early detection of renal affection in neonates is vital for early treatment and prevention of dangerous complications, so the using of some markers like urinary neutrophil gelatinase associated lipocalin (uNGAL), interleukin-18 (uIL-18) is very important as the commonly used detectors as creatinine are very late. Patient and methods: This study included 80 neonates and was carried out at neonatal intensive care unit (NICU), pediatrics department, Tanta university hospital, Egypt from 6/2013 to 6/2015. Group 1 (kidney injury-patient group): This group included forty neonates Group 2 (Control Group): This group included forty healthy neonates from outpatient clinic. uNGAL, uIL-18 and serum creatinine were assessed in 80 neonates at day 1 and day 3 of neonatal intensive care unit admission who had renal affection later proved by BUN serum creatinine. Results: Means of uNGAL, uIL-18 and serum creatinine in the day 1 of admission in cases and control groups were (30.94 ± 10.05 vs 6.7 ± 4.49), (11.61 ± 9.00 vs 1.1.98 ± 1.18) and (0.64 ± 0.17 vs 0.59 ± 0.19) respectively with p-value <0.05 which was significant in uNGAL and uIL-18 only. Conclusions: uNGAL and uIL-18 are considered simple and accurate markers in early detection of renal impairment in neonates which are better than serum creatinine

Detection of Kidney Organ Condition Using Hidden Markov Models

The frequencies of chronic kidney disease are likely to continue to increase worldwide. So people need to take a precaution, which is by maintaining kidney health and early detection of renal impairment by analyzing the composition of the iris is known as iridology. This paper presents a novel approach using a one-dimensional discrete Hidden Markov Model (HMM) classifier and coefficients Singular Value Decomposition (SVD) as a feature for image recognition iris to indicate normal or abnormal kidney. The system has been examined on 200 iris images. The total images of the abnormal kidney condition were 100 images and those for the normal kidney condition were 100 images. The system showed a classification rate up to 100% using total of image for training and testing the system unspecified, resize iris image 56x46 pixels, coefficient values U(1,1), Σ(1,1) and Σ(2,2), quantized values [18 10 7], and classify by 7-state HMM with .pgm format database.

Detection of Kidney Organ Condition Using Hidden Markov Models

The frequencies of chronic kidney disease are likely to continue to increase worldwide. So people need to take a precaution, which is by maintaining kidney health and early detection of renal impairment by analyzing the composition of the iris is known as iridology. This paper presents a novel approach using a one-dimensional discrete Hidden Markov Model (HMM) classifier and coefficients Singular Value Decomposition (SVD) as a feature for image recognition iris to indicate normal or abnormal kidney. The system has been examined on 200 iris images. The total images of the abnormal kidney condition were 100 images and those for the normal kidney condition were 100 images. The system showed a classification rate up to 100% using total of image for training and testing the system unspecified, resize iris image 56x46 pixels, coefficient values U(1,1), Σ(1,1) and Σ(2,2), quantized values [18 10 7], and classify by 7-state HMM with .pgm format database.

Evaluation of serum cystatin C as an indicator of early renal function decline in type 2 diabetes

ObjectivesThis study was conducted to evaluate the clinical usefulness of cystatin C levels in the serum in predicting renal impairment in patients with type 2 diabetes.BackgroundIn clinical practice, the glomerular filtration rate is often estimated from plasma creatinine levels. Several studies have shown cystatin C to be a better marker for the diagnosis of impaired renal function.Materials and methodsPlasma samples were obtained from 20 healthy individuals and 40 patients with diabetes mellitus type 2 for the determination of the levels of creatinine and cystatin. In addition, we classified all participants according to the urine albumin/creatinine ratio.ResultsPatients were categorized into the following groups depending on their urine albumin/creatinine ratio (mg/g creatinine): macroalbuminuric, microalbuminuric, and normoalbuminuric. There were no significant differences in age and sex between the three groups. However, the estimated glomerular filtration rate was significantly lower in the macroalbuminuric group compared with the microalbuminuric and normoalbuminuric groups, and cystatin C showed a highly significant difference in detecting early decline in diabetic patients.ConclusionFrom this study, we concluded that estimation of the serum cystatin C level is a useful, practical, and noninvasive tool for early detection of renal impairment in the course of diabetes.

Serum Cystatin C an Early Indicator of Renal Function Decline in Type 2 Diabetes

Objectives: evaluation of cystatin C level in the serum as a predictor of early renal impairment in type 2 diabetic patients. Background: the glomerular filtration rate (GFR) is often estimated from plasma creatinine. Several studies have shown that cystatin C (Cys C) can be used as a better marker for the early detection of renal function decline. Methods: patients were classified according to the urine albumin/creatinine ratio (ACR).Plasma samples were obtained from 20 healthy persons and from 40 patients with diabetes mellitus type 2 for determination of the level of creatinine and cystatin C. Results: There were no significant differences in age and sex between the three groups. However, There was a significant positive correlation between cystatin C and age, A/C ratio, HbA1c, FBS, 2HPP, DM duration and serum creatinine, and there was a significant negative correlation between cystatin C and glomerular filtration rate. eGFR was significantly lower in the macroalbuminuric group than in the micro-albuminuric and normo-albuminuric groups, and cystatin C showed the highest sensitivity and specificity in detecting micro and macro-albuminuria and accordingly early renal function decline in diabetic patients. Conclusion: from this study we concluded that serum cystatin C is a useful, practical, and non-invasive tool for early detection of renal impairment in the course of diabetes.