Functional Status Of Kidney Research Articles

Evaluation of renal function with renography in patients with renal colic

Objective: Urolithiasis is responsible for the majority of urological emergencies. Although computed tomography (CT) scan can identify urinary obstruction caused by stones, there is a growing concern about exposure to radiation made by this method. Renal scintigraphy can provide valuable insights regarding the functional status of kidneys and can significantly reduce exposure to radiation.
 The goal of present study was to assess renal function through renal scintigraphy in patients with acute renal colic and it explores the association between renal scintigraphy performance and ultrasound in terms of detecting hydronephrosis.
 Methods: For this study, 20 patients with acute renal colic were chosen. Each patient underwent renal ultrasonography and subsequently received renal scintigraphy with Technetium-99m diethylenetriaminepentaacetic acid (Tc-99m DTPA). Cohen's Kappa coefficient and Cramer's V correlation were employed to demonstrate the extent of agreement between ultrasound and renal scintigraphy. 
 Results: 12 (60%) patients were male. Glomerular filtration rate (GFR) values were correlated with Cockcroft-Gault equation and the Gates method (P=0.002, r=0.642). There was a good agreement and a statistically significant relationship between ultrasound and renal scintigraphy in terms of detecting obstructive uropathy in both kidneys.
 Conclusion: To conclude, GFR values were correlated between Cockcroft-Gault equation and the Gates method in patients with acute renal colic. There was a good agreement and statistically significant relationship between ultrasound and obstructive renography results in both kidneys. However, we found no association between perfusion phase of renal scintigraphy and ultrasonography in terms of hydronephrosis detection.

EFFECT OF GENTABIFERON-B ON THE FUNCTIONAL STATUS OF KIDNEYS IN SUBACUTE EXPERIMENT

The article presents data on the study of the effect of gentabiferon-B on the functional status of kidneys in white rat males with prolonged administration of the drug for 21 days. It was found that the administration of gentabiferon-B at doses of 1/50 and 1/20 LD50 did not have a significant effect on renal function in terms of spontaneous and induced diuresis, urea and creatinine concentrations, and no significant changes were revealed by pathomorphological examination. In rats, after a course of gentabiferon-B administration at a dose of 1/10 LD50, according to the above mentioned indicators, there were registered significant changes relative to the control group. However, all of them were reversible, which was confirmed by the results of studies 10 days after the drug withdrawal.

Comparison of Jaffe and enzymatic methods for creatinine estimation and their effect in GFR calculation in a tertiary care hospital

Introduction and Aim: Serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) gives the idea of overall functional status of kidney. Measurement of SCr by different method and discordant result between them can misclassify different stages of chronic kidney disease (CKD). Many of the tertiary care health centre, SCr measured by Jaffe method is still the method of choice because of its cost effectiveness even if it is more susceptible for interference. Our aim was to measure SCr level by both Jaffe’s & enzymatic method and analysing the discordance rate of eGFR and their effect in staging of kidney disease in CKD patients.
 Materials and Methods: In this observational study 330 serum sample were analysed for creatinine by Jaffe’s and enzymatic methods in a fully automated analyser using commercially available kits. Modification of Diet in Renal Disease (MDRD) formula was used for estimating GFR.
 Results: In 330 subjects eGFR values calculated on incorporating SCr were found as 58.84 ± 68.34 (median (IQR) = 26.67(15.09-90.84) and 44.49 ± 41.18 (Median (IQR) = 26.86 (14.69-67.69))
 ml/min/1.73 m2 respectively by Jaffe’s and enzymatic method. Concordance correlation coefficient between two methods for SCr was statistically significant. Bland-Altman plot showed with increasing value of SCr, the difference between the SCr values given by these two methods increased. Jaffe’s creatinine has lower value in comparison to enzymatic Cr. There was a significant difference between eGFR obtained from SCr estimated by Jaffe’s and enzymatic method.
 Conclusion: All laboratory should use uniform method for creatinine estimation. Enzymatic method for creatinine estimation should not be compromised over cost of test, so that less variability in creatinine result can lead to more accurate staging of the disease.

Eş Zamanlı Kronik Koroner Arter Hastalığı ve Prostat Adenokarsinoması Olan Renal Disfonksiyonlu Hastaların Kompleks Tedavisinde L-Karnitinin Etkisi

Objective: The aim of the study is to evaluate the effect of L-Carnitine on the dynamics of inflammation, insulin resistance (IR), functional status of kidneys in the complex therapy of patients with coronary heart disease (CHD) in combination with prostate adenocarcinoma and renal dysfunction. Material and Methods: Forty two men with prostate adenocarcinoma and coronary heart disease were enrolled. The patients were randomly and blindly divided into 2 groups: Group I patients were treated with L-Carnitine in addition to standard treatment; Group II patients received only conventional treatment. Standard laboratory blood tests, lipid profile, glucose, renal and liver function tests, serum C-reactive protein (CRP), insulin, testosterone levels, echocardiographic examination were performed for all patients at baseline and after 10 days of treatment. Results:Median level of HOMA index was 3.1 [1.9; 4.8] mg/ml. Insulin resistance was established in 54.8% patients of Group I and 40% patients of control group (p<0.05). In Group I, the mean insulin index and HOMA index decreased by 15.4% (p=0.001) and 19.2% (p=0.003), respectively. The supplementation of L-Carnitine in standard therapy contributed to a significant decrease in serum creatinine level and an increase in the level of glomerular filtration rate (GFR) in Group I patients (p<0.05). Conclusion: The supplementation of L-Carnitine in the complex therapy of patients with coronary artery disease in combination with prostate adenocarcinoma contributes to a significant decrease in insulin resistance, improves the functional state of kidneys.

CALCULUS RENAL FAILURE

Background: Urolithiasis is a common urological disease in Pakistan. Calculusrenal failure is a urological emergency that required immediate intervention to prevent furtherdeterioration of renal function. Objectives: The purpose of this study is to present clinical profileof calculus renal failure patient and to report our experience of management of such patients.Study Design: Descriptive Cross sectional study. Setting and Period: Department of urologyServices Hospital from July 2015 to December 2016 were included. Materials and Methods:Patients of all ages of either sex who presented with calculus renal failure. The patients withobstructive uropathy due to causes other than stone disease were excluded. Demographicinformation along with detailed history recorded. Baseline investigations included Completeblood counts, serum creatinine, serum electrolytes and ultrasound for KUB. For stone positionXray KUB in every case &amp; CT in selected cases performed. Functional status of individual kidneywas assessed by renal scan with differential GFR. After initial emergency treatment, all patientswere subjected to definite treatment depending upon stone location and functional status ofkidney. Results: A total of 68 patients were recruited for this study. The mean age of the patientswas 48.8 + 14.13 with range 23-90. 52(76.5%) of the patients were male and 16(23.5%)were females. Most common presentation was lumber pain 46 (67.6%) followed by anorexia 42(61.8%). The average presence of the symptoms was 17.70 days. At initial management of thecondition contained, 16(23.5%) of the patients managed by peritoneal dialysis /Hemodialysis,10(14.7%) by unilateral PCN, 16(23.5%) by Bilateral PCN, unilateral JJ stenting done in 8(11.8%)while bilateral JJ stenting in 07 (10.9%), 6(8.8%). 10(14.7%) patient were managed with URS/Lithoclast therapy without any prior diversion. Renal function in 08 patients (11.8%) did notimproved after initial management and they remained on maintenance dialysis. Conclusion: Intime diagnosis and early proper treatment improves the outcome.

ANTITOXIC AND NEPHROPROTECTIVE ACTION OF "POLYPHITOL-1" PHYTO-COMPOSITION IN CASE OF CADMIUM INTOXICATION IN YOUNG NOT SEXUALLY MATURE RATS

Abstract. Under conditions of increasing pollution of the environment medical and biological studies related to prophylaxis and treatment of adverse influence of ecotoxicants in respect to age are of great importance. Young organism is especially sensitive to the influence of toxic agents because of the insufficient development of the main regulatory systems, imperfection of mechanisms of protection, low adaptability, and morphological and functional characteristics of the organism.Objective - to study protective influence of the phytopreparation Polyphitol-1 on the total toxicity and functional status of kidneys under conditions of experimental cadmium toxicosis in young not sexually mature animals.Material and methods. The study was conducted with young (5-6 weeks) juvenile male rats in the period of their growth and sexual maturation. Subchronic intoxication was induced by daily administration of cadmium chloride into the stomach for 30 days (0.03 mg/kg). Polyphitol-1 (PPh-1) was administered into the stomach at a dose of 2.5 ml/kg 2 hours before administering the dose of the metal. On the 30th day the content of cadmium ions in the organism was examined, together with indexes of excretory, ionic, and acidic regulating function of the kidneys. The intact animals of the same age, lived under the similar vivarium conditions, were used as the control.Results. It was found that the body mass of the intoxicated animals increased only 15.9% for 30 days in comparison with the initial level; this number is 3.7 times less than for the control animals. Owing to PPh-1 administration the mass of the animals increased 39.4%; this is 2.5 times higher than for the intoxicated animals. Under conditions of cadmium intoxication the most sensitive target organs, where the accumulation of cadmium turned out to be the highest, are the kidneys and liver. The content of metal cations in them grew in 17.0 and 8.6 times, respectively. Under the influence of PPh-1 the accumulation of metal in the organism of animals lowered, specifically in the liver – by a factor of 1.8, in the kidneys – by a factor of 1.7. Against a background of cadmium nephrotoxicity medical and preventive administration of PPh-1 increased diuresis by a factor of 1.3, significantly lowered proteinuria; glomerular filtration, depressed under conditions of metal toxicosis, increased by a factor of 1.9, which halved the level of creatinine in the blood plasma down to the level of the control animals. The transport of sodium ions in nephron intensified, its proximal reabsorbtion increased by a factor of 2.3. The filtration fraction of sodium ions increased by a factor of 2.2, and their excretive fraction and clearance decreased by a factor of 2,6-3,0. Also, the compromised tubular-glomerular feedback was restored.Conclusions. Medical and preventive administration of PPh-1 phytocomposition lowers the toxic influence of cadmium intoxication on the organism of young not sexually mature animals (suppresses the inhibitory influence of cadmium chloride on the physiological increase of the body mass, decreases the accumulation of cadmium ions in the organism). Administration of PPh-1 restores the rate of glomerular filtration, eliminates retention azotemia, activates the transport of sodium in the nephron, which promotes its reabsorbtion and decreases its loss by the organism. Owing to its nephroprotective action, PPh-1 normalizes the disordered excretory, ionic and acidic regulating functions of the kidneys, restores the mechanisms of glomerular-tubular and tubular-tubular equilibrium and tubular-glomerular feedback.

Nephrogenic factors of resistance to antihypertensive treatment in patients with essential hypertension

Aim . To study the prevalence of renal and renovascular disorders in the development and progression of primary arterial hypertension (HT) resistant to combination antihypertensive therapy (AHT) in cardiac and therapeutic patients of general hospital. Material and methods. 286 patients with essential HT stages 1-3, including 105 patients with stages 2-3 with the signs of treatment resistance were included into the study. All patients were treated with personalized AHT in accordance with current guidelines for the management of HT. Laboratory and instrumental assessment of a functional status of kidneys was performed. Results. A group of patients with resistant HT made 36.7% of the total number of examined patients. The most significant distinction in patients with resistant HT was a high incidence of changes in renal vessels and infrarenal aorta. Deformation of the abdominal aorta (9.7%), renal arteries tortuosity (7.3%), vasourethral conflict (4.8%) were detected in this group significantly more often. Conclusion. Congenital and acquired lesions of renal arteries are detected several times more often in patients with resistant essential HT.