Glomerular Filtration Rate In Patients Research Articles

The correlation between pentraxin-3, matrix metalloproteinase-9, and estimated glomerular filtration rate in patients with chronic kidney disease

Background: Chronic kidney disease (CKD) is diagnosed when there is a sustained decrease in the estimated glomerular filtration rate (EGFR) over a period of more than 3 months. While Pentraxin-3 (PTX-3) and Matrix Metalloproteinase-9 (MMP-9) levels increase during the acute phase of the kidney injury, chronic conditions often exhibit alteration in the epithelial mesenchymal transition (EMT).Objectives: This study aimed to elucidate the correlation between serum PTX-3, MMP-9, and eGFR in patients with CKD. Method: Thirty hypertensive patients with CKD stages 3, 4, and 5, aged between 16 and 65 years, were enrolled in the study (15 males and 15 females). Diagnosis of CKD was based on the 2012 Kidney Disease Improving Global Outcomes (KDIGO) criteria, utilizing serum creatinine, and CKD-epidemiology Collaboration (CKD-EPI) estimates. Subsequently, serum MMP-9 and PTX-3 levels were quantified. Result: Patients with CKD exhibited significantly higher serum levels of PTX3 and MMP9. Furthermore. a significant negative connection between PTX-3, MMP-9, and EGFR was observed. Additionally, CKD patients displayed a correlation between PTX-3 and MMP-9 concentrations.Conclusion: Plasma levels of PTX-3 and MMP-9 serve as unique, promising, and important markers that contribute to the pathogenesis of CKD.

Sarcopenia, adiposity and large discordance between cystatin C and creatinine-based estimated glomerular filtration rate in patients with cancer.

Creatinine-based estimated glomerular filtration rate (eGFRCRE) may overestimate kidney function in patients with sarcopenia. While cystatin C-based eGFR (eGFRCYS) is less affected by muscle mass, it may underestimate kidney function in patients with obesity. We sought to evaluate the relationship between body composition defined by computed tomography (CT) scans and discordance between creatinine, eGFRCRE and eGFRCYS in adult patients with cancer. This study is a cross-sectional study of consecutive adults with cancer with an abdominal CT scan performed within 90days of simultaneous eGFRCRE and eGFRCYS measurements between May 2010 and January 2022. Muscle and adipose tissue cross-sectional areas were measured at the level of the third lumbar vertebral body using a validated deep-learning pipeline. CT-defined sarcopenia was defined using independent sex-specific cut-offs for skeletal muscle index (<39cm2/m2 for women and <55cm2/m2 for men). High adiposity was defined as the highest sex-specific quartile of the total (visceral plus subcutaneous) adiposity index in the cohort. The primary outcome was eGFR discordance, defined by eGFRCYS>30% lower than eGFRCRE; the secondary outcome was eGFRCYS>50% lower than eGFRCRE. The odds of eGFR discordance were estimated using multivariable logistic regression modelling. Unadjusted spline regression was used to evaluate the relationship between skeletal muscle index and the difference between eGFRCYS and eGFRCRE. Of the 545 included patients (mean age 63±14years, 300 [55%] females, 440 [80.7%] non-Hispanic white), 320 (58.7%) met the criteria for CT-defined sarcopenia, and 136 (25%) had high adiposity. A total of 259 patients (48%) had >30% eGFR discordance, and 122 (22.4%) had >50% eGFR discordance. After adjustment for potential confounders, CT-defined sarcopenia and high adiposity were both associated with >30% eGFR discordance (adjusted odds ratio [aOR] 1.90, 95% confidence interval [CI] 1.12-3.24; aOR 2.01, 95% CI 1.15-3.52, respectively) and >50% eGFR discordance (aOR 2.34, 95% CI 1.21-4.51; aOR 2.23, 95% CI 1.19-4.17, respectively). A spline model demonstrated that as skeletal muscle index decreases, the predicted difference between eGFRCRE and eGFRCYS widens considerably. CT-defined sarcopenia and high adiposity are both independently associated with large eGFR discordance. Incorporating valuable information from body composition analysis derived from CT scans performed as a part of routine cancer care can impact the interpretation of GFR estimates.

Measurement of glomerular filtration rate in patients undergoing renal surgery for cancer: eGFR vs mGFR in the era of precision medicine.

In the era of precision medicine, determining reliable renal function assessment remains a critical and debatable issue, especially in nephrology and oncology. This paper delves into the significance of accurately measured Glomerular Filtration Rate (mGFR) in clinical practice, highlighting its essential role in guiding medical decisions and managing kidney health, particularly in the context of renal cancer (RC) patients undergoing nephrotoxic anti-cancer drugs. The limitations and advantages of traditional GFR estimation methods, primarily using serum biomarkers like creatinine and cystatin C, are discussed, emphasizing their possible inadequacy in cancer patients. Specifically, newer formulae designed for GFR estimation in cancer patients may not perform at best in RC patients. The paper explores various methods for direct GFR measurement, including the gold standard inulin clearance and alternatives like iohexol plasma clearance. Despite the logistical challenges of these methods, their implementation is crucial for accurate renal function assessment. The paper concludes by emphasizing the need for continued research and innovation in GFR measurement methodologies to improve patient outcomes, particularly in populations with complex medical needs.

Association of Dyslipidemia in Decreased Glomerular Filtration Rate in Patients with CKD KDIGO ≥ 3

Association of Dyslipidemia in Decreased Glomerular Filtration Rate in Patients with CKD KDIGO ≥ 3

A Cross-sectional Study on Assessment of Estimated Glomerular Filtration Rate in Patients with Stable Chronic Obstructive Pulmonary Disease

A Cross-sectional Study on Assessment of Estimated Glomerular Filtration Rate in Patients with Stable Chronic Obstructive Pulmonary Disease

Analysis of glomerulopathies in kidney neoplasms

Background. Malignant neoplasms, including those of the kidneys, are widespread in the world. The main treatment for kidney tumors is surgery, one of its options is nephrectomy. Malignant tumors of various localizations can lead to a variety of kidney damage. Glomerulopathies of various origins are often asymptomatic, and therefore, patients do not seek medical help. For the diagnosis of glomerulopathies, it is necessary to assess morphological changes with the formulation of an immunofluorescence reaction and electron microscopy.The aim: to analyze the clinical manifestations, frequency and structure of glomerulopathies in kidney neoplasms.Patients and Methods. The study included 141 patients. The patients underwent nephrectomy, the daily protein loss, the number of altered erythrocytes in the urine, the level of creatinine in the blood serum were determined, and the glomerular filtration rate (CKD-EPI) was calculated. Morphological evaluation of samples included immunofluorescence reaction and electron microscopy. To assess the statistical significance of the relationship between variables, Spearman's nonparametric rank correlation coefficient (Rs) was calculated. The results obtained were considered significant at p&lt;0.05. RESULTS. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies. CONCLUSION. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist Keywords: tumor, glomerulonephritis, diabetic nephropathy, glomerular filtration rate&gt; ˂ 0.05.Results. Glomerulopathies were detected in 41.8 % of patients. Glomerulonephritis was observed in 10.6 % of cases and diabetic nephropathy was detected in 31.2 % of patients. Prior to nephrectomy, proteinuria was higher in patients with glomerulonephritis; after surgical treatment, there were no differences in the level of proteinuria. Before nephrectomy, there were no significant differences in glomerular filtration rate; after surgery, glomerular filtration rate was higher in patients without glomerular pathology. After one year, there was a significant decrease in glomerular filtration rate in patients with glomerulopathies.Conclusion. When examining the surgical material, the morphologist should also evaluate changes in the kidney tissue outside the tumor. It is advisable to jointly manage the patient by an oncologist and a nephrologist.

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.

Korelasi Kadar Ureum Dan Kreatinin Pada Pasien Anemia Di RSU Duta Mulya Majenang

Anemia caused by a deficiency of erythropoietin can occur in patients with chronic kidney disease. Kidney function refuses to produce erythropoietin in equal measure, as a result there is a tendency for a linear relationship between hemoglobin level and glomerular filtration rate in patients with kidney disease. One way to diagnose kidney failure is by assessing or measuring serum urea and creatinine levels, because these two compounds can only be excreted by the kidneys. The aim of the study was to determine the correlation between urea and creatinine levels in anemic patients at Duta Mulya Majenang Hospital. This type of research was descriptive with a cross-sectional study design, with a sample of all anemic patients who were examined for urea and creatinine at Duta Mulya Majenang Hospital in January - March 2023 according to the inclusion and exclusion criteria, a total of 66 samples. The results showed that the majority of patients with chronic kidney failure were elderly, namely aged 46-65 years with a total sample of 43 patients (65.2%) and mostly suffered by women as many as 35 patients (53.0%). The correlation between urea and creatinine levels in all samples showed results that exceeded normal values. The conclusion of this study is that there is a correlation between serum urea and creatinine levels in anemic patients at Duta Mulya Majenang Hospital.

Changes in estimated glomerular filtration rate in patients administered proton pump inhibitors: a single-center cohort study.

Proton pump inhibitor (PPI) use may be associated with renal dysfunction. Renal dysfunction in PPI users requires evaluation of development and progression risks simultaneously, using estimated glomerular filtration rate (eGFR) slope, which indicates changes in eGFR per year. To the best of our knowledge, no studies have evaluated eGFR slope in PPI users. This study investigated the association between PPI use and renal dysfunction using eGFR slope.A single-center cohort study was conducted using the health records data at Hamamatsu University Hospital in Japan. Participants were defined as first users of acid-suppressing drugs (PPIs or Histamine H2 receptor antagonists (H2RAs)) from 2010 to 2021 and continuously prescribed for ≥ 90days. The H2RA group was used for the propensity-score matching (PSM) to the PPI group to minimize the effects of confounders. The eGFR slope was estimated using a linear mixed effects model. Participants were stratified by baseline eGFR and age, respectively, as subgroup analyses.A total of 4,649 acid-suppressing drug users met the inclusion criteria, including 950 taking H2RAs and 3,699 PPIs. After PSM, 911 patients were assigned to each group. The eGFR slopes of the PPI and H2RA users were -4.75 (95% CI: -6.29, -3.20) and -3.40 (-4.38, -2.42), respectively. The difference between the groups was not significant. Significant declines in eGFR were observed with PPIs with baseline eGFR ≥ 90 and age < 65.PPI use for ≥ 90days may hasten eGFR decline compared to H2RA use, especially in patients with eGFR ≥ 90 or age < 65.

Factors Related to the Occurrence of Anemia in Pre-Dialysis Chronic Kidney Disease Patients at Prof. Dr. I Goesti Ngoerah Gede Ngoerah Hospital, 2020-2022

Background: Patients with chronic kidney disease (CKD) are most commonly found to develop complications such as anemia. This complication is caused by deficiencies of erythropoietin, iron, folic acid, and vitamin B12. The prevalence of anemia is associated with patient's glomerular filtration rate (GFR), age, gender, and erythrocyte index. Aims: The aim of this study is to report prevalence of anemia in CKD pre-dialysis patients and factors related to the incidence of anemia in CKD pre-dialysis patients at Prof. Dr. I Goesti Ngoerah Gede Ngoerah Hospital in 2020-2022. Methods: This research is descriptive analytical with a cross-sectional approach by using medical record data of pre-dialysis CKD patients from the Prof. Dr. I Goesti Ngoerah Gede Ngoerah Hospital which obtained a sample of 712 patients. Results: It was found that cases of anemia in pre-dialysis CKD patients were mostly found in women (75%), age group ≥65 years (73.6%), and stage IV (88.2%) and V (94.1%). Pre-dialysis CKD patients stage ≥III (stage III-V) were 1.6 times more likely to develop anemia compared to patients with stages I and II (OR 1.641, 95% CI: 1.175-2.293; p=0.004), as well as female gender 1,6 times more likely to suffer from anemia compared to male patients (OR 1.610, 95% CI: 1.138-2.277; p=0.007). Conclusion: The overview of anemia cases in CKD pre-dialysis patients were dominated by men, age group ≥65 years, and stage V. Prevalence of anemia increases when the patient is stage ≥III (stage III-V) and female. Keywords: Chronic Kidney Disease, anemia, pre-dialysis, age, gender, stage

Effect of Tyrosine Kinase Inhibitor Therapy on Estimated Glomerular Filtration Rate in Patients with Chronic Myeloid Leukemia

IntroductionThe advent of tyrosine kinase inhibitors (TKIs) was revolutionary in the management of chronic myeloid leukemia (CML). Although TKIs were generally considered to be safe, they can be associated with renal injury. We evaluated the effect of TKIs on renal functions in a cohort of patients with long-term follow-up. Material and MethodsWe retrospectively examined patients with chronic phase CML treated with TKIs. We analyzed the estimated glomerular filtration rate (eGFR) of patients from the initiation of TKI to the last follow-up. eGFR values of CML patients were compared to those of patients with stage 1 or 2 chronic kidney disease (CKD). ResultsA total of 195 patients with CML and 138 patients with CKD were examined. eGFR decline was 1.556 ml/min/1.73m2/year for patients with CML (P = .221). Patients receiving second-generation TKIs (2GTKI) were estimated to have 0.583 ml/min/1.73m2 higher eGFR value than that of the imatinib group, but it was not significant (P = .871). eGFR of patients who had used bosutinib had a downward trend. Duration of TKI therapy, age, and hypertension were found to be significant factors in eGFR decline for CML patients. Lower baseline GFR was associated with an increased risk of CKD development. ConclusionImatinib could result in a decline in eGFR which was clinically similar to early-stage CKD patients. We did not observe significant kidney function deterioration in patients receiving 2GTKIs including dasatinib and nilotinib. We recommend close renal function monitoring in patients receiving imatinib, especially for elderly patients with lower baseline eGFR and hypertension.

Recommended Methods of Drug Dosing Adjustment for Patients With Renal Impairment.

Since 2020, there have been changes in Food and Drug Administration guidance and in recommendations by national organizations with a focus on kidney diseases pertaining to the choice of equations used to estimate creatinine clearance and glomerular filtration rate in patients with renal impairment. This includes a recommendation by the National Kidney Foundation to avoid the use of the Cockcroft-Gault equation for drug dosing in patients with renal impairment. This commentary provides an overview of recent recommendations concerning kidney function assessment that have important implications for drug dosing in patients with renal impairment and provides suggestions for implementing these recommendations.

Relationship between the neutrophil-to-lymphocyte ratio and estimated glomerular filtration rate in patients with primary aldosteronism: a cross-sectional study

Objective: To investigate the associations between neutrophil-to-lymphocyte ratio (NLR) and estimated glomerular filtration rate (eGFR) in patients with primary aldosteronism (PA). Methods: This study was a cross-sectional study. Consecutive patients diagnosed with PA and admitted to the Second Affiliated Hospital of Nanchang University from October 2017 to April 2022 were enrolled. General information, blood routine, renal function, and other clinical data of the patients were collected. Based on the median NLR of the enrolled patients, NLR<median was defined as low NLR. Low eGFR was defined as an eGFR<60 ml·min-1·1.73 m-2. Multiple linear regression and multivariate logistic regression models, smooth curve fitting and threshold effect exploration were used to analyze the relationship between NLR and eGFR in PA patients, and stratified analysis and interaction tests were used to evaluate potential variables that may affect the correlation between NLR and eGFR. Results: This study finally included 743 PA patients, aged (50.3±10.4) years, 42.9% (319/743) were female, and the median NLR was 2.3. After adjusting for sex, age, body mass index (BMI) and other factors, multiple linear regression analysis showed that high NLR was negatively correlated with eGFR (β=-4.9, P=0.008), and multivariate logistic regression analysis showed that high NLR was associated with low eGFR (OR=3.1, P=0.002). In the corrected smooth curve, NLR is U-shaped correlation with eGFR, and the inflection point is at NLR=3.5. When the NLR was<3.5, the eGFR decreased with the increase of NLR (corrected β=-4.7, P<0.001); When the NLR was≥3.5, the eGFR increased with the increase of NLR (corrected β=5.8, P=0.031). The results of stratified analysis showed that there was an interaction between the association of NLR and eGFR with the presence or absence of hyperlipidemia (P interaction=0.017), and the correlation between NLR and eGFR was stronger in PA patients with hyperlipidemia. Conclusion: In the PA patients, there is a U-shaped relationship between NLR and eGFR, and higher NLR is associated with lower eGFR. PA patients with elevated NLR should undergo additional screening for chronic kidney disease and receive related preventive interventions.

Prognostic implication of glomerular filtration rates in patients with chronic thromboembolic pulmonary hypertension who have undergone balloon pulmonary angioplasty.

Chronic thromboembolic pulmonary hypertension (CTEPH) plays a key role in the deterioration of lung hemodynamics and contributes to secondary dysfunction of the right heart, which is consistently accompanied by systemic malperfusion and a reduced glomerular filtration rate (GFR). The prognosis of CTEPH is markedly influenced by renal function. The aim of the present study was to evaluate the prognostic value of GFR in patients with CTEPH who have undergone balloon pulmonary angioplasty (BPA). From December 2012 to September 2020, a total of 47 patients diagnosed with CTEPH who received BPA were retrospectively studied. Patients were categorized according to their renal function on admission into two groups: GFR >53 and ≤53. Biological, clinical and demographic data of the patients were collected. Data for the two groups in hospital and during follow-up were systematically analyzed and compared. All-cause mortality, death from right heart failure (RHF) and rehospitalization associated with RHF were considered major adverse events (MAEs). The results revealed that the 6-min walk distance, N-terminal pro-B type natriuretic peptide (NT-proBNP), Troponin I and right ventricle diameter were significantly lower, and tricuspid annular plane systolic excursion was significantly higher in the GFR >53 group compared with the GFR ≤53 group at final follow-up. In addition, GFR levels were significantly correlated with NT-proBNP at baseline and final follow-up. Furthermore, based on a multivariate analysis, it was determined that the decreased GFR was an independent predictor of MAEs during follow-up. Therefore, it may be concluded that in addition to being associated with right ventricular function, decreased GFR is also a prognostic marker in CTEPH treated with BPA.

Baseline Urine Albumin-to-Creatinine Ratio is Associated With Decline of Estimated Glomerular Filtration Rate in Patients Newly Diagnosed With Type 2 Diabetes Mellitus: An Observational 5-year Cohort Study

ObjectiveThis study aimed to investigate the association between baseline albuminuria and the progression of diabetic kidney disease (DKD) in patients newly diagnosed with type 2 diabetes mellitus (DM). MethodsA retrospective cohort study was conducted among 604 patients aged ≥18 years who were newly diagnosed with type 2 DM between January 2014 and 31 December 2017 at an outpatient clinic in a tertiary hospital in China. The incidence of albuminuria was determined and the associations between albuminuria at baseline and the progression of DKD estimated by estimated glomerular filtration rate slope were evaluated using binary logistic regression analysis. ResultsAt diagnosis of type 2 DM, 18.8% of patients had albuminuria, with 17.4% having microalbuminuria and the other 1.4% having macroalbuminuria. During the 5-year follow-up period, patients with albuminuria at the baseline experienced a more rapid decline of estimated glomerular filtration rate over time than patients with normoalbuminuria at baseline (−2.6 vs −1.5 mL/min/1.73 m2 per year, P =.01). Albuminuria at baseline is independently associated with the progression of DKD. ConclusionsThe prevalence of albuminuria is 18.8% in patients newly diagnosed with type 2 diabetes and the occurrence of albuminuria can predict steeper annual decline in kidney function.

Predicting the overall survival of patients with chronic lymphocytic leukemia in the dynamics of the disease

Relevance. The high prevalence of chronic lymphocytic leukemia (CLL) in elderly and senile patients of the European population dictates the need to find a publicly available solution to the problem of prognosis in this cohort of patients. Previously, a relationship was established between the survival of patients with CLL and the value of the glomerular filtration rate (GFR) at the time of diagnosis. The purpose of the study: to assess the relationship of GFR with the survival of CLL patients in the course of the disease. Materials and methods: 207 patients (98 men and 109 women) aged 45 to 80 years with CLL A-C according to Binet and known overall survival were studied. Annually from the 1st to the 5th year of the course of the disease, the maximum value of the patient's GFR was taken into account according to the CKD-EPI formula. The data was processed by data mining using a logical classification algorithm. Results. With a GFR value of more than 76 ml/min/1.73 m2 during the first year of the disease, more than 75 ml/min/1.73 m2 during the second year of the disease, more than 70 ml/min/1.73 m2 during the third year of the disease, more than 68 ml/min/1.73 m2 during the fourth and fifth years of the disease, the patient will overcome the calculated parameters of the median survival for the corresponding stage of CLL according to Binet. Otherwise, the overall survival of the patient will be less than the calculated median survival according to Binet. This article provides illustrative clinical examples. Conclusion. It was found that the value of GFR in CLL patients gradually decreases with the course of the disease, however, the value of this parameter in the dynamics of the disease can be considered as a significant factor in predicting the survival of patients with CLL. Based on the results, an application for an invention No. 2023108368 was filed.

Serum and fecal zonulin as a biomarker of increased intestinal epithelial permeability in patients with renal insufficiency

BACKGROUND: Determination of zonulin level in body fluids is one of the widely used clinical methods for diagnosing the leaky gut syndrome. Meanwhile, a decrease in the glomerular filtration rate can potentially affect the content of zonulin in patients with impaired renal function.&#x0D; AIM: to evaluate the content of serum and fecal zonulin in subjects at different stages of chronic kidney disease.&#x0D; MATERIALS AND METHODS: The cross-sectional study included 3 groups of patients: 1) 155 patients with end-stage renal disease receiving hemodialysis treatment; 2) 30 patients with chronic kidney disease C3a-5 (glomerular filtration rate 60 ml/min/1.73 m2); 3) 20 relatively healthy individuals with glomerular filtration rate 60 ml/min/1.73 m2. The groups were comparable in gender, age, body mass index, smoking status and etiological structure of chronic kidney disease. The concentration of zonulin in blood serum and feces was assessed by using commercially available ELISA kit.&#x0D; RESULTS: There were no significant differences in serum zonulin between groups. There was a significant direct correlation of serum zonulin with age, creatinine, C-reactive protein and inverse with glomerular filtration rate in patients at predialysis stages of chronic kidney disease. At the same time, in hemodialysis patients serum zonulin did not depend on any of the defined clinical and demographic indicators.It was also found that the concentration of fecal zonulin significantly increased concurrently with an advance of renal insufficiency and reached maximum values in patients with end-stage renal disease. Meanwhile, the correlation analysis did not reveal association between fecal zonulin and kidney function parameters in individuals with mild and moderate chronic kidney disease. Only the hemodialysis group observed a significant direct correlation of fecal zonulin with C-reactive protein.&#x0D; CONCLUSION: Evaluation of fecal, but not serum zonulin level is preferable to use as a biomarker of increased intestinal epithelial permeability in patients with impaired renal function, since its concentration in the blood is likely to be significantly affected by reduced glomerular filtration rate.

Clopidogrel-Related High Residual Platelet Reactivity Associated with Estimated Glomerular Filtration Rate in Patients with Acute Ischemic Stroke

Introduction: There are few studies on the relationship between the occurrence of clopidogrel-related high residual platelet reactivity (HRPR) and estimated glomerular filtration rate (eGFR) at admission in patients with ischemic stroke. The aim of this study was to investigate the possible relationship between the two. Methods: Patients who were hospitalized and diagnosed with acute ischemic stroke were recruited from July 1, 2017, to June 30, 2018, at Shanghai TCM-Integrated Hospital. Renal function was measured within 24 h of enrollment and eGFR was calculated. Patients were tested for platelet reactivity using the VerifyNow system after 7 days of antiplatelet therapy with clopidogrel 75 mg/d alone, and patients with P2Y12 reaction unit values ≥230 were diagnosed with HRPR. The association between HRPR and eGFR was analyzed. Results: A total of 274 patients were enrolled in the study, of whom 91 (33.21%) had HRPR. Multivariate logistic regression analysis suggested that an increased risk of HRPR was independently associated with female sex and reduced eGFR (female sex: OR = 2.24, 95% CI: 1.26–3.99, p = 0.006; mild chronic kidney disease [CKD]: OR = 2.95, 95% CI: 1.47–5.93, p = 0.002; moderate CKD: OR = 3.07, 95% CI: 1.08–8.75, p = 0.04). Conclusion: Decreased eGFR is an independent risk factor for the occurrence of HRPR in patients with ischemic stroke.

Comparative characteristics of patients with arterial hypertension with positive and negative reactions to salt load at night time

Objective: comparison of peripheral and central blood pressure, vascular wall stiffness and glomerular filtration rate in patients divided into salt-sensitive and salt-resistant based on the dynamics of blood pressure during night time after salt loading.Materials and methods: the study included 180 patients with arterial hypertension: 96 men (53%) and 84 (47%) women, median age 59 (56-64) years. Salt sensitivity was assessed according to the method of V.I. Kharchenko with distribution into groups according to the results of blood pressure dynamics at night. Peripheral and central blood pressure, vascular stiffness, and glomerular filtration rate were compared.Results: in 61% of salt resistant patients, there was a sufficient decrease in blood pressure during nocturnal sleep — the “dipper” profile, while in the group of salt sensitive patients, the decrease in blood pressure was sufficient only in 48%. Glomerular filtration rate was also higher in salt resistant patients compared to salt sensitive: 76,5 ml/min./1.73m2 versus 68 ml/min./1,73m2.Conclusion: arterial hypertension is more severe in salt sensitive patients, which was reflected in the intergroup comparison of peripheral and central blood pressure, vascular stiffness, and excretory function of the kidneys. Assessment of salt sensitivity at night may be useful in identifying high-risk groups of patients requiring the most careful monitoring and “aggressive” antihypertensive therapy.

Glomerular filtration rate in patients with type 2 diabetes mellitus: is serum isthmin-1 level a possible link?

IntroductionIsthmin-1 (Ism-1) is a novel adipokine. However, little is known regarding the association between Ism-1 and type 2 diabetes mellitus (T2DM). This study aimed to investigate the relationship between serum...