Higher Urea Levels Research Articles

Determination of reference intervals for metabolic profile of Hanwoo cows at early, middle and late gestation periods

BackgroundMetabolic profile was initially designed as a presymptomatic diagnostic aid based on statistical analyses of blood metabolites to provide an early warning of certain types of metabolic disorder. However, there is little metabolic profile data available about Korean Hanwoo cows. Therefore, this study aimed to determine the reference intervals of metabolic profile for Korean Hanwoo cows.MethodsHealthy animals (2,205) were selected and divided into early (day 1 to 95), middle (day 96 to 190) and late (day 191 to 285) period according to their gestating period. Metabolic profile including total protein (TP), albumin (Alb), urea (UREA), glucose (Glu), total cholesterol (T-Cho), long-chain fatty acid (LCFA), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), creatinine (Crea), calcium (Ca), inorganic phosphorous (iP) and magnesium (Mg) were analyzed using a TBA-40FR automatic biochemical analyzer. The data of Korean Hanwoo cows were then compared to those of the Japanese Wagyu cows.ResultsMost of the data of the Korean Hanwoo cows were relatively higher than those of Japanese Wagyu cows, with the exception of Glu and GGT. This may indicate that the nutritional level of feed for the Korean Hanwoo cows was higher than that of the Japanese Wagyu cows because of the different feeding system. In particular, relatively higher levels of UREA and LCFA were observed in the Korean Hanwoo cows, and this may also contribute to the low reproduction efficiency.ConclusionsThese findings may provide some theoretical basis for understanding the reproductive and feeding situation of Korean Hanwoo cows.

The incidence of contrast medium-induced nephropathy following endovascular aortic aneurysm repair: assessment of risk factors.

The aim of the study was to investigate the incidence of contrast medium-induced nephropathy (CIN) and risk factors for CIN following endovascular abdominal aortic aneurysm repair or thoracic endovascular aortic aneurysm repair. After exclusion criteria, 139 (121 males, 18 females) patients aged 20-86 (median 65.5) years who underwent endovascular aortic aneurysm repair between January 2002 and September 2013 were included in this retrospective study. CIN, with ≥25% increase in serum creatinine levels within 3 days after contrast medium administration, was compared to the patients' demographics, risk factors, type and complexity of the endovascular operation, parameters regarding to the contrast medium, preoperative estimated glomerular filtration rate (eGFR), and preoperative and early postoperative serum parameters. Statistical analyses were performed with Kolmogorov-Smirnov, χ (2) and Student's t tests. CIN, detected in 39 of 139 patients (28%), was correlated with preoperative eGFR <60 ml/min/1.73 m(2) (P = 0.04) and high preoperative and postoperative serum urea and creatinine levels. Postoperative serum urea levels (P < 0.001) were significant in multivariate analysis. In patients undergoing endovascular aortic aneurysm repair, CIN was correlated with preoperative and postoperative renal impairment, while it was not correlated with the contrast medium dose.

Genetic and environmental determinants of the urea level in cow's milk

Abstract. This study was conducted on a sample of 2237 Polish Holstein-Friesian cows. The aim was to estimate the effect of selected environmental factors on the level of urea in cow's milk and on its genetic parameters, i.e. the heritability coefficients, and genetic correlation with other selected traits of milk production. The present study has revealed the existence of a highly significant influence of herd, year of calving, parity, lactation phase, and milk performance level on the urea content in cow's milk. A high urea level in milk was detected in samples collected from older animals, both during the winter season and the middle phase of lactation (101–200 days). The heritability estimates were generally at a low level, particularly in terms of milk yield (0.183) and urea content (0.152–0.159), which may indicate the dominant role of the environment in shaping them. Relatively low values of genetic correlation (−0.097–0.140) between the urea content and other traits suggest that improvement of milk yield and its composition modify the urea level in milk only to a small degree.

Predictors of survival in children with methymalonic acidemia with homocystinuria in Beijing, China: a prospective cohort study.

(i) To determine whether clinical features and biochemical parameters help to predict survival of methylmalonic acidemia with homocystinuria; (ii) To find the cutoff values of biochemical parameters for predicting survival of methylmalonic acidemia with homocystinuria. A prospective cohort study. A pediatric tertiary hospital in Beijing; all patients were followed until death or June 2013. 45 pediatric patients diagnosed with methylmalonic acidemia with homocystinuria between 2006 and 2012. The data of clinical characteristics and pretreatment biochemical parameters were collected. The Cox regression analysis was performed to identify independent risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The best cutoff values for these independent factors were determined by the receiver characteristic curve. Newborn onset (OR=6.856, 95%CI=2.241-20.976, P=0.001), high level of methylmalonic acid in urine (OR=1.022, 95%CI=1.011-1.033, P<0.001), and high level of urea in serum (OR=1.083, 95%CI=1.027-1.141, P=0.003) were independent negative risk factors for survival of patients with methylmalonic acidemia and homocystinuria. The cutoff values of maximum predictive accuracy of methylmalonic acid in urine and urea in serum were respectively 5.41 mmol/mmol creatinine and 7.80 mmol/L by receiver operating characteristic curve analysis. The patients of methylmalonic acidemia with homocystinuria tend to have an adverse outcome if they have newborn onsets. Elevated urea and urinary methylmalonic acid are predictors of adverse outcomes for the patients. They show similar effect for predicting severe adverse prognosis. The combination of methylmalonic acid in urine concentration and urea in serum concentration provided the most accurate predictive tool.

Camel milk attenuates the biochemical and morphological features of diabetic nephropathy: Inhibition of Smad1 and collagen type IV synthesis

Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus (DM) that worsens its morbidity and mortality. There is evidence that camel milk (CM) improves the glycemic control in DM but its effect on the renal complications especially the DN remains unclear. Thus the current study aimed to characterize the effects of CM treatment on streptozotocin (STZ)-induced DN. Using STZ-induced diabetes, we investigated the effect of CM treatment on kidney function, proteinuria, renal Smad1, collagen type IV (Col4), blood glucose, insulin resistance (IR), lipid peroxidation, the antioxidant superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH). In addition renal morphology was also examined. The current results showed that rats with untreated diabetes exhibited marked hyperglycemia, IR, high serum urea and creatinine levels, excessive proteinuria, increased renal Smad1 and Col4, glomerular expansion, and extracellular matrix deposition. There was also increased lipid peroxidation products, decreased antioxidant enzyme activity and GSH levels. Camel milk treatment decreased blood glucose, IR, and lipid peroxidation. Superoxide dismutase and CAT expression, CAT activity, and GSH levels were increased. The renoprotective effects of CM were demonstrated by the decreased serum urea and creatinine, proteinuria, Smad1, Col4, and preserved normal tubulo-glomerular morphology. In conclusion, beside its hypoglycemic action, CM attenuates the early changes of DN, decreased renal Smad1 and Col4. This could be attributed to a primary action on the glomerular mesangial cells, or secondarily to the hypoglycemic and antioxidant effects of CM. The protective effects of CM against DN support its use as an adjuvant anti-diabetes therapy.

Leishmania (Viannia) braziliensis in dogs in Brazil: epidemiology, co-infection, and clinical aspects.

Leishmaniasis is an endemic disease present in 98 countries. In Brazil, the northeast region accounts for approximately half of the cases in humans, and has experienced an increased number of positive cases in dogs. In this study, we investigated the epidemiology of canine leishmaniasis in the city of Ilhéus, Bahia, using serological and molecular techniques and evaluated the possible environmental risk factors and associated clinical signs. Blood samples were collected from 560 dogs in urban and peri-urban areas in Ilhéus, northeastern Brazil. Genomic DNA was extracted from the selected animals and subjected to molecular analysis using Leishmania species-specific primers and diagnosis of Trypanosoma cruzi. A total of 54.72% of dogs were positive for Leishmania braziliensis, and animals positive for both Leishmania infantum and T. cruzi were not identified. Hematologic variables were not statistically associated with cases of L. braziliensis. However, the positive animal group showed lower red blood cell and platelet counts and higher levels of urea and serum creatinine. Few dogs presented clinical signs compatible with the presence of Leishmania. Age of more than 2 years and specific hair colors were associated with positive results for L. braziliensis. The geoclimatic characteristics of the region may improve parasite survival, reproduction, and vectors. This may explain the higher rate of dogs identified as positive in this study.

Metabolic acidosis and its association with nutritional status in hemodialysis

Metabolic acidosis is a common problem in dialysis patients and plays an important role in the pathogenesis of protein-energy malnutrition in these patients. To assess the prevalence of metabolic acidosis in hemodialysis and search their association with nutritional status. A cross-sectional study was performed in hemodialysis patients at a single center. Nutritional status was assessed by anthropometric, biochemical and multifrequency bioelectrical impedance analysis. Metabolic acidosis was defined as serum bicarbonate (BIC) < 22 mEq/L and patients were divided into 3 groups according to BIC (< 15.15 to 21.9 and ≥ 22). The association between BIC and continuous variables was investigated using the Kruskal Wallis test. The linear correlation between BIC and the variables of the study was also tested. We studied 95 patients, 59% male, mean age 52.3 years. The prevalence of metabolic acidosis was 94.7%. BMI, interdialytic weight gain and PTH were significantly different among the 3 groups of BIC. The BIC was negatively correlated with urea, phosphorus and interdialytic weight gain. There was no significant correlation with albumin, phase angle and lean body mass index. The prevalence of metabolic acidosis was high in this population, and a lower BIC correlated with higher levels of urea, PTH, phosphorus, interdialytic weight gain and lower BMI. The evaluation of acid-basic status should be routinely implemented in dialysis patients by considering the negative effects of acidosis on the nutritional status, inflammation and bone disease.

Multi-factor analysis of failure of renal replacement therapy in acute renal failure developed after cardiac surgery

IntroductionAcute renal failure (ARF) is a rare (2-15%), but severe complication of cardiac surgery with overall mortality reaching 40-80%. In order to save patients’ lives they are treated with renal replacement therapy (RRT). The aim of our study was to assess the impact of different perioperative factors on mortality among patients treated with RRT because of acute renal failure, which occurred as a complication of a heart surgery.Material and methodsRetrospective analysis included 45 patients, operated in the years 2009-2013, who underwent renal replacement therapy in order to treat postoperative ARF. The perioperative factors were analysed in two groups: group 1 – patients who died before discharge; and group 2 – those who survived until hospital discharge.ResultsForty-five of 3509 cardiac surgical patients (1.25%) required RRT after the surgery. A total of 23 (51.11%) died before discharge (group 1). Patients in group 1 were characterised by older age (70.21 vs. 67 years), higher mean EuroSCORE value (9.28 vs. 7.15) (p < 0.05), higher percentage of concomitant surgery (63.63% vs. 28.57%) (p < 0.05) and of admission of catecholamines in the postoperative period (100% vs. 68.42%) (p < 0.005), and higher mean urea blood level prior to RRT initiation (156.65 vs. 102.54 mg/dl) (p < 0.05).ConclusionsThe statistically relevant death predictors proved to be: high EuroSCORE, concomitant surgery, and high urea level at RRT initiation and admission of catecholamines in the postoperative period. After conformation in further studies, those factors may prove useful in stratification of death risk among surgical patients requiring RRT.

Cytokines Modulate the "Immune-Metabolism" Interactions during Behçet Disease: Effect on Arginine Metabolism.

Aim and Methods. In this study, we evaluated NOS and arginase activities and their regulation during Behçet disease, a systemic chronic inflammatory disorder with uncertain etiology. The peripheral blood mononuclear cells of 36 patients and 15 control samples (PBMC) were cultured in either RPMI 1640, MEM, or DMEM complemented with 10% of FBS and antibiotics. Cultures were performed with or without the control or patients plasma. Subsequent treatment contained anticytokines (IL-6, TGF-β), a mitogenic effector (PHA), or NOS modulators (L-NMMA, BH4). Culture supernatants were harvested after 24 h of incubation. NO and urea measurements were, respectively, performed by modified Griess and Berthelot methods. Results. Higher urea levels were found in patients' plasma compared to the control's (P < 0.05). NOS modulators induced inverted production profiles for NO and urea (P < 0.05). Their results differed depending on the clinical findings (P < 0.05). It was also found that cytokine neutralization induced different response profiles in patients as opposed to control cultures (P < 0.05). Conclusion. Our results suggest that arginases can compete with NOS2 for L-arginine during Behçet disease. Both enzymes are regulated by environmental cytokines and substrate availability. Furthermore, it seems that NOS/arginase balance is dependent on clinical expression.

Effects of subchronic exposure of PSP Ganoderma lucidum on renal function and histopathology feature in Rattus novergicus Wistar strain

Background: Ganoderma lucidum, commonly referred to as Lingzhi in China, is a fungus that has been widely used through the centuries for the general promotion of health and longevity in Asian countries. Aims and Objective: To determine the effects of subchronic exposure of PSP G. lucidum on renal function and renal histopathology feature in Rattus novergicus Wistar strain. Materials and Methods: A total of 80 male and female Wistar rats, aged 2–3 months with a body weight of 200–300 g, were divided into four treatment groups: dose group 0 (control group), group PSP G. lucidum dose of 300, 600, and 1200 mg/kg for 90 days. Parameters measured were urea and creatinine levels and renal histopathology feature. Result: From the research, the highest urea levels were found in the group in which female Wistar rats were treated with PSP dose of 300 mg/kg/day with an average concentration of urea of 33.2 mg/dL, whereas creatinine levels were found to be equally high on treatment with PSP dose of 1200, 600, and 300 mg/kg/day with an average concentration of urea of 0.3 mg/dL. On histopathological examination, no morphological abnormalities were found. The results of one-way analysis of variance test showed no significant difference at all PSP G. lucidum doses. Conclusion: It is concluded that giving PSP G. lucidum in three variant doses does not cause dysfunction and histological damage to the renal function.

Renoprotective, anti-oxidative and anti-apoptotic effects of oral low-dose quercetin in the C57BL/6J model of diabetic nephropathy.

BackgroundDiabetic nephropathy (DN) is one of the major causes of end-stage renal disease in diabetic patients. Increasing evidence from studies in the rodents has suggested that this disease is associated with increased oxidative stress due to hyperglycemia. In the present study, we evaluated the renoprotective, anti-oxidative and anti-apoptotic effects of the flavonoid quercetin in C57BL/6J model of DN.MethodsDN was induced by streptozotocin (STZ, 100 mg/kg/day, for 3 days) in adult C57BL/6J mice. Six weeks later, mice were divided into the following groups: diabetic mice treated with quercetin (DQ, 10 mg/kg/day, 4 weeks), diabetic mice treated with vehicle (DV) or non-treated non-diabetic (ND) mice.ResultsQuercetin treatment caused a reduction in polyuria (~45%) and glycemia (~35%), abolished the hypertriglyceridemia and had significant effects on renal function including, decreased proteinuria and high plasma levels of uric acid, urea and creatinine, which were accompanied by beneficial effects on the structural changes of the kidney including glomerulosclerosis. Flow cytometry showed a decrease in oxidative stress and apoptosis in DN mice.ConclusionTaken together, these data show that quercetin effectively attenuated STZ-induced cytotoxicity in renal tissue. This study provides convincing experimental evidence and perspectives on the renoprotective effects of quercetin in diabetic mice and outlines a novel therapeutic strategy for this flavonoid in the treatment of DN.

Impacts of crowding, trawl duration and air exposure on the physiology of stingarees (family: Urolophidae).

Research on physiological stress and post-capture mortality of threatened species caught as bycatch is critical for the management of fisheries. The present study used laboratory simulations to examine the physiological stress response of sparsely spotted stingarees (Urolophus paucimaculatus) subjected to one of four different trawl treatments, including two different trawl durations as well as ancillary stressors of either air exposure or crowding. Physiological indicators (plasma lactate, urea, potassium and glucose) and changes in white blood cell counts were measured from blood samples taken throughout a 48 h recovery period. Mortality was low throughout this study (15% overall) and occurred only after >48 h following air exposure, crowding and 3 h trawl simulations. Plasma lactate, glucose and urea concentrations were identified as potential indicators of physiological stress, while plasma potassium and white blood cell counts were too variable to identify changes that would be expected to have biological consequences for stingarees. The characterization of the temporal profiles of physiological indicators facilitates a more accurate assessment of secondary stressors by identifying the best timing to sample stingaree blood when investigating post-capture stress physiology. High levels of lactate, increasing glucose and depressed urea were all recorded in response to air exposure following trawling, indicating that this is the primary source of stress in stingarees caught in trawling operations. These findings highlight the importance of improving bycatch sorting procedures to reduce the time out of the water for trawl-caught stingarees.

Geriatric Assessment and Prognostic Factors of Mortality in Very Elderly Patients With Community-Acquired Pneumonia

IntroductionTo assess the relationship between the parameters obtained in the geriatric assessment and mortality in elderly people with community-acquired pneumonia in an acute care geriatric unit. MethodsFour hundred fifty-six patients (≥75years). Variables: age, sex, referral source, background, consciousness level, heart rate, breathing rate, blood pressure, laboratory data, pleural effusion, multilobar infiltrates, functional status (activities of daily living) prior to admission [Lawton index (LI), Barthel index (BIp)] prior to and at admission (BIa), cognitive status [Pfeiffer test (PT)], comorbidity [Charlson index (ChI)] and nutrition (total protein, albumin). ResultsA hundred ten patients died (24.2%) during hospitalization. These patients were older (86.6±6.4 vs 85.1±6.4, P<.04), had more comorbidity (ChI 2.35±1.61 vs 2.08±1.38; P<.083), worse functional impairment [(LI: 0.49±1.15 vs 1.45±2.32, P<.001) (BIp: 34.6±32.9 vs 54.0±34.1, P<.001) (BIa: 5.79±12.5 vs 20.5±22.9, P<.001)], a higher percentage of functional loss at admission (85.9±23.2 vs 66.4±28.6; P<.0001), worse cognitive impairment (PT: 7.20±3.73 vs 5.10±3.69, P<.001) and malnutrition (albumin 2.67±0.54 vs 2.99±0.49, P<.001). Mortality was higher with impaired consciousness [49.2% (P<.01)], tachypnea [33.3% (P<.01)], tachycardia [44.4% (P<.002), high urea levels [31.8 (P<.001)], anemia [44.7% (P<.02)], pleural effusion [42.9% (P<.002)], and multilobar infiltrates [43.2% (P<.001)]. In the multivariate analysis, variables associated with mortality were: age≥90years [OR: 3.11 (95% CI: 1.31–7.36)], impaired consciousness [3.19 (1.66–6.15)], hematocrit<30% [2.87 (1.19–6.94)], pleural effusion [3.77 (1.69–8.39)] and multilobar infiltrates [2.76 (1.48–5.16)]. Female sex and a preserved functional status prior (LI≥5) and during admission (BIa≥40) were protective of mortality [0.40 (0.22–0.70), 0.09 (0.01–0.81) and 0.11 (0.02–0.51)]. ConclusionsGeriatric assessment parameters and routine clinical variables were associated with mortality.

Glycyrrhetinic Acid-Based Thermoresponsive Hydrogel As a Synthetic Extracellular Matrix for Hepatocyte Culture and Recovery

Glycyrrhetinic acid-based thermoresponsive hydrogels P(NIPAAm-co-GAA) were prepared and used to promote initial cell adhesion, growth, and recovery by lowering temperature for further tissue engineering or bioartificial liver applications. The compositions, morphologies and properties of hydrogels were characterized by element analysis, scanning electron microscopy (SEM), and water contact angle measurement (WCA), respectively. P(NIPAAm-co-GAA) hydrogels exhibited a shift between hydrophilicity and hydrophobicity by controlling temperature. Adhesion, growth, detachment, and physiological functions of human hepatocyte (HL-7702) cultured on P(NIPAAm-co-GAA) hydrogels were examined. The introduction of glycyrrhetinic acid (GA) with specific affinity to hepatocyte promoted the adhesion and proliferation of HL-7702 cells effectively. Importantly, HL-7702 cells cultured on P(NIPAAm-co-GAA) hydrogels maintained high levels of urea and albumin synthesis. HL-7702 cells grown on P(NIPAAm-co-GAA) hydrogels can also be recovered spontaneously by only reducing culture temperature without any damage. Furthermore, the behaviors of HL-7702 and human hepatoma cells (HepG2) on P(NIPAAm-co-GAA) hydrogels were evaluated comparatively. The result revealed that P(NIPAAm-co-GAA) hydrogels facilitated HL-7702 but inhibited the growth of HepG2. Glycyrrhetinic acid-based thermoresponsive hydrogel was shown to be a promising matrix for cultivation of functional hepatocytes.

Flow injection analysis biosensor for urea analysis in urine using enzyme thermistor.

There is a need for analytical methods capable of monitoring urea levels in urine for patients under clinical monitoring to appraise renal function. Herein, we present a practical method to quantify levels of urea in human urine samples using flow injection analysis-enzyme thermistor (FIA-ET) biosensor. The biosensor comprises a covalently immobilized enzyme urease (Jack bean) on aminated silica support, which selectively hydrolyzes the urea present in the sample. Under optimized conditions, the developed biosensor showed a linear response in the range of 10-1,000mM, R (2) = 0.99, and response time of 90s in 100mM phosphate buffer (PB) (flow rate of 0.5mL/min, sample volume of 0.1mL, and pH7.2). The urea-spiked human urine samples showed minimal matrix interference in the range of 10-1,000mM. Recoveries were obtained (92.26-99.80%) in the spiked urine samples. The reliability and reproducibility of the developed biosensor were found satisfactory with percent relative standard deviation (% RSD) = 0.741. The developed biosensor showed excellent operational stability up to 30weeks with 20% loss in original response when used continuously at room temperature. These results indicate that the developed biosensor could be very effective to detect low and high levels of urea in urine samples.

Comments on "Serum Urea:Albumin Ratio as a Prognostic Marker in Critical Patients With Non-chronic Kidney Disease".

Sir, I read the article “Serum Urea:Albumin Ratio as a Prognostic Marker in Critical Patients With Non-Chronic Kidney Disease” by Gundpatil et al. with great interest. I congratulate authors for making this important observation. It deals with the determination of significance of urea:albumin ratio (UAR) as prognostic marker in estimating the ICU stay and mortality of patients admitted in ICU [1]. I would like to make the following comments on this article. Authors have related the high levels of urea with pre-renal azotemia, subclinical renal dysfunction and negative nitrogen balance attributed to high protein catabolism. I would like to add that there could be excess production of urea due to various other reasons like increased production of urea in the liver by metabolism of drugs like tetracycline and corticosteroids, and high protein diet [2]. So we should consider these factors before making any prognosis related predictions. Also, decreased elimination of urea due to dehydration or infection may give false positive results. Similarly, low albumin levels may be due to ailments like Crohn’s disease [3] and low protein diet may give false negative results. Therefore, we should be cautious in considering UAR as prognostic marker. Also, UAR may vary among patients. New prognostic markers should be searched for making the prognosis prediction more accurate. I hope that the above-mentioned points might add to the article by Gundpatil et al.

The Relation Between Carotid Intima Media Thickness and Serum Osteoprotegerin Levels in Nonalcoholic Fatty Liver Disease

This study was designed to evaluate carotid intima media thickness (CIMT) and serum osteoprotegerin (OPG) levels in nonalcoholic fatty liver disease (NAFLD) in comparison to healthy controls and to investigate factors predicting the CIMT increase. A total of 60 outpatients [median (min-max) age 44.5 (24.0-65.0) years, 63.3% were females] diagnosed with NAFLD via ultrasonography performed during their admission to our hospital for any reason and 30 control subjects [median (min-max) age 39.5 (24.0-57.0) years, 73.3% were females] with normal liver echogenicity in ultrasonography were included in this study. Data on demographic characteristics, anthropometric measurements, biochemical and hematological tests, CIMT measurement, serum levels for OPG, and predictive factors for the CIMT increase were collected. Median (min-max) CIMT [0.60 (0.40-1.10) vs. 0.50 (0.30-0.60), P<0.001) and OPG (pg/mL) [65.0 (18.1-272.8) vs. 32.0 (10.1-82.3), P<0.001] levels were significantly higher in NAFLD patients compared to controls, while there was a significant positive correlation between CIMT and serum OPG (r=0.42, P<0.001). Mean CIMT value was determined to increase significantly by 0.001 cm (P=0.001) for each 1 pg/mL of increase in OPG levels, by 0.103 cm (P<0.001) in case of concomitant NAFLD (P<0.001), and by 0.006 cm (P<0.001) for each 1 pg/mL of increase in urea levels. Our findings indicate higher levels of serum OPG and CIMT in patients with NAFLD compared to controls along with a positive correlation between serum OPG and CIMT levels. High levels of serum OPG, presence of NAFLD, and high levels of serum urea seem to be the independent risk factors predictive for the CIMT increase.

Urea protects Caenorhabditis elegans against hypertonic stress: a genetic model for cellular responses to urea? (1099.7)

Urea is a cell‐permeable nitrogenous waste product that denatures macromolecules and causes cellular stress at high concentrations. However, urea accumulates in the mammalian renal medulla as a part of the urine concentrating mechanism and in elasmobranch fish to balance the high osmolarity of seawater. Although high concentrations of urea can be detrimental, pre‐exposure of mammalian cells to moderate concentrations promotes resistance to high concentrations of the impermeable osmolyte NaCl in addition to high urea. Although the mechanisms of this conditioning are poorly defined, studies to date indicate that they are largely distinct from pathways activated by high levels of NaCl. The nematode Caenorhabditis elegans can tolerate extremely high levels of NaCl and other impermeable osmolytes in part by accumulating the organic osmolyte glycerol and by modulating protein translation. Here, we conducted a series of experiments investigating the effects of urea in C. elegans to determine if this genetically tractable system might be useful for defining protective mechanisms. We find that C. elegans can tolerate extremely high levels of urea (~600 mM) and that pre‐exposure to moderate urea promotes resistance to high urea and high NaCl. Therefore, the general protective effects of moderate urea levels appear to be highly conserved and therefore amenable to genetic analysis in C. elegans. Our ongoing studies include determining if the mechanisms of urea protection in C. elegans are distinct from those initiated by NaCl.Grant Funding Source: NSF Grant IOS1120130 to KPC

Valoración geriátrica y factores pronósticos de mortalidad en pacientes muy ancianos con neumonía extrahospitalaria

IntroductionTo assess the relationship between the parameters obtained in the geriatric assessment and mortality in elderly people with community-acquired pneumonia in an acute care geriatric unit. MethodsFour hundred fifty-six patients (≥75years). Variables: age, sex, referral source, background, consciousness level, heart rate, breathing rate, blood pressure, laboratory data, pleural effusion, multilobar infiltrates, functional status (activities of daily living) prior to admission [Lawton index (LI), Barthel index (BIp)] prior to and at admission (BIa), cognitive status [Pfeiffer test (PT)], comorbidity [Charlson index (ChI)] and nutrition (total protein, albumin). ResultsA hundred ten patients died (24.2%) during hospitalization. These patients were older (86.6±6.4 vs 85.1±6.4, P<.04), had more comorbidity (ChI 2.35±1.61 vs 2.08±1.38; P<.083), worse functional impairment [(LI: 0.49±1.15 vs 1.45±2.32, P<.001) (BIp: 34.6±32.9 vs 54.0±34.1, P<.001) (BIa: 5.79±12.5 vs 20.5±22.9, P<.001)], a higher percentage of functional loss at admission (85.9±23.2 vs 66.4±28.6; P<.0001), worse cognitive impairment (PT: 7.20±3.73 vs 5.10±3.69, P<.001) and malnutrition (albumin 2.67±0.54 vs 2.99±0.49, P<.001). Mortality was higher with impaired consciousness [49.2% (P<.01)], tachypnea [33.3% (P<.01)], tachycardia [44.4% (P<.002), high urea levels [31.8 (P<.001)], anemia [44.7% (P<.02)], pleural effusion [42.9% (P<.002)], and multilobar infiltrates [43.2% (P<.001)]. In the multivariate analysis, variables associated with mortality were: age ≥90years [OR: 3.11 (95%CI: 1.31 to 7.36)], impaired consciousness [3.19 (1.66 to 6.15)], hematocrit <30% [2.87 (1.19 to 6.94)], pleural effusion [3.77 (1.69 to 8.39)] and multilobar infiltrates [2.76 (1.48 to 5.16)]. Female sex and a preserved functional status prior (LI≥5) and during admission (BIa≥40) were protective of mortality [0.40 (0.22 to 0.70), 0.09 (0.01 to 0.81) and 0.11 (0.02 to 0.51)]. ConclusionsGeriatric assessment parameters and routine clinical variables were associated with mortality.

A Statistical Analysis of the Effects of Urease Pre-treatment on the Measurement of the Urinary Metabolome by Gas Chromatography-Mass Spectrometry.

Urease pre-treatment of urine has been utilized since the early 1960s to remove high levels of urea from samples prior to further processing and analysis by gas chromatography-mass spectrometry (GC-MS). Aside from the obvious depletion or elimination of urea, the effect, if any, of urease pre-treatment on the urinary metabolome has not been studied in detail. Here, we report the results of three separate but related experiments that were designed to assess possible indirect effects of urease pre-treatment on the urinary metabolome as measured by GC-MS. In total, 235 GC-MS analyses were performed and over 106 identified and 200 unidentified metabolites were quantified across the three experiments. The results showed that data from urease pre-treated samples 1) had the same or lower coefficients of variance among reproducibly detected metabolites, 2) more accurately reflected quantitative differences and the expected ratios among different urine volumes, and 3) increased the number of metabolite identifications. Overall, we observed no negative consequences of urease pre-treatment. In contrast, urease pretreatment enhanced the ability to distinguish between volume-based and biological sample types compared to no treatment. Taken together, these results show that urease pretreatment of urine offers multiple beneficial effects that outweigh any artifacts that may be introduced to the data in urinary metabolomics analyses.