Serum Urea Levels Research Articles

The Effect of Green-Synthesized Ag Nanoparticles on the Levels of Creatinine and Urea in the Blood Serum of Rats

The Effect of Green-Synthesized Ag Nanoparticles on the Levels of Creatinine and Urea in the Blood Serum of Rats

Levisticum officinale extract protects against CCl4-induced hepatotoxicity through anti-inflammatory, anti-fibrotic, and antioxidant properties in rats

Objective: To investigate the hepatoprotective effects of Levisticum officinale extract on CCl4-induced hepatotoxicity. Methods: Different doses of Levisticum officinale extract were given orally to rats for 10 days, then rats received a single dose of CCl4 (2.5 mL/kg, 50% v/v in liquid paraffin). Biochemical and histopathological assays were performed to assess the effects of the extract on liver function and architecture. Moreover, antioxidant and oxidative markers as well as inflammatory and fibrotic indicators were measured. Results: Pretreatment with Levisticum officinale extract significantly mitigated CCl4-induced damage to liver structure, improved serum levels of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, urea, total bilirubin, and total protein, enhanced glutathione content and superoxide dismutase and catalase activities in the liver, as well as decreased plasma and hepatic malondialdehyde levels. Immunohistochemical results demonstrated that the extract reduced Ki-67 and α-SMA expression and Masson’s trichrome staining revealed decreased liver collagen in rats treated with Levisticum officinale extract. Moreover, Levisticum officinale extract markedly decreased the gene expressions of TNF-α, 1L-6, TGF-β1, MCP-1, and COX-2. Conclusions: Levisticum officinale extract exerts hepatoprotective effects on CCl4-induced hepatotoxicity through antioxidant, anti-inflammatory, and anti-fibrotic activities.

Astaxanthin supplementation ameliorates simulated heat stress by regulating physio-biochemical responses in Sirohi goats.

The present study was undertaken to assess the ameliorative effect of dietary supplementation of astaxanthin in Sirohi goats under simulated heat stress conditions. Eighteen healthy female Sirohi goats were divided equally into three groups (n = 6): Heat-Stressed Control (HSC), Treatment 1 (T1), and Treatment 2 (T2). During the experiment, goats in the T1 group were supplemented with astaxanthin at the rate of 25mg/animal/day, while those in the T2 group received supplementation of 50mg/animal/day. The experiment was conducted for 42 days: 14 days of acclimatization period, next 21 days animals were exposed to 42ºC for 6h from 09:00h to 15:00h and 7 days of recovery period. On a daily basis, we recorded the physiological responses of goats and collected environmental data at the experimental site. Blood samples were collected 0 and 14th days of acclimatization, on 1st, 6th, 11th, 16th and 21st day of heat exposure and on the 7th day of the recovery period. The rectal temperature and respiration rates of the treatment groups were lower than those of the HSC group during the exposure period. Heat stress in the supplemented groups was associated with reduced levels of hepatic enzymes such as AST and ALT. Serum urea, creatinine and albumin levels were significantly (P < 0.05) different between control and treatment groups. It was thus concluded that dietary inclusion of antioxidant astaxanthin can ameliorate induced thermal load as evident from changes in physio-biochemical parameters in the Sirohi goats, that was more prominent at 50mg/ animal/day than 25mg/ animal/day.

Mitigating Acetaminophen-Induced Kidney Injury: The Protective Role of Grape Seed and Peanut Skin Extracts through the iNOS/CYP2E1 Pathway.

The rising number of acute kidney injury cases worldwide due to acetaminophen (APAP) emphasizes the critical need for effective prevention strategies to counteract APAP's detrimental effects. This study examined the kidney-protective capabilities of ethanolic extracts from grape seeds and peanut skins (GSEE and PSEE, respectively) in comparison with silymarin in rats that experienced an APAP overdose. The phenolic compounds in these extracts were measured by using high-performance liquid chromatography (HPLC). In the experiment, Sixty adult male albino rats were divided into five groups of 12. The Control group received 0.5 mL of saline via a gastric tube. Group II received acetaminophen (APAP, 640 mg/kg per day via a gastric tube) to induce renal injury, following Ucar et al. and Islam et al. Groups III, IV, and V received silymarin (50 mg/kg), grape seed extract (200 mg/kg), and peanut skin extract (200 mg/kg), respectively, along with 640 mg of APAP/kg per day for 21 days. Post APAP treatment, significant increases in serum urea and creatinine levels were noted, along with notable decreases in the percentage of body weight gain. Furthermore, there were increases in oxidative stress and inflammatory markers in the kidney tissues, including heightened mRNA expressions of renal iNOS and CYP2E1, which were confirmed through histological studies. The administration of GSEE, PSEE, and silymarin mitigated these adverse effects, likely due to their high phenolic content, which is recognized for its antioxidant and anti-inflammatory effects. GSEE, in particular, showed efficacy comparable to that of silymarin. Molecular docking studies revealed that APAP impeded critical enzymes essential for cellular antioxidant defense, whereas the bioactive compounds in the grape seed and peanut skin extracts effectively inhibited key enzymes and receptors involved in inflammation and oxidative stress. These findings suggest that GSEE and PSEE could serve as viable alternative treatments for kidney damage induced by APAP. Further research to isolate and identify these effective compounds is recommended.

Raziskovanje toksičnosti, ki jo povzroča trikloroocetna kislina na hepato-renalni sistem, in posredovanje prehrane, bogate z deviškim kokosovim oljem

Virgin coconut oil (VCO) is known for many beneficial health effects associated with its phenolic acids and flavonoid contents. We investigated the mechanisms underlying the antioxidative, anti-inflammatory, and anti-apoptotic mechanisms of Virgin Coconut oil-rich diet in treating trichloroacetic acid (TCA)-induced hepatic and renal damage in rats. Rats received TCA (250 mg/Kg b.wt, p.o) for ten days, followed by 5%, 10% or 15% VCO per gram feed for twenty-one days. Serum liver enzymes, urea, creatinine, tissue oxidative stress parameters, and inflammatory and apoptotic markers were then evaluated along with histological examination. TCA raised serum transaminases (ALT, AST), alkaline phosphatase (ALP), total bilirubin, urea and creatinine levels, which were abrogated by a VCO-rich diet dose-dependently. The activity of superoxide dismutase, catalase, glutathione peroxidase and nuclear factor erythroid 2-related factor 2 in the liver and kidney were enhanced, while malondialdehyde, tumour necrosis factor-α, interleukin-1β, nuclear factor-kB level hitherto increased by TCA were quashed by the VCO- rich diet (p&lt;0.05). Similarly, the augmented level of Caspase-3 in the organs exposed to TCA was downregulated in favour of significantly increased BCl-2. Further, histomorphometry data validated the biochemical findings observed for the anti-inflammatory and anti-apoptotic potentials of VCO. Hepatocyte ballooning, pleomorphism and vascular congestion in the liver, loss of tubular architecture, tubular congestion and leukocyte infiltration in the kidney, all occasioned by TCA-intoxication, were evidently mitigated. Virgin coconut oil-rich diet could ameliorate liver and renal injury associated with trichloroacetic acid exposure via antioxidative, anti-inflammatory and anti-apoptotic mechanisms.

Therapeutic role of Arabic gum against nicotinamide/streptozotocin-induced diabetes and nephropathy in Wistar rats

Background Chronic kidney disease is mainly caused by diabetic nephropathy and also causes a lot of suffering and death for people with diabetes, as one of the worst long-term complications. Arabic gum (AG) has been reported to have antioxidant, hypolipidemic and hypoglycemic effects. Objective The goal of this study was to scrutinize the antioxidant and anti-inflammatory roles of AG against nicotinamide (NA)/streptozotocin (STZ)-induced diabetic nephropathy in Wistar rats. Materials and methods The experiment involved three groups of 18 adult male Wistar rats (six each). The normal control group received 0.9% NaCl orally for 8 weeks. The diabetic group received NA intraperitoneal injection (120 mg/kg b.w.) followed by 60 mg/kg body weight (bw) STZ in citrate buffer (pH 4.5) after 15 min. After confirming the induction of diabetes, animals received 0.9% NaCl orally for 8 weeks. The AG-treated diabetic group received 20 mg AG/kg bw/day orally for 8 weeks after diabetes induction. Results and conclusion Diabetic rats exhibited hyperglycemia which was confirmed by increased levels of serum fasting glucose and fructosamine. Elevated serum urea, creatinine, uric acid, cystatin c, and sodium levels were noticed in the serum of diabetic rats while potassium levels were markedly reduced reflecting nephropathy. Oxidative stress was evident in the diabetic kidney, as indicated by increased malondialdehyde (MDA) and decreased reduced glutathione (GSH), glutathione peroxidase (GPx) and superoxide dismutase (SOD). AG administration ameliorated elevated fasting blood glucose and serum fructosamine levels as well as the kidney function parameters in serum. AG also attenuated oxidative stress and increased antioxidant capacity in the diabetic kidney. Immune-inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α), nuclear factor kappa B (NF-κB), and tumor suppressor protein (p53) expression were significantly upregulated in diabetic rats, but AG produced a downregulation of them. Thus, AG possesses an antidiabetic effect and has a nephropreventive effect that was manifested by a decrease of urea, creatinine, uric acid, cystatin c and sodium. AG also has anti-inflammatory and antioxidant effects and minimizes histopathological alterations in the kidneys of diabetic rats. Despite these ameliorative effects, the efficacy and safety of AG as an adjunct drug for diabetic kidney disease needs to be validated by more scientific research.

A Comparative Study of Biomarker Levels for Iraqi Individuals’ Smokers and Non-Smokers Depending on the Duration of Smoking

Smoking is a widespread public health challenge globally, impacting societal health and economy while elevating the risk of cardiovascular and peripheral vascular diseases. This study aims to examine hematological parameters (HB, PCV%, WBC, RBC, PLT, ESR), liver and kidney function, lipid profile, and electrolytes (K+, Na+, Ca++) in male smokers aged 20-55 from Baghdad City, subdivided by smoking duration (≥5 years and &lt;5 years), compared to non-smoking controls. A total of sixty participants were recruited across three areas (Diyala Bridge, Mada'in, Talbieh), with each group comprising thirty individuals. Venipuncture was performed for blood sample collection. Results revealed statistically significant elevations in total WBC and RBC counts, hematocrit, hemoglobin, total cholesterol, and liver enzymes (GOT, GPT, ALP) among smokers compared to non-smokers (p&lt;0.05 or p&lt;0.001). Serum uric acid, urea, and creatinine levels were significantly higher in smokers (p&lt;0.001), while triglyceride levels showed no significant difference (p&gt;0.05) between groups. Smokers with longer duration (&gt;5 years) exhibited higher HB, triglyceride, and Na+ levels compared to shorter-term smokers. Sensitivity analysis indicated Na+ as a potentially effective biomarker for smoking-related health impacts, complementing PCV% and urea sensitivity. The study underscores the association between smoking and oxidative stress, notably reflected in elevated GOT and GPT levels, suggesting implications for antioxidant therapies in managing smoking-induced oxidative damage. These findings contribute novel insights into biomarker responses influenced by smoking duration and advocate for targeted public health strategies and further research into antioxidant interventions to mitigate smoking-associated health risks effectively.

Mechanisms by which Mettl3 regulates pericyte-myofibroblast transdifferentiation through PI3K/AKT signaling pathway

Objective: To investigate the role and underlying mechanisms of methyltransferase (Mettl) 3 in the process of angiotensin Ⅱ (Ang Ⅱ)-induced pericyte-to-myofibroblast transdifferentiation and renal fibrosis. Methods: C57BL/6J mice were used, in cell experiments, mouse renal pericytes were isolated and cultured using magnetic bead sorting. These pericytes were then induced to transdifferentiate into myofibroblasts with 1×106 mmol/L Ang Ⅱ, which was the Ang Ⅱ group, while pericytes cultured in normal conditions served as the control group. Successful transdifferentiation was verified by immunofluorescence staining, Western blotting, and real-time reverse transcription PCR (RT-qPCR) for α-smooth muscle actin (α-SMA). The levels of m6A modifications and related enzymes (Mettl3, Mettl14), Wilms tumor 1-associated protein (WTAP), fat mass and obesity protein (FTO), ALKBH5, YTHDF1, YTHDF2, YTHDC1, YTHDC2, YTHDC3 were assessed by Dot blot, RT-qPCR and Western blot. Mettl3 expression was inhibited in cells using lentivirus-mediated Mettl3-shRNA transfection, creating sh-Mettl3 and Ang Ⅱ+sh-Mettl3 groups, while lentivirus empty vector transfection served as the negative control (Ang Ⅱ+sh-NC group). The impact of Ang Ⅱ on pericyte transdifferentiation was observed, and the expression of downstream phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway proteins, including PI3K, AKT, phosphorylated AKT at serine 473 (p-AKT (S473)), and phosphorylated AKT at threonine 308 (p-AKT (T308)), were examined. PI3K gene transcription was inhibited by co-culturing cells with actinomycin D, and the half-life of PI3K mRNA was calculated by measuring residual PI3K mRNA expression over different co-culture time. The reversibility of Mettl3 inhibition on Ang Ⅱ-induced pericyte-to-myofibroblast transdifferentiation was assessed by adding the AKT activator SC79 to the Ang Ⅱ+sh-Mettl3 group. In animal experiments, mice were divided into these groups: sham group (administered 0.9% sterile saline), Ang Ⅱ group (infused with Ang Ⅱ solution), sh-Mettl3 group (injected with Mettl3 shRNA lentivirus solution), Ang Ⅱ+sh-Mettl3 group (infused with Ang Ⅱ solution and injected with Mettl3 shRNA lentivirus solution), and Ang Ⅱ+sh-Mettl3+SC79 group (administered Ang Ⅱ solution and Mettl3 shRNA lentivirus, with an additional injection of SC79). Each group consisted of six subject mice. Blood pressure was measured using the tail-cuff method before and after surgery, and serum creatinine, urea, and urinary albumin levels were determined 4 weeks post-surgery. Kidney tissues were collected at 28 days and stained using hematoxylin-eosin (HE) and Masson's trichrome to assess the extent of renal fibrosis. Results: Primary renal pericytes were successfully obtained by magnetic bead sorting, and intervened with 1×106 mmol/L Ang Ⅱ for 48 hours to induce pericyte-to-myofibroblast transdifferentiation. Dot blot results indicated higher m6A modification levels in the Ang Ⅱ group compared to the control group (P<0.05). RT-qPCR and Western blot results showed upregulation of Mettl3 mRNA and protein levels in the Ang Ⅱ group compared to the control group (both P<0.05). In the Ang Ⅱ+sh-Mettl3 group, Mettl3 protein expression was lower than that in the Ang Ⅱ group, with reduced expression levels of α-SMA, vimentin, desmin, fibroblast agonist protein (FAPa) and type Ⅰ collagen (all P<0.05). Compared to the control group, PI3K mRNA expression level was elevated in the Ang Ⅱ group, along with increased p-AKT (S473) and p-AKT (T308) expressions. In the Ang Ⅱ+sh-Mettl3 group, PI3K mRNA expression and p-AKT (S473) and p-AKT (T308) levels were decreased (all P<0.05). The half-life of PI3K mRNA was shorter in the Ang Ⅱ+sh-Mettl3 group than that in the Ang Ⅱ+sh-NC group (2.34 h vs. 3.42 h). The ameliorative effect of Mettl3 inhibition on Ang Ⅱ-induced pericyte-to-myofibroblast transdifferentiation was reversible by SC79. Animal experiments showed higher blood pressure, serum creatinine, urea, and 24-hour urinary protein levels, and a larger fibrosis area in the Ang Ⅱ group compared to the sham group (all P<0.05). The fibrosis area was smaller in the Ang Ⅱ+sh-Mettl3 group than that in the Ang Ⅱ group (P<0.05), but increased again upon addition of SC79. Conclusion: Mettl3-mediated RNA m6A epigenetic regulation is involved in Ang Ⅱ-induced pericyte-to-myofibroblast transdifferentiation and renal fibrosis, potentially by affecting PI3K stability and regulating the PI3K/AKT signaling pathway.

Polystyrene microplastics facilitate renal fibrosis through accelerating tubular epithelial cell senescence

Microplastics (MPs), emerging contaminants, are easily transported and enriched in the kidney, suggesting the kidney is susceptible to the toxicity of MPs. In this study, we explored the toxicity of MPs, including unmodified polystyrene (PS), negative-charged PS-SO3H, and positive-charged PS-NH2 MPs, in mice models for 28 days at a human equivalent concentration. The results showed MPs significantly increased levels of UREA, urea nitrogen (BUN), creatinine (CREA), and uric acid (UA) levels in serum and white blood cells, protein, and microalbumin in urine. In the kidney, MPs triggered persistent inflammation and renal fibrosis, which was caused by the increased senescence of tubular epithelial cells. Moreover, we identified the critical role of the Klotho/Wnt/β-catenin signaling pathway in the process of MPs induced senescence of tubular epithelial cells, promoting the epithelial-mesenchymal transformation of epithelial cells. MPs supported the secretion of TGF-β1 by senescent epithelial cells and induced the activation of renal fibroblasts. On the contrary, restoring the function of Klotho can alleviate the senescence of epithelial cells and reverse the activation of fibroblasts. Thus, our study revealed new evidence between MPs and renal fibrosis, and adds an important piece to the whole picture of the plastic pollution on people's health.

Urea Level and Depression in Patients with Chronic Kidney Disease.

Depression is common in patients with chronic kidney disease (CKD). Experimental studies suggest the role of urea toxicity in depression. We assessed both the incidence of antidepressant prescriptions and depressive symptoms (measured by CESD (Center for Epidemiologic Depression) scale) in 2505 patients with CKD (Stage 3-4) followed up over 5 years in the Chronic Kidney Disease Renal Epidemiology and Information Network (CKD-REIN) cohort. We used a joint model to assess the association between the serum urea level and incident antidepressant prescriptions, and mixed models for the association between the baseline serum urea level and CESD score over the 5-year follow-up. Among the 2505 patients, 2331 were not taking antidepressants at baseline. Of the latter, 87 started taking one during a median follow-up of 4.6 years. After adjustment for confounding factors, the hazard ratio for incident antidepressant prescription associated with the serum urea level (1.28 [95%CI, 0.94,1.73] per 5 mmol/L increment) was not significant. After adjustment, the serum urea level was associated with the mean change in the CESD score (β = 0.26, [95%CI, 0.11,0.41] per 5 mmol/L increment). Depressive symptoms burden was associated with serum urea level unlike depression events. Further studies are needed to draw firm conclusions and better understand the mechanisms of depression in CKD.

Medicinal evaluation and molecular docking study of osajin as an anti-inflammatory, antioxidant, and antiapoptotic agent against sepsis-associated acute kidney injury in rats

Despite efforts to find effective drugs for sepsis-associated acute kidney injury (SA-AKI), mortality rates in patients with SA-AKI have not decreased. Our study evaluated the protective effects of isoflavone osajin (OSJ) on SA-AKI in rats by targeting inflammation, oxidative stress, and apoptosis, which represent the cornerstones in the pathophysiological mechanism of SA-AKI. Polymicrobial sepsis was induced in rats via the cecal ligation and puncture (CLP) technique. Markers of oxidative stress were evaluated in kidney tissues using biochemical methods. The expression of interleukin-33 (IL-33), 8-hydroxydeoxyguanosine (8-OHdG), caspase-3, and kidney injury molecule-1 (KIM-1) was evaluated as indicators of inflammation, DNA damage, apoptosis, and SA-AKI respectively in the kidney tissues using immunohistochemical and immunofluorescent detection methods. The CLP technique significantly (p < 0.001) increased lipid peroxidation (LPO) levels and significantly (p < 0.001) decreased the activities of superoxide dismutase and catalase in kidney tissues. In the renal tissues, strong expression of IL-33, 8-OHdG, caspase-3, and KIM-1 was observed with severe degeneration and necrosis in the tubular epithelium and intense interstitial nephritis. In contrast, the administration of OSJ significantly (p < 0.001) reduced the level of LPO, markedly improved biomarkers of antioxidant status, decreased the levels of serum creatinine and urea, lowered the expression of IL-33, 8-OHdG, caspase-3, and KIM-1 and alleviated changes in renal histopathology. A promising binding score was found via a molecular docking investigation of the OSJ-binding mode with mouse IL-33 (PDB Code: 5VI4). Therefore, OSJ protects against SA-AKI by suppressing the IL-33/LPO/8-OHdG/caspase-3 pathway and improving the antioxidant system.

Efficacy of stem cells versus microvesicles in ameliorating chronic renal injury in rats (histological and biochemical study)

Chronic exposure to heavy metals as aluminum chloride (AlCl3) could result in severe health hazards such as chronic renal injury. The present study aimed to evaluate the therapeutic potential of adipose tissue-derived stem cells (ASCs) in comparison to their microvesicles (MV) in AlCl3-induced chronic renal injury. Forty-eight adult male Wistar rats were divided into four groups: Control group, AlCl3-treated group, AlCl3/ASC-treated group, and AlCl3/MV-treated group. Biochemical studies included estimation of serum urea and creatinine levels, oxidative biomarkers assay, antioxidant biomarkers, serum cytokines (IL-1β, IL-8, IL-10, and IL-33), real time-PCR analysis of renal tissue MALT1, TNF-α, IL-6, and serum miR-150-5p expression levels. Histopathological studies included light and electron microscopes examination of renal tissue, Mallory trichrome stain for fibrosis, Periodic acid Schiff (PAS) stain for histochemical detection of carbohydrates, and immunohistochemical detection of Caspase-3 as apoptosis marker, IL-1B as a proinflammatory cytokine and CD40 as a marker of MVs. AlCl3 significantly deteriorated kidney function, enhanced renal MDA and TOS, and serum cytokines concentrations while decreased the antioxidant parameters (SOD, GSH, and TAC). Moreover, serum IL-10, TNF-α, miR-150-5p, and renal MALT1 expression values were significantly higher than other groups. Kidney sections showed marked histopathological damage in both renal cortex and medulla in addition to enhanced apoptosis and increased inflammatory cytokines immunoexpression than other groups. Both ASCs and MVs administration ameliorated the previous parameters levels with more improvement was detected in MVs-treated group. In conclusion: ASCs-derived MVs have a promising ameliorating effect on chronic kidney disease.

Caloric and time restriction diets improve acute kidney injury in experimental menopausal rats: role of silent information regulator 2 homolog 1 and transforming growth factor beta 1.

Estrogen has a protective impact on acute kidney injury (AKI); moreover, reducing the daily intake of calories impedes developing diseases. The present study aimed to determine the effects of calorie restriction (CR) and time restriction (TR) diets on the expression of silent information regulator 2 homolog 1 (SIRT1), transforming growth factor beta 1 (TGF-β1), and other indicators in the presence and absence of ovaries in AKI female rats. The female rats were divided into two groups, ovariectomized (OVX) and sham, and were placed on CR and TR diets for eight weeks; afterward, AKI was induced by injecting glycerol, and kidney injury indicators and biochemical parameters were measured before and after AKI. After AKI, the levels of urine albumin excretion rate, urea, and creatinine in serum, and TGF-β1 increased, while creatinine clearance and SIRT1 decreased in kidney tissue. CR improved kidney indicators and caused a reduction in TGF-β1 and an increase in SIRT1 in ovary-intact rats. Moreover, CR prevented total antioxidant capacity (TAC) decrease and malondialdehyde (MDA) increase resulting from AKI. Before AKI, an increase in body weight, fasting blood sugar (FBS), low-density lipoprotein (LDL), triglyceride (TG), and total cholesterol (TC), and a decrease in high-density lipoprotein (HDL) were observed in OVX rats compared to sham rats, but CR prevented these changes. The effects of TR were similar to those of CR in all indicators except for TGF-β1, SIRT1, urea, creatinine, and albumin. The present study indicated that CR is more effective than TR in preventing AKI, probably by increasing SIRT1 and decreasing TGF-β1 in ovary-intact animals.

A safe and effective protocol for postdilution hemofiltration with regional citrate anticoagulation

BackgroundRegional citrate anticoagulation (RCA) is recommended during continuous renal replacement therapy. Compared to systemic anticoagulation, RCA provides a longer filter lifespan with the risk of metabolic alkalosis and impaired calcium homeostasis. Surprisingly, most RCA protocols are designed for continuous veno-venous hemodialysis or hemodiafiltration. Effective protocols for continuous veno-venous hemofiltration (CVVH) are rare, although CVVH is a standard treatment for high-molecular-weight clearance. Therefore, we evaluated a new RCA protocol for postdilution CVVH.MethodsThis is a monocentric prospective interventional study to evaluate a new RCA protocol for postdilution CVVH. We recruited surgical patients with stage III acute kidney injury who needed renal replacement therapy. We recorded dialysis and RCA data and hemodynamic and laboratory parameters during treatment sessions of 72 h. The primary endpoint was filter patency at 72 h. The major safety parameters were metabolic alkalosis and severe hypocalcemia at any time.ResultsWe included 38 patients who underwent 66 treatment sessions. The mean filter lifespan was 66 ± 12 h, and 44 of 66 (66%) filters were patent at 72 h. After censoring for non-CVVH-related cessation of treatment, 83% of all filters were patent at 72 h. The delivered dialysis dose was 28 ± 5 ml/kgBW/h. The serum levels of creatinine, urea and beta2-microglobulin decreased significantly from day 0 to day 3. Metabolic alkalosis occurred in one patient. An iCa++ below 1.0 mmol/L occurred in four patients. Citrate accumulation did not occur.ConclusionsWe describe a safe, effective, and easy-to-use RCA protocol for postdilution CVVH. This protocol provides a long and sustained filter lifespan without serious adverse effects. The risk of metabolic alkalosis and hypocalcemia is low. Using this protocol, a recommended dialysis dose can be safely administered with effective clearance of low- and middle-molecular-weight molecules.Trial registrationThe study was approved by the medical ethics committee of Heinrich-Heine University Duesseldorf (No. 2018-82KFogU). The trial was registered in the local study register of the university (No: 2018044660) on 07/04/2018 and was retrospectively registered at ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT03969966) on 31/05/2019.

Effectiveness of setarud (IMOD™) in attenuating gentamicin-induced nephrotoxicity in male rats

BackgroundGentamicin (GEN) can have serious adverse effects including nephrotoxicity. Setarud (IMOD™) is a new herbal drug with beneficial immune effects, obtained by mixing Tanacetum vulgare (tansy), Rosa canina and Urtica dioica (nettle) extracts as well as selenium, flavonoids and carotenes. This novel study aims to evaluate the effectiveness of Setarud (IMOD™) in attenuating GEN-induced nephrotoxicity in male rats. Twenty-eight adult male Sprague Dawley rats (weighing 180–200 g) were randomly divided into four groups (7 rats in each group): Control, IMOD treated (20 mg/kg body weight), GEN treated (100 mg/kg body weight), and GEN + IMOD co-treated. Injections were done intraperitoneally for 12 days. Serum urea, creatinine (Cr), Cr clearance, malondialdehyde (MDA), reduced glutathione (GSH) level, and activities of antioxidant enzymes Peroxidase (POD), Catalase (CAT), and Glutathione peroxidase (GPx) were measured by the colorimetric method. Volume density of proximal convoluted tubule (PCT), tubular necrosis, tubular cast formation, and leukocytic infiltration were evaluated histopathologically.ResultsIn the GEN group, there were significantly higher serum urea, Cr, and MDA levels with lower Cr clearance, GSH levels, POD, GPx and CAT activities, and PCT volume density with presence of tubular necrosis compared to the control and IMOD groups (P < 0.05). Treatment with IMOD significantly reduced the levels of urea, Cr and MDA, and increased Cr clearance and the activities of POD and CAT enzymes (P < 0.05). No significant differences in the activity of GSH and GPx were reported in the GEN + IMOD co-treated group compared to the GEN group. Moreover, IMOD significantly ameliorated PCT volume density and renal lesions caused by GEN.ConclusionIMOD (20 mg/kg body weight) can attenuate GEN-induced nephrotoxicity in rats by inhibition of oxidative stress or increasing the normal activity of antioxidant enzymes. Further studies are recommended on the effects of different doses of IMOD.

Study of Serum Complement 3 Split Product iC3b /C3 Ratio in a Cohort of Systemic Lupus Erythematosus Patients

Abstract Background Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease that causes widespread multi organ inflammation. The exact cause of SLE remains unclear; however, genetic, hormonal, and environmental factors contribute to the development of the disease. Aim of the Work The aim of this study is to measure the ratio of complement split product iC3b to C3 and its relation to disease activity and lupus nephritis in a cohort of SLE patients. Patients and Methods This study is a Cross sectional case control study conducted in internal medicine and Rheumatology unit, Ain Shams university hospital and Rheumatology unit, Maadi military hospital. Our study included. Results The present study shows that female were (76%) in active group of SLE patients and (60%) in inactive group while male were (24%) and (40%) respectively. with no significant difference. The mean of Disease Duration was (5.66 ± 1.97) with a range from 3 and 10 years in active group of SLE patients and (5.08 ± 1.54) with a range from 3 and 9 years in inactive group. with no significant difference. Regarding clinical manifestations of SLE the present study shows that active group of SLE patients had statistically highly significant increase in incidence of lupus nephritis, arthritis, serositis, oral ulcers, malar rash (p &amp;lt; 0.001) with significant increase in incidence of alopecia and neurological manifestations (p &amp;lt; 0.05). The current study shows that active group of SLE patients had statistically significantly higher mean ESR, anti-DNA titre, 24hr urinary proteins, serum creatinine, serum urea, and GFR levels (p = 0.000) than inactive group, Also active group had significant leucopenia, anemia (p = 0.000, 0.005 respectively) and C3 was significantly more consumed than inactive group (p &amp;lt; 0.05) Conclusion The ratio of complement split product iC3b to C3 concentrations correlates with the extent of SLE disease activity more than C3 alone. Furthermore, the iC3b:C3 ratio may discriminate between patients with lupus nephritis and patients without lupus nephritis. Detection of SLE disease activity and lupus nephritis by iC3b/C3 ratio help to make a proper decision in management to induce remission.

The Effect of Periodontitis on Fibroblast Growth Factor 23 Levels in Predialysis Chronic Kidney Disease Patients.

Introduction Chronic kidney disease (CKD) is known to cause an increase in fibroblast growth factor 23 (FGF23). Periodontitis, a condition recognized as a risk factor for CKD, is also potentially associated with the increment of FGF23. This study aims to compare FGF23 levels in CKD patients with and without periodontitisand non-CKDpatients with and without periodontitis. Correlation with serum phosphate, calcium, and intact parathyroid hormone (iPTH) was assessed. Additionally, associations between FGF23, calcium, phosphate, iPTH, creatinine, urea, plaque score, and bleeding score with periodontitis in CKD patients were determined. Method A total of 124 participants were categorized into four groups: CKD patients with periodontitis (n=31), CKD patients without periodontitis (n=32), periodontitis patients without CKD (n=32), and healthy population (n=29). The selected CKD patients include those from stages 3 and 4 (predialysis) patients. Serum levels of FGF23, calcium, phosphate, iPTH, creatinine, and urea were analyzed. Oral examinations were conducted to determine the presence and absence of periodontitis and assess plaque and bleeding scores. Result A significantly higher level of FGF23 was found in CKD compared to non-CKD groups; however, no difference was observed with the presence of periodontitis in both CKD and non-CKD. There was no significant correlation found between FGF23 and serum calcium, phosphate, or iPTH concerning periodontal status. Apart from the bleeding score, there was no association between FGF23, calcium, phosphate, iPTH, creatinine, urea, and plaque score with the presence of periodontitis in CKD patients. Conclusion The presence of periodontitis was not associated with higher FGF23 levels in CKD patients. Changes in FGF23, calcium, phosphate, iPTH, creatinine, urea, and plaque score could not be attributed to the presence of periodontitis in CKD patients.

Sociodemographic features, serum urea, creatinine and blood urea nitrogen/creatinine ratio in chronic kidney disease patients – A record based retrospective study

Objectives: Chronic kidney disease (CKD) is a progressive reduction in renal function. It is a condition where the kidneys lose their normal function, especially excretory and regulatory functions. Urea and creatinine are good indicators of a normal functioning kidney and an increase in the serum indicates kidney dysfunction. Blood urea nitrogen (BUN) and serum creatinine are widely accepted and the most common parameters to assess renal functions. The present study was done to assess the serum urea, creatinine levels, and BUN-creatinine ratio (BCR) in CKD subjects. Material and Methods: It was a record-based retrospective study. Data were obtained from the Medical Records Department. The patients diagnosed with CKD in August 2023 were extracted from the records. Details such as hospital ID, age, gender, and blood parameters such as serum urea, creatinine levels, and BCR were obtained. Categorical data were summarized as frequency (percentage). Results: It was found that the number of male patients was 24 (75.4%) and the number of female patients was 14 (24.6%). The majority of patients belonging to the age group category of 50–75 were 42 in number (73.6%). Abnormal creatinine values were found in 54 patients (94.7%). Conclusion: The present study found that male gender and age group 50–75 years were most commonly affected with CKD. The serum creatinine level was found to be predominately abnormal compared to the serum urea level and BCR.

Potassium diformate affects the growth and development of broilers by improving intestinal function and digestive enzyme activity

Gut health of broiler chickens is essential for production performance. The present study aimed to evaluate the impact of dietary supplementation with potassium diformate (KDF) on growth performance and intestinal health in broiler chickens. A total of 180 Arbor Acres (AA) broiler chickens were randomly allocated into 3 treatments, with 6 replicates, containing 10 chicks in each replicate. The treatment groups were: control group (CON) was fed a basal diet; KDF-4 groups fed the basal diet with 4 g/kg KDF; KDF-8 groups fed the basal diet with 8 g/kg KDF. The experiment period lasted for 42 d. During the starter phase, the ADFI and F/G of broilers in KDF groups were lower (P < 0.05) compared to the CON group. Furthermore, the BW and ADG in KDF-4 group was improved (P<0.05). The treatment groups exhibited a significant increase (P < 0.05) in both ADG and ADFI during the grower and overall phase. Moreover, the F/G in KDF-4 group was lower (P < 0.05) compared to the CON and KDF-8 groups. The semi-eviscerated weight rate (SEWR), eviscerated carcass weight rate (ECWR), pectoral muscle rate (PMR), and leg muscle rate (LMR) of broilers were improved (P < 0.05) in KDF groups. The serum levels of glucose (GLU) and UREA (UA) were significantly higher (P < 0.05) in KDF-8 group. Additionally, the nutrient apparent utilization rate of dry matter (DM), energy (EE), and crude protein (CP) were improved (P < 0.05) in KDF-4 group. The villus height (VH) and villus height to crypt depth ratio (V/C) of duodenum, jejunum, and ileum were higher (P < 0.05) in KDF groups compared to the CON group, while crypt depth (CD) was significantly reduced (P < 0.05). The digestive enzyme activities of lipase (LIP), amylase (AMS), or trypsin (TPS) were significantly enhanced (P < 0.05) in the intestinal chyme, while the total bacterial count, Escherichia coli, Lactobacilli, Bifidobacteria, and Bacillus were reduced (P < 0.05) in the ileum. This study demonstrates that the inclusion of KDF in the diet of broilers leads to improvements in growth, slaughter performance, nutrient utilization rate, and maintenance of intestinal health.

Evaluation of Serum Electrolyte Abnormalities and Kidney Function to Assess Risk of Kidney Disease in Hypertensive Patients at Kenyatta National Hospital

HTN is a known leading cause of kidney disease with over 20% of the population aged 20 years or older with HTN developing CKD. Complications from HTN and kidney disease contribute significantly to global mortality. In Kenya, data from WHO shows that about 4 million individuals suffer from CKD, with many progressing to kidney failure. The aim was to assess serum electrolyte abnormalities and kidney function among hypertensive patients at KNH. The study utilized cross-sectional retrospective data from KNH patient records. The CKD-EPI equation was used to calculate eGFR. Fisher et al.’s equation determined sample size. Data were stratified by variables such as DBP, age, sex, SBP, proteinuria, serum creatinine, urea levels, serum electrolytes, and eGFR. Data collection involved 189 patients: 82 males (43.4%) and 107 females (56.6%), with a median age of 54.00 years. 93 patients (49.20%) were &lt;54 years and 96 (50.80%) were ≥54 years. 78.84% of HTN patients had abnormal serum creatinine levels, and 54.5% had abnormal serum urea levels. 58.7% showed proteinuria. Elevated sodium levels (&gt;145 mmol/l) affected 39.68% of patients, while reduced potassium levels (&lt;3.5 mmol/l) were found in 15.34%. 41.27% had elevated chloride levels above 106 mmol/l. CKD stages varied: 3.2% had G1, 17.5% had G2, 14.8% had G3a, 29.1% had G3b, 16.4% had G4, and 19.0% had G5. Reduced renal function, estimated using GFR, was prevalent among hypertensive patients (79.4%) (95% CI:72.9-82.9), notably those ≥54 years. In conclusion, the risk of progressive kidney disease was high amongst hypertensive patients and this was evident from the proportion of patients who have abnormal kidney function including proteinuria. Early screening and implementation of therapeutic strategies can improve patient’s quality of life.