Normal Creatinine Research Articles

Evaluation of Early Postoperative Period Results of Patients With Type 2 Diabetes Taking Oral Anti-Diabetics Or Insulin Medications, With Microalbuminuria and Normal Creatinine Levels After Coronary Artery Bypass.

Acute kidney injury (AKI) is one of the most important complications after cardiac surgery and is one of the main causes of morbidity and mortality. Diabetes mellitus also is one of the main risk factors for renal dysfunction in coronary artery bypass graft (CABG). In this study, we aimed to compare the early postoperative period results of type 2 diabetes patients taking oral antidiabetics (OAD) or insulin medications, with microalbuminuria and normal creatinine levels after CABG. Eighty patients with type 2 diabetes and taking OAD or receiving insulin medication all with normal creatinine levels with microalbuminuria were included in this study. Preoperative creatinine values of the patients, albumin levels in spot urine, creatinine levels on the postoperative 3rd day, duration of ventilation, amount of drainage, length of stay in the intensive care unit, length of stay in the hospital, mediastinitis, and mortality rates were recorded. A statistically significant increase in creatinine was found in both taking OAD type 2 diabetes and insulin medication with microalbuminuria. When the two groups were compared with each other, the increase in creatinine levels of the patients using insulin was higher than the patients taking OAD. It also was statistically significant. According to the result of our study, it can be suggested that postoperative creatinine elevation is observed in patients with type 2 diabetes mellitus with microalbuminuria and with normal creatinine levels, either having insulin medication or not. The elevation is higher in patients having insulin medication, while other results are similar, except for impaired renal function.

Evaluation of the possibility of using urinary neutrophil gelatinase-dependent lipocalin as a predictor of acute kidney injury in intensive care unit patients

Introduction: Due to the increase in the incidence of acute kidney injury (AKI), especially in patients admitted to the intensive care unit (ICU), its occurrence has been studied using biomarkers such as urinary neutrophil gelatinase-dependent lipocalin (uNGAL). However, its clinical utility has not yet been approved. Objectives: This study aimed to investigate the possibility of using uNGAL as a predictor of AKI in patients admitted to the ICU. Patients and Methods: This prospective study was conducted on 32 patients admitted to the ICU who had normal creatinine level at the ICU admission and did not fulfill the RIFLE (risk, injury, failure, loss of kidney function, and end-stage kidney disease) criteria. Initially, creatinine level and the sequential organ failure assessment (SOFA) score were recorded. In the first 24 hours of hospitalization, urine samples were taken from patients to assess uNGAL levels. In the following days, creatinine levels and the day of its rise were recorded. The incidence of AKI was assessed based on the RIFLE criteria, and the relationship between the AKI incidence and the uNGAL level at admission was assessed. Results: The mean (SD) of patients’ age was 63 ± 17 years, and 18 patients (56%) were male. The cause of hospitalization was post-cardiac surgery in 21 patients (66%). The median SOFA score of patients was 2.5 at admission. According to the RIFLE criteria, 47% of patients had kidney problems at different stages. The median length of hospital stay was 13 days, while four patients (13%) died. Range and mean (SD) of uNGAL level at admission in all patients was 46.1 to 172.5 ng/mL and 89.94 ± 30.9 ng/mL, respectively, which was not significantly different between the two sexes and between living and deceased patients. Although the mean of uNGAL increased in patients in the risk and injury stage of the RIFLE criteria compared to normal patients, the difference between them was not significant. The increase in uNGAL was directly related to the increase in SOFA score (Spearman’s rho = 0.360, P = 0.043), while its changes was not significantly related to age or creatinine elevation ratio. Conclusion: The findings of our study showed that, in ICU admitted patients, first-day uNGAL level was not helpful in predicting AKI based on the RIFLE criteria.

Profil Klirens Kreatinin pada Pasien Penyakit Ginjal di RSUD Dr. Doris Sylvanus Kota Palangka Raya

Kidney disease is the loss of kidney function. This results in salt retention, nitrogen wastewater, and a decrease in urine volume. Kidney disorders are characterized by structural or functional abnormalities of the kidneys that last more than three months. Indicators to see the ability of renal glomerular filtration can be done by checking creatinine clearance. Creatinine clearance is the number of millimeters of plasma cleared of creatinine by the kidneys in one minute. This study aimed to determine the level of creatinine clearance in patients with kidney disease in RSUD dr. Doris Sylvanus City of Palangka Raya. This research was conducted by quantitative descriptive method, with the number of research samples as many as 15 outpatient kidney disease patients who had not performed hemodialysis at the Clinical Pathology Laboratory of RSUD dr. Doris Sylvanus Palangka Raya, with a sampling technique in the form of Accidental Sampling. The examination method used is the measurement of creatinine clearance as a marker of the glomerular filtration rate (GFR) using the Cockroft-Gault formula. The results showed that based on the value of normal creatinine clearance, as much as 7%, and the decreased value of creatinine clearance, as much as 93%.

A \u201ccat\u201d-astrophic case of Bartonella infective endocarditis causing secondary cryoglobulinemia: a case report

BackgroundCulture-negative infective endocarditis (IE) constitutes approximately 10% of all cases of IE. Bartonella endocarditis is a common cause of culture-negative endocarditis and is associated with a high mortality rate. To date, no cases of Bartonella IE has been reported in association with cryoglobulinemia in the UK. We present a unique case of Bartonella IE causing secondary cryoglobulinemia in a young female.Case presentationA 17-year-old female with a background of pulmonary atresia and ventricular septal defect repaired with a cardiac conduit at the age of 4, presented with a one-year history of weight loss (from 53 to 39 kg) and poor appetite. She subsequently developed a vasculitic rash and haematoproteinuria with decline in renal function, requiring urgent hospital admission. Initial blood tests showed a near normal creatinine, but a raised cystatin C. Renal biopsy showed focal necrotizing glomerulonephritis with no acute tubular necrosis or chronic change. Subsequent blood tests supported a diagnosis of cryoglobulinaemic vasculitis (high rheumatoid factor, low complement, polyclonal gammopathy, Type 3 cryoglobulin). A weak positive PR3 meant there was some uncertainty about whether this could be a primary ANCA-associated vasculitis (AAV). Initial workup for an infectious cause, including multiple blood cultures, were negative. However, an echocardiogram showed definite vegetations on her surgical conduit. The patient did not respond to empirical antimicrobials and so was referred for surgical revision of her conduit. Tissue samples obtained intra-operatively demonstrated Bartonella species. With targeted antimicrobials post-operatively, she improved with resolution of immunologic abnormalities and at last review had a normal renal profile. On reviewing her social history, she had adopted several stray cats in the preceding year; and thus, the cause of the Bartonella infection was identified.ConclusionThis is the first reported case of Bartonella endocarditis causing secondary cryoglobulinemia reported in the UK. The key learning points from this case include that Bartonella endocarditis can present as a cryoglobulinaemic vasculitis and should be considered in any differential when the cause of cryoglobulinaemia is not clear and to enquire about relevant exposures especially when culture-negative endocarditis is suspected.

STUDY OF RENAL RESISTIVITY INDEX IN LIVER CIRRHOSIS IN PREDICTING THE INCIDENCE OF HEPATORENAL SYNDROME

In patients with End Stage Liver Disease (ESLD) with ascites,Hepatorenal syndrome (HRS) is a complication with grave prognosis.Doppler evaluation of Renal Resistive Index (RRI) is a simple way of prognostication of patients with high risk of developing HRS.We evaluated 50 consecutive cirrhosis patients with ascites who fulfilled the inclusion criteria and measured RRI index on admission and found that it is a reliable marker of progression to HRS and predicting the renal function at 3 months. Methods: 50 patients of liver cirrhosis from K R Hospital,Mysuru,who met the inclusion criteria were studied from January 2018 to June 2019. Detailed history and physical examination were done. Liver function, renal function test,PT-INR,ultrasound abdomen including RRI was done.Child-Turcotte-Pugh (CTP) score and Model for End stage Liver Disease (MELD) score were calculated. Results: This study included 50 subjects with liver cirrhosis.In our study,5 of the patients (10%) developed HRS during the follow up period of 3 months.3 of them showed increased RRI (>0.7),while 2 of them showed normal RRI (p < 0.002). In those subjects with a normal creatinine during follow up,RRI was elevated in 8 % of the subjects (p < 0.002).Mean RRI in subjects who developed HRS was 0.77 ± 0.11.Mean RRI in patients who did not have HRS was 0.61 ± 0.04. Interpretation and conclusion: In our study, we noted that intrarenal Resistive Index values measured at the time of admission were significantly increased in cirrhotic patients who developed HRS during the 3 months follow up period.

Gambaran Kadar Kreatinin Serum Pada Pasien Rawat Inap Yang Didiagnosis Diabetes Melitus Tipe 2

Uncontrolled Diabetes Mellitus will lead to long-term complications, namely decreased organ function, especially the kidneys, nerves, eyes, blood vessels and heart. Diabetic nephropathy is a complication that is often found in DM patients and attacks the kidneys. Serum creatinine examination is used to assess kidney function in patients with Type 2 Diabetes Mellitus. This purpose of research is to describe the description of serum creatinine levels in inpatients diagnosed with Type 2 Diabetes Mellitus at Dr. Kariadi Semarang. This study uses descriptive quantitative. The data comes from the medical records of inpatients diagnosed with Type 2 DM at Dr. RSUP. Kariadi Semarang who examined creatinine levels in the period January - April 2020 with the total sampling method. From this study, inpatients diagnosed with Type 2 DM at Dr. Kariadi Semarang were 79 respondents with male sex as many as 49 people (62%) and women 30 people (38%). In 79 respondesnts, there are 2 respondents (2.5%) had low creatinine levels, 7 respondents (8.9%) had normal creatinine levels, while 70 respondents (91.1%) had high creatinine levels. 43 male patients (88.6%) were included in the category of high creatinine levels. Based on age, it was dominated by the late elderly (55 – 65 years) as many as 32 people (40.5%) with the late elderly patients as many as 28 people (87.5%) having high creatinine levels. Conclusion: In 79 respondesnts (100%), there are 72 respondents (91.1%) who have abnormal creatinine levels and 7 respondents (8.9%) have normal creatinine levels.

Case series of acute kidney injury in children with SARS-CoV2 associated multisystem inflammatory syndrome

PurposeIn the first part of 2021 in Khimki regional hospital was eight-times increase of hemolytic-uremic syndrome (HUS) in children vs 2020. There are some data on association of HUS and COVID-19 in the literature. Our aim to describe case series of HUS in children with SARS-Cov2 associated multisystem inflammatory syndrome (MIS-C).Methods & MaterialsWe developed 8 children, age 1-11 yrs. (Me 4,5), 3M/5F. All had anemia (Hb 58 - 105, Me 83,8 g/l), thrombocytopenia (45 -136, Me 84*109/l) and kidney injury (azotemia, diuresis decrease, reduced GFR).ResultsIn anamnesis nobody had COVID-19, SARS-Cov2 RNA (oropharyngeal swab) was negative. 6 had anti-SARS-Cov2 IgG. 3 patients had antibody inversion during hospitalization. That means, they developed acute kidney injury (AKI) in early convalescence period of COVID-19. 6 children had fever, vomiting and diarrhea in anamnesis. 1 had only myalgia, 1 had transient hemorrhagic rush.All children had SIRS: ESR acceleration (15-43 mm/h), CRP increase in 6 cases (not more 5 norms), elevated ferritin (307-648 mkg/l) and D-dimer (3,24-8 mkg/ml). Mixed urinary syndrome was noted: proteinuria (0,1 - 6 g/l), hematuria (RBC 6-50). 100% had azotemia: urea (12,7-65,3, Me 35 mmol/l), creatinine (74-1450,2, Me 499 mkmol/l). GFR by Schwartz formula was reduced in all cases (1,7-58,1 ml/min/1,73 m2). 3 had anuria, 2 oliguria. Renal replacement therapy (RRT) performed in 5 cases: 3 hemodiafiltration (HDF) only; 2 - HDF + plasma exchange (1 - 7 procedures). All children were complex treated and discharged with normal clinical urine test and creatinine level, diuresis 1,6-2,4 ml/kg/h.ConclusionIn MIS-C pathogenesis thrombotic microangiopathia is one of the key points. We saw elevation of HUS in children in the COVID-19-pandemia period. 6 from 8 described cases had connection of AKI with previous COVID-19. In addition, they all had SIRS markers, corresponding diagnostic criteria of SARS-Cov2 associated multisystem inflammatory syndrome.

Prognostic stratification for patients with neuroendocrine tumours receiving 177Lu-Dotatate.

177Lu-Dotatate is increasingly used in patients with advanced neuroendocrine tumour (NET). However, few prognostic markers are available to stratify progression-free survival (PFS) of patients who received 177Lu-Dotatate. Clinicopathological data including baseline circulating biomarkers of patients with advanced NET who received 177Lu-Dotatate were routinely collected and were retrospectively analysed. Continuous variables were normalized by dividing them by their upper normal limits. The whole data set was randomly divided into a training set and a validation set. Univariate and multivariate logistic regression analyses were used to identify independent markers and to develop a scoring model to predict treatment failure at 1 year. In total, 195 patients were included. Elevated baseline chromogranin A (CgA), normal creatinine and previous chemotherapy were three risk factors independently associated with 1-year treatment failure. By combining these risk factors, a scoring model was developed which could accurately predict 1-year treatment failure both in the training set (area under curve, AUC, 0.813; 95% CI, 0.731-0.895; P< 0.001) and in the validation set (AUC, 0.816; 95% CI, 0.644-0.968; P< 0.001). After selecting a score of 29.7 as the cut-off value of the scoring model, patients could be stratified into two groups namely low-risk and high-risk with significantly different 1-year treatment failure rate, PFS and overall survival (OS; P< 0.001) both in the training set and validation set. In conclusion, baseline CgA, creatinine level and previous chemotherapy were independently associated with 1-year treatment failure of patients with advanced NET who received 177Lu-Dotatate and the scoring model and prognostic stratification based on these markers could accurately predict 1-year treatment failure, PFS and OS.

Effect of ACEi and ARBs vs Non ACEi/ ARBs in Hypertension with Respect to Renal Outcomes in COVID-19 Infection: A Retrospective Cohort Study

Introduction: The Acute Kidney Injury (AKI) is one of the most common complications following Coronavirus Disease2019 (COVID-19) infection. The presence of high density of Angiotensin Converting Enzyme 2 (ACE2) receptors in Type 2 alveolar epithelial cells, vascular endothelium and proximal convoluted tubules explains the involvement of systemic organs in COVID-19 infection. Systemic hypertension is one of the most common co-morbidities associated with COVID19 infection with high mortality, specially in patients of severe disease with AKI. The antihypertensives, which work by Renin Angiotensin Aldosterone System (RAAS) inhibition like ACE inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs) can upregulate the enzyme ACE2, so the incidence and risk of AKI in hypertensive patients who have COVID-19 infection is common. Aim: To determine the risk of developing AKI and mortality in hypertensive patients, with COVID-19 infection, on ACEi or ARBs as compared to non ACEi and non ARBs. Materials and Methods: This was a retrospective cohort study conducted on 116 admitted hypertensive patients, who were positive for COVID-19 infection from the month of April 2021 to September 2021. The study patients were divided into two groups- group A and group B. The group A was on ACEi or ARBs and group B was on non ACEi/ARBs. The patients baseline history, clinical examination and the blood investigations like Renal Function Test (RFT), Liver Function Test (LFT), Echocardiography (ECG), Chest X-ray, 2 Dimensional ECHO (2D-ECHO), Arterial Blood Gases (ABG) were done for all the patients. The normal Blood Pressure (BP) was less than 140/90 mmHg.The normal creatinine was 0.6 to 1.5 mg/dL and normal urea was 19 to 45 mg/dL. The RFT was repeated on every day of hospital stay duration. The patients were followed-up for one month from day of starting the study. The parameters were recorded, assessed on day 7th and day 30th of the study. All parameters were compared between the final outcome of the patients by 30th day of study and the class of antihypertensives used to control hypertension. The Pearson’s Chi-square test, Fisher’s exact and Analysis of Variance (ANOVA) were used for testing the significance of relationship and outcome between group A and group B study patients. Results: The mean duration of hypertension in both the groups was 7.6 years. In group A 53 (45.7%) were on ACEi and ARBs, in group B, 63 (54.3%) were on non ACEi/ARBs. In the group A, the serum creatinine of more than &gt;1.5 mg/dL at 7th day of study was found in 28 (52.8%) patients and on 30th day it was found in 8 (15.09%) patients (p-value=0.065). Again in the group A, blood urea of more than 45 mg/dL on 7th day of study was found in 30 (56.6%) patients and on 30th day it was found in 9 (16.98%) patients (p-value=0.064). In the group B, the serum creatinine &gt;1.5 mg/dL on day 7th of study was found in 36 (57.14%) patients and on day 30th it was in 24 (38.09%) patients (p-value=0.061). Again in group B, the blood urea of &gt;45 mg/dL on day 7th was found in 35 (55.55%) patients and on day 30th it was found in 16 (25.39%) patients (p-value=0.074). Of the patients on group A (ACEi and ARBs) 28 (52.83%) were on supplemental oxygen, 12 (22.6%) were on Non Invasive Ventilation (NIV), one was intubated and 12 (22.6%) did not require oxygen (p-value=0.727). Of the patients on group B (non ACEi/ARBs) 33 (52.4%) were on supplemental oxygen, 12 (19.04%) were on NIV, 5 (7.93%) were intubated and 13 (20.63%) did not require oxygen. In the patients of group A, 35 (66.03%) were recovered and 18 (33.96%) died, in the group B 40 (63.49%) cases were recovered, while 23 (36.50%) died (p-value=0.781). Conclusion: There was no significant and demonstrable association between specific groups of antihypertensives with renal outcomes and mortality in hypertensive patients with COVID-19 infection. By above observations this study concludes that, there is no specific role of ACE2 receptors in renal outcome and mortality in hypertension with COVID-19 infection.

Correlation of serum uric acid with lipid profile in patients with type 2 diabetes mellitus with normal creatinine level: Report from a tertiary care hospital in India.

ABSTRACTBackground:Increased serum uric acid (SUA) level is considered a risk factor for kidney diseases in type 2 diabetes mellitus (T2DM) patients. Deranged lipid profile in T2DM is an overall risk factor for cardiovascular complications.Aim:This study aimed to find the correlation between SUA and serum lipid profile in T2DM patients who had serum creatinine levels within normal limits.Materials and Methods:This cross-sectional observational study was conducted in a tertiary care hospital in eastern India. Serum creatinine level was measured first. Then, patients with serum creatinine levels within normal limits were recruited as the final sample. Anthropometric measurements were conducted by an experienced clinician. A 12-h fasting venous blood sample was used to measure serum urea, lipids, sugar, and glycated hemoglobin.Results:A total of 176 (male = 104 [59.1%], female = 72 [40.9%]) T2DM patients with a median age of 46 (Q1–Q3 = 40–55) years participated in the study. There was no gender difference in fasting blood sugar (FBS) (P = 0.57), SUA (P = 0.42), and high-density lipoprotein-cholesterol (HDL-C) (P = 0.17). Females showed higher total cholesterol (TC) (P < 0.0001), triglyceride (TG) (P = 0.002), low-density lipoprotein-cholesterol (LDL-C) (P = 0.0002), and very-low-density lipoprotein-cholesterol (VLDL-C) (P = 0.01). SUA showed significant positive correlation with TG (rs = 0.65, P < 0.0001) and VLDL-C (rs = 0.63, P < 0.0001) and significant negative correlation with HDL-C (rs = −0.35, P < 0.0001) and FBS (rs = −0.45, P < 0.0001).Conclusions:A higher level of SUA, an indicator for kidney disease in T2DM patients, may be associated with a higher TG and VLDL-C and lower FBS and HDL-C. Thus, SUA should be monitored along with lipid profile for early detection of the risk of kidney diseases.

Study of Creatinin Levels of Patients Receiving Antipsycotic Treatment at Mutiara Sukma Psychiatric Hospital, Nusa Tenggara Barat

Mental disorders are clinical and social problems that must be addressed immediately. Long-term use of the drug can cause damage to kidney function and worsen the work of the kidneys. Creatinine is a waste product of creatine phosphate metabolism that occurs in the muscles and is then released into the blood circulation, then transported to the kidneys. The purpose of this study was to determine how the creatinine levels of mental patients receiving antipsychotic treatment at Rumah Sakit Jiwa Mutiara Sukma Hospital, Nusa Tenggara Barat Province. The research method used is qualitative. The type of research used is descriptive, namely looking at data from the Clinical Pathology laboratory installation and medical records to determine the results of examination of creatinine levels in patients with mental disorders. The results showed that from data in the Clinical Pathology laboratory and medical records at Rumah Sakit Jiwa Mutiara Sukma, NTB Province from June-December 2020 with a total of 40 data, there were 30 patients (75%) who had normal creatinine levels, 2 patients (5%) had normal creatinine levels. creatinine levels were low, and 8 patients (20%) had high creatinine levels.

Sero-prevalence and Associated Complications of Hepatitis B Virus Infected Patients of Khyber Pakhtunkhwa

Background: Hepatitis B infection is among the most significant public health challenge worldwide. The prevalence of HBV infection is common among most populations in Peshawar, including pregnant women. Objective: The present study aims to estimate the prevalence and complications associated with clinical parameters and risk factors in patients with HBV. Methodology: A total 150 patients were reported and subjected to Enzyme linked assay (ELISA) for HBeAg test and HBs-Ag by immunochromaticgraphic assay (ICT). RT-PCR assay was used for detection of HBV DNA load. A study designed Performa was used for face-to-face interview to collect data from the study participants. Results: According to our study, highest prevalence was found in Peshawar 34% and the second highest prevalence in Waziristan 20.2%. The results showed highest prevalence in male (54%) than female (46%) and amongst female patients, 10% were pregnant. According to patient’s age, the highest prevalence was found group 26-35 years 34.2% and lowest prevalence was &lt;= 15 years 2.6%. In our study patients were reported on the base of antigen were 94 (62.7%) of patients with HBsAg positive and 56 HBeAg positive (37.3%). Among total patients, 5.3% were co-infected with HCV and no patients were observed co-infected with HDV or HIV. In current study, the prevalence of family affected on the base of relation was found with 21.3%, amongst these 9.3% (spouse affected), 2.7% (mother affected), sibling affected patients (4%) and children affected (5.3%) were observed. The data showed patients with normal ALT 81.3% and 18.7% with elevated and the patients 9.4% and 90.6% found with elevated and normal creatinine level respectively. The normal bilirubin (93.3%), raised bilirubin (6.7%), normal ultrasound (83.7%) and 16.3% dysfunction ultrasound were reported in patients after antiviral drugs treatment. The study surveyed 64% and 36% patients reported under tenofovir and entecavir treatment with different duration and 36%. The less mortality rate of patients leading HBV infection was reported 1.3% in this study due to renal failure and diabetics. Conclusion: The male are more exposed to the environment and that is why highest frequency infected as compared to the female. The main reason of high HBV prevalence was less awareness in people and highest prevalence on the base of family history in spouse because may close contact. Keywords: HBV,Elisa, ICT, virus , antviral

Overview of Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients at Royal Prima Hospital Medan Indonesia

Diabetes Mellitus (DM) is a chronic disease characterized by blood glucose (blood sugar) levels exceeding normal. Diabetic nephropathy is a chronic microvascular complication that often occurs in diabetics. This study presents a picture of diabetic nephropathy in type 2 DM patients at the Royal Prima Hospital in Medan. This research is a type of descriptive research. The sample from this study was the total data of patients suffering from diabetic nephropathy who met the inclusion and exclusion criteria at Royal Prima Hospital from January 1, 2020 – to December 31, 2020. The inclusion criteria for the subjects of this study were complete patient medical records, type 2 diabetes patients, urinalysis tests. (proteinuria ≥ +2), renal function examination exceeds normal values, blood urea, and creatinine. The mean age of diabetic nephropathy patients was 57.52 years and the majority were 62 men (50.8%). The average picture of urea levels in diabetic nephropathy patients is 51.8 and the average creatinine level is 1.48. The majority of patients with diabetic nephropathy do not have proteinuria. And the average blood sugar level is 267 mg/dL. In conclusion, the incidence of diabetic nephropathy is highest in patients aged 57 years. The mean value of urea level is 51.80 mg/dl, creatinine value is 1.48 mg/dl, and the average blood sugar level is 267 mg/dl. Most proteinuria was in the negative category of as many as 107 people (87%).

The platelet-lymphocyte ratio is a promising predictor of early postoperative acute kidney injury following cardiac surgery: a case-control study.

BackgroundAcute kidney injury (AKI) is a common complication following cardiac surgery. This study explored the correlation between hematological biomarkers and the occurrence of postoperative AKI following cardiac surgery.MethodsThis was a retrospective case-control, single-center study. This study enrolled 91 patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) support in Guangdong Provincial People’s Hospital Zhuhai Hospital between March 2019 and July 2021. The baseline serum creatinine levels of the patients was <132.6 µmol/L. The patients’ electronic medical records were retrospectively reviewed. AKI was diagnosed according to the Kidney Disease Improving Global Outcomes (KDIGO) 2012 Acute Kidney Injury Guideline criteria. Patients who sustained AKI in the 48 hours following cardiac surgery were categorized as Group A (n=48), while patients with normal serum creatinine levels postoperatively were categorized as Group B (n=43). The baseline demographic and clinical characteristics of the two groups were compared. Univariate analysis was performed to evaluate the correlation between biomarkers and postoperative AKI. Multivariate logistic regression was performed to identify the predictors of AKI following cardiac surgery.ResultsForty-eight patients were diagnosed with AKI during the first 48 hours after cardiac surgery, while 43 patients were found to have normal creatinine levels postoperatively. Multivariate logistic regression analysis revealed advanced age (P=0.007), preoperative increased creatinine (P=0.023), duration of intraoperative hypotension (P=0.027), and the platelet-lymphocyte ratio (P/LR; P=0.042) as predictors of AKI following cardiac surgery with CPB. This study was performed in a single center, which might not be generalized to whole population. Ongoing review and modification of the surgical protocols may contribute to bias of the study.ConclusionsThe P/LR can be obtained from a routine blood test, and may potentially be utilized as an independent indicator of AKI following cardiac surgery.

Course of renal involvement in the short term in children with coronavirus disease 2019.

Renal involvement among pediatric patients with coronavirus disease 2019 (COVID-19) ranges between 10% and 80%. Given the limited information about its prognosis, the objective of this study was to describe the short-term course of patients in whom renal involvement was detected during hospitalization due to COVID-19. This was an observational, cross-sectional study in patients aged 1 month to 18 years who had COVID-19 and renal involvement. Those with a known kidney disease were excluded. A total of 27 patients with renal involvement were identified; 14 of them were followed-up to study their disease course for 3 months after diagnosis. All of the patients had achieved normal plasma creatinine levels during hospitalization and, at the time of outpatient follow-up, which took place 145 days (92-193) later, all had normal blood pressure and urinary values, except for 1 patient who continued with microscopic hematuria. Course was favorable; in most patients, renal involvement had fully resolved.

Hand-Held Raman Spectrometer-Based Dual Detection of Creatinine and Cortisol in Human Sweat Using Silver Nanoflakes.

The conventional tissue biopsy method yields isolated snapshots of a narrow region. Therefore, it cannot facilitate comprehensive disease characterization and monitoring. Recently, the detection of tumor-derived components in body fluids─a practice known as liquid biopsy─has attracted increased attention from the biochemical research and clinical application viewpoints. In this vein, surface-enhanced Raman scattering (SERS) has been identified as one of the most powerful liquid-biopsy analysis techniques, owing to its high sensitivity and specificity. Moreover, it affords high-capacity spectral multiplexing for simultaneous target detection and a unique ability to obtain intrinsic biomolecule-fingerprint spectra. This paper presents the fabrication of silver nanosnowflakes (SNSFs) using the polyol method and their subsequent dropping onto a hydrophobic filter paper. The SERS substrate, which comprises the SNSFs and hydrophobic filter paper, facilitates the simultaneous detection of creatinine and cortisol in human sweat using a hand-held Raman spectrometer. The proposed SERS system affords Raman spectrometry to be performed on small sample volumes (2 μL) to identify the normal and at-risk creatinine and cortisol groups.

BRAF Mutations and Inflammatory Gene Expression in Myeloma Cells from Patients with Renal Dysfunction

BRAF Mutations and Inflammatory Gene Expression in Myeloma Cells from Patients with Renal Dysfunction

A Randomized Phase III Study of Venetoclax-Based Time-Limited Combination Treatments (RVe, GVe, GIVe) Vs Standard Chemoimmunotherapy (CIT: FCR/BR) in Frontline Chronic Lymphocytic Leukemia (CLL) of Fit Patients: First Co-Primary Endpoint Analysis of the International Intergroup GAIA (CLL13) Trial

A Randomized Phase III Study of Venetoclax-Based Time-Limited Combination Treatments (RVe, GVe, GIVe) Vs Standard Chemoimmunotherapy (CIT: FCR/BR) in Frontline Chronic Lymphocytic Leukemia (CLL) of Fit Patients: First Co-Primary Endpoint Analysis of the International Intergroup GAIA (CLL13) Trial

Does Preoperative Estimated Glomerular Filtration Rate (eGFR) Predict Short-Term Surgical Outcomes in Patients Undergoing Pancreatic Resections?

IntroductionPreoperative eGFR has been found to be a reliable predictor of post-operative outcomes in patients with normal creatinine levels who undergo surgery. The aim of our study was to evaluate the impact of preoperative eGFR levels on short-term post-operative outcomes in patients undergoing pancreatectomy. MethodsThe American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) pancreatectomy file (2014–2017) was queried for all adult patients (age ≥ 18) who underwent pancreatic resection. Patients were stratified into two groups based on their preoperative eGFR (eGFR < 60 mL/min/1.73m2 and eGFR ≥ 60 mL/min/1.73m2). Outcome measures included post-operative pancreatic fistula, discharge disposition, hospital length of stay, 30-day readmission rate, and 30-day morbidity and mortality. Multivariate logistic regression analysis was performed. ResultsA total of 21,148 were included in the study of which 12% (n = 2256) had preoperative eGFR < 60 mL/min/1.73m2. Patients in the eGFR < 60 group had prolonged length of stay, were less likely to be discharged home, had higher minor and major complication rates, and higher rates of mortality. On logistic regression analysis, lower preoperative eGFR (< 60 mL/min/1.73m2) was associated with higher odds of prolonged length of stay [aOR: 1.294 (1.166–1.436)], adverse discharge disposition [aOR: 1.860 (1.644–2.103)], minor [aOR: 1.460 (1.321–1.613)] and major complications [aOR: 1.214 (1.086–1.358)], bleeding requiring transfusion [aOR: 1.861 (1.656–2.091)], and mortality [aOR: 2.064 (1.523–2.797)]. ConclusionPreoperative decreased renal function measured by eGFR is associated with adverse outcomes in patients undergoing pancreatic resection. The results of this study may be valuable in improving preoperative risk stratification and post-operative expectations.

Association Between 25(OH)Vitamin D, HbA1c and Albuminuria in Diabetes Mellitus: Data From a Population-Based Study (VIDAMAZON)

BackgroundThe effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified.ObjectiveEvaluate the relationship between 25-hydroxy-vitamin D [25(OH)D], HbA1c, and albuminuria in Diabetes Mellitus (DM).Patients and MethodsCross-sectional study with 1576 individuals with DM who had 25(OH)D, HbA1c, and albuminuria levels measured. Patients with abnormal creatinine levels were excluded, in order to avoid interference on VD levels by impaired kidney function.ResultsPatients with HbA1c ≥7% had lower 25(OH)D when compared to patients with HbA1c <7% (29.7 ± 10.2 vs 28.1 ± 9.9 ng/ml, p = 0.003) and 25(OH)D levels seems to predict 1.5% of HbA1c behavior. The 25(OH)D concentrations in patients with normoalbuminuria were higher than the levels observed in those with micro or macroalbuminuria (29.8 ± 9.0 vs 26.8 ± 8.6 and 25.1 ± 7.6, respectively, p = 0.001), patients who had 25(OH)D <20 ng/ml and 25(OH)D <30 ng/ml were at a higher risk of presenting albuminuria [OR = 2.8 (95% CI = 1.6 – 4.9), p<0.001, and OR = 2.1 (95% CI = 1.3 - 4.6), p<0.001, respectively]. In our regression model, albuminuria was influenced by HbA1c (r² = 0.076, p<0.00001) and 25(OH)D (r² = 0.018, p = 0.002) independently.ConclusionOur study found an association between vitamin D levels, HbA1c and DKD. Additionally, our data suggest that the association between urinary albumin excretion and vitamin D levels is independent of glycemic control in patients with diabetes. Even though our patients presented normal creatinine levels, it is necessary further prospective studies to confirm if this association precedes or not the loss of renal function.