Plasma Chloride Research Articles

Urinary chloride excretion in critical illness and acute kidney injury: a paediatric hypothesis-generating cohort study post cardiopulmonary bypass surgery.

Renal chloride metabolism is currently poorly understood but may serve as both a diagnostic and a treatment approach for acute kidney injury. We investigated whether plasma chloride, ammonia and glutamine as well as urinary chloride, ammonium and glutamine concentrations may serve as markers for acute kidney injury in paediatric patients. We conducted a prospective observational trial in a tertiary care paediatric intensive care unit. Ninety-one patients after cardiopulmonary bypass surgery were enrolled. Plasma glutamine, creatinine, (serum) albumin, urinary electrolytes and glutamine were collected pre-cardiopulmonary bypass surgery, at paediatric intensive care unit admission, and at 6, 12, 24, 48 and 72 h after paediatric intensive care unit admission. The urinary strong ion difference was calculated. The median urinary chloride excretion decreased from 51 mmol/L pre-cardiopulmonary bypass to 25 mmol/L at paediatric intensive care unit admission, and increased from 24 h onwards. Patients with acute kidney injury had lower urinary chloride excretion than those without. The median urinary strong ion difference was 59 mmol/L pre-cardiopulmonary bypass, rose to 131 mmol/L at 24 h and fell to 20 mmol/L at 72 h. The plasma chloride rose from 105 mmol/L pre-cardiopulmonary bypass to a maximum of 109 mmol/L at 24 h. At 24 h the plasma chloride concentration was associated with the presence of acute kidney injury. There was no association between plasma or urinary amino acids and chloride excretion or kidney injury. In conclusion, renal chloride excretion decreased in all patients, although this decrease was more pronounced in patients with acute kidney injury. Our findings may reflect a response of the kidneys to critical illness, and acute kidney injury may make these changes more pronounced. Targeting chloride metabolism may offer treatment approaches to acute kidney injury.

Acute renal response to changes in carbon dioxide in mechanically ventilated female pigs.

Kidney response to acute and mechanically induced variation in ventilation associated with different levels of PEEP has not been investigated. We aimed to quantify the effect of ventilatory settings on renal acid-base compensation. Forty-one pigs undergoing hypo- (<0.2 Lkg-1 min-1, PEEP 25 cmH2O), intermediate (0.2-0.4 Lkg-1 min-1 with either PEEP 5 or 25 cmH2O), or hyper-ventilation (>0.4 Lkg-1 min-1, PEEP 5 cmH2O) for 48 h were retrospectively included. The decrease in pH paralleled the decrease in plasma strong ion difference (SID) in hyper- and intermediately ventilated groups with lower PEEP. In contrast, the plasma SID remained nearly constant in hypo- and intermediately ventilated groups with higher PEEP. Changes in plasma chloride concentration accounted for the changes in plasma SID (conditional R2 = 0.86). The plasma SID changes were paralleled by mirror changes in urinary SID. Higher PEEP (25 cmH2O), compared to lower PEEP (5 cmH2O) dampened or abolished the renal compensation through its effect on hemodynamics (higher central venous and mean pulmonary pressures), irrespective of minute ventilation. During mechanical ventilation, the compensatory renal response to respiratory derangement is immediate and progressive but can be dampened by high PEEP levels.

CaCl2-Citrate Regional Anticoagulation with Continuous Veno-Venous Haemodialysis Leads to Unwanted Chloride Loading Compared to Continuous Veno-Venous Hemofiltration with Systemic Anticoagulation

Introduction: Chloride transfers during continuous renal replacement therapy (CRRT) have not been adequately described and may differ based on CRRT technique. We aimed to measure chloride mass transfer (JS,Cl) during CRRT and identify associated determinants. Methods: We performed a two-centre, prospective, observational study in France and Australia in ICU patients with CRRT initiated for <24 h. Patients received continuous veno-venous hemofiltration (CVVH) or continuous veno-venous haemodialysis (CVVHD, with citrate-CaCl2 regional anticoagulation). Over a 24 h period, plasma and effluent chloride concentrations were measured every 4 h to compute chloride mass transfer (JS,Cl, in mmol.min-1) using a modality-specific model, with negative value indicating chloride transfer towards the patient. Secondary outcomes were the identification of CRRT settings associated with JS,Cl (using multivariate mixed effects regression). Results are presented with median (interquartile range). Results: Between February 2021 and August 2022, we enrolled 37 patients (64 [56–71] years, 67% male), for a total of 20 CVVHD and 20 CVVH sessions. Over 24 h, plasma chloride concentrations were significantly higher, and JS,Cl significantly lower during CVVHD, compared to CVVH (−0.10 [−0.33 to 0.15] vs. 0.01 [−0.10 to 0.13] mmol.min-1, p < 0.05). With both modalities, net ultrafiltration (QUFNET) and plasma chloride concentrations were the principal determinants of JS,Cl, with higher QUFNET being associated with an increase in JS,Cl during CVVHD. Also, CVVHD sessions demonstrated a concentration gradient between the plasma and the effluent chamber of −6 [−9 to −4] mmol.L-1. Finally, CaCl2 reinjection during CVVHD accounted for 35% [32–60%] of total JS,Cl in sessions with a negative JS,Cl. Conclusion: Compared to CVVH, CVVHD with regional citrate anticoagulation was associated with greater chloride mass transfer to the patient and higher plasma chloride concentrations. This was due to high dialysate chloride concentrations and CaCl2 reinjection. This effect could only be controlled by high net ultrafiltration flow rates.

Evaluating the suitability of nitrate-nitrogen levels for post-smolt Atlantic salmon Salmo salar production in RAS with assistance from heart rate bio-loggers

Previous onsite research determined that post-smolt Atlantic salmon Salmo salar growth, health, and welfare were unaffected by exposure to 99 mg/L nitrate-nitrogen (NO3-N) in freshwater recirculating aquaculture systems (RAS). A subsequent study was conducted to determine if higher concentrations negatively impact Atlantic salmon within a similar size range. Salmon production metrics were compared in triplicate RAS with NO3-N levels increasing from 100 to 250 mg/L (“high”) vs. 50–100 mg/L NO3-N (“low”). An average feed loading rate of 2.53 kg feed/m3 makeup water/day was maintained to facilitate natural NO3-N accumulation up to 75–100 mg/L, and sodium nitrate was continuously dosed to achieve higher concentrations. All-female diploid and all-female triploid Atlantic salmon were comingled in six replicated RAS, resulting in 227 fish/tank with an initial mean weight of 0.35 kg. Six diploid salmon with surgically implanted heart rate bio-loggers were included in each RAS. Continuously logged heart rates were matched with frequently measured NO3-N levels to determine the onset of a physiological response. At the end of the 6-month study, salmon exposed to the high and low NO3-N conditions weighed 1.84 ± 0.05 and 1.91 ± 0.02 kg, respectively (p > 0.05). Diploid and triploid salmon growth rates, feed conversion ratios, maturation prevalence, survival, fin condition, and cataract scores were unaffected (p > 0.05). However, salmon heart rates were generally higher in the high NO3-N treatment after concentrations exceeded 150 mg/L NO3-N. Higher plasma chloride, hematocrit, and hemoglobin levels (p < 0.05) consistent with an adaptive response to a stressor were also measured in salmon from the high NO3-N RAS during this period. These findings suggest that NO3-N concentrations < 150 mg/L do not affect post-smolt Atlantic salmon under similar operating conditions, including freshwater RAS without denitrification technologies and water hardness >300 mg/L as CaCO3. Additional research is required to determine if higher NO3-N concentrations are suitable for Atlantic salmon production over longer exposure periods and with naturally produced NO3-N levels imparted by reduced water exchange. Feed- and nitrogen-loading rates conducive to maintaining the tested NO3-N levels are reported.

Association between serum chloride levels and estimated glomerular filtration rate among US adults: evidence from NHANES 1999–2018

PurposeChloride, the predominant anion in extracellular fluid from humans, is essential to maintaining homeostasis. One important metric for thoroughly assessing kidney function is the estimated glomerular filtration rate (eGFR). However, the relationship between variations in serum chloride concentration and eGFR in general populations has been poorly studied. Therefore, the purpose of this study is to elucidate the correlation between serum chloride levels and eGFR within the United States’ adult population.MethodsThis cohort study was conducted using data from the National Health and Nutrition Examination Survey (NHANES), which covered the years 1999–2018. We employed multiple linear regression analysis and subgroup analysis to evaluate the correlation between serum chloride concentration and eGFR. To examine the nonlinear association between serum chloride levels and eGFR, restricted cubic spline analyses were employed.ResultsData from 49,008 participants in this cohort study were used for the chloride analysis. In the comprehensively adjusted model, a noteworthy inverse relationship was discovered between chloride plasma concentration and eGFR. Restricted cubic spline analyses revealed a significant nonlinear relationship between chloride levels and eGFR (P for overall < 0.001 and P for nonlinear < 0.001). A significant interaction was observed between eGFR and plasma chloride concentration (all P < 0.001 for interaction) among the subgroups characterized by sex, household income to poverty ratio, BMI, hypertension, and diabetes.ConclusionOur findings suggest that higher levels of chloride plasma concentration were linked to decreased eGFR. These findings underscore the significance of monitoring chloride plasma concentration as a potential indicator for identifying individuals at risk of developing chronic kidney disease (CKD).

#2725 Chronic kidney disease is a risk factor for hyperchloremic metabolic acidosis after plasma exchange

Abstract Background and Aims Observational studies have demonstrated that metabolic acidosis due to hyperchloremia is an often encountered metabolic disorder following plasma exchange (PE) with an albumin-saline solution. Because of the reduced capacity for acid and chloride excretion, we hypothesized that patients with chronic kidney disease have the highest risk for hyperchloremic metabolic acidosis, in particular when multiple PE sessions are performed in a limited period. Method We prospectively collected data from all patients who received PE at Amsterdam UMC, between February 2023, and January 2024. We collected data on demographics, exchanged plasma volume, replacement fluids, and collected blood for analysis of sodium, chloride and bicarbonate before and after plasma exchange. We selected patients who received ≥5 plasma exchanges in an intensive cycle (≥4.2 sessions/week). We excluded patients who received Omniplasma, intravenous sodium bicarbonate or dialysis during the PE period. We assessed the effect of PE and kidney function on plasma bicarbonate and chloride concentration throughout the PE period with repeated measures mixed ANOVA, corrected for baseline plasma bicarbonate concentration, volume of exchanged plasma and PE intensity. Results Data from 26 patients, corresponding to 130 plasma exchanges, were included in the analysis. The mean age was 56 ± 14 years and 46% was female. Mean eGFR was 45 ± 14 ml/min/1.73 m2. Patients with an eGFR ≤59 ml/min/1.73 m2 (n = 17) had a significantly lower baseline plasma bicarbonate concentration (19.0 ± 2.8 versus 24.0 ± 1.9 mmol/L; p &amp;lt; 0.001) and used oral bicarbonate supplements (29% versus 0%; p = 0.02) more often than patients with an eGFR ≥60 ml/min/1.73 m2 (n = 9). Despite the lower baseline plasma bicarbonate and more frequent use of oral bicarbonate supplements, the plasma bicarbonate levels decreased the most in subjects with an eGFR ≤59 ml/min/1.73 m2 (mean difference −4.2; 95% CI −7.1 to −1.3; p = 0.006; Fig. 1A) during a cycle of 5 PE sessions. Baseline plasma chloride concentration was similar in both groups (103 ± 7 vs 103 ± 4 mmol/L) and increased the most in patients with an eGFR ≤59 ml/min/1.73 m2 (mean difference −1.4; 95% CI −2.2 to 5.0; p = 0.426; Fig. 1B). Conclusion Repeated plasma exchange with albumin-saline as a replacement fluid is associated with a significant decrease in plasma bicarbonate concentration in patients with impaired kidney function. Future studies should determine whether this hyperchloremic metabolic acidosis has impact on the patients’ symptoms or long-term outcome.

Diurnal rhythm of aquaporins expression and function in the kidney

Aquaporins (AQPs) are a protein family that plays a major role in maintaining water homeostasis. Aquaporin 2 (AQP2) and 3 (AQP3) are expressed on the collecting duct and regulated by the antidiuretic hormone, arginine vasopressin (AVP). AVP binds to its receptor on the collecting duct leading to increased expression of AQP2 on the apical membrane and AQP3 on the basolateral membrane to drive water reabsorption and promote urine concentration. We know that there are biological circadian rhythms that are critical for maintaining homeostasis. Therefore, we aimed to determine AQP2 and AQP3 expression and urine concentrating ability during their active time and inactive time in male and female mice. We hypothesize that there is a diurnal pattern in AQP2 and AQP3 expression or abundance leading to the variation of urine concentrating ability. Male (n=12) and female (n=12) C57BL/6J mice (10-11 weeks old) were euthanized in the middle of their active period (midnight) or the middle of their inactive period (noon). Spot urine osmolality was determined using a freezing point osmometer. Plasma sodium, chloride, and blood urea nitrogen (BUN) plasma concentration using an i-STAT blood analyzer. We localized aquaporins in kidney sections by using a diaminobenzidine chromagen method with antibodies against AQP2, AQP2 pS256 (an activation site), AQP2 pS261(an inhibitory site), and AQP3. Then, using a blinded method, the program Fiji Image J was used to quantify aquaporins on collecting ducts by using the integrated density (IntDen) parameter after calibrating into optical density (OD). We found that urine osmolality of control mice during their active period (2449±442.3 mOsm/ kg) was higher than that in the inactive time (1684±705.6 mOsm/kg, p = 0.0043). The plasma sodium concentration was higher in the active time (145±1.782 mmol/ L) than in the inactive time (142.9±1.311 mmol/L) with p = 0.0026. The plasma chloride (Cl−) and plasma BUN were also higher in the active time (Cl− = 115.2±1.4 mmol/L; BUN = 23±3.6 mmol/L) than in the inactive time mice (Cl− = 111±2.0 mmol/L, p &lt; 0.0001; BUN = 19.75±2.5 mmol/L, p = 0.0187). AQP2 was differentially expressed. During the active period, in both male and female mice, AQP2 was highly expressed in the collecting duct but was obviously reduced during the inactive period (active time = 4083±1006 OD; inactive time = 1243±608 OD, p &lt; 0.001). Moreover, AQP2 activation as determined by phosphorylation S256, was also greater during the active period (1148±404 OD) than inactive (221±96 OD, p = 0.002). Interestingly, the inhibitory site, phosphorylation of S261, was also greater during the active period (592 ± 378 OD) than the inactive period (162 ± 36 OD, p = 0.039). We found no significant difference in AQP3 localization or abundance. In summary, we showed that there is diurnal variability in urine osmolality (higher in their active period) that is supported by increased AQP2 expression during the active period of the mice, regardless of sex. Future studies will aim to determine if antagonizing and stimulating the vasopressin 2 receptor affects urine concentration in a diurnal manner. Intramural UAB funds to KAH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Short-term effects of small volume saline infusion on acid base equilibrium in critically ill patients.

Short-term acid-base effects of 0.9% saline solution infusion are not well described. Aim of this study was to assess the effects of a fluid challenge with 0.9% saline in critically ill patients according to the Stewart's approach, which allows a precise determination of acid base equilibrium. In 40 mechanically ventilated critically ill patients, acid-base variables according to Stewart's approach were measured before and after 30 minutes from the infusion of 0.5L of 0.9% saline. Patients were divided in saline responder (fractional sodium excretion increase <0.5) and non-responders, and in patients with (estimated glomerular filtration rate >63 mL/min) and without renal impairment. After saline infusion, plasma sodium concentration did not change (138 [135-141] vs. 138 [135-140] mEq/L, P=0.646), while chloride concentration significantly increased (102 [100-106] vs. 104 [191-106] mEq/L, P=0.003), reducing strong ion difference (37.0 [34.9-38.0] vs. 35.4 [32.7-37.5] mEq/L, P=0.004) without any impact on pH, due to the concomitant albumin dilution. In saline non-responders, the increase of plasma chloride concentration caused a reduction in strong ion difference, while in saline responders both plasma chloride concentration and strong ion difference remained similar. Patients with and without renal impairment presented a similar acid-base response. The infusion of 0.9% saline reduced strong ion difference by increasing plasma chloride concentration, with no effect on pH due to concomitant albumin dilution. Saline non-responders, characterized by the ability to excrete the sodium excess, were more likely to suffer the acidifying effects of saline infusion, while renal function did not affect the acid-base response to saline infusion.

Lactato de sodio 0,5 molar vs. suero salino hipertónico al 3% en el traumatismo de cráneo grave con hipertensión intracraneana: estudio clínico piloto

ObjectiveTo evaluate the effectiveness of hypertonic sodium lactate (HSL) 0.5 molar in the treatment of intracranial hypertension (ICH) compared to 3% hypertonic saline (HS) in critically ill patients with severe traumatic brain injury (TBI). MethodsProspective, experimental, randomised study conducted in an Intensive Care Unit (ICU) of a university hospital in critically ill patients with TBI and ICH. Those with ICH were randomised into two groups to receive LSH 0.5M or SSH 3% 500 cc with crossover of intervention according to pH or chloremia. Intracranial pressure (ICP) and internal milieu variables were determined. Results11 patients were enrolled (54.5% to LSH; 45.5% to SSH). Sixty-four infusions were performed, 45 LSH, 19 SSH. Non-crossover was 90.9% vs. 75%, respectively (p = 0.098). ICP decreased 11.66±6.49mmHg (p < 0.0001) with LSH vs. 10.1±9.19mmHg with SSH (p< 0.0001), without significant difference between both groups. Natraemia increased 3.11±1.87 mEq/L with LSH (p < 0.0001) and 5.43±4.41 mEq/L with SSH (p < 0.0001), in favour of SSH (p = 0.004). The chloremia decreased 1.95±2.60 mEq/L with LSH (p < 0.0001) and increased 5.78±3.7 mEq/L with SSH (p < 0.0001), significant difference of p < 0.0001. ConclusionsLSH 0.5M is as effective as SSH 3% in the control of ICH in patients with TBI, causing a smaller increase in plasma sodium and chloride levels, preventing the development of hyperchloremic acidosis.

Optimization of Platelet-Rich Plasma Preparation for Regenerative Medicine: Comparison of Different Anticoagulants and Resuspension Media.

Platelet-rich plasma (PRP) has emerged as a promising therapy in regenerative medicine. However, the lack of standardization in PRP preparation protocols presents a challenge in achieving reproducible and accurate results. This study aimed to optimize the PRP preparation protocol by investigating the impact of two different anticoagulants, sodium citrate (SC) and ethylenediaminetetraacetic acid (EDTA), and resuspension media, plasma versus sodium chloride (NaCl). Platelet recovery rates were calculated and compared between groups, in addition to platelet activity and vascular endothelial growth factor (VEGF) released into plasma after PRP activation. The platelet recovery rate was higher with EDTA in comparison to SC (51.04% vs. 29.85%, p = 0.005). Platelet activity was also higher, with a higher expression of two platelet antibodies, platelet surface P-Selectin (CD62p) and PAC-1, in the EDTA group. The concentration of VEGF was higher with SC in comparison to EDTA (628.73 vs. 265.44 pg/mL, p = 0.013). Platelet recovery rates and VEGF levels were higher in PRP resuspended in plasma when compared to NaCl (61.60% vs. 48.61%, p = 0.011 and 363.32 vs. 159.83 pg/mL, p = 0.005, respectively). Our study reinforces the superiority of EDTA (as anticoagulant) and plasma (for resuspension) in obtaining a higher platelet recovery and preserving platelet functionality during PRP preparation.

The Predictive Value of Plasma Sodium and Other Laboratory Parameters in Determining Complicating Appendicitis in Children

Objective: Finding a reliable preoperative predictor of complicated acute appendicitis (AA) has been a challenging diagnostic problem. The present study aimed to identify potential factors that may predict complicated AA in the pediatric emergency department (ED) based on routine, widely available laboratory tests on admission to the ED, including plasma sodium concentration. Methods: We retrospectively reviewed clinical and laboratory data of pediatric patients with AA who underwent emergency surgery at our department between January 2020 and December 2022. The patients were divided into two groups: histopathologically proven complicated AA (n = 80) and noncomplicated AA (n = 155). Results: Complicated AA was associated with reduced plasma sodium and chloride concentrations (p < 0.001, both), decreased values of lymphocytes (p = 0.002), elevated C-reactive protein (CRP) (p < 0.001), and elevated values of white blood cells (WBC) and neutrophils (p = 0.012 and 0.001, respectively). In binomial logistic regression, increased levels of CRP and WBC and decreased levels of sodium were predictors of complicated AA. The area under the receiver operating characteristic curve was 0.825 (95% confidence interval: 0.764, 0.886). Conclusion: We identified mild hyponatremia and elevated CRP and WBC values as potential markers for distinguishing complicated from uncomplicated pediatric AA with implications for surgical approaches for treating complicated AA and conservative approaches for treating uncomplicated AA.

Effects of Myrcene Addition to Water on Plasma Biochemical Characteristics of Common Carp, Cyprinus carpio, During Transportation

Background: Sedative agents are utilized to mitigate stress and improve fish welfare during and after transportation. Objectives: We aimed to assess the effects of myrcene addition to the transportation water on the plasma biochemical profile of common carp, Cyprinus carpio. Methods: For this purpose, common carp (mean weight of 45.3±1.65 g) were transported in plastic bags containing myrcene at concentrations of 0 (CTL), 10 (10 M), 20 (20 M), 30 (30 M), and 50 (50 M) µL/L for 6 h. Then, their plasma parameters were compared to those values before transportation (BT). Results: Transportation significantly (P&lt;0.05) decreased plasma total protein, albumin, alternative complement, lysozyme, sodium, and chloride, while increasing potassium, calcium, alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase in the CTL treatment, as compared to BT. Adding 50 µL/L myrcene to water prevented total plasma protein and albumin loss. Supplementing 20 µL/L myrcene to water prevented or reduced the changes in plasma ions, alanine aminotransferase, and alkaline phosphatase. Addition of 10-50 µL/L myrcene to water decreased the changes in plasma aspartate aminotransferase. Adding 20 and 30 µL/L myrcene to water mitigated the changes in plasma alternative complement, as 30 µL/L myrcene increased plasma lysozyme activity. Transportation and myrcene addition had no significant effects on plasma immunoglobulin (P&gt;0.05). However, a significant increase was observed in plasma globulin in the 20 M treatment (P&lt;0.05). Conclusion: In summary, adding 20 µL/L myrcene to the transport water of common carp reduced hepatic enzyme levels and improved immune parameters, and therefore, the use of myrcene improves fish welfare during transportation.

Calcium carbide-ripened plantain induced alterations in plasma electrolytes concentration and kidney function in rats.

Artificial fruit ripening agents such as ethanol, ethylene, ethephon, and calcium carbide (CaC2) is usually employed in stimulating the fruit ripening process. Currently, there is a paucity of information regarding the effects of various artificial fruits ripening methods on the health status of consumers. In this study, the physiological effects and possible health hazards associated with the consumption of plantain ripened by CaC2 and other non-chemical methods on the kidneys were investigated. Artificially ripened plantain was mixed with rat feed and fed to Wistar albino rats for four weeks, and the levels of plasma electrolytes (Na+, HCO3-, K+, and Cl-), urea, creatinine, as well as histological changes in the kidneys were determined. Results indicated that rats fed with carbide-ripened plantain had a significantly high level of plasma bicarbonate (HCO3-) compared to control rats., but there was no difference in the level of plasma sodium (Na+). However, the levels of plasma potassium (K+) and chloride (Cl-) were significantly low in rats fed with CaC2-ripened plantain as compared to the control rats. Furthermore, the levels of urea and creatinine were significantly high in rats fed with CaC2-ripened plantain compared to the control animals. Histological analyses showed glomeruli atrophy and tubular necrosis in kidneys of rats fed with CaC2-ripened plantain, thereby further indicating toxicity to the kidneys. Histological evidence and alterations in the level of the plasma electrolytes, urea, and creatinine suggest that consumption of fruits ripened with calcium carbide may be harmful to the kidneys.

Comparative therapeutic efficacy of hypertonic saline solution andisotonic normal saline for fore-stomach impaction disorders in buffaloes (Bubalus bubalis)

The aim of present investigation was to evaluate the comparative therapeutic efficacy of isotonic (0.9%) saline solution (NSS) and hypertonic (7.5%) saline solution (HSS) along with supportive medical treatment in buffaloes suffered with forestomach impaction. A total of 26 buffaloes were undertaken in two groups. In Group 1, twenty buffaloes were infused with isotonic (0.9%) saline solution 20 ml/kg body weight and in Group 2 six buffaloes were infused with hypertonic saline solution (7.5%) 2 ml/kg. The physical parameters (heart rate and respiration rate) were decreased more significantly in Group 1 after treatment. Similar trend was observed in the pretreatment hematological parameters viz. Hb, PCV, TLC, neutrophil count and ESR after fluid therapy which was indicative of expansion of plasma volume. There was not much effect on rumen liquor parameters after fluid therapy. The biochemical profile (Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), bilirubin, Blood Urea Nitrogen (BUN), creatinine, total protein, glucose, globulin and fibrinogen) was more significantly declined in Group 1 after fluid therapy, whereas plasma sodium and chloride levels significantly increased, and plasma potassium level more significantly decreased in Group 2. The recovery rates were 60% and 17% respectively in Group 1 and Group 2. Thus, Isotonic (0.9%) saline solution appears to more effective in therapeutic management of forestomach impaction in buffaloes.

Determination of the Procoagulant Activity of Extracellular Vesicle (EV) Using EV-Activated Clotting Time (EV-ACT).

The role of extracellular vesicles (EV) in various diseases is gaining increased attention, particularly due to their potent procoagulant activity. However, there is an urgent need for a bedside test to assess the procoagulant activity of EV in clinical settings. This study proposes the use of thrombin activation time of EV-rich plasma as a measure of EV's procoagulant activity. Standardized procedures were employed to obtain sodium-citrated whole blood, followed by differential centrifugation to obtain EV-rich plasma. The EV-rich plasma and calcium chloride were added to the test cup, and the changes in viscoelasticity were monitored in real-time using an analyzer. The natural coagulation time of EV-rich plasma, referred to as EV-ACT, was determined. The results revealed a significant increase in EV-ACT when EV was removed from plasma obtained from healthy volunteers, while it significantly decreased when EV was enriched. Furthermore, EV-ACT was considerably shortened in human samples from preeclampsia, hip fracture, and lung cancer, indicating elevated levels of plasma EV and promotion of blood hypercoagulation. With its simple and rapid procedure, EV-ACT shows promise as a bedside test for evaluating coagulation function in patients with high plasma EV levels.

ASSESSMENT OF RENAL FUNCTION IN DIABETIC WISTAR RATS TREATED WITH ETHANOL EXTRACT OF Cucumis sativus FRUIT.

As a fast-growing metabolic disorder diabetes mellitus is one of the leading causes of death worldwide. Nephropathy (damage to kidney leading to renal failure) is a microvascular complication of the disease. The aim of the present study was to assess renal function in diabetic rats treated with ethanol extract of Cucumis sativus fruit. Male Wistar rats (n = 25, mean weight = 215 ± 15 g) were randomly assigned to five groups (5 rats per group): control, diabetic, metformin, 200 mg/kg body weight (bwt) extract and 300 mg/kg bwt extract groups. Diabetes mellitus was induced in the rats via intraperitoneal injection of streptozotocin (STZ) at a dose of 50 mg/kg bwt. The diabetic rats were then treated for 21 days with metformin (50 mg/kg bwt) or the extract at doses of 200 and 300 mg/kg bwt, respectively, leaving the diabetic group untreated. The results showed that induction of diabetes mellitus using STZ significantly increased plasma urease activity, and urea and chloride concentrations, but it reduced the weight of rat kidney and concentrations of sodium, potassium and bicarbonate ions significantly (p &lt; 0.05). However, treatment of the diabetic rats with the extract markedly reduced plasma urease, and urea and chloride ion concentrations, while increasing kidney weight, organ/body weight ratio as well as concentrations of sodium, potassium and bicarbonate ions (p &lt; 0.05). The effect of the extract on potassium and chloride ions was dose-dependent. These results indicate that ethanol extract from the medicinal plant C. sativus fruit can ameliorate kidney dysfunction caused by STZ-induced diabetes mellitus.

Prognostic significance of plasma chloride in elderly patients hospitalized for acute heart failure.

Previous studies demonstrated the relationship between hypochloraemia and poor prognosis in patients hospitalized for acute heart failure (AHF). However, the usefulness of chloride in clinical practice remains uncertain, notably in very old patients with predominantly heart failure (HF) with preserved ejection fraction (HFpEF). We aimed to evaluate the prognostic impact of chloride in a cohort of very aged patients with AHF and the possible existence of different phenotypes of hypochloraemia with distinct clinical significance. It was an observational study of 429 patients hospitalized for AHF in which chloraemia was measured. Two different phenotypes of hypochloraemia were identified by their relationship with estimated plasma volume status (ePVS) as a proxy of intravascular congestion. The endpoint of interest was time to all-cause mortality and the composite of death and/or HF readmission. A multivariable Cox proportional hazard regression model was constructed to analyse the endpoints. The median age was 85 (78-92) years, 266 (62%) were women, and 80% had HFpEF. After multivariable analysis, chloraemia, but not natraemia, was associated with the risk of death and HF readmission in a U-shaped pattern. The phenotype characterized by hypochloraemia and low ePVS (depletional) was associated with an increased risk of mortality when compared with patients with normochloraemia [hazard ratio (HR) 1.86, P=0.008]. In contrast, hypochloraemia with high ePVS (dilutional) had no prognostic significance (HR 0.94, P=0.855). In very old patients hospitalized with AHF, plasma chloride was associated with the risk of death and HF readmission in a U-shaped pattern and could potentially be used for congestion phenotyping.

Investigations on some indicators in the blood of cattle with orosthenic activity tongue rolling.

Hematological studies were carried out in cattle with tongue-rolling hyperactivity in order to establish the etiopathogenetic mechanisms of this behavioral disorder. Cattle were divided into two groups: Group 1 (n = 12), control animals that did not demonstrate the tongue-rolling orosthenic activity, and Group 2 (n = 12), cattle that manifested this stereotyped behavior. Blood samples were collected from all cattle twice at 10-day intervals from Vena jugularis for analysis of red blood cell counts, hemoglobin (HGB) content, mean corpuscular volume (MCV), mean corpuscular HGB (MCH), mean corpuscular HGB concentration (MCHC), hematocrit (HCT), white blood cell counts (WBC), and differential white cell counts [lymphocytes (LYM), monocytes (MON), and granulocytes (GRAs)]. Some blood biochemical constituents were assayed: calcium, inorganic phosphorus, magnesium, plasma total protein, blood glucose, total bilirubin, urea, creatinine, chlorides, cholesterol, triglycerides, and albumin, as well as the enzyme activities of aspartate amino-transferase (AST), alanine amino-transferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (γ-GT), lactate dehydrogenase (LDH), and creatine kinase (CK). Blood concentrations of the hormones adrenaline, noradrenaline, cortisol, adrenocorticotropic hormone (ACTH), dopamine, serotonin, free thyroxine, thyroid-stimulating hormone, and trace elements manganese, copper, and iron were determined. It was found out that the cattle with tongue-rolling hyperactivity did not demonstrate changes in red blood picture (HGB, HCT, MCV, MCH, MCHC), white blood picture (WBC, LYM, MON, GRA), blood biochemistry (Ca, P, Mg, TP, Glu, TB, urea, creatine, Cl, Chole, TG, and Alb), AST, ALT, ALP, γ-GT, LDH, and CK activities, Cu, and Fe levels. In the study, increased concentrations of adrenaline, noradrenaline, cortisol, ACTH, and serotonin were established. The data demonstrating increased levels of adrenaline, noradrenaline, cortisol, and ACTH confirmed the etiological role of environmental stressors in the emergence of oral hyperactivity. Increased serotonin concentrations in the blood suggest that cattle with the stereotype are probably "happy" with tongue rolling. The lack of changes in blood trace elements manganese, copper, and iron allowed excluding their deficiency as a probable cause in the etiology of the disorder.

The GH/IGF axis in the sea lamprey during metamorphosis and seawater acclimation

How the growth hormone (GH)/insulin-like growth factor (IGF) system affects osmoregulation in basal vertebrates remains unknown. We examined changes in the expression of components of the GH/IGF axis and gill ion transporters during metamorphosis and following seawater (SW) exposure of sea lamprey. During metamorphosis, increases in gill nka and nkcc1 and salinity tolerance were accompanied by increases in pituitary gh, liver igf1, gill ghr and igf1, but not liver ghr. SW exposure of fully metamorphosed sea lamprey resulted in slight increases in plasma chloride concentrations after SW exposure, indicating a high level of SW tolerance, but no major changes in mRNA levels of gill ion transporters or components of the GH/IGF axis. Our results indicate that metamorphosis is a critical point in the lifecycle of sea lamprey for stimulation of the GH/IGF axis and is temporally associated with and likely promotes metamorphosis and SW tolerance.

Altered Neuronal Discharge in the Organum Vasculosum of the Lamina Terminalis Contributes to Dahl Salt-Sensitive Hypertension.

Salt-sensitive hypertension in humans and experimental models is associated with higher plasma and cerebrospinal fluid sodium chloride (NaCl) concentrations. Changes in extracellular NaCl concentrations are sensed by specialized neurons in the organum vasculosum of the lamina terminalis (OVLT). Stimulation of OVLT neurons increases sympathetic nerve activity (SNA) and arterial blood pressure (ABP), whereas chronic activation produces hypertension. Therefore, the present study tested whether OVLT neuronal activity was elevated and contributed to SNA and ABP in salt-sensitive hypertension. Male Dahl salt-sensitive (Dahl S) and Dahl salt-resistant (Dahl R) rats were fed 0.1% or 4.0% NaCl diets for 3 to 4 weeks and used for single-unit recordings of OVLT neurons or simultaneous recording of multiple sympathetic nerves during pharmacological inhibition of the OVLT. Plasma and cerebrospinal fluid Na+ and Cl- concentrations were higher in Dahl S rats fed 4% versus 0.1% or Dahl R rats fed either diet. In vivo single-unit recordings revealed a significantly higher discharge of NaCl-responsive OVLT neurons in Dahl S rats fed 4% versus 0.1% or Dahl R rats. Interestingly, intracarotid infusion of hypertonic NaCl evoked greater increases in OVLT neuronal discharge of Dahl S versus Dahl R rats regardless of NaCl diet. The activity of non-NaCl-responsive OVLT neurons was not different across strain or diets. Finally, inhibition of OVLT neurons by local injection of the gamma-aminobutyric acid agonist muscimol produced a greater decrease in renal SNA, splanchnic SNA, and ABP of Dahl S rats fed 4% versus 0.1% or Dahl R rats. A high salt diet activates NaCl-responsive OVLT neurons to increase SNA and ABP in salt-sensitive hypertension.