Serum Blood Urea Research Articles

Ameliorative effect of rutecarpine supplementation against cisplatin-induced nephrotoxicity in rats via inhibition of monocyte chemoattractant protein-1, intercellular adhesion molecule-1, high-mobility group box 1, and nuclear factor kappa B.

Cisplatin, the pioneering heavy metal compound, stands out as a potent drug for the treatment of various solid tumors. However, its clinical utility is hampered by notable toxicity and adverse effects, particularly nephrotoxicity. The potency of rutecarpine, a phytochemical, in mitigating cisplatin-induced nephrotoxicity was assessed in the present study. In this experimental setup, healthy male Wistar rats were grouped into four and Group I rats served as the control group, receiving only vehicle control. Group II rats were subjected to cisplatin treatment alone, administered intraperitoneally at a dosage of 7mg/kg body weight on the 19th, 20th, and 21st days. Group III and IV rats were orally administered with rutecarpine at doses of 10 and 20mg/kg body weight, respectively, starting from Day 1 and continuing daily for 21 days. Additionally, they were injected intraperitoneally with cisplatin at the same dosage and schedule as Group II. Relative kidney weight and renal biochemical markers blood urea nitrogen, lactate dehydrogenase, serum urea, and creatinine were measured to assess rutecarpine inhibitory potency against cisplatin toxicity. Markers of oxidative damage and antioxidants levels were quantified in the ruteacarpine- and cisplatin-treated rats. The study investigated the anti-inflammatory property of rutecarpine in cisplatin-induced nephrotoxicity by analyzing inflammatory cytokines. Renal tissue levels of monocyte chemoattractant protein-1, intercellular adhesion molecule-1, high-mobility group box 1, and nuclear factor kappa B, key markers of nephrotoxicity, were quantified to assess rutecarpine's potential to mitigate cisplatin-triggered damage. Histopathological examinations were performed to confirm the impact of rutecarpine against cisplatin-induced nephrotoxicity. Treatment with rutecarpine notably reduced renal biochemical markers, prevented renal edema, and attenuated oxidative stress-induced damage in cisplatin-treated rats. Both inflammatory and nephrotoxicity markers showed significant decreases in rats treated with rutecarpine along with cisplatin. Histological analysis affirmed that rutecarpine pretreatment effectively prevented cisplatin-induced nephrotoxicity. The study findings demonstrate that rutecarpine ameliorates cisplatin-triggered nephrotoxicity through its antioxidant and anti-inflammatory properties, suggesting that rutecarpine supplementation alongside cisplatin treatment could potentially reduce nephrotoxicity in cancer patients.

Assessment of B2-Microglobulin Analysis for Renal Insufficiency in Iraqi β-Thalassemia Major Patients

Background: Beta-thalassemia is the most prevalent genetic hemoglobin apathy in the world. It is caused by a reduction or absence of beta-globin chain production, which is typically a portion of adult hemoglobin (HbA, which is α2β2). This genetic anomaly will lead to a rapid erythrocyte turnover, severe anemia, and compensatory ineffective erythropoiesis. The purpose of the current research is to reveal diagnostic, and predictive biomarkers that can be performed to detect the decline in renal function in β-thalassemia major patients with early stage renal impairment with high sensitivity and specificity, ascertain changes in B2-microglobulin as a biomarker in β-thalassemia patient. Objective: The samples were collected from Karama Hospital-Genetic Hematology Center/Baghdad during the period from the 1st of September 2022 until the 1st of January 2023. Methods: The patient group consisted of 45 patients with β-thalassemia major with repeated blood transfusion and the control group consisted of 45 individuals who seemed to be healthy. Age ranged between (18-35) years (for patients and control). The serum samples were used to measure biochemical parameters, S.Creatinine, blood urea, and Urine B2-microglobulin were measured from urine samples. B2-microglobulin level in Urine was estimated by Sandwich enzyme-linked immunosorbent assay (ELISA) technique, while serum Blood Urea and Serum Creatinine concentration were calculated by Colorimetric Kit by Spectrophotometer method, and Ferritin level in blood was estimated by BioMrieux Mini Vidas. Results: The statistical examination was carried out using SPSS software. B2-microglobulin biomarkers in the thalassemia Patient group were significantly higher than those in the control group (p<0.001). While serum ferritin, B.Urea and S.Cr increased in patient groups compared to the control group (p<0. 005). Conclusions: All parameters included in this study are significantly higher in β-thalassemia patients than in healthy subjects. Renal hemosiderosis and asymptomatic renal dysfunction are prevalent among β-thalassemia major patients with repeated blood transfusions, which are not found in routine renal investigations.

Effects of Plasma Therapy on Laboratory Factors and Clinical Improvement of COVID-19 Patients

Objectives: Over 50 million confirmed cases and 1.5 million fatalities worldwide have been linked to the COVID-19 pandemic. Researchers have used convalescent plasma (CP) from recovered patients, which includes neutralizing antibodies, to develop therapeutics for virus neutralization and prevention. This study assessed the effectiveness of CP using several clinical and laboratory variables. Methods: The intervention group received two doses of CP on the day of hospitalization, while the control group received standard care. Clinical and analytical data were documented and evaluated before plasma therapy and on the third and fifth days after therapy. The results were measured in the patient’s blood using the ELISA method. Results: The present study showed that the ICU hospitalization times for the control and CP groups were similar, with a slightly lower mortality rate in the CP group (6.2% vs. 8.2%, p > 0.05). There was no significant association between COVID-19 and clinical factors such as blood pressure, heart rate (HR), respiration rate (RR), and temperature. The blood serum urea, serum LDH, ALT, PTT, PLT, and IL-6 were significantly higher in the CP group than in the control group (p <0.05). Our results indicated that there was no difference in blood pH, PO2 , HCO3 , ESR, WBC counts, serum troponin, Na, AST, CRP, D-dimer, and PT between patients in the CP and control groups. Conclusion: Overall, in certain instances, CP therapy may help individuals with COVID-19 recover. In general, additional research is required to determine the efficacy of plasma treatment in COVID-19 patient care.

Study of the Efficacy and Safety of Darbepoetin Alfa versus Epoetin Alfa in the Treatment of Anemia in Pediatric Patients on Regular Hemodialysis

Abstract Background Anemia is a common comorbidity in patients with chronic kidney disease (CKD). That affects the vast majority and can have a significant impact on patient morbidity and mortality. Erythropoiesis-stimulating agents (ESAs) are the main lines in management of anemia in hemodialysis patients. Replacement therapy with recombinant human erythropoietin (r- HuEPO) has provided an effective treatment for patients with renal “Epoetin alfa” is a recombinant erythropoietin with the same amino acid sequence as human erythropoietin (EPO). In comparison to epoetin alfa, darbepoetin alfa (DPO) contains an increased amount of sialic acid-containing carbohydrate chains. It shows a much longer elimination half-life than epoetin alfa, with prolonged erythropoietic effect. Aim of the Work to evaluate whether darbpoetin and epopoetin alpha can be used interchangeably on the same patient, achieving the same desired effect and to detect any difference in the occurrence of side effects between both ESAs. Patient and Methods This was a crossover study that took place in the Pediatrics Dialysis unit, Children’s Hospital, Ain Shams University. The study was conducted on 40 children with end stage renal disease on regular hemodialysis over a period of 6 months. The patients were randomly put into two groups A and B, each group contained 20 patients. Each group received one type of ESA either ( darbpoetin alpha or epopoetin alpha )for 3 months and then shifted to the other type of ESA for another 3 months. The dosage of epoetin alfa used was (200 IU/kg/week) and a conversion rate of EPO: DPO, 300:1. A period of 6 weeks was agreed as a washout period after the first drug given in both groups in which no results were recorded but ESA was not stopped due to its essentiality. Blood tests (hemoglobin (Hb), serum urea, serum creatinine and iron profile; (S. iron, S. ferritin, TIBC, and transferrin saturation)) were withdrawn at the start and the end of the 3 months’ period of each drug. Results We found no difference on the Hb level with both drugs. The interchange between them did not yield any significant drop in the Hb levels. Hb target in both EPO and DPO was reached in 22.5% of total cases, and was not reached in 62.5%. This proved that both drugs give the same effect with nearly negligible difference. No serious Sside effect as convulsions, hypertension, and thrombosis were noticed in both groups. Conclusion The target Hb was not reached in most patients of both groups of ESRD on regular hemodialysis at the unit and none of both drugs showed superior results or less side effects than the other.

Evaluation of some Biochemical and Hematological Parameters in Patients with Chronic Kidney Disease

Background: Chronic kidney disease is a condition that results from an indefinite change in the structure and function of the kidneys. A slow, steady progression characterizes it and is irreversible. Objectives: This study aims to evaluate the findings of certain biochemical and hematological tests in samples from Iraqi CKD patients. Methods: This study included 90 subjects, where 70 patients with chronic kidney disease and 20 healthy individuals. Blood samples were collected from the patients during their visits to Ghazi Al-Hariri Surgical Specialties' Hospital- Medical City, Baghdad, Iraq. Age, sex and body mass index were assessed for each participant followed by renal function tests [serum blood urea, creatinine, uric acid and estimated glomerular filtration rate], and complete blood count. Also, serum levels of uromodulin and cystatin C were measured statistically studies were carried out using analysis of variance (ANOVA). Results: the study demonstrated a highly significant (P<0.001) increase in blood urea, serum creatinine and uric acid levels, while a significant (P<0.05) decrease in estimated glomerular filtration rate levels in patients compared to the control group. On the other hand, it showed a highly significant (P<0.001) decrease in hemoglobin and hematocrit values and a significant (P<0.05) decrease in the red blood cell count. Patients had revealed a significant (P<0.05) increase in cystatin C level and a decrease in uromodulin level when compared to the control group. conclusion: the present study shows that chronic kidney disease patients have upregulated renal function parameters blood urea, serum creatinine and with downregulated estimated glomerular filtration rate, while hematological disorder was more prevalent in patients. On the other hand, cystatin C level revealed an increase while uromodulin level showed a decrease in Iraqi patients.

Haemato-biochemical parameters of lambs fed tannin containing Daniellia oliveri seed meal based diet

Abstract This study investigated the effect of replacement of conventional protein source groundnut cake (GNC) with toasted-decorticated Daniellia oliveri seed meal (DSM) on haemato-biochemical parameters of lambs. Twenty intact 6-month-old lambs were used in an 84-day experiment. The animals were randomly divided into four treatments containing 0, 25, 50 and 75% DSM replacement levels for GNC. Five animals were randomly allotted to one of dietary treatments in a completely randomised design. The concentrates were formulated to have similar (P>0.05) CP of 181.0 g/kg DM on average. All the other nutrients in the formulated supplements were significantly different (P<0.05). There were increases in levels of organic matter (924.9–961.00 g/kg DM), non-fibre carbohydrates (238.03–329.36 g/kg DM) as well as condensed tannins, as the level of inclusion of DSM in the concentrate diet increased. Packed cell volume, white blood cell, lymphocytes, serum urea and glucose linearly increased (P<0.05) but mean corpuscular haemaoglobin concentration linearly decreased (P<0.05) while other haematological and serum parameters were similar among diets. Blood parameters were within established ranges for healthy sheep. The results indicate that tannins containing Daniellia oliveri seed meal can be incorporated up to 75% without compromising body immunity system and health of the animals.

#1373 Effect of Astragalus membranaceus normalized acute kidney injury-induced renal conditions corelated with serum carnosine

Abstract Background and Aims Astragalus membranaceus (AM) exhibits various pharmacological effects against several diseases, including chronic kidney disease (CKD) (see http://nccih.nih.gov/health/astragalus). We have previously investigated the correlation between AM and acute kidney injury (AKI), which is an important factor causing CKD pathogenesis or progression. Recently, we demonstrated that old mice showed lethality in response to 20 mg/kg cis-diamminedichloroplatinum (CDDP), which is a general dose used to generate AKI in young mice. AKI also occurred in response to a reduced dose of cisplatin, which was completely reversible in young mice. The administration of AM to mice (20 mg/kg) significantly improved AKI pathology, especially in old mice treated with a reduced dose of cisplatin, thereby demonstrating the therapeutic effect of AM against age-dependent AKI pathogenicity. More recently, we found that serum carnosine levels correlated with renal conditions in AM. Here, we examined the effects associated with serum carnosine levels to prevent AKI and delay CKD progression [1]. Methods Female C57BL/6 mice (52 weeks old) were orally administered either an AM powder mixed with sterilized 0.5% methylcellulose 400 (w/v) (AM group) or only 0.5% methylcellulose 400 (control). Four hours after the most recent dose (20 mg/kg of AM twice a day), 0.5 mg/ml CDDP (reduced dose: 10 mg/kg or 0.9% NaCl for the CG) was injected intraperitoneally into old mice. Subsequently, we measured the blood serum urea nitrogen (BUN) and creatinine (CRE) levels, which are biomarkers of AKI, and assessed histochemical changes in kidney sections stained with anti-CD3 and anti-CD68 antibodies 20 h and 3 d after CDDP injection (n = 6 per group). Thereafter, serum carnosine levels in the samples collected from each sample (n = 6 per group) were determined using a carnosine ELISA kit (Novus, NBP2-75013). Data were analyzed statistically using PRISM software, and statistical significance was set at P = 0.05. Results Higher susceptibility to a half CDDP dose in old mice was indicated by increased BUN levels and the histological damage caused to renal tubule epithelial cells and glomeruli; however, no pathological change was observed in younger mice. Histochemical analysis of old mice showed a significant increase in the number of CD3-positive cells following AKI induction; however, AM pretreatment ameliorated these inflammatory conditions. Our recent findings suggest that a correlation exists between the effects of AM and serum carnosine levels. Fig. 1 shows that different serum carnosine levels were observed in old control mice (white box), probably because of age-dependent pathogenesis. However, serum carnosine was concentrated to lower levels after AM administration (orange box), suggesting an age-dependent AM effect. Moreover, owing to the effect of AM on CDDP-AKI, serum carnosine levels changed transiently but significantly in old mice (blue and yellow boxes) within 20 h; this indicates that age-dependent renal conditions were improved by the AM effect and correlated with serum carnosine levels. Conclusion AM administration normalizes the renal pathology caused by age-dependent susceptibility to CDDP-AKI; this is particularly true for older mice, wherein serum carnosine is downregulated but concentrated. Serum carnosine can be effective in preventing AKI pathology in old mice, regardless of the AM effects. We believe that AM can prevent age-dependent accumulation of AKI pathology, thereby facilitating CKD progression.

Study on Anti-fatigue Effects and Mechanisms of Polysaccharide from Paris polyphylla.

The objectives of this study were to investigate the anti-fatigue effects of Paris polyphylla polysaccharide component 1 (PPPm-1) and explore its mechanisms. A mouse model of exercise-induced fatigue was established by weight-bearing swimming to observe the effects of different concentrations of PPPm-1 on weight-bearing swimming time. The anti-fatigue effect of PPPm-1 was determined by the effects of contraction amplitude, contraction rate, and diastolic rate of the frog gastrocnemius muscle in vivo before and after infiltration with 5 mg/mL PPPm-1. The effects of PPPm-1 on the contents of blood lactate, serum urea nitrogen, hepatic glycogen, muscle glycogen in the exercise fatigue model of mice, and acetylcholine (ACh) content and acetylcholinesterase (AChE) activity at the junction of the frog sciatic nerve-gastrocnemius under normal physiological, and Na+-K+-ATPase and Ca2+-Mg2+-ATPase activities of the frog gastrocnemius were determined by enzyme-linked immunosorbent assay (ELISA), to investigate the anti-fatigue mechanisms of PPPm-1. The results showed that PPPm-1 could significantly prolong the weight-bearing swimming time in mice (P < 0.01), decrease the contents of blood lactate and serum urea nitrogen, increase the contents of the hepatic glycogen and muscle glycogen of mice after exercise fatigue compared with those of the control group, and there was extremely significant difference in most indicators (P < 0.01). The 5mg/mL of PPPm-1 could significantly promote the contraction amplitude, contraction rate, and relaxation rate of the gastrocnemius muscle in the frogs, and the content of ACh at the junction of the frog sciatic nerve-gastrocnemius (P < 0.01), but it had obvious inhibitory effetc on the activity of AChE at the junction of the frog sciatic nerve-gastrocnemius (P < 0.01). PPPm-1 could increase the Na+-K+-ATPase and Ca2+-Mg2+-ATPase activities of gastrocnemius in the frogs (for Ca2+-Mg2+-ATPase, P < 0.01). The above results suggested that the PPPm-1 had a good anti-fatigue effect, and its main mechanisms were related to improving endurance and glycogen reserve, reducing glycogen consumption, lactate and serum urea nitrogen accumulation, and promoting Ca2+ influx.

BIOCHEMICAL PARAMETERS OF BLOOD OF LABORATORY ANIMALS IN CASE OF PROLONGED CONTACT WITH THE RESEARCH MATERIAL

The purpose of this study was to determine the biochemical parameters of blood of laboratory animals in prolonged contact with the experimental material&#x0D; Materials and methods. An experimental study was conducted in the laboratories and vivarium of the State Institution "Institute of Spine and Joint Pathology named after Prof. M.I. Sitenko" on 28 white laboratory rats aged 6 months with a body weight of 200 to 250 grams. The animals were randomly divided into two groups: a control group (14 rats) and an experimental group (14 rats), which were exposed to dental glass ionomer cement at a dose of 1.0 mg/kg. Toxic effects were evaluated for 1 month. The blood sampling procedure included tail vein dilation, disinfection, tail fixation, and blood collection. The study was conducted in special conditions with full feeding.&#x0D; Results. The study found no significant negative effects of prolonged use of dental glass ionomer cement (GIC) on kidney function. Analysis of diuresis, urea and creatinine levels in urine and blood serum showed no statistically significant differences between males and females. No sugar, ketones, or protein were detected in the animals' urine. Serum creatinine levels were (65.47±4.6) μmol/l in males and (63.38±7.1) μmol/l in females, while serum urea levels were (4.84±0.47) μmol/l in males and (4.67±0.42) μmol/l in females. Urinary urea levels were (374.35±20.7) mmol/l in males and (371.15±22.3) mmol/l in females.&#x0D; Conclusions. The obtained results of the study indicate statistically significant deviations in the studied indicators of the functional state of the kidneys both in males and females after prolonged use of dental glass-inomer cement based on polyacrylate carboxylate. The presence of sugar, ketones and protein was not detected in the urine of the animals. The analysis of serum creatinine levels showed no statistically significant differences between the conditions, and serum urea levels did not differ between them either. Thus, it can be concluded that the use of glass-inomer cement has no negative effect on the functional state of the kidneys in the studied animals.

Development of a microfluidic device for the dual detection and quantification of ammonia and urea from the blood serum

The concoction of microfluidics and IoT to realize Point-of-Care (PoC) diagnostic devices have become of great interest in the present world. Urea is the biomarker for diseases such as pre-eclampsia, hepatic encephalopathy, chronic renal failure, hepatocellular carcinoma, different types of cancers, various kinds of viral infections, etc. Ammonia is associated with parkinsonism, muscle wasting, sarcopenia, osteoporosis, etc. Hence their detection is beneficial in the healthcare sector. Herein, an IoT-enabled microfluidic-based colorimetric device has been developed to detect and quantify both ammonia and urea in blood serum. The entire device casing was 3D printed, and the microfluidic chip was fabricated using poly (dimethylsiloxane) and glass. Incorporation of Node MCU as the microcontroller provided the device with enhanced capabilities for data recording and transmission, even in remote areas. The device was capable of detecting ammonia and urea in a wide range. The ammonia was detected in the range of 0.5–10 mg L-1 with a limit of detection (LoD) of 0.1879 mg L-1, while the urea was detected in the 100–500 mg L-1 range with a LoD of 21.4091 mg L-1. The developed device was 3D printed, portable, miniaturized, IOT enabled, and cost-efficient, with a power consumption of a mere 5 V, thus opening new avenues in sustainable point-of-care diagnostics. Moreover, the device was added with offline and online data visualization capabilities, thus increasing its user-friendliness.

Antioxidant associated chemoprophylaxis effect of natural spice and green vegetable on hepatotoxicity.

This is a case control and cohort study, conducted at Department of Biochemistry in FUAST, compressing 24 number of albino Wistar rats. Illicium verum (star anise) natural spice and green vegetable broccoli are used for chemo-preventive herbal treatment in relation with vitamin C antioxidant activity. Hepatotoxicity was induced in liver of model rats by giving interperitoneally single injection of 200 mg/kg bod weight (B.W) of N-nitrosodiethylamine and orally giving 1 mg/kg BW phenobarbital for 14 days during disease prorogation period. The vitamin C analysis from Illicium verum (star anise), green broccoli, orange juice, orange peel and orange pulp was done by iodometric quantitative and qualitative titration method. Rats were given compound according to their bodyweight as 1 mg/kg B.W. After 14 days (Disease Promotion and Propagation Period) and 28 days (Disease cure period) of treatment behavioral activity was monitored by locomotors activity in open field experiment, stimulatory activity in home cage and anxiolytic effects observed in light and dark apparatus and also in T maze. Behavioral activity were significantly increased in Illicium verum and green broccoli treated rats. Hematological study including hemoglobin (Hb), white blood cells (WBC), red blood cells (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW) and Platelets was done by abbot laboratory analyzer cell. The value of Hb and RBC was also significantly increased in star anise and broccoli treated rats, showed proper function of RBC in microcirculation. WBC was also in normal range revealed that no disease regards to bone marrow and leukemia's. The biochemical activity of rats including urea, creatinine, total protein, albumin, globulin, A/G ratio, amylase and calcium in blood serum were analyzed while, liver health or performance was also determined by LFT (liver function test). Behavioral and laboratorial variables were analyzed by using SPSS v. 20 and p-value < 0.05 was considered statistically significant. The study report noticeable significant effect of Illicium verum and broccoli on hepatotoxicity of experimental model. Recent experimental study statistical outcomes show reciprocal relationship between the consumption of vegetable diet and natural spice with the risk of Hepatotoxicity. Thus, the aim of the study is to enhance the function of star anise or illicium verum natural spice and green vegetable broccoli as an anticancer or chemoprophylaxis agent.

Biochemical disorders in mild protein-energy deficiency in children: gender peculiarities

The growth of protein-energy malnutrition (PEM) in children with prevalence of endogenous factors of the causes of development has not been decreasing in the Russian Federation and all over the world for the last decades. This determines the relevance of multifaceted study of this pathology. Consequences of PEM suffered in early childhood can have a remote character of realization and influence on human health during the whole life. A separate problem of PEM is the identification of mild forms of pathology, which are often missed. The pathogenesis of PEM is insufficiently studied, in particular, the variability of pathology development depending on gender. The aim of the research was to characterize the peculiarities of the blood metabolic profile of infants at the initial stage of PEM with regard to gender. Material and methods. 38 children (20 boys, 18 girls) aged from 1 to 12 months with the degree I of PEM were examined; the comparison group consisted of 30 children (18 boys, 12 girls) aged from 2 to 12 months. Laboratory monitoring included general and biochemical blood tests with evaluation of such parameters as the content of total protein, albumin, hemoglobin, transferrin, urea, creatinine, glucose, lactate, pyruvate, triglycerides, the activity of lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, creatine phosphokinase, using hematological analyzer (MEDONIC, Boule Diagnostics AB, Japan) and biochemical analyzer (Cobas Integra 400plus, Roche Diagnostics, Switzerland). Results. In children with a mild degree of PEM the blood levels of total protein, albumin, hemoglobin, transferrin didn't differ from that in the comparison group. Against this background, there is an increase in blood serum urea level in all children and a significant increase in creatinine level, which is most pronounced in girls, in whom this indicator is 2.5 fold higher than in the comparison group and by 79% higher than in boys (p≤0.05). In combination with body weight deficiency, this characterizes the development of catabolic stress. A decrease in blood glucose level was detected in all children of the main group; a decrease in triglycerides was revealed in boys (-33%; p≤0.05) with stability of the index in girls. The increase in pyruvate blood serum level in boys (+21%; p≤0.05) with a tendency to decrease in girls is accompanied by a significant elevation in the lactate/pyruvate ratio (by 75% in boys and 3 fold in girls, p≤0.05). Conclusion. There are gender peculiarities of metabolic in children of the first year of life with a mild degree of PEM. In male children there is a decrease in the levels of glucose and triglycerides as energy substrates with the orientation to the ketosis formation. In girls, a more intense character of catabolic stress is observed with stable blood levels of triglycerides with a tendency to develop lactacidosis.

Efficiency of Platelet Transfusion in Patients with Moderate-to-Severe Chronic Kidney Disease and Thrombocytopenia.

There have been relatively few studies revealing a decreased platelet count in chronic kidney disease (CKD). Although this hematological abnormality is not as well documented as renal anemia, platelet functions are altered in the uremic environment and there is an increased risk of bleeding. The aim of this study was to assess the effectiveness of the administration of platelet concentrate in CKD based on how patient prognosis was influenced by platelet transfusion therapy. The study monitored 104 patients with CKD and thrombocytopenia who received platelet transfusion during their hospitalization in the period from 2015 to 2021. The complete blood cell count, serum urea and creatinine, and inflammatory status were tested upon admission. The number of transfused platelet units were considered for each patient. A Kruskal-Wallis H test showed that for one transfused platelet unit, the distribution of the number of platelets (×103/µL) was the same across the categories of associated diagnoses, which was seen as possible risk factors for thrombocytopenia, including liver cirrhosis and urosepsis. With a single exception, all patients exceeded the critical threshold of 20 × 103/µL and 14 patients remained under 50 × 103/µL. Even though our patients exceeded the critical threshold of platelet numbers, in patients with multiple comorbidities, severe, uncontrolled hemorrhages could not be prevented in 4.83% of cases.

Clinical picture of ankylosing spondylitis in HLA-B27 positive and negative patients

The link between the HLA-B27 gene and ankylosing spondylitis (AS) has been known for almost 50 years. During this time, it has been discovered that some of the clinical manifestations of the disease are uniformly associated with the disease in almost all populations, while the other part depends on the ethnicity of the patients. Unique associations characteristic only of certain ethnic groups are also periodically described. Objective: to analyze the clinical features of the inpatient population with AS in relation to their HLA-B27 status. Material and methods. Cross sectional study of 200 consecutive AS patients admitted to the rheumatology department of the V.A. Nasonova Research Institute of Rheumatology. All patients underwent standard clinical examination recommended for assessment of AS activity and functional status. The levels of transaminases, uric acid, urea, creatinine, interleukin (IL) 6 and IL17 in blood serum were also examined. Results and discussion. HLA-B27 was detected in 166 (83 %) of 200 patients with AS (in 89.8 % of men and in 73.2 % of women; p = 0.003). Among HLA-B27 positive patients with AS, 63.9 % were men, and among HLA-B27 negative patients, 35.3 % were men (p = 0.002). The mean age of AS onset was 5 years higher in HLA-B27-negative patients, and the disease was about 2 times less likely to occur in childhood in them. Syndesmophytes were detected in 25 % of HLA-B27 positive patients and in 15 % of patients who did not have this antigen (p &gt; 0.05). Syndesmophytes were found in 31.1 % of HLA-B27 positive and 25 % of HLA-B27 negative men. 15 % of women with HLA-B27 and 9 % of women without this antigen had syndesmophytes (p = 0.022). Inflammatory bowel disease was more common in HLA-B27-negative patients, whereas uveitis and psoriasis were less common. Activity rates and incidence of arthritis and enthesitis were similar in HLA-B27 positive and negative patients. Serum concentration of IL17 was six times higher in HLA-B27 negative patients than in HLA-B27 positive patients (p = 0.012). Conclusion. In the Russia’s AS patient population there are associations with HLA-B27, characteristic for most ethnic groups (e. g., earlier onset of the disease) and associations not found in all ethnic groups (e. g., a more severe course, a higher incidence of arthritis and enthesitis). In addition, the concentration of IL17 in the blood serum of HLA-B27 negative patients was six times higher than that of HLA-B27 positive patients. This may indicate non-canonical mechanisms of pathogenesis of AS that develop in the absence of the HLA-B27 gene, which requires further research.

Antidiabetic, Antioxidative and Antihyperlipidemic Effects of Strawberry Fruit Extract in Alloxan-Induced Diabetic Rats.

Strawberry (Fragaria × ananassa) is one of the accomplished sources of bioactive compounds, including anthocyanin, phenolic acids, flavonols, ellagitannins, and a diverse range of minerals and vitamins that can help to boost human health. This study was carried out to explore the antidiabetic, antioxidative and antihyperlipidemic potential of strawberry extracts against alloxan-induced (100 mg/kg body weight) diabetic rats. Accordingly, rats were categorized into six groups including control (G0), positive control (G1), treatment groups (G2, G3, and G4) given strawberry extract at 250, 500, and 750 mg/kg of body weight, respectively, and G5 provided metformin @70 mg/kg BW for 28 days with ad libitum diet. At the trial termination, the rats were sacrificed and were subjected to analysis including body weight, blood glucose level and glycemic indicators, antioxidant parameters, lipid profile, renal function test (RFT), liver function test (LFT) and histopathology for pancreatic tissues. The results indicated that treatment of diabetic rats with strawberry extract at 500 mg/kg body weight (BW) resulted in significant reductions in blood glucose level, serum urea, and creatinine as well as significant increases in body weight, insulin activity, and protein levels. In addition, the diabetic rats that did not receive strawberry extract (control) exhibited an increase in plasma glucose, urea, uric acid, creatinine, and a decrease in body weight and insulin levels. Briefly, it is reported that strawberry fruit extracts reduced blood sugar levels, possess hypolipidemic potential, and helped to maintain antioxidant levels in alloxan-induced diabetic rats.

Anthropometric characteristics and indicators of protein-­energy metabolism in adolescent girls with dynamic physical activity

Objective — to study the anthropometric characteristics of adolescent girls 12—18 years old, engaged in the have dynamic physical activity, and to determine the indicators of their protein-energy metabolism.&#x0D; Materials and methods. Examinations involved 37 girls aged 12—18, who were engaged in the dynamic sports 3­4 times a week for 3—8 years. The comparison group included 34 practically healthy girls of the same age with similar weight and height parameters who were physically inactive. All girls were examined by a pediatrician, an endocrinologist, a gynecologist, and a psychiatrist. The following anthropometric parameters were examined: height, body weight, shoulder width, arm length, arm span, chest girth, leg length, waist circumference, hip circumference, body mass index was calculated. The concentration of urea in blood serum was determined by the fluorometric method, the levels of creatinine, lactate, activity of lactate dehydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase and creatine kinase in the blood serum were determined by the photometric method. The blood analysis of female athletes was carried out after two days of rest after training. Statistical processing of data was carried out with the help of Exсel, SPSS, Statgrafics programs.&#x0D; Results and discussion. Low physical activity of adolescent girls was associated with a higher risk of primary dysmenorrhea (OR 3.75; CI 95 %) and the presence of gallbladder folds and deformities (OR 2.34; CI 95 %). No significant differences were revealed in the anthropometric characteristics of the girls with different physical activity. This may indicate the physiological nature of their training regime. Underweight of girls was 1.31 times more likely to be associated with sports (risk ratio (RR) 1.31; CI 95 %), and overweight was 1.45 times more common in adynamic teenagers (RR 1.45; CI 95 %). Levels of urea, creatinine, lactate, activity of ALT, LDH, creatine kinase were significantly higher in group of athletically active girls aged 12—14 than in group of inactive ones, and for athletic girls aged 15—18, the higher levels of alanine aminotransferase and lactate dehydrogenase were noticed.&#x0D; Conclusions. Engagement in the dynamic sports three times a week during 3­8 years does not lead to significant changes in the anthropometric characteristics of adolescent girls compared to physically inactive ones. Sports girls have higher levels of urea, creatinine, lactate, LDH, ALT and creatine kinase, which indicates the intensity of muscle work and the activation of protein­-energy metabolism.

#4153 OUTCOMES OF COVID-19 INFECTION AMONG MAINTENANCE HEMODIALYSIS PATIENTS – EXPERIENCE FROM THE FIRST COVID-19 HOSPITAL IN SERBIA

Abstract Background and Aims Patients on maintenance hemodialysis (HD) might be particularly vulnerable to severe COVID-19 due to their older age and numerous comorbidities. Furthermore, their specific treatment regimen substantially exposes them to the risk of infection. The abrupt onset of the novel coronavirus disease (COVID-19) pandemic required prompt action and immediate reorganization of healthcare services while maintaining the necessary standard of treatment for chronic patients. In this study, we aimed to analyze clinical features and risk factors for poor outcomes in maintenance HD patients with COVID-19. Method We analyzed data for 226 maintenance HD patients (67.7% male, age range 25 – 90 years, time on dialysis 6 – 278 months) who contracted COVID-19 in their original dialysis units and were therefore transferred for further HD treatment to the first hospital in Serbia transformed to exclusively admit COVID-19 patients at the onset of the epidemic. According to the local protocol, all patients were hospitalized while being dialyzed. Data were collected from clinical charts and patient histories for the period between March 19, 2020, and March 19, 2022, and analysed with SPSS software, version 22 (IBM Corporation, New York, USA). Results A total of 1384 HD treatments were performed in 226 patients (6.12±4.50, range 1 – 34 per patient). Most patients (98.7%) had at least one comorbidity: hypertension (68.1%), diabetes (26.1%), cardiovascular disease (16.4%), cerebrovascular disease (7.5%), malignancy (9.3%), chronic respiratory disease (4.0%) or autoimmune disease (1.8%). The average number of comorbidities was 1.9±1.0 (range 0 – 4). Only 2.2% of all patients were vaccinated. Most patients (78.0%) had bilateral pneumonia upon admission, 15.3% had normal pulmonary X-ray, 5.1% had unilateral pneumonia and 1.7% had ARDS. 34% of the patients required mechanical ventilation. Fifty-seven patients (25.2%) received corticosteroid therapy, 5.3% were treated with chloroquine, 2.7% received antiviral therapy and 1.8% were administered IL6 antagonist. The overall mortality rate was 39.4%. Patients who died were significantly older (67.6±12.4 vs 63.2±12.7; p = 0.012), more often had cardiovascular disease (p = 0.046) and bilateral pneumonia (p&amp;lt;0.001), had worse CT severity score (13.0±5.1 vs 9.2±5.0; p&amp;lt;0.001) and required invasive mechanical ventilation (p&amp;lt;0.001) and had fewer HD treatments performed during hospitalization (5.1±4.8 vs 6.8±4.2; p = 0.007). They also had significantly higher white blood cells count (8.3±5.3 vs 5.6±2.9; p&amp;lt;0.001), serum urea (24.9±12.0 vs 21.1±8.4 mmol/L; p = 0.01), LDH (119.8±95.5 vs 63.9±72.9 IU/L; p&amp;lt;0.001), CRP (157.8±239.1 vs 61.1±94.8 mg/dL; p = 0.008), IL-6 (14.9±36.0 vs 2.8±7.3 pg/mL; p = 0.004), and Ddimer (372.3±294.1 vs 240.7±101.5 ng/mL; p&amp;lt;0.001). Multiple logistic regression showed a significant association between mortality and older age (OR 1.11, 95% CI 1.04-1.18, p = 0.001), need for mechanical ventilation (OR 43.1, 95% CI 9.5-198.6; p&amp;lt;0.001), higher CT severity score (OR 1.16, 95% CI 1.07 – 1.25; p&amp;lt;0.001), fewer HD procedures performed (OR 0.80, 95% CI 0.69-0.93; p = 0.003), and higher D-dimer levels (OR 1.00, 95% CI 1.00 - 1.01; p = 0.012). Conclusion Maintenance HD patients are considered a high-risk population for contracting COVID-19 and developing a severe form of the disease. Older age, higher CT severity score

#4598 ADMINISTRATION OF ASTRAGALUS MEMBRANACEUS IMPROVES RENAL CONDITIONS AND SERUM CARNOSINE LEVELS IN AN ACUTE KIDNEY INJURY MODEL

Abstract Background and Aims Astragalus membranaceus (AM) exhibits various pharmacological effects against many diseases, including chronic kidney disease (CKD) (see http://nccih.nih.gov/health/astragalus). Acute kidney injury (AKI) is a sudden episode of kidney failure. AKI occurs frequently but is believed to heal completely and is likely an important factor causing CKD pathogenesis or progression. Previously, we demonstrated the lethal dose in old mice is 20 mg/kg cis-diamminedichloroplatinum (CDDP), and the dosage that will cause AKI in young mice is 14 mg/kg of CDDP. Low doses of CDDP caused AKI in old mice. However, the same dosage in young mice would manifest AKI that was subsequently completely reversible. On administration of AM, old mice (50 mg/kg) showed significantly improved AKI pathology, suggesting the therapeutic effect of AM is age-dependent with regard to AKI pathogenicity. Here, we further examined the possible effect of AM in preventing AKI and delaying CKD progression. Method Female C57BL/6 mice were separated into three groups based on age: young, 10 weeks; middle-aged, 35 weeks; and old, 52 weeks. The mice received oral administered of either AM powder mixed with sterilized 0.5% methylcellulose 400 (w/v) (AM group) or 0.5% methylcellulose 400 alone in the control group (CG). Four hours after most recent dose (twice a day at 20 mg/kg AM), 0.5 mg/ml CDDP (reduced dose: 14 mg/kg or 0.9% NaCl for the CG) was injected intraperitoneally. We measured blood serum urea nitrogen (BUN) and creatinine (CRE) levels, which are biomarkers of AKI. Additionally, we assessed histochemical changes in kidney sections stained with anti-CD3 and anti-CD68 antibodies after the mice were sacrificed on day x. Thereafter, serum carnosine levels in the samples collected 4 hours after AM administration (n = 6 per group) were determined using a carnosine ELISA kit (Novus, NBP2-75013). Data were analyzed statistically with PRISM software. Significance was considered P = 0.05. Results The 14 mg/kg CDDP dose in old mice significantly increased BUN and CRE levels and caused histological damage in renal tubule epithelial cells and glomeruli. However, these pathological changes were not observed in young and middle-aged mice receiving the same CDDP dose. Histochemical analysis of the old mice showed a significant increase in the number of CD3- and CD68-positive cells following AKI induction (Fig. 1). However, the increase of these inflammatory markers was clearly ameliorated by the AM pretreatment in the experimental group. Serum carnosine levels were markedly increased in young and middle-aged mice following AM administration (Fig. 2). Moreover, the serum carnosine concentration in old mice was upregulated at levels corresponding to those in young mice with AM administration. However, serum carnosine levels showed no additional increase after AM administration in old mice and remained stable. Our findings suggest that normal renal conditions show a simple upregulation of serum carnosine level after AM administration. Furthermore, AM administration improves renal conditions in old mice with high levels of CD-3 positive cells in particular (Fig. 1, arrow). Figure 2 shows the increased and then subsequent stabilizing of the serum carnosine levels (Fig. 2, arrow). Conclusion AM administration can upregulate serum carnosine in younger mice and shows at least some effectiveness in older mice, where serum carnosine is downregulated but concentrated. Serum carnosine might not be necessary for reducing the pathogenesis of AKI in younger mice, but it becomes important to prevent AKI in old mice. This indicates the effect of AM is probably age-dependent because AKI sequelae manifested spontaneously in all mice but were specifically ameliorated when administered to old mice as opposed to younger mice who recovered completely irrespective of AM administration.

Дослідження впливу аргініну глутамату на репаративні процеси у щурів з харчовою депривацією

The purpose of the study was to experimentally substantiate the feasibility of arginine glutamate using, for the correction of reparative disorders in rats with partial food deprivation. Materials and methods. The work uses such research methods as modeling of food deprivation according to a patented method, modeling a wound defect of rat’s skin, evaluating the healing of wound defects by taking pictures with a camera with a resolution of 12 megapixels and subsequent processing with a special computer program Universal desktop ruler, version 11, for determining the area, determination of integral indicators of total protein, albumin, glucose, urea in blood serum of rats by spectrophotometric methods (“Filicit-diagnostics”). Statistical processing of the obtained results was carried out using non-parametric methods of analysis (MANOVA-test) using Statistica 6.0 software. Differences at p&lt;0.05 were considered significant. Results and discussion. As a result of the food crisis, the share of hungry people in the world increases every year, and in 2022 it reached 9.8% of the world population. Starvation directly and indirectly prevents the successful healing of wounds, which is also complicated by impaired liver function. Partial food deprivation was accompanied by a violation of metabolic processes in the body of rats: a decrease in body weight (about 30%, p&lt;0.05), a probable decrease in the content of glucose (by 24.5%), total protein and albumin (by 16.1 and 26.2%, respectively, p&lt;0.05) with a simultaneous increase in the content of indicators of nitrogen metabolism in the blood. In addition, nutritionally deficient animals had a 4.7-day delay in wound healing compared to the control group. The use of arginine glutamate, in food-deprived rats caused a reduction in the wound skin defect and was accompanied by a partial normalization of metabolic processes: the total protein content and the amount of blood albumin were higher than those in the model pathology group without correction by 10.2 and 12.9%, respectively (p&lt;0.05), the glucose content increased (+12.2%); simultaneously blood urea content was lower by 25.2% (p&lt;0.05). Conclusion. The obtained data are an experimental basis for further clinical studies of the possibility of practical use of arginine glutamate in the complex treatment of patients with wound processes, especially under conditions of nutritional insufficiency

Metabolic Alterations in Acute Cerebral Ischemia.

Cerebral ischemia is a major health problem worldwide, that affects millions of people, leaving a major percentage of them with major disabilities, therefore becoming one of the most resource consuming pathology. Beside the blockage of blood supply of the brain that leads to loss of cellular function and neuronal necrosis, metabolic processes are modified in the whole body through mechanisms that are not fully explained yet. The results in the analysis of the 2 groups, one with 70 patients with stroke and another with 68 patients with no cerebral infarction, revealed that brain ischemia is more often found in patients with atrial fibrillation and higher blood pressure values. The metabolic changes, found in the stroke group, are represented by increased values of blood glucose, serum urea and lower levels of creatinine levels. Also, the value of leucocytes count and the erythrocyte sedimentation rate were shown to be increased in stroke patients, indicating that inflammation is highly present in cerebral infarction. In the regard of these findings, cerebral ischemia is associated with major systemic disruptions that could be significant pathogenic factors and also effects of the complex processes that take place in the affected brain region, but further investigation should be done in order to explain all the mechanisms involved and also the possible impact in prophylaxis and acute management of stroke.