Urea Levels Research Articles

Long-Term Survival of Patient with End-Stage Renal Disease Using Bayesian Mixture Cure Rate Frailty Models.

Along with the increasing prevalence of ESRD in developing countries, the use of more up-to-date statistical models is highly recommended. It is crucial to control potential cure pattern and heterogenicity among patients. In this longitudinal study, the data of 170 hemodialysis patients who visited the dialysis department of Shafa Hospital in Kerman from 2006 to 2016 were collected. To provides robust estimates the time to event data (death) were analyzed with a gamma frailty mixed cure Weibull model (MC-WG) using Bayesian inference. About 49% of patients experienced the death and median survival time was 37.5 months. Older patients (0.264), female patients (0.269), and patients with higher mean serum urea levels (0.186) had a higher risk of death. Moreover, we observe a decrease in death with increase in Creatine (Cr). In the MC-WG Bayesian model, the diabetes, AST, calcium, phosphorus and uric acid variables had a significant effect on the survival of hemodialysis patients, while they were not significant in the Cox PH model. The results of MC-WG Bayesian model are more consistent with other studies.

Establishment and validation of a clinical risk scoring model to predict fatal risk in SFTS hospitalized patients

BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infection with a high case fatality rate. Significant gaps remain in studies analyzing the clinical characteristics of fatal cases.MethodsFrom January 2017 to June 2023, 427 SFTS cases were included in this study. A total of 67 variables about their demographic, clinical, and laboratory data were collected. Univariate logistic regression and the least absolute shrinkage and selection operator (LASSO) method was used to screen predictors from the cohort. Multivariate logistic regression was used to identify independent predictors and nomograms were developed. Calibration, decision curves and area under the curve (AUC) were used to assess model performance.ResultsThe multivariate logistic regression analysis screened out the four most significant factors, including age > 70 years (p = 0.001, OR = 2.516, 95% CI 1.452–4.360), elevated serum PT (p < 0.001, OR = 1.383, 95% CI 1.143–1.673), high viral load (p < 0. 001, OR = 1.496, 95% CI 1.290–1.735) and high level of serum urea (> 8.0 μmol/L) (p < 0.001, OR = 4.433, 95% CI 1.888–10.409). The AUC of the nomogram based on these four factors was 0.813 (95% CI, 0.758–0.868). The bootstrap resampling internal validation model performed well, and decision curve analysis indicated a high net benefit.ConclusionsThe nomogram based on age, elevated PT, high serum urea level, and high viral load can be used to help early identification of SFTS patients at risk of fatality.

Urea Concentration Detection in Milk Using Microscopic Image Processing Algorithm under Ultraviolet Light Approach

The adulteration of milk is a pressing concern for the citizens of India and people all around the globe. Due to a lack of regulation compliance and insufficient surveillance infrastructure, it is noticeably worse in emerging and slow-growing nations. One of the most common and dangerous adulterants in milk is urea. If the permissible quantity of urea in milk is surpassed, it could have a major negative impact on people's health. All existing methods of urea detection require time, expertise, costly chemicals, and enzymes, along with exorbitant instruments and instrument-specific expertise. The key to overcoming this challenge is having the infrastructure to detect adulterated milk. This study aims to identify a cost- effective and largely implementable system for quantitative detection of urea content to identify adulterated milk primarily for milk distribution centers in India. The proposed milk adulteration detection system, dubbed the MADS, entails a cost-effective, rapid, accurate, precise, and completely novel method for the quantitative computation of urea levels in adulterated milk. It is a device that detects the concentration of particles of urea in milk using a microscopic image processing algorithm under ultraviolet light. Using ultraviolet light and a proprietary program in Python, the isolation of the urea particle from the rest of the milk solids is done and the area concentration, as an average of the value calculated in each of the frames of the video captured through the microscopic camera, is computed. This gives the final urea concentration in milk, which can be used to check whether the concentration follows the government guidelines and exceeds the legal limit.

Protective Role of Ovothiol-A against Muscle and Kidney Injuries in Obese Rats

Background: Obesity is a serious chronic metabolic disease impairing health damaging many organs such as kidneys and muscles. Ovothiol-A (Ovo-A) has been found to keep the redox balance normal in sea urchins indicating its antioxidant characteristics. Aim: This study aims to investigate the protective effects of Ovo-A on kidneys and muscles in obese rats. objective: Investigation of the protective effect of Ovo-A on kidneys and muscles in obese rats. Methods: In-silco studies were performed on lactate dehydrogenase (LDH) and creatine kinase (CK) with Ovo-A to compute their binding affinities. Obesity was induced by high-fat diet (HFD) for 4 weeks. Wistar rats were used in this study as 6 rats per group as control, HFD, Ovo-A (200 and 400 mg/Kg, p.o) groups. Results: Docking results have revealed that Ovo-A has affinities to bind to LDH (-8.5 kcal/mol) and CK (-17.7 kcal/mol). Ovo-A reduced the levels of uric acid, urea, creatinine, LDH, CK, malondialdehyde (MDA), and nitric oxide (NO), while increasing the levels of glutathione (GSH), catalase (CAT), and glutathione-S-transferase (GST). Histopathological investigations have revealed that Ovo-A restored the renal and muscular structure. Conclusion: The current study showed that Ovo-A has a protective effect on kidneys and muscles in obese rats. Ovo-A enhances renal and muscular functions by inhibiting LDH and CK activities and improving the antioxidant system. Ovo-A is more effective in the high dose.

Utilization of the dialysate to characterize dialysis adequacy by using microwave urea biosensor based on complementary split-ring resonator (CSRR)

The aim of this study is going to develop a monitoring approach for measuring blood urea concentration. This method uses microwave technology and complementary split-ring resonator (CSRR) to assess dialysis adequacy. The robust electric field near CSRR sides produces a high-sensitivity surface to a change in the nearby urea level. The proposed biosensor detection range spans from 1 to 100 mg/dL by modifying resonance frequency and peak attenuation. The biosensor was developed to operate at the main resonance frequency of 2.4 GHz, but all harmonics within the frequency range of 1–10 GHz were analyzed. A container incorporates the dialysate as the material being tested on the top of the sensor. Accurate measurement of blood urea variations using spent dialysate compared to the blood-based method has benefits due primarily to the lack of repetitive blood sampling. The innovative biosensor offers a non-invasive and convenient method to accurately evaluate the quantitative urea concentration in spent dialysate without the necessity of disposable chemicals. The biosensor has been designed to possess noteworthy attributes such as detecting minuscule concentration variations, low-cost fabrication, compact size, high sensitivity, and its ability to provide real-time results. By merging these features, the sensor demonstrates remarkable potential for non-invasively monitoring blood urea levels while seamlessly integrating with other dialysis devices. The initiative purpose of this study is going to offer renal patients methods for assessing dialysis adequacy with minimal impact on human health.

Punica granatum L. peel extract protects diabetic nephropathy by activating the Nrf-2/HO-1 pathway.

Diabetes raises cardiovascular morbidity and mortality worldwide and causes retinopathy, neuropathy, and nephropathy. Punica granatum L. (Pomegranate) is a fruit that has been used for its medicinal properties in various cultures. This article aims to investigate the antioxidant, anti-inflammatory, anti-apoptotic activity of Punica granatum L. peel ethanol extract (PGE) and its efficacy on NF-κB and Nrf-2/HO-1 signaling pathways in kidney tissue of rats with streptozotocin-induced diabetes. Single dose STZ 60mg/kg/i.p. rats were given to induce diabetes and blood glucose measurements were taken 7 days later. PGE 10mg/kg/p.o. administered to the treatment groups for 20 days. Blood, kidney, and pancreas samples taken from anesthetized rats were analyzed biochemically and histopathologically. It was observed that STZ increased the levels of urea, uric acid and creatine in the blood, while PGE significantly decreased these parameters. The diabetic group had higher MDA and lower renal tissue GSH level, CAT, GPx, and SOD activity than the control group. STZ also enhanced inflammation, apoptosis, Bax, Caspase-3, and NF-κB expression, and decreased Bcl-2, HO-1, and Nrf-2 expression. Experimental results showed that PGE has the potential to alleviate the harmful effects on the kidney and pancreas by altering the mentioned parameters in diabetic rats.

Evaluation of probiotic efficacy of indigenous yeast strain, Saccharomyces cerevisiae Y-89 isolated from a traditional fermented beverage of West Bengal, India having protective effect against DSS-induced colitis in experimental mice.

Increasing awareness regarding health promotion and disease prevention has driven inclusion of fermented foods and beverages in the daily diet. These are the enormous sources of beneficial microbes, probiotics. This study aims to isolate yeast strains having probiotic potential and effectivity against colitis. Initially, ninety-two yeast strains were isolated from Haria, an ethnic fermented beverage of West Bengal, India. Primary screening was done by their acid (pH 4) and bile salt (0.3%) tolerance ability. Four potent isolates were selected and found effective against Entamoeba histolytica, as this human pathogen is responsible to cause colitis. They were identified as Saccharomyces cerevisiae. They showed luxurious growth even at 37 oC, tolerance up to 5% of NaCl, resistance to gastric juice and high bile salt (2.0%) and oro-gastrointestinal transit tolerance. They exhibited good auto-aggregation and co-aggregation ability and strong hydrophobicity. Finally, heat map and principal component analysis revealed that strain Y-89 was the best candidate. It was further characterised and found to have significant protective effects against DSS-induced colitis in experimental mice model. It includes improvement in colon length, body weight and organ indices; reduction in disease activity index; reduction in cholesterol, LDL, SGPT, SGOT, urea and creatinine levels; improvement in HDL, ALP, total protein and albumin levels; decrease in coliform count and restoration of tissue damage. This study demonstrates that the S. cerevisiae strain Y-89 possesses remarkable probiotic traits and can be used as a potential bio-therapeutic candidate for the prevention of colitis.

Agronomic responses and economic returns from wheat–canola rotation under Humalite and urea applications

AbstractHumalite is a humic acid‐rich biostimulant known for its ability to improve plant agronomic parameters and increase crop nitrogen use. Limited field research exists on Humalite effect, its application rate, and its interaction with urea, especially at reduced rates on grain agronomic parameters. Therefore, a field study was conducted from 2021 to 2023 at three Alberta sites—Battle River Research Group (BRRG), Gateway Research Organization (GRO), and St. Albert Research Station (St. Albert), in a split‐plot design with four replications, three urea levels (i.e., recommended, half‐recommend, and zero urea) combined with five Humalite rates (0, 56 (or 112), 224, 448, and 896 kg ha−1). In 2021, the highest wheat yields were observed at half urea rates plus 224 kg ha−1 at BRRG (35% yield increase), GRO (8.4% yield increase), and St. Albert (33.5% yield increase). In 2022, canola yields were unaffected by Humalite application rates. In 2023, wheat yields from half‐recommended and recommended urea rates plots outperformed zero urea plots across all sites, regardless of Humalite rates. The highest wheat grain protein content values were observed at 224–448 kg ha−1 of Humalite plus half‐recommended or recommended urea rate. Depending on the site, the highest net revenue resulted from half urea rates plus Humalite at application rates between 112 and 448 kg ha−1 in wheat, that is, optimal Humalite rate for increased profitability. Therefore, the incorporation of biostimulants such as Humalite can reduce urea use and contribute to the sustainability of wheat cropping systems.

Assessment of Biochemical Potential of Rhizopus oligosporus as Starter Culture to Enhance the Nutritional Value of Palm Kernel Cake for Animal Feed Formulation

The objective of this study was to assess the biochemical potential of Rhizopus oligosporus as a starter culture to enhance the nutritional value of palm kernel cake (PKC) for animal feed formulation using appropriate standard methods. Among the experimental groups, the batch of birds fed with solid-state fermented PKC as a 50% maize replacement showed a noteworthy weight gain (p &lt; 0.05) in relation to the control group, while the other experimental groups exhibited a weight loss. Serum levels of ALT, AST, ALP, creatinine, and blood urea did not show a notable difference from the reference group and those on the experimental diets. These findings collectively suggest that the pre-treatment of PKC using R. oligosporus holds the potential to elevate its nutritional quality for utilization in animal feed applications.

Evaluation of Thyroid Hormone, Fibroblast Growth Factor 23 and Cystatin C Concentrations in Patients with Chronic Kidney Disease

The age of 20-≤71years old. Also, in the current study, 30 healthy people were taken as a control group. Findings of the current study revealed substantial variations between chronic kidney disease (CKD) levels. The results of the current study demonstrated significant differences in s. urea between studied groups. Whereas, s. urea levels in CKD patients (107.42±8.52), were demonstrated a significant (P≤0.05) elevated in compared to a control (19.35± 2.16). while, creatinine levels in CKD patients (6.81± 0.55) demonstrated a significant (P≤0.05) elevated in compared to a control (0.84± 0.19). T3 levels in the end stage (5.17± 0.14) indicated a significant (P≤0.05) reduced than in other CDK stages and control group (6.34±0.28). T4 levels in the end stage (7.17±0.14) were significantly lower (P≤0.05) than in other CDK stages and control group (10.44±0.31). Thyroid-stimulating hormone (TSH) levels in the end stage (2.83±0.12) increased significantly (P≤0.05) compared to other CDK stages and control group (1.52±0.24). In contrast, fibroblast growth factor 23 (FGF-23) levels in the end stage (184.03±17.31) increased significantly (P≤0.05) as compared to other CDK stages and control group (5.16±0.45). Cystatin C level in CKD patients (17.11±1.94) was demonstrated a significant (P≤0.05) elevated in compared to a control (8.04±0.37). It is concluded from the study that CKD patients suffer from hypothyroidism based on hormone concentrations. The study also revealed a negative correlation between FGF-23 and Cystatin C levels with eGFR in CKD patients.

Prevalence and Awareness on Diabetes and Risk Factors for Developing Diabetic Retinopathy Among Patients Attending Eye OPD: A Cross Sectional Pilot Study

Background: Diabetes mellitus is a major public health problem worldwide. Diabetic patients may suffer from many complications including diabetic retinopathy, which may lead to blindness. Early identification and increasing the level of awareness regarding diabetes and diabetic retinopathy among individuals helps in reducing burden on healthcare and economic worldwide. The management of diabetes poses a challenge to the medical and nursing staff as well as to the patients themselves9. Objective: To assess the Prevalence and Awareness on Diabetes and Risk Factors for Developing Diabetic Retinopathy among patients attending Eye OPD. Materials and methods: A quantitative research approach with Hospital based cross sectional descriptive research design was used in this study. 125 patients were selected using convenient sampling technique and who fulfill the inclusion criteria of the study. Data was collected using self-reporting questionnaires for demographic variables, IDRS to Assess Prevalence of Risk For Diabetes, Clinical And Behavioral Data To identify various Risk Factor For Developing Diabetic Retinopathy and Structured Awareness Questionnaire For DM and DR. Data was analyzed using descriptive and inferential statistics. Results: A total of 125 patients have given their consent and they were approached. The majority of participant were age group of 51-60 i.e. 41(32.8%) and 67(53.6%) were female. 94(75.2%) were Hindu and 87(69.6%) were belongs to nuclear family. A majority of the participant 92(73.6%) were married and 41(32.8%) are illiterate. Majority’s 57(45.6%) family income is between Rs 11837 – 17755 and 82(65.6%) were Unemployed whereas 102(81.6%) were Non-Vegetarian in their dietary habits. Of the 125 patients, 69(55.2%) were moderate risk for DM among which 52(41.6%) of patients were known case of DM. Study finding shows that Risk factors for developing diabetes retinopathy were history of diabetes with duration of 5 years or less and with type II DM, Physical Inactivity, history of cataract surgery, On insulin/Oral diabetic treatment, tobacco consumption, RBS (101-200mg/dl), level of cholesterol(200- 239 mg/dl) and urea level (26-35mg/dl). 83(66.4%) of participant had moderate awareness regarding DM and DR. Study findings also shown that there is a significant association between awareness with age, marital status, education, family income, knowledge on diabetic eye and frequency of eye check up. Study findings showed that there is a significant association between awareness with gender, religion, type of family, marital status and education were found significant at p&lt;0.05 Conclusion: A majority of the participant had moderate risk for DM as well as also had moderate awareness regarding DM. Health Education and promotion will also help to increase awareness regarding Diabetes in the country.

Dose-response curves for the effects of Lactobacillus plantarum on growth performance, feed utilization, and health status of Litopenaeus vannamei shrimp. Optimizing the economic efficiency of supplementation

Abstract A 14-weeks feeding trial was conducted to employ polynomial regression analysis to establish the optimal dosage of Lactobacillus plantarum (Lac) for enhancing the growth performance, digestive enzyme activities, and blood biochemical, redox balance, and immunity response of Litopenaeus vannamei shrimp (initial body weight = 2.94 ± 0.03 g). A total of 240 healthy Litopenaeus vannamei shrimp were randomly distributed into four equal groups and were fed diets containing 0, 200, 400 and 800 mg Lac /kg diet respectively for 98 days. Increasing the levels of dietary Lac cubically improved growth performance and feed utilization ( p &lt;0.01), the optimal doses were established at 600 and 650 mg Lac/kg diet, respectively. Muscles thickness decreased significantly in all treated group compared to the control ( p &lt;0.05). The dietary treatment quadratic ally affected total protein ( p &lt;0.0001), tri-glycerides ( p &lt;0.0001), and cortisol ( p =0.0097), the optimal responses were observed at 650, 700, and 600 mg Lac/kg diet, respectively. Meanwhile the activities of liver enzymes (ALT and AST), the levels of blood urea and digestive enzymes (amylase and proteases) were cubically enhanced by the treatment, the optimal dosages were at 600 and 650 mg Lac/kg diet for liver enzymes, and urea concentration, respectively and at 650 and 700 mg Lac/kg diet for the activities of amylase and protease, respectively. With regards to redox balance, increasing the levels of Lac caused a quadratic decrease in the levels of malondialdehyde ( p =0.0398) and a cubic increase in the activities of superoxide dismutase ( p =0.0265), and catalase ( p =0.0163), the corresponding dose–response curves showed that the optimal dose was at 650 mg/kg diet. However, the levels of total antioxidant capacity were in a quadratic increase ( p =0.0372), maximizing at a level of 600 mg Lac / kg diet. Concerning the immunity response, both of lysozyme and IgM significantly affected by the dietary treatment ( p =0.0002 and 0.0001, respectively), maximizing at 600 and 650 mg Lac/kg diet, respectively. Dietary supplementation of Lac had significant and substantial impacts on the economic efficiency ( p &lt;0.0001). In conclusion, the dietary inclusion of 600-700 mg Lac /kg diet can be used as an effective and practical feeding strategy to enhanced growth performance, feed efficacy, redox balance and nonspecific immune responses in Litopenaeus vannamei shrimp.

Особливості перебігу хронічної хвороби нирок у пацієнтів з артеріальною гіпертензією, цукровим діабетом та хронічним гломерулонефритом

Chronic kidney disease (CKD), especially its terminal stage, is a serious problem in modern medicine. There are certain features of the course of CKD in patients with arterial hypertension (AH), diabetes mellitus (DM), and chronic glomerulonephritis (CGN). The purpose of the study was to study the course of CKD against the background of hypertension, diabetes and chronic hypertension based on clinical and laboratory examination data to assess the severity of the patients' condition. Materials and methods. 86 patients with stage V chronic renal failure (CKD) were examined, who were divided into 3 groups depending on the existing concomitant disease. Group 1 (n – 35) included patients with CKD and hypertension, group 2 (n – 28) – patients with CKD and diabetes, and group 3 (n – 23) – patients with CKD and CGN. Anthropometric, general clinical, laboratory and instrumental research methods were performed on all patients. Research results and their discussion. Analyzing the data of a general blood test, 100 % of patients in all three groups had a decrease in hemoglobin and erythrocyte levels. A significant decrease in the level of albumin (p &lt; 0.05) and an increase in the levels of urea (p &lt; 0.001) and creatinine (p &lt; 0.001) were also found, which indicated a pronounced decrease in kidney function and significant kidney damage. Analyzing the results of the ionic composition of the blood, a significant increase in the levels of phosphorus and parathyroid hormone was found in patients of the III group (CNN and CGN). Conclusions: 1. In all groups of patients with CKD of the V degree in combination with concomitant hypertension, diabetes mellitus or CGN, persistent anemia was noted, which was manifested by a progressive drop in hemoglobin to the levels of 86.22 ± 3.61 g/l, 83.89 ± 3.06 g/l and 83.22 ± 3.49 g/l, respectively. 2. In such patients, a pronounced decrease in kidney function was noted, which was manifested by a delay in the release of the products of protein metabolism from the blood due to a decrease in the levels of albumin (p &lt; 0.05), a significant increase in the levels of urea (p &lt; 0.001), creatinine (p &lt; 0.001) and a decrease glomerular filtration rate. 3. In the group of patients with a combination of CKD stage V and CGN, a significant increase in phosphorus and parathyroid hormone levels was found (p &lt; 0.01). Such an increase in the level of parathyroid hormone in blood serum may be associated with a drop in the level of calcium in the blood of such patients and the subsequent progressive increase in the level of inorganic phosphate and the development of hyperphosphatemia.

Plasma activated water effects on behavior, performance, carcass quality, biochemical changes, and histopathological alterations in quail

BackgroundPlasma-activated water (PAW) is an innovative promising technology which could be applied to improve poultry health. The current study investigated the effects of drinking water supply with PAW on quail behaviour, performance, biochemical parameters, carcass quality, intestinal microbial populations, and internal organs histopathology. A total of 54 twenty-one-day-old Japanese quail chicks were randomly allotted to three treatments provided with PAW at doses 0, 1 ml (PAW-1), and 2 ml (PAW-2) per one litter drinking water. Each treatment contained 6 replicates (3 birds/ cage; one male and two females).ResultsThe results clarified that there were no significant (P > 0.05) changes in behaviour, and performance. For the biochemical indicators, the PAW-1 group showed significantly higher serum H2O2, total protein and globulin levels compared with the other groups (P = 0.015, < 0.001, and 0.019; respectively). PAW groups had significantly lower serum creatinine and urea levels than the control (P = 0.003). For the carcass quality, the internal organs relative weight between different treatments was not changed. In contrast, there was a significant increase in the meat colour, taste, and overall acceptance scores in PAW groups compared with the control one (P = 0.013, 0.001, and < 0.001; respectively). For the intestinal microbial population, lactobacilli count was significantly higher in PAW-2 compared with the control group (P = 0.014), while there were no changes in the total bacterial count between different treatment groups. Moreover, mild histological changes were recorded in the intestine, liver, and spleen of PAW groups especially PAW-2 compared with the control one.ConclusionsPAW offered benefits, such as reducing creatine and urea levels, improving meat characteristics, and increasing lactobacilli count, all of which are crucial for sustainable quail farming. Therefore, further research is needed.

Pomegranate juice recuperates N’-Nitrosodiethylamine-induced kidney injury: evidence from biochemical and histological approaches

BackgroundPomegranate is considered as one of the oldest elixirs having various properties. Renal fibrosis is a preliminary sign of pathological degradation in most ailments related to kidney. Several efforts have been made for the discovery of cost-effective and safe therapeutics for the alleviation of renal diseases. There is a major dearth of studies on the action of pomegranate juice (PGJ) against NDEA-instigated kidney injury. This study investigates the protective and antifibrotic action of PGJ in restricting the occurrence of experimental renal fibrosis in Wistar rats. Renal injury was generated by a single intraperitoneal dose of 10 ml kg−1 b.wt. (1% NDEA stock), while fresh PGJ (i.p.) in doses of 2 ml kg−1 b.wt was administered thrice a week on alternate days for two weeks to observe amelioration. The renal function indices (blood urea, creatinine, and uric acid), SOD, CAT, LPO levels and renal anatomy (H&E, MT, Picrosirius and SEM) were investigated.ResultsThe assessment of renal function demonstrates augmented levels of blood urea, creatinine and uric acid in NDEA-administered groups in comparison with controls. SOD, CAT declined significantly in NDEA Day-7- and Day-14-treated animals, while the MDA levels raised by ~ 70.5% and ~ 76.3% in these groups, respectively. However, supplementation of PGJ provided recuperation from these elevated levels in injured groups. H&E staining of the controls exhibited normal renal structure with intact glomerulus and Bowman’s capsule, while NDEA generated congestion of glomerular tuft, convoluted tubules with cloudy swelling and multiple subsidence of the renal tissue. Noticeable presence of collagen fibers in the interstitium of cortex region of kidney was observed by MT staining along with gross ultrastructural deterioration in NDEA-administered animals by electron microscopy. PGJ supplementation exhibited restoration of renal anatomy and physiology.ConclusionsPomegranate may be considered as a potent nutraceutical to prevent NDEA-induced renal damage and may be included as a daily dietary supplement.

The Effect of Deep Breathing Exercise Therapy Combination of Aromatherapy Based on Orem's Self Care Theory on Fatigue and Sleep Quality in Chronic Kidney Disease Patients Hemodialysis

Patients hemodialysis with experience complaints of anemia, fatigue, sleep disturbances, and increased urea levels. Fatigue and sleep disorders are still a high problem in Indonesia. Increased urea levels can cause decreased appetite, poor nutritional intake and complaints of fatigue. The aim of the research was to analyze the effect of deep breathing exercise therapy combined with Orem self-care based aromatherapy on fatigue levels and sleep quality. The design in this research is quasi-experimental. Population of all hemodialysis patients at RSI Jemursari Surabaya. The sample size was 40 people, divided into 2 groups, namely the intervention group and the control group. The sampling technique was taken using a total sampling technique. Data were analyzed using the independent t-test a &lt; 0.05 and looking at the difference in values using the delta test. The results of research conducted at RSI Jemursari Surabaya, showed that the average fatigue score in the intervention group before giving deep breathing exercise therapy, a combination of aromatherapy based on self-care Orem, was 36.90 and after being given the intervention, it was found to decrease by 15.90, while the control group did not. given any therapy, according to hospital standards of 34.65 and experienced a decrease of 19.65. Based on the independent t - test, it shows p = 0.003 and sleep quality shows p = 0.001, which means that deep breathing exercise therapy combined with aromatherapy based on Orem self-care has an effect on fatigue and sleep quality. Deep breathing exercise therapy a combination of aromatherapy based on Self-Care Orem according to standards, can reduce fatigue levels and improve sleep quality.

TOXICITY TEST OF KELAKAI LEAF EXTRACT (Stenochlaena palustris) TOWARD WISTAR RAT KIDNEY (Rattus norvegicus)

Background: Excessive free radicals cause oxidative stress which is dangerous for the body. The number of free radicals in the body can be controlled with the presence of antioxidants. Kelakai leaves (Stenochlaena palustris.) are known to have activity as an antioxidant which has the potential to become an ingredient in herbal medicine. Purpose: To prove whether there is a toxic effect of administering kelakai leaf extract on the kidneys of Wistar rats based on analysis of blood urea and creatinine levels. Method: A pure experimental study with a posttest-only with control group design method, there were 4 groups consisting of 1 negative control group and 3 treatment groups who were given kelakai leaf extract orally for 28 days and then analyzed the blood urea and creatinine levels of the Wistar rats. Results: The average values of urea and creatinine levels in the three treatment groups were still within the normal range. There was a significant difference in the urea levels of all groups (p&lt;0.05), and there was no significant difference in the creatinine levels of treatment groups 2 and 3 (p&gt;0.05). Conclusion: Kelakai leaf extract given orally for 28 days did not cause toxic effects on the kidneys of Wistar rats based on analysis of blood urea and creatinine levels.

Non-targeted metabolomics analysis of fermented traditional Chinese medicine and its impact on growth performance, serum biochemistry, and intestinal microbiome of weaned lambs

Fermented traditional Chinese medicines (TCMs) have been identified as a low-cost and promising feed additive to to alleviate weaning stress in young livestock and poultry effectively. This study investigated the impact of probiotic fermentation on the metabolite content of BanQi (Radix Isatidis and Astragalus membranaceus) extract while also examined the effects of both fermented-BanQi (FBQ) and unfermented-BanQi (UBQ) on growth performance, serum biochemistry, intestinal villi, and gut microbiota in weaned lambs. This study demonstrated that compared with UBQ, FBQ contained significantly higher levels of free amino acids (e.g., phenylalanine and isoleucine), short peptides (e.g., Val–Leu–Pro–Val–Pro–Gln and Gly–Leu), and the active ingredients (e.g., vindesine and reserpine) (P < 0.05). The addition of FBQ to the diet significantly increased the final body weight and average daily gain of weaned lambs (P < 0.05). In addition, FBQ significantly increased the total protein level in the serum and the villus length of the jejunum and ileum in lambs, while significantly reduced the levels of aspartate aminotransferase (AST) and urea (P < 0.05). Sequencing of the intestinal flora showed that FBQ improved the diversity of intestinal flora and promoted the enrichment of beneficial bacteria in the lamb intestine, such as Mogibacterium and Butyrivibrio, compared to NC or UBQ groups (P < 0.05). Fermentation with Bacillus subtilis can enhance the content of free amino acids, peptides, and active ingredients in BanQi extract, making it an effective method to improve the efficacy of traditional Chinese medicine. Adding FBQ to the diet can improve the growth performance of weaned lambs, and its mechanism may be related to increasing the height of intestinal villi and increasing the diversity of intestinal flora.

Correlation between salivary and serum biomarkers of kidney function in chronic kidney disease patients attending the nephrology clinics at Teaching Hospital Karapitiya, Sri Lanka

The present study was designed to determine the correlation between salivary and serum levels of creatinine and urea in patients with chronic kidney disease (CKD) and to propose the use of saliva as an alternative medium for the analysis of biochemical parameters of kidney function. Accordingly, an analytical cross-sectional study was carried out using 100 CKD patients attending the Nephrology Clinics at Teaching Hospital Karapitiya, Sri Lanka. Saliva and serum samples were collected from the patients for the estimation of creatinine and urea using spectrophotometric assay kits. Of the total, the majority of the patients were found within CKD stage 3 (82%). The salivary and serum concentrations of creatinine varied within the range of 0.20 - 2.10 mg/dL and 1.54 – 11.6 mg/dL, whereas the salivary and serum concentrations of urea varied within the range of 68.04 – 127.59 mg/dL and 60.14 – 168.25 mg/dL respectively within the study population. Significant positive correlations were observed between the salivary and serum concentrations of creatinine (r= 0.985, p=0.01), and urea (r= 0.942, p=0.01), and between salivary concentrations of creatinine and urea (r=0.887, p=0.01). A significant difference was observed in the salivary biomarkers between mild to moderate stages of CKD patients and severe to end-stage CKD patients. No significant association was observed in the salivary markers with the age and sex of the patients. The area under curve values in the receiver operating characteristic analysis was&gt;0.9 (95% CI). These findings revealed high levels of diagnostic accuracy in salivary biomarkers suggesting the potential use of saliva for the assessment of kidney function in CKD patients.

Impacts of gentamycin toxicity: nephroprotective role of guarana through different signaling pathways.

Gentamicin is a widely used aminoglycosidic antibiotic since its discovery. Like any other medication gentamicin causes unwanted side effects such as hepatotoxicity and nephrotoxicity. This study aims to examine the antioxidant effect of the guarana seed extract in protecting renal tissue. Forty male mice were divided into four groups (group one was control with free access to food and water, group two was treated orally with 300mg/kg of guarana seed extract daily, group three was injected intraperitoneally with 100mg/kg of gentamicin daily and the fourth group was co-treated with both 300mg/kg of guarana seed extract orally and injected intraperitoneally with 100mg/kg of gentamicin daily) for two weeks. Serum levels of urea, creatinine, AST, ALT, IL-1β and IL-6 have significantly elevated in the gentamicin treated group and those changes were not found in the guarana co-treated group. In gentamicin treated mice, a significant reduction was observed in two antioxidants SOD and GPX accompanied by downregulation of Ho-1 and Nrf2 while, that did not happen in the guarana seed extract co-treated group. Histopathology and immunohistochemistry slides show that the guarana seed extract prevents degenerative and necrotic events in tubular epithelial tissues caused by gentamicin toxicity. In conclusion, current data suggest that gentamicin can damage renal tissues when given at 100mg/kg/day, however, the guarana seed extract may be capable of preventing that event when cotreated with the gentamicin as a supplement.