Urinary Creatinine Levels Research Articles

Change in ratio levels of KIM-1 / urine creatinine and increase serum creatinine levels in human immunodeficiency virus (HIV) patients receiving tenofovir-based antiretroviral (ARV) combination therapy

Background: Human immunodeficiency virus (HIV)-associated nephropathy refers to developing kidney disease associated with HIV infection. Tenofovir is associated with an increased risk of acute kidney injury (AKI). Kidney injury molecule-1 (KIM-1) in urine is very specific for kidney injury. This study aimed to determine the changes in the ratio between the levels of KIM-1/urine creatinine and the increase in serum creatinine levels with the incidence of decreased kidney function in people with HIV. Method: This was an observational-analytic study. Subjects were taken using consecutive sampling at Sanglah Hospital Denpasar in 2018. KIM-1 levels were measured by the ELISA method. Results: This study involved 35 patients (21 males and 14 females) with a mean age of 34.89 ± 10.05 years old. The average levels of KIM-1/urine creatinine at 0 hours was 11.039 ± 12.175 ng/ml), KIM-1/urine creatinine at 12 was 12.382 ± 14.671 ng/ml), KIM-1/urine creatinine at 72 was 10.272 ± 11.843 ng/ml). There were no statistically significant differences in the ratio of hours 0 to 12 hours (p = 0.295), and between hours 0-72 (p = 0.413). But there was a significant difference in creatinine levels for 3 months with the initial mean serum (0.848 ± 0.201) and 3 months of evaluation (1.002 ± 0.198) (p = <0.001). Conclusion: There was no difference in the ratio of changes in serum KIM-1/creatinine levels during the evaluation of 0, 12, and 72 hours. However, there was an increase in serum creatinine levels between the beginning and 3 months of evaluation.

Analysis of cadmium accumulation in community adults and its correlation with low-grade albuminuria

ObjectiveTo investigate the effects of chronic non-occupational exposure to cadmium (Cd) on renal injury in residents living in the urban areas of China. MethodsIn this cross-sectional study, we recruited 1000 participants in Shanghai from August 2015 to August 2017 and collected data on their socio-demographic characteristics, lifetime occupation, and lifestyle factors. The urinary Cd, urinary albumin, urinary creatinine, serum creatinine, urea, and uric acid levels were tested, and 683 participants completed those measurements. ResultsThe median urinary Cd concentration of this study population was 0.77 μg/g. The urinary Cd concentration was significantly higher in the female, older, and lower body mass index populations. There were 148 participants with dominant albuminuria who had higher urinary Cd levels than those without dominant albuminuria (0.98 vs. 0.72 μg/g; P < 0.001). Among participants without dominant albuminuria, there were 134 participants with low-grade albuminuria (13.84 ≤ ACR < 30 mg/g) and 401 participants who had normal urinary albumin excretion (ACR < 13.84 mg/g). Compared with those who had normal urinary albumin excretion, those with low-grade albuminuria had significantly higher urinary Cd levels (0.83 vs. 0.69 μg/g; P < 0.001). Among those without dominant albuminuria, participants in the highest quartile of urinary Cd were more likely to have low-grade albuminuria than those in the lowest quartile (Odd's ratio = 2.98; P < 0.001). Further adjustment for age, sex, and BMI or other potential confounding factors did not change the magnitudes of the associations. Moreover, we conducted multivariable stepwise linear regression analysis within 134 low-grade albuminuria participants and demonstrated that urinary Cd concentration (P < 0.001) were independent determinants of urine albumin after adjusting for relevant confounders. ConclusionThe urinary Cd levels observed in Chinese urban adults are substantial and associated with an increased risk of low-grade albuminuria. Our findings suggest that potential sources of environmental Cd exposure should be explored, and the associated renal toxicity should be studied in more detail in future.

The ameliorative effect of kaempferol against CdCl2- mediated renal damage entails activation of Nrf2 and inhibition of NF-kB.

This study evaluated the nephroprotective effect of kaempferol against cadmium chloride (CdCl2) -induced nephropathy in rats. It also investigated if activation of Nrf2 is a common mechanism of action. Adult male rats ((150 ± 15g) were divided into 4 groups (n = 8/each) as a control (1% DMSO, orally), control + kaempferol (200mg/kg, orally), CdCl2 (50mg/l in drinking water), and CdCl2 + kaempferol (200mg/kg)-treated rats. All treatments were conducted for 8weeks. Kaempferol significantly attenuated CdCl2-induced weight loss, reduction in kidney weights, and the injury in the glomeruli, proximal tubules, and distal tubules in the treated rats. It also significantly lowered serum levels of urea and creatinine, increased urine output and urinary creatinine levels and clearance but reduced urinary levels of albumin urinary albumin exertion (UAER), and urinary albumin/creatinine ratio (UACR) in these rats. In parallel, kaempferol downregulated renal levels of cleaved caspase-3 and Bax and unregulated those of Bcl2. In the kidney tissues of the control animals and CdCl2 rats, kaempferol significantly attenuated oxidative stress, inflammation and significantly boosted levels of manganese superoxide dismutase and glutathione. Also, and in both groups, kaempferol suppressed the nuclear levels of NF-κB p65, downregulated Keap1, and stimulated the nuclear activation and protein levels of Nrf2. In conclusion, kaempferol is a potential therapeutic drug to prevent CdCl2-induced nephropathy due to its anti-inflammatory and anti-oxidant effects mediated by suppressing NF- NF-κB p65 and transactivating Nrf2.

Evaluation of the prognostic value of urinary creatinine levelin patients hospitalized with the diagnosis ofchronic systolic heart failure in Seyed Al-Shohada Hospitalin Urmia, Iran

— Introduction: Heart failure patients have frequent hospitalization leading to decreased quality of life and life expectancy. The purpose of this study was to evaluate the prognostic value of urinary creatinine test in immunecompromised patients with systolic heart failure. Material and methods: This tudy was counducted on 122 patients hospitalized in Urmia. The inclusion criterion was according to cardiac EF obtained from echocardiography and patients with EF less than 45% were considered. In the morning, urine samples were taken from them and the amount of urinary creatinine and other parameters were registered. Results: According to the Pearson correlation test, there was no significant relationship between body weight, height, and body mass index with urinary creatinine, but there was no significant relationship between urinary creatinine and serum creatinine (p&gt;0.05). There is a positive and significant relationship between urinary creatinine level and GFR. There is also a significant relationship between diastolic blood pressure and urinary creatinine. Conclusion: The results of the present study indicate the importance of paying attention to urinary creatinine as an effective underlying factor in predicting the symptoms of heart failure.

Botanical from the Fruits Mesocarp of Raphia vinifera Displays Antiproliferative Activity and Is Harmless as Evidenced by Toxicological Assessments.

Raphia vinifera is widely used to treat several diseases including digestive disorders, dysentery, and genitourinary infections. In this study, the mineral contents, the cytotoxicity, and the toxicological effect of the crude CHCl3/MeOH extract (RVM) from the mesocarp of Raphia vinifera were evaluated. The mineral contents were evaluated using the method described by the Association of Official Analytical Chemists (AOAC). The cytotoxicity of both extract and chemical compounds from the plants was determined by a resazurin reduction assay (RRA). The toxicological studies were carried out using the experimental procedure of the Organization for Economic Cooperation and Development (OECD). After killing the rats, biochemical, histopathological, and hematological studies were performed. The result indicated that RVM is rich in zinc (6.52 mg/100 g of DM) and sodium (194.5 mg/100 g of DM). RVM had a cytotoxicity effect with IC50 values lower than 30 μg/mL in 18/18 cancer cell lines tested. These recorded IC50 values were between 12.35 µg/mL (toward CCRF-CEM leukemia cells) and 26.66 µg/mL (toward SKMel-505 BRAF wild-type melanoma cells). Raphvinin 4 displayed good cytotoxicity against MaMel-80aBRAF-V600E homozygous mutant with the IC50 of 10.42 μM. RVM was relatively nontoxic to rats, the median lethal dose (DL50) being above 5000 mg/kg body weight. However, during the oral administration period extending for 28 days, precautions should be taken due to the increase in urinary creatinine level and decrease in spleen weight in the male rats given the highest dose (1000 mg/kg) of extract. Conclusively, the extract of Raphia vinifera is weakly toxic in rats and could be further used in the development of anticancer phytomedicines.

The Association of Urine Creatinine With Kidney Stone Prevalence in US Adults: Data From NHANES 2009-2018.

BackgroundThe primary objective of this project is to explore the association of urine creatinine (UCR) with the prevalence rate of kidney stones.MethodThe National Health and Nutrition Examination Survey (NHANES) database was employed to conduct a cross-sectional study. The analysis samples included adults aged ≥20 years from five consecutive cycles of the NHANES 2009–2018. The association between UCR and kidney stones was detected using univariate and multivariate logistic regression analyses. Further, subgroup analyses were performed to evaluate the subgroup effects.ResultsAfter adjustment for all confounders, multiple logistic regression analysis revealed a weak positive relationship between UCR and kidney stone (OR = 1.015, 95% CI: 1.008–1.021). In the subgroup analysis stratified by sex, age, or race, the risk further increased in men (OR = 1.014, 95% CI: 1.005–1.023), women (OR = 1.015, 95% CI: 1.005–1.025), white race (OR = 1.022, 95% CI: 1.013–1.030), aged 40–59 years (OR = 1.017, 95% CI: 1.006–1.028), and aged 60–80 years (OR = 1.017, 95% CI: 1.006–1.028).ConclusionsOur results confirmed a moderately increased risk of kidney stone formation attributed to high levels of UCR, especially in middle-aged and older adults and the white race. However, because of the cross-sectional design of the study, causal inferences cannot be made.

The association of arterial stiffness with estimated excretion levels of urinary sodium and potassium and their ratio in Chinese adults.

Arterial stiffness is an independent cardiovascular risk factor. However, the association between sodium/potassium intake and arterial stiffness in the Chinese population is unclear. Therefore, we performed a large, community-based cross-sectional study to reach a more definitive conclusion. The study was conducted at the Third Xiangya Hospital in Changsha between August 2017 and September 2019. Urinary sodium, potassium, and creatinine levels were tested from spot urine samples during physical examinations of each recruited participant. The 24-hour estimated urinary sodium excretion (eUNaE) and estimated urinary potassium excretion (eUKE) levels were calculated using the Kawasaki formula (used as a surrogate for intake). The brachial-ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) were measured using an automatic waveform analyzer. In 22,557 subjects with an average age of 49.3 ± 10.3 years, the relationships of the ABI and baPWV with the levels of eUNaE, eUKE and the ratio of sodium to potassium (Na/K ratio) were analyzed. A significant negative relationship was found between the eUKE and baPWV levels (β = 2.41, p < 0.01), whereas the Na/K ratio was positively associated with baPWV (β = 2.46, p < 0.01), especially in the overweight and hypertensive populations (both pinteraction = 0.04). The association of eUNaE quartiles with baPWV presented a J-shaped curve after adjusting for confounders. In addition, a positive association was observed between the Na/K ratio and the ABI (β = 0.002, p < 0.01). In this study, high potassium and/or low sodium intake was further confirmed to be related to vascular stiffness in Chinese individuals.

Quantification of Fetal Renal Function Using Fetal Urine Production Rate and Its Reflection on the Amniotic and Fetal Creatinine Levels During Pregnancy.

Adequate prediction of fetal exposure of drugs excreted by the kidney requires the incorporation of time-varying renal function parameters into a pharmacokinetic model. Published data on measurements of fetal urinary production rate (FUPR) and creatinine at various gestational ages were collected and integrated for prediction of the fetal glomerular filtration rate (GFR). The predicted GFR values were then compared to neonatal values recorded at birth. Collected data for FUPR across different gestational ages using both 3D (N = 517) and 2D (N = 845) ultrasound methods showed that 2D techniques yield significantly lower estimates of FUPR than 3D (p < 0.0001). A power law function was shown to best capture the change in FUPR with fetal age (FA) for both 2D (); and 3D () data. The predicted FUPR based on the observed 3D data was shown to be strongly linearly related (R2 = 0.95) to measured values of amniotic creatinine concentration (N = 664). The FUPR3D data together with creatinine levels in the fetal urine and serum resulted in median predicted fetal GFR values of 0.47, 1.2, 2.5, and 4.9 ml/min at 23, 28, 33, and 38 weeks of fetal age (50% CV), respectively. These values are in good agreement with neonatal values observed immediately at birth. The derived FUPR and creatinine functions can be utilized to assess fetal renal maturation and predict fetal renal clearance.

Renoprotective potential of myo-inositol on diabetic kidney disease: Focus on therole of the PINK1/Parkin pathway and mitophagy receptors.

Recent studies have emphasized the role of mitochondria in renal function as well as in renal injury. Poor mitochondrial quality control mechanisms including mitochondrial fusion, fission and mitophagy are major contributors for progression of diabetic renal injury. The current study is aimed to evaluate the protective role of myo-inositol (MI) against diabetic nephropathy (DN) by utilizing high glucose exposed NRK 52E cell and streptozotocin (STZ) induced DN model. MI supplementation (at doses 37.5and 75 mg/kg) ameliorated albuminuria and enhanced the renal function as indicated significant improvement in urinary creatinine and urea levels. On the other hand, the western blot analysis of both in vitro and in vivo studies has revealed poor mitophagy in renal cells which was reversed upon myo-inositol treatment. Apart from targeting the canonical PINK1/Parkin pathway, we also focused on the role mitophagy receptors prohibitin (PHB) and NIP3-like protein (NIX). A significant reduction in expression of NIX and PHB2 was observed in renal tissue of diabetic control rats and high glucose exposed NRK 52E cells. Myo-inositol treatment resulted in positive modulation of PINK1/Parkin pathway as well as PHB2 and NIX. Myo-inositol also enhanced the mitochondrial biogenesis in renal tissue of diabetic rat by upregulating Nrf2/SIRT1/PGC-1α axis. The current study thus underlines the renoprotective effect myo-inositol, upregulation of mitophagy proteins and mitochondrial biogenesis upon myo-inositol treatment.

Renal Parameters in Mild, Moderate, and Chronic Cigarette Smokers

Objective: To explore the link between cigarette smoking and kidney function through renal parameter assessment. Methods: The present study was performed at the Department of Biochemistry Santosh Medical College, Ghaziabad, India, from September 2019 to April 2021. In this study, 140 subjects were included, out of which 35 were non-smokers, 35 smoked &lt;5 cigarette per day, 35 smoked 5-10 cigarette per day, and the remaining 35 smoked more than 10 cigarettes per day. Results: Blood urea, serum creatinine, urinary albumin, and uACR levels were found to increase significantly (p&lt;0.001) in smokers as compared to non-smokers. These increases were higher among chronic cigarette smokers (p&lt;0.001) as opposed to mild and moderate smokers. In contrast, serum uric acid, e-GFR, and urinary creatinine levels decreased significantly (p&lt;0.001) in smokers when compared to non-smokers, with a higher decrease observed in chronic cigarette smokers (p&lt;0.001) as opposed to the mild and moderate cigarette smokers. Conclusion: Alterations in urinary albumin, serum urea, serum creatinine, urinary creatinine, and e-GFR are associated with the risk of renal dysfunction.

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

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

Extract of Corallodiscus flabellata attenuates renal fibrosis in SAMP8 mice via the Wnt/\u03b2-catenin/RAS signaling pathway

BackgroundFibrosis is one of the most common pathological features of the aging process of the kidney, and fibrosis in aging kidneys also aggravates the process of chronic kidney disease (CKD). Corallodiscus flabellata B. L. Burtt (C. flabellata, CF) is a commonly used botanical drug in Chinese folklore. However, few studies have reported its pharmacological effects. This study aimed to explore the effect of CF ethanol extract on renal fibrosis in SAMP8 mice and identify potentially active compounds.MethodsSenescence-accelerated mouse-prone 8 (SAMP8) were used as animal models, and different doses of CF were given by gavage for one month. To observe the degree of renal aging in mice using β-galactosidase staining. Masson staining and the expression levels of Col-I, α-SMA, and FN were used to evaluate the renal fibrosis in mice. The protein expression levels of Nrf2 pathway and Wnt/β-catenin/RAS pathway in the kidney were measured. And β-galactosidase (β-gal) induced NRK-52E cells as an in vitro model to screen the active components of CF.ResultsThe CF ethanol extract significantly inhibited the activity of renal β-galactosidase and the expression levels of Col-I, α-SMA, and FN in SAMP8 mice, and improved Masson staining in SAMP8 mice. CF remarkably reduced urinary protein, creatinine, urea nitrogen and serum levels of TNF-α and IL-1β in SAMP8 mice, and significantly increased the levels of SOD and GSH-Px. Moreover, CF activated the Nrf2 pathway and blocked the Wnt/β-catenin/RAS pathway in the kidneys of mice. Besides, 3,4-dihydroxyphenylethanol (SDC-0-14, 16) and (3,4-dihydroxyphenylethanol-8-O-[4-O-trans-caffeoyl-β-D-apiofuranosyl-(1→3)-β-D-glucopyranosyl (1→6)]-β-D-glucopyranoside (SDC-1-8) were isolated from CF, which reduced the senescence of NRK-52E cells, and maybe the active ingredients of CF playing the anti-aging role.ConclusionsOur experiments illuminated that CF ethanol extract may ameliorate renal fibrosis in SAMP8 mice via the Wnt/β-catenin/RAS pathway. And SDC-0-14,16 and SDC-1-8 may be the material basis for CF to exert anti-renal senescence-related effects.

Beneficial effect of trimetazidine on folic acid-induced acute kidney injury in mice: Role of HIF-1α/HO-1.

Acute kidney injury (AKI) is a complex syndrome associated with a decrease in renal function and a significant impact on patient outcomes. Injection of folic acid (FA) in mice is used for studying the pathogenesis of AKI. This study investigated the impact of trimetazidine (a metabolic modulator-antianginal drug; TMZ), against FA-induced AKI.AKI was induced by FA (250 mg/kg, ip) in mice. Two doses of TMZ were administered orally for 10 days.Administration of TMZ at a high dose (20 mg/kg) exhibited significant decreases in the renal somatic index (RSI), serum levels of lactate dehydrogenase (LDH), creatinine (Cr), blood urea nitrogen (1), and proteins level in urine. Moreover, TMZ significantly increased creatinine clearance (CCr), serum albumin, urine creatinine, and urine urea levels. This improvement in markers of kidney damage was associated with marked renal antioxidant effects (↓NO and ↓lipid peroxidation, normalized reduced glutathione (GSH) level and superoxide dismutase (SOD) activity, and increased HIF-1α/HO-1 level). Furthermore, TMZ significantly decreased FA-induced expression of MPO and inflammatory cytokine IL-18, TNF-α, and NF-κB p65 subunit. Renal apoptosis, along with apoptotic markers, were enhanced by FA injection and suppressed by TMZ administration (↓Caspase-3, ↓Bax, and ↑Bcl2 expression). Finally, TMZ amended FA-induced histopathological changes in kidneys.By mitigating functional alteration, oxidative stress, and preventing the development of inflammatory and apoptosis signals, TMZ provides dose-dependent defense against FA-induced AKI mainly via stimulation of hypoxia-inducible factor-1 alpha (HIF-1α)/heme oxygenase-1 (HO-1) pathway.

Investigation of angiotensin-1 converting enzyme 2 gene (G8790A) polymorphism in patients of type 2 diabetes mellitus with diabetic nephropathy in Pakistani population.

BackgroundType 2 diabetes mellitus is a multifactorial disease that escalates the risk of other associated complications such as diabetic neuropathy, retinopathy, and nephropathy. Diabetic nephropathy is a microvascular condition that leads to end-stage renal disease (ESRD). There are several genes involved in disease development and it is a challenging task to investigate all of these. Nonetheless, identifying individual gene roles can assist in evaluating the combinatorial effects with other genes. Angiotensin-1 converting enzyme 2 (ACE2), is the key regulator of blood pressure in the Renin-Angiotensin-Aldosterone System that hydrolyzes angiotensin II (vasoconstrictor) into angiotensin 1–7 (vasodilator). The association of different variants of the ACE2 with the risk of type 2 diabetes mellitus has been determined in various populations with susceptibility to other complications. This study was aimed to investigate the association of Angiotensin-1 converting enzyme 2 polymorphism, G8790A, with the increased risk of type 2 diabetes mellitus (T2DM) development with the complication of diabetic nephropathy (DN) in the Pakistani population.MethodsIn this case-control study, a total of 100 healthy controls and 100 patients of type 2 diabetes mellitus aged > 40 years, having disease duration ≥ 10 years were compared. The G8790A polymorphism in ACE2 was analyzed by allele-specific polymerase chain reaction (AS-PCR). The urinary albumin excretion (UAE), urinary creatinine, and albumin to creatinine ratios (ACR) were determined to assess renal function status. Pearson bivariate correlation coefficients were calculated to investigate the relationship among all the parameters. Crude and adjusted odds ratios were found to determine any risk association between ACE2 G8790A polymorphisms and disease development. The p-values < 0.05 were considered significant.ResultsA homogeneity was obtained regarding the distribution of data by sex, BMI, diastolic blood pressure, pulse rate and urinary creatinine levels between case and control groups. The ACR showed a significant correlation with UAE (r = 0.524, p = 0.001), urinary creatinine (r = -0.375, p = 0.001) and random blood sugar levels (r = 0.323, p = 0.005) with the complication of diabetic nephropathy in T2DM patient. Females with the AA genotype had a 10-fold increased risk for the development of type 2 Diabetes (OR = 9.5 [95% CI = 2.00–21.63] p<0.002). Males having A allele showed a significant association for susceptibility of type 2 Diabetes (OR = 3.807 [95% CI = 1.657–8.747] p<0.002). However, none of the genotypes or alleles revealed an association for diabetic nephropathy in male and female patients. Urinary ACR was also found to be positively correlated with UAE (r = 0.642 p = 0.001 & 0.524, p = 0.001) and random blood sugar levels (r = 0.302, p = 0.002 & r = 0.323, p = 0.005) in T2DM and T2DM+DN groups, respectively.ConclusionThe study finding indicated that female AG/AA genotype and male A genotype of G8790A polymorphism in the ACE2 gene were associated with type 2 diabetes mellitus as a genetic risk factor but are not associated with diabetic nephropathy in the Pakistani population.

Interactions between nocturnal melatonin secretion, metabolism, and sleeping behavior in adolescents with obesity

Background/objectivesSleeping behavior and individual prospensity in sleep timing during a 24 h period, known as chronotypes, are underestimated factors, which may favor the development of obesity and metabolic diseases. Furthermore, melatonin is known to play an important role in circadian rhythm, but was also suggested to directly influence metabolism and bodyweight regulation. Since disturbed and shifted sleep rhythms have been observed in adolescents with obesity, this study aimed to investigate potential interactions between melatonin secretion, chronobiology, and metabolism. In addition, the influence of artificial light especially emitted by electronic devices on these parameters was of further interest.Subjects/methodsWe performed a cross-sectional study including 149 adolescents (mean age 14.7 ± 2.1 years) with obesity. Metabolic blood parameters (e.g., cholesterol, triglycerides, uric acid, and insulin) were obtained from patients and correlated with nocturnal melatonin secretion. Melatonin secretion was determined by measuring 6-sulfatoxymelatonin (MT6s), the major metabolite of melatonin in the first-morning urine, and normalized to urinary creatinine levels to account for the urinary concentration. Chronobiologic parameters were further assessed using the Munich ChronoType Questionnaire.ResultsSubjects with insulin resistance (n = 101) showed significantly lower nocturnal melatonin levels compared to those with unimpaired insulin secretion (p = 0.006). Furthermore, triglyceride (p = 0.012) and elevated uric acid levels (p = 0.029) showed significant associations with melatonin secretion. Patients with late chronotype showed a higher incidence of insulin resistance (p = 0.018). Moreover, late chronotype and social jetlag were associated with the time and duration of media consumption.ConclusionWe identified an association of impaired energy metabolism and lower nocturnal melatonin secretion in addition to late chronotype and increased social jetlag (misalignment of biological and social clocks) in adolescents with obesity. This might point towards a crucial role of chronotype and melatonin secretion as risk factors for the development of pediatric and adolescent obesity.

Urinary neutrophil gelatinase-associated lipocalin might be an associated marker for anticipating scar formation in children with vesicoureteral reflux

Introduction: Vesicoureteral reflux (VUR) is considered as the most common urogenital abnormality occurring in children. There is no reliable and routine clinical test that is non-invasive and rapid for recognizing the renal scars from VUR. Objectives: Urine neutrophil gelatinase-associated lipocalin (uNGAL) can be the best indicator for early diagnosis of scar formation in children with VUR. Patients and Methods: Children with primary VUR admitted to Hamadan’s Besat hospital from March to December 2020 were included in this cross-sectional study. A dimercaptosuccinic acid (DMSA) scan was employed to assess all subjects in order to diagnose scar formation at least 180 days after the last episode of urinary tract infection (UTI). Additionally, uNGAL and its ratio to urine creatinine (uCr) levels were measured. Results: During the study, all 63 cases (male/female, 13.50) with VUR were included for further evaluation. The mean age of the patients was 59.1 ± 34.7 months (range 2 to 132 months). Twelve subjects suffered from unilateral VUR, while bilateral VUR inflicted 51. According to the disease severity, nine patients had mild, 35 had moderate, and 19 had a severe form of VUR. No significant difference was observed between patients with (n = 31) and without (n = 32) renal scars regarding mean levels of the uNGAL and uNGAL/uCR ratios (P&gt;0.05). Conclusion: We found no significant difference between the groups with and without the renal scar in terms of biomarker levels.

CoTe nanorods based electrochemical sensor for quantitative detection of albumin from chronic kidney disease patients

• Highly selective electrochemical sensing of albumin by CoTe nanorods. • LOD and LOQ of CoTe-GCE for albumin is 0.09 nM and 0.003 nM, respectively. • Stability of CoTe-GCE upto 100 cycles of cyclic voltammetry. • CoTe-GCE quantifies albumin from urine samples of chronic kidney disease (CKD) patients. • Statistical modelling of urine albumin reveals positive relation with ACR and negative with urine creatinine. Electrochemical sensing monitors the levels of biomolecules and is specific, rapid, low cost, and automated. An electrical stimulus given to biological system helps in detecting electrical response through oxidation–reduction peaks in a cyclic voltammogram (CV). Herein, an electrochemical sensor based on CoTe nanorods is developed for albumin sensing. Sensing parameters such as scan rate, pH, concentration, and effect of interferences are optimized. Linearity, detection and quantification limits for CoTe modified glassy carbon electrode (CoTe-GCE) are 0.961 nM, 0.09 nM and 0.003 nM respectively. The stability of designed sensor is measured by running 100 cycles of CV. CoTe-GCE quantifies albumin from urine samples of chronic kidney disease (CKD) patients. Normal distribution of data (albumin, albumin to creatinine ratio (ACR), and creatinine) is found out by Shapiro-Wilk test. The correlation of urine albumin by Pearson’s correlation analysis reveals positive relation with ACR (P = 0.000, r = 0.043*) and negative with urine creatinine (p = 0.003, r = -0.141*). Using CoTe-GCE electrochemical sensor, albumin and creatinine levels in urine can be used as prognostic factors in CKD patients before disease progresses to end-stage renal disease (ESRD).

Maslinic acid activates renal AMPK/SIRT1 signaling pathway and protects against diabetic nephropathy in mice

BackgroundDiabetic nephropathy has been a devastating complication. Clinically, there is an urgent need for nephroprotective agents to delay the onset of diabetic nephropathy and ameliorate its symptoms. Maslinic acid is a pentacyclic triterpene acid with protective effect on multiple organs against oxidative stress and inflammation. In this research, we hypothesized that maslinic acid protects renal function against diabetic nephropathy.MethodsC57BL/6 J male mice administrated with 50 mg/kg of Streptozocin (STZ) daily were used to establish diabetic mouse model (blood glucose levels > 300 mg/dL). Urinary levels of albumin, total proteins, and creatinine were analyzed by an automatic analyzer. H&E staining was used to evaluate renal damage. qRT-PCR and ELISA were performed to investigate the inflammation and oxidative stress in renal tissues. Western blot was used to assess the activation of AMPK signaling.ResultsMaslinic acid treatment alleviated the loss of body weight and blood glucose in diabetic mice. Renal structure and function were protected by maslinic acid in diabetic mice. 20 mg/kg maslinic acid treatment for 8 weeks significantly alleviated the oxidative stress and inflammation in the kidney of diabetic rats. Maslinic acid treatment activated the renal AMPK/SIRT1 signaling pathway.ConclusionMaslinic acid ameliorates diabetic nephropathy and activates the renal AMPK/SIRT1 signaling pathway.

Negatively interactive effect of chromium and cadmium on obesity: Evidence from adults living near ferrochromium factory

BackgroundResearchers have reported that chromium (Cr) exposure may be associated with metabolism of glucose and lipids in residents living in a long-term Cr polluted area. Previous statistical analysis is mainly focused on individual chromium exposure. Furtherly, we aim to investigated the independent, combined, and interaction effects of the co-exposure of urine Cr (UCr) with cadmium (UCd), lead (UPb) and manganese (UMn) on body mass index (BMI), waist circumference, and the risk of overweight and abdominal obesity. MethodWe enrolled 1187 participants from annual surveys between 2017 and 2019. Heavy metal concentrations in urine were standardized using covariate-adjusted urine creatinine levels. Multiple linear/logistic regression models were applied to measure the single effect of urine heavy metal concentration on the outcomes. The quantile-based g-computation (g-comp) model was used to evaluate the combined effect of metal mixture on the outcomes and to compare the contribution of each metal. Both additive and multiplicative interactions were measured for UCr with UCd, UPb, UMn on the outcomes. Analysis was performed on the overall population and stratified by smoking habit. ResultsFor the overall study population, UCr was positively associated with BMI (p trend = 0.023) and waist circumference (p trend = 0.018). For smoking participants, the g-comp model demonstrated that the metal mixture was negatively associated with BMI, with UCr and UCd contributing the most in the positive and negative direction. A negative additive interaction was observed between UCr and UCd on BMI and abdominal obesity. We did not observe a significant interaction effect of UCr with UPb or UMn. ConclusionOur study indicated that Cr and Cd exposure may be associated with BMI and waist circumference, with combined and interaction effects of the heavy metals noted. Further epidemiological and experimental researches could simultaneously consider single and complex mixed exposure to verify the findings and biological mechanisms.

Mitigation of dexamethasone-induced nephrotoxicity by modulating the activity of adrenergic receptors: Implication of Wnt/β-arrestin2/β-catenin pathway

The present study aimed to investigate the role of α and β-adrenergic receptors (βARs) in mediation or modulation of the dexamethasone-induced nephrotoxicity by using different pharmacological interventions. Nephrotoxicity was induced by subcutaneous injection of dexamethasone (10 mg/kg) for 7 days in Wistar albino rats. Eight groups were used: control; dexamethasone; carvedilol; phenylephrine; carvedilol and phenylephrine; propranolol; doxazosin; propranolol and doxazosin. At the end of experiment, rats were euthanized and blood, urine and kidney samples were collected. Serum and urinary creatinine and urinary total protein levels were measured. Also, the renal tissue levels of diacylglycerol (DAG); Akt kinase activity, malondialdehyde (MDA), NADPH oxidase 2 (NOX2), transforming growth factor-β (TGF-β), Wnt3A and β-catenin were recorded. Furthermore, histopathological and β-arrestin2-immunohistochemical examinations of renal tissues were performed. Results: Dexamethasone induced glomerular damage, proteinuria, renal oxidative stress and upregulated the renal Wnt/β-arrestin2/β-catenin pathway and the profibrotic signals. Blocking the α1 and βARs by carvedilol reduced the dexamethasone-induced nephrotoxicity. Pre-injection of phenylephrine did not reduce the reno-protective action of carvedilol. Blocking the βARs only by propranolol reduced the dexamethasone-induced nephrotoxicity to the same extent of carvedilol group. Blocking the α1ARs only by doxazosin reduced dexamethasone-induced nephrotoxicity to a higher extent than other treatments. However, combined use of propranolol and doxazosin did not synergize the reno-protective effects of doxazosin. Conclusion: Dexamethasone induces nephrotoxicity, possibly, by upregulating the Wnt/β-arrestin2/β-catenin pathway. Blocking either α1ARs or βARs can effectively protect against the dexamethasone-induced nephrotoxicity. However, combined blocking of α1ARs and βARs does not synergize the reno-protective effects.