Urinary Urea Excretion Research Articles

Variações diárias nas excreções de creatinina e derivados de purinas em novilhas

Objetivou-se avaliar as variações nas excreções diárias de creatinina e de uréia na urina utilizando coletas durante seis dias consecutivos em novilhas de origem leiteira; avaliou-se também o efeito da duração do período de coleta sobre a estimativa da produção microbiana obtida a partir dos derivados de purinas na urina. Utilizaram-se onze novilhas de grau de sangue predominantemente Holandês, com 287 ± 49 kg, considerando o grupo de animais como amostra aleatória simples da população. Para comparação entre dias de coletas, empregou-se análise de variância como ferramenta para isolamento do erro puro, adotando-se modelo constituído pelo efeito aleatório de animal e pelo efeito fixo de dia de avaliação. O volumoso foi constituído de silagem de milho fornecida à vontade. Diariamente, foram fornecidos 2,0 kg de concentrado por animal. O período experimental teve duração de seis dias, pois os animais já estavam adaptados à dieta. As coletas de urina foram realizadas utilizando-se sondas de Folley nº 22 ou 26, sendo determinado o volume urinário diário. As excreções urinárias de creatinina, uréia, alantoína, ácido úrico e derivados de purinas totais não foram afetadas pelos dias de coleta de urina. Do mesmo modo, a quantidade estimada de proteína microbiana não diferiu entre os dias de coleta de urina. O valor médio para a excreção de creatinina foi de 30,5 mg/kgPV, 124,84 mg/kg0,75 ou 1,1 mmol/kg0,75. A ausência de efeito de número de dias sobre a excreção de creatinina tem grande aplicação prática, pois, além de reduzir o trabalho com tempos longos de coleta, permite a redução dos custos da pesquisa, podendo ser recomendadas coletas de urina com duração de 24 horas.

Effects of Cortisol on Carbohydrate, Lipid, and Protein Metabolism: Studies of Acute Cortisol Withdrawal in Adrenocortical Failure

Cortisol is an important catabolic hormone, but little is known about the metabolic effects of acute cortisol deficiency. The objective of the study was to test whether clinical symptoms of weight loss, fatigue, and hypoglycemia could be explained by altered energy expenditure, protein metabolism, and insulin sensitivity during cortisol withdrawal in adrenocortical failure. We studied seven women after 24-h cortisol withdrawal and during replacement control during a 3-h basal period and a 3-h glucose clamp. Cortisol withdrawal generated cortisol levels close to zero, a 10% decrease in basal energy expenditure, increased TSH and T(3) levels, and increased glucose oxidation. Whole-body glucose and phenylalanine turnover were unaltered, but forearm phenylalanine turnover was increased. During the clamp glucose, infusion rates rose by 70%, glucose oxidation rates increased, and endogenous glucose production decreased. Urinary urea excretion decreased by 40% over the 6-h study period. Cortisol withdrawal increased insulin sensitivity in terms of increased glucose oxidation and decreased endogenous glucose production; this may induce hypoglycemia in adrenocortical failure. Energy expenditure and urea loss decreased, indicating that weight and muscle loss in Addison's disease is caused by other mechanisms, such as decreased appetite. Increased muscle protein breakdown may amplify the loss of muscle protein.

Differing urinary urea excretion among children with idiopathic hypercalciuria and/or hyperuricosuria

Objective To estimate dietary protein intake in children with idiopathic hypercalciuria (HC) and/or hyperuricosuria (HU). Patients and methods We compared the 24-h urinary excretion of urea, as a reflection of protein intake, in four age- and sex-matched groups, each comprising 56 consecutive children: (1) HC, (2) HU, (3) HC + HU and (4) control. Results Urinary urea excretion was significantly higher in HC, HU and HC + HU than in controls. HC and HU children had similar urea excretion. HC + HU children had urinary urea significantly higher than HC and HU, but urinary calcium similar to HC and urinary uric acid excretion similar to HU subjects. Urinary calcium was significantly ( R 2 = 0.21) correlated with urea excretion in HC children only, whereas urinary uric acid was significantly ( R 2 = 0.21) correlated with urinary urea in HU children only. No significant correlation between urinary urea and calcium or uric acid excretion was found in HC + HU patients although they had the highest urinary urea. A significant ( p = 0.004) interaction between urinary urea and sodium in increasing urinary calcium excretion resulted only in the HC group. Conclusion The association of dietary protein excess with HC and/or HU is conditioned by an individual (genetic?) predisposition and may be produced by different mechanisms.

Urea metabolism in beef steers grazing Bermudagrass, Caucasian bluestem, or gamagrass pastures varying in plant morphology, protein content, and protein composition1,2,3,4

Pastures of Bermudagrass (Cynodon dactylon, BG), Caucasian bluestem (Bothriochloa caucasica, CBS), and gamagrass (Tripsacum dactyloides, GG) were evaluated from the perspectives of forage composition, selection during grazing, and N metabolism in beef steers. All pastures were fertilized with 78 kg/ha of N approximately 60 and 30 d before sample collection. In 2000 and 2001, 12 steers (250 kg of BW) were blocked based on BW and then assigned randomly to a replicated, randomized complete block design, with 2 pastures of each forage and 2 steers per pasture. Three other steers with esophageal fistulas were used to collect masticate samples to represent intake preferences. Herbage mass was >1,900 kg/ha. After at least 14 d of adaptation, urine and blood samples were collected for determination of serum urea N and percentage of urinary N in the form of urea. One steer per pasture (6 steers per year) was infused i.v. with (15,15)N urea for 50 h before collecting urine for 6 h to measure urea N enrichment, urea entry rate, urinary urea excretion, gut urea recycling, and return of urea N to the ornithine cycle. The canopy leaf:stem DM ratio differed (P = 0.01) among BG (0.50), CBS (1.01), and GG (4.00). Caucasian bluestem had less CP (% of DM) than GG or BG in the canopy (9.6 vs. 12.0 or 12.3, P = 0.07) and in the masticate (9.8 vs. 14.7 or 13.9, P = 0.04). Bermudagrass had less true protein (% of CP) than CBS or GG in the canopy (72.9 vs. 83.3 or 83.0, P = 0.07) and in the masticate (73.7 vs. 85.8 or 88.0, P = 0.04). Compared with GG and BG, CBS had less serum urea N (10.1 or 12.2 vs. 2.5 mM, P = 0.01), urea entry rate (353 or 391 vs. 209 mmol of N/h, P = 0.07), and urinary urea excretion (105 or 95 vs. 18 mmol of N/h, P = 0.04), and a greater return of urea N to the ornithine cycle as a proportion of gut urea recycling (0.109 or 0.118 vs. 0.231, P = 0.02). Urea production and recycling in these steers responded more to the N concentration in the grasses than to differences in plant protein fractions. There was no evidence of improved N capture by the steers due to changes in the leaf:stem ratio among the grasses at the herbage mass evaluated.

Effects of Different Protein Supplements on Milk Production and Nutrient Utilization in Lactating Dairy Cows

Sixteen (8 ruminally cannulated) multiparous and 8 primiparous lactating Holstein cows were used in 6 replicated 4×4 Latin squares to test the effects of feeding supplemental protein as urea, solvent soybean meal (SSBM), cottonseed meal (CSM), or canola meal (CM) on milk production, nutrient utilization, and ruminal metabolism. All diets contained (% of DM) 21% alfalfa silage and 35% corn silage plus 1) 2% urea plus 41% high-moisture shelled corn (HMSC), 2) 12% SSBM plus 31% HMSC, 3) 14% CSM plus 29% HMSC, or 4) 16% CM plus 27% HMSC. Crude protein was equal across diets, averaging 16.6%. Intake and production were substantially reduced, and milk urea, blood urea, and ruminal ammonia were increased on urea vs. the diets supplemented with true protein. Although intake was lower in cows fed SSBM compared with CM, no differences were observed for milk yield among SSBM, CSM, and CM. Yields of fat and protein both were lower on CSM than on CM, whereas SSBM was intermediate. Milk urea and milk protein contents also decreased when CSM replaced SSBM or CM. Diet did not affect ruminal volatile fatty acids except that isobutyrate concentration was lowest on urea, intermediate on CSM, and greatest on SSBM and CM. Urinary excretion of urea N and total N was greatest on urea, intermediate on SSBM and CM, and lowest on CSM. Apparent N efficiency (milk N/N intake) was lower on the CSM diet than on the SSBM diet. Overall, production and N utilization were compromised when the diets of high-yielding dairy cows were supplemented with urea rather than true protein and the value of the true proteins, from most to least effective, was in the order CM > SSBM > CSM.

An NMR-based metabonomic investigation on effects of milk and meat protein diets given to 8-year-old boys

The objective of the study was to investigate the ability of an NMR-based metabonomic approach, applied to biofluids, to explore and identify overall exogenous and endogenous biochemical effects of a short-time high intake of milk protein or meat protein given to prepubertal children, the aim being to compare relative differences and not an absolute quantification. A total of twenty-four 8-year-old boys were asked to take 53 g protein as milk (n 12) or meat daily (n 12). At baseline and after 7 d, urine and serum samples were collected and high-resolution 1H NMR spectra were acquired on these using a 800 MHz spectrometer. The milk diet reduced the urinary excretion of hippurate, while the meat diet increased the urinary excretion of creatine, histidine and urea. The NMR measurements on serum revealed minor changes in the lipid profile, which most probably should be ascribed to an increase in the content of SCFA in the blood after consumption of the milk diet. The meat diet had no effect on the metabolic profile of serum. The study for the first time demonstrates the capability of proton NMR-based metabonomics to identify the overall biochemical effects of consumption of different animal proteins. The urine metabolite profile is more susceptible to perturbations as a result of short diet interventions than the serum metabolite profile. The milk diet-induced reduction in urinary excretion of hippurate suggests alterations in gut microflora, which may be useful information for further studies elucidating the effects of bioactive components in milk.

Gluconeogenic Substrates and Hepatic Gluconeogenic Enzymes in Streptozotocin-Diabetic Rats: Effect of Mulberry (Morus indicaL.) Leaves

Mulberry (Morus indica L.) leaves, the sole food of the silk worm, were evaluated for antidiabetic effects in streptozotocin (STZ)-diabetic rats. Treatment with dried mulberry leaf powder at 25% of the diet for a period of 8 weeks was found to be remarkably beneficial to STZ-diabetic rats as evidenced by controlled hyperglycemia and glycosuria. In addition, mulberry leaves countered (reversed) the alterations in gluconeogenic substrates in STZ-diabetic rats as indicated by significant reduction in serum pyruvic and lactic acid levels, a significant increase in proteins and a significant decrease in free amino acid, urea, and creatinine levels in blood, and a decreased urinary excretion of urea and creatinine. Anomalies in the activities of hepatic gluconeogenic enzymes associated with impaired glucose homeostasis in STZ-diabetic rats were ameliorated by feeding the mulberry leaf-supplemented diet, indicating that control over hyperglycemia and associated complications in the diabetic state by mulberry leaves is by way of regulation of gluconeogenesis. With respect to all the parameters, mulberry leaves were more effective than the oral hypoglycemic drug glibenclamide.

Substituição do milho pela casca de café ou de soja em dietas para vacas leiteiras: comportamento ingestivo, concentração de nitrogênio uréico no plasma e no leite, balanço de compostos nitrogenados e produção de proteína microbiana

Objetivou-se avaliar o efeito da substituição do milho pela casca de café ou pela casca de soja em dietas à base de cana-de-açúcar, com 60% de concentrado, sobre o comportamento ingestivo, o pH e a concentração de amônia no líquido ruminal, a excreção de uréia na urina (EU), a concentração de N-uréia no plasma (NUP) e no leite (NUL), o balanço de compostos nitrogenados e a síntese de proteína microbiana em vacas leiteiras, em comparação a uma dieta com silagem de milho. Foram utilizadas 12 vacas holandesas, puras e mestiças, distribuídas em três quadrados latinos 4 x 4. A dieta controle foi composta de silagem de milho e 40% de concentrado (SiMi), com base na MS. Foram utilizadas três dietas contendo cana-de-açúcar e 60% de concentrado, de modo que os percentuais de substituição do milho foram 0% (CMi), 25% com casca de café (CCC) ou 50% com casca de soja (CCS), com base na MS total da dieta. O tempo total de mastigação foi menor para a dieta SiMi e não foi afetado pela inclusão de casca de café ou casca de soja. O pH ruminal não diferiu nos tempos 0 e 3 horas após a alimentação matinal. A dieta CCC resultou, três horas após alimentação, em menor concentração de amônia ruminal em relação às demais, com exceção da dieta CMi. Não foram observadas diferenças na EU e NUL, sendo registrados valores médios de 179,31 mg/kg de PV e 12,59 mg/dL, respectivamente. A substituição do milho pela casca de café ou de soja não promove melhora no ambiente ruminal. A síntese de compostos nitrogenados microbianos e a eficiência microbiana ruminal não são influenciadas pelas dietas e apresentam valores médios de 273 g/dia e 130,08 gPBmic/kg de NDT, respectivamente.

Very low protein diet supplemented with ketoanalogs improves blood pressure control in chronic kidney disease

Blood pressure (BP) is hardly controlled in chronic kidney disease (CKD). We compared the effect of very low protein diet (VLPD) supplemented with ketoanalogs of essential amino acids (0.35 g/kg/day), low protein diet (LPD, 0.60 g/kg/day), and free diet (FD) on BP in patients with CKD stages 4 and 5. Vegetable proteins were higher in VLPD (66%) than in LPD (48%). LPD was prescribed to 110 consecutive patients; after run-in, they were invited to start VLPD. Thirty subjects accepted; 57 decided to continue LPD; 23 refused either diet (FD group). At baseline, protein intake (g/kg/day) was 0.79+/-0.09 in VLPD, 0.78+/-0.11 in LPD, and 1.11+/-0.18 in FD (P<0.0001). After 6 months, protein intake was lower in VLPD than LPD and FD (0.54+/-0.11, 0.78+/-0.10, and 1.04+/-0.21 g/kg/day, respectively; P<0.0001). BP diminished only in VLPD, from 143+/-19/84+/-10 to 128+/-16/78+/-7 mm Hg (P<0.0001), despite reduction of antihypertensive drugs (from 2.6+/-1.1 to 1.8+/-1.2; P<0.001). Urinary urea excretion directly correlated with urinary sodium excretion, which diminished in VLPD (from 181+/-32 to 131+/-36 mEq/day; P<0.001). At multiple regression analysis (R2=0.270, P<0.0001), BP results independently related to urinary sodium excretion (P=0.023) and VLPD prescription (P=0.003), but not to the level of protein intake. Thus, in moderate to advanced CKD, VLPD has an antihypertensive effect likely due to reduction of salt intake, type of proteins, and ketoanalogs supplementation, independent of actual protein intake.

Whole-body vibration can reduce calciuria induced by high protein intakes and may counteract bone resorption: A preliminary study

Excess protein intake can adversely affect the bone via an increase in calcium excretion, while suitable mechanical loading promotes osteogenesis. We therefore investigated whether vibration exposure could alleviate the bone mineral losses associated with a metabolic acidosis. Ten healthy individuals aged 22 – 29 years (median = 25) underwent three 5-day study periods while monitoring their dietary intake. The study consisted of recording the participants' usual dietary intake for 5 consecutive days. Participants were then randomly divided into two groups, one of which received a protein supplement (2 g · kg−1 body mass · day−1; n = 5) and the other whole-body low-magnitude (3.5 g), low-frequency (30 Hz) mechanical vibration (WBV) delivered through a specially designed vibrating plate for 10 min each day (n = 5). Finally, for the third treatment period, all participants consumed the protein supplement added to their normal diet and were exposed to WBV exercise for 10 min per day. Daily urine samples were collected throughout the experimental periods to determine the excretion of calcium, phosphate, titratable acid, urea, and C-telopeptide. As expected, when the participants underwent the high protein intake, there was an increase in urinary excretion rates of calcium (P < 0.001), phosphate (P < 0.003), urea (P < 0.001), titratable acid (P < 0.001), and C-telopeptide (P < 0.05) compared with baseline values. However, high protein intake coupled with vibration stimulation resulted in a significant reduction in urinary calcium (P = 0.006), phosphate excretion (P = 0.021), and C-telopeptide (P < 0.05) compared with protein intake alone, but did not affect titratable acid and urea output. The participants showed no effect of WBV exercise alone on urinary excretion of calcium, phosphate, urea, titratable acid, or C-telopeptide. The results indicate that vibration stimulation can moderate the increase in bone resorption and reduction in bone formation caused by a metabolic acidosis.

Usual ACE Inhibitor Therapy in CKD Patients Is Associated with Lower Plasma Aldosterone Levels than Usual Angiotensin Receptor Blocker Therapy

Background: Attenuating aldosterone (ALDO) effects may be important in slowing kidney and cardiovascular disease progression. This study tested whether ACE inhibitor (I) therapy achieves lower plasma (p) ALDO levels than angiotensin receptor blocker (ARB) therapy when they are used under usual clinical conditions in chronic kidney disease (CKD) patients. Methods: Consecutive CKD patients (n = 123) were studied. They were clinically stable and receiving either ACEI (n = 77) or ARB (n = 46) (physician’s choice) for ≧3 months. Results: Mean pALDO in the ACEI cohort was 7.8 ± 5.7 (SD) ng/dl compared to 12.3 ± 9.8 ng/dl in the ARB cohort (p = 0.0018, normal ambulatory pALDO 9.4–33.8 ng/dl). The pALDO difference was not explained by differences in age, sex, race, body weight, diagnosis of diabetes; the use of β-blockers, calcium channel blockers or diuretic; systolic or diastolic blood pressure; plasma renin, serum creatinine, sodium, potassium, or bicarbonate levels; 24-hour urine potassium, sodium, urea or protein excretion; or ACEI or ARB dose. Conclusions: Mean pALDO is about 60% higher with ARB therapy than ACEI therapy when these drugs are customarily used in CKD patients. This difference could be clinically important with regard to kidney and cardiovascular protection.

Insulin resistance and low urinary citrate excretion in calcium stone formers

Epidemiological data suggest an association between kidney stones and some features of metabolic syndrome such as an overweight condition, arterial hypertension or glucose intolerance. However, mechanisms remain to be elucidated. This study aimed to evaluate insulin resistance, as assessed by homeostasis model assessment (HOMA-IR), and urine composition analysis in patients affected by calcium nephrolithiasis. A cohort of 61 (38 male, 29–57 years of age) non-diabetic calcium stone formers was studied. Data about body mass index, arterial blood pressure, serum biochemistry including parathyroid hormone and calcitriol were recorded in all the patients; fasting glucose and insulin were determined to calculate HOMA-IR value and accordingly the patients were grouped into tertiles. Urine pH and urinary excretion of calcium, citrate, phosphate, oxalate, uric acid, urea and creatinine were measured on 24 h urine samples. Patients of the highest HOMA-IR tertile showed lower urine citrate levels than patients of the lowest HOMA-IR tertile (475 ± 243 vs. 630 ± 187 mg/24 h, p < 0.05), whereas no difference was detected as far as urinary oxalate, calcium, uric acid, phosphate, and urine pH and urine volume output were concerned. HOMA-IR values were positively related to uric acid serum levels ( r = 0.31, p < 0.05) and negatively to urinary citrate excretion ( r = −0.26, p < 0.05). Hypocitraturic patients showed higher levels of HOMA-IR than normocitraturic ones (3.03 ± 0.92 vs. 2.25 ± 1.19, p < 0.05). This study shows that a higher level of insulin resistance is associated with lower urinary citrate excretion, and that hypocitraturic patients show a greater insulin resistance than normocitraturic calcium stone formers. This may be related to changes in citrate, Na +–K + and H + renal tubule transports, which have been described in insulin resistance. In conclusion, insulin resistance may contribute to an increased risk of calcium stone formation by lowering urinary citrate excretion. This finding suggests the need for a careful metabolic assessment in patients known to form calcium stones in order to ensure stone recurrence prevention and cardiovascular protection.

Renal responses to acute lead waterborne exposure in the freshwater rainbow trout ( Oncorhynchus mykiss)

The possible nephrotoxic effects of waterborne lead exposure (as Pb(NO 3) 2) were investigated in the freshwater rainbow trout ( Oncorhynchus mykiss). Kidney lead accumulation was time-dependent, increasing upon exposure to 0.57 ± 0.01 mg dissolved Pb L −1 for up to 96 h with a significantly higher burden occurring in the posterior kidney compared to the anterior segment. Urine analyses in trout exposed to 1.20 ± 0.09 mg dissolved Pb L −1 revealed a significant increase in urinary lead excretion rate throughout 96 h of exposure. Urine flow rate and glomerular filtration rate (GFR) were not impacted with the exception of a significant decrease in GFR from 84 to 96 h in lead-exposed trout. Urine pH decreased significantly over time in lead-exposed fish. Correspondingly, urine ammonia excretion rate showed a marked increase from 48 h onwards. In experimental fish, urine glucose excretion was significantly greater by 96 h while urine lactate, urea and protein excretion were not significantly altered by lead exposure. The urine excretion rate of Ca 2+ increased significantly by approximately 43% after only 24 h of lead exposure, and was maintained at a higher rate than controls for up to 96 h. Magnesium excretion increased in a time-dependent fashion, reaching a two- to three-fold rise by 96 h. In contrast, rates of Na + and Cl − excretion were decreased in experimental fish by approximately 30% by 48 h, this trend continuing for the duration of lead-exposure. There were no changes in any of these parameters in similarly treated control fish. Clearance ratio analyses indicated progressive decreases in the net reabsorption efficiencies of the renal system for Ca 2+, Mg 2+, Pb, and glucose, suggesting that the active tubular transport mechanisms for these substances were inhibited by lead exposure, while Na +, K +, Cl −, lactate, and protein reabsorptions were unaffected. Net ammonia secretion increased. We conclude that changes in renal function both reflect and help to minimize some of the associated disturbances in systemic physiology. Lead-induced ionoregulatory toxicity in rainbow trout, particularly the disturbance of Ca 2+ homeostasis, is not exclusively a branchial phenomenon, but is in part a result of disruption of ionoregulatory mechanisms at the kidney. This action of lead outside the gills is critical to consider when developing guidelines for water quality.

Causes of Hypocitraturia in Recurrent Calcium Stone Formers: Focusing on Urinary Potassium Excretion

Multiple factors associated with hypocitraturia have been identified. However, limited studies addressing the causal relationship to hypocitraturia are available. We therefore conducted this study to determine factors associated with hypocitraturia and show their causal relationship in recurrent calcium stone formers. Dietary review and 24-hour urine samples were obtained from all recurrent calcium stone formers referred for metabolic workup in the stone clinic. One month of oral potassium chloride supplementation was prescribed to stone formers to determine the causal relationship between urinary potassium and citrate levels. Eighty-three subjects, 44 men and 39 women, were recruited to participate in this study. Hypocitraturia (citrate < 300 mg/d [<1.43 mmol/d]) was found in 50.6% of subjects. Four independent urinary variables associated with hypocitraturia were identified, including potassium level, net gastrointestinal alkaline absorption, calcium level, and titratable acid. Urinary potassium level was the strongest predictor of urinary citrate level. Hypocitraturic subjects also had lower fruit intake compared with subjects with high urinary citrate levels. Potassium chloride supplementation to a subgroup of this population (n = 58) resulted in a significant increase in urinary citrate excretion (350.73 +/- 27.25 versus 304.15 +/- 30.00 mg/d [1.67 +/- 0.13 versus 1.45 +/- 0.14 mmol/d]; P < 0.02), but no alteration in fractional excretion of citrate (19.7% +/- 2.7% versus 23.1% +/- 2.4%; P > 0.05). Hypocitraturia was found to be a common risk factor associated with recurrent calcium stone formation and low urinary potassium level, low alkaline absorption, low urinary calcium level, and high titratable acid excretion. Hypocitraturia is predominantly of dietary origin. Estimation of fruit intake should be included in the metabolic evaluation for recurrent calcium stone formation.

Protective role of sulphated polysaccharides in abating the hyperlipidemic nephropathy provoked by cyclosporine A.

Cyclosporine A (CsA)-induced nephrotoxicity hampers the immense therapeutic potential of such a powerful immunosuppressant. The present study was conducted with an aim to explicate the contribution of sulphated polysaccharides (SPS) in abating the lipid abnormalities induced by CsA in the rat kidney. Hyperlipidemia associated with nephrotic syndrome may play a role in the worsening of renal function. Male albino Wistar rats sorted into four groups were used for the study. CsA was given at a dose of 25 mg/kg body weight, orally for 21 days. Significant alterations in the lipid profile as well an increase in the activity of cholesterol ester synthase, coupled with a decrease in cholesterol ester hydrolase and lipoprotein lipase enzyme activities were noted in the plasma and kidneys of CsA-administered rats. A marked increase in the lipoprotein fractions, low-density lipoprotein (LDL) and very low density lipoprotein (VLDL), along with a decrease in the HDL level were found in CsA-administered rats. The degree of nephrotoxicity allied with lipid discrepancies was evident from augmented urinary excretion of urea, uric acid and creatinine. Further, an enhanced susceptibility of the apo B-containing lipoproteins (LDL + VLDL) to oxidation in vitro, induced by copper ions was also found in the plasma of CsA given groups. While SPS co-treated groups (5 mg/kg body weight, subcutaneously) revealed a normalized lipid profile and lipid metabolizing enzymes, the supplementation of SPS also brought back the elevated urinary constituents close to that of the controls and substantially minimized the oxidative changes. With these observations, it may be concluded herein that SPS may be an ideal choice as a renoprotective and hypolipidemic agent against CsA-induced hyperlipidemic nephropathy.

Consumo, digestibilidade e excreção de uréia e derivados de purinas em novilhas de diferentes pesos

Objetivou-se avaliar a influência do peso vivo de novilhas sobre o consumo e a digestibilidade da MS, MO, EE, PB, fibra em detergente neutro corrigida para cinzas e proteína (FDNcp) e carboidratos não-fibrosos corrigidos (CNFcp), os consumos de NDT e de proteína degradada no rúmen (PDR), a produção de proteína microbiana e a excreção de compostos nitrogenados na urina e comparar as metodologias de coleta spot e de coleta total de urina. Foram utilizadas 22 novilhas com cinco diferentes pesos (523, 453, 315, 235 e 118 kg), distribuídas em delineamento inteiramente casualizado, com cinco tratamentos (P523, P453, P315, P235 e P118). A alimentação foi constituída de silagem de milho e concentrado, fornecido na proporção de 1,5 kg/dia (tratamentos P523, P453, P315 e P235) ou 2 kg/dia (tratamento P118). Os consumos dos nutrientes em kg/dia e em %PV aumentaram e diminuíram linearmente, respectivamente, com o aumento do peso dos animais. As digestibilidades da MS, MO e o teor de NDT não diferiram entre os tratamentos, enquanto as de PB e FDNcp foram distintas entre os tratamentos, sendo maior e menor, respectivamente, no tratamento P118. A excreção de uréia na urina (em mg/kgPV) foi maior no tratamento P118, variando com o peso vivo e com o consumo de PB e PDR. A produção microbiana, estimada pela excreção urinária de derivados de purinas, não diferiu entre as metodologias de coleta spot e coleta total de urina, sendo menor no tratamento P118. A coleta de urina spot pode ser utilizada para estimativa da excreção de compostos nitrogenados na urina, independentemente do peso vivo. A quantidade de nutrientes ingeridos diariamente aumenta com o peso vivo, entretanto, o consumo desses nutrientes, expresso em %PV, diminui à medida que o peso vivo aumenta.

Polynocturia in chronic kidney disease is related to natriuresis rather than to water diuresis

Nocturnal polyuria has been well known in renal insufficiency. Recently, we found that as renal function deteriorated in chronic kidney disease (CKD), natriuresis was enhanced during the night with nocturnal blood pressure elevation. In the present study, we investigated whether nocturnal polyuria in CKD was due to the inability to concentrate urine, as previously proposed, or based on osmotic diuresis mainly by natriuresis. In 27 CKD patients, circadian rhythms of urinary sodium, potassium, urea and osmolar excretion rates (U(Na)V, U(K)V, U(urea)V, U(osm)V) as well as of urinary volume (V) and free-water clearance (C(H(2)O)) were estimated during both daytime (6:00 to 21:00) and nighttime (21:00 to 6:00). Then, the night/day ratios of these parameters were analysed in relation to creatinine clearance (C(cr)) as a marker of glomerular filtration rate. C(cr) had significantly negative relationships with night/day ratios of V (R = -0.69; P < 0.0001), U(osm)V (R = -0.54; P = 0.004) and U(Na)V (R = -0.63; P = 0.0005), but no correlation with night/day ratios of C(H(2)O) (R = -0.33; P = 0.1), U(K)V (R = -0.29; P = 0.1) or U(urea)V (R = -0.31; P = 0.1). Linear and multiple regression analysis identified nocturnal natriuresis rather than urea excretion as an independent determinant of nocturia. As renal function deteriorated, nocturnal polyuria was seen, being consistent with classical recognition. Furthermore, this increase in nocturnal urine volume seemed related to osmotic diuresis mainly by natriuresis rather than to water diuresis or urea excretion.

Artificial neural networks for assessing the risk of urinary calcium stone among men

The pathophysiology of idiopathic calcium oxalate nephrolithiasis involves metabolic abnormalities. Previous studies gave conflicting results about the metabolic factors in stone formers. Artificial neural networks (ANN) are new methods based on computer programming that have outperformed conventional methods in prediction of outcomes in different medical applications. The aim of our study was to compare with ANN the clinical and biochemical parameters implicated in urinary calcium stone between stone formers (SF) and controls (C). We compared 11 clinical and biochemical variables among 119 male idiopathic calcium oxalate SF and 96 C by univariate and multivariate statistical analyses. Univariate analyses included discriminant analysis, logistic regression analysis, and ANN. For multivariate analyses, stepwise discriminant analysis and ANN were performed. Variables included age, body mass index (BMI), family history of nephrolithiasis, supersaturation with respect to calcium oxalate, calcemia, and 24-h urinary calcium, oxalate, uric acid, urea, sodium, and citrate. With univariate and multivariate analyses, ANN were as efficient as classical statistical analyses in discriminating the different parameters. The sensitivity, the specificity, and the percentage of correctly classified patients were similar in all analyses. With ANN, supersaturation (receiver operating characteristic, ROC curves index 0.73) and urea (ROC 0.72) were the most discriminant followed by family history and urinary calcium (ROC 0.67). ROC index was 0.63 for citrate, 0.61 for oxalate and urate, 0.60 for sodium and calcemia, 0.58 for age, and 0.56 for BMI, but these parameters were not statistically different between SF and C. ANN gave additional information since they made it possible to determine the cut-off values of the parameters and their predictive power. Cut-off values for being a stone former were 8.9 for supersaturation and 363 mmol/day for urinary urea with a predictive power of 0.69 and 0.70, respectively. Univariate and multivariate analysis evidenced supersaturation and 24-h urinary urea excretion as the most discriminant parameters between the two populations. In addition to high supersaturation, the negative impact of protein intake was confirmed.

Casca de algodão em substituição parcial à silagem de capim-elefante para novilhos. 2. Parâmetros ruminais e séricos, produção microbiana e excreção urinária de compostos nitrogenados

Quatro novilhos holandeses fistulados no rúmen, com peso médio de 259 kg, foram distribuídos em um quadrado latino 4 x 4 para se avaliar o efeito dos níveis de casca de algodão na dieta de novilhos sobre a concentração de nitrogênio uréico no soro (NUS) e de amônia no rúmen, o pH ruminal, a excreção urinária de uréia e derivados de purinas e a produção de proteína microbiana estimada pelo método das bases purinas omasais e da excreção de derivados de purinas na urina. As dietas experimentais continham na base da matéria seca: 0, 10, 20 e 30% de casca de algodão peletizada, em substituição à silagem de capim-elefante, sendo a dieta total constituída de 60% de volumoso. Não houve efeito dos diferentes tratamentos sobre o pH e as concentrações de amônia no rúmen. A concentração de NUS e a excreção de uréia (em mg/kgPV) diminuíram, enquanto a excreção de derivados de purinas na urina e a síntese de proteína microbiana no rúmen aumentaram linearmente com a inclusão da casca de algodão nas dietas. A estimativa da síntese de proteína microbiana não diferiu entre as metodologias das bases purínicas omasais e dos derivados de purina na urina. A casca de algodão mostrou-se um bom volumoso alternativo, podendo ser fornecida até o nível de 30% na MS total na dieta de novilhos de origem leiteira.

Urinary urea excretion in idiopathic hypercalciuria of children

Objective In adults, it is well known that high protein intake may increase the risk of nephrolithiasis through increased urinary calcium excretion and other mechanisms. We aimed to assess the role of protein intake on urinary calcium excretion in children with idiopathic hypercalciuria (HC). Patients and methods The 24-h urinary urea excretion as a reflection of protein intake was evaluated in 65 children with HC and in 76 normocalciuric control children. All of them were on a free diet and did not receive any specific drug. Results Urinary urea excretion was 18.9 ± 6.6 (SD) mmol/kg/day in the HC group and 14.2 ± 4.9 in controls ( P < 0.0001). Urinary urea excretion significantly decreased with age, as well as with body weight and height gain in both groups. Calcium excretion significantly increased with increasing sodium and urea excretion in the HC but not the control group. There was a significant ( P = 0.005) interaction between urinary sodium and urea excretion in the rising calciuria of the HC group. Multiple regression analysis showed that, in the HC group, variations in urinary urea explained 11.4% of the entire variability of urinary calcium excretion, whereas adding the urinary sodium effect increased this relation only to 16%. Conclusion Children with HC have a higher dietary protein intake than normocalciuric children. The decrease in urea excretion with increasing age and body mass may reflect the relatively higher protein intake of young growing individuals. Salt and protein have a cumulative effect on rising calcium excretion in HC children, but the role of protein intake is outstanding.