Spot Urine Samples Research Articles

Fractional excretion of total protein in patients with nephrotic syndrome.

The urine protein to creatinine ratio (UPCR) correlates well with the 24-h urine protein test (24-h UPT) and is a reliable indicator of proteinuria. However, in nephrotic syndrome, the correlation between the UPCR and the 24-h UPT tends to decrease. To address this, we introduced the fractional excretion of total protein (FETP), which reflects serum total protein and creatinine levels because severe hypoproteinemia and/or elevated serum creatinine levels tend to occur under these conditions. The 24-h UPT corrected for body surface area (BSA) (24-h UPT/BSA) was used to take body size into consideration. The correlation coefficients for 24-h UPT/BSA and FETP and 24-h UPT/BSA and UPCR were calculated. The statistical significance of the differences between these coefficients was also calculated. Thirty-six pediatric patients with nephrotic syndrome were included in this study. The FETP was calculated as total protein clearance/creatinine clearance (%). Correlation coefficients were calculated for 24-h UPT/BSA and FETP and 24-h UPT/BSA and UPCR. The statistical significance of the differences between these coefficients was also calculated. The mean ± standard error of FETP was 0.11% ± 0.013%. The correlation coefficients of FETP and UPCR with 24-h UPT/BSA were 0.91 and 0.81, respectively. The FETP demonstrated a significantly stronger correlation with 24-h UPT/BSA than with UPCR (p = 0.01). The FETP correlated more strongly with 24-h UPT/BSA than with UPCR in patients with nephrotic syndrome. The FETP is a reliable indicator of proteinuria in nephrotic syndrome, especially in patients with severe hypoproteinemia or elevated serum creatinine levels.

No change in 24-h sodium intake estimated from spot urine in Norwegian adults from 2006 to 2019: the population-based Trøndelag Health Study (HUNT).

Monitoring time trends in salt consumption is important for evaluating the impact of salt reduction initiatives on public health outcomes. There has so far not been available data to indicate if salt consumption in Norway has changed during the previous decade. We aimed to assess whether average 24-h salt intake estimated from spot urine samples in the adult population of mid-Norway changed from 2006-2008 to 2017-2019 and to describe variations by sex, age and educational level. Repeated cross-sectional studies. The population-based Trøndelag Health Study (HUNT). In each of two consecutive waves (HUNT3: 2006-2008 and HUNT4: 2017-2019), spot urine samples were collected from 500 men and women aged 25-64 years, in addition to 250 men and women aged 70-79 years in HUNT4. Based on spot urine concentrations of Na, K and creatinine and age, sex and BMI, we estimated 24-h Na intake using the International Cooperative Study on Salt and Blood Pressure (INTERSALT) equation for the Northern European region. Mean (95 % CI) estimated 24-h salt intakes in men were 11·1 (95 % CI 10·8, 11·3) g in HUNT3 and 10·9 (95 % CI 10·6, 11·1) g in HUNT4, P = 0·25. Corresponding values in women were 7·7 (95 % CI 7·5, 7·9) g and 7·7 (95 % CI 7·5, 7·9) g, P = 0·88. Mean estimated salt intake in HUNT4 decreased with increasing age in women, but not in men, and it did not differ significantly across educational level in either sex. Estimated 24-h salt intake in adult men and women in mid-Norway did not change from 2006-2008 to 2017-2019.

Efficacy and Safety of Vildagliptin for Type 2 Diabetes in Patients With Diabetic Kidney Disease.

Vildagliptin is one of the dipeptidyl peptidase-4 (DPP-4) inhibitors that have been shown to improve hyperglycemia in clinical trials among patients with type 2 diabetes. However, few studies have examined the efficacy of vildagliptin in patients with diabetic kidney disease (DKD). Eight patients with DKD received oral vildagliptin 50-100 mg/day. The duration of diabetes was 6.7±5.9 years and observation period was 23.6±9.8 months. Changes in fasting blood glucose, and hemoglobin A1c (HbA1c), estimated glomerular filtration rate (eGFR), and urine protein-to-creatinine ratio (UPCR) were studied before and after the administration of vildagliptin. Vildagliptin treatment significantly decreased fasting blood glucose and HbA1c, compared to baseline (132±56 mg/dl, p=0.036, 6.0±0.3, p=0.041, respectively). UPCR tended to be decreased, albeit without statistical significance. However, eGFR was decreased after the administration of vildagliptin. No significant adverse effects were observed in all patients during the study. Although the sample size was limited and the observation period was brief, vildagliptin was found to be an effective and reasonably well-tolerated treatment for patients with DKD.

IODINE STATUS IN ROMANIA AFTER 20 YEARS OF MANDATORY SALT IODIZATION: DISCORDANT RESULTS IN SCHOOLCHILDREN AND NEONATES.

To monitor the iodine status in Romanian schoolchildren and neonates after 20 years of mandatory salt iodization. In a national representative sample of 1352 children (7-12 years) we measured median urinary iodine concentration (mUIC) and creatinine (UCC) in spot urine samples and investigated household use of iodized salt. From 18349 neonates registered in the MEDILOG program for TSH screening we calculated the percentage of neonatal TSH >5 mIU/L (<3% indicating adequate iodine intake). mUIC in schoolchildren was 141 µg/L (bootstrapped 95% CI 134, 146), showing adequate iodine intake in all but 1 county; mUIC was similar in historical endemic and non-endemic counties (140 µg/L and 143 ug/L, respectively) and in urban and rural areas (140 µg/L and 142 µg/L, respectively); mUIC/UCC = 118 ug/g. Iodized salt was used in 62% of households. In children using iodized salt (61.7%), mUIC was higher than in those using coarse (non-iodized) salt (24.6%): 150 vs. 121 µg/L (p<0.001). The percentage of nTSH >5 mIU/L was 14.7% (3.2%-27.3%), higher in non-endemic counties and urban areas. The current salt iodization program for households and bakery industry ensures an adequate iodine intake in schoolchildren. Discordantly, nTSH levels indicate a mild-moderate ID in neonates, suggesting ID in pregnant women. The percentage of households using iodized salt is below the recommended >90% needed for an efficient ID prevention program. More efforts should be directed to increase the public awareness on the health risks of ID and the benefits of ID prevention, notably for the neurointellectual development in children.

Evaluation of three prediction formulas of 24-hour urinary sodium excretion in Chinese residents: a systematic review and meta-analysis.

To determine the appropriateness of three widely used formulas estimating 24-h urinary Na (24hUNa) from spot urine samples in the Chinese population. Systematic review and meta-analysis. Literature review was conducted to identify studies for estimating 24hUNa using the Kawasaki, Tanaka and INTERSALT formulas simultaneously in PubMed, Embase and the Cochrane library databases. The mean difference (MD) and correlation coefficients (r) between measures and estimates from different formulas were assessed. Information extraction and quality assessment were performed in thirteen studies involving 8369 subjects. Two studies which affected the overall robustness were excluded in the 'leave-one-out' sensitivity analyses. Within the final meta-analysis included eleven studies and 7197 participants, 36·07 mmol/d (95 %CI 16·89, 55·25) of MD was observed in the Kawasaki formula, and -19·62 mmol/d (95 %CI -37·37, -1·87) in the Tanaka formula and -35·78 mmol/d (95 %CI -50·76, -20·80) in the INTERSALT formula; a pooled r-Fisher's Z of 0·39 (95 %CI 0·32, 0·45) in the Kawasaki formula, 0·43 (95 %CI 0·37, 0·49) in the Tanaka formula and 0·36 (95 %CI 0·31, 0·42) in the INTERSALT formula. Subgroup analyses were conducted to explore the possible factors affecting the accuracy of the formula estimation from three mainly aspects: population types, Na intake levels and urine specimen types. The meta-analysis suggested that the Tanaka formula performed a more accurate estimate in Chinese population. Time of collecting spot urine specimens and Na intake level of the sample population might be the main factors affecting the accuracy of the formula estimation.

Development of a food frequency questionnaire for the estimation of dietary (poly)phenol intake.

Background: (Poly)phenol intake has been associated with reduced risk of non-communicable diseases in epidemiological studies. However, there are currently no dietary assessment tools specifically developed to estimate (poly)phenol intake in the UK population. Objectives: This study aimed to develop a novel food frequency questionnaire (FFQ) to capture the dietary (poly)phenol intake in the UK and assess its relative validity with 7 day diet diaries (7DDs) and plasma and urine (poly)phenol metabolites. Methods: The KCL (poly)phenol FFQ (KP-FFQ) was developed based on the existing EPIC (European Prospective Investigation into Diet and Cancer)-Norfolk FFQ, which has been validated for energy and nutrient intake estimation in the UK population. Participants aged 18-29 years (n = 255) completed both the KP-FFQ and the EPIC-Norfolk FFQ. In a subgroup (n = 60), 7DD, spot urine, and fasting plasma samples were collected. An in-house (poly)phenol database was used to estimate (poly)phenol intake from FFQs and 7DDs. Plasma and urinary (poly)phenol metabolite levels were analysed using a validated ultra-high-performance liquid chromatography-triple quadrupole mass spectrometry method. The agreements between (poly)phenol intake estimated using the KP-FFQ, EPIC-Norfolk FFQ and 7DDs, as well as plasma and urinary biomarkers, were evaluated by intraclass correlation coefficients (ICC), weighted kappa, quartile cross-classification, and Spearman's correlations, and the associations were investigated using linear regression models adjusting for energy intake and multiple testing (false discovery rate (FDR) < 0.05). Results: The mean (standard deviation, SD) of total (poly)phenol intake estimated from KP-FFQs was 1366.5 (1151.7) mg d-1. Fair agreements were observed between ten (poly)phenol groups estimated from KP-FFQs and 7DDs (kappa: 0.41-0.73), including total (poly)phenol intake (kappa = 0.45), while the agreements for the rest of the 17 classes and subclasses were poor (kappa: 0.07-0.39). Strong positive associations with KP-FFQ were found in ten (poly)phenols estimated from 7DDs, including dihydroflavonols, theaflavins, thearubigins, flavones, isoflavonoids, ellagitannins, hydroxyphenylacetic acids, total stilbenes, resveratrol, and tyrosols with stdBeta ranged from 0.61 (95% confidence interval CI: 0.42 to 0.81) to 0.95 (95% CI: 0.86 to 1.03) (all FDR adjusted p < 0.05). KP-FFQs estimated (poly)phenol intake exhibited positive associations with 76 urinary metabolites (stdBeta: 0.28 (95% CI: 0.07-0.49) to 0.81 (0.62-1.00)) and 19 plasma metabolites (stdBeta: 0.40 (0.17-0.62)-0.83 (0.64-1.02)) (all FDR p < 0.05). The agreement between KP-FFQs and the EPIC-Norfolk FFQs was moderate (ICC 0.51-0.69) for all (poly)phenol subclasses after adjusting for energy intake. Compared with the EPIC-Norfolk FFQs estimated (poly)phenol intake, stronger and more agreements and associations were found in KP-FFQs estimated (poly)phenol with 7DDs and biomarkers. Conclusion: (Poly)phenol intake estimated from KP-FFQ exhibited fair agreements and moderate to strong associations with 7DDs and biomarkers, indicating the novel questionnaire may be a promising tool to assess dietary (poly)phenol intake.

Proteomic Correlates Of Urinary Protein Creatinine Ratio In Heart Failure With Preserved Ejection Fraction

Proteomic Correlates Of Urinary Protein Creatinine Ratio In Heart Failure With Preserved Ejection Fraction

Usefulness of the Reborn Soup for the Reduction of Salt Intake.

The purpose of the present study was to investigate the influence of reborn soup on the perceptions of saltiness and palatability. Subjects comprised 103 staff working at Kokura Daiichi Hospital (22 males, 81 females, and mean age: 35 ± 12 years old). They tested soups (commercially available soup with 0.9% NaCl solutions (A), commercially available soup with 0.6% NaCl solutions (B), and reborn soup diluted to 0.6% NaCl solutions (C)). Evaluations of saltiness and palatability for each solution were conducted using a visual analog scale in a double-blinded randomized manner. We estimated 24-hour salt excretion using spot urine samples to estimate salt intake and also assessed blood pressure, the awareness of salt intake using a self-description questionnaire score, and other confounding factors including lifestyle factors. In all subjects, the average estimated salt intake was 9.0 ± 2.0 g/day, and the rates at which subjects met the established salt intake targets were 15.1% in 73 females without hypertension (<6.5 g/day), 23.5% in 17 males without hypertension (<7.5 g/day), and 0.0% in 13 subjects with hypertension (<6.0 g/day). In both saltiness and palatability, B scored significantly lower than A, but C scored significantly higher than B. Salt intake levels were categorized into tertiles (Q1, lowest; Q3, highest). C scored significantly higher for palatability in the Q1 group than in the Q3 group. Most participants exceeded the established targets of salt intake. The high-salt-intake group might be able to feel less palatable. Our results indicate that reborn soup may be effective in reducing salt intake without loss of palatability.

Effects of Iodinated Contrast-enhanced CT on Urinary Iodine Levels in Postoperative Patients with Differentiated Thyroid Cancer.

This study aims to observe the fluctuating urine iodine levels in patients with differentiated thyroid cancer (DTC) following iodinated contrastenhanced computed tomography (eCT) scans. The presence of iodine in iodinated contrast agents (ICAs) can impede the effectiveness of radioactive iodine treatment (RAIT) and diagnostic scans in individuals diagnosed with DTC, as it can engage in competitive interactions with 131I. According to established guidelines, it is recommended to postpone RAIT for a period of three to four months in individuals who have had prior exposure to ICAS. The measurement of spot urine iodine concentration is a valuable indicator for assessing the overall iodine content throughout the body. The objective is to identify the optimal timing for administering postoperative RAIT in DTC patients. At various time points after surgery, a cohort of 467 random urine samples (126 male samples, 341 female samples, age (45±12 years)) was obtained from 269 DTC patients. The samples were analyzed for urinary iodine and urinary creatinine levels, and the urinary iodine/urine creatinine ratio (I/Cr) was computed. All samples were divided into two groups according to whether eCT before operation: the non-enhanced CT (eCT-) group and the enhanced CT (eCT+) group. The urine samples in the eCT- group were categorized into four subgroups according to the duration of strict low iodine diet (LID): (eCT-I+) no LID; (eCT-I-2W) 2 weeks of LID; (eCT-I-4W) 4 weeks of LID; and (eCT-I-6W) 6 weeks of LID. The last three groups were merged into the eCT- and effective LID group (eCT- I-). The urine samples from the eCT+ group were categorized into five subgroups: (0.5M eCT+)0.5 month after eCT+; (1M eCT+)1 month after eCT+; (2M eCT+) 2 months after eCT+; (3M eCT+) 3 months after eCT+; (≥4M eCT+) ≥4 months after eCT+. In addition, the patients within 2 months after eCT+ were divided into 2 groups according to their LID: no effective LID group (eCT+ I+) and effective LID group (eCT+ I-). Utilizing the Kruskal-Wallis and Mann-Whitney U rank sum tests, the differences in I/Cr between groups were compared. In the eCT-group, the I/Cr ratios of eCT-I-2W, eCT-I-4W, and eCT-I-6W were significantly lower than those of eCT-I+ (χ2 values: 4.607.99, all P 0.05). However, there was no significant difference in I/Cr between eCT-I-2W, eCT- I-4W, and eCT-I-6W (2 values: 0.591.31, all P > 0.05). Significantly higher I/Cr values were observed in 0.5M eCT+ and 1M eCT+ than in eCT-I+ (χ2 values: 3.22 and 2.18, respectively, all P<0.05). There was no significant difference in I/Cr between 2M eCT+ and eCT-I+ (χ2 = 0.76, P = 0.447). The I/Cr rations of 3M eCT+, ≥4M eCT+ were not significantly different with eCT-I- (χ2 values: 1.76; 0.58; all P > 0.05). However, they were considerably lower than eCT-I+ (χ2 values: 7.03; 5.22; all P<0.05). The I/Cr for patients who underwent eCT within two months (eCT+ I-, eCT+ I+) did not differ significantly (χ2 = 1.79, P = 0.073). For patients who are considering receiving radioactive iodine therapy (RAIT) following a diagnosis of differentiated thyroid cancer (DTC), it is recommended that the interval between RAIT treatment and enhanced computed tomography [eCT] scans be conducted at least three months.

EVALUATION OF PHYSIOLOGICAL BIOMARKERS AS POSSIBLE PREDICTIVE FACTORS AND PROGNOSIS MARKERS OF KIDNEY INJURY IN DOGS NATURALLY INFECTED WITH LEISHMANIA INFANTUM

Impaired renal function is one of the main characteristics of dogs infected with Leishmania infantum. Early diagnosis of kidney injury is essential for improving patient’s prognosis. This study aims to evaluate physiological biomarkers as predictors of kidney injury and prognostic markers. Medical records of fifty-nine dogs of different breed, age, and sex, naturally infected with L. infantum, were analyzed. Red blood cells, leucocytes, platelets count, hematocrit, total plasma proteins, plasma globulin, plasma albumin, serum creatinine, serum urea, serum phosphorus, serum symmetrical dimethyl arginine, urine analysis, urinary density, urinary protein creatinine ratio, urinary creatinine, urinary protein, and systemic blood pressure were examined in trial 0. Six months after trial 0, twenty-four dogs returned for clinical and laboratory examination. The second medical record analysis was identified as trial 1. The twenty-four dogs were examined using the same tests performed in trial 0. The physiological biomarker such as platelets and leukocyte count, hematocrit, serum phosphorus, urinary density, and systemic blood pressure, showed a significant correlation as prognostic and predictive factors of kidney injury in dogs. The platelet count was used as the physiological biomarker to show the value as a predictive factor and prognostic marker related to biomarkers of kidney injury in dogs naturally infected with L. infantum.

Proteinuria in predicting adverse outcomes in women with severe features of pre-eclampsia from a developing country: Aprospective cohort study.

To study the adverse maternal and perinatal outcomes in women with severe pre-eclampsia (SPE) among different ranges of proteinuria. This prospective cohort study was conducted in Jawaharlal Institute of Postgraduate Medical Education and Research, India. After obtaining informed written consent, the 202 singleton women fulfilling the criteria of severe features of pre-eclampsia were stratified based on the value of urine protein-creatinine ratio (UPCR) as mild, moderate, severe, and massive proteinuria during pregnancy. Clinical outcomes were assessed and patients were followed up until 12 weeks postpartum to identify persistent proteinuria and hypertension. Of the 202 women with SPE, adverse maternal outcomes were seen in 34.65% (n = 70) and adverse perinatal outcomes in 75.74% (n = 153). The demographic and clinical factors were similar among women with increasing severity of proteinuria, except for mean systolic blood pressure, serum creatinine and total serum protein. UPCR was found to have a significant correlation with composite adverse perinatal outcome (P < 0.001) and individual outcomes of neonatal intensive care unit admission for >48 h (P = 0.01) and neonatal sepsis (P = 0.02) but not adverse maternal outcomes (P = 0.201). The optimum UPCR cutoff for adverse perinatal outcomes was 1.6 (sensitivity, 73.2%; specificity, 52.7%). In addition, 14.85% of the women had a persistently elevated UPCR and 3.96% had hypertension at 3 months postpartum. In women with SPE, severe and massive proteinuria were related to composite adverse perinatal outcome but not composite adverse maternal outcome. Moreover, antenatal 24-h proteinuria was significantly associated with persistent proteinuria. Significant proteinuria in women with SPE poses a risk for chronic renal dysfunction, requiring follow-up.

Renal biomarkers, clinical parameters, and renal Doppler velocimetry in bitches with cystic endometrial hyperplasia-pyometra complex.

Cystic endometrial hyperplasia (CEH)-pyometra complex is the most common uterine infection in adult and elderly bitches and can cause renal dysfunction. The aim of this study was to measure and compare urinary creatinine, urea, symmetric dimethylarginine (SDMA), urinary protein-creatinine ratio (UPC), measurement of systolic blood pressure (SBP), and Doppler velocimetry of renal arteries in patients with CEH-pyometra complex before and after an average of 6 months of treatment, evaluating the possibility of the changes persisting. The evaluation was conducted at two moments: M1 (at the diagnosis of CEH-pyometra, n = 36) and M2 (after an average of six months of treatment, n = 16). For the control group, eight bitches with no changes in blood tests or history of conditions underwent Doppler ultrasound evaluation of the renal arteries. At both M1 and M2, we measured creatinine, urea, and serum SDMA, UPC, SBP, and Doppler ultrasound of the renal arteries. Patients were evaluated according to the following groups: azotemic (AZO) and non-azotemic (NAZO), and open and closed cervix pyometra. The parameters were compared between animals present in both moments presented as M1R (bitches that were in M1 and M2) and M2. Statistical significance was considered when p < .05. The medians found for creatinine in M1 were as follows: 1.15 mg/dL, being 1.8 mg/dL for AZO (12/36) and 0.95 mg/dL for NAZO (24/36); and in M2: 0.85 mg/dL (16/16), being 1.15 mg/dL for AZO (4/16) and 0.8 mg/dL for NAZO (12/36). For urea, in M1 it was 36 mg/dL (32/36), with AZO being 103 mg/dL (11/32) and 33 mg/dL in NAZO (21/32); and in M2 32 mg/dL (16/ 16), being 29 mg/dL for AZO (4/36), and 31 mg/dL for NAZO (3/15). The median SDMA measured in M1R was 17 μg/dL (15/16), with AZO being 31 μg/dL (3/15), and NAZO being 16.5 μg/dL (12/15); and in M2, SDMA was 12 μg/dL (16/16), with AZO being 12.5 μg/dL (4/16), and NAZO being 12 μg/dL (12/16). The median UPC measured in M1 was 1.15 (10/36), with AZO being 0.25 (1/10), and NAZO being 1.38 (9/10); and in M2, it was 0.2 (13/16), being 0.1 in AZO (4/13), and 0.2 (9/16) in NAZO. For SBP, in M1, it was 118 mmHg (30/36), with AZO being 102 mmHg (10/30) and 133 mmHg in NAZO (20/30); and in M2 142.5 mmHg (12/16), being 155 mmHg for AZO (4/12), and 140 mg/dL for NAZO (8/12). When comparing animals with open and closed cervixes, a difference was found between SDMA measurements (p = .001). There was a distinction between PI and RI of the left and right kidneys consecutively (p = .007; p = .033; p = .019; p = .041). Correlations found in M1: SDMA × PI RIM DIR (r = 0.873; p = .002), SDMA × PSV RIM ESQ (r = 0.840; p = .004), SDMA × EDV RIM ESQ (r = 0.675; p = .046). With this study, we conclude a return to normality of renal biomarkers and clinical parameters after six months. Yet, there is a persistence of Doppler velocimetric measurements between the two moments. Thus, this parameter is not suitable for identifying and classifying chronic kidney injury in bitches with pyometra.

The correlation of spot urinary protein-to-creatinine ratio with 24-h urinary protein excretion in various glomerulopathies.

Proteinuria is an important and well-known biomarker of many forms of kidney injury. Its quantitation is of particular importance in the diagnosis and management of glomerular diseases. Its quantification can be done by several methods. Among these, the measurement of 24-h urinary protein excretion is the gold standard method. However, it is cumbersome, time-consuming, and inconvenient for patients and is not completely foolproof. Many alternative methods have been tested over time albeit with conflicting results. Among the latter, the measurement of urine protein-to-creatinine ratio (uPCR) in single-voided urinary samples is widely used. The majority of studies found a good correlation between uPCR in single urine samples with 24-h urinary protein estimation, whereas others did not. To investigate the correlation of spot uPCR with 24-h urinary protein estimation in patients suffering from different forms of glomerulopathies at a single large-volume nephrological center in Pakistan. This cross-sectional, observational study was conducted at the Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan from September 2017 to March 2018. All newly presenting adult patients with proteinuria who were being investigated for suspected glomerulonephritis and persistent proteinuria with ages between 18 to 60 years were enrolled. All patients were given detailed advice regarding 24-h urine collection starting at 7:00 AM for total protein and creatinine excretion estimations. A spot urine sample was collected the next day at the time of submission of a 24-h urine sample for measuring uPCR along with a blood sample. The data of patients were collected in a proforma. SPSS version 20.0 was used for statistical analysis. A total of 157 patients were included. Their mean age was 30.45 ± 12.11 years. There were 94 (59.8%) males and 63 (40.2%) females. The mean 24-h urinary protein excretion was 3192.78 ± 1959.79 mg and the mean spot uPCR was 3.16 ± 1.52 in all patients. A weak but significant correlation was observed between spot uPCR and 24-h urinary protein excretion (r = 0.342, P = 0.01) among all patients. On subgroup analysis, a slightly better correlation was found in patients older than 47 years (r = 0.78), and those with body mass index > 25 kg/m2 (r = 0.45). The Bland and Altman's plot analysis comparing the differences between spot uPCR and 24-h protein measurement also showed a wide range of the limits of agreement between the two methods. Overall, the results from this study showed a significant and weakly positive correlation between spot uPCR and 24-h urinary protein estimation in different forms of glomerulopathies. The agreement between the two methods was also poor. Hence, there is a need for careful interpretation of the ratio in an unselected group of patients with kidney disease.

Iodine intake in the Swiss population 100years after the introduction of iodised salt: a cross-sectional national study in children and pregnant women.

The Swiss voluntary salt iodisation programme has successfully prevented iodine deficiency for 100years, but dietary habits are changing and todayonly one-third of processed foods contain iodised salt. We aimed to monitor the current iodine status in childrenand pregnant women. We conducted a nationwide cross-sectional study in children (6-12years) and pregnant women and measured the urinary iodine concentration (UIC) in spot urine samples. We estimated the iodine intake using UIC and urinary creatinine concentration (UCC) and determined the prevalence of intakes below the average requirement (AR) using the SPADE method. We measured dried blood spot (DBS) thyroglobulin (Tg), TSH and total T4 in pregnant women. The median UIC was 127μg/L (bootstrapped 95% CI 119, 140, n = 362) in children and 97μg/L (bootstrapped 95% CI 90, 106, n = 473) in pregnant women. The estimated prevalence of inadequate iodine intake (< 65μg/day) was 5.4% (bootstrapped 95% CI 0.0, 14.6) in children. Half (47%) of the women consumed iodine-containing multivitamin and mineral supplements (≥ 150μg/day). Compared to non-users, users had higher median UIC (129 vs. 81μg/L, P < 0.001), lower prevalence of inadequacy (< 160μg/day; 0.2 vs. 31%) and lower DBS-Tg (23 vs. 29μg/L, P < 0.001). All women were euthyroid. The Swiss diet and current salt fortification provides adequate iodine intake in children, but not in all pregnant women. Iodine supplements cover the dietary gap in pregnancy but are not universally consumed. Therefore, improved use of iodised salt in processed foods is desired to ensure adequate iodine intake in all population groups. This trial was registered at clinicaltrials.gov as NCT04524013.

Exploring the Utility of Urinary Creatinine Adjustment for KIM-1, NGAL, and Cystatin C for the Assessment of Kidney Function: Insights from the C-KidnEES Cohort.

Normalization of urinary biomarkers of kidney injury is a common practice in clinical and research settings to account for variations in urine concentration, and urinary creatinine is often used as a reference. However, to date, there is no consensus on the adjustment of urinary biomarkers with creatinine, and both absolute and creatinine-adjusted biomarker levels are adopted for making interpretations of kidney health. Hence, the present study aimed to investigate the associations of urinary creatinine with three widely used kidney injury biomarkers, KIM-1, NGAL, and cystatin C, to validate the applicability of urinary creatinine as a reference for normalization. A cross-sectional study was performed with 2100 students, 10-18 years of age in the Children's Kidney Environmental Exposure Study (C-KidnEES) cohort established in Sri Lanka. As identified in linear regression analyses, normalization of urinary KIM-1, NGAL, and Cys-C to urinary creatinine did not result in significant under-adjustment or over-adjustment to the absolute urinary concentrations, giving no specific rationale for creatinine adjustment. Hence, absolute urinary concentrations of the above biomarkers can be adopted for the characterization of subclinical kidney injury in adolescents in community studies where early morning urine sampling is practiced. However, for spot urine samples, consideration of both absolute and creatinine-adjusted biomarker levels would be a better approach.

Dietary Magnesium Intake and Proteinuria: Is There a Relationship?

The possible relationship between dietary magnesium status and proteinuria has been suggested by a number of previous studies. However, human studies on this association are limited. Therefore, the present study aimed to investigate the independent relationship between dietary magnesium intake and urinary protein excretion. The present study was a post hoc analysis of the previous randomized clinical trial that evaluated the effect of dietary phosphorus restriction on proteinuria. The baseline data of 90 participants with proteinuria and chronic kidney disease was used to measure the association between dietary magnesium intake and proteinuria. Participants were asked to record their 24-h food intake for three days a week in a questionnaire. Urinary protein to creatinine ratio (UPCR) in a random urine sample was measured to be a marker for proteinuria. Out of 90 patients included in the study, 47 were men and 43 were women. The mean ± standard deviation of age and body mass index were 59.05 ± 14.16 years and 29.02 ± 5.54 kg/m2, respectively. The patients' average daily dietary intake of energy and magnesium were 2183 kcal and 169.44 mg, respectively. A significant inverse correlation was found between the dietary intake of magnesium and UPCR (r = - 0.219, p = 0.042). This association remained significant even after adjusting for confounding variables (β = - 0.222, p = 0.028). The findings of the present study showed a significant inverse relationship between the magnesium intake and proteinuria. Although, the design of the current research was cross-sectional, it has provided a basis for conducting future longitudinal studies and trials to better elucidate such a relationship.

Association between parental smoking and child exposure to environmental tobacco smoke in Israel

BackgroundEnvironmental tobacco smoke (ETS) exposure in children can cause delayed lung development and lifelong cardiovascular damage. The aim of this study was to measure ETS exposure in children in Israel in 2020–2021 using urinary cotinine (UC) measurements and to assess correlates of ETS exposure, including parental smoking.MethodsIn the framework of the National Human Biomonitoring Program, spot urine samples and questionnaire data were collected from 166 children aged 4–12 years, during the years 2020–2021. We collected urine samples in 233 adults, 69 of whom were parents of children included in the study. Parents of participating children were asked about parental smoking, child’s exposure to ETS and smoking policy at home. Cotinine and creatinine were measured in urine. Creatinine-adjusted and unadjusted urine cotinine (UC) geometric means were calculated. Associations between potential correlates and UC concentrations were analyzed in univariate and multivariate analyses. For 69 child-parent pairs, correlation between child and parental UC was analyzed.ResultsBased on urinary cotinine measurement, 65.2% of children of smokers are exposed to ETS, compared to 20.7% of children in non-smoking families. Greater numbers of smokers living in the home (beta = 1.27, p < 0.01), and low maternal education (beta = − 2.32, p < 0.01) were associated with higher levels of UC in a multivariate analysis. Spearman correlations showed a positive moderate correlation between UC in 69 child–parent pairs (r = 0.52, p < 0.01).ConclusionsIn order to reduce child exposure to ETS, smoking parents should be urgently targeted for smoking cessation and smoke-free home interventions. Further interventions are needed to protect all children from ETS.

Metabolomic Insights on Potassium Excretion, Blood Pressure, and Glucose Homeostasis: The African-PREDICT Study

BackgroundLow-potassium intake is associated with a higher risk of type 2 diabetes and hypertension. Both conditions occur more frequently in Black populations, who also consume less potassium-rich foods. ObjectivesUsing metabolomics to identify dysregulated metabolic pathways associated with low-potassium excretion may procure more accurate entry points for nutritional prevention and intervention for type 2 diabetes and hypertension. MethodsA total of 440 White and 350 Black adults from the African-PREDICT study (aged 20–30 y) were included. Twenty-four-hour blood pressure (BP) was measured. Potassium, sodium, and fasting glucose concentrations were analyzed in 24-h urine and plasma samples. Liquid chromatography-tandem mass spectrometry-based metabolomics included the analyses of amino acids and acylcarnitines in spot urine samples. ResultsBlack participants had lower urinary potassium concentrations than Whites (36.6 compared with 51.1 mmol/d; P < 0.001). In White but not Black adults, urinary potassium correlated positively with 2-aminoadipic acid (2-AAA) (r = 0.176), C3-[propionyl]carnitine (r = 0.137), C4-[butyryl]carnitine (r = 0.169) and C5-[isovaleryl]carnitine (r = 0.167) in unadjusted and 2-AAA (r = 0.158) and C4-carnitine (r = 0.160) in adjusted analyses (all P < 0.05 and q < 0.05). Elevated C0-, C3-, and C5-carnitine in turn were positively associated with systolic BP (Black and White groups), diastolic BP (Black group), and glucose (White group) (all P < 0.05). ConclusionsRacial differences are an important consideration when investigating nutrient–metabolite relationships and the role thereof in cardiovascular disease. Only in White adults did urinary potassium associate with 2-AAA and short-chain acylcarnitines. These metabolites were positively related to BP and fasting plasma glucose concentrations. In White adults, the metabolomic profiles related to potassium excretion may contribute to BP regulation and glucose homeostasis.This trial was registered at clinicaltrials.gov as NCT03292094.

The East Bay Diesel Exposure Project: a biomonitoring study of parents and their children in heavily impacted communities

BackgroundDiesel exhaust (DE) exposures pose concerns for serious health effects, including asthma and lung cancer, in California communities burdened by multiple stressors.ObjectiveTo evaluate DE exposures in disproportionately impacted communities using biomonitoring and compare results for adults and children within and between families.MethodsWe recruited 40 families in the San Francisco East Bay area. Two metabolites of 1-nitropyrene (1-NP), a marker for DE exposures, were measured in urine samples from parent–child pairs. For 25 families, we collected single-day spot urine samples during two sampling rounds separated by an average of four months. For the 15 other families, we collected daily spot urine samples over four consecutive days during the two sampling rounds. We also measured 1-NP in household dust and indoor air. Associations between urinary metabolite levels and participant demographics, season, and 1-NP levels in dust and air were evaluated.ResultsAt least one 1-NP metabolite was present in 96.6% of the urine samples. Detection frequencies for 1-NP in dust and indoor air were 97% and 74%, respectively. Results from random effect models indicated that levels of the 1-NP metabolite 6-hydroxy-1-nitropyrene (6-OHNP) were significantly higher in parents compared with their children (p-value = 0.005). Urinary 1-NP metabolite levels were generally higher during the fall and winter months. Within-subject variability was higher than between-subject variability (~60% of total variance versus ~40%, respectively), indicating high short-term temporal variability.ImpactBiomonitoring, coupled with air monitoring, improves understanding of hyperlocal air pollution impacts. Results from these studies will inform the design of effective exposure mitigation strategies in disproportionately affected communities.

Urinary concentrations of bisphenol A, parabens and benzophenone-type ultra violet light filters in relation to sperm DNA fragmentation in young men: A chemical mixtures approach

People are daily exposed to multiple endocrine disruptor compounds (EDCs) that may interfere with different molecular and cellular processes, promoting a potential estrogenic, androgenic, or anti-androgenic state. However, most epidemiological studies attempting to establish relationships between EDCs exposure and health effects are still considering individual compounds. A few studies have shown associations between exposure to individual non-persistent EDCs and sperm DNA fragmentation (SDF) in different male populations. Thus, the aim of this study was to investigate associations between combined exposure to non-persistent EDCs and SDF index in young men. A cross-sectional study was conducted with 158 healthy university students from Southeaster Spain. The participants provided spot urine and semen samples on the same day. The concentrations of urinary bisphenol A (BPA), benzophenones [2,4-dihydroxybenzophenone (BP-1); 2,2′,4,4′-tetrahydroxybenzophenone (BP-2), 2-hydroxy-4-methoxybenzophenone (BP-3), 2,2′-dihydroxy-4-methoxybenzophenone (BP-8), 4-hydroxybenzophenone (4OHBP)], and parabens (methylparaben, ethylparaben, propylparaben, butylparaben) were measured by dispersive liquid-liquid microextraction and ultrahigh-performance liquid chromatography with tandem mass spectrometry detection. SDF was analysed using a Sperm Chromatin Dispersion test. Statistical analyses were carried out using Bayesian Kernel Machine Regression models to evaluate associations between combined exposure to these compounds and SDF index while adjusting by relevant covariates. The increase in urinary concentration of 4OHBP was found to be the most important contributor to the negative association between urinary EDCs concentrations and SDF index, being of −5.5 % [95 % CI: −10.7, −0.3] for those in percentile 50, and − 5.4 % [95 % CI: −10.8, −0.1] for those in percentile 75. No significant associations were observed between other EDCs and SDF index. Our findings show that urinary 4OHBP levels may be associated with a decrease in the SDF index. Nonetheless, the effects we observed were likely to be small and of uncertain clinical significance. Further research is needed to replicate our findings in other male populations.