P0208DIFFERENTIAL ADAPTATION OF RENAL FUNCTION IN TWO TYPES OF INTENSE PHYSICAL EXERCISE

Abstract Background and Aims Marathon running induces AKI even in adequately prepared and healthy athletes. Heat stress, maintained during more than 2h, has been proposed as one of the leading causes of AKI in marathons runners. Other possible explanations of AKI in this setting could be associated with a reduction of blood supply to the kidneys during the exercise, inadequate hydration or actual structural damage due to microtraumatisms. However, the effect of vigorous exercise of shorter duration on renal function has not been previously described although most risk factors described could also affect kidney function in this type of physical activity. Method 40 volunteer healthy athletes were enrolled in this study. Subjects participated in two physical tests (10km running, 1.5km swimming) which were separated by at least two weeks from each other. These tests were chosen because of their similar oxygen consumption rate and metabolic load. Vitals, blood and urine samples were collected immediately before and after each test. Informed consent was obtained from all participants. The project was funded by Consejería de Sanidad, Junta de Castilla y León (GRS1732/A/18). Results Athletes ranged from 23 to 53 years old. 35% were female. A comparison of hemodynamic and analytical parameters is summarized in Table 1. Running induced a significantly higher rise of serum creatinine and inflammatory markers compared to swimming. Additionally, running caused an increment of serum phosphorus and uric acid levels. Both types of exercise caused a mild increase of urinary albumin/creatinine ratio. Conclusion Compared to swimming, running was associated with a greater rise of serum creatinine, possibly linked to a higher degree of acute inflammation and blood flow redistribution to the muscles. The rise of serum uric acid levels may be associated with increased metabolism and reduced elimination of this molecule while running.

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Serum uric acid as a predictor for nephritis in Egyptian patients with systemic lupus erythematosus

Lupus ◽

10.1177/0961203320979042 ◽

2020 ◽

pp. 096120332097904

Author(s):

Eman Ahmed Hafez ◽

Sameh Abd El-mottleb Hassan ◽

Mohammed Abdel Monem Teama ◽

Fatma Mohammed Badr

Keyword(s):

Systemic Lupus Erythematosus ◽

Renal Function ◽

Uric Acid ◽

Lupus Nephritis ◽

Serum Creatinine ◽

Disease Activity ◽

Lupus Erythematosus ◽

Systemic Lupus ◽

Group 2 ◽

Group 1

Objective Lupus nephritis (LN) is closely associated with hyperuricemia, and uric acid is considered a risk factor for renal involvement in systemic lupus erythematosus (SLE). This study aimed to examine the association between serum uric acid (SUA) level and LN development and progression in SLE patients with normal renal function. Methods A total of 60 SLE patients with normal renal function from Ain Shams University Hospital were selected and assigned to group 1 (30 patients with LN) and group 2 (30 patients without LN). All patients were subjected to history taking, clinical examination, disease activity assessment based on SLE disease activity index (SLEDAI) and renal SLEDAI (SLEDAI-R) scores, and laboratory investigations, including as SUA, complete blood count, blood urea nitrogen (BUN), serum creatinine, creatinine clearance, urine analysis, protein/creatinine ratio, 24-h urinary protein excretion, Antinuclear antibodies (ANA), anti-dsDNA antibody, and serum complement (C3, C4). Results Disease duration, SLEDAI score, and SUA level were higher in group 1 than in group 2 (p < 0.001). SUA level was positively correlated with SLEDAI and SLEDAI-R scores, proteinuria, urinary casts, renal biopsy class, disease activity and chronicity indices, BUN level, and serum creatinine level but was negatively correlated with creatinine clearance (p < 0.05). SUA was a predictor of LN development in SLE patients (sensitivity, 83.3%; specificity, 70%). Conclusion SUA is associated with the development of lupus nephritis in patients with normal kidney function also SUA in-dependently correlated with disease activity and chronicity in LN.

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Relationship between severity of hypertension and renal impairment in preeclampsia

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v11i3.36256 ◽

2018 ◽

Vol 11 (3) ◽

pp. 213

Author(s):

Khairun Nahar ◽

Ferdousi Islam ◽

Naila Atik Khan

Keyword(s):

Blood Pressure ◽

Renal Function ◽

Uric Acid ◽

Renal Impairment ◽

Serum Creatinine ◽

Preeclamptic Patient ◽

Blood Pressures ◽

Mild Preeclampsia ◽

The Mean ◽

The Relationship

<p class="Abstract">The aim of this study was to determine the relationship between the severity of hypertension and renal impairment in preeclampsia. This study was conducted on 92 diagnosed cases of mild (n=42) and severe (n=50) preeclampsia patients from August 2010 to July 2011. All the patients were almost identical in terms of age and socioeconomic status. The results of the study showed that the mean serum creatinine and uric acid levels were significantly high in severe preeclampsia patient compared to mild preeclampsia and both systolic and diastolic blood pressures had the positive and significant effects on the serum creatinine and uric acid levels. In conclusion, impairment of renal function has the positive and significant relationship with the severity of blood pressure in the preeclamptic patient.</p>

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Kidney protection by pretreatment with free radical scavengers and allopurinol: Renal function at recirculation after warm ischaemia in rabbits

Clinical Science ◽

10.1042/cs0710245 ◽

1986 ◽

Vol 71 (3) ◽

pp. 245-251 ◽

Cited By ~ 25

Author(s):

R. Hansson ◽

S. Johansson ◽

O. Jonsson ◽

S. Pettersson ◽

T. Scherstén ◽

...

Keyword(s):

Superoxide Dismutase ◽

Renal Function ◽

Serum Creatinine ◽

Kidney Tissue ◽

Urine Osmolality ◽

Free Radical Scavengers ◽

Control Group ◽

Creatinine Concentration ◽

Pronounced Increase ◽

Before And After

1. Renal function and morphology were studied before and after 60 min of renal ischaemia and contralateral nephrectomy in five groups of rabbits. The animals were pretreated with superoxide dismutase, catalase, allopurinol or mannitol. One group was not pretreated and served as a control. 2. A moderate transient increase in serum creatinine concentration was observed in the control rabbits, while a significantly less pronounced increase was noted after pretreatment with superoxide dismutase, catalase and mannitol. 3. Pretreatment with allopurinol did not significantly reduce the postoperative increase in serum creatinine and sodium excretion, but the urine osmolality returned to normal more rapidly than in the control group. 4. The appearance under the light microscope of kidney tissue taken from surviving rabbits was found to be normal irrespective of pretreatment. Severe tubular necrosis was observed in the kidneys from rabbits that died during the observation period.

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Correlation of serum uric acid with renal function parameters in preeclampsia.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.12.4267 ◽

2020 ◽

Vol 27 (12) ◽

pp. 2703-2707

Author(s):

Muddasir Zia ◽

Rukhshan Khurshid ◽

Uzma Jabbar ◽

Adnan Riaz ◽

Roohi Jabbar ◽

...

Keyword(s):

Renal Function ◽

Uric Acid ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Cross Sectional Study ◽

Urinary Protein ◽

Estimation Of Parameters ◽

Cross Sectional ◽

Significant Difference ◽

Relationship Of

Objectives: Study was designed to find out the Correlation of serum uric acid with renal function parameters in Preeclampsia. Study Design: Cross Sectional study. Setting: Sir Ganga Ram Hospital Lahore. Period: July 2016 to July 2017. Material & Methods: Level of serum uric acid, serum creatinine and blood urea of 40 Preeclamptic women and 30 gestation-matched normotensive controls were estimated. Their Demographic and clinical characteristics were noted. The blood sample was analyzed for biochemical parameters, blood urea, serum uric acid, serum creatinine and urinary protein. Result: Mean age and gestational age of women was 25 weeks with BMI 29 Kg/m2. Level of serum uric acid and blood urea and serum creatinine were increased, but significant difference only observed with serum uric acid and blood urea with marked proteinuria. An inverse relationship of serum uric acid with urinary protein was observed. A direct relationship, of serum uric acid with serum creatinine was observed. Conclusion: it is concluded that estimation of parameters of renal function of preeclamptic women are important along with hyperuicaemia.

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Incidence and Progress of Vesicoureteric Reflux after Primary Fulguration of Posteriorurethralvalves

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v3i2.23916 ◽

2015 ◽

Vol 3 (2) ◽

pp. 71-77

Author(s):

MM Masud Pervez ◽

Kaniz Hasina ◽

Md Ashraf Ul Huq

Keyword(s):

Renal Function ◽

Serum Creatinine ◽

Creatinine Level ◽

Pearson Correlation ◽

Vesicoureteric Reflux ◽

Correlation Test ◽

Positive Correlation ◽

Before And After ◽

Pearson Correlation Test

Introduction: Posterior urethral valve (PUV) is the most frequent cause of urethral obstruction in male child. These lesions usually result in lifelong disabilities with incontinence and decreased renal function despite optimal medical management. Primary fulguration without upper tract diversion is the preferred modality of treatment in most cases of PUV. Regular follow-up is needed to check completion of valve fulguration, renal function, status of hydronephrosis, vesicoureteric reflux (VUR), urinary tract infection (UTI), and bladder function.Materials and methods: We conducted interventional study among 30 purposively selected patients of PUV in the Department of Pediatric surgery, Dhaka Medical College Hospital (DMCH), Dhaka, over a period of 20 months from December 2009 to July 2011. Age of study subjects varied from 2 days to 14 years. Among the 30 patients, 16 were children in the age group between 1year to14 years (53.3%), 11(36.7%) were infants and the rest 03(10%) were neonates. Most of the patients presented with weak urinary stream, dribbling of urine, straining at micturition, UTI and palpable bladder. All children were subjected to ultrasonography (USG), blood urea, serum creatinine, routine urine examination and culture studies. Structured questionnaire was used to collect information regarding improvement or disappearance of VUR and renal functional status before & after primary fulguration of PUV.Results: Average serum creatinine level was found gradually decreased in subsequent follow up in comparison with the previous one. This difference of creatinine level was found statistically significant in t-test (p<0.01). Average blood urea nitrogen (BUN) was also decreased which was found statistically significant (p<0.05). VUR was present in 63.3% cases. Non- VUR was found in 60% cases on right side and 50% cases on left side. On the third follow-up after 3 months it became 73.3% on right side and 63.3% on left side. Positive correlation found in Pearson correlation test about the changes of reflux grades before and after fulguration was significant at the level of 0.01(p<0.001). It was significant on both left and right kidneys. Positive correlation found in Pearson correlation test about the changes of GFR before and after fulguration was also significant at the level of 0.01(p <0.001). Collected data was cleaned, edited and analyzed with the help of software SPSS window version 15.0.Conclusion: In this study, VUR disappeared in some cases and decreased in majority of the cases by 3 months after adequate restoration of urethral patency. Renal function came to normal range in two thirds of the cases.J. Paediatr. Surg. Bangladesh 3(2): 71-77, 2012 (July)

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Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies

Indian Journal of Medical Biochemistry ◽

10.5005/jp-journals-10054-0005 ◽

2016 ◽

Vol 20 (1) ◽

pp. 21-27 ◽

Cited By ~ 1

Author(s):

Rajeev Ranjan ◽

Anjana Singh

Keyword(s):

Renal Function ◽

Uric Acid ◽

Serum Creatinine ◽

Renal Dysfunction ◽

Cystatin C ◽

Normal Pregnancy ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Function Tests ◽

Renal Function Tests

ABSTRACT Background Glomerular endotheliosis is an essential component in the pathophysiology of gestational hypertension (GH) and preeclampsia (PE) which results in renal dysfunction. This is not always detected by routine renal function tests, such as serum creatinine, urea, and uric acid. Cystatin C, an endogenous cysteine protease inhibitor, is completely absorbed by renal tubules and has been shown to be an ideal marker of glomerular filtration rate (GFR), which needs to be evaluated in assessing renal dysfunction occurring in GH and PE. Aims The present study is designed to evaluate serum cystatin C levels in normal pregnancy, GH, and PE and compare its efficacy with traditional renal function tests. Materials and methods In this prospective cross-sectional study, 75 subjects enrolled, comprised of 25 subjects each of normal pregnancy, GH, and PE. Serum cystatin C, blood urea, serum creatinine, serum uric acid, and urinary protein/creatinine ratio were estimated in all subjects prior to delivery. Results All renal parameters including cystatin C were significantly raised in GH and PE compared with control group. However, only serum cystatin C level (and no other renal parameters) was significantly higher in PE group compared with GH group. Area under the curve for cystatin C was maximum (0.917) compared with other parameters. Cystatin C had a higher sensitivity and specificity than other conventional markers. Conclusion Serum cystatin C is a better marker of renal dysfunction in hypertensive pregnancies. How to cite this article Singh A, Gupta M, Ranjan R, Saini V, Gupta SK. Cystatin C is a Better Marker of Renal Dysfunction in Hypertensive Pregnancies. Indian J Med Biochem 2016; 20(1):21-27.

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Identifikasi Risiko dan Pencegahan Terhadap Nefropati Akibat Kontras

Jurnal Radiologi Indonesia ◽

10.33748/jradidn.v2i1.50 ◽

2016 ◽

Vol 2 (1) ◽

pp. 52-58

Author(s):

Andre Tjie Wijaya ◽

Budiawan Atmadja

Keyword(s):

Renal Function ◽

Serum Creatinine ◽

Contrast Medium ◽

Volume Expansion ◽

Contrast Induced Nephropathy ◽

Iodinated Contrast Medium ◽

Iodinated Contrast ◽

Before And After ◽

History Of ◽

Careful Assessment

The increase of application of iodinated contrast medium in diagnostic practice, combined with the increase of renal insufciency patients and elderly resulted in increasing incidency of contrast-induced nephropathy (CIN). The use of iodinated contrast medium need a careful assessment between risk and beneft, especially in patients with history of renal disease and elderly. Assessment of renal function is based on glomerular fltration rate, not serum creatinine. Avoidance of iodinated contrast medium is the frst step to prevent the development of CIN. Consideration of alternative imaging is important. But, if iodinated contrast medium is needed, volume expansion intravenous before and after administration is the next acknowledged prevention step.

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Comparison of Allopurinol And Febuxostat in Asymptomatic Hyperuricemic Patients and their Impact on Serum Creatinine

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2019070 ◽

2019 ◽

Vol 10 (1) ◽

pp. 17-21

Author(s):

Tafazzul Hussain ◽

Musarrat Sultana ◽

Syeda Amber Zaidi ◽

Syed Saud Hasan ◽

Mohsin Turab ◽

...

Keyword(s):

Renal Function ◽

Uric Acid ◽

Serum Creatinine ◽

Serum Uric Acid ◽

Blood Parameters ◽

Mean Difference ◽

P Value ◽

Baseline Serum ◽

Group A ◽

Group B

Objective: To determine the effect of Allopurinol & Febuxostat for the treatment of hyperuricemic patients & its influence on renal function by measuring serum creatinine level. Study Design & setting: The clinical trial was conducted at Dr. Ruth K M Pfau Civil Hospital, Karachi, during the period of September 2018 to March 2019 Methodology: 60 patients with sUA > 6.8 mg/dl were registered. A detailed history was taken, patient's baseline serum Uric Acid (sUA) & serum Creatinine were measured. Patients were divided into two groups to receive Allopurinol, 300 mg & Febuxostat 80 mg, daily for 90-days. The blood parameters were repeated at day 30 and 90. Results: Group-A (Allopurinol treated patients) baseline uric acid changed from mean 8.79 ± 0.98 mg/dl to 6.40 ± 0.86 mg/dl at day 90. In Group-B (Febuxostat treated patients) sUA baseline mean changed from 8.85 ± 0.97 mg/dl to 5.96 ± 0.68 mg/dl. Mean difference ± SD change of serum uric acid in Group-A was 2.39 ± 1.15 mg/dl and with Group-B it was 2.90 ± 0.87 mg/dl. Mean Serum Creatinine in Group-A changed from 1.54 ± 0.39 mg/dl to mean 1.48 ± 0.40 mg/dl compared with Group-B where it changed from 1.42 ± 0.30 mg/dl to 1.45 ± 0.31 mg/dl at day-90. Mean difference ± SD of serum Creatinine in Group-A was 0.11 ± 0.25 mg/dl & in Group-B it was, 0.03 ± 0.15 mg/dl. The above changes were statistically non-significant with p-value of 0.144. Conclusion: Allopurinol and Febuxostat treatment resulted in improvement of serum Uric Acid levels while maintaining their renal function

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The Effect of Submaximal Exercise on Blood Creatinine, Urea, Total Protein and Uric Acid Levels of Trained and Untrained Subjects

Baltic Journal of Sport and Health Sciences ◽

10.33607/bjshs.v3i66.542 ◽

2018 ◽

Vol 3 (66) ◽

Cited By ~ 1

Author(s):

Alina Gailiūnienė ◽

Arvydas Stasiulis ◽

Jolanta Michailovienė

Keyword(s):

Renal Function ◽

Uric Acid ◽

Total Protein ◽

Nitrogen Compounds ◽

Blood Samples ◽

Before And After ◽

Group 2 ◽

Exercise Induced ◽

Blood Creatinine ◽

Group 1

There are numerous studies about exercise-induced sports hematuria, proteinuria, acute renal failure following a marathon (Steward, Posen, 1980; Poortmans et al., 2001; Ayca et al., 2006). But studies investigating the effects of exercise on blood indicators of renal function are quite few.The aim of this study was to investigate the effects of submaximal veloergometric exercise on very important bio-chemical indicators of renal function — level nitrogen compounds in the blood. We investigated concentration of creatinine, urea, total protein and uric acid in venous blood samples before and after submaximal veloergometric exercise. Those nitrogen compounds were studied in three groups of subjects.The study was performed with 10 trained (Group 1), 10 untrained subjects (Group 2) and 10 subjects with I o hiper-tensive status (Group 3). The age range was 20.5—21.3 years, weight — 71.8—77.3 kg, height — 180—177 cm. All subjects voluntered to participate in the study after providing written informed consent. The study was approved in accordance with the Declaration of Helsinki. Blood samples were collected before and after the submaximal velo-ergometric test into vacumtrainer tubes. Concentrations of creatinine, urea, total protein and uric acid in the serum were determined using Technicon Auto Analyzer ADVIA 1650 system.All data were reported as mean ± standard deviation (SD) unless otherwise speciﬁ ed, and statistical signiﬁ cance was recognized when p ≤ 0.05.No statistically signiﬁ cant difference was observed between pre- and post exercise blood creatinine, urea, total protein and uric acid mean levels of all group subjects. A marked exercise induced increase in blood creatinine and total protein concentrations was observed when the results of trained and untrained participants’ parameter differences were compared after the exercise.A signiﬁ cant (p < 0.05) exercise-induced increase in blood urea and total protein concentration was observed when the mean values of Group 1 and Group 2 before the exercise and parameters after the exercise were compared.When blood creatinine, urea, total protein and uric acid levels were compared separately for the participants, it was observed that seven persons in Group 1 and three persons in Group 2 showed a marked exercise-induced increase in the blood nitrogen compounds level.Research results suggest that 1) the testing exercise-induced statistically insigniﬁ cant (p > 0.05) increases in the blood parameters of nitrogen compounds (creatinine, urea, total protein and uric acid) could be due to the common phenomenon of the physical stress and catecholamine effects, 2) postexercise changes of blood nitrogen compounds were signiﬁ cant (p < 0.05) when the results of Group 1 with Group 2 participants were compared. The signiﬁ cant differences in metabolic responce in Group 1 and Group 2 participants probably reﬂ ect differences in work volume and intensity, and 3) further studies are needed to be performed on more subjects to evaluate exercise-speciﬁ c effects on postexercise changes of blood nitrogen compounds in athletes and nonathletes.Keywords: blood, creatinine, urea, total protein, uric acid.

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Maternal-Perinatal Variables in Patients with Severe Preeclampsia Who Develop Acute Kidney Injury

Journal of Clinical Medicine ◽

10.3390/jcm10235629 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5629

Author(s):

Patrocinio Rodríguez-Benitez ◽

Irene Aracil Moreno ◽

Cristina Oliver Barrecheguren ◽

Yolanda Cuñarro López ◽

Fátima Yllana ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Renal Function ◽

Uric Acid ◽

Caesarean Section ◽

Serum Creatinine ◽

Kidney Injury ◽

Severe Preeclampsia ◽

History Of ◽

Nicu Admission

Introduction: At present, we are witnessing an increase in preeclampsia, especially the most severe forms, which are associated with an increased risk of maternal-perinatal morbidity and mortality. As a severity criterion, acute kidney injury (AKI) has been associated with a worse prognosis, and for this reason, the maternal and perinatal variables associated with AKI in patients with severe preeclampsia (SP) were analysed in this study. Methods: An observational, retrospective, single-centre study of patients with SP treated at a tertiary hospital between January 2007 and December 2018 was conducted. The case criteria based on the criteria established by the ACOG Practice Guidelines for Gestational Hypertension and Preeclampsia. AKI is considered when serum creatinine exceeds 1.1 mg/dL in a pregnant woman with previously normal renal function. In patients with existing chronic kidney disease (CKD), it is referred to as AKI if the baseline serum creatinine increases by 1.5 fold. Pregestational, gestational and postpartum variables were analysed up to 12 weeks postpartum using univariate and multivariate logistic regression analysis. Results: During the study period, 76,828 births were attended, and 303 pregnant women were diagnosed with SP. The annual incidence of SP increased gradually throughout the study period, reaching 1.79/100 births/year in 2018. Acute kidney injury (AKI) occurred in 24.8% of the patients. The multivariate analysis revealed an increased association with a history of previous CKD, the use of assisted reproductive techniques and caesarean section. Uric acid and thrombotic microangiopathy (TMA) had a high correlation with AKI. Indications for caesarean section are associated with AKI in SP. Regarding perinatal outcomes in cases of AKI, there was a higher percentage of neonates who required foetal lung maturation with steroids and an increased need for NICU admission. No case of maternal death was recorded; however, an increase in neonatal mortality was found among patients who did not develop AKI. After 12 weeks postpartum, 72 patients were referred to the nephrology consultation for persistent hypertension, proteinuria or renal failure. Conclusions: In preeclampsia, AKI is a common complication, especially among patients with a history of CKD, those who became pregnant using assisted reproduction techniques and those who delivered via caesarean section. The perinatal impact of AKI is mainly centred on a higher rate of NICU admission and a lower mortality rate. Among biochemical and haematological markers, the uric acid level prior to renal failure has a direct and significant correlation with the risk of AKI, as does the development of TMA in patients with preeclampsia. Therefore, the monitoring of renal function in cases of preeclampsia should be strict, and referral for a nephrology consultation may be necessary in some cases.

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