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【Objective】 To analyze the correlation between CT attenuation value of renal papilla and occurrence and development of renal calculi. 【Methods】 The clinical data of 100 patients with calcium oxalate stones treated during Aug.2020 and Jul.2022 were retrospectively analyzed, including 60 with primary stones, and 40 with recurrent stones. The 30 healthy volunteers were enrolled in the control group. CT attenuation value of renal papilla was measured with plain scan CT, and risk factors were identified with the receiver operating characteristic (ROC) curve. The correlation of CT attenuation value and 24 h urine metabolism was analyzed. 【Results】 The CT attenuation value of renal papilla was significantly higher in the primary group [34.92 (IQR: 3.84)] and recurrent group [43.00 (IQR: 8.74)] than in the control group [32.58 (IQR: 5.21)] (P<0.05). Compared with the primary group, the recurrent group had decreased citric acid level but increased calcium level in 24 h urine (P<0.05). The citrate ion and calcium ion were correlated with the CT attenuation value (P<0.05). 【Conclusion】 Patients with high renal papilla density have a high risk of stone formation and recurrence. Increased renal papilla density is a warning signal for the development of stones. The high calcium and low citric acid in 24 h urine have certain effects on the occurrence and development of urolithiasis. Intake of calcium should be limited and citric acid should be supplemented in patients with calcium oxalate stones.
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BACKGROUND@#The dietary habits and lifestyle changes during the COVID-19 pandemic could affect the urinary risk factors in kidney stone formers. In this study, we investigated the effects of the COVID-19 pandemic on 24-h urine metabolites, as a surrogate for dietary intake, in patients with kidney stones, in Tehran, Iran.@*METHODS@#We evaluated the medical records of all patients with urolithiasis who visited in our stone prevention clinic from the beginning of COVID-19 in Iran to 1 year later (Feb 2020-Feb 2021) and compared it with the patients' medical records in the same period a year before COVID-19 (Feb 2019-Feb 2020).@*RESULTS@#The results of our stone prevention clinic showed a decrease in the number of visits during COVID-19. Twenty-four-hour urine urea, sodium, and potassium were significantly lower, and 24-h urine magnesium was significantly higher during COVID-19. Higher 24-h urine oxalate was only shown in patients with the first-time visit, whereas lower 24-h urine uric acid and citrate were only shown in patients with the follow-up visits.@*CONCLUSIONS@#COVID-19 pandemics may change some of the dietary habits of the patients, including lower salt, protein, and fruit and vegetable intake. Although economic issues, restricted access, or sanitation issues may be the reason for the undesirable dietary changes, the importance of a quality diet should be discussed with all patients, as possible. Since the number of patients visited in the stone clinic was lower during COVID-19, virtual visits could be an excellent alternative to motivate patients with kidney stones.
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Humans , COVID-19 , Iran/epidemiology , Kidney , Kidney Calculi/prevention & control , Pandemics , Risk Factors , SARS-CoV-2ABSTRACT
@#Objective To analyze urine volume and dietary salt intake assessed by two 24 h urine specimens，to discuss its application value for evaluating population level and individual level dietary salt intake． Methods The subjects aged 18-69 years were selected from four counties in Shandong Province and Jiangsu Province from 2013 to 2014 by using multi-stage stratified cluster random sampling method． A questionnaire survey was conducted and two 24 h urine with an interval of one day were collected． The differences between two 24 h urine volume，and the dietary salt intake between two 24 h urine were assessed at individual level and population level． Ｒesults A total of 1 288 subjects was( 42．3± 14．0) years old，of which 626( 48．6%) were males． The average urine volume of the subjects was ( 1 462±437) ml． The first 24 h urine volume ( 1 427±488) ml was lower than the second 24 h urine volume ( 1 498± 552) ml ( t = -4．439，P＜0．001) ． The dietary salt intake was ( 9．8±3．3) g，and the dietary salt intake of males ( 10．1±3．5) g was higher than that of females ( 9．5±3．1) g ( t = 3．09，P= 0．002) ． There was a significant difference in dietary salt intake among different age groups ( F= 7．57，P＜0．001) ． The dietary saltintake of 1 136 ( 88．2%) subjects was higher than the recommended level． At the individual level，the participants with the absolute difference with 1g between the subjects’two 24 h urinary salt excretion was 279 ( 21．7%) ，and the participants with the absolute difference with ＞3 g was 48．5%． At the population level，the first 24 h urinary salt excretions ( 9．9 ± 4．1) g was similar to that in the second 24 h urine and ( 9．7±4．0) g ( P= 0．1021) ． The intraclass correlation coefficients between salt excretions in the two 24 h urine was 0．508( 95% CI: 0．451-0．559) ． Conclusion The results of this study suggest that 24 h urinary salt excretion can better assess the salt intake at population level，but cannot accurately reflect the individual’s salt intake．
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Objective To analyze the correlation between urinary albumin/creatinine ratio (ACR) and 24-hour urinary microalbumin (UMA) and evaluate the predictive value of ARC for early diabetic nephropathy.Methods A total of 368 patients with type 2 diabetes mellitus were retrospectively collected.Early diabetic nephropathy was defined as 24h UMA 30～＜300 mg/24h.The correlation between ACR and 24hUMA,and the area under the receiver operating characteristic (ROC) curve of ACR in diagnosis of early diabetic nephropathy were calculated.Gender,age,course of disease,fasting venous blood glucose,glycosylated hemoglobin,blood pressure,triglyceride and total cholesterol were used as adjusting variables to establish univariate and multivariate logistic models of ACR for early diabetic nephropathy,respectively.A regression model was used to evaluate the diagnostic value of ACR for early diabetic nephropathy.Results The correlation between ACR and 24h UMA was 0.658.The area under ROC curve of ACR for early diabetic nephropathy was 0.907 before and 0.933 after adjustments of gender,age,course of disease,fasting venous blood glucose,glycosylated hemoglobin,blood pressure,triglyceride and total cholesterol,respectively.The OR value of ACR of diabetic nephropathy was 2.016 before and 2.762 after same adjustments.The calibration of Hosmer-Lemeshow chi-square test evaluation model was 19.362 before (P=0.13) and 14.928 after adjustments (P=0.061).Conclusion ACR is a better predictor for early diabetic nephropathy although its value is influenced by gender,age,course of disease,blood sugar,lipid,and blood pressure.
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Objective To observe the effects of salvianolate on blood biochemical indexes, pathological changes of renal tissue and expression of CD2AP and Desmin protein in membranous nephropathy rats induced by cationic bovine serum albumin. And to explore the renal protective effect of salvianolate on membranous nephropathy rats and its possible mechanism. Methods Healthy male SD rats were randomly divided into normal group and modle group. Rat models of membranous nephropathy were reproduced by injection of cationized bovine serum albumin through tail vein. Model successful rats were randomly divided into model group, benazepril group, and salvianolate groups (16.7, 33.3, and 66.7 mg/kg). Each group was given the dose of the corresponding drugs. After treatment, the level of 24 h urine total protein (UTP), serum total cholesterol (TC), triglyceride (TG), total protein (TP), albumin (ALB), urea nitrogen (BUN), and serum creatinine (Scr) were detected. Immunofluorescence, light microscope, and electron microscope were used to observe the pathological changes of rat kidney. Immunohistochemistry and real-time PCR were used to detect the expression of CD2AP and Desmin. Results Compared with the control group, levels of UTP, TC, and TG increased significantly (P < 0.01), levels of serum TP and ALB decreased significantly (P < 0.01) in the model group. Compared with the model group, the UTP, TC, and TG of each treatment group were significantly decreased (P < 0.05, 0.01), while the TP and ALB were significantly increased (P < 0.01). There was no significant difference in the UTP, TC, TG, TP, and ALB among each dosage of salvianolate and benazepril group. And there was no significant difference among each dose group of salvianolate. There was no significant difference among each groups in the level of BUN and Scr. Compared with the normal group, the expression of CD2AP in model group was significantly decreased and Desmin was significantly increased (P < 0.01). Compared with the model group, the expression of CD2AP increased and Desmin decreased in each treatment group (P < 0.01), but there was no difference among the treatment groups. Conclusion Salvianolate has kidney protective effect on membranous nephropathy rats. The mechanism may be related to up-regulating the expression of CD2AP, down-regulating the expression of Desmin, inhibiting podocyte injury and protecting the integrity of the glomerular filtration barrier.
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OBJECTIVE:To observe the clinical efficacy of sitagliptin combined with benazepril in the treatment of diabetic nephropathy(DN). METHODS:Sixty DN patients admitted to our hospital during Sept. 2014-Jun. 2015 were divided into sitagliptin group,benazepril group,drug combination group according to random number table,with 20 cases in each group. Based on routine treatment,sitagliptin group was given sitagliptin 100 mg orally,qd;benazepril group was given Benazepril 10 mg orally,qd;drug combination group was given sitagliptin 100 mg+benazepril 10 mg orally,qd. The drug dosage would be doubled if the blood pressure of patients in 3 groups had not yet reached the standard. Treatment course of 3 groups lasted for 12 weeks. The levels of 24 h urine protein,IL-6 and Cys-C were measured in 3 groups before and after treatment. Clinical efficacies and the occurrence of ADR were observed. RESULTS:Total response rate of drug combination group(90.00%)was significantly higher than those of sitagliptin group (65.00%)and benazepril group(70.00%);there was statistically significance(P0.05). No obvious ADR was found in 3 groups during treatment. CONCLUSIONS:Both sitagliptin and benazepril can decrease the levels of 24 h urine protein,IL-6 and Cys-C,while drug combination shows better effect and clinical response rate,and does not influence the safety of drug use.
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OBJECTIVE:To observe clinical efficacy and safety of torasemide in the treatment of chronic heart failure(CHF). METHODS:94 patients with CHF were selected and randomly divided into control group and observation group,with 47 cases in each group. Control group were treated with routine treatment,such as bed rest,oxygen inhalation,control of total body fluid in-take,routine anti-heart failure therapy and use of diuretic in 24 h. Based on the above treatment,observation group were treated with Torasemide injection with initial dose of 5-10 mg,qd,gradually increasing to 20 mg/d,maximal does of 40 mg/d. Both group re-ceived 7 days of continuous treatment. Clinical efficacies were observed in 2 groups as well as serum potassium and sodium,Scr,24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function before and after treatment. The occurrence of ADR was compared between 2 groups. RESULTS:The total effective rate of observation group was 61.70%,which was significantly higher than that of control group (46.81%),with statistical significance (P0.05). There was no statistical significance in 24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function between 2 groups before and after treatment(P>0.05);after treatment,24 h urine volume and the rate ofⅠ-Ⅱgrade cardiac function of 2 groups were increased significantly,the observation group was higher than the control group, with statistical significance (P0.05). CONCLUSIONS:Torasemide is effective for CHF,and can promote diuresis and the recovery of cardiac function with good safety.
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High salt intake is related to an increase in blood pressure and development of hypertension. However, currently, there are no national representative data in Brazil using the gold standard method of 24-h urine collection to measure sodium consumption. This study aimed to determine salt intake based on 24-h urine collection in a sample of 272 adults of both genders and to correlate it with blood pressure levels. We used a rigorous protocol to assure an empty bladder prior to initiating urine collection. We excluded subjects with a urine volume <500 mL, collection period outside of an interval of 23-25 h, and subjects with creatinine excretion that was not within the range of 14.4-33.6 mg/kg (men) and 10.8-25.2 mg/kg (women). The mean salt intake was 10.4±4.1 g/day (d), and 94% of the participants (98% of men and 90% of women) ingested more than the recommended level of 5 g/d. We found a positive association between salt and body mass index (BMI) categories, as well as with salt and blood pressure, independent of age and BMI. The difference in systolic blood pressure reached 13 mmHg between subjects consuming less than 6 g/d of salt and those ingesting more than 18 g/d. Subjects with hypertension had a higher estimated salt intake than normotensive subjects (11.4±5.0 vs 9.8±3.6 g/d, P<0.01), regardless of whether they were under treatment. Our data indicate the need for interventions to reduce sodium intake, as well the need for ongoing, appropriate monitoring of salt consumption in the general population.
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Humans , Male , Female , Adult , Middle Aged , Blood Pressure/physiology , Sodium Chloride, Dietary/administration & dosage , Sodium/urine , Blood Pressure/drug effects , Brazil , Cross-Sectional Studies , Time Factors , Urban Population , Urine Specimen Collection/methodsABSTRACT
ObjectiveTo define the difference of urine analysis result,α1-microglobulin (α1-MG) and β2-microglobulin ( β2-MG) between those patients suffering from calcium oxalate stone,non-calcium oxalate stone and non-urolithiasis controls at the same time period.MethodsData from 100 patients admitted to the Department of Urology,First Affiliated Hospital of Anhui Medical University from July,2010 to September,2010 were reviewed.66 patients (45 men,21 women) suffered from urolithiasis,and 34 patients (22 men,12 women) were non-urolithiasis.Patients' ages in urolithiasis group varied from 13 to 78 years and the male to female ratio was 2.1∶1.0.The patients in non-urolithiasis controlgroup aged from 12 to 80 years and the male to female ratio was 1.8∶1.0.Blood and urine were taken from the patient the next morning after admission.The biochemistry from blood and 24 h urine were measured by automatic biochemistry analyzer.The α 1-MG and β2-MG content were measured by radioimmunoassay.The stone compositions were analyzed by infrared spectroscopy.ResultsThere was difference in the levels of serum creatinine and blood urea nitrogen among three groups ( P ＜ 0.05).In controls,those with calcium oxalate stone had higher level of urinary α1-MG and β2-MG,but there were no differences in the urinary electrolyte levels.Group of non-calcium oxalate stones urinary uric acid levels were higher than calcium oxalate and control groups,the difference was statistically significant.ConclusionsIn the formation of uric acid stones,uric acid increased as independent risk factors.α1-MG,β2-MG may promote the formation of calcium oxalate stones.
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Blood C-peptide,first-void fasting urinary C-peptide/creatinine ratio ( UCPCR ),second-void fasting UCPCR,and 24 h urinary C-peptide (UCP) were determined in 90 type 2 diabetics and 30 health volunteers.The results showed that first-void fasting UCPCR and second-void fasting UCPCR were positively related to 24 h UCP and the index of islet β-cell function( all P＜0.01 ).
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<p><b>OBJECTIVES</b>Concerns over dietary exposure to bisphenol A (BPA), an endocrine disruptor, have been raised because BPA is contained in resins and plastics commonly used for the preservation of food and beverages. The purpose of the present study was to assess daily intake levels of BPA in a group of male subjects by measuring total urinary BPA (free BPA plus BPA released by treatment with β-glucuronidase), as well as determining intra-individual variation in BPA excretion.</p><p><b>METHODS</b>Twenty-four-hour urine was collected from 5 subjects for 5 consecutive days for the evaluation of between-day variation in urinary BPA excretion and from 36 male subjects for the estimation of the level of daily BPA intake. BPA in the urine samples was measured by GC/MS/MS following enzymatic hydrolysis of BPA glucuronate, solid phase extraction, and derivatization.</p><p><b>RESULTS</b>A large between-day variation was found over 5 days for the daily excretion of urinary BPA in the 5 subjects. The daily excretion of urinary BPA was distributed log-normally in the 36 male subjects, with the median value being 1.2 μg/day (range: <0.21-14 μg/day), which was far below the Tolerable Daily Intake (0.01 mg/kg bw) recommended by a scientific committee in the European Commission in 2002. However, the maximum estimated intake per body weight (0.2 μg/kg/day) was only one order of magnitude lower than the reported lowest level for reproductive/behavioral effects in pregnant mice (2 μg/kg/day).</p><p><b>CONCLUSIONS</b>Measuring urinary BPA in urine is a suitable approach for estimating short-term BPA intake levels in individuals and/or estimating the average exposure level of populations. Urine analyses will be increasingly important in the human health risk assessment of BPA.</p>
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Objectives: Concerns over dietary exposure to bisphenol A (BPA), an endocrine disruptor, have been raised because BPA is contained in resins and plastics commonly used for the preservation of food and beverages. The purpose of the present study was to assess daily intake levels of BPA in a group of male subjects by measuring total urinary BPA (free BPA plus BPA released by treatment with β-glucuronidase), as well as determining intra-individual variation in BPA excretion. Methods: Twenty-four-hour urine was collected from 5 subjects for 5 consecutive days for the evaluation of between-day variation in urinary BPA excretion and from 36 male subjects for the estimation of the level of daily BPA intake. BPA in the urine samples was measured by GC/MS/MS following enzymatic hydrolysis of BPA glucuronate, solid phase extraction, and derivatization. Results: A large between-day variation was found over 5 days for the daily excretion of urinary BPA in the 5 subjects. The daily excretion of urinary BPA was distributed log-normally in the 36 male subjects, with the median value being 1.2 μg/day (range: <0.21-14 μg/day), which was far below the Tolerable Daily Intake (0.01 mg/kg bw) recommended by a scientific committee in the European Commission in 2002. However, the maximum estimated intake per body weight (0.2 μg/kg/day) was only one order of magnitude lower than the reported lowest level for reproductive/behavioral effects in pregnant mice (2 μg/kg/day). Conclusions: Measuring urinary BPA in urine is a suitable approach for estimating short-term BPA intake levels in individuals and/or estimating the average exposure level of populations. Urine analyses will be increasingly important in the human health risk assessment of BPA.
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BACKGROUND: Soluble adhesion molecules including soluble vascular cell adhesion molecule-1 (sVCAM-1) are released during an infalmmatory process such as artherosclerosis. Elevated sVCAM-1 also has been reported in diabetic nephropathy. But, the clinical significance of elevated of sVCAM-1 is not certain. We measured serum sVCAM-1 for the purpose to validate the clinical usefulness in diabetic nephropathy. METHODS: In this study, we measured serum sVCAM-1 in 12 normal subjects and 64 type 2 diabetic patients with proteinuria over 300 mg/day [median 24-h urine protein (range): 2.2 (0.3-18.7) g/day]. We evaluated the relationship of serum sVCAM-1 with lipoproteins including total cholesterol, LDL, oxidized LDL (oxLDL), HDL, and lipoprotein(a) (Lp(a)), with markers of inflammation including high-sensitivity CRP (hs-CRP), serum albumin and fibrinogen, and with renal parameters including 24-h urine protein, serum creatinine and homocysteine. RESULTS: In patients with diabetic nephropathy, median sVCAM-1 was 561 ng/mL (range 183-1304), which was significantly higher than that of normal subjects (324 ng/mL; 213-760, p< 0.05). In the diabetic nephropathy patients, sVCAM-1 was positively correlated with serum creatinine (r=0.34, p< 0.01), serum Lp(a) (r=0.27, p< 0.05) and 24-h urine protein (r=0.26, p< 0.05). In a multiple linear regression analysis, 24-h urine protein and serum Lp(a) were associated with an increased level of sVCAM-1 (r2=0.22, p=0.003). CONCLUSION: In summary, a positive correlation of sVCAM-1 with 24-h urine protein suggests that high sVCAM-1 may reflect increased production of sVCAM-1 due to more advanced renal injury. A positive association of sVCAM-1 and serum Lp(a) also suggests increased release of sVCAM-1 from associated atherosclerotic lesions in these patients. These results suggest that sVCAM-1 may be closely related with the renal function in patients with overt diabetic nephropathy.
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Humans , Cholesterol, LDL , Creatinine , Diabetes Mellitus, Type 2 , Diabetic Nephropathies , Fibrinogen , Homocysteine , Inflammation , Linear Models , Lipoprotein(a) , Lipoproteins , Proteinuria , Serum Albumin , Vascular Cell Adhesion Molecule-1ABSTRACT
Objective To study the relationship between chemical composition of urinary stones and metabolic disturbance. Methods 284 urinary stone patients who had undergone analysis of stone composition were evaluated;of them 191 patients had entire blood biochemistry results and 24-h urine analysis results.The relationship between stone composition and metabolic disturbance was analyzed using ?2 test. Results Calcium oxalate stones were found in 195 cases (68.7%),infection stones in 41 cases ( 14.4%),uric stones in 38 cases (13.4%),phosphate stones in 6 cases (2.1%) and cystine stones in 4 cases (1.4%).Metabolic disturbance was found in 176 (92.1%) of 191 patients with entire blood biochemistry results and 24-h urine analysis results.Among the 176 patients,hypercalciuria occurred in 27 cases (14.1%),hyperuricosuria in 54 cases (28.3%),hyperoxluria in 41 cases (21.5%),hyperphophauria in 55 cases (28.8%),hypocitraturia in 128 cases (67.0%),hypomagnesiuria in 80 cases (41.9%),24-h urine volume