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Purpose: Vascular endothelial growth factor inhibitors (anti?VEGF) have been shown to be effective in the treatment of diabetic macular edema. However, there is little information about the systemic effects of intraocular administration of anti?VEGF drugs in patients with coexistent diabetic nephropathy because it can produce adverse renal effects. Methods: This retrospective cohort study analyzed the effect of intravitreal anti?VEGF drugs (bevacizumab, ranibizumab, or aflibercept) on eFGR and microalbuminuria (MicA) in patients with diabetic macular edema and nonproliferative retinopathy without chronic kidney disease (CKD). Results: Sixty?six patients were included, 54.5% male and 45.5% female, with a mean age of 66.70 ± 11.6 years. The mean follow?up of patients with antiangiogenic treatment was 42.5 ± 28.07 months, and the mean number of injections was 10.91 ± 7.54. In 12.1% of the cases, there was a worsening of the glomerular filtration rate (eFGR) and a 19.7% worsening of the microalbuminuria (MicA). The number of injections was not related to the worsening of the eFGR (P = 0.74) or the MicA (P = 0.239). No relationship was found between the type of drug and the deterioration of the GFR (P = 0.689) or the MicA (P = 0.53). Conclusions: Based on the results, there is a small proportion of patients with increase in MicA and the decrease in eFGR after anti?VEGF therapy, and these was no associated with the number of injection or the drug type. Ophthalmologists should be aware of renal damage in order to do a close monitoring of renal function and proteinuria after intravitreal administration of anti?VEGF mainly in hypertensive patients.
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Introducción: La diabetes mellitus constituye una enfermedad de elevada morbilidad y mortalidad. Objetivo: Caracterizar clínica y epidemiológicamente la diabetes mellitus tipo 2 y el uso de la microalbuminuria en el daño renal precoz. Materiales y métodos: Se realizó un estudio transversal mediante una muestra no probabilística de 94 pacientes, en un universo de 187 enfermos con diabetes mellitus 2, en el Servicio de Medicina Interna del Hospital Clínico Quirúrgico Docente Amalia Simoni, de Camagüey. El mismo tuvo lugar entre enero de 2020 y enero de 2021. Se analizaron variables como edad, sexo, hábitos tóxicos, estado nutricional, tiempo de evolución de la diabetes, comorbilidades, valor de la microalbuminuria y su relación con el tiempo de evolución de la enfermedad. Para el procesamiento de los datos se empleó el programa estadístico SPSS 19.0. Resultados: Prevalecieron el grupo de 60 años y más, el sexo femenino, el tabaquismo como hábito tóxico, y el sobrepeso. Según el tiempo de evolución de la enfermedad, prevaleció el rango de 6 a 10 años. Las comorbilidades principales fueron la hipertensión arterial y la cardiopatía isquémica. La relación entre el tiempo de evolución de la enfermedad y la aparición de microalbuminuria patológica, demostró la utilidad de esta en la detección del daño renal precoz en pacientes con 6 a 10 años de evolución. Conclusiones: Se demostró el papel de la microalbuminuria en la detección del daño renal precoz en pacientes con diabetes mellitus tipo 2.
Introduction: Diabetes mellitus is a disease with high morbidity and mortality. Objective: To characterize clinically and epidemiologically type 2 diabetes mellitus and the use of microalbuminuria in early kidney damage. Materials and methods: A cross-sectional study was carried out using a non-probabilistic sample of 94 patients from a universe of 187 patients with type2 diabetes mellitus treated in the Internal Medicine Service of the Teaching Clinical-Surgery Hospital "Amalia Simoni", of Camagüey. It was conducted between January 2020 and January 2021. Variables such as age, sex, toxic habits, nutritional status, time of evolution of diabetes, comorbidities; value of albuminuria and its relationship with the time of evolution of the disease were analyzed. The SPSS 19.0 statistical program was used for data processing. Results: The age group of 60 years old and over, female sex, smoking as a toxic habit, and overweight prevailed. According to the time of evolution of the disease, the range of 6 to 10 years prevailed. The main comorbidities were arterial hypertension and ischemic heart disease. The relationship between the time of evolution of the disease and the appearance of pathological microalbuminuria demonstrated its usefulness in the detection of early kidney damage in patients with 6 to 10 years of evolution. Conclusions: The role of microalbuminuria in the detection of early kidney damage in patients with type 2 diabetes mellitus was demonstrated.
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Introduction:Metabolic syndrome (MetS) predicts cardiovascular disease, and patients with this condition and type 2 diabetes have increased albuminuria, significantly impacting cardiovascular mortality and kidney disease progression. A considerable number of interventions to control MetS exist and are considered efficient, including the use of medication and changes in lifestyle. However, which approaches are effective in controlling albuminuria remains unclear. This systematic review protocol aims to map in the available literature whether lifestyle, medication, and surgical intervention for MetS have an impact on reducing albuminuria in adult patients. Methods: The Joanna Briggs Institute methodology for systematic reviews will be followed. Cochrane Database of Systematic Reviews, Scopus, Embase, and MEDLINE/PubMed databases will be used. For the Gray Literature, the DART-Europe E-theses Portal. There will be no language restriction. Studies written after 2009 will be included due to the consensus and definition of metabolic syndrome. This review will include studies considering pharmacological and non-pharmacological treatments for controlling albuminuria in patients with MetS. Studies where MetS is described in children and adolescents, animals, pregnant women, and patients with type 1 diabetes will be excluded. First, the selection will be based on reading the title and summary of the texts retrieved in the search strategy, followed by reading the relevant texts in full by two reviewers. After the selection of the studies, the extraction of the data, analysis, and synthesis will be conducted according to the JBI methodology
Subject(s)
Humans , Adult , Middle Aged , Proteinuria , Therapeutics , Metabolic Syndrome , Life Style , Cardiovascular Diseases/metabolism , Exercise , MEDLINE , PubMed , DietABSTRACT
La enfermedad renal diabética es una patología de presentación frecuente y una costosa complicación de la diabetes. Se considera una de las principales causas de insuficiencia renal e ingreso a Terapia de Reemplazo renal. En la práctica clínica, la enfermedad renal diabética se diagnostica por albuminuria, una disminución de la tasa de filtración glomerular estimada (eGFR), o ambos. Actualmente existe la posibilidad de detectar varios marcadores tempranos, como el CKD273, el mismo que se asoció con un mayor riesgo de progresión a microalbuminuria, siendo una alerta temprana de presentación de nefropatía diabetica, varios años antes de su presentación.
SUMMARY Diabetic kidney disease is a common presenting condition and a costly complication of diabetes. It is considered one of the main causes of renal failure and admission to renal replacement therapy. In clinical practice, diabetic kidney disease is diagnosed by albuminuria, a decrease in estimated glomerular filtration rate (eGFR), or both. Currently, there is the possibility of detecting early markers such as CKD273, which was associated with an increased risk of progression to microalbuminuria, being an early warning of the presentation of diabetic nephropathy, several years before its presentation.
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Background: Diabetes mellitus is a common chronic disease with high morbidity and mortality. Chronic inflammation has been considered the potential pathogenesis responsible for the development of diabetic complications. The utility of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) is being assessed and projected as novel, inexpensive, and reliable tools of disease progression and prognostication in various diseases. Aim and Objectives: In the present study, the association of NLR and PLR levels with microalbuminuria levels in diabetic patients is studied to find utility of NLR and PLR to predict disease progression. Materials and Methods: Patients were categorized into four different groups based on their HbA1c levels as Group I – Normal (with HbA1c in range 4%?5.6%), Group II – Pre-diabetic (with HbA1c in range 5.7%?6.4%), Group III – Diabetics (with HbA1c in range 6.5?7.0), and Group IV – Diabetics (with HbA1c > 7.0). The sensitivity and specificity of NLR and PLR values as a screening tool for early nephropathy in each category were analyzed. Utility of NLR and PLR as independent markers of glycemic control was evaluated using Pearson correlation analysis. Results: In this study, Group I patients showed significant relation between NLR, PLR with creatinine, urea, and microabluminuria while in Group II, NLR and microalbuminuria showed significant relationship. In Group III and IV, no such relation was seen. Conclusion: Our study found no significant correlation of NLR and PLR levels with microalbuminuria levels in diabetic patients and also that NLR and PLR are not much useful for assessing glycemic control.
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Increased level of Fibrinogen is supposed to be a risk factor for Macrovascular disease. Insulin acutely increases Fibrinogen production in an individual with Type 2 Diabetes. There is a correlation between fibrinogen level and duration of Diabetes. Aim : To evaluate the levels of Plasma Fibrinogen and its association with Microalbuminuria and glycemic control in patients of Type 2 Diabetes Mellitus (T2DM). Materials and Methods : A hospital-based Cross-Sectional Study was conducted at the Department of Medicine, Bharati Hospital and Research Centre. The study aimed to evaluate the levels of plasma fibrinogen and its association with microalbuminuria and glycemic control in patients with T2DM. A total of 100 subjects (males and females) presenting with Diabetes Mellitus to our hospital were included in the study after informed consent. A detailed clinical history and relevant laboratory investigations were done. Statistical Analysis : The quantitative data was represented as their Mean盨D. Categorical and nominal data were expressed in percentage. The t-test was used for analysing quantitative data, or else non-parametric data were analysed by Mann Whitney test. All analysis was carried out by using SPSS software version 21. Results : Mean Fibrinogen level in study cases was 507.8 mg/dl with 26% had Fibrinogen levels of more than 500 mg/dl. Micro and Macro-albuminuria were seen in 25% and 9% cases. Mean Fibrinogen level was significantly more in cases with a duration of Diabetes 5 years, poor glycemic control and Microalbuminuria. Conclusion : Microalbuminuric Diabetic patients and poor Glycemic control patients showed higher fibrinogen levels. It can be concluded that Hyperfibrinogenaemia may precede the onset of Clinical Vascular Complications
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Background: Microalbuminuria is multifactorial and it is an important marker for diabetic nephropathy. The aim of thestudy was to assess the incidenceand association of serum magnesium levels, serum uric acid levels and microalbuminuria in patients with type 2DM. Methods:This study was a cross-sectional study conducted for a period of 2 years from October 2015 to September 2017, where the patients diagnosed as type 2 DM admitted in AJIMS were taken up for the study. All the patients’ blood sample was sent for estimation of serum magnesium, serum uric acid, FBS, PPBS, HBA1C and urine spot albumin:creatinine ratio. Results:In our study, out of 100 patients with type 2 diabetes, 79 patients had microalbuminuria. Out of these, 83.3% (N=75) was having hypomagnesemia (p<0.000) associated with microalbuminuria. Hyperuricemia was seen in 63% (N=63) of the population but 79.4% (N=50) hyperuricemics were associated with microalbuminuria(p<0.000).Conclusions:There was a significant microalbuminuria in patients with type 2 DM, with reduced serum Mg levels and elevated serum uric acid levels ascompared with patients who had serum Mg and uric acid levels withinthe normalrange.
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Background: Globally, as of 2010, an estimated 285 million people had diabetes, with type 2 making up about 90% of the cases. Its incidence is estimated to almost double, by 2030. Diabetic nephropathy is a consequence of long standing diabetes. The prevalence of microalbuminuria predicts progression to diabetic nephropathy. Measurement of glycated hemoglobin (HbA1c) has become the preferred method of diagnosis as well as assessing long-term glycaemic control. The present study was conducted to determine the magnitude and prevalence of microalbuminuria in relation to HbA1c in a group of diabetic patients admitted in Comilla Medical College Hospital of Bangladesh. Objectives: The relationship between HbA1c and microalbuminuria of diabetic patients was assessed in a hospital-based cross-sectional study in a tertiary level hospital.Material & Methods:A hospital-based cross-sectional descriptive study was carried out in department of Medicine, Comilla Medical College Hospital from 1st July, 2011 to 30th June, 2012. One hundred known admitted diabetic patients with age 25� years were included in this study.Results:Microalbuminuria had a significant correlation with HbA1c (p<0.05) (r=0.24). Increasing HbA1c was associated with increasing microalbuminuria above optimal cut-off points of HbA1c 7%. The prevalence of microalbuminuria was 33.33 % at HbA1c(6.1-6.9)%, whereas it was 75% at HbA1c (7.1-7.9)%. Microalbuminuria was 38.74 � 9.76 mg/gm (p<0.05) at HbA1c <7%, whereas it was 65.86 � 21.29 mg/gm (p<0.05) at HbA1c ?7%.Conclusions:The present study found an early onset of microalbuminuria in the selected community which could be due to poor glycaemic control (high HbA1c ? 7%) after excluding other causes of microalbuminuria. Screening for microalbuminuria and HbA1c test should be done in both newly and already diagnosed diabetic patients as an early marker of renal dysfunction and glycaemic control.
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Background: Urinary tract infection is a collective term for infections that involve any part of the urinary tract. It is one of the most common infections in local primary care. There are wide range of factors identified that can increase susceptibility to UTI, like sexual intercourse, congenital abnormalities, urinary obstruction, prior history of UTI, diabetes, urogenital surgery, estrogen deficiency. Diabetes mellitus has been a significant risk factor for complicated UTI. Presence of microalbumin in urine in patients of urinary tract infection may be a predictor of intrinsic renal pathology and its presence is a predictor of ongoing progressive damage to kidneys. Microalbuminuria is also associated with cardiovascular events and diabetic nephropathy. Early diagnosis of microalbuminuria will decrease the incidence of end stage renal disease and cardiovascular events. The present study was thus conducted to evaluate prevalence of microalbuminuria in patients diagnosed with urinary tract infections.Material & Methods:The present hospital based case control study was conducted on 60 patients visiting the outpatient clinic (OPD) of Department of Urology, Government Medical College and Rajindra Hospital, Patiala and diagnosed with UTI and the control group consisted of 20 age and gender matched individuals. Estimation of urine microalbumin was done by Enyme linked immunoassay(ELISA) kit method in Department of Biochemistry, GMC Patiala.Results:Out of 60 cases of UTI included in the present study, prevalence of microalbuminuria was observed in 43.3% among cases of UTI . A total of 85% of the cases with positive urine culture had microalbuminuria (p<0.01).Conclusions:Microalbuminuria and ACR can be recommended for predicting ESRD at an early stage of kidney disease.
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Aim: The Aim of study is to measure the prevalence of albuminuria (both microalbuminuria and macroalbuminuria) among type 2 diabetic patients and to estimate its role on severity of diabetic retinopathy in type 2 diabetics. Materials and Methods: A cross sectional study conducted at ophthalmology department,Dr SN Medical College, Jodhpur, Rajasthan in 300 type 2 diabetic patients in one year of study period. All the patients had done ocular examination. The ETDRS scale used for grading Diabetic retinopathy. A morning urine sample used for detecting albuminuria. Urine albumin excretion values 30-300 mg in 24 hrs considered as microalbuminuria and values >300 mg in 24 hrs considered as macroalbuminuria.The analysis was done using SPSS 16.0. Results: The prevalence of microalbuminuria is 31.80% and prevalence of macroalbuminuria is 20.60%. Patients with macroalbuminuria has a greater prevalence of diabetic retinopathy as compare to patients who has normo or microalbuminuria which is statistically significant, p value< 0.001. Conclusion:In type 2 diabetics patients Microalbuminuria is a very useful in estimating the severity of diabetic retinopathy. Patients who have microalbuminuria is on higher risk for the development and progression of diabetic retinopathy
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Objective:To investigate the effect of Yiqi Dihuang Decoction assisting conventional western medicine therapy in the treatment of early diabetic nephropathy (DN) with deficiency of qi and yin.Methods:A total of 117 patients with early DN who met the inclusion criteria from June 2018 to December 2020 in Beijing Hospital of Traditional Chinese Medicine Shunyi Branch were divided into a control group of 58 patients and a treatment group of 59 patients according to the random number table method. The control group was treated with conventional western medicine therapy, and the treatment group was additionally treated with Yiqi Dihuang Decoction on the basis of the control group. Both groups were treated for 1 month. Serum levels of IL-1, macrophage scavenger receptor A (SR-A), TNF-α, C-C motif chemokine 2 (CCL2), GSH-Px and SOD were detected by ELISA before and after treatment. Cystatin C (Cys C) and SCr levels were detected by automatic biochemical analyzer. The urinary albumin was determined by radioimmunoassay, urinary creatinine determined by rate method, and urinary albumin/creatinine ratio (UACR) and glomerular filtration rate (eGFR) were calculated. The adverse events during treatment and clinical efficacy were evaluated.Results:The total effective rate was 94.92% (56/59) in the treatment group and 81.03% (47/58) in the control group, and the difference between the two groups was statistically significant ( χ2=5.35, P=0.021). After treatment, UACR [(92.28±15.42) mg/g vs. (108.42±20.76)mg/g, t=4.78], eGFR [(91.42±13.18) m·min -1·1.73m -2vs. (95.30±15.94) m·min -1·1.73m -2, t=2.02], SCr [(65.30±9.54) μmol/L vs. (70.18±12.53) μmol/L, t=5.42], Cys C [(0.65±0.12)mg/L vs. (1.07±0.26)mg/L, t=11.25] in the treatment group were significantly lower than those in the control group ( P<0.05). Serum SR-A [(37.18±6.10) μg/L vs. (51.51±7.12) μg/L, t=11.70], CCL2 [(13.12±1.63) μg/L vs. (19.68±2.90) μg/L, t=15.12], TNF-α [(20.57±3.50) ng/L vs. (29.68±4.17) ng/L, t=12.81], IL-1 [(8.47±0.97) ng/L vs. (13.12±1.57) ng/L, t=19.31] levels in the treatment group were significantly lower than those in the control group ( P<0.01); serum SOD [(24.09±3.12) mg/L vs. (18.72±2.76) mg/L, t=9.85] activity and GSH-Px [(231.57±25.38) mg/L vs. (174.58±22.96) mg/L, t=12.73] in the treatment group were significantly higher than those in the control group ( P<0.01). During the treatment period, the incidence of adverse events was 10.34% (6/58) in the control group and 6.78% (4/59) in the treatment group, and there was no significant difference between the two groups ( χ2=0.48, P=0.490). Conclusion:Yiqi Dihuang Decoction assisted with conventional western medicine can effectively improve the renal function of patients with early DN syndrome of qi and yin deficiency, inhibit the body's inflammatory response and oxidative stress response, and improve clinical efficacy.
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Background: Non-alcoholic fatty liver disease (NAFLD) represents a considerable percentage of chronic liver diseases worldwide. The liver is not the only organ affected by NAFLD but also affects other organs such as the cardiovascular system and the kidney. In recent decades, there has been a growing body of evidence linking NAFLD to kidney function. So, the current study aims to assess the percentage of chronic kidney disease (CKD) in NAFLD patients and its link to different stages of hepatic fibrosis. Patients and Methods: A case-control study evaluated 62 non-alcoholic fatty liver disease patients and a control group of 38 volunteers with apparently healthy livers (normal echo pattern by ultrasound). All participants underwent serum creatinine measurement, albumin creatinine ratio in urine, calculation of estimated glomerular filtration rate (eGFR), abdominal ultrasound, and fibroScan examination. Results: The authors showed that the percentage of patients with chronic kidney diseases (patients with GFR less than 60 ml or micro-albuminuria) were significantly higher among NAFLD groups than in healthy controls. There was a significant positive correlation between the albumin creatinine ratio and subcutaneous fat thickness, BMI, and steatosis degrees. The estimated glomerular filtration rate (eGFR) and the age of the patients had a significant negative correlation. In comparison, the eGFR and AST levels had a significant positive correlation. Conclusions: Our results showed that NAFLD substantially raises the risk of getting CKD
Subject(s)
Creatinine , LiverABSTRACT
Resumen Si bien aún no hay una definición precisa de inflamación sistémica en EPOC, su reconocimiento se ha basado en estudios que han demostrado un aumento de concentración plasmática de diversos marcadores inflamatorios entre ellos proteína C reactiva (PCR) y, en los últimos años se ha postulado también la microalbuminuria. Los objetivos de este trabajo fueron determinar la microalbuminuria y la PCR como potenciales biomarcadores de inflamación sistémica. Para ello se reclutaron pacientes EPOC estable y tabaquistas no EPOC diagnosticados mediante espirometria, mayores a 40 años sin HTA ni diabetes tipo I ó II, en el periodo comprendido entre octubre de 2017 a marzo de 2019. A ambos grupos se le extrajo una muestra de sangre venosa para determinar PCR ultrasensible y 3 muestras de orina para determinar microalbuminuria, tomando una media de las mismas. Se consideró albuminuria significativa cuando en al menos dos de tres determinaciones hubiese valores entre 30 y 300 mg/g de creatinina urinaria. La PCR ultrasensible se consideró positiva con un valor igual o superior a 5 mg/L. De los 47 pacientes analizados se obtuvo una albuminuria media de 13.91 ± 5.04 en el grupo EPOC en comparación con 2.50 ± 0.36 del grupo control. De la misma forma se compararon las medias de PCR ultrasensible, arrojando un valor de 5.06 ± 2.24 en los pacientes EPOC en relación a 2.46 ± 0.51 de los controles. Ambas variables mostraron diferencias estadísticamente no significativas entre los grupos de estudio (p = 0,058 para albuminuria media y p = 0.330 para PCR ultrasensible).
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Abstract There isn't yet a clear definition for systemic inflammation in COPD (chronic obstructive pulmonary disease), but its recognition has been based on studies that show an increase in the plasma concentration of various inflammatory markers, such as the c-reactive protein (CRP), and in recent years, also the microalbuminuria has been suggested. The purposes of this work were to determine the microalbuminuria and CRP as potential biomarkers of systemic inflammation. We enrolled patients with stable COPD and non-COPD smokers diagnosed through spirometry; older than 40 years without AHT (arterial hypertension) or diabetes type I or II, between October 2017 and March 2019. In both groups, a venous blood sample was collected to determine high-sensitivity CRP and 3 urine samples were taken to determine microalbuminuria, calculating the mean value. At least two out of three determinations between 30 and 300 mg/g of urine creatinine were considered to be significant albuminuria. The high-sensitivity CRP was considered positive with a value ≥ 5 mg/L. Of the 47 analyzed patients, a mean albuminuria of 13.91 ± 5.04 was obtained in the COPD group, in comparison with 2.50 ± 0.36 in the control group. Also, the high-sensitivity CRP mean values were compared, showing 5.06 ± 2.24 in COPD patients and 2.46 ± 0.51 in the control group. Both variables showed non-statistically significant differences between the study groups (p = 0.058 for mean albuminuria and p = 0.330 for high-sensitivity CRP).
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Objetivou-se no presente estudo comparar as técnicas de coleta de urina via sondagem uretral e cistocentese guiada por ultrassom, afim de verificar se o método de coleta pode influir nos resultados laboratoriais. Foram utilizados 12 cães machos, sem histórico de enfermidades, dos quais coletou-se cinco mililitros (mL) de urina via sondagem uretral e cinco mL via cistocentese guiada por ultrassom, ambas no mesmo momento. Posteriormente foi realizada a análise física (cor, odor, densidade, turbidez), química (urobilinogênio, glicose, corpos cetônicos, bilirrubina, proteína, nitrito, pH, sangue e leucócitos) e sedimentoscopia (avaliação de 10 campos de luz, objetiva de 40x). Cilindros urinários, cristais, corpúsculos gordurosos, espermatozoides, bactérias e células vesicais foram classificados qualitativamente como: ausentes (0), discretos (1), moderados (2) e intensos (3). Hemácias, leucócitos, e células de descamação foram quantificadas a partir da média dos campos analisados. As análises bioquímicas de microalbuminúria, creatinina e proteína total urinárias foram realizadas a partir do sobrenadante urinário, removido das amostras após centrifugação, e utilizados kits reagentes, conforme recomendação do fabricante, sendo a leitura em espectrofotômetro. Em todos os testes realizados os valores de p encontrados foram superiores 0,05 (p>0,05), excluindo-se a possibilidade de haver diferenças significativas dos resultados laboratoriais obtidos pelas duas formas de coleta.
The objective of this study was to compare two techniques of urine collection, urethral catheterization and ultrasound-guided cystocentesis, in order to verify if the collection method may influence the laboratory results. Twelve male dogs were used, with no history of diseases, of which five milliliters (mL) of urine were collected by urethral catheterization and five mL by both at the same time. Subsequently, the samples underwent physical analysis (color, smell, density andturbidity), chemical analysis (urobilinogen, glucose, ketone bodies, bilirubin, protein, nitrite, pH, blood and leukocytes) and sedimentoscopy (evaluation of 10 light fields, 40x objective). Urinary casts, fatty corpuscles, spermatozoa, bacteria and bladder epithelial cells were classified qualitatively as absent (0), discrete (1), moderate (2) and intense (3). Red blood cells, leukocytes and desquamation cells were quantified from the mean of the analyzed fields. The urine supernatants were obtained after centrifugation and were used for biochemical analyzes of microalbuminuria, urinary protein and creatinine. The reagent kits were used as recommended by the manufacturer and the samples were read by spectrophotometry. All tests presented p values higher than 0,05 (p>0,05), excluding the possibility of significant differences between the laboratory results of both forms of urine collection.
Subject(s)
Animals , Dogs , Cystocele/diagnosis , Dogs/physiology , Proteinuria , Biochemical Reactions/analysis , Urinalysis/veterinaryABSTRACT
Objetivou-se no presente estudo comparar as técnicas de coleta de urina via sondagem uretral e cistocentese guiada por ultrassom, afim de verificar se o método de coleta pode influir nos resultados laboratoriais. Foram utilizados 12 cães machos, sem histórico de enfermidades, dos quais coletou-se cinco mililitros (mL) de urina via sondagem uretral e cinco mL via cistocentese guiada por ultrassom, ambas no mesmo momento. Posteriormente foi realizada a análise física (cor, odor, densidade, turbidez), química (urobilinogênio, glicose, corpos cetônicos, bilirrubina, proteína, nitrito, pH, sangue e leucócitos) e sedimentoscopia (avaliação de 10 campos de luz, objetiva de 40x). Cilindros urinários, cristais, corpúsculos gordurosos, espermatozoides, bactérias e células vesicais foram classificados qualitativamente como: ausentes (0), discretos (1), moderados (2) e intensos (3). Hemácias, leucócitos, e células de descamação foram quantificadas a partir da média dos campos analisados. As análises bioquímicas de microalbuminúria, creatinina e proteína total urinárias foram realizadas a partir do sobrenadante urinário, removido das amostras após centrifugação, e utilizados kits reagentes, conforme recomendação do fabricante, sendo a leitura em espectrofotômetro. Em todos os testes realizados os valores de p encontrados foram superiores 0,05 (p>0,05), excluindo-se a possibilidade de haver diferenças significativas dos resultados laboratoriais obtidos pelas duas formas de coleta.
The objective of this study was to compare two techniques of urine collection, urethral catheterization and ultrasound-guided cystocentesis, in order to verify if the collection method may influence the laboratory results. Twelve male dogs were used, with no history of diseases, of which five milliliters (mL) of urine were collected by urethral catheterization and five mL by both at the same time. Subsequently, the samples underwent physical analysis (color, smell, density andturbidity), chemical analysis (urobilinogen, glucose, ketone bodies, bilirubin, protein, nitrite, pH, blood and leukocytes) and sedimentoscopy (evaluation of 10 light fields, 40x objective). Urinary casts, fatty corpuscles, spermatozoa, bacteria and bladder epithelial cells were classified qualitatively as absent (0), discrete (1), moderate (2) and intense (3). Red blood cells, leukocytes and desquamation cells were quantified from the mean of the analyzed fields. The urine supernatants were obtained after centrifugation and were used for biochemical analyzes of microalbuminuria, urinary protein and creatinine. The reagent kits were used as recommended by the manufacturer and the samples were read by spectrophotometry. All tests presented p values higher than 0,05 (p>0,05), excluding the possibility of significant differences between the laboratory results of both forms of urine collection.
Subject(s)
Animals , Dogs , Urinary Catheterization/veterinary , Urinary Reservoirs, Continent/veterinary , Urinalysis/veterinary , Dogs/urine , Urine Specimen Collection/methods , Biochemical Reactions/analysisABSTRACT
ABSTRACT Objective: Evaluate ferritin levels in children and adolescents with type 1 diabetes mellitus and its relation to diabetic microvascular complications, and metabolic control. Subjects and methods: This study included 180 children and adolescents with type 1 diabetes mellitus (T1DM) with a mean age of 14.9 ± 3.1 years and 180 apparently normal children matched for age and sex (control group). All children were evaluated with full history taking, thorough clinical examination, laboratory assessment of high-sensitivity C-reactive protein and hemoglobin A1c (HbA1c), and evaluation of the presence of microvascular complications. Serum ferritin levels were measured using electrochemiluminescence immunoassay. The patients were divided into two groups according to the presence or absence of microvascular complications. Results: Serum ferritin levels were significantly higher in patients with T1DM in both groups compared with healthy controls (p < 0.001). Additionally, patients with microvascular complications had higher serum ferritin concentrations than those without microvascular complications (p < 0.001). Patients with microalbuminuria showed higher ferritin levels compared with patients without microalbuminuria (p < 0.05). Stepwise regression analysis revealed that levels of HbA1c and urinary albumin excretion were independently related to ferritin levels (p < 0.001 for both). On receiver operating characteristic (ROC) curve analysis, a ferritin cutoff value of 163.6 ng/mL differentiated patients with microvascular complications from those without microvascular complications with a sensitivity of 92.1% and specificity of 93.4%. Conclusion: Serum ferritin levels are elevated in T1DM, particularly in patients with microvascular complications.
Subject(s)
Humans , Child , Adolescent , Diabetes Mellitus, Type 1 , Glycated Hemoglobin/analysis , Albuminuria , Ferritins , Glycemic ControlABSTRACT
Background: Recent advancements in diagnostic modalities for microalbuminuria have shown that urinaryexcretion of albumin is more in hypertensive patients as compared to subjects with normal blood pressure.Microalbuminuria is known to be associated with certain complications like dyslipidemia, cardiac complications,atherosclerosis and kidney disease. Purpose: To analyze the prevalence of microalbuminuria and its clinicalcorrelation with essential hypertension. Material and Methods: The study was of cross-sectional design,which was carried out in outpatient and inpatient departments of Medicine in DY Patil Medical School andHospital, Nerul, Navi Mumbai. Results: Out of total 190 study participants 96 were normotensive controls,while 94 were hypertensive patients. Mean age in control group was 48 ± 9.4 years, while that in hypertensivegroup, it was 49.2 ± 10.2 years. The 24 hours mean urinary excretion of albumin in hypertensive patients withmicroalbuminuria was found to be 80.21, while it was 12.91 and 7.89 in hypertensive patients withoutmicroalbuminuria and control groups, respectively. Conclusion: Early screening to detect microalbuminuriain early stages will help to initiate appropriate treatment regimen and prevent the risk of complications and thusimprovement in prognosis.
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Background: Sickle cell disease prevalence is more in central part of India. This study tries to find extent of renal involvement, risk factors and screening tests in sickle cell disease.Methods: Study was Cross sectional observational study. Demographic and clinical findings were recorded. Renal function tests like serum creatinine, blood urea nitrogen, eGFR were studied. Presence of microalbuminuria was checkeed. Ultrasonography abdomen was done to see the texture and corticomedullary differentiation of kidney.Results: Total 143 patients were studied. Out of which, 117 homozygous (SS type), 26 heterozygous (AS type). Majority belonged to school going age group (i.e. 5 to 10 year age group) with male preponderance in homozygous state. Microalbuminuria was more common in crisis state (61.84% in SS pattern and 83.33% in AS pattern) as compared to steady state in both SS and AS pattern patients. Dipstic method detected more proteinuria than heat coagulation suggesting dipstick method superior to heat coagulation test. Low eGFR was common in patients with SS pattern as compared to patients with AS pattern and was significantly associated with microalbuminuria in both steady state and crisis state. Abnormal USG was seen 3.44% in patients with SS pattern. Renal involvement started below 5 years of age and then increases with age, homozygous childrens in crisis state are affected more.Conclusions: Renal involvement is common in sickle cell anemia i.e it is seen in 50% of the patients. Increasing age, male sex and homozygous state were risk factors. Simple test like dipstic method and heat coagulation test can be used as screening test to detect microalbumiburia, with dipstic method being superior. Presence of microalbuminuria can detect early renal involvement in sickle cell disease. This will help in early diagnosis and management of such patients which avoids further renal complications and thus prevents mortality and morbidity.
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Background: Metabolic syndrome includes a constellation of various metabolic abnormalities that have been associated with cardiovascular disease, stroke and all-cause mortality in the general population. It has now been established that it is also associated with renal dysfunction. This study was done to assess renal function in metabolic syndrome in Indian population as well as its correlation with different parameters of the metabolic syndrome.Methods: A cross-sectional study was conducted in a university hospital from 2014 - 2015. Renal functions were studied in 100 obese individuals, 50 with and 50 without metabolic syndrome after informed consent and the results were analysed.Results: 100 obese individuals, 50 with and 50 without metabolic syndrome were compared. All underwent a physical examination and relevant investigations. All parameters of renal function showed significant derangement in cases as compared to controls. 38 patients (76%) among the cases (N=50) of metabolic syndrome had altered renal functions versus 9 patients (18%) among controls (n=50). Individually, there was a significant correlation of altered renal function (reduced estimated glomerular filtration rate eGFR and presence of microalbuminuria) with fasting blood glucose and systolic blood pressure (p=0.001), diastolic pressure (p=0.003) and triglyceride levels (p=0.036). High density lipoprotein-cholesterol levels did not show a significant correlation.Conclusions: Obese individuals with metabolic syndrome have significant derangement of renal functions as compared to those without metabolic syndrome. Most parameters of the syndrome are also independently associated with alteration of renal functions.