Understanding of the role of serum creatinine in a subset of the Brazilian population / Conhecimento de uma amostragem da população brasileira sobre a função da creatinina sérica

Abstract Introduction: Chronic kidney disease is usually asymptomatic, and its diagnosis depends on laboratory tests, with emphasis on serum creatinine and proteinuria. Objective: To assess knowledge on the role of serum creatinine as a biomarker of kidney function in a sample of the Brazilian population. Method: Cross-sectional observational study conducted in São Paulo (SP, Brazil), in which a random adult population was interviewed. Results: A total of 1138 subjects were interviewed, with a median age of 36 years old (27-52); 55.1% were female. Regarding the "creatinine" biomarker, 40.6% stated they had never performed such a test. When asked about their knowledge on the usefulness of this exam, only 19.6% knew its function. The other responses were "I don't know" (71.6%), evaluating heart function (0.9%) and liver function (7.8%). Of those who reported they had already taken a creatinine test, only 29.4% correctly identified the role of creatinine. When dividing the groups into "knows" and "does not know" the function of creatinine, a statistically significant difference (p < 0.05) was observed regarding level of education, female sex, being a healthcare student/worker, having ever measured creatinine, knowing someone with kidney disease and older age. In the multivariate analysis, the main variable related to knowing the creatinine role was having previously taken the test (OR 5.16; 95% CI 3.16-8.43, p < 0.001). Conclusion: There is a significant lack of knowledge about creatinine and its use in checkups. The results indicate that greater efforts are needed from healthcare professionals to raise awareness on the role of serum creatinine.

Resumo Introdução: A doença renal crônica costuma ser assintomática e seu diagnóstico depende da realização de exames laboratoriais, com destaque para a creatinina sérica e pesquisa de proteinúria. Objetivo: Avaliar em uma amostra da população brasileira o conhecimento sobre o papel da creatinina sérica como marcador de função renal. Método: Estudo observacional transversal realizado na cidade de São Paulo (SP, Brasil), em que foi entrevistada uma população adulta aleatória. Resultados: Foram entrevistados 1138 indivíduos, com idade mediana de 36 anos (27-52); 55,1% do sexo feminino. Com relação ao marcador "creatinina", 40,6% afirmaram que nunca realizaram tal dosagem. Quando questionados quanto ao conhecimento sobre a utilidade desse exame, somente 19,6% sabiam a sua função. As outras respostas foram "não sei" (71,6%), avaliar o funcionamento do coração (0,9%) e fígado (7,8%). Dos que afirmaram já terem realizado o exame de creatinina, somente 29,4% acertaram a função da creatinina. Ao dividir os grupos em "sabe" e "não sabe" a função da creatinina, percebeu-se diferença estatisticamente significante (p < 0,05) em relação ao grau de escolaridade, sexo feminino, ser aluno/trabalhador da saúde, ter dosado creatinina alguma vez, conhecer alguém com doença renal e maior idade. Na análise multivariada, a principal variável relacionada com conhecer a função da creatinina foi ter realizado o exame anteriormente (OR 5,16; IC 95% 3,16-8,43, p < 0,001). Conclusão: Há grande desconhecimento sobre a creatinina e seu uso em check-ups. Os resultados indicam que é necessário maior esforço por parte dos profissionais de saúde para divulgar o papel da creatinina sérica.

Renal deficit and associated factors in children born with low birth weight / Déficit renal e fatores associados em crianças nascidas com baixo peso

ABSTRACT Introduction: Kidney problems may be due to low birth weight alone or may occur in association with other conditions. The objective this study was to evaluate the association between maternal and birth characteristics, anthropometric measurements, and kidney function deficit in low birth weight infants. Methods: Cross-sectional study with children who were born weighing < 2500 grams and were under outpatient follow-up. Maternal factors investigated were prenatal care and presence of hypertension, diabetes, and infection during pregnancy. The children's variables were sex, gestational age, birth weight, Apgar score, use of nephrotoxic medications, age, body weight at the time of evaluation, height, and serum creatinine and cystatin C dosages. The glomerular filtration rate (GFR) was estimated with the combined Zapittelli equation. Multivariate logistic regression model was used for identification of associated factors, with renal function deficit (GFR < 60 mL/min/1.73 m2) as the dependent variable. Results: Of the 154 children evaluated, 34.42% had kidney function deficit. Most of them had a gestational age > 32 weeks (56.6%), a mean birth weight of 1439.7 grams, and mean estimated GFR of 46.9 ± 9.3 mL/min/1.73 m2. There was a significant association of GFR < 60 mL/min/1.73 m2 with children's current weight and use of nephrotoxic drugs. Discussion: Children born with low birth weight had a high prevalence of kidney function deficit and current normal weight was a protective factor while the use of nephrotoxic drugs during perinatal period increased the chance of kidney deficit. These findings reinforce the need to evaluate the kidney function in these children, especially those who use nephrotoxic drugs.

RESUMO Introdução: Problemas renais podem ser devido apenas ao baixo peso ao nascer ou podem ocorrer em associação com outras condições. O objetivo deste estudo foi avaliar a associação entre características maternas e de nascimento, medidas antropométricas e déficit da função renal em bebês de baixo peso ao nascer. Métodos: Estudo transversal com crianças que nasceram com peso < 2500 gramas e estavam sob acompanhamento ambulatorial. Os fatores maternos investigados foram cuidados pré-natal e presença de hipertensão, diabetes e infecção durante a gravidez. As variáveis das crianças foram sexo, idade gestacional, peso ao nascer, índice Apgar, uso de medicamentos nefrotóxicos, idade, peso corporal no momento da avaliação, altura e dosagens séricas de creatinina e cistatina C. A taxa de filtração glomerular (TFG) foi estimada com a equação combinada de Zapittelli. Utilizou-se um modelo de regressão logística multivariada para identificação de fatores associados, com déficit da função renal (TFG < 60 mL/min/1,73 m2) como variável dependente. Resultados: Das 154 crianças avaliadas, 34,42% apresentaram déficit da função renal. A maioria tinha idade gestacional > 32 semanas (56,6%), peso médio ao nascer de 1439,7 gramas, e TFG média estimada de 46,9 ± 9,3 mL/min/1,73 m2. Houve uma associação significativa da TFG < 60 mL/min/1,73 m2 com o peso atual das crianças e o uso de medicamentos nefrotóxicos. Discussão: Crianças nascidas com baixo peso apresentaram alta prevalência de déficit da função renal e o peso atual normal foi um fator de proteção, enquanto o uso de medicamentos nefrotóxicos durante o período perinatal aumentou a chance de déficit renal. Estes achados reforçam a necessidade de avaliar a função renal destas crianças, especialmente aquelas que usam medicamentos nefrotóxicos.

Value of serum creatinine-to-cystatin C ratio in assessing the prognosis of hepatitis B virus-related acute-on-chronic liver failure / 临床肝胆病杂志

ObjectiveTo investigate the clinical value of serum creatinine-to-cystatin C ratio （CCR） in evaluating the prognosis of hepatitis B virus-related acute-on-chronic liver failure （HBV-ACLF）. MethodsA retrospective analysis was performed for the clinical data of 130 patients with HBV-ACLF （treatment group） who were hospitalized in Department of Infectious Diseases， The First Affiliated Hospital of Soochow University， from January 2021 to November 2022. According to the treatment outcome， they were divided into survival group with 87 patients and death group with 43 patients； according to the presence or absence of infection， they were divided into infection group with 37 patients and non-infection group with 93 patients. A total of 30 individuals who underwent physical examination during the same period of time were enrolled as control group. Routine blood test results were collected on the day of admission， including white blood cell count， platelet count， neutrophil count， and lymphocyte count； serum creatinine， cystatin C， serum albumin （Alb）， and prothrombin time （PT） were observed on the day of admission and on days 5， 10， and 15 of hospitalization， and related indicators were calculated， including CCR， neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， prognostic nutritional index （PNI）， CCR5 （CCR on day 5 after admission）， ΔCCR5 （CCR on day 5 after admission minus CCR on the day of admission）， CCR10 （CCR on day 10 after admission）， ΔCCR10 （CCR on day 10 after admission minus CCR on day 5 after admission）， CCR15 （CCR on day 15 after admission）， and ΔCCR15 （CCR on day 15 after admission minus CCR on day 10 after admission）. The above indicators were compared between the survival group and the death group and between the infection group and the non-infection group. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups. The univariate and multivariate logistic regression analyses were used to investigate the influencing factors for disease prognosis； the receiver operating characteristic （ROC） curve was used to assess the value of CCR in predicting HBV-ACLF death events， and the DeLong test was used for comparison of the area under the ROC curve （AUC）. ResultsThere were significant differences in CCR， NLR， PNI， PT， and Alb at baseline between the treatment group and the healthy control group （all P<0.001）， and there were significant differences in CCR， NLR， and PT between the survival group and the death group on the day of admission （all P<0.05）. Among the 130 patients with HBV-ACLF， there were 25 in the precancerous stage， 48 in the early stage， 32 in the intermediate stage， and 25 in the advanced stage， and there were significant differences in baseline CCR， PLR， and PT between the patients in different stages of HBV-ACLF （all P<0.05）. There were significant differences in ΔCCR5 and NLR between the infection group and the non-infection group （P<0.05）， and there were significant differences in ΔCCR5， CCR10， and CCR15 between the survival group and the death group （all P<0.05）. The multivariate logistic regression analysis showed that ΔCCR5 （odds ratio ［OR］=1.175， 95% confidence interval ［CI］： 1.098‍ — ‍1.256， P<0.001）， NLR （OR=0.921， 95%CI： 0.880‍ — ‍0.964， P<0.001）， and PT （OR=0.921， 95%CI： 0.873‍ — ‍0.973， P=0.003） were independent influencing factors for the prognosis of HBV-ACLF patients. ΔCCR5 had an AUC of 0.774， a sensitivity of 0.687， and a specificity of 0.757， and the AUC of ΔCCR5+PT+NLR was 0.824， which was significantly higher than the AUC of ΔCCR5， NLR， or PT alone （all P<0.05）. ConclusionΔCCR5， NLR， and PT can reflect the condition and prognosis of patients with HBV-ACLF and are independent predictive indicators for death events in patients with HBV-ACLF. The combination ofΔCCR5， PT， and NLR has the best predictive efficiency.

A spurious elevation of serum creatinine level in a patient with Crohn's disease without histologic kidney damage: a case report and review of the literature / Elevação espúria do nível de creatinina sérica em ­paciente com doença de Crohn sem lesão renal histológica: relato de caso e revisão da literatura

ABSTRACT Patients with inflammatory bowel disease (IBD) are prone to develop kidney injury. Renal involvement in IBD patients is usually diagnosed by the measurement of serum creatinine and the estimation of the glomerular filtration rate. We describe a patient with IBD who presented with large fluctuations in his serum creatinine level (~3.0-fold) without significant histologic abnormalities and with a normal cystatin C level. This appears to be related to a high-protein diet and intermittent fasting. Even though the impact of a high-protein diet on mild elevations of the serum creatinine level has been described, large fluctuations in serum creatinine from diet alone, as seen in this case, have never been reported, raising the question about the potential contribution of inflamed bowel on gut absorption or metabolism of creatinine. This case highlights the importance of a detailed history, including the dietary habits, when encountering a patient with increased serum creatinine level, and careful interpretation of serum creatinine in a patient with a creatinine high-protein diet or underlying IBD.

RESUMO Pacientes com doença inflamatória intestinal (DII) são propensos a desenvolver lesão renal. O envolvimento renal em pacientes com DII é geralmente diagnosticado pela medição da creatinina sérica e pela estimativa da taxa de filtração glomerular. Descrevemos um paciente com DII que apresentou grandes flutuações em seu nível de creatinina sérica (~3,0 vezes) sem anormalidades histológicas significativas e com nível normal de cistatina C. Isso parece estar relacionado a uma dieta rica em proteínas e jejum intermitente. Ainda que o impacto de uma dieta rica em proteínas em elevações leves do nível de creatinina sérica tenha sido descrito, nunca foram relatadas grandes flutuações na creatinina sérica apenas devido à dieta, como observado neste caso, o que levanta a questão sobre a possível contribuição do intestino inflamado na absorção intestinal ou no metabolismo da creatinina. Esse caso destaca a importância de um histórico detalhado, incluindo os hábitos alimentares, ao se deparar com um paciente com nível de creatinina sérica aumentado, e a interpretação cuidadosa da creatinina sérica em um paciente com dieta rica em proteínas ou DII subjacente.

Caracterización clínica de la Nefropatía por Poliomavirus BK en pacientes trasplantados renales / Clinical characterization of Polyomavirus BK nephropathy in kidney transplanted patients

INTRODUCCIÓN. La nefropatía por poliomavirus BK resulta un problema emergente en el trasplante renal, pues contribuye a la pérdida temprana de los injertos renales. OBJETIVO. Caracterizar clínicamente a los pacientes trasplantados renales con nefropatía por poliomavirus BK. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo, realizado en el Hospital de Especialidades Carlos Andrade Marín en el período 2013-2022, se obtuvo una base de datos anonimizada, 479 pacientes trasplantados renales, de estos se identificaron 37 pacientes que corresponde a un 7,7% con nefropatía por poliomavirus BK, se realizó un análisis con el programa estadístico SPSS v26®. RESULTADOS. La población estuvo caracterizada por pacientes del sexo masculino (56,8%), con una edad media de 48,2 años, el donante cadavérico fue el más frecuente (94,5%), la mayor parte del tratamiento de la nefropatía por poliomavirus BK consistió en cambio de micofenolato sódico a everolimus y se mantuvo con 50% de Tacrolimus y Prednisona (40,5%); al valorar el cambio de los valores de creatinina, los niveles más elevados fueros a los 12 meses cuando la pérdida renal fue temprana (p: 0,042), y de la misma manera a los 12 meses, fueron más elevados los niveles de creatinina cuando el diagnóstico histopatológico fue Nefropatía por Poliomavirus Clase 3 (p: 0,01). DISCUSIÓN. La prevalencia de la nefropatía se mantuvo por debajo del 10% reportado a nivel global, la creatinina empeoró en pacientes con pérdida temprana del injerto renal y con una clase patológica avanzada, hecho reportado en la fisiopatología de la enfermedad. CONCLUSIÓN. La pérdida del injerto renal temprano presentó una creatinina más alta que la tardía. Es recomendable un tamizaje adecuado para la detección temprana del virus BK siendo crucial para prevenir el deterioro de la función renal y limitar la posterior pérdida del injerto.

INTRODUCTION: BK polyomavirus nephropathy is emerging as a significant concern in kidney transplantation, as it contributes to the early loss of renal grafts. OBJECTIVE: The aim of this study was to clinically characterize renal transplant recipients with BK polyomavirus nephropathy. MATERIALS AND METHODS: An observational and descriptive study was conducted at Carlos Andrade Marín Specialties Hospital during the period of 2013 to 2022. An anonymized database comprising 479 renal transplant patients was utilized. Among these, 37 patients, constituting 7.7%, were identified with BK polyomavirus nephropathy. Data analysis was performed using the statistical program SPSS v26®. RESULTS: The study population was predominantly composed of male patients (56.8%) with a mean age of 48.2 years. Deceased donors accounted for the majority (94.5%) of cases. The primary approach for managing BK polyomavirus nephropathy involved transitioning from mycophenolate sodium to everolimus, alongside maintaining a regimen of 50% tacrolimus and 40.5% prednisone. When assessing changes in creatinine values, the highest levels were observed at 12 months, coinciding with early renal loss (p: 0.042). Similarly, at the 12-month mark, elevated creatinine levels were associated with a histopathological diagnosis of Polyomavirus nephropathy Class 3 (p: 0.01). DISCUSSION: The prevalence of nephropathy remained below the globally reported threshold of 10%. Creatinine levels worsened in patients experiencing early graft loss and an advanced pathological classification, aligning with established disease pathophysiology. CONCLUSION: Early renal graft loss was associated with higher creatinine levels compared to delayed loss. Adequate screening for early detection of BK virus is recommended, as it plays a crucial role in preventing renal function deterioration and limiting subsequent graft loss.

Comparison of GFR measurement with a two-blood sample technique using [99mTc]Tc-DTPA vs. creatinine-based equations in potential kidney donors / Comparação da medição da TFG com uma técnica com duas amostras de sangue usando [99mTc]Tc-DTPA vs. equações baseadas em creatinina em potenciais doadores de rim

ABSTRACT Introduction: Accurate determination of glomerular filtration rate (GFR) is crucial for selection of kidney donors. Nuclear medicine methods are considered accurate in measuring GFR but are not always easily available. The four-variable Modification of Diet in Renal Disease (MDRD4), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), and Full Age Spectrum (FAS) formulas are common equations for estimating GFR and are recommended for initial assessment of kidney donors. The aim of this study was to evaluate the performance of these GFR estimation equations compared with technetium-99m diethylenetriaminepentaacetic acid ([99mTc]Tc-DTPA) clearance. Methods: We compared GFR estimation by [99mTc]Tc-DTPA clearance using a two-blood sample method with estimation by MDRD4, CKD-EPI, and FAS creatinine-based equations in a population of healthy potential kidney donors. Results: A total of 195 potential kidney donors (68.2% female; mean age 49 years, range 21-75 years) were included in this study. Mean [99mTc]Tc-DTPA measured GFR (mGFR) was 101.5 ± 19.1 mL/min/1.73 m2. All three equations underestimated the GFR value measured by [99mTc]Tc-DTPA (MDRD4: -11.5 ± 18.8 mL/min/1.73 m2; CKD-EPI: -5.0 ± 17.4 mL/min/1.73 m2; FAS: -8.3 ± 17.4 mL/min/1.73 m2). Accuracy within 30% and 10% of the measured GFR value was highest for CKD-EPI. Conclusion: The CKD-EPI equation showed better performance in estimating GFR in healthy potential kidney donors, proving to be a more accurate tool in the initial assessment of kidney donors. However, creatinine-based equations tended to underestimate kidney function. Therefore, GFR should be confirmed by another method in potential kidney donors.

RESUMO Introdução: Determinar precisamente a taxa de filtração glomerular (TFG) é crucial para seleção de doadores de rim. Métodos de medicina nuclear são considerados precisos na medição da TFG, mas nem sempre estão facilmente disponíveis. As fórmulas Modification of Diet in Renal Disease de 4 variáveis (MDRD4), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), e Full Age Spectrum (FAS) são equações comuns para estimar a TFG, sendo recomendadas para avaliação inicial dos doadores. Este estudo visou avaliar o desempenho destas equações de estimativa da TFG em comparação com o clearance do tecnécio-99m-ácido dietilenotriaminopentacético ([99mTc]Tc-DTPA). Métodos: Comparamos a TFG por clearance de [99mTc]Tc-DTPA usando um método com duas amostras de sangue com estimativa da TFG pelas equações MDRD4, CKD-EPI e FAS baseadas em creatinina em uma população de potenciais doadores saudáveis. Resultados: Incluiu-se 195 potenciais doadores de rim (68,2% mulheres; idade média de 49 anos, intervalo 21-75 anos). A TFG média medida por [99mTc]Tc-DTPA foi 101,5 ± 19,1 mL/min/1,73m2. As três equações subestimaram o valor da TFG medida por [99mTc]Tc-DTPA (MDRD4: -11,5 ± 18,8 mL/min/1,73 m2; CKD-EPI: -5,0 ± 17,4 mL/min/1,73 m2; FAS: -8,3 ± 17,4 mL/min/1,73 m2). A precisão dentro de 30% e 10% do valor da TFG medida foi maior para CKD-EPI. Conclusão: A equação CKD-EPI mostrou melhor desempenho na estimativa da TFG em potenciais doadores de rim saudáveis, revelando-se uma ferramenta mais precisa na avaliação inicial dos doadores. Entretanto, equações baseadas em creatinina tendem a subestimar a função renal. Portanto, a TFG deve ser confirmada por outro método em potenciais doadores.

Effect of Hayani Date (Phoenix dactylifera L) Peels on Blood Sugar, Blood Lipids, Liver and Kidney Functions, and Inflammation in Diabetic Rats

This study aimed to investigate the effect of Hayani date peel powder and its methanolic extract on glycemia and lipidemia in streptozotocin-induced diabetic rats as well as their effects on kidney and liver functions in addition to their anti-inflammatory activity. Twenty-four rats were used in this study, six of them served as normal control (group 1) which continued feeding on the basal diet, while the remaining 18 rats were injected with streptozotocin (50mg/kg) to induce diabetes. The diabetic rats were divided into three groups (6 rats each), one of them feeding on the basal diet only which acted as diabetic control (group 2), another group fed on the basal diet and treated orally with the peel extract in a concentration of 250 mg/kg body weight (group 3), while the third group was treated with peel powder merged in the basal diet with a concentration of 5% w/w (group 4). The results showed that the extract and the powder of the peels significantly decreased the blood glucose, glycated hemoglobin (HbAlc), total cholesterol (TC), total triglycerides (TG), low density lipoprotein cholesterol (LDL-c), very low density lipoprotein cholesterol (VLDL-c), alanine transaminase (ALT), aspartate transaminase (AST), creatinine, and uric acid as well as cyclooxygenase-2 (COX-2), prostaglandin 2 (PGE2), tumor necrosis factor alpha (TNF-?), interleukin 1B (IL-1?), and inducible nitric oxide synthase (iNOS) levels. In contrast, significant increases in serum insulin, high density lipoprotein cholesterol (HDL-c), and albumin were noticed in comparison to diabetic control. Generally, the peel extract was more effective than the peel powder. It is recommended by eating the whole fruit of date without peeling.

Primeras recomendaciones de consenso SLANH - COLABIOCLI / Primeiras Recomendações de Consenso SLANH - COLABIOCLI / (Sociedad Latinoamericana de Nefrología e Hipertensión - Confederación Latinoamericana de Bioquímica Clínica) / Informe de la tasa de filtración glomerular estimada junto a la determinación de la creatininemia en población adulta / First SLANH-COLABIOCLI Consensus Recommendations

Resumen La enfermedad renal crónica (ERC) es de alta prevalencia en América Latina y en todo el mundo. Se estima que entre 10 y 20% de la población adulta es portadora de ERC y su prevalencia va en aumento. La ERC progresa en forma silenciosa. Su diagnóstico temprano y oportuno permite iniciar un tratamiento efectivo, en la mayoría de los casos, para detener la enfermedad. Desde hace mucho tiempo, el análisis de la creatininemia es la principal prueba utilizada para valorar la función renal, pero su confiabilidad es limitada. De acuerdo con las recomendaciones de las GUIAS KDOQI del año 2002 la tasa de filtración glomerular estimada (TFGe) obtenida a través de fórmulas, se estableció como una de las herramientas principales para detectar la enfermedad renal de manera precoz, ya que alerta de forma precisa al médico y al equipo de salud sobre el nivel de función renal del paciente. La detección de una TFGe disminuida (menor de 60 mL/min/1,73 m2) es clínicamente relevante, ya que permite establecer el diagnóstico de enfermedad renal en adultos. En el año 2022, en una encuesta realizada por SLANH y COLABIOCLI dirigida a los laboratorios de análisis clínicos de América Latina (n: 237), el 49% de los mismos no informaban la TFGe rutinariamente. En base a esta realidad SLANH y COLABIOCLI elaboraron estas recomendaciones de consenso en referencia al uso de la TFGe.

Abstract Chronic kidney disease (CKD) has a high prevalence worldwide and in Latin America (10 to 20% of the adult population) and is increasing. CKD progresses silently. Opportune diagnosis and treatment are effective in most cases to improve outcomes. Serum creatinine was the main test to assess kidney function, but its reliability is limited. Through the KDOQI Guidelines 2002, the estimated glomerular filtration rate (eGFR) obtained from equations was established as one of the main tools for the early detection of kidney disease in clinical practice. The detection of a decreased eGFR (less than 60 mL/min/1.73 m2) is clinically relevant. This cut-off level establishes the diagnosis of kidney disease in adults. In 2022 SLANH and COLABIOCLI conducted a survey among the clinical laboratories from Latin America. The survey included 237 laboratories, 49% of which did not routinely report the eGFR. Based on this situation, SLANH and COLABIOCLI have elaborated the following consensus recommendations regarding the use of eGFR.

Resumo A doença renal crônica (DRC) é altamente prevalente na América Latina e em todo o mundo. Estima-se que entre 10 e 20% da população adulta seja portadora de DRC e sua prevalência esteja aumentando. A DRC progride silenciosamente. Seu diagnóstico precoce e oportuno permite iniciar um tratamento eficaz, na maioria dos casos, para estancar a doença. Faz muito tempo, a análise da creatinina tem sido o principal teste usado para avaliar a função renal mas sua confiabilidade é limitada. De acordo com as recomendações dos GUIAS KDOQI do ano de 2002, a estimativa da taxa de filtração glomerular (eGFR), obtida por meio de fórmulas, consolidou-se como uma das principais ferramentas para a detecção precoce da doença renal, visto que alerta com precisão ao médico e ao equipe de saúde sobre o nível de função renal do paciente. A detecção de uma eGFR diminuída (inferior a 60 mL/min/1,73 m2) é clinicamente relevante, pois permite estabelecer o diagnóstico de doença renal em adultos. No ano de 2022, em pesquisa realizada pela SLANH e COLABIOCLI dirigida a laboratórios de análises clínicas da América Latina (n: 237), 49% deles não relataram rotineiramente eGFR. Com base nessa realidade, SLANH e COLABIOCLI prepararam essas recomendações de consenso sobre o uso de eGFR.

Assessment of serum magnesium and correlation with glycemic control and complication in type 2 diabetes mellitus – A cross-sectional study in a tertiary care hospital in eastern zone of India

Background: Diabetes mellitus (DM) is an expanding global health problem. Type 2 DM (T2DM) patients account about 90% of total DM patients. Magnesium is important for different physiological mechanism. Hypomagnesemia is common in T2DM patient. Magnitude of hypomagnesemia is related with glycemic control and is associated with complications of T2DM. Aims and Objectives: Our aim of the study was to assess the prevalence of hypomagnesemia in patients of T2DM patients and to find their correlation with glycemic control and complications of T2DM patients in rural population of eastern zone of India. Materials and Methods: The hospital-based cross-sectional study includes 99 male and female DM patients between 15 and 60 years age. Fasting blood sugar, postprandial blood sugar, HbA1c, serum total magnesium, and urine albumin creatinine ratio were measured. Data were entered into Microsoft Excel spreadsheet and then analyzed by SPSS (version 25.0; SPSS Inc.) and GraphPad Prism (version 5.0). P < 0.05 was considered statistically significant. Results: From our study, we observed that hypomagnesemia is common in T2DM patients. The magnitude of hypomagnesemia is correlated with glycemic control (P < 0.0001). Moreover, hypomagnesemia is associated with diabetic kidney diseases (P < 0.05). Conclusion: It can be concluded that serum magnesium should be monitored in all T2DM patients and should be managed appropriately because hypomagnesemia may induce complications in T2DM patients.

Self-Measured Blood Pressure and Target Organ Damage in Newly Detected Hypertension in South Gujarat, India

Introduction: Blood pressure transient spikes have been considered to be noise and only a hindrance to a proper assessment of typical blood pressure, which is defined as the actual underlying average blood pres-sure over a long period of time. The current study aimed to see if the highest Self measured Systolic blood Pressure could be utilized to forecast the occurrence of Target organ damage and evaluate the independent association between the maximum Self measured Systolic blood Pressure and Target organ damage in indi-viduals with untreated hypertension. Method: We evaluated the urine albumin/creatinine ratio (UACR) and carotid intima-media thickness (IMT) using ultrasonography in 462 hypertensive individuals who had never taken treatment for their hypertension. Residential blood pressure was recorded. Result: The maximal Self measured Systolic blood Pressure had considerably higher association coefficients with left ventricular mass index (LVMI) and carotid intima-media thickness than the mean Self measured Sys-tolic blood Pressure. Irrespective of the mean Self measured Blood pressure level, multivariate regression studies showed that the maximal Self measured Systolic blood Pressure was independently related with left ventricular mass index and carotid intima-media thickness. Conclusion: Transiently high blood pressure measurements recorded at Self measured shouldn't be dis-missed as noise but rather taken seriously as significant warning signs of hypertensive Target organ damage in the heart and arteries.

Restorative effect of jogging on lower limb muscles / Efeito reparador da corrida moderada sobre a musculatura dos membros inferiores / Efecto restaurador del trote moderado sobre los músculos de los miembros inferiores

ABSTRACT Introduction: Jogging can be a great way to improve physical condition, boosting mind and body. Its method of movement is simple, and there are no sporting limitations as to age, gender, or training place. Jogging is believed to help repair muscle and joint injuries in the lower limbs. Objective: To explore the effects of running on recovering lower limb muscles. Methods: We surveyed 60 undergraduate students who took a 400-meter test at the same site. According to the test results, they were divided into low, medium, and high fitness levels. A questionnaire survey was also used with 20 undergraduate students from the Physical Education Department. Four groups of volunteers did some jogging exercises. Physiological, biochemical, and muscle strength measurements were performed after jogging. The data were statistically treated. Results: The magnitude of change in the sagittal angle of the knee and ankle joint did not increase significantly with increasing jogging rate. The changes in the sagittal angles of the hip, knee, and ankle joints were the same for the volunteers with different jogging rates. After 60 minutes of exercise, the low-fitness group showed faster breathing, an elevated heart rate, and a higher rate of lactate and creatinine in the blood. After 120 minutes of exercise training, all sedentary volunteers showed an increase in lactate, creatinine, respiratory rate, and heart rate (P<0.05). The test performance started to decrease at 400 meters. Conclusion: The maximal activation of different parts of the locomotor system changed under different rates of movement. Brief, controlled jogging may be beneficial to lower limb muscles. Still, long-term jogging may cause even more damage to the body and deleterious changes to rehabilitation in blood and biochemical parameters. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A corrida moderada pode ser uma ótima maneira de melhorar a condição física, impulsionando mente e corpo. Seu método de movimento é simples e não há limitações esportivas quanto a idade, sexo ou local de treino. Acredita-se que a corrida moderada possa auxiliar no reparo de lesões musculares e articulares nos membros inferiores. Objetivo: Explorar os efeitos da corrida sobre a musculatura nos membros inferiores em recuperação. Métodos: Foram pesquisados 60 estudantes de graduação que fizeram um teste de 400 metros no mesmo local. De acordo com os resultados do teste, eles foram divididos em baixo, médio e alto nível de aptidão física. Também se utilizou uma pesquisa por questionário com 20 estudantes universitários do Departamento de Educação Física. Quatro grupos de voluntários fizeram alguns exercícios de corrida moderada. As medidas fisiológicas, bioquímicas e de força muscular foram realizadas após a corrida moderada. Os dados foram tratados estatisticamente. Resultados: A magnitude da mudança no ângulo sagital da articulação do joelho e tornozelo não aumentou significativamente com o aumento da taxa de corrida moderada. As mudanças nos ângulos sagitais das articulações do quadril, joelho e tornozelo foram as mesmas para os voluntários com diferentes taxas de corrida moderada. Após 60 minutos de exercício, o grupo de baixa condição física apresentou uma respiração mais rápida, um ritmo cardíaco elevado e uma taxa maior de lactato e creatinina no sangue. Após 120 minutos de treinamento físico, todos os voluntários sedentários apresentaram um aumento de lactato, creatinina, frequência respiratória e cardíaca (P<0,05). O desempenho do teste começou a diminuir aos 400 metros. Conclusão: A ativação máxima de diferentes partes do sistema locomotor alterou-se sob diferentes taxas de movimento. A corrida moderada breve e controlada pode ser benéfica a musculatura dos membros inferiores, porém a corrida moderada de longo prazo pode causar ainda mais danos ao corpo e mudanças deletérias à reabilitação nos parâmetros sanguíneos e bioquímicos. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El trote moderado puede ser una gran manera de mejorar la condición física, impulsando la mente y el cuerpo. Su método de movimiento es sencillo y no existen limitaciones deportivas en cuanto a edad, sexo o lugar de entrenamiento. Se cree que trotar puede ayudar a reparar las lesiones musculares y articulares de las extremidades inferiores. Objetivo: Explorar los efectos de la carrera en la recuperación de los músculos de las extremidades inferiores. Métodos: Se encuestó a 60 estudiantes universitarios que realizaron una prueba de 400 metros en el mismo lugar. Según los resultados de la prueba, se dividieron en nivel de aptitud bajo, medio y alto. También se utilizó una encuesta con 20 estudiantes de grado del Departamento de Educación Física. Cuatro grupos de voluntarios realizaron ejercicios de trote. Se realizaron mediciones fisiológicas, bioquímicas y de fuerza muscular después del trote moderado. Los datos fueron tratados estadísticamente. Resultados: La magnitud del cambio en el ángulo sagital de la articulación de la rodilla y el tobillo no aumentó significativamente con el aumento de la velocidad del trote. Los cambios en los ángulos sagitales de las articulaciones de la cadera, la rodilla y el tobillo fueron los mismos para los voluntarios con diferentes ritmos de trote. Después de 60 minutos de ejercicio, el grupo de baja forma física mostró una respiración más rápida, una frecuencia cardíaca elevada y un mayor índice de lactato y creatinina en la sangre. Tras 120 minutos de entrenamiento físico, todos los voluntarios sedentarios mostraron un aumento del lactato, la creatinina, la frecuencia respiratoria y la frecuencia cardíaca (P<0,05). El rendimiento de la prueba comenzó a disminuir a partir de los 400 metros. Conclusión: La activación máxima de diferentes partes del aparato locomotor cambió bajo diferentes ritmos de movimiento. El trote moderado y de forma controlada puede ser beneficioso para los músculos de las extremidades inferiores, pero trotar a largo plazo puede causar aún más daño al cuerpo y cambios nocivos para la rehabilitación en los parámetros sanguíneos y bioquímicos. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Prognostic value of age, creatinine, and left ventricular ejection fraction risk score in patients evaluated with fractional flow reserve: a cross-sectional study

SUMMARY OBJECTIVE: In this study, we investigated the relationship between age, creatinine, and left ventricular ejection fraction risk score and the severity of coronary lesions detected by applying fractional flow reserve in the patient group presenting with chronic coronary syndrome. Also, we presented long-term follow-up results in patients whose age, creatinine, and left ventricular ejection fraction score was evaluated by the fractional flow reserve procedure. METHODS: This study was planned retrospectively and in two centers. For this purpose, 114 patients who met the study criteria and who underwent elective fractional flow reserve between January 2014 and January 2019 were included in the study. Age, creatinine, and left ventricular ejection fraction was calculated as age/left ventricular ejection fraction +1 (if estimated glomerular filtration rate<30 mL/min). RESULTS: They were divided into two groups according to the cutoff value of the age, creatinine, and left ventricular ejection fraction score. A total of 76 patients had an age, creatinine, and left ventricular ejection fraction score of ≤1.17 (Group I) and 38 patients had an age, creatinine, and left ventricular ejection fraction score of >1.17 (Group II). The number of patients with severe lesions in fractional flow reserve was significantly higher in Group II compared with Group I (60.5 vs. 32.9%, p=0.005). According to the Kaplan-Meier analysis, a significant increase was observed in major adverse cardiac events and mortality during the follow-up period in the group with a high-risk score (Log Rank: 15.01, p<0.001 and Log Rank: 8.51, p=0.004, respectively). CONCLUSION: In light of the data we obtained from our study, we found a correlation between the severity of the lesion detected in fractional flow reserve and the age, creatinine, and left ventricular ejection fraction scores. In addition, we found that patients with high age, creatinine, and left ventricular ejection fraction scores had higher mortality and major adverse cardiac events rates during follow-up.

Serum and urinary angiotensinogen levels as prognostic indicators in acute kidney injury: a prospective study

SUMMARY OBJECTIVE: The delayed increase in serum creatinine levels poses challenges in the timely diagnosis of acute kidney injury. This study aimed to investigate the relationship between serum angiotensinogen and urinary angiotensinogen levels and the prognosis of renal function in patients diagnosed with acute kidney injury. METHODS: A total of 79 newly diagnosed acute kidney injury patients aged 18 years and older were enrolled. Serum angiotensinogen and urinary angiotensinogen levels were measured at the onset of the disease, as well as on the 15th and 30th days of follow-up. After 3 months, renal function was evaluated by measuring serum creatinine levels. RESULTS: Among the acute kidney injury patients, those in Kidney Disease: Improving Global Outcomes stage 3 exhibited significantly higher urinary angiotensinogen/urine creatinine levels compared with stages 1 and 2 patients at the time of diagnosis (p<0.05). Furthermore, a positive correlation was observed between the urinary angiotensinogen/urine creatinine level at the time of diagnosis and the serum creatinine level at the third month (r=0.408, p=0.048). CONCLUSION: The findings suggest that urinary angiotensinogen levels can serve as an indicator of the severity of acute kidney injury. Monitoring urinary angiotensinogen levels could potentially contribute to the prognosis assessment and management of acute kidney injury patients.

A retrospective analysis to estimate trough concentrations of teicoplanin in patients with suspected or documented Gram-positive infections

Abstract Teicoplanin is a glycopeptide antibiotic commonly used to treat Gram-positive bacterial infections in the clinic. The aim of this study was to provide a therapeutic reference for the clinical application and dosage regimen adjustment of teicoplanin by identifying factors associated with its plasma trough concentration (Ctrough). A retrospective study was performed on patients with suspected or documented Gram-positive infections who were hospitalized from November 2017 to January 2020 and treated with teicoplanin while undergoing routine therapeutic drug monitoring (TDM). A total of 112 Ctrough trough measurements were obtained from 72 patients were included in this study. SPSS software was used for correlation analysis and receiver operator characteristic curve (ROC) analysis. The Ctrough for teicoplanin showed statistically significant relationships (P<0.05) with PLT, Scr, CLcr, eGFR, BUN and Cys-C. ROC curve analysis revealed that CLcr and eGFR were more sensitive and specific for Ctrough compared to the other factors. These findings should be considered in the clinical application of teicoplanin and for its dosage adjustment.

Validation of equations to estimate kidney function with and without adjustment by race/color in Brazilian adults (ELSA-Brazil) / Validação das equações para estimativa da função renal com e sem ajuste por raça/cor em adultos brasileiros (ELSA-Brasil)

ABSTRACT Objective: To evaluate accuracy and agreement between creatinine clearance (CrCl) measured in 12-h urine and glomerular filtration rate (GFR) calculated by the Modification of Diet in Renal Disease (MDRD-4) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas, with and without adjustment for race/color. Methods: Baseline data from the Longitudinal Study of Adult Health (ELSA-Brazil) in adults (35-74 years of age) of both genders were used. Serum creatinine was measured in fasting blood and urinary creatinine was measured in an overnight 12-h urine collect. The agreement between CrCl and the calculated GFR was analyzed by the Bland-Altman method. One-way analysis of variance (ANOVA) with race/color factor was used to verify differences between means of CrCl and GFR with and without correction for race/color. Statistical significance was accepted for p<0.05. Results: From 15,105 participants in the ELSA-Brazil, 12,813 had a validated urine collect. The Bland-Altman diagrams showed that formulas and CrCl agree with each other with a better accuracy for GFR <90 mL/.min x 1.73m2. The adjustment by race/color increased data dispersion. In this range, one-way ANOVA of CrCl with race/color factor showed similarity between groups (p=0.27). Conclusion: MDRD-4 and CKD-EPI are useful formulas for screening cases of chronic kidney disease, and correction by race/color, only in blacks or in black and brown subjects, proved to be unnecessary and reduced the reliability of the equations.

RESUMO Objetivo: Avaliar a acurácia e a concordância entre o clearance de creatinina (ClCr) medido na urina de 12 h e a taxa de filtração glomerular (TFG) calculada pelas fórmulas Modification of Diet in Renal Disease (MDRD-4) e Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), com e sem ajuste por raça/cor. Métodos: Foram usados dados da linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil), em adultos (35-74 anos) de ambos os sexos. A creatinina sérica foi medida no sangue em jejum e a creatinina urinária foi medida na urina de 12 h coletada no período noturno. A concordância entre o ClCr e a TFG calculada pelas fórmulas foi analisada pelo método de Bland-Altman. Análise de variância (ANOVA) de uma via com fator raça/cor foi usada para comparar médias do ClCr e da TFG calculadas com e sem ajuste por raça/cor. A significância estatística foi aceita para p<0,05. Resultados: Dos 15.105 participantes do ELSA-Brasil, 12.813 tiveram a coleta urinária de 12 h validada. Os diagramas de Bland-Altman mostraram que as fórmulas e o ClCr concordam entre si e têm melhor acurácia para TFG <90 mL/min/1,73m2, e que o ajuste por raça/cor aumenta a dispersão dos dados. Nessa faixa, a ANOVA de uma via do ClCr com fator raça/cor mostrou semelhança entre grupos (p=0,27). Conclusão: MDRD-4 e CKD-EPI são fórmulas adequadas para rastreamento da doença renal crônica na população brasileira, sendo desnecessário o ajuste por raça/cor para o uso desses instrumentos, uma vez que a introdução do ajuste tanto em pretos quanto em pretos e pardos diminuiu a acurácia dos métodos.

Cistatina C: la necesidad de su conocimiento en la atención preventiva de daño renal / Cystatin c: the need to know it in the preventive care of kidney damage

El conocimiento y actualización sobre la Cistatina C como marcador de daño renal precoz es en extremo necesario para los profesionales de la salud con vistas a mejorar el diagnóstico temprano de enfermedad renal. Las autoras realizaron una revisión bibliográfica actualizada a través de varios estudios científicos, lo que permitió poder informar que aun cuando para la evaluación de la función renal uno de los marcadores sanguíneos convencionales más utilizados es la creatinina, el estudio sanguíneo de Cistatina C no está sometido a diferentes fuentes de variabilidad biológica, ni a factores dependientes del paciente, por lo que sería idóneo tenerlo en cuenta como marcador de función renal precoz.

Knowledge and updating on Cystatin C as a marker of early kidney damage is extremely necessary for health professionals with a view to improving early diagnosis of kidney disease. The authors carried out an updated bibliographical review through various scientific studies, which allowed us to inform that even when for the evaluation of renal function one of the most widely used conventional blood markers is creatinine, the Cystatin C blood study is not subjected to different sources of biological variability, nor to factors dependent on the patient, so it would be ideal to take it into account as a marker of early renal function.

Development of national secondary reference materials of urea and creatinine in frozen human serum / 中华检验医学杂志

Objective:To develop a national secondary reference material of Urea and Creatinine in frozen human serum as a standard for metrological traceability.Methods:According to JJF1343-2012 "General and Statistical Principles for Characterization of Reference Materials" and JJF 1006-1994 " Technical Norm of Primary Reference Material ", the homogeneity, stability, and commutability were evaluated;Using the JCTLM recommended methods, the value of the reference materials was assigned through collaboration with 6 accredited reference laboratories from Guangdong Provincial Hospital of Chinese Medicine, Beijing Aerospace General Hospital, Shenzhen Mindray Bio-Medical Electronics, Maccura Biotechnology, Beijing Leadman Biochemistry, and Zhejiang MedicalSystem Biotechnology. Uncertainty components including inhomogeneity, stability and value assignment were evaluated.Results:The results of one-way analysis of variance of homogeneity for the reference materials showed P>0.05, and the stability evaluation was less than the critical value of the t-test. The measured values were in the 95% confidence interval in the four conventional detection systems for commutability, and the certified values and expanded uncertainties were urea:(14.7±0.3) mmol/L ( k=2),Cr:(313.9±14.5) μmol/L ( k=2). Conclusion:The prepared secondary reference materials of urea and creatinine had promising homogeneity, stability, and commutable, the values of urea and creatinine concentration in reference materials were accurate and reliable.

Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years / 中华内科杂志

Objective:To investigate the prevalence of albuminuria in Chinese residents aged >35 years and its potential association with cardiovascular disease (CVD).Methods:A total of 34 647 Chinese subjects aged ≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015. Data were collected through questionnaires, physical examinations, and laboratory tests. Albuminuria was categorized into 3 types according to urinary albumin-to- creatinine ratio: normal (<30 mg/g), microalbuminuria (MAU, 30-300 mg/g), and macroalbuminuria (≥300 mg/g). Measurement data were expressed as xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 test or Kruskal-Wallis test was used to examine differences. Logistic regression was used for multivariate analyses. SAS 9.4 software was used for statistical analyses, and P<0.05 was considered statistically significant. Results:The prevalence of abnormal albuminuria was 19.1%; the prevalence was 17.2% for MAU and lower in males (13.8%) than females (20.1%, P<0.01). The risk of CVD was higher among subjects with MAU ( OR=1.23, 95% CI 1.12-1.35) and macroalbuminuria ( OR=1.86, 95% CI 1.50-2.32). When MAU was complicated by hypertension and diabetes mellitus, the CVD risk was 1.76 times higher. Conclusions:The prevalence of MAU is high among Chinese subjects aged 35 years and over. Those with MAU have higher CVD risk, especially those with hypertension and diabetes mellitus.

Cross-sectional associations between reproductive lifespan duration and urinary albumin-creatinine ratio / 中华内科杂志

Objective:To investigate the association between reproductive lifespan duration (RLD) and urinary albumin-creatinine ratio (UACR) in a Chinese postmenopausal population.Methods:This cross-sectional study included 11 055 naturally postmenopausal women from seven regions of China from May to December 2011. RLD was divided into four groups. Propensity score matching was performed to reduce bias, and logistic regressions and stratifications were conducted to investigate the association between RLD and increased UACR (≥30 mg/g). Mediation effect analysis was performed to quantify the effect of RLD on cardiovascular disease (CVD) induced by elevated UACR.Results:There were 2 373 participants with a RLD of 18-31 years, 2 888 participants with a RLD of 32-34 years, 2 472 participants with a RLD of 35-36 years, and 3 322 participants with a RLD of 37-50 years. The shortest RLD (18-31 years) group was characterized with older age ( P<0.001), a higher incidence of CVD ( P=0.025), and the highest level of UACR ( P<0.001). After adjusting for confounders, women with a longer RLD (37-50 years group) exhibited a lower risk of UACR elevation compared with those with the shortest RLD (18-31 years group) ( OR=0.72, 95% CI 0.64-0.82, P<0.001). Every 1-year extension in RLD was linked to a 2% reduction in the risk of UACR elevation ( OR=0.98, 95% CI 0.97-0.99, P<0.001). Stratified analysis revealed a more significant association between RLD and UACR in women who were a normal weight ( P=0.003) or overweight ( P=0.001), in those without CVD history ( P=0.001), and in those with impaired estimated glomerular filtration rate ( P=0.004). The mediation casual analysis showed that 3.0% of proteinuria inducing CVD events was mediated by RLD ( P=0.048). Conclusion:A longer RLD (37-50 years) is associated with a lower UACR in Chinese postmenopausal women.

Investigation and analysis of individual iodine nutrition among students aged 8 to 15 in Dongtai City, Jiangsu Province in 2021 / 中华地方病学杂志

Objective:To analyze the individual iodine nutrition status and its influencing factors among students aged 8 to 15 in Dongtai City, Jiangsu Province.Methods:From May to August 2021, a total of 905 students aged 8 to 15 were selected as survey subjects in Dongtai City based on the sampling method in the "National Monitoring Plan for Iodine Deficiency Disorders" (2016 version). Salt samples from students' homes were collected for salt iodine testing. Urine samples of students were collected for urinary iodine and creatinine testing. The creatinine correction method was used to estimate individual 24 h urinary iodine excretion and calculate iodine intake. At the same time, basic information (age, gender, height, weight, etc.) and consumption frequency of iodine rich foods (seafood, eggs, meat, milk, solid snacks) of students were collected through questionnaires and actual measurements.Results:The coverage rate of iodized salt in Dongtai City was 98.2% (889/905), the qualified rate of iodized salt was 97.9% (870/889), and the consumption rate of qualified iodized salt was 96.1% (870/905). The median estimated 24 h urinary iodine excretion was 179.7 μg/d. The median estimated iodine intake was 195.4 μg/d, the constituent ratio of estimated iodine intake < recommended nutrient intake (RNI) was 16.2% (147/905), RNI-tolerable upper intake level (UL) was 63.4% (574/905), and > UL was 20.3% (184/905). The medians estimated 24 h urinary iodine excretion of students aged 8-10, 11-13 and 14-15 were 157.4, 193.0 and 236.5 μg/d, respectively, and the difference was statistically significant ( H = 55.42, P < 0.001). The median estimated 24 h urinary iodine excretion of boys was higher than that of girls (222.6 vs 148.6 μg/d), and the median estimated 24 h urinary iodine excretion of urban students was higher than that of township students (215.6 vs 162.7 μg/d), the differences were statistically significant ( Z = - 8.41, - 5.66, P < 0.001). There were statistically significant differences in the median estimated 24 h urinary iodine excretion between students with different body mass index (weight loss, overweight, obesity, normal; H = 56.15, P < 0.001) and iodine rich foods consumption frequencies (seafood, meat, milk, eggs, solid snacks; H = 23.15, 21.20, 60.77, 20.01, 24.47, P < 0.001). Conclusion:Iodine deficiency or excess exists in students aged 8-15 in Dongtai City, and girls aged 8-10 who are physically emaciated are the focus of attention for iodine deficiency.