Kidney Function in Hypertensive Patients with Left Ventricular Hypertrophy.

BACKGROUND: Impairment of kidney function is one of the long-term sequelae of hypertension and it contributes to increased morbidity and mortality in hypertensive patients. Left ventricular hypertrophy (LVH) is a common complication of hypertension which can worsen the outcome in affected patients. This study was designed to compare kidney function in hypertensive patients with LVH with that in hypertensive patients without LVH. METHODS: The study was conducted among hypertensive patients attending cardiology clinics at two tertiary hospitals in Nigeria. A questionnaire was used to obtain demographic and clinical information from the participants. Kidney function was determined by measuring serum urea and creatinine, urinary creatinine and microalbumin. Echocardiography was performed to detect LVH. Results of kidney function tests were compared between participants who had LVH and those who did not. RESULTS: Of the 105 participants recruited, 58 (55.2%) were males. The median age of all participants was 52 (interquartile range (IQR) 40-61) years and LVH was confirmed in 48 (45.7%) of them. Participants with LVH were older (55 vs 49 years; p=0.02) but had lower weight (74 vs 78 kg; p=0.04). Participants without LVH had higher microalbuminuria (5.2 vs 4.05 mg/dl; p=0.03), lower estimated glomerular filtration rate (62 vs 92 ml/min/1.73 m2; p=0.004), and higher stages of CKD. CONCLUSION: Hypertensive patients with LVH had lower levels of microalbuminuria, higher estimated GFR, and lower stages of CKD compared to those with no LVH.

CONTEXTE: L'altération de la fonction rénale est l'une des séquelles à long terme de l'hypertension et contribue à une morbidité et une mortalité accrues chez les patients hypertendus. L'hypertrophie ventriculaire gauche (HVG) est une complication fréquente de l'hypertension qui peut aggraver le pronostic chez les patients concernés. Cette étude visait à comparer la fonction rénale chez les patients hypertendus avec HVG à celle des patients hypertendus sans HVG. MÉTHODES: L'étude a été menée auprès de patients hypertendus fréquentant des cliniques de cardiologie dans deux hôpitaux tertiaires au Nigeria. Un questionnaire a été utilisé pour obtenir des informations démographiques et cliniques auprès des participants. La fonction rénale a été déterminée en mesurant l'urée sérique et la créatinine, la créatinine urinaire et la microalbuminurie. Une échocardiographie a été réalisée pour détecter l'HVG. Les résultats des tests de fonction rénale ont été comparés entre les participants présentant une HVG et ceux qui n'en présentaient pas. RÉSULTATS: Sur les 105 participants recrutés, 58 (55,2 %) étaient des hommes. L'âge médian de tous les participants était de 52 ans (plage interquartile (IQR) de 40 à 61) et l'HVG a été confirmée chez 48 (45,7 %) d'entre eux. Les participants avec une HVG étaient plus âgés (55 vs 49 ans ; p=0,02) mais avaient un poids plus faible (74 vs 78 kg ; p=0,04). Les participants sans HVG avaient une microalbuminurie plus élevée (5,2 vs 4,05 mg/dl ; p=0,03), un taux de filtration glomérulaire estimé plus bas (62 vs 92 ml/min/1,73 m2; p=0,004) et des stades plus élevés de maladie rénale chronique. CONCLUSION: Les patients hypertendus avec HVG présentaient des niveaux plus faibles de microalbuminurie, un taux de filtration glomérulaire estimé plus élevé et des stades plus bas de la maladie rénale chronique par rapport à ceux sans HVG. MOTS-CLÉS: Hypertrophie ventriculaire gauche, Hypertension, Fonction rénale, Maladie rénale chroniqu.

Concentration and reduction of antibiotic residues in selected wastewater treatment plants and receiving waterbodies in Durban, South Africa.

In the province of KwaZulu-Natal, South Africa the incidence of resistant tuberculosis, upper respiratory tract diseases as well as diarrhoeal and parasitic infections is high. Treatment of these diseases with antibiotics is partly reflected by the excretion of the respective antibiotics and their subsequent occurrence in wastewater. Their quantitative reduction in wastewater treatment reflects their potential environmental as well as human impact, the latter due to the use of the recipient water for domestic purposes and for irrigation. Information of the occurrence and reduction of different classes of antibiotics in wastewater treatment is sparse, especially the particle bound fraction of these. Due to this, analyses of aqueous and particle bound antibiotics in untreated wastewater of four selected wastewater treatment plants (WWTPs) and their receiving water bodies was carried out in Durban, South Africa. The treatment step especially considered was the biological one, represented by activated sludge and trickling filters. The treatment further included secondary clarifiers and final chlorine disinfection. Composite samples were collected during the period February 2017 to May 2017 and analysed with online solid phase extraction - high performance liquid chromatography mass spectrometry (SPE-HPLC-MS). For the 13 assessed antibiotics, the limit of detection (LOD) and the limit of quantification (LOQ) ranged from 0.07 to 0.33 ng L-1 and 0.23 to 1.09 ng L-1 respectively, while the total percentage recovery was in the range of 51 to 111%. The percentage of individual antibiotics bound to the particulate fraction normally lost by sample (influent) filtration, if not analysed in parallel, was in the range of 2.6%-97.3% (n = 32). In this fraction (sludge from centrifuge sample), the concentration of bound antibiotics of all the target antibiotics were detected in the influent of all WWTP in concentration ranges between 1.3 ng L-1 (Azithromycin; AZI) to 81,748 ng L-1 (Ciprofloxacin; CIP). The antibiotics with the highest median concentrations in receiving water bodies of the respective WWTP were; Sulfamethoxazole; SUL (239 ng L-1) WWTP "K", Ciprofloxacin; CIP (708 ng L-1) WWTP "S" and Albendazole; ALB (325 ng L-1 and 683 ng L-1) WWTP "P" and "I" respectively. The overall percentage removal efficiency for the four WWTPs ranged from 21% to 100%. The biological treatment steps, activated sludge and trickling filters, were effective in removing antibiotics especially with the trickling filter and the impact of the sedimentation stage after activated sludge treatment.

Identification of antibiotics in wastewater: current state of extraction protocol and future perspectives.

The release and occurrence of antibiotics in the aquatic environment has generated increased attention in the past few decades. The residual antibiotic in wastewater is important in the selection for antimicrobial resistance among microorganisms and the possibility of forming toxic derivatives. This review presents an assessment of the advancement in methods for extraction of antibiotics with solid phase extraction and liquid-liquid extraction methods applied in different aquatic environmental media. These advanced methods do enhance specificity, and also exhibit high accuracy and recovery. The aim of this review is to assess the pros and cons of the methods of extraction towards identification of quinolones and sulphonamides as examples of relevant antibiotics in wastewater. The challenges associated with the improvements are also examined with a view of providing potential perspectives for better extraction and identification protocols in the near future. From the context of this review, magnetic molecular imprinted polymer is superior over the remaining extraction methods (with the availability of commercial templates and monomers), is based on less cumbersome extraction procedures, uses less solvent and has the advantage of its reusable magnetic phase.