creatinine

摘要： BACKGROUND As of June 1,2020,over 370000 coronavirus disease 2019(COVID-19)deaths have been reported to the World Health Organization.However,the risk factors for patients with moderate-to-severe or severe-to-critical COVID-19 remain unclear.AIM To explore the characteristics and predictive markers of severely and critically ill patients with COVID-19.METHODS A retrospective study was conducted at the B11 Zhongfaxincheng campus and E1-3 Guanggu campus of Tongji Hospital affiliated with Huazhong University of Science and Technology in Wuhan.Patients with COVID-19 admitted from 1st February 2020 to 8th March 2020 were enrolled and categorized into 3 groups:The moderate group,severe group and critically ill group.Epidemiological data,demographic data,clinical symptoms and outcomes,complications,laboratory tests and radiographic examinations were collected retrospectively from the hospital information system and then compared between groups.RESULTS A total of 126 patients were enrolled.There were 59 in the moderate group,49 in the severe group,and 18 in the critically ill group.Multivariate logistic regression analysis showed that age[odd ratio(OR)=1.055,95%(confidence interval)CI:1.099-1.104],elevated neutrophil-to-lymphocyte ratios(OR=4.019,95%CI:1.045-15.467)and elevated high-sensitivity cardiac troponin I(OR=10.126,95%CI:1.088-94.247)were high-risk factors.CONCLUSION The following indicators can help clinicians identify patients with severe COVID-19 at an early stage:age,an elevated neutrophil-to-lymphocyte ratio and high sensitivity cardiac troponin I.

摘要： BACKGROUND The indirect methods of reference intervals(RI)establishment based on data mining are utilized to overcome the ethical,practical challenges and the cost associated with the conventional direct approach.AIM To generate RIs for serum creatinine in children and adolescents using an indirect statistical tool.METHODS Data mining of the laboratory information system was performed for serum creatinine analyzed from birth to 17 years for both genders.The timeline was set at six years from January 2013 to December 2018.Microsoft Excel 2010 and an indirect algorithm developed by the German Society of Clinical Chemistry and Laboratory Medicine’s Working Group on Guide Limits were used for the data analysis.RESULTS Data were extracted from 96104 samples and after excluding multiple samples for the same individual,we calculated RIs for 21920 males and 14846 females,with stratification into six discrete age groups.CONCLUSION Serum creatinine dynamics varied significantly across gender and age groups.

摘要： Background: Percutaneous coronary intervention is now the best way of management of acute coronary syndrome (ACS). Contrast induced nephropathy is a serious complication and greatly dependent on several factors. It is still unclear whether the vascular access migrates CIN risk. Objective: To study the impact of Radial Access (RA) compared with Femoral Access (FA) on developing contrast-induced nephropathy (CIN) in patients undergoing invasive management of acute coronary syndrome (ACS). Methods: Sixty patients eligible for invasive management of ACS at cardiology department (Menoufia University hospital and National Heart Institute) were randomized into two groups. Group I: included 30 patients with femoral approach and Group II: included 30 patients with radial approach. The occurrence of CIN estimated by KDIGO definition (absolute increase in serum creatinine (SCr) by ≥0.5 mg/dl within 48 hours;or increase in SCr to ≥25% of baseline) was estimated in both groups. Results: Only 9 patients (15%) developed CIN, 5 patients (55.6%) of them underwent PCI through FA without statistically significant difference between the two approaches.Conclusion: CIN is considered a potential complication of percutaneous coronary intervention (PCI). Our study did not show the preference of using an approach over the other.

摘要： Aim: To describe the epidemiological, clinical, etiologic and therapeutic aspects of patients with acute obstructive renal failure at the Medical Surgical Center of Urology (MSCU). Materials and methods: this was a descriptive retrospective study of 106 patient records treated for acute renal failure from January 2012 to December 2016. Patients came for spontaneous consultation or were referred. They had benefited from a clinical and paraclinical assessment at the end of which the diagnosis of acute renal failure was retained and then an effective management at the MSCU. The variables studies were clinical, paraclinical, therapeutic and progressive. The treatment included: hemodialysis, urinary diversion (suprapubic, urethrovesical and ureteral), trans-urethral resection of the prostate, trans-urethral resection of the bladder, nephrostomy, endoscopic incision of catheter valves, posterior urethra or laparoscopic nephroureterectomy as indicated. The emergency treatments consisted of removing the obstacle and the etiological treatment was done later. External follow-up consultation varied by etiology. Results: In 4 years we had treated 106 patients, a frequency of 26.5%. The average age was 47.83 years with extreme of 2 and 80 years old. The sex ratio was 68 men for 38 women. The mean serum creatinine level was 37.8 mg/l (335 μmol/l). The etiologies were: prostatic pathologies (n = 38), lithiasic pathologies (n = 20) and gynecological pathologies (n = 18). The treatments were: endoscopic resection of prostate (n = 24), bladder (n = 6), posterior urethral valves (n = 4), JJ probe (n = 27) and nephrostomy (n = 23). The result was good (normalization of creatinine serum) in 79 patients, the persistence of elevated serum creatinine was observed in 4 patients and 18 patients died. Conclusion: Acute obstructive renal failure is a common diagnosis in our exercise setting at MSCU where it can be managed with respect to our technical platform.

摘要： Objective: The aim of the present study was to investigate the clinical and nutritional factors influencing the renal function of the transplanted kidney during a one-year follow-up period after transplantation. Patients: The present prospective observational study included 52 patients who underwent kidney transplantation at Jichi Medical University Hospital from 2014 to 2016. Results: The serum creatinine (sCr) concentration at one month after transplantation was closely related to the concentration at 12 months. The recipients were divided into two groups based on the sCr concentration at one month after transplantation. Recipients with a sCr concentration greater than or equal to the median were classified into Group H, while those with concentrations that were less than the median were classified into Group L. A stepwise multiple regression analysis demonstrated that the salt intake in male recipients was an independent predictor of the renal function at 12 months (β = 0.663, p β = 0.618, p < 0.01). Moreover, in female recipients, the BMI and serum uric acid values in Group H were significantly higher than those in Group L. The BMI values of the female recipients in Group H were significantly higher than those in Group L at all times during the follow-up period (p < 0.01). Conclusion: The daily salt intake was independently associated with the renal function at one year after kidney transplantation in male recipients. In female recipients, the BMI was independently associated with the sCr concentration during the one-year follow-up period.

摘要： Background: One of the most common causes of renal impairment and development of chronic kidney disease is diabetes mellitus type 2 (DM 2). The aim of this prospective study was to determine the role of Resistive Index (RI) as a non-invasive marker for the evaluation of renal impairment in patients with DM 2. Material and Methods: 47 patients with DM 2 in mean age 62.66 ± 10.081 years were included in the study for the period of one year. All of them were with well-compensated diabetes mellitus (HbA1c Results: Patients with RI 0.05 for all). There was significant difference between the groups according to serum creatinine (p = 0.026), GFR (p = 0.044) and the degree of proteinuria (p = 0.001). There was a positive correlation between RI and serum creatinine (r = 0.418;p = 0.001) and between RI and proteinuria (r = 0.396;p = 0.004). A negative correlation relationship between RI and GFR values was found (r = –0.413;p = 0.011). Conclusions: RI may be used as an indicator for the assessment of the severity of renal impairment in patients with DM 2. It correlates well with serum creatinine, GFR and proteinuria, which are proven biochemical parameters indicating the degree of renal damage in patients with DM 2.

摘要： Malakwang (Hibiscus species) is a common vegetable regularly used in the diet and traditional health care support in Uganda. In this study, the efficacy of malakwang leaf extract as a potential regulator of serum lipids, urea and creatinine was investigated in hyperlipidemic rats. Forty two albino rats were arranged randomly into seven groups of six and fed with diets. Four experimental and three control groups were considered in the design. The rats in the experimental groups were fed on high fat diets containing different amounts of leaf extract from red and white malakwang variants. Control groups were fed on diets devoid of malakwang: a basic standard rat diet;high fat diet;and high fat with atorvastatin. The diets were administered daily and rat weight determined. On the last day, blood was drawn from the rats and the serum analysed for lipids, creatinine and urea using spectrophotometric techniques. Statistical analysis was used to estimate mean differences in weight and concentration of the biochemical parameters between experimental and control groups. Results indicated a decrease in weight gained up to the fourth week in rats fed on the high fat diet with malakwang leaf extract. There was a significant difference in the levels of low density lipoprotein cholesterol (p malakwang leaf extract. No significant change was noted in total cholesterol and triglycerides. Whereas there was a higher level of serum creatinine with the two malakwang variants (p malakwang (Hibiscus) exhibited capacity to reduce low density lipoprotein cholesterol, maintained serum urea but not creatinine. This may offer prospects for using malakwang in the dietary approaches to address public health concerns linked to high level of cholesterols.

摘要： AIM To evaluate the influence of creatinine methodology on the performance of chronic kidney disease(CKD)-Epidemiology Collaboration Group-calculated estimated glomerular filtration rate(CKD-EPI-eGFR) for CKD diagnosis/staging in a large cohort of diabetic patients. METHODS Fasting blood samples were taken from diabetic patients attending our clinic for their regular annual examination, including laboratory measurement of serum creatinine and eGFR.RESULTS Our results indicated an overall excellent agreement in CKD staging(kappa = 0.918) between the Jaffé serum creatinine-and enzymatic serum creatinine-based CKDEPI-eGFR, with 9% of discordant cases. As compared to the enzymatic creatinine, the majority of discordances(8%) were positive, i.e., associated with the more advanced CKD stage re-classification, whereas only 1% of cases were negatively discordant if Jaffé creatinine was used for eGFR calculation. A minor proportion of the discordant cases(3.5%) were re-classified into clinically relevant CKD stage indicating mildly to moderately decreased kidney function(< 60 m L/min per 1.73 m^2). Significant acute and chronic hyperglycaemia, assessedas plasma glucose and Hb A1 c levels far above the recommended glycaemic goals, was associated with positively discordant cases. Due to a very low frequency, positive discordance is not likely to present a great burden for the health-care providers, while intensified medical care may actually be beneficial for the small number of discordant patients. On the other hand, a very low proportion of negatively discordant cases(1%) at the 60 m L/min per 1.73 m^2 eGFR level indicate a negligible possibility to miss the CKD diagnosis, which could be the most prominent clinical problem affecting patient care, considering high risk of CKD for adverse patient outcomes. CONCLUSION This study indicate that compensated Jaffé creatinine procedure, in spite of the glucose-dependent bias, is not inferior to enzymatic creatinine in CKD diagnosis/staging and therefore may provide a reliable and cost-effective tool for the renal function assessment in diabetic patients.

摘要： Considering the fact that the results of laboratory tests provide useful information about the state of health of patients, determination of reference value is considered an intrinsic part in the development of laboratory medi-cine. There are still huge differences in the analytical methods used as well as in the associated reference intervals which could consequently significantly affect the proper assessment of patient health. In a constant effort to increase the quality of patients' care, there are numerous international initiatives for standardiza-tion and/or harmonization of laboratory diagnostics in order to achieve maximum comparability of laboratory test results and improve patient safety. Through the standardization and harmonization processes of analytical methods the ability to create unique reference intervals is achieved. Such reference intervals could be applied globally in all laboratories using methods traceable to the same reference measuring system and analysing the biological samples from the populations with similar socio-demographic and ethnic characteristics. In this review we outlined the results of the harmonization processes in Croatia in the field of population based reference intervals for clinically relevant blood and serum constituents which are in accordance with ongoing activity for worldwide standardization and harmonization based on traceability in laboratory medicine.