scholarly journals Comparison of Clinical Trajectories before Initiation of Renal Replacement Therapy between Diabetic Nephropathy and Nephrosclerosis on the KDIGO Guidelines Heat Map

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Masanori Abe ◽  
Kazuyoshi Okada ◽  
Noriaki Maruyama ◽  
Hiroyuki Takashima ◽  
Osamu Oikawa ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Clinical Characteristics ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Single Center ◽  
Heat Map ◽  
Kdigo Guidelines ◽  
Rate Of Decline

This study investigated differences between the clinical trajectories of diabetic nephropathy and nephrosclerosis using the Kidney Disease: Improving Global Outcomes (KDIGO) heat map and the clinical characteristics between the two diseases at RRT initiation. This single-center, retrospective study enrolled 100 patients whose estimated glomerular filtration rate (eGFR) was ≥45 mL/min/1.73 m2at their first visit and who were initiated on RRT. Fifty consecutive patients were assigned to each of the diabetic nephropathy and nephrosclerosis groups. All data for simultaneously measured eGFR and urinary albumin to creatinine ratio (UACR) were collected from first visit to RRT initiation and were plotted on the KDIGO heat map. Diabetic nephropathy was characterized by higher blood pressure and UACR and lower age, eGFR, and serum albumin levels compared with nephrosclerosis at RRT initiation. The vast majority of patients with diabetic nephropathy and eGFR < 60 mL/min/1.73 m2had concomitant macroalbuminuria, whereas for patients with nephrosclerosis, even when eGFR was <45 mL/min/1.73 m2, many still had normoalbuminuria or microalbuminuria. The rate of decline of eGFR was significantly faster in the diabetic nephropathy group than that in the nephrosclerosis group. The clinical trajectories of diabetic nephropathy and nephrosclerosis differed markedly on the KDIGO heat map.

Haematuria

2016 ◽  
Vol 9 (12) ◽  
pp. 717-722
Author(s):  
Abigail Davis
Keyword(s):  
Blood Cells ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Renal Stones ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Urological Cancer ◽  
Common Causes ◽  
Post Streptococcal Glomerulonephritis ◽  
Exercise Induced

Haematuria is the presence of red blood cells in the urine, it is classified into two types: visible and non-visible. Non-visible haematuria is considered significant if blood is detected in two-out-of-three urine samples taken 2 to 3 weeks apart. Common causes of haematuria in adults include urinary tract infection, exercise-induced haematuria, nephrological disease, bladder cancer and renal stones. Common causes of haematuria in children include hypercalciuria, IgA nephropathy and post-streptococcal glomerulonephritis. Patients with visible haematuria should be referred for investigation to exclude urological cancer. Patients with non-visible haematuria should have their blood pressure, urinary albumin-to-creatinine ratio and estimated glomerular filtration rate measured, to determine if they require onward referral to secondary care. The new National Institute for Health and Care Excellence guidelines for recognition and referral of suspected cancer identify those patients with haematuria that should be referred through the 2-week wait pathway.

scholarly journals Meta-analyses identify DNA methylation associated with kidney function and damage

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Pascal Schlosser ◽  
Adrienne Tin ◽  
Pamela R. Matias-Garcia ◽  
Chris H. L. Thio ◽  
Roby Joehanes ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Dna Methylation ◽  
Glomerular Filtration Rate ◽  
Kidney Disease ◽  
Glomerular Filtration ◽  
Kidney Function ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Urinary Albumin ◽  
Creatinine Ratio

AbstractChronic kidney disease is a major public health burden. Elevated urinary albumin-to-creatinine ratio is a measure of kidney damage, and used to diagnose and stage chronic kidney disease. To extend the knowledge on regulatory mechanisms related to kidney function and disease, we conducted a blood-based epigenome-wide association study for estimated glomerular filtration rate (n = 33,605) and urinary albumin-to-creatinine ratio (n = 15,068) and detected 69 and seven CpG sites where DNA methylation was associated with the respective trait. The majority of these findings showed directionally consistent associations with the respective clinical outcomes chronic kidney disease and moderately increased albuminuria. Associations of DNA methylation with kidney function, such as CpGs at JAZF1, PELI1 and CHD2 were validated in kidney tissue. Methylation at PHRF1, LDB2, CSRNP1 and IRF5 indicated causal effects on kidney function. Enrichment analyses revealed pathways related to hemostasis and blood cell migration for estimated glomerular filtration rate, and immune cell activation and response for urinary albumin-to-creatinineratio-associated CpGs.

scholarly journals Intermittent Bi-Daily Sub-cutaneous Teriparatide Administration in Children With Hypoparathyroidism: A Single-Center Experience

2021 ◽  
Vol 9 ◽  
Author(s):  
Julie Bernardor ◽  
Sacha Flammier ◽  
Sara Cabet ◽  
Sandrine Lemoine ◽  
Roland Chapurlat ◽  
...  
Keyword(s):  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Urinary Calcium ◽  
Creatinine Ratio ◽  
Total Calcium ◽  
Single Center Experience ◽  
Symptomatic Hypocalcemia ◽  
75Th Quartile ◽  
Phosphate Control

Introduction: The use of teriparatide has been reported in children with hypoparathyroidism as an investigational physiologic replacement therapy.Methods: We aimed to retrospectively report our pediatric experience of bi-daily sub-cutaneous teriparatide. Results are presented as median (25th−75th quartile). As part of the routine follow-up of these patients with hypoparathyroidism, total calcium at H0 (i.e., just before injection) and H4 (i.e., 4 h after teriparatide injection) and other biomarker parameters were regularly assessed.Results: At a median age of 10.7 (8.1–12.6) years, an estimated glomerular filtration rate (eGFR) of 110 (95–118) mL/min/1.73 m2, calcium levels of 1.87 (1.81–1.96) mmol/L and an age-standardized phosphate of 3.8 (2.5–4.9) SDS, teriparatide therapy was introduced in 10 patients at the dose of 1.1 (0.7–1.5) μg/kg/day (20 μg twice daily), with further adjustment depending on calcium levels. Six patients already displayed nephrocalcinosis. Severe side effects were reported in one child: two episodes of symptomatic hypocalcemia and one of iatrogenic hypercalcemia; one teenager displayed dysgueusia. Calcium levels at H0 did not significantly increase whilst calcium at H4 and phosphate levels significantly increased and decreased, respectively. After 12 months, eGFR, calcium and age-standardized phosphate levels were 108 (90–122) mL/min/1.73 m2, 2.36 (2.23–2.48) mmol/L, 0.5 (−0.1 to 1.5), and 68 (63–74) nmol/L, respectively, with a significant decrease in phosphate levels (p = 0.01). Urinary calcium and calcium/creatinine ratio remained stable; no nephrolithiasis was observed but two moderate nephrocalcinosis appeared.Conclusion: Intermittent teriparatide therapy significantly improves calcium and phosphate control, without increasing calciuria. It appears to be safe and well-tolerated in children.

scholarly journals Association of neutrophil-to-lymphocyte ratio and microalbuminuria in patients with normal eGFR

2018 ◽  
Vol 56 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Aysun Aybal Kutlugun ◽  
Fatma Ayerden Ebinc ◽  
Mujgan Tek Ozturk ◽  
Fatma Kaplan Efe ◽  
İbrahim Karadag ◽  
...  
Keyword(s):  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Urinary Albumin Excretion ◽  
Urinary Albumin ◽  
Neutrophil To Lymphocyte Ratio ◽  
Platelet To Lymphocyte Ratio ◽  
Positive Correlation ◽  
Lymphocyte Ratio ◽  
Albumin Excretion ◽  
Urine Albumin

Abstract Aims. The aim of this study was to evaluate the association between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and microalbuminuria in patients with normal estimated glomerular filtration rate (eGFR). Methods. 174 patients who had eGFR ≥ 60 mL/min/1.73 m2 were studied. Patients were divided into two groups according to the urinary albumin excretion as microalbuminuric group (n = 105) and normoalbuminuric group (n = 69). NLR and PLR levels were calculated. Results. NLR was significantly higher (p < 0.05) in microalbuminuric patients (1.91 ± 0.70) compared with normoalbuminuric patients (1.63 ± 0.53). A positive correlation was found between urine albumin excretion and NLR in the whole study group (r = 0.214, p < 0.005). Conclusions. Higher NLR levels were found in microalbuminuric patients with normal eGFR. Also a significant positive correlation was observed between albuminuria and NLR.

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