The 99mTc-DTPA Urinary Clearance Method May Be Preferable to the Plasma Disappearance Method for Assessing Glomerular Filtration Rate in Diabetic Nephropathy

2015 ◽  
Vol 128 (3-4) ◽  
pp. 367-372 ◽  
Author(s):  
Shih-Han S. Huang ◽  
Misha Eliasziw ◽  
J. David Spence ◽  
Guido Filler ◽  
William C. Vezina ◽  
...  
Author(s):  
Asriyani Azikin ◽  
Fitriani Mangarengi ◽  
Uleng Bahrun

Diabetic nephropathy is one of the fairly severe Diabetes Mellitus (DM) complications and the main cause of renal failure that can result in mortality. Hyperglycemia in DM induces kidney injury that may result in hemodynamic and metabolic alterations, endothelial dysfunction and inflammatory cells activation. A persistent and continuous inflammation is observed in diabetic nephropathy. One of the inflammation process progression indicators is Neutrophil-Lymphocyte Ratio (NLR). To find out the relationship between NLR and decreased Glomerular Filtration Rate (GFR) in diabetic nephropathy. This study was an observational study with a retrospective approach. This study was conducted in Clinical Pathology Laboratory Installation and Medical Record Installation of Dr. Wahidin Sudirohusodo Makassar Hospital by collecting the patient’s data during February 2015 to February 2016. Patients that were diagnosed as type 2 DM without diabetic nephropathy complication were taken as control and those diagnosed as type 2 DM with diabetic nephropathy were treated as study subjects. One hundred and thirteen (113) samples met the inclusion criteria, consisting of 73 diabetic nephropathy patients with Chronic Kidney Disease (CKD) 13 diabetic nephropathy patients without CKD and 27 type 2 DM patients without diabetic nephropathy complication. Patients consisted of 57 males (50.4%) and 56 females (49,6%). Neutrophil-lymphocyte ratio and GFR values in the group of diabetic nephropathy without CKD were 2.03±0.68 and 85.38±24.63, respectively. Whereas, the NLR and GFR values in control group were 1.74±0.54 and 90.03±28.60, respectively. In the group of diabetic nephropathy with CKD, NLR value increased by 3.19±1.83 and GFR decrease by 30.54±16.45. Spearman test indicated a significant relationship between NLR increase and decreased GFR (r = -0.635, p=0.00). There is a significant relationship between  NLR increase and decreased GFR in patients with diabetic nephropathy. 


2012 ◽  
Vol 08 (01) ◽  
pp. 40 ◽  
Author(s):  
George Jerums ◽  
Elif Ekinci ◽  
Sianna Panagiotopoulos ◽  
Richard J MacIsaac ◽  
◽  
...  

In the early 1980s, studies in type 1 diabetes suggested that glomerular filtration rate (GFR) loss begins with the onset of macroalbuminuria. However, recent evidence indicates that up to one-quarter of subjects with diabetes reach a GFR of less than 60 ml/min/1.73 m2(chronic kidney disease [CKD] stage 3) before developing micro- or macroalbuminuria. Furthermore, the prospective loss of GFR can be detected in early diabetic nephropathy (DN) well before CKD stage 3. Early GFR loss usually reflects DN in type 1 diabetes but, in older patients with type 2 diabetes, the assessment of early GFR loss needs to take into account the effects of aging. The assessment of GFR is now feasible at clinical level, using formulas based on serum creatinine, age, gender, and ethnicity. Overall, the estimation of early GFR loss is more accurate with the Chronic Kidney Disease Epidemiology (CKD–EPI) formula than with the Modification of Diet in Renal Disease (MDRD) study formula, but there is some evidence that the CKD-EPI formula does not exhibit better performance than the MDRD formula for estimating GFR in diabetes. Both formulas underestimate GFR in the hyperfiltration range. Formulas based on the reciprocal of cystatin C can also be used to estimate GFR, but their cost and lack of assay standardization have delayed their use at clinical level. In summary, early GFR loss is an important marker of DN as well as a potentially reversible target for interventions in DN.


Renal Failure ◽  
2008 ◽  
Vol 30 (1) ◽  
pp. 21-29 ◽  
Author(s):  
Thomas F. Mueller ◽  
Juliane Raeder ◽  
Karl Oettl ◽  
Sabine Zitta ◽  
Gert Klausmann ◽  
...  

2021 ◽  
Vol 90 (1) ◽  
pp. 44-51
Author(s):  
I.I. Topchii ◽  
P.S. Semenovykh ◽  
O.M. Kirienko ◽  
D.O. Kirienko ◽  
O.I. Tsygankov ◽  
...  

Currently, diabetes mellitus is a complex global problem, which is increasing every year. So in 2019, diabetes in the world was detected in 463 million adults (from 20 to 79 years old). And the main cause of death in patients with diabetes mellitus is cardiovascular complications. The features of functional and structural changes in the heart were studied in patients with type 2 diabetes mellitus and nephropathy. A total of 75 patients with type 2 diabetes mellitus were examined, of which 50 patients had diabetic nephropathy of varying severity. The control group consisted of 20 healthy individuals. The control group consisted of 20 practically healthy patients. After a clinical examination, depending on the state of renal function, all patients were divided into the following groups: group I consisted of 25 patients with type 2 diabetes mellitus without signs of nephropathy; group II consisted of 26 patients with type 2 diabetes mellitus with normal glomerular filtration rate and albuminuria; group III consisted of 24 patients with type 2 diabetes mellitus with decreased glomerular filtration rate and albuminuria. To study changes in hemodynamics and structural parameters of the heart, patients underwent transthoracic echocardiography on an ULTIMA PA ultrasound machine (Radmir, Ukraine) using a sectoral phased transducer with a frequency range of 2–3 MHz according to the standard technique according to the recommendations of the American Echocardiographic Society. Indicators the patients underwent anthropometric measurements. Patients with diabetic nephropathy and albuminuria and decreased glomerular filtration rate showed an increase in the linear dimensions of the heart in comparison with controls and patients without signs of nephropathy. With diabetic nephropathy patients have a significant increase in left ventricular myocardial mass and a significant increase in the detection rate of left ventricular hypertrophy up to 91.3 % in patients with albuminuria and preserved renal function and up to 100.0 % with a decrease in glomerular filtration rate. Keywords: diabetes mellitus, hypertonic disease, diabetic nephropathy, heart remodeling, chronic kidney disease.


2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Li-ping Wang ◽  
Yu-zhen Gao ◽  
Bin Song ◽  
Guo Yu ◽  
Hui Chen ◽  
...  

Background. We conducted a systematic review and meta-analysis of existing literature to evaluate the different outcomes of microRNAs (miRNAs) in diabetic nephropathy (DN), including urinary albumin excretion rates, urinary albumin creatinine rates, glomerular filtration rate, HbAc1, and creatinine.Methods. Electronic databases including PUBMED, MEDLINE, and EMBASE were searched for eligible publications to July 2018. The following comparisons between treatment groups were included: normal group versus DN group; control group versus micro/macroalbuminuria group.Results. Twelve eligible studies that included 2500 participants were finally recruited in this meta-analysis. Fifteen miRNAs (miRNA-21, miRNA-181b, miRNA-194, miRNA-30, miRNA-215, and others) were upregulated whereas seven miRNAs (miRNA-26a, miRNA-126, miRNA-424, miRNA-574-3p, miR-223, miR-155, and miR-192) were downregulated in the DN group compared with control groups. The miR-133b, miR-342, miR-30, miR-192, miR-194, and miR-215 were significantly correlated in urinary albumin excretion rates (r=0.33, 95% CI= 0.26-0.39). miR-192, miR-217, miR-15b, miR-34a, and miR-636 were correlated with urinary albumin creatinine rates (r=0.69; 95% CI=0.12-0.92), while miR-133b, miR-345, miR-33, miR-326, miR-574-3p, miR-126, miR-217, miR-15b, miR-34a, and miR-636 were significantly correlated with HbAc1 (r =0.23, 95% CI = 0.15-0.31). There were twelve miRNAs that were closely related to the glomerular filtration rate (r=0.28, 95% CI =0.21-0.34). Creatinine (r=0.33, 95% CI = 0.22-0.40) was significantly different between normal and DN groups.Conclusions. The meta-analysis acquired the correlations between miRNAs and outcomes including UAER, UACR, eGFR, HbAc1, and creatinine in DN. It suggested that miRNAs may participate in the pathogenesis of DN process.


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