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Stehlé T, Delanaye P. Which is the best glomerular filtration marker: Creatinine, cystatin C or both? Eur J Clin Invest 2024:e14278. [PMID: 38949475 DOI: 10.1111/eci.14278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 06/10/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The glomerular filtration rate (GFR) is estimated by the serum or plasma concentration of creatinine and/or cystatin C using equations that include demographic data. The equations worldwide most widely used are those of the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) consortium and updated in 2021 to remove the Afro-American racial correction factor. In 2021 and then in 2023, the European Kidney Function Consortium also developed equations based on creatinine and cystatin C, usable across the full age spectrum, and constructed by including the Q value (i.e. the median creatinine or cystatin C in healthy men and women, which is customizable for specific populations). METHODS The aim of this narrative review is to examine the strengths and weaknesses of each biomarker. RESULTS Both biomarkers have non-GFR determinants, namely muscle mass, protein intake and tubular secretion for creatinine; dysthyroidism and systemic corticosteroids for cystatin C, as well as other more debated determinants (diabetes, obesity, proteinuria, inflammatory syndrome). These non-GFR determinants are the reason why no equation based on a single endogenous biomarker has an accuracy within 30% greater than 90% over the entire age spectrum (in at least one patient in 10, estimated GFR is at least 30% higher or at least 30% lower than the measured GFR). CONCLUSION Equations combining the two biomarkers provide a better estimate of GFR, particularly in the subgroup of patients whose estimates based on each of the biomarkers are highly discordant. These patients must also be identified as being at increased risk of morbidity, particularly cardiovascular, and mortality.
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Affiliation(s)
- Thomas Stehlé
- Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire «Innovative therapy for immune disorders», Créteil, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Univ. Paris Est Créteil, Créteil, France
| | - Pierre Delanaye
- Department of Nephrology-Dialysis-Transplantation, University of Liège, CHU Sart Tilman, Liège, Belgium
- Department of Nephrology-Dialysis-Apheresis, Hôpital Universitaire Carémeau, Nîmes, France
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2
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Atta S, Vo-Dinh T. Improved solution-based SERS detection of creatinine by inducing hydrogen-bonding interaction for effective analyte capture. Talanta 2024; 278:126373. [PMID: 38901075 DOI: 10.1016/j.talanta.2024.126373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/20/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]
Abstract
Recently, solution-based surface-enhanced Raman scattering (SERS) detection technique has been widely recognized due to its cost-effectiveness, simplicity, and ease of use. However, solution-based SERS is limited for practical applications mainly because of the weak adsorption affinity of the target biomolecules to the surface of plasmonic nanoparticles. Herein, we developed a highly sensitive solution-based SERS sensing platform based on mercaptopropionic acid (MPA)-capped silver-coated gold nanostars (SGNS@MPA), which allows efficient enrichment on the nanostars surface for improved detection of an analyte: creatinine, a potential biomarker of chronic kidney disease (CKD). The SGNS@MPA exhibited high enrichment ability towards creatinine molecules in alkaline medium (pH-9) through multiple hydrogen bonding interaction, which causes aggregation of the nanoparticles and enhances the SERS signal of creatinine. The detection limit for creatinine was achieved at 0.1 nM, with a limit of detection (LOD) value of 14.6 pM. As a proof-of-concept demonstration, we conducted the first quantitative detection of creatinine in noninvasive human fluids, such as saliva and sweat, under separation-free conditions. We achieved a detection limit of up to 1 nM for both saliva and sweat, with LOD values as low as 0.136 nM for saliva and 0.266 nM for sweat. Overall, our molecular enrichment strategy offers a new way to improve the solution-based SERS detection technique for real-world practical applications in point-of-care settings and low-resource settings.
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Affiliation(s)
- Supriya Atta
- Fitzpatrick Institute for Photonics, Durham, NC, 27708, USA; Department of Biomedical Engineering, Duke University, Durham, NC, 27708, USA
| | - Tuan Vo-Dinh
- Fitzpatrick Institute for Photonics, Durham, NC, 27708, USA; Department of Biomedical Engineering, Duke University, Durham, NC, 27708, USA; Department of Chemistry, Duke University, Durham, NC, 27708, USA.
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3
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Opdebeeck B, Van den Branden A, Adriaensen S, Orriss IR, Patel JJ, Geryl H, Zwijsen K, D’Haese PC, Verhulst A. β,γ-Methylene-ATP and its metabolite medronic acid affect both arterial media calcification and bone mineralization in non-CKD and CKD rats. JBMR Plus 2024; 8:ziae057. [PMID: 38764790 PMCID: PMC11102572 DOI: 10.1093/jbmrpl/ziae057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/07/2024] [Accepted: 03/26/2024] [Indexed: 05/21/2024] Open
Abstract
Arterial media calcification or pathological deposition of calcium-phosphate crystals in the vessel wall contributes significantly to the high mortality rate observed in patients with CKD. Extracellular nucleotides (ie, ATP or UTP) regulate the arterial calcification process by interacting with (1) purinergic receptors and (2) breakdown via ecto-nucleotidases, such as ectonucleotide pyrophosphatase/phosphodiesterase NPP1 or NPP3, affecting the local levels of calcification inhibitor, pyrophosphate, and stimulator inorganic phosphate (PPi/Pi ratio). Also, it has been shown that ATP analogs (ie, β,γ-methylene-ATP [β,γ-meATP]) inhibit vascular smooth muscle cell calcification in vitro. In the first experiment, daily dosing of β,γ-meATP (2 mg/kg) was investigated in rats fed a warfarin diet to trigger the development of non-CKD-related arterial medial calcifications. This study showed that β,γ-meATP significantly lowered the calcium scores in the aorta and peripheral vessels in warfarin-exposed rats. In a second experiment, daily dosing of 4 mg/kg β,γ-meATP and its metabolite medronic acid (MDP) was analyzed in rats fed an adenine diet to promote the development of CKD-related arterial medial calcification. Administration of β,γ-meATP and MDP did not significantly decrease aortic calcification scores in this model. Moreover, both compounds induced deleterious effects on physiological bone mineralization, causing an imminent risk for worsening the already compromised bone status in CKD. Due to this, it was not possible to raise the dosage of both compounds to tackle CKD-related arterial calcification. Again, this points out the difficult task of targeting solely ectopic calcifications without negatively affecting physiological bone mineralization. On the other hand, aortic mRNA expression of Enpp1 and Enpp3 was significantly and positively associated with aortic calcification scores, suggesting that normalizing the aortic NPP1/3 activity to control values might be a possible target to treat (CKD-induced) arterial media calcifications.
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Affiliation(s)
- Britt Opdebeeck
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Astrid Van den Branden
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Saar Adriaensen
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Isabel R Orriss
- Department of Comparative Biomedical Science, Royal Veterinary College, London NW1 0TU, United Kingdom
| | - Jessal J Patel
- Department of Comparative Biomedical Science, Royal Veterinary College, London NW1 0TU, United Kingdom
| | - Hilde Geryl
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Kathleen Zwijsen
- Laboratory of Experimental Medicine and Pediatrics, Inflamed Center of Excellence, University of Antwerp, Antwerp 2610, Belgium
| | - Patrick C D’Haese
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
| | - Anja Verhulst
- Laboratory of Pathophysiology, Department of Biomedical Sciences, University of Antwerp, Antwerp 2610, Belgium
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Ashkenazi-Hoffnung L, Schiller O, Krubiner M, Dagan O, Haskin O, Manor-Shulman O, Feinstein Y, Shochat T, Shostak E, Yarden-Bilavsky H. Vancomycin Dosing and Its Association With Acute Kidney Injury in Pediatric Cardiac Intensive Care Patients Under 3 Months of Age. Pediatr Infect Dis J 2024:00006454-990000000-00879. [PMID: 38808996 DOI: 10.1097/inf.0000000000004415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND The standard vancomycin regimen for term neonates is 45 mg/kg/day. However, the optimal starting vancomycin dosing for achieving therapeutic levels in young infants in cardiac intensive care units remains unknown. Moreover, data on the association of supratherapeutic vancomycin levels with acute kidney injury (AKI) are limited. METHODS Retrospective study of infants ≤3 months old, receiving vancomycin following congenital heart surgery at postoperative intensive care unit admission. Assessed were vancomycin dosing, achievement of therapeutic trough concentration of 10-20 mg/L and development of AKI, based on the modified Kidney Disease Improving Global Outcomes criteria. RESULTS Inclusion criteria were met by 109 patients with a median age of 8 days (IQR: 6-16). The mean (SD) vancomycin dose required for achieving therapeutic concentration was 28.9 (9.1) mg/kg at the first postoperative day. Multivariate logistic regression identified higher preoperative creatinine levels and shorter cardiopulmonary bypass time as predictors of supratherapeutic vancomycin concentrations (c-index 0.788). During the treatment course, 62 (56.9%) developed AKI. Length of stay and mortality were higher in those who developed AKI as compared with those who did not. Multivariate logistic regression identified higher vancomycin concentration as a predictor for postoperative AKI, OR, 3.391 (95% CI: 1.257-9.151), P = 0.016 (c-index 0.896). CONCLUSION Our results support a lower starting vancomycin dose of ~30 mg/kg/day followed by an early personalized therapeutic approach, to achieve therapeutic trough concentrations of 10-20 mg/L in cardiac postoperative term infants. Supratherapeutic concentrations are associated with an increased risk for AKI, which is prevalent in this population and associated with adverse outcomes.
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Affiliation(s)
- Liat Ashkenazi-Hoffnung
- From the Department of Day Hospitalization, Schneider Children's Medical Center, Petach Tikva, Israel
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Pediatric Infectious Diseases Unit, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Ofer Schiller
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Mor Krubiner
- Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Ovadia Dagan
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Orly Haskin
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Pediatric Institute of Nephrology, Schneider Children's Medical Center, Petach Tikva, Israel
| | - Orit Manor-Shulman
- Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Yael Feinstein
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Tzippy Shochat
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Statistical Consultant, Clinical Research Authority, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel
| | - Eran Shostak
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
| | - Havatzelet Yarden-Bilavsky
- Faculty of Medicine and Health Sciences, Tel Aviv University, Tel Aviv, Israel
- Pediatric Clinical Pharmacology Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel
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Bereyhi M, Zare-Dorabei R. High-Sensitivity Creatinine Detection via a Dual-Emission Ratiometric Fluorescence Probe Incorporating Amino-MIL-53@Mo/ZIF-8 and Rhodamine B. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2024; 40:5890-5899. [PMID: 38452371 DOI: 10.1021/acs.langmuir.3c03793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Quantifying creatinine (Cn) in biological fluids is crucial for clinically assessing renal insufficiency, thyroid irregularities, and muscle damage. Therefore, it is crucial for human health to have a simple, quick, and accurate Cn analysis technique. In this study, we have successfully synthesized a 3D ratiometric dual-metal-organic framework, namely, the amino-MIL-53@Mo/ZIF-8 and rhodamie B heterostructure, using an internal strategy for sustained growth. The dual-MOF functions as an adsorbent and preconcentrates Cn. The pH, reaction time, and volume ratio of amino-MIL-53@Mo/ZIF-8/rhodamie B were optimized using the one-variable-at-a-time technique in this study. The quantitative study of the Cn concentration for this RF biosensor was obtained under ideal conditions (R2 = 0.9962, n = 3), encompassing the linear range of 0.35-11.1 μM. The detection and quantitation limits were 0.18 and 0.54 nM, respectively. Both intra- and interday reproducibility showed high repeatability of the RF biosensor, UV-vis, and ZETA potential studies, and the Stern-Volmer relationship was used to clarify the fluorescence quenching process. These superior sensing capabilities and the benefits of simple manufacturing, acceptable stability, and practicality make the RF biosensor intriguing for ultrasensitive Cn detection in practical applications.
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Affiliation(s)
- Mohammad Bereyhi
- Research Laboratory of Spectrometry & Micro and Nano Extraction, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
| | - Rouholah Zare-Dorabei
- Research Laboratory of Spectrometry & Micro and Nano Extraction, Department of Chemistry, Iran University of Science and Technology, Tehran 16846-13114, Iran
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Bhatt P, Kukkar D, Yadav AK, Kim KH. Carbon dot-copper nanocomposite-based fluorescent sensor for detection of creatinine in urine samples of CKD patients. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 307:123666. [PMID: 37992650 DOI: 10.1016/j.saa.2023.123666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/05/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023]
Abstract
Creatinine (CR) is accepted as a clinical biomarker of chronic kidney disease (CKD) such as renal injury and kidney failure. To help facilitate the prognosis of CKD, a highly luminescent carbon dot (CD)-based fluorescent (FL) sensor has been built and employed for CR detection in diverse media (e.g., artificial and human urine). CDs, synthesized from sucrose precursor by a rapid microwave-assisted method (average diameter 20 nm), exhibited highly luminescent green emission upon UV exposure (λexcitation = 390 nm, λemission = 453 nm) with excellent temporal stability over three months. The nanocomposites are formed between CDs and metal ions (e.g., Cu2+) to realize the optimum biosensing of CR. Although Cu2+ ions showcases a maximum quenching (73 %) of the CDs, Cu2+/CDs system restores 77 % of the original FL intensity upon the addition of CR. The linear detection range and limit of detection for CR are estimated as 10-5 to 0.1 mg·dL-1 (R2 = 0.936) and 5.1 × 10-16 mg·dL-1, respectively. Furthermore, our biosensor shows excellent reproducibility and selectivity for CR in urine samples of healthy subjects and CKD patients. The Bland-Altman analysis for urine samples (n = 30) showcased an excellent agreement (R2 = 0.95) between our method and the gold standard 'Jaffe' method. These observations supported the practical utility of our method proposed for detection of CR in clinical samples.
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Affiliation(s)
- Poornima Bhatt
- Department of Biotechnology, Chandigarh University, Gharuan, Mohali 140413, Punjab, India; University Centre for Research and Development, Chandigarh University, Gharuan, Mohali 140413, Punjab, India
| | - Deepak Kukkar
- Department of Biotechnology, Chandigarh University, Gharuan, Mohali 140413, Punjab, India; University Centre for Research and Development, Chandigarh University, Gharuan, Mohali 140413, Punjab, India.
| | - Ashok Kumar Yadav
- Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, Seongdong-gu, Seoul 04763, Republic of Korea.
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7
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Zhou L, Yang Y, Fu X, Xia B, Li C, Lu C, Qi Y, Zhang H, Liu T. The protective effect and molecular mechanism of glycyrrhizic acid glycosides against Tripterygium glycosides induced nephrotoxicity based on the RhoA/ROCK1 signalling pathway. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117100. [PMID: 37648177 DOI: 10.1016/j.jep.2023.117100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/27/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Tripterygium glycosides (TG), which are extracted from the traditional Chinese medicine, Tripterygium wilfordii Hook F. (TwHF), has promising applications in the treatment of renal diseases; however, since its active components exerts bidirectional kidney toxicity, its clinical application is severely restricted. AIM OF THE STUDY Recent investigations have demonstrated definite toxicity-reducing effects from glycyrrhizic acid glycosides (GA) when combined with TG; however, the mechanism remains unclear. To our knowledge, this is the first study to investigate the specific molecular mechanism by which GA alleviates TG-induced renal toxicity from the perspective of tight junctions. MATERIALS AND METHODS Dynamic analyses, which investigated the changes in kidney toxicity biomarkers for different combinations and concentrations of TG and GA, were conducted for three weeks on SD rats and renal tissue structural changes were examined after three weeks of administration. Additionally, the transcription and translation levels of the relevant tight junctions and RhoA/ROCK1/MLC signalling proteins were analysed in HK-2 cells. RESULTS Our study showed that TG can cause transient tubulotoxicity at certain doses, and that the combined application of GA and TG can repair tight junction structures by regulating the key factors in the RhoA/ROCK1/MLC signalling pathway, thus reducing TG-induced nephrotoxicity. CONCLUSIONS Overall, this study provides a new strategy to reduce TG-induced toxicity by protecting renal tight junctions.
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Affiliation(s)
- Liu Zhou
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Yifei Yang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Xiaotong Fu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Bing Xia
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Chun Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Chenna Lu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Ying Qi
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Haijing Zhang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
| | - Ting Liu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Science, Beijing, 100700, China.
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Zhang Q, Yang R, Liu G, Jiang S, Wang J, Lin J, Wang T, Wang J, Huang Z. Smartphone-based low-cost and rapid quantitative detection of urinary creatinine with the Tyndall effect. Methods 2024; 221:12-17. [PMID: 38006950 DOI: 10.1016/j.ymeth.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 11/27/2023] Open
Abstract
This research aims to develop a robust and quantitative method for measuring creatinine levels by harnessing the enhanced Tyndall effect (TE) phenomenon. The envisioned sensing assay is designed for practical deployment in resource-limited settings or homes, where access to advanced laboratory facilities is limited. Its primary objective is to enable regular and convenient monitoring of renal healthcare, particularly in cases involving elevated creatinine levels. The creatinine sensing strategy is achieved based on the aggregation of gold nanoparticles (AuNPs) triggered via the direct crosslinking reaction between creatinine and AuNPs, where an inexpensive laser pointer was used as a handheld light source and a smartphone as a portable device to record the TE phenomenon enhanced by the creatinine-induced aggregation of AuNPs. After evaluation and optimization of parameters such as AuNP concentrations and TE measurement time, the subsequent proof-of-concept experiments demonstrated that the average gray value change of TE images was linearly related to the logarithm of creatinine concentrations in the range of 1-50 μM, with a limit of detection of 0.084 μM. Meanwhile, our proposed creatinine sensing platform exhibited highly selective detection in complex matrix environments. Our approach offers a straightforward, cost-effective, and portable means of creatinine detection, presenting an encouraging signal readout mechanism suitable for point-of-care (POC) applications. The utilization of this assay as a POC solution exhibits potential for expediting timely interventions and enhancing healthcare outcomes among individuals with renal health issues.
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Affiliation(s)
- Qun Zhang
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350117, PR China
| | - Rui Yang
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350122, PR China
| | - Gang Liu
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350117, PR China
| | - Shiyan Jiang
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350117, PR China
| | - Jiarui Wang
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350117, PR China
| | - Juqiang Lin
- School of Opto-Electronic and Communication Engineering, Xiamen University of Technology, Xiamen 361024, PR China
| | - Tingyin Wang
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350117, PR China
| | - Jing Wang
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350117, PR China.
| | - Zufang Huang
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Provincial Key Laboratory of Photonics Technology, Fujian Normal University, Fuzhou 350117, PR China.
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Safdar A, Akram W, Khan MA, Alvi MN. Comparison of Pakistani CKD-EPI, new Asian-modified CKD-EPI and revised Lund-Malmö study equations in a South Asian CKD population: a study from a Pakistani CKD cohort. J Nephrol 2024; 37:119-129. [PMID: 37646987 DOI: 10.1007/s40620-023-01749-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/29/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Newly proposed estimating glomerular filtration rate equations need to be studied, evaluated and compared for chronic kidney disease staging, diagnosis and medication dosing in South Asians. The objectives of the study were (1) to assess the performance of the CKD-EPIPK, CKD-EPIAsian-Modified, and LMRevised equations in the Pakistani chronic kidney disease population, and (2) to investigate prospective implications on chronic kidney disease classification and end-stage kidney disease prevalence. METHODS We conducted a cross-sectional analysis on a chronic kidney disease cohort of 385 participants 18 years of age or above. RESULTS CKD-EPIPK showed the lowest bias (- 1.33 ml/min/1.73 m2), highest precision [IQR, 2.33 (- 2.36, - 0.03)] and enhanced P30 accuracy (89.35%) compared to the CKD-EPIAsian-Modified and LMRevised equations. The mean difference (ml/min/1.73 m2), 95% limit of agreement (ml/min/1.73 m2) of the equations were; CKD-EPIAsian-Modified: - 5.98, - 13.03, LMRevised: - 4.06, - 8.13 and CKD-EPIPK: - 1.18, - 6.14 (P < 0.001). CKD-EPIAsian-Modified and LMRevised showed upward re-classification of the GFR categories compared to the CKD-EPIPK equation except in the G5 category where the highest count (217, 56.36%) was noted for the CKD-EPIPK equation. End-stage kidney disease prevailed in all age groups according to all equations, and the prevalence was high in females in all equations. CONCLUSION CKD-EPIPK showed the best performance, whereas both CKD-EPIAsian-Modified and LMRevised showed poor performance and did not offer a sufficient advantage in chronic kidney disease classification and end-stage kidney disease prevalence estimation over CKD-EPIPK. Hence, CKD-EPIPK seems ideal for South Asians, thus appropriate measures should be taken for its implementation, at least in Pakistani laboratories.
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Affiliation(s)
- Aqsa Safdar
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan.
| | - Waqas Akram
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan
| | - Mahtab Ahmad Khan
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan
| | - Muhammad Nadeem Alvi
- Faculty of Pharmaceutical Sciences, University of Central Punjab, Avenue 1, Khayaban-e-Jinnah Road, Johar Town, Lahore, 54000, Punjab, Pakistan
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Soleimani N, Dehghani S, Anbardar MH, Mohammadzadeh S, Amirinezhad Fard E, Zare Sheibani A, Esmaeili MJ, Ebrahimi M. Comparing Jaffe and Enzymatic Methods for Creatinine Measurement at Various Icterus Levels and Their Impacts on Liver Transplant Allocation. Int J Anal Chem 2023; 2023:9804533. [PMID: 37886708 PMCID: PMC10598504 DOI: 10.1155/2023/9804533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
The Model for End-Stage Liver Disease (MELD) scoring system is used to prioritize liver transplantations and assess disease severity. This includes the international normalized ratio (INR), creatinine, and total bilirubin. Since there are several ways to measure creatinine, MELD scores can produce inconsistent results. The objectives of this study were to define a valid cut-off for bilirubin interference in creatinine measurement and to assess the effects of various icteric levels on creatinine measurement and liver transplant allocation. A total of 400 serum samples were categorized into four groups based on their icteric indices and total bilirubin levels, including non-, mild, moderate, and severe icteric samples. Both chemical Jaffe and enzymatic techniques were used to determine the creatinine levels in all four groups, and the findings were compared. In parallel, serum samples from 83 liver transplant candidate patients were divided into three groups depending on their bilirubin levels and then similarly evaluated and interpreted. The MELD scores were then computed for each group and compared. In icteric samples, the enzymatic method produced higher results for the creatinine concentrations than the Jaffe method did, and the mean creatinine difference rose from 0.08 in nonicteric group to 1.95 in groups with severe icterus. In addition, the enzymatic approach yielded higher findings for creatinine and subsequently for MELD scores in patients who were liver transplant candidates. When the bilirubin concentration was above the 4 mg/dL threshold, there were differences between the approaches for both the creatinine and the MELD score (p values: 0.0001 and 0.027, respectively). The chemical Jaffe is a readily available and considerably cost-effective method for measuring creatinine. However, it is influenced by a variety of known and unknown interfering substances, and it should be applied cautiously when working with icteric samples. Alternate techniques such as the enzymatic method should be considered when the bilirubin level exceeds 4 mg/dL. Though this cut-off is instrument and kit-dependent, each laboratory is advised to have its cut-off for bilirubin interference.
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Affiliation(s)
- Neda Soleimani
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pathology, Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sima Dehghani
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Anbardar
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pathology, Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sahand Mohammadzadeh
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Pathology, Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Elaheh Amirinezhad Fard
- Medical Immunology, Department of Pathology, Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Atefeh Zare Sheibani
- Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Javad Esmaeili
- Department of Pathology, Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marsa Ebrahimi
- Medical Laboratory, Department of Pathology, Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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11
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Frymoyer A, Schwenk HT, Brockmeyer JM, Bio L. Impact of model-informed precision dosing on achievement of vancomycin exposure targets in pediatric patients with cystic fibrosis. Pharmacotherapy 2023; 43:1007-1014. [PMID: 37401162 DOI: 10.1002/phar.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Vancomycin is commonly used to treat acute pulmonary exacerbations in pediatric patients with cystic fibrosis (CF) and a history of methicillin-resistant Staphylococcus aureus. Optimizing vancomycin exposure during therapy is essential and area under-the-curve (AUC)-guided dosing is now recommended. Model-informed precision dosing (MIPD) utilizing Bayesian forecasting is a powerful approach that can support AUC-guided dose individualization. The objective of the current study was to examine the impact of implementing an AUC-guided dose individualization approach supported via a MIPD clinical decision support (CDS) tool on vancomycin exposure, target attainment rate, and safety in pediatric patients with CF treated with vancomycin during clinical care. METHODS A retrospective chart review was performed in patients with CF at a single children's hospital comparing pre- and post-implementation of a MIPD approach for vancomycin supported by a cloud-based, CDS tool integrated into the electronic health record (EHR). In the pre-MIPD period, vancomycin starting doses of 60 mg/kg/day (<13 years) or 45 mg/kg/day (≥13 years) were used. Dose adjustment was guided by therapeutic drug monitoring (TDM) with a target trough 10-20 mg/L. In the post-MIPD period, starting dose and dose adjustment were based on the MIPD CDS tool predictions with a target 24 h AUC (AUC24 ) 400-600 mg*h/L. Exposure and target achievement rates were retrospectively calculated and compared. Rates of acute kidney injury (AKI) were also compared. RESULTS Overall, 23 patient courses were included in the pre-MIPD period and 21 patient courses in the post-MIPD period. In the post-MIPD period, an individualized MIPD starting dose resulted in 71% of patients achieving target AUC24 compared to 39% in the pre-MIPD period (p < 0.05). After the first TDM and dose adjustment, target AUC24 achievement was also higher post-MIPD versus pre-MIPD (86% vs. 57%; p < 0.05). AKI rates were low and similar between periods (pre-MIPD 8.7% vs. post-MIPD 9.5%; p = 0.9). CONCLUSION An MIPD approach implemented within a cloud-based, EHR-integrated CDS tool safely supported vancomycin AUC-guided dosing and resulted in high rates of target achievement.
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Affiliation(s)
- Adam Frymoyer
- Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Hayden T Schwenk
- Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Jake M Brockmeyer
- Department of Pharmacy, Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA
| | - Laura Bio
- Department of Pharmacy, Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA
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12
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Chen CC, Chu CH, Lin YC, Huang CC. Neurodevelopment After Neonatal Acute Kidney Injury in Very Preterm-Birth Children. Kidney Int Rep 2023; 8:1784-1791. [PMID: 37705902 PMCID: PMC10496073 DOI: 10.1016/j.ekir.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction This study aimed to assess head circumference (HC) growth and neurodevelopmental outcomes in very preterm-birth children after neonatal acute kidney injury (AKI). Methods This longitudinal follow-up cohort included 732 very preterm neonates of gestational age <31 weeks admitted to a tertiary center between 2008 and 2020. AKI was categorized as nonoliguric and oliguric AKI based on the urine output criteria during admission. We compared the differences in death, z scores of HC (zHC) at term-equivalent age (TEA) and at corrected ages of 6, 12, and 24 months, and the neurodevelopmental outcomes at corrected age of 24 months after neonatal nonoliguric and oliguric AKI. Results Among the 154 neonates who developed AKI, 72 had oliguric AKI and 82 had nonoliguric AKI. At TEA, oliguric AKI, but not nonoliguric AKI, was independently associated with lower zHC than non-AKI (mean differences, -0.49; 95% confidence interval [CI], -0.92 to -0.06). Although the 3 groups were comparable in zHC at corrected ages of 6, 12, and 24 months, the oliguric AKI group, but not the nonoliguric AKI group, had a higher rate of microcephaly by corrected age of 24 months. In addition, the oliguric AKI group, but not the nonoliguric AKI group, was more likely to die (61% vs. 9%) and have neurodevelopmental impairment (41% vs. 14%) compare with the non-AKI group. After adjustment, oliguric (adjusted odds ratio [aOR], 8.97; 95% CI, 2.19-36.76), but not nonoliguric, AKI was associated with neurodevelopmental impairment. Conclusion Neonatal oliguric AKI is associated with neurodevelopmental impairment in very preterm-birth children. Long-term head-size and neurodevelopmental follow-up after neonatal AKI is warranted.
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Affiliation(s)
- Chih-Chia Chen
- Graduate Institute of Clinical Medicine, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Hsiang Chu
- Department of Statistics, Tunghai University, Taichung, Taiwan
| | - Yung-Chieh Lin
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chao-Ching Huang
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pediatrics, College of Medicine, Taipei Medical University, Taipei, Taiwan
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13
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Selin AK, Lilliehöök I, Forkman J, Larsson A, Pelander L, Strage EM. Biological variation of biochemical urine and serum analytes in healthy dogs. Vet Clin Pathol 2023; 52:461-474. [PMID: 37316471 DOI: 10.1111/vcp.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 10/21/2022] [Accepted: 11/27/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Biological variation (BV) of urinary (U) biochemical analytes has not been described in absolute terms, let alone as a ratio of the U-creatinine or fractional excretion in healthy dogs. These analytes are potential diagnostic tools for different types of kidney damage and electrolyte disorders in dogs. OBJECTIVES We aimed to investigate the BV of specific gravity, osmolality, creatinine, urea, protein, glucose, chloride, sodium, potassium, calcium, and phosphate in urine from healthy pet dogs. METHODS Blood and urine samples from 13 dogs were collected once weekly for 8 weeks. Samples were analyzed in duplicate and in randomized order. For each sample, U-analyte and serum concentrations were measured, and U-analyte/U-creatinine and fractional excretion (FE) were calculated. Components of variance, estimated by restricted maximum likelihood, were used to determine within-subject variation (CVI ), between-subject variation (CVG ), and analytical variation (CVA ). Index of individuality (II) and reference change values were calculated. RESULTS CVI for all urine analytes varied between 12.6% and 35.9%, except for U-sodium, U-sodium/U-Cr, and FE-sodium, which had higher CVI s (59.5%-60.7%). For U-protein, U-sodium, U-potassium, U-sodium/U-creatinine, FE-urea, FE-glucose, FE-sodium, FE-potassium, and FE-phosphate II were low, indicating that population-based RIs were appropriate. The remaining analytes had an intermediate II, suggesting that population-based RIs should be used with caution. CONCLUSION This study presents information on the biological variation of urinary and serum biochemical analytes from healthy dogs. These data are important for an appropriate interpretation of laboratory results.
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Affiliation(s)
- Anna K Selin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
- AniCura Albano Animal Hospital and AniCura Gärdets Animal Clinic, Stockholm, Sweden
| | - Inger Lilliehöök
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Johannes Forkman
- Department of Crop Production Ecology, Swedish University of Agriculture Sciences, Uppsala, Sweden
| | - Anders Larsson
- Department of Medical Sciences, Clinical Chemistry, Uppsala University, Uppsala, Sweden
| | - Lena Pelander
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Emma M Strage
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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14
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Huang CY, Güiza F, Wouters P, Mebis L, Carra G, Gunst J, Meersseman P, Casaer M, Van den Berghe G, De Vlieger G, Meyfroidt G. Development and validation of the creatinine clearance predictor machine learning models in critically ill adults. Crit Care 2023; 27:272. [PMID: 37415234 PMCID: PMC10327364 DOI: 10.1186/s13054-023-04553-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND In critically ill patients, measured creatinine clearance (CrCl) is the most reliable method to evaluate glomerular filtration rate in routine clinical practice and may vary subsequently on a day-to-day basis. We developed and externally validated models to predict CrCl one day ahead and compared them with a reference reflecting current clinical practice. METHODS A gradient boosting method (GBM) machine-learning algorithm was used to develop the models on data from 2825 patients from the EPaNIC multicenter randomized controlled trial database. We externally validated the models on 9576 patients from the University Hospitals Leuven, included in the M@tric database. Three models were developed: a "Core" model based on demographic, admission diagnosis, and daily laboratory results; a "Core + BGA" model adding blood gas analysis results; and a "Core + BGA + Monitoring" model also including high-resolution monitoring data. Model performance was evaluated against the actual CrCl by mean absolute error (MAE) and root-mean-square error (RMSE). RESULTS All three developed models showed smaller prediction errors than the reference. Assuming the same CrCl of the day of prediction showed 20.6 (95% CI 20.3-20.9) ml/min MAE and 40.1 (95% CI 37.9-42.3) ml/min RMSE in the external validation cohort, while the developed model having the smallest RMSE (the Core + BGA + Monitoring model) had 18.1 (95% CI 17.9-18.3) ml/min MAE and 28.9 (95% CI 28-29.7) ml/min RMSE. CONCLUSIONS Prediction models based on routinely collected clinical data in the ICU were able to accurately predict next-day CrCl. These models could be useful for hydrophilic drug dosage adjustment or stratification of patients at risk. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Chao-Yuan Huang
- Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Fabian Güiza
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Wouters
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Liese Mebis
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Giorgia Carra
- Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Jan Gunst
- Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Philippe Meersseman
- Department of General Internal Medicine, Medical Intensive Care Unit, University Hospitals Leuven, Leuven, Belgium
| | - Michael Casaer
- Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Greet Van den Berghe
- Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Greet De Vlieger
- Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Geert Meyfroidt
- Laboratory of Intensive Care Medicine, Academic Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
- Department of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium.
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15
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Gama RM, Griffiths K, Vincent RP, Peters AM, Bramham K. Performance and pitfalls of the tools for measuring glomerular filtration rate to guide chronic kidney disease diagnosis and assessment. J Clin Pathol 2023:jcp-2023-208887. [PMID: 37164629 DOI: 10.1136/jcp-2023-208887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 04/28/2023] [Indexed: 05/12/2023]
Abstract
Accurate diagnosis, classification and risk stratification for chronic kidney disease (CKD) allow for early recognition and delivering optimal care. Creatinine-based glomerular filtration rate (GFR), urinary albumin: creatinine ratio (UACR) and the kidney failure risk equation (KFRE) are important tools to achieve this, but understanding their limitations is important for optimal implementation.When accurate GFR is required (eg, chemotherapy dosing), GFR is measured using an exogenous filtration marker. In routine clinical practice, in contrast, estimated GFR (eGFR) from serum creatinine (SCr), calculated using the enzymatic method±UACR, is recommended. Limitations of SCr include non-GFR determinants such as muscle mass, diet and tubular handling. An alternative or additional endogenous filtration marker is cystatin C, which can be used alongside SCr for confirmatory testing of CKD. However, its role in the UK is more limited due to concerns regarding false positive results.The recommended creatinine-based eGFR equation in the UK is the CKD Epidemiology Collaboration 2009 equation. This was recently updated to a race-neutral 2021 version and demonstrated reduced bias in people of Black ethnicity, but has not been validated in the UK. Limitations are extremes of age, inaccuracy at greater GFRs and reduced generalisability to under-represented ethnicity groups.The KFRE (based on age, sex, SCr and UACR) has recently been developed to help determine 2-year and 5-year risk of progression to end-stage kidney disease. It has been validated in over 30 countries and provides meaningful quantitative information to patients. However, supporting evidence for their performance in ethnic minority groups and kidney diseases such as glomerulonephritis remains modest.In conclusion, early identification, risk stratification of kidney disease and timely intervention are important to impact kidney disease progression. However, clinician awareness of the limitations and variability of creatinine, cystatin C and the eGFR equations, is key to appropriate interpretation of results.
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Affiliation(s)
- Rouvick M Gama
- Department of Inflammation Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK
- King's Kidney Care, King's College Hospital, London, UK
| | - Kathryn Griffiths
- King's Kidney Care, King's College Hospital, London, UK
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Royce P Vincent
- Department of Clinical Biochemistry (Synnovis), King's College Hospital, London, UK
- Department of Nutrition and Dietetics, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Adrien Michael Peters
- Department of Nuclear Medicine, King's College Hospital NHS Foundation Trust, London, UK
| | - Kate Bramham
- King's Kidney Care, King's College Hospital, London, UK
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
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16
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Kukkar D, Chhillar M, Kim KH. Application of SERS-based nanobiosensors to metabolite biomarkers of CKD. Biosens Bioelectron 2023; 232:115311. [PMID: 37086564 DOI: 10.1016/j.bios.2023.115311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 04/24/2023]
Abstract
A clinical diagnosis of chronic kidney disease (CKD) is commonly achieved by estimating the serum levels of urea and creatinine (CR). Given the limitations of the conventional diagnostic assays, it is imperative to seek alternative, economical strategies for the detection of CKD-specific biomarkers with high specificity and selectivity. In this respect, surface-enhanced Raman spectroscopy (SERS) can be regarded as an ideal choice. SERS signals can be greatly amplified by noble metal nanoparticles (e.g., gold nanoparticles (GNPs)) of numerous sizes, shapes, and configurations to help achieve ultra-sensitive single molecule-level detection at 10-15 M (up to 10 orders of magnitude more sensitive than fluorescence-based detection). The irregular geometry of GNPs with spike-like tips, dimers, and aggregates with small nanogaps (i.e., due to plasmon coupling such as Raman hot spots) play a pivotal role in enhancing the specificity and sensitivity of SERS. This review critically outlines the performance of SERS-based biosensors in the ultrasensitive detection of CKD biomarkers in various body fluids in terms of basic quality assurance parameters (e.g., limit of detection, figure of merit, enhancement factor, and stability of the biosensor). Moreover, the challenges and perspectives are described with respect to the expansion of such sensing techniques in practical clinical settings.
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Affiliation(s)
- Deepak Kukkar
- Department of Biotechnology, Chandigarh University, Gharuan, Mohali, 140413, Punjab, India; University Centre for Research and Development, Chandigarh University, Gharuan, Mohali, 140413, Punjab, India
| | - Monika Chhillar
- Department of Biotechnology, Chandigarh University, Gharuan, Mohali, 140413, Punjab, India; University Centre for Research and Development, Chandigarh University, Gharuan, Mohali, 140413, Punjab, India
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-Ro, Seoul, 04763, South Korea.
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17
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Nagarajan A, Sethuraman V, Sasikumar R. Non-enzymatic electrochemical detection of creatinine based on a glassy carbon electrode modified with a Pd/Cu 2O decorated polypyrrole (PPy) nanocomposite: an analytical approach. ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2023; 15:1410-1421. [PMID: 36826445 DOI: 10.1039/d3ay00110e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
The major constraints of standard enzymatic biosensors are poor long-term storage stability and high cost. Hence, there is extensive research towards fabrication of reliable enzymeless biosensors based on nanomaterials. In this paper, we present the development of an enzymeless electrochemical biosensor for highly precise detection of creatinine. This involves the use of a simple yet effective alternative to the commonly utilized Pd/Cu2O/PPy nanocomposite, which was characterized by different analytical methods. The present electrochemical sensor provides a wide detection range (0.1 to 150 μM), low detection limit (0.05 μM) and high sensitivity (0.207 μA), and is capable of detecting the creatinine level in human urine samples, which are inexpensive. The results are reproducible, and the sensor is stable. The sensor demonstrates good electrocatalytic activity and selectivity towards the detection of creatinine in the presence of various other similar biological entities. When compared to other existing counterparts, the electrocatalytic behaviour of the present sensor is comparable, if not better. So, the present electrochemical sensor for creatinine might be employed as a long-term diagnostic alternative.
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Affiliation(s)
- A Nagarajan
- Department of Physical Chemistry, University of Madras, Guindy Campus, Chennai-600025, Tamil Nadu, India.
| | - V Sethuraman
- Research and Development, New Energy Storage Technology, Lithium-ion Division, Amara Raja Battery Ltd, Karakambadi-517520, Tirupati, Andhra Pradesh, India
| | - R Sasikumar
- Department of Physical Chemistry, University of Madras, Guindy Campus, Chennai-600025, Tamil Nadu, India.
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18
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Evaluation of the Accuracy of Cr and BUN Using the ABL90 FLEX PLUS Blood Gas Analyzer and the Equivalence of Candidate Specimens for Assessment of Renal Function. J Clin Med 2023; 12:jcm12051940. [PMID: 36902727 PMCID: PMC10003958 DOI: 10.3390/jcm12051940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND The ABL90 FLEX PLUS (Radiometer) is a blood gas analyzer that also provides creatinine (Cr) and blood urea nitrogen (BUN) results. We assessed the accuracy of the ABL90 FLEX PLUS to measure Cr and BUN and find suitable candidate specimens against primary specimens (heparinized whole-blood (H-WB)). METHODS Paired H-WB, serum, and sodium-citrated whole-blood (C-WB) samples (105) were collected. The Cr and BUN levels in the H-WB using the ABL90 FLEX PLUS were compared with those of the serum using four automated chemistry analyzers. The suitability of the candidate specimens was assessed at each medical decision level according to the CLSI guideline EP35-ED1. RESULTS The respective mean differences of the ABL90 FLEX PLUS for the Cr and BUN were below -0.10 and -3.51 mg/dL compared to the other analyzers. The systematic differences between the serum and the H-WB at the low, medium, and high medical decision levels were all 0% for Cr, but those of the C-WB were -12.96%, -11.81%, and -11.30%, respectively. Regarding imprecision, the SDserum/SDH-WB ratios at each level were 0.14, 1.41, and 0.68, whereas the SDC-WB/SDH-WB ratios were 0.35, 2.00, and 0.73, respectively. CONCLUSIONS The ABL90 FLEX PLUS provided Cr and BUN results comparable with the four widely used analyzers. Among the candidates, the serum was suitable for Cr testing using the ABL90 FLEX PLUS, while the C-WB did not satisfy the acceptance criteria.
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19
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Córdoba-Moreno MO, Mendes MT, Markus RP, Fernandes PA. Rat resistance to rheumatoid arthritis induction as a function of the early-phase adrenal-pineal crosstalk. J Physiol 2023; 601:535-549. [PMID: 36287128 DOI: 10.1113/jp283456] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/07/2022] [Indexed: 02/03/2023] Open
Abstract
Chronic inflammatory diseases are triggered by causal stimuli that might occur long before the appearance of the symptoms. Increasing evidence suggests that these stimuli are necessary but not always sufficient to induce the diseases. The murine model of type II collagen emulsified in Freund's incomplete adjuvant (collagen-induced arthritis) to induce rheumatoid arthritis (RA) follows this pattern as some animals do not develop the chronically inflamed phenotype. Considering that in the immune-pineal axis (IPA) theory adrenal-pineal cross-talk adjusts early phases of inflammatory processes, we investigated whether differences in IPA activation could explain why some animals are resistant (RES) while others develop RA. We observed a similar increase in 6-sulfatoxymelatonin (aMT6s) excretion from day 3 to 13 in both RES and RA animals, followed by a significant decrease in RA animals. This pattern of aMT6s excretion positively correlated with plasma corticosterone (CORT) in RES animals. Additionally, RA animals presented a lower aMT6s/CORT ratio than saline-injected or RES animals. Plasmatic levels of tumour necrosis factor were similar in both groups, but interleukin (IL)-1β and monocyte chemotactic protein 1 (MCP-1) levels were lower in RES compared to RA animals. IL-2 and IL-4 were decreased in RES animals compared to saline-injected animals. The aMT6s/CORT ratio inversely correlated with the paw thickness and the inflammatory score (levels of IL-1β, MCP-1, IL-2 and IL-4 combined). Thus, adrenocortical-pineal positive interaction is an early defence mechanism for avoiding inflammatory chronification. KEY POINTS: Immune-pineal axis imbalance is observed in early-phase rheumatoid arthritis development. Only resistant animals present a positive association between adrenal and pineal hormones. The 6-sulfatoxymelatonin/corticosterone ratio is decreased in animals that develop rheumatoid arthritis. The inflammatory score combining the levels of nocturnal interleukin (IL)-1β, monocyte chemotactic protein 1, IL-2 and IL-4 presents a very strong positive correlation with the size of inflammatory lesion. The 6-sulfatoxymelatonin/corticosterone ratio presents a strong negative correlation with the inflammatory score and paw oedema size.
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Affiliation(s)
| | | | - Regina P Markus
- Department of Physiology, University of São Paulo, São Paulo, Sao Paulo, Brazil
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20
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Nanoparticle-antibody conjugate-based immunoassays for detection of CKD-associated biomarkers. Trends Analyt Chem 2022. [DOI: 10.1016/j.trac.2022.116857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Gaillard F, Ould Rabah M, Garcelon N, Touam M, Neuraz A, Legendre C, Anglicheau D, Prié D, Bienaimé F. Allograft function and muscle mass evolution after kidney transplantation. J Cachexia Sarcopenia Muscle 2022; 13:2875-2887. [PMID: 36106518 PMCID: PMC9745471 DOI: 10.1002/jcsm.13066] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 07/07/2022] [Accepted: 07/15/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Advanced chronic kidney disease is associated with muscle wasting, but how glomerular filtration rate (GFR) recovery after kidney transplantation is associated with muscle mass is unknown. METHODS We took advantage of the simultaneous measurement of GFR (using iohexol plasma clearance; ioGFR) and creatinine excretion rate (a surrogate marker of muscle mass; CER) performed 3 months after transplantation and at a later time point at our institution to investigate the interplay between allograft function, muscle mass, and outcome in kidney transplant recipients. RESULTS Between June 2005 and October 2019, 1319 successive kidney transplant recipients (mean age 50.4 ± 14.6; 38.7% female) underwent GFR measurement at our institution 3 months after kidney transplantation. CER (CER3 ) and ioGFR (ioGFR3 ) were 7.7 ± 2.6 μmol/min and 53 ± 17.1 mL/min/1.73 m2 , respectively. Multivariable analysis identified female gender, older donor and recipient age, reduced body mass index, coronary disease, dialysis history, proteinuria, and reduced ioGFR3 as independent predictors of low CER3 (ioGFR3 : β coefficient 0.19 [95% confidence interval 0.14 to 0.24]). A total of 1165 patients had a subsequent CER measurement after a median follow-up of 9.5 months. Of them, 373 (32%) experienced an increase in CER > 10%, while 222 (19%) showed a CER decrease of more than 10%. Multivariable analysis adjusted for CER3 and other confounders identified ioGFR3 as an independent predictor of CER at follow-up (β coefficient 0.11 [95% confidence interval 0.07 to 0.16]). In multivariable Cox analysis, reduced CER at 3 months or at follow-up were consistently associated with mortality (hazard ratio [95% confidence interval] at 3 months: 0.82 [0.74 to 0.91]; at follow-up: 0.79 [0.69 to 0.99]) but not with graft loss. CONCLUSIONS Glomerular filtration rate recovery is a determinant of muscle mass variation after kidney transplantation. Early interventions targeting muscle mass gain may be beneficial for kidney transplant recipients.
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Affiliation(s)
- François Gaillard
- Service de Transplantation, Néphrologie et Immunologie Clinique, Hôpital Edouard Herriot et faculté de médecine, Université Lyon 1, Lyon, France
| | - Mélissa Ould Rabah
- Service de Physiologie, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.,Faculté de médecine, Université de Paris-Cité, Paris, France
| | - Nicolas Garcelon
- Université de Paris-Cité, Imagine Institute, Data Science Platform, INSERM UMR 1163, Paris, France
| | - Malik Touam
- Service de Néphrologie et Transplantation, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France
| | - Antoine Neuraz
- Service d'Informatique Médical, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France
| | - Christophe Legendre
- Faculté de médecine, Université de Paris-Cité, Paris, France.,Service de Néphrologie et Transplantation, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.,Institut Necker-Enfants Malades, INSERM U1151, Paris, France
| | - Dany Anglicheau
- Faculté de médecine, Université de Paris-Cité, Paris, France.,Service de Néphrologie et Transplantation, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.,Institut Necker-Enfants Malades, INSERM U1151, Paris, France
| | - Dominique Prié
- Service de Physiologie, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.,Faculté de médecine, Université de Paris-Cité, Paris, France.,Institut Necker-Enfants Malades, INSERM U1151, Paris, France
| | - Frank Bienaimé
- Service de Physiologie, Hôpital Necker-Enfants Malades, Assistance-Publique-Hôpitaux de Paris, Paris, France.,Faculté de médecine, Université de Paris-Cité, Paris, France.,Institut Necker-Enfants Malades, INSERM U1151, Paris, France
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22
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Beauval N, Leroyer A, Hisbergues M, Allorge D, Maboudou P, Howsam M, Nisse C. Stability of trace element concentrations in frozen urine - Effect on different elements of more than 10 years at - 80 °C. J Trace Elem Med Biol 2022; 74:127080. [PMID: 36179463 DOI: 10.1016/j.jtemb.2022.127080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Analysis of urinary trace elements is widely used in Human Biology, especially in occupational and environmental biomonitoring. Collections of urine samples are of great interest for those studying trace elements but many of them are actually unused, in part perhaps because of a lack of knowledge about the stability of trace element concentrations under such storage conditions. The aim of this study was to evaluate the impact of a long-term frozen storage on the measurement of the urinary concentration of 10 trace elements. METHOD Forty-eight urinary samples were re-analysed by inductively coupled plasma mass spectrometry (ICP-MS) for the quantification of As, Cd, Co, Cr, Mn, Ni, Pb, Sb, Tl, and Zn, after 11-13 years of frozen storage at - 80 °C. RESULTS A slight water loss likely occurred, even at - 80 °C, but seems to be compensated by using creatinine-adjusted concentrations. Concentrations of As, Cd, Pb, Tl, Zn, and possibly Mn, did not suffer from major modification during storage, while the plastic container likely contaminated samples with Sb. The technological evolution over 13 years may have affected some results, especially those with lower concentrations, and must be taken into account when comparing data over time. CONCLUSION This study provides some promising preliminary data on the stability of trace element concentrations during long-term frozen storage, and some evidence that urine samples in existing biobanks remain a valuable resource, even if they were collected many years ago.
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Affiliation(s)
- Nicolas Beauval
- University of Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France.
| | - Ariane Leroyer
- University of Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, F-59000 Lille, France
| | - Michael Hisbergues
- University of Lille, Inserm, CHU Lille, CRB-CIC 1403 - Centre de Ressources Biologiques du Centre d'Investigation Clinique, F-59000 Lille, France
| | - Delphine Allorge
- University of Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France
| | | | - Mike Howsam
- University of Lille, Inserm, CHU Lille, Institut Pasteur Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France
| | - Catherine Nisse
- University of Lille, CHU Lille, Institut Pasteur Lille, ULR 4483 - IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, F-59000 Lille, France
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23
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Verma A, Figueroa Villalba C, Choucair I, El-Khoury JM. A case of spuriously low serum creatinine concentrations in a patient with acetaminophen poisoning. Clin Chim Acta 2022; 535:195-196. [PMID: 36075459 DOI: 10.1016/j.cca.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Anuj Verma
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, United States; Department of Pathology, Yale School of Medicine, New Haven, CT, United States
| | | | - Ibrahim Choucair
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, United States
| | - Joe M El-Khoury
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, United States.
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24
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Sorvor E, Owiredu WKBA, Okyere P, Annani-Akollor ME, Donkor S, Bannor R, Sorvor FB, Ephraim RK. Assessment of Serum Free Light Chains as a Marker of Diabetic Nephropathy; A Cross-Sectional Study in the Kumasi Metropolis. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:881202. [PMID: 36992723 PMCID: PMC10012065 DOI: 10.3389/fcdhc.2022.881202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022]
Abstract
AimsAlthough traditional tests such as serum urea, creatinine, and microalbuminuria have been widely employed in the diagnosis of diabetic nephropathy, their sensitivity and accuracy are limited because kidney damage precedes the excretion of these biomarkers. This study investigated the role of serum free light chains in the disease manifestation of diabetic nephropathy.Materials and MethodsUsing a cross-sectional design we recruited 107 diabetes mellitus out-patients who visited the Diabetes and Renal Disease Clinics at the Komfo Anokye Teaching Hospital, Manhyia District Hospital, and Suntreso Government Hospital all in Ghana from November 2019 to February 2020. Five (5) mls of blood was collected from each participant and analyzed for fasting blood glucose (FBG) urea, creatinine, immunoglobulin free light chains. Urine samples were obtained and analyzed for albumin. Anthropometric characteristics were also measured. Data were analyzed using descriptive analysis, analysis of variance (ANOVA) test, Tukey HSD post hoc, and Kruskal Wallis test. Chi-squared test was used to examine if there are significant associations with the indicators of interest. In addition, Spearman’s correlation was used to test for associations between appropriate variables. Receiver operating characteristic analysis (ROC) was also performed to assess the diagnostic performance of free light chains.ResultsThe mean age of studied participants was 58.2 years (SD: ± 11.1), 63.2% were females and most of the participants were married (63.0%). The mean FBG of the studied participants was 8.0mmol/L (SD: ± 5.86), and the average duration of diabetes mellitus (DM) was 11.88 years (SD: ± 7.96). The median serum Kappa, Lambda, and Kappa: Lambda ratios for the studied participants were 18.51 (15.63-24.18), 12.19(10.84-14.48), and 1.50(1.23-1.86) respectively. A positive correlation was observed between albuminuria and; Kappa (rs=0.132; p=0.209), and Lambda (rs=0.076; p=0.469). However, a negative correlation was observed between albuminuria and K: L ratio (rs=-0.006; p=0.956).ConclusionsThe current study observed an increasing trend in the levels of free light chains and degree of diabetic nephropathy, although not statistically significant. The exploration of serum free light chains as a better marker of diabetic nephropathy showed very promising results but further studies are required to elucidate its predictive value as a diagnostic tool for diabetic nephropathy.
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Affiliation(s)
- Elizabeth Sorvor
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Suntreso Government Hospital, Kumasi, Ghana
| | - William K. B. A. Owiredu
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Perditer Okyere
- Department of Internal Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sampson Donkor
- Department of Molecular Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Bannor
- Department of Allied Health Sciences, University of Connecticut, Storrs, United States
- UConn Center for mHealth and Social Media, Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, United States
| | | | - Richard K.D. Ephraim
- Department of Medical Laboratory Science, University of Cape Coast, Cape Coast, Ghana
- *Correspondence: Richard K.D. Ephraim,
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25
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Dong Y, Luo X, Liu Y, Yan C, Li H, Lv J, Yang L, Cui Y. A disposable printed amperometric biosensor for clinical evaluation of creatinine in renal function detection. Talanta 2022; 248:123592. [PMID: 35671549 DOI: 10.1016/j.talanta.2022.123592] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/01/2022] [Accepted: 05/25/2022] [Indexed: 01/09/2023]
Abstract
In clinical practice, sera creatinine level is regarded as a crucial biomarker for the diagnosis, staging and monitoring of kidney disease. An amperometric biosensor is rapid, accurate, and cost-effective, with a portability and a simple operation. Herein, we report for the firsttime a disposable, printed amperometric biosensor for the clinical evaluation of creatinine in renal function detection. The sensor is constructed based on Prussian blue/carbon-graphite paste as the working electrode and the immobilization of creatinine amidohydrolase, creatine amidinohydrolase and sarcosine oxidase. The creatinine biosensor shows a linear detection range from 0.05 to 1.4 mM with a detection time of about 3 min. In addition, the sensor shows a high stability that can maintain above 86% of the initial activity after being stored for over 4 months. Moreover, the sensor shows almost the same results as those with the Jaffe method for measuring the real blood samples. We anticipate that the creatinine biosensor could be widely used in the medical and healthcare areas, especially for at-home testing and onsite medical examinations.
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Affiliation(s)
- Yaping Dong
- Department of Medicine, Renal Division, Hospital 1, Peking University, Beijing, 100034, PR China; School of Materials Science and Engineering, Peking University, Beijing, 100871, PR China
| | - Xiaojin Luo
- School of Materials Science and Engineering, Peking University, Beijing, 100871, PR China
| | - Yiqun Liu
- School of Materials Science and Engineering, Peking University, Beijing, 100871, PR China
| | - Cunling Yan
- Department of Clinical Laboratory, Hospital 1, Peking University, Beijing, 100034, PR China
| | - Haixia Li
- Department of Clinical Laboratory, Hospital 1, Peking University, Beijing, 100034, PR China
| | - Jicheng Lv
- Department of Medicine, Renal Division, Hospital 1, Peking University, Beijing, 100034, PR China.
| | - Li Yang
- Department of Medicine, Renal Division, Hospital 1, Peking University, Beijing, 100034, PR China
| | - Yue Cui
- School of Materials Science and Engineering, Peking University, Beijing, 100871, PR China.
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26
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Ahmad Khushaini MA, Azeman NH, Mat Salleh M, Tg Abdul Aziz TH, A Bakar AA, De La Rue RM, Md Zain AR. Exploiting a strong coupling regime of organic pentamer surface plasmon resonance based on the Otto configuration for creatinine detection. OPTICS EXPRESS 2022; 30:14478-14491. [PMID: 35473189 DOI: 10.1364/oe.448947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/11/2022] [Indexed: 06/14/2023]
Abstract
The sandwiched material-analyte layer in the surface plasmon resonance (SPR)-Otto configuration emulates an optical cavity and, coupled with large optical nonlinearity material, the rate of light escaping from the system is reduced, allowing the formation of a strong coupling regime. Here, we report an organic pentamer SPR sensor using the Otto configuration to induce a strong coupling regime for creatinine detection. Prior to that, the SPR sensor chip was modified with an organic pentamer, 1,4-bis[2-(5-thiophene-2-yl)-1-benzothiopene]-2,5-dioctyloxybenzene (BOBzBT2). To improve the experimental calibration curve, a normalisation approach based on the strong coupling-induced second dip was also developed. By using this procedure, the performance of the sensor improved to 0.11 mg/dL and 0.36 mg/dL for the detection and quantification limits, respectively.
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27
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Thammajinno S, Buranachai C, Kanatharana P, Thavarungkul P, Thammakhet-Buranachai C. A copper nanoclusters probe for dual detection of microalbumin and creatinine. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2022; 270:120816. [PMID: 34995852 DOI: 10.1016/j.saa.2021.120816] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
A fluorescent probe based on glutathione-capped copper nanoclusters (GSH-CuNCs) was developed for the detection of dual targets, human serum albumin (HSA) and creatinine, in human urine. The GSH-CuNCs were synthesized by a one-pot green method using ascorbic acid as a reducing agent. The detection of HSA was in a turn-on mode via electrostatic interaction in a basic condition while the detection of creatinine was in a turn-off mode via non-covalent bonding in an acidic condition. Under optimal conditions, the linear range and detection limit of HSA were 5.0 nM to 150 nM and 1.510 ± 0.041 nM, while those of creatinine were 30 μM to 1000 μM and 13.0 ± 1.0 μM. This easily fabricated nanocluster probe provided a fast response with high sensitivity, and good selectivity. Recoveries from urine samples were in the range of 81.44 ± 0.25 to 109.22 ± 0.57% for HSA and 80.57 ± 0.16 to 109.0 ± 0.10% for creatinine. The urinary analytical results from the fluorescent probe were in good agreement (P > 0.05) to those obtained from immunoturbidimetric and enzymatic methods, signifying the excellent performance of this sensing system.
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Affiliation(s)
- Supitcha Thammajinno
- Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Chittanon Buranachai
- Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Thailand Center of Excellence in Physics, Commission on Higher Education, 328 Si Ayutthaya Road, Bangkok 10400, Thailand
| | - Proespichaya Kanatharana
- Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
| | - Panote Thavarungkul
- Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Thailand Center of Excellence in Physics, Commission on Higher Education, 328 Si Ayutthaya Road, Bangkok 10400, Thailand
| | - Chongdee Thammakhet-Buranachai
- Division of Physical Science, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Trace Analysis and Biosensor, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand; Center of Excellence for Innovation in Chemistry, Faculty of Science, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.
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28
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El Azab EF, Mostafa HS. Geraniol ameliorates the progression of high fat‐diet/streptozotocin‐induced type 2 diabetes mellitus in rats via regulation of caspase‐3, Bcl‐2, and Bax expression. J Food Biochem 2022; 46:e14142. [DOI: 10.1111/jfbc.14142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Eman Fawzy El Azab
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences at Al Qurayyat Jouf University Al Qurayyat Saudi Arabia
- Biochemistry Department, Faculty of Science Alexandria University Alexandria Egypt
| | - Heba Sayed Mostafa
- Food Science Department, Faculty of Agriculture Cairo University Giza Egypt
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Zhu C, Zhang H, Shen Z, Chen J, Gu Y, Lv S, Li Y, Zhu B, Ding X, Zhang X. OUP accepted manuscript. Clin Kidney J 2022; 15:1322-1332. [PMID: 35756734 PMCID: PMC9217656 DOI: 10.1093/ckj/sfac070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Indexed: 11/14/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
| | | | - Ziyan Shen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Institute of Kidney and Dialysis, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yulu Gu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Shiqi Lv
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
| | - Bowen Zhu
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
- Shanghai Medical Center of Kidney Disease, Shanghai, China
- Shanghai Key Laboratory of Kidney and Blood Purification, Shanghai, China
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30
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Kight EC, Hussain I, Bowden AK, Haselton FR. Recurrence monitoring for ovarian cancer using a cell phone-integrated paper device to measure the ovarian cancer biomarker HE4/CRE ratio in urine. Sci Rep 2021; 11:21945. [PMID: 34754053 PMCID: PMC8578327 DOI: 10.1038/s41598-021-01544-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 10/21/2021] [Indexed: 12/14/2022] Open
Abstract
Ovarian cancer has a poor cure rate and rates of relapse are high. Current recurrence detection is limited by non-specific methods such as blood testing and ultrasound. Based on reports that human epididymis four (HE4) / creatinine (CRE) ratios found in urine are elevated in ovarian cancers, we have developed a paper-based device that combines lateral flow technology and cell phone analysis to quantitatively measure HE4/CRE. Surrogate samples were used to test the performance over clinically expected HE4/CRE ratios. For HE4/CRE ratios of 2 to 47, the percent error was found to be 16.0% on average whether measured by a flatbed scanner or cell phone. There was not a significant difference between the results from the cell phone or scanner. Based on published studies, error in this method was less than the difference required to detect recurrence. This promising new tool, with further development, could be used at home or in low-resource settings to provide timely detection of ovarian cancer recurrence.
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Affiliation(s)
- Emily C Kight
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA
| | - Iftak Hussain
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA.,Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37232, USA
| | - Audrey K Bowden
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA.,Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, TN, 37232, USA
| | - Frederick R Haselton
- Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, 37232, USA. .,Department of Chemistry, Vanderbilt University, Nashville, TN, 37232, USA.
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31
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Höglund K, Palmqvist H, Ringmark S, Svensson A. Quantification of normetanephrine in canine urine using ELISA: evaluation of factors affecting results. J Vet Diagn Invest 2021; 34:28-35. [PMID: 34697963 PMCID: PMC8689017 DOI: 10.1177/10406387211052984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Catecholamine release increases in dogs with pheochromocytomas and in situations of stress. Although plasma catecholamines degrade rapidly, their metabolites, normetanephrine (NME) and metanephrine (ME), are stable in acidified urine. Our aim was to verify a human urine ELISA kit for the quantification of NME and ME in canine urine and to determine the effects on metabolite stability of sampling time (morning or midday) and day (ordinary or day spent in a clinic). We analyzed 179 urine samples from 17 healthy dogs. For NME, the mean intra-assay CV was 6.0% for all samples and 4.3% for the canine control; inter-assay CVs were 3.3, 3.8, and 12% for high and low concentration human urine positive controls supplied in the ELISA kit and a positive canine control, respectively; spike-recovery was 90-101%. For ME, mean intra-assay CV was 6.5% for samples and 9.0% for the canine control; inter-assay CVs were 12.7, 7.2, and 22.5% for high and low concentration human urine positive controls supplied in the ELISA kit and a positive canine control, respectively; spike-recovery was 85-89%. Dilution recovery was unsatisfactory for both metabolites. Based on our verification results, NME was selected for remaining analyses. We found no effect on NME concentrations of acidification or room temperature storage for up to 24 h. The NME:creatinine ratio was higher after the first of 3 clinic days compared to the same morning (111.2 ± 5.5 vs. 82.9 ± 5.3; p < 0.0001), but not on the other days. NME verification results were generally superior to ME. Dilution studies were unsatisfactory for both metabolites. Given that NME was stable without acidification at room temperature, urine samples can be collected at home. The clinic environment can cause higher NME:creatinine ratios, especially in unaccustomed dogs.
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Affiliation(s)
- Katja Höglund
- Departments of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Hanna Palmqvist
- Animal Nutrition and Management, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Sara Ringmark
- Departments of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Anna Svensson
- Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Mohammed-Ali Z, Bagherpoor S, Diker P, Hoang T, Vidovic I, Cursio C, Leung F, Brinc D. Performance evaluation of all analytes on the epoc® Blood Analysis System for use in hospital surgical and intensive care units. Pract Lab Med 2021; 22:e00190. [PMID: 34589568 PMCID: PMC8461111 DOI: 10.1016/j.plabm.2020.e00190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022] Open
Abstract
Objective To evaluate the performance of the epoc hand-held analyzer against the RAPIDPoint 500 blood gas analyzer and laboratory analyzers where applicable. Methods Venous or arterial whole blood samples collected in balanced heparinized syringes were obtained from 69 patients (35 females, 34 males) predominantly (77%) from the surgical unit and intensive care unit (ICU). Method comparison was performed for all analytes on the epoc System against the RAPIDPoint 500 Blood gas analyzer or laboratory analyzers where applicable. Results: Mean bias was <5% for blood gases, electrolytes, lactate and glucose. Hematocrit showed a bias of -6.76% (95% CI = -8.91, - 4.61) compared to the HemataSTAT-II method, whereas calculated total hemoglobin showed a bias of 1.51% (95% CI = -1.04, 4.06) against the Sysmex XN-10 hematology analyzer. Creatinine showed the largest bias relative to laboratory analyzers, Abbott Architect c8000 Jaffe method (13.54%, 95% CI = 5.43, 21.65) and Roche Cobas c702 enzymatic method (30.01%, 95% CI = 12.64, 47.38). Conclusions: The epoc system is fit for use in the surgical and ICU setting for the measurement of all analytes except for creatinine.
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Affiliation(s)
- Zahraa Mohammed-Ali
- Department of Laboratory Medicine and Pathobiology University of Toronto, Toronto, ON, Canada
| | | | | | - Thuy Hoang
- Michener Institute for Applied Health Sciences, Toronto, ON, Canada
| | | | | | - Felix Leung
- Department of Laboratory Medicine and Pathobiology University of Toronto, Toronto, ON, Canada.,Mount Sinai Hospital, Toronto, ON, Canada
| | - Davor Brinc
- Department of Laboratory Medicine and Pathobiology University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
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Yao L, Cai K, Mei F, Wang X, Fan C, Jiang H, Xie F, Li Y, Bai L, Peng K, Deng W, Lai S, Wang J. Urine Nitric Oxide Is Lower in Parents of Autistic Children. Front Psychiatry 2021; 12:607191. [PMID: 34093255 PMCID: PMC8175662 DOI: 10.3389/fpsyt.2021.607191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 04/16/2021] [Indexed: 01/15/2023] Open
Abstract
Parents raising children with autism spectrum disorder (ASD) usually carry on their daily life under tremendous stress, but limited empirical research has been devoted to this population. It is known that parents' health status directly impacts therapeutic outcome of ASD children. As an important regulator in cardiovascular, nervous and immune systems, nitric oxide (NO) levels haven't been reported in parents of ASD children yet. In this study, we measured urine nitrite and nitrate from 43 ASD parents (ASD-P), and 43 healthy adults in the same range of age (Control) who didn't have any ASD descendants. Comparison between the ASD-P and Control groups showed that NO 2 - , NO 3 - , and NO 2 - / NO 3 - were all significantly lower in the ASD-P group. Analysis on the interaction effect of sex and group indicated that urine NO 3 - of mothers in ASD-P was lower than that in females of the Control group, but no significant difference was observed between males in both groups. It is for the first time that urine nitric oxide metabolites (nitrite, nitrate) levels were precisely reported to differentiate parents of autistic children from other adults without ASD descendants. This phenomenon suggests that parents (especially mothers) of autistic children might have experienced more mental and physical stressors, which led to decreased NO levels during metabolism. Further investigations are necessary to uncover the etiology of low urine NO among parents of autistic children.
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Affiliation(s)
- Lulu Yao
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Kun Cai
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Fanghua Mei
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Xiaohua Wang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Chuangang Fan
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Hong Jiang
- Department of Child Health Care, Huangshi Maternity and Child Health Care Hospital, Wuhan, China
| | - Fang Xie
- Department of Child Health Care, Huangshi Maternity and Child Health Care Hospital, Wuhan, China
| | - Ying Li
- Department of Child Health Care, Huangshi Maternity and Child Health Care Hospital, Wuhan, China
| | - Lu Bai
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Kang Peng
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Wenwen Deng
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
| | - Shenghan Lai
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jun Wang
- National 111 Center for Cellular Regulation and Molecular Pharmaceutics, Hubei University of Technology, Wuhan, China.,Department of Biomedicine and Biopharmacology, Hubei University of Technology, Wuhan, China
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Felício JS, de Rider Britto HA, Cortez PC, de Souza Resende F, de Lemos MN, de Moraes LV, de Aquino VT, de Souza Parente F, de Queiroz NNM, Abrahão Neto JF, de Alcântara AL, da Silva WM, de Souza Neto NJK, Freire Piani PP, de Souza ÍJA, Silva LDSD, de Oliveira MCNI, Said NM, Nascimento de Lemos G, de Melo FTC, Gomes DL, Contente Braga de Souza AC, de Sá Oliveira dos Reis M, Leal VSG, Lobato IJC, Felício KM. Association Between 25(OH)Vitamin D, HbA1c and Albuminuria in Diabetes Mellitus: Data From a Population-Based Study (VIDAMAZON). Front Endocrinol (Lausanne) 2021; 12:723502. [PMID: 34690928 PMCID: PMC8530245 DOI: 10.3389/fendo.2021.723502] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The effect of glycemic control on diabetic kidney disease (DKD) is well known. Recent evidence has suggested that Vitamin D (VD) may have a nephroprotective effect in diabetes, but the relationship between VD, glycemic control, and albuminuria has yet to be clarified. OBJECTIVE Evaluate the relationship between 25-hydroxy-vitamin D [25(OH)D], HbA1c, and albuminuria in Diabetes Mellitus (DM). PATIENTS AND METHODS Cross-sectional study with 1576 individuals with DM who had 25(OH)D, HbA1c, and albuminuria levels measured. Patients with abnormal creatinine levels were excluded, in order to avoid interference on VD levels by impaired kidney function. RESULTS Patients with HbA1c ≥7% had lower 25(OH)D when compared to patients with HbA1c <7% (29.7 ± 10.2 vs 28.1 ± 9.9 ng/ml, p = 0.003) and 25(OH)D levels seems to predict 1.5% of HbA1c behavior. The 25(OH)D concentrations in patients with normoalbuminuria were higher than the levels observed in those with micro or macroalbuminuria (29.8 ± 9.0 vs 26.8 ± 8.6 and 25.1 ± 7.6, respectively, p = 0.001), patients who had 25(OH)D <20 ng/ml and 25(OH)D <30 ng/ml were at a higher risk of presenting albuminuria [OR = 2.8 (95% CI = 1.6 - 4.9), p<0.001, and OR = 2.1 (95% CI = 1.3 - 4.6), p<0.001, respectively]. In our regression model, albuminuria was influenced by HbA1c (r² = 0.076, p<0.00001) and 25(OH)D (r² = 0.018, p = 0.002) independently. CONCLUSION Our study found an association between vitamin D levels, HbA1c and DKD. Additionally, our data suggest that the association between urinary albumin excretion and vitamin D levels is independent of glycemic control in patients with diabetes. Even though our patients presented normal creatinine levels, it is necessary further prospective studies to confirm if this association precedes or not the loss of renal function.
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35
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Zhang Y, Sherwin CM, Gonzalez D, Zhang Q, Khurana M, Fisher J, Burckart GJ, Wang Y, Yao LP, Ganley CJ, Wang J. Creatinine-Based Renal Function Assessment in Pediatric Drug Development: An Analysis Using Clinical Data for Renally Eliminated Drugs. Clin Pharmacol Ther 2020; 109:263-269. [PMID: 32696977 DOI: 10.1002/cpt.1991] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/30/2020] [Indexed: 11/09/2022]
Abstract
The estimated glomerular filtration rate (eGFR) equations based on serum creatinine (SCR) have been used for pediatric dose adjustment in drug labeling. This study evaluated the performance of those equations in estimating individual clearance of drugs that are predominantly eliminated by glomerular filtration, using clinical data from the renally eliminated drugs gadobutrol, gadoterate, amikacin, and vancomycin. The eGFR was compared with the observed drug clearance (CL) in 352 pediatric patients from birth to 12 years of age. Multiple eGFR equations overestimated the drug CL on average, including the original and bedside Schwartz equations, which showed an average eGFR/CL ratio between 1 and 3. Further analysis with bedside Schwartz equation showed a higher eGFR/CL ratio in the subjects with a lower SCR or CL. Supraphysiological eGFR as high as 380 mL/min/1.73 m2 was obtained using the bedside Schwartz equation for some of the subjects, most of whom are children < 2 years of age with SCR < 0.2 mg/dL. Excluding the subjects with supraphysiological eGFR from the analysis did not change the overall trend of overestimation. In conclusion, Schwartz equations led to an overestimation of drug clearance for the drugs evaluated. When greater precision is required in predicting eGFR for pediatric patients, such as in drug dosing, revised k constants for the Schwartz equation or new methods of glomerular filtration rate estimation may be necessary.
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Affiliation(s)
- Yifei Zhang
- Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Catherine M Sherwin
- Department of Pediatrics, Wright State University School of Medicine, Dayton Children's Hospital, Dayton, Ohio, USA
| | - Daniel Gonzalez
- Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Qunshu Zhang
- Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Mona Khurana
- Division of Pediatric and Maternal Health, Office of Drug Evaluation IV, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jeffrey Fisher
- Division of Biochemical Toxicology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas, USA
| | - Gilbert J Burckart
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Yaning Wang
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Lynne P Yao
- Division of Pediatric and Maternal Health, Office of Drug Evaluation IV, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Charles J Ganley
- Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jian Wang
- Office of Drug Evaluation IV, Office of New Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
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36
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Kolouchova K, Jirak D, Groborz O, Sedlacek O, Ziolkowska N, Vit M, Sticova E, Galisova A, Svec P, Trousil J, Hajek M, Hruby M. Implant-forming polymeric 19F MRI-tracer with tunable dissolution. J Control Release 2020; 327:50-60. [PMID: 32730953 DOI: 10.1016/j.jconrel.2020.07.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 07/13/2020] [Accepted: 07/15/2020] [Indexed: 12/29/2022]
Abstract
Magnetic resonance imaging (MRI) using 19F-based tracers has emerged as a promising multi-purpose noninvasive diagnostic tool and its application requires the use of various 19F-based tracers for the intended diagnostic purpose. In this study, we report a series of double-stimuli-responsive polymers for use as injectable implants, which were designed to form implants under physiological conditions, and to subsequently dissolve with different dissolution rates (t1/2 ranges from 30 to more than 250 days). Our polymers contain a high concentration of fluorine atoms, providing remarkable signal detectability, and both a hydrophilic monomer and a pH-responsive monomer that alter the biodistribution properties of the implant. The implant location and dissolution were observed using 19F MRI, which allows the anatomic extent of the implant to be monitored. The dissolution kinetics and biocompatibility of these materials were thoroughly analyzed. No sign of toxicity in vitro or in vivo or pathology in vivo was observed, even in chronic administration. The clinical applicability of our polymers was further confirmed via imaging of a rat model by employing an instrument currently used in human medicine.
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Affiliation(s)
- Kristyna Kolouchova
- Institute of Macromolecular Chemistry CAS, Heyrovsky Square 2, 162 06 Prague 6, Czech Republic; Department of Physical and Macromolecular Chemistry, Faculty of Science, Charles University, Hlavova 8, Prague 2 128 00, Czech Republic
| | - Daniel Jirak
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague 4, Czech Republic; Department of Science and Research, Faculty of Health Studies, Technical University of Liberec, Studentska 1402/2, 461 17 Liberec, Czech Republic.
| | - Ondrej Groborz
- Institute of Macromolecular Chemistry CAS, Heyrovsky Square 2, 162 06 Prague 6, Czech Republic; Department of Organic Chemistry, Charles University, Faculty of Science, Hlavova 8, 128 43 Prague 2, Czech Republic; Institute of Biophysics and Informatics, Charles University, First Faculty of Medicine, Salmovská 1, 120 00 Prague 2, Czech Republic; Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Flemingovo square 542/2, 162 06 Prague 6, Czech Republic
| | - Ondrej Sedlacek
- Department of Organic and Macromolecular Chemistry, Ghent University, Krijgslaan 281-S4, 9000 Ghent, Belgium
| | - Natalia Ziolkowska
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague 4, Czech Republic; Institute of Biophysics and Informatics, Charles University, First Faculty of Medicine, Salmovská 1, 120 00 Prague 2, Czech Republic
| | - Martin Vit
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague 4, Czech Republic; Technical University of Liberec, Faculty of Mechatronics Informatics and Interdisciplinary Studies, Studentska 1402/2, 461 17 Liberec, Czech Republic
| | - Eva Sticova
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague 4, Czech Republic
| | - Andrea Galisova
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague 4, Czech Republic
| | - Pavel Svec
- Institute of Macromolecular Chemistry CAS, Heyrovsky Square 2, 162 06 Prague 6, Czech Republic; Department of Physical and Macromolecular Chemistry, Faculty of Science, Charles University, Hlavova 8, Prague 2 128 00, Czech Republic
| | - Jiri Trousil
- Institute of Macromolecular Chemistry CAS, Heyrovsky Square 2, 162 06 Prague 6, Czech Republic
| | - Milan Hajek
- Department of Diagnostic and Interventional Radiology, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague 4, Czech Republic
| | - Martin Hruby
- Institute of Macromolecular Chemistry CAS, Heyrovsky Square 2, 162 06 Prague 6, Czech Republic.
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Yildirimel M, Atalar MN, Abusoglu S, Eryavuz Onmaz D, Sivrikaya A, Abusoglu G, Unlu A. Measurement of serum creatinine levels with liquid chromatography-tandem mass spectrometry: comparison with Jaffe and enzymatic methods. ACTA ACUST UNITED AC 2020. [DOI: 10.1515/tjb-2019-0357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
Objectives
Our aim was to validate a mass spectrometric creatinine method and compare this method with Jaffe and enzymatic serum creatinine methods.
Methods
90 samples were included. The levels were classified into three groups according to serum creatinine results as Group 1: Lower (n=30) (0.16–0.59 mg/dL), Group 2: Normal (n=30) (0.62–1.18 mg/dL) and Group 3: Higher (n=30) (1.33–3.88 mg/dL). Jaffe and enzymatic creatinine measurements were performed on the Beckman Coulter AU5800 autoanalyzer.
Results
Serum creatinine was linear from 0.039 up to 10 mg/dL, CV and bias values were ranged between 1.9–3.8% and 2–15%. Correlation coefficients were 0.990 (95% confidence interval 0.984–0.993), 0.992 (95% confidence interval 0.988–0.995) and 0.994 (95% confidence interval 0.991–0.996) for LC-MS/MS-Enzymatic, LC-MS/MS-Jaffe and Enzymatic-Jaffe, respectively.
Conclusions
Although, Jaffe method for serum creatinine measurement is still much more practical and cheap, so in use for routine practice, tandem mass spectrometric detection of serum creatinine can be used as an accurate and specific method for verification of discordant clinical results, existence of possible interferences and serum levels under 0.5 mg/dL creatinine results such as pediatric or pregnant populations.
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Affiliation(s)
- Mehmet Yildirimel
- Selcuk University Faculty of Medicine , Department of Biochemistry , Konya , Turkey
| | - Mehmet Nuri Atalar
- Igdir University , Faculty of Science and Letters , Department of Biochemistry , Igdir , Turkey
| | - Sedat Abusoglu
- Selcuk University Faculty of Medicine , Department of Biochemistry , Konya , Turkey
| | - Duygu Eryavuz Onmaz
- Selcuk University Faculty of Medicine , Department of Biochemistry , Konya , Turkey
| | - Abdullah Sivrikaya
- Selcuk University Faculty of Medicine , Department of Biochemistry , Konya , Turkey
| | - Gulsum Abusoglu
- Selcuk University Vocational School of Health , Department of Medical Laboratory Techniques , Konya , Turkey
| | - Ali Unlu
- Selcuk University Faculty of Medicine , Department of Biochemistry , Konya , Turkey
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Chikomba CE, Padoa CJ, Tanyanyiwa D. Evaluation of the impact of delayed centrifugation on the diagnostic performance of serum creatinine as a baseline measure of renal function before antiretroviral treatment. South Afr J HIV Med 2020; 21:1056. [PMID: 32832109 PMCID: PMC7433244 DOI: 10.4102/sajhivmed.v21i1.1056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/11/2020] [Indexed: 01/01/2023] Open
Abstract
Background The measurement of serum creatinine is a standard requirement of the medical management of people living with HIV. Renal dysfunction is common, both as a complication of HIV-infection and as a result of its treatment. The detection of abnormal renal function before the start of antiretroviral therapy will impact patient management and the outcome of treatment. Objectives This study aimed to determine if a time delay in the centrifugation of serum samples affected the creatinine level and the estimated glomerular filtration rate as recorded on the analytical platforms used in the laboratory. Methods Twenty-two (n = 22) HIV-positive, newly diagnosed and treatment-naïve patients were randomly recruited from Alexandra Health Clinic, Johannesburg, South Africa. Serum samples were centrifuged at six time intervals following receipt of the sample viz. < 4 h (baseline), 6 h, 24 h, 48 h, 72 h and 96 h. Creatinine concentrations were measured on the Roche platform utilising the enzymatic and kinetic Jaffe methods. Whole blood samples were also analysed with the Abbott i-STAT point-of-care instrument. The estimated glomerular filtration rate was calculated using the Cockcroft Gault, CKD-Epidemiology Collaboration and Modified Diet and Renal Disease v3/4 equations. Results At baseline (< 4 h) there was good agreement between the enzymatic and kinetic Jaffe methods: bias 1.7 µmol/l. The enzymatic and i-STAT creatinine concentrations were stable over 96 h viz. changes of 1.8% and 5.7%. However, from 24 h onwards agreement between the enzymatic and kinetic Jaffe methods was poor with the latter measuring 43.7 µmol/l higher than the enzymatic method at 96 h. Creatinine concentrations measured with the kinetic Jaffe method increased significantly in samples centrifuged after 6 h (p < 0.001, 61.7% change), and resulted in a 95% decline in eGFR at 96 h as determined with the CKD-Epidemiology Collaboration equation. Conclusion The analysis of serum creatinine using the isotope dilution mass spectrometry traceable kinetic Jaffe method is unreliable if performed on samples centrifuged ≥ 6 h after collection. The raised creatinine concentration can affect clinical decisions such as renal functional assessment, choice of antiretroviral drug or regimen, and the dose and frequency of medication.
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Affiliation(s)
- Chemedzai E Chikomba
- Department of Chemical Pathology, National Health Laboratory Services, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Carolyn J Padoa
- Department of Chemical Pathology, National Health Laboratory Services, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
| | - Donald Tanyanyiwa
- Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Science, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Piestansky J, Galba J, Kovacech B, Parrak V, Kovac A, Mikuš P. Capillary electrophoresis and ultra‐high‐performance liquid chromatography methods in clinical monitoring of creatinine in human urine: A comparative study. Biomed Chromatogr 2020; 34:e4907. [DOI: 10.1002/bmc.4907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Juraj Piestansky
- Department of Pharmaceutical Analysis and Nuclear Pharmacy Comenius University in Bratislava Bratislava Slovak Republic
- Toxicological and Antidoping Center Comenius University in Bratislava Bratislava Slovak Republic
| | - Jaroslav Galba
- Department of Pharmaceutical Analysis and Nuclear Pharmacy Comenius University in Bratislava Bratislava Slovak Republic
- AXON Neuroscience R&D Bratislava Slovak Republic
| | - Branislav Kovacech
- AXON Neuroscience R&D Bratislava Slovak Republic
- Institute of Neuroimmunology, Slovak Academy of Science Bratislava Slovak Republic
| | - Vojtech Parrak
- AXON Neuroscience R&D Bratislava Slovak Republic
- Institute of Neuroimmunology, Slovak Academy of Science Bratislava Slovak Republic
| | - Andrej Kovac
- AXON Neuroscience R&D Bratislava Slovak Republic
- Institute of Neuroimmunology, Slovak Academy of Science Bratislava Slovak Republic
| | - Peter Mikuš
- Department of Pharmaceutical Analysis and Nuclear Pharmacy Comenius University in Bratislava Bratislava Slovak Republic
- Toxicological and Antidoping Center Comenius University in Bratislava Bratislava Slovak Republic
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Sodium-Glucose Cotransporter 2 Inhibitors and Kidney Outcomes: True Renoprotection, Loss of Muscle Mass or Both? J Clin Med 2020; 9:jcm9051603. [PMID: 32466262 PMCID: PMC7291210 DOI: 10.3390/jcm9051603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/18/2020] [Accepted: 05/21/2020] [Indexed: 02/06/2023] Open
Abstract
Inhibitors of sodium-glucose cotransporter 2 (SGLT2) have emerged as practice-changing treatments for patients with type 2 diabetes, reducing both the risk of cardiovascular events and kidney events. However, regarding the latter, caution is warranted, as these kidney endpoints are defined using glomerular filtration rate estimations based on creatinine, the non-enzymatic product of creatine residing in muscles. Creatinine-based estimations of the glomerular filtration rate are only valid if the treatment has no effect on changes in muscle mass over time. Yet, circumstantial evidence suggests that treatment with SGLT2 inhibitors does result in a loss of muscle mass, rendering serum creatinine-based kidney endpoints invalid. Currently, it cannot be excluded that the described renoprotective effect of SGLT2 inhibitors is in part or in whole the consequence of a loss of muscle mass. Post-hoc analyses of existing trials or new trials based on kidney function markers independent of muscle mass can provide more definitive answers on the proposed renoprotective effects of SGLT2 inhibitors.
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Wen X, Xiong Y, Jin L, Zhang M, Huang L, Mao Y, Zhou C, Qiao Y, Zhang Y. Bisphenol A Exposure Enhances Endometrial Stromal Cell Invasion and Has a Positive Association with Peritoneal Endometriosis. Reprod Sci 2020; 27:704-712. [PMID: 32046440 DOI: 10.1007/s43032-019-00076-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/02/2019] [Indexed: 11/25/2022]
Abstract
Results of previous epidemiology studies on BPA exposure and endometriosis (EMs) risk were inconsistent, and were limited by inappropriate control selection, incorrect BPA detection method, and the generalization of different subtypes of EMs. Upregulated matrix metalloproteinase (MMP) 2 and MMP9 are involved in the development of EMs. We conducted a case-control study among 120 EMs patients and 100 healthy women to evaluate the relationships between BPA exposure and MMP2, MMP9 expressions, and the risk of EMs subtypes. Besides, we used human endometrial stromal cell lines (HESCs) to investigate the underlying mechanisms. Creatinine-adjusted urinary BPA concentrations were positively correlated with serum MMP2, MMP9 levels, and the risk of peritoneal EMs (third vs lowest quartile: OR 4.92, 95% CI 1.47, 16.50; fourth versus lowest quartile: OR 3.70, 95% CI 1.07, 12.74, Ptrend = 0.030). The risk of peritoneal EMs increased approximately tenfold when creatinine-adjusted urinary BPA concentration was 2 μg/g. In vitro study found that BPA exposure increased MMP2, MMP9 expressions in a dose-dependent manner. The effects of BPA on HESCs could be blocked by G protein-coupled estrogen receptor (GPER) inhibitor or mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) inhibitor. This study provides evidence that BPA exposure promotes peritoneal EMs, and raises a concern about the potential toxicity of BPA on the female reproductive system.
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Affiliation(s)
- Xue Wen
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
| | - Yao Xiong
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
| | - Ling Jin
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
| | - Ming Zhang
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
| | - Lei Huang
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
| | - Yanhong Mao
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
| | - Chun Zhou
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
| | - Yuan Qiao
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China
| | - Yuanzhen Zhang
- Reproductive Medicine Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China.
- Hubei Clinical Research Center for Prenatal Diagnosis and Birth Health, Wuhan, 430071, Hubei, People's Republic of China.
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China.
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42
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Huang Z, Scotland KB, Li Y, Guo J, McGeer PL, Lange D, Chen DDY. Application of multisegment injection on quantification of creatinine and standard addition analysis of urinary 5‐hydroxyindoleacetic acid simultaneously with creatinine normalization. Electrophoresis 2020; 41:183-193. [DOI: 10.1002/elps.201900456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/07/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Zi‐Ao Huang
- Department of ChemistryUniversity of British Columbia Vancouver British Columbia Canada
| | - Kymora B. Scotland
- Department of Urologic Sciences, The Stone Centre at Vancouver General HospitalUniversity of British Columbia Vancouver British Columbia Canada
| | - Yueyang Li
- Department of ChemistryUniversity of British Columbia Vancouver British Columbia Canada
| | - Jian‐Ping Guo
- Aurin Biotech Inc. Vancouver British Columbia Canada
| | | | - Dirk Lange
- Department of Urologic Sciences, The Stone Centre at Vancouver General HospitalUniversity of British Columbia Vancouver British Columbia Canada
| | - David D. Y. Chen
- Department of ChemistryUniversity of British Columbia Vancouver British Columbia Canada
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43
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Non-enzymatic electrochemical determination of creatinine using a novel screen-printed microcell. Talanta 2020; 207:120277. [DOI: 10.1016/j.talanta.2019.120277] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 08/13/2019] [Accepted: 08/16/2019] [Indexed: 01/30/2023]
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44
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Love SA, Schulz K, Stack P, Abdirizak S, Souriyayong M, Malhotra R, Xu C, Pamidi PVA. Clinical Evaluation of a New Point-of-Care System for Chemistry Panel Testing. J Appl Lab Med 2019; 4:180-192. [DOI: 10.1373/jalm.2019.029900] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/04/2019] [Indexed: 11/06/2022]
Abstract
Abstract
Background
GEM Premier ChemSTAT™ is a point-of-care (POC) system that measures Na+, K+, Ca++, Cl−, glucose, hematocrit, creatinine, blood urea nitrogen (BUN), tCO2, pH, pCO2, and lactate from a single whole blood specimen, providing rapid results in POC settings such as the emergency department (ED). Accurate measurements of creatinine in whole blood and reporting of estimated glomerular filtration rate (eGFR) can minimize adverse effects of contrast-induced nephropathy.
Methods
Heparinized whole blood specimens from the ED were analyzed on the ChemSTAT by POC staff. Method comparison was performed against the cobas Integra c501 for creatinine, BUN, and tCO2, and against the GEM Premier 4000 for all other analytes. Precision was conducted with whole blood specimens assayed in triplicate over 6 days. Creatinine results from whole blood and plasma were used for eGFR, by isotope dilution mass spectrometry-traceable Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations, and eGFR concordance was assessed.
Results
Creatinine, BUN, and tCO2 correlated well with plasma samples on the cobas, and all other analytes correlated well with whole blood specimens on the GEM Premier 4000 across the tested sample ranges. The regression slope was 0.951 to 1.047, along with a correlation coefficient (r) of ≥0.982 for all analytes. The pooled within-sample precision was 0% to 2.5% for all analytes.
Conclusions
ChemSTAT demonstrated a strong correlation with the comparative methods and excellent precision. The system's analytical performance and continuous quality management make it suitable for use in the ED to provide rapid reliable test results, which could minimize the time to treatment and improve ED efficiency.
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Affiliation(s)
- Sara A Love
- Department of Laboratory Medicine and Pathology, Hennepin Healthcare, Minneapolis, MN
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Karen Schulz
- Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN
| | - Penney Stack
- Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN
| | - Sharifa Abdirizak
- Hennepin Healthcare Research Institute, Hennepin Healthcare, Minneapolis, MN
| | | | | | - Clarke Xu
- Instrumentation Laboratory, Bedford, MA
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45
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Krausz AD, Dewar R, Burns MA. Accuracy Evaluation of a Tetrabromophenolphthalein Ethyl Ester Colorimetric Assay for Urinary Albumin. J Appl Lab Med 2019; 4:201-213. [PMID: 31639665 DOI: 10.1373/jalm.2019.030031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/08/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND The tetrabromophenolphthalein ethyl ester (TBPE) assay has been used to quantify urinary albumin in point-of-care devices. We assessed the accuracy of this TBPE assay for urinary albumin through comparison with an established immunoturbidimetric method (ADVIA 1800 Chemistry System, Siemens). METHODS We developed a TBPE assay protocol to quantify albumin in the range associated with microalbuminuria (0-200 mg/L). The Jaffe reaction and a 3-dimensional (3D) surface were used to compensate for creatinine interference. Spiked simulated urine samples and patient samples were used to compare the TBPE assay with the immunoturbidimetric method. Multiple linear regression was used to analyze factors that could account for discrepancies between the 2 methods. RESULTS We found that creatinine interfered with the TBPE assay. To compensate, a 3D surface was successfully used to quantify albumin in spiked deionized water and simulated urine samples. In spiked simulated urine samples, the immunoturbidimetric method underestimated the albumin concentration by 2 to 45 mg/L, and the TBPE assay overestimated it by 9 to 82 mg/L. In patient samples, the albumin concentrations measured with the TBPE assay and the immunoturbidimetric method differed by an average of 184 mg/L. CONCLUSIONS The TBPE assay is a function of the creatinine concentration, and a 3D surface can be used to provide accurate albumin concentrations for standard samples. The corrected TBPE method and the immunoturbidimetric method deviated from known concentrations of spiked samples. Further investigation and comparisons with a third albumin measurement method, such as LC-MS/MS, are necessary before conclusions on the accuracy of the TBPE assay can be made.
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Affiliation(s)
- Alyse D Krausz
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI
| | - Rajan Dewar
- Michigan Medicine, Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Mark A Burns
- Department of Chemical Engineering, University of Michigan, Ann Arbor, MI.
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46
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Hu X, Liu F, Li W, Wang X, Deng H. Sensitive Detection of Serum Creatinine Based on β-Cyclodextrin-Ferrocenylmethanol Modified Screen-printed Electrode. ANAL SCI 2019; 35:903-909. [PMID: 31061240 DOI: 10.2116/analsci.19p015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Ferrocenylmethanol (Fc-OH) is included in β-cyclodextrin (β-CD) to form the β-CD-Fc-OH complex by host-guest supramolecular interaction. β-CD dissociates from the β-CD-Fc-OH complex due to the conversion of Fc-OH to Fc+-OH under a stimulus of oxidant. In our study, Fc-OH is oxidized after a series of enzymatic reactions of creatinine, which blocks the other means for oxidation of Fc-OH. And the background noise is reduced for testing for serum creatinine (sCr). The chronoamperometry signal for creatinine (with a constant potential -0.3 V vs. Ag/AgCl) increases linearly in the 1 - 1000 μM range, with a limit of detection as low as 0.5 μM. The amperometric potential of -0.3 V greatly prevents the interference of various redox substances in serum. The biosensor was used to test 120 clinical specimens and the results showed a linear correlation with the biochemical analyzer (R2 = 0.9885). The biosensor could be applied to clinical trials and offers good prospects for clinical sCr detection.
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Affiliation(s)
- Xinmin Hu
- Department of Laboratory Medicine, The Third Xiangya Hospital, Central South University
| | - Fang Liu
- Clinical Laboratory, Changsha Central Hospital
| | - Wenti Li
- Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University
| | - Xiaochun Wang
- Department of Laboratory Medicine, The Third Xiangya Hospital, Central South University
| | - Hongyu Deng
- Clinical Laboratory, Hunan Cancer Hospital & The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University
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47
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Itoh H, Wang RS, Maki S, Niu Q, Shang H, Su Y, Weng Z, Saito H, Miura N, Takahashi M. Effects of work schedule and period of exposure on changes in urinary chromium and nickel excretion among rotating shift workers in a stainless-steel plant. Chronobiol Int 2019; 36:1439-1446. [PMID: 31368363 DOI: 10.1080/07420528.2019.1645159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We investigated the association between the period of exposure and changes in urinary excretion of chromium and nickel among rotating shift workers in a stainless-steel plant. The study participants were composed of two groups: the workers who were occupationally exposed to metals ("exposed group") and those who were not occupationally exposed to metals ("unexposed group"). The exposed and unexposed groups consisted of 56 and 40 male rotating shift workers, respectively. Urine samples were collected immediately before and immediately after the day shift, evening shift, and night shift. Urinary chromium and nickel were measured using inductively coupled plasma mass spectrometry. To correct for variations in urine dilution, urinary metal concentrations were expressed as a ratio to urinary creatinine concentration. In the exposed group, post-shift urinary excretion of chromium was significantly higher than pre-shift excretion. However, although urinary chromium excretion clearly increased after the day and night shift [63% (p < .0001) and 87% (p < .0001), respectively], urinary chromium excretion after the evening shift was only slightly higher than that measured before the evening shift (8%, p = .028). Similar patterns were found for urinary nickel excretion (p = .0001, 0.20, and 0.18 for the day, evening, and night shifts, respectively). Non-uniform urinary excretion of metals between the day shift, evening shift, and night shift were observed in the exposed group; specifically, urinary metal excretion increased only slightly during the evening shift. In the unexposed group, no significant increase or decrease was found in median urinary chromium or nickel excretion (p= .63-0.87). Work shift-specific permissible exposure level would be necessary.
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Affiliation(s)
- Hiroaki Itoh
- Department of Epidemiology and Environmental Health, Juntendo University Faculty of Medicine , Tokyo , Japan.,Graduate School of Environment and Information Sciences, Yokohama National University , Yokohama , Japan.,National Institute of Occupational Safety and Health , Tama-ku, Kawasaki , Japan
| | - Rui-Sheng Wang
- National Institute of Occupational Safety and Health , Tama-ku, Kawasaki , Japan
| | - Syou Maki
- National Institute of Occupational Safety and Health , Tama-ku, Kawasaki , Japan.,Laboratory of Molecular Chemistry, Faculty of Pharmacy, Osaka Ohtani University , Osaka Pref , Japan
| | - Qiao Niu
- Department of Occupational and Environmental Health, Shanxi Medical University , Taiyuan , China
| | - Huizhen Shang
- Center for Disease Control and Prevention, Taiyuan Steel and Iron Limited Co , Taiyuan , China
| | - Yougong Su
- General Hospital, Taiyuan Steel and Iron Limited Co , Taiyuan , China
| | - Zuquan Weng
- National Institute of Occupational Safety and Health , Tama-ku, Kawasaki , Japan.,College of Biological Science and Engineering, Fuzhou University , Fuzhou , China
| | - Hiroyuki Saito
- National Institute of Occupational Safety and Health , Tama-ku, Kawasaki , Japan
| | - Nobuhiko Miura
- National Institute of Occupational Safety and Health , Tama-ku, Kawasaki , Japan
| | - Masaya Takahashi
- National Institute of Occupational Safety and Health , Tama-ku, Kawasaki , Japan
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48
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Charlton JR, Boohaker L, Askenazi D, Brophy PD, Fuloria M, Gien J, Griffin R, Hingorani S, Ingraham S, Mian A, Ohls RK, Rastogi S, Rhee CJ, Revenis M, Sarkar S, Starr M, Kent AL. Late onset neonatal acute kidney injury: results from the AWAKEN Study. Pediatr Res 2019; 85:339-348. [PMID: 30546043 PMCID: PMC6438709 DOI: 10.1038/s41390-018-0255-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/19/2018] [Accepted: 11/23/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Most studies of neonatal acute kidney injury (AKI) have focused on the first week following birth. Here, we determined the outcomes and risk factors for late AKI (>7d). METHODS The international AWAKEN study examined AKI in neonates admitted to an intensive care unit. Late AKI was defined as occurring >7 days after birth according to the KDIGO criteria. Models were constructed to assess the association between late AKI and death or length of stay. Unadjusted and adjusted odds for late AKI were calculated for each perinatal factor. RESULTS Late AKI occurred in 202/2152 (9%) of enrolled neonates. After adjustment, infants with late AKI had higher odds of death (aOR:2.1, p = 0.02) and longer length of stay (parameter estimate: 21.9, p < 0.001). Risk factors included intubation, oligo- and polyhydramnios, mild-moderate renal anomalies, admission diagnoses of congenital heart disease, necrotizing enterocolitis, surgical need, exposure to diuretics, vasopressors, and NSAIDs, discharge diagnoses of patent ductus arteriosus, necrotizing enterocolitis, sepsis, and urinary tract infection. CONCLUSIONS Late AKI is common, independently associated with poor short-term outcomes and associated with unique risk factors. These should guide the development of protocols to screen for AKI and research to improve prevention strategies to mitigate the consequences of late AKI.
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Affiliation(s)
| | - Louis Boohaker
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Askenazi
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patrick D Brophy
- Golisano Children's Hospital, University of Rochester School of Medicine, Rochester, NY, USA
| | - Mamta Fuloria
- The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jason Gien
- University of Colorado, Children's Hospital Colorado, Aurora, CO, USA
| | | | | | - Susan Ingraham
- Kapi'olani Medical Center for Women and Children, Honolulu, HI, USA
| | - Ayesa Mian
- Golisano Children's Hospital, University of Rochester School of Medicine, Rochester, NY, USA
| | | | | | | | - Mary Revenis
- Children's National Medical Center, The George Washington University School of Medicine and The Health Sciences, Washington, DC, USA
| | - Subrata Sarkar
- C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Michelle Starr
- Seattle Children's Hospital/University of Washington, Seattle, WA, USA
| | - Alison L Kent
- Golisano Children's Hospital, University of Rochester School of Medicine, Rochester, NY, USA
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49
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Srithunyarat T, Svensson A, Hanås S, Höglund OV, Hagman R, Lilliehöök I, Olsson U, Ljungvall I, Häggström J, Ström Holst B, Pettersson A, Höglund K. Evaluation of an ELISA for metanephrines in feline urine. J Vet Diagn Invest 2018; 30:887-893. [PMID: 30136903 DOI: 10.1177/1040638718793168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Catecholamines can be used to evaluate neuroendocrine tumors, stress, and potentially pain, but catecholamines degrade rapidly. Their metabolites normetanephrine (NME) and metanephrine (ME) have better stability in urine. In cats, urine sampling in a home environment would be beneficial to reduce effects of clinical stress and simplify sampling. We evaluated a human urine ELISA for analysis of NME and ME in feline urine, and investigated the effects of acidification, cat tray pellets, and storage time at room temperature up to 8.5 h. In 26 feline urine samples, mean NME concentration was 192 ± 80 ng/mL, mean intra- and inter-assay CV was 6.5% and 4.2%, respectively, and spike recovery was 98-101%, but dilutional recovery was unsatisfactory. For ME, mean intra- and inter-assay CV was 10.2% and 4.1%, respectively. Mean urine ME concentration was 32.1 ± 18.3 ng/mL, close to the kit's lowest standard, and spike recovery was 65-90%; the ELISA could not be validated for ME. The stability study, performed for NME on 12 urine samples, did not identify differences between acidified and non-acidified samples, cat tray pellets, or storage time, and no interaction effects. The ME ELISA was not suitable for feline urine; performance of the NME ELISA was acceptable, except for dilution recovery. For analysis of NME, feline urine can be sampled at home using cat tray pellets and stored at room temperature up to 8.5 h without acidification.
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Affiliation(s)
- Thanikul Srithunyarat
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Department of Surgery and Theriogenology, Khon Kaen University, Khon Kaen, Thailand
| | - Anna Svensson
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Sofia Hanås
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden.,Evidensia Animal Clinic, Västerås, Sweden
| | - Odd V Höglund
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ragnvi Hagman
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Inger Lilliehöök
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ulf Olsson
- Unit of Applied Statistics and Mathematics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ingrid Ljungvall
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Jens Häggström
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Bodil Ström Holst
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Ann Pettersson
- Departments of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Katja Höglund
- Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
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50
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Küme T, Sağlam B, Ergon C, Sisman AR. Evaluation and comparison of Abbott Jaffe and enzymatic creatinine methods: Could the old method meet the new requirements? J Clin Lab Anal 2017; 32. [PMID: 28205269 DOI: 10.1002/jcla.22168] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 01/14/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The aim of this study is to evaluate and compare the analytical performance characteristics of the two creatinine methods based on the Jaffe and enzymatic methods. METHODS Two original creatinine methods, Jaffe and enzymatic, were evaluated on Architect c16000 automated analyzer via limit of detection (LOD) and limit of quantitation (LOQ), linearity, intra-assay and inter-assay precision, and comparability in serum and urine samples. The method comparison and bias estimation using patient samples according to CLSI guideline were performed on 230 serum and 141 urine samples by analyzing on the same auto-analyzer. RESULTS The LODs were determined as 0.1 mg/dL for both serum methods and as 0.25 and 0.07 mg/dL for the Jaffe and the enzymatic urine method respectively. The LOQs were similar with 0.05 mg/dL value for both serum methods, and enzymatic urine method had a lower LOQ than Jaffe urine method, values at 0.5 and 2 mg/dL respectively. Both methods were linear up to 65 mg/dL for serum and 260 mg/dL for urine. The intra-assay and inter-assay precision data were under desirable levels in both methods. The higher correlations were determined between two methods in serum and urine (r=.9994, r=.9998 respectively). On the other hand, Jaffe method gave the higher creatinine results than enzymatic method, especially at the low concentrations in both serum and urine. CONCLUSIONS Both Jaffe and enzymatic methods were found to meet the analytical performance requirements in routine use. However, enzymatic method was found to have better performance in low creatinine levels.
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Affiliation(s)
- Tuncay Küme
- Medical Biochemistry Department, Dokuz Eylül University Medical Faculty, Izmir, Turkey.,Central Laboratory, Dokuz Eylül University Hospital, Izmir, Turkey
| | - Barıs Sağlam
- Biochemistry Laboratory, Biga State Hospital, Çanakkale, Turkey
| | - Cem Ergon
- Central Laboratory, Dokuz Eylül University Hospital, Izmir, Turkey.,Medical Microbiology Department, Dokuz Eylül University Medical Faculty, Izmir, Turkey
| | - Ali Rıza Sisman
- Medical Biochemistry Department, Dokuz Eylül University Medical Faculty, Izmir, Turkey.,Central Laboratory, Dokuz Eylül University Hospital, Izmir, Turkey
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