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Sheeraz AS, Aiswarya E, Kumara BN, Sonia J, Rodrigues RV, Sheikh N, Vidyasagar S, Kunder RA, Elangovan S, Mohanty PS, Prasad KS. Additive-manufactured paper-PMMA hybrid microfluidic chip for simultaneous monitoring of creatinine and pH in artificial urine. Analyst 2024; 149:3882-3890. [PMID: 38973472 DOI: 10.1039/d4an00796d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024]
Abstract
Nowadays, kidney dysfunction is a common health issue due to the modernized lifestyle. Even though medications are commercially available to treat kidney diseases, early diagnosis is crucial and challenging. Clinically, measuring urine creatinine and pH has gained significant interest as a way to diagnose kidney diseases early. In the present work, we attempted to develop a low-cost, robust, accurate and naked-eye colorimetric method to determine both creatinine levels and pH variations in artificial urine samples using a simple 3D-printed hybrid microfluidic device. Creatinine was detected by the incorporation of the traditional Jaffe test onto the hybrid paper-PMMA microfluidic device and pH (4-8) was measured by a simple anthocyanin test. Notably, the tests were established without employing any sophisticated or costly instrument clusters. The developed 3D-printed microfluidic probe showed a limit of detection (LOD) of 0.04 mM for creatinine over a concentration range of 1-10 mM, with a regression coefficient (R2) of 0.995 in laboratory conditions. Interestingly, the experimental data obtained with artificial urine exhibited a wide linear range from 0.1 mM to 5 mM under different pH values ranging from 4 to 8 in the presence of matrices commonly found in urine samples other than proteins, indicating the potential use of this method in pre-clinical analysis. Since the wide linear range of urine creatinine in artificial urine samples falls well below the clinically relevant concentrations in humans (0.07-0.27 mM), the developed lab-on-chip device is further suitable for clinical evaluation with proper ethical clearance. This 3D-printed hybrid microfluidic colorimetry-based creatinine detection and pH indicator platform can be beneficial in the healthcare sector due to the on-site testing capability, cost-effectiveness, ease of use, robustness, and instrument-free approach.
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Affiliation(s)
- Asim Syed Sheeraz
- School of Biotechnology, KIIT (Deemed to be University), Bhubaneswar, Odisha, India.
| | - Edoth Aiswarya
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
| | - B N Kumara
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
| | - J Sonia
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
| | - Relisha Viyona Rodrigues
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
| | - Nazmin Sheikh
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
| | - Sachin Vidyasagar
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
| | - Rachana A Kunder
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
| | - Selvakumar Elangovan
- School of Biotechnology, KIIT (Deemed to be University), Bhubaneswar, Odisha, India.
| | - Priti Sundar Mohanty
- School of Biotechnology, KIIT (Deemed to be University), Bhubaneswar, Odisha, India.
| | - K Sudhakara Prasad
- Nanomaterial research laboratory (NMRL), Nano Division, Yenepoya Research Centre, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575 018, India.
- Centre for Nutrition Studies, Yenepoya (Deemed to be University), Deralakatte, Mangalore 575018, India
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Hormozi Jangi SR. Developing a label-free full-range highly selective pH nanobiosensor using a novel high quantum yield pH-responsive activated-protein-protected gold nanocluster prepared by a novel ultrasonication-protein-assisted procedure. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 322:124829. [PMID: 39018671 DOI: 10.1016/j.saa.2024.124829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/02/2024] [Accepted: 07/13/2024] [Indexed: 07/19/2024]
Abstract
A novel, label-free, ultra-selective, reproducible, and reversible pH nanobiosensor was developed for analyzing biofluids, food samples, and real water media utilizing a novel activated-protein-protected gold nanocluster with an ultra-narrow emission band, termed as ABSA-AuNCs. The ABSA-AuNCs were synthesized via a novel ultrasonication-protein-assisted procedure, for the first time, using activated bovine serum albumin as both capping and reducing agents. The ABSA-AuNCs revealed a highly narrow symmetric emission spectrum (λmax = 330.0 nm upon excitation at 312-317 nm), and a highly narrow size distribution of 2.9-3.7 nm along with an enhanced quantum yield of 28.3 %. At present, with a full width at half maximum (FWHM) of 14.0 nm, ABSA-AuNCs have the narrowest bandwidth of fluorescent nanomaterials reported to date. The ABSA-AuNCs were characterized for their stability, size, morphology, crystallinity, structural, and optical properties. The ABSA-AuNCs were found to be appropriate for constructing a label-free ultraselective pH nanobiosensor. A linear range over 2.0-11.0, fast response time of less than 5 s, and long-term stability of 99.7 % after 500 min were achieved. The %RSD for repeatability, intra-day reproducibility, and inter-day reproducibility was found to be 1.4 %, 1.7 %, and 2.3 %, in order, to reveal high repeatable and reproducible results. The selectivity of the pH biosensor was evaluated upon the addition of different interferents, indicating an excellent pH selectivity for the ABSA-AuNCs. Real sample analysis proved the feasibility of the ABSA-AuNCs for accurate, precise, and reliable pH sensing in biofluids (undiluted blood and urine), a variety of food samples, and several real water samples.
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Wang C, Xue Q, Li H, Qi H, Li X. Urine multi-index intelligent detection based on polymer/paper hybrid microfluidic biochip for hyperuricemia monitoring. Anal Chim Acta 2024; 1312:342742. [PMID: 38834261 DOI: 10.1016/j.aca.2024.342742] [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: 03/12/2024] [Revised: 05/07/2024] [Accepted: 05/17/2024] [Indexed: 06/06/2024]
Abstract
Hyperuricemia (HUA) has gradually become a public health burden as an independent risk factor for a variety of chronic diseases. Herein, a user-friendly point-of-care (POC) detection system (namely "Smart-HUA-Monitor") based on smartphone-assisted paper-based microfluidic is proposed for colorimetric quantification of HUA urinary markers, including uric acid (UA), creatinine (CR) and pH. The detection limits of UA and CR were 0.0178 and 0.5983 mM, respectively, and the sensitivity of pH were 0.1. The method was successfully validated in artificial urine samples and 100 clinical samples. Bland-Altman plots showed a high consistency between μPAD and the testing instruments (HITACHI 7600 Automatic Analyzer, URIT-500B Urine Analyzer and AU5800B automatic biochemical analyzer) in hospital. Smart-HUA-Monitor provides an accurate quantitative, rapid, low-cost and reliable tool for the monitoring and early diagnosis of HUA urine indicators.
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Affiliation(s)
- Cuicui Wang
- Institute of Biomedical Precision Testing and Instrumentation, College of Biomedical Engineering, Taiyuan University of Technology, Jinzhong, Shanxi, 030600, China
| | - Qing Xue
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030000, China; Academy of Medical Sciences, Shanxi Medical University, Taiyuan, Shanxi, 030000, China
| | - Haiqin Li
- Institute of Biomedical Precision Testing and Instrumentation, College of Biomedical Engineering, Taiyuan University of Technology, Jinzhong, Shanxi, 030600, China.
| | - Hao Qi
- Department of Endocrinology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030000, China.
| | - Xiaochun Li
- Institute of Biomedical Precision Testing and Instrumentation, College of Biomedical Engineering, Taiyuan University of Technology, Jinzhong, Shanxi, 030600, China.
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Xue X, Sun M, Yan F, Dalbeth N, He Y, Li X, Qi H, Chen Y, Yuan X, Li M, Ji A, Terkeltaub R, Li C. Superiority of Low-Dose Benzbromarone Add-On to Low-Dose Febuxostat Compared With Febuxostat Monotherapy in Gout With Combined-Type Hyperuricemia. Arthritis Care Res (Hoboken) 2024; 76:703-711. [PMID: 38130040 PMCID: PMC11039362 DOI: 10.1002/acr.25283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/17/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE There is an unmet need for simpler urate-lowering therapy (ULT) regimens that achieve the serum urate target and improve the overall quality of gout care. We report a comparative effectiveness trial of febuxostat monotherapy versus benzbromarone add-on to low-dose febuxostat in gout specifically with combined renal urate underexcretion and overload. METHODS A prospective randomized trial was conducted on patients with combined-type hyperuricemia and estimated glomerular filtration rate >60 mL/min/1.73 m2 1:1 randomly assigned to febuxostat and benzbromarone combination therapy (initially febuxostat at 20 mg/day, with benzbromarone at 25 mg/day added onto 20 mg/day of febuxostat if not at target) or febuxostat monotherapy (initially 20 mg/day, escalating to 40 mg/day if not at target). The primary end point at 12 weeks was the proportion achieving a serum urate (SU) level <360 μmol/L. Other outcomes included altered liver and kidney function, new-onset urolithiasis, and gout flares. RESULTS There were 250 participants randomized; 219 completed 12-week treatment. More patients in the febuxostat and benzbromarone combination group achieved the SU target compared to patients in the febuxostat monotherapy group (75.5% vs 47.7%; odds ratio 3.37 [95% confidence interval 1.90-5.98]). Safety profiles were comparable between the two groups. CONCLUSION Simply adding on low-dose benzbromarone (25 mg/day) to low-dose (20 mg/day) febuxostat showed superior urate lowering compared to febuxostat monotherapy in gout with a combined-type hyperuricemia. For selected patients, expedited achievement of the SU target in more than 75% of patients using one titration step and low xanthine oxidase inhibitor and uricosuric doses is a potential alternative to standard ULT regimens.
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Affiliation(s)
- Xiaomei Xue
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingshu Sun
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
- Department of Rheumatology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Fei Yan
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Yuwei He
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xinde Li
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Han Qi
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Chen
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Xuan Yuan
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
| | - Maichao Li
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Aichang Ji
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Robert Terkeltaub
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Changgui Li
- Department of Endocrinology and Metabolism, the Affiliated Hospital of Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
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He Y, Xue X, Dalbeth N, Terkeltaub R, Chen Y, Yan F, Pang L, Li X, Yuan X, Cheng X, Li C, Sun M. COVID-19 Vaccination and Gout Flare Risk in Patients With Infrequent or Frequent Flares: A Prospective Cohort Study. Arthritis Care Res (Hoboken) 2024; 76:131-139. [PMID: 37553607 DOI: 10.1002/acr.25215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 07/07/2023] [Accepted: 08/03/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE To assess post-COVID-19 vaccination gout flare risk with differing baseline flare burden. METHODS We prospectively studied gout patients with infrequent or frequent flares, defined as ≤1 flare/year or ≥2 flares/year, respectively. COVID-19 vaccine-naive patients managed with urate-lowering therapy between February and June 2021 were included and voluntarily decided on vaccination. Participants were followed for 12 weeks after enrollment or first vaccine dose. Gout flares and risk factors were compared between groups. RESULTS Of 530 participants, 308 (58.1%) had infrequent flares and 222 (41.9%) had frequent flares at baseline, with 248 (142 infrequent and 106 frequent) receiving two-dose COVID-19 vaccination. Vaccination increased cumulative flare incidence at 12 weeks in the infrequent but not the frequent flare group (26.1% vs 10.8%, P = 0.001, compared with 60.4% vs 65.5%, P = 0.428). Flare incidence in the final 4 weeks of observation decreased significantly only in the vaccinated infrequent flare group (4.3% vs 12.0%, P = 0.017). Multivariable analyses showed that vaccination (odds ratio [OR] 2.82, 95% confidence interval [95% CI] 1.50-5.30, P = 0.001), flare in the preceding year (OR 1.95, 95% CI 1.03-3.71, P = 0.04), and body mass index (OR 1.09, 95% CI 1.01-1.19, P = 0.03) were independently associated with increased flare risk in the infrequent flare group. Baseline serum urate (mg/dl) was an independent risk factor in the frequent flare group (OR 1.23, 95% CI 1.05-1.45, P = 0.012). CONCLUSION COVID-19 vaccination was associated with increased early gout flares only in patients with previously infrequent flares.
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Affiliation(s)
- Yuwei He
- The Affiliated Hospital of Qingdao University, Shandong Provincial Clinical Research Center for Immune Diseases and Gout, and Qingdao University, Qingdao, China
| | - Xiaomei Xue
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | | | - Robert Terkeltaub
- VA San Diego Medical Center, San Diego, and University of California San Diego, La Jolla, California
| | - Ying Chen
- The Affiliated Hospital of Qingdao University and Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Fei Yan
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lei Pang
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xinde Li
- The Affiliated Hospital of Qingdao University and Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | | | - Xiaoyu Cheng
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Changgui Li
- The Affiliated Hospital of Qingdao University, Shandong Provincial Clinical Research Center for Immune Diseases and Gout, and Qingdao University, Qingdao, China
| | - Mingshu Sun
- The Affiliated Hospital of Qingdao University and Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
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Yang CB, Cai ZL, Li QZ, Tang F, Wu JJ, Yang J, Zhang YR, Li B, Yang P, Ye X, Yang LM. Rapid discrimination of urine specific gravity using spectroscopy and a modified combination method based on SPA and spectral index. JOURNAL OF BIOPHOTONICS 2024; 17:e202300323. [PMID: 37769060 DOI: 10.1002/jbio.202300323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 09/30/2023]
Abstract
To achieve high-accuracy urine specific gravity discrimination and guide the design of four-waveband multispectral sensors. A modified combination strategy was attempted to be proposed based on the successive projections algorithm (SPA) and the spectral index (SI) in the present study. First, the SPA was used to select four spectral variables in the full spectra. Second, the four spectral variables were mathematically transformed by SI to obtain SI values. Then, SPA gradually fusions the SI values and establishes models to identify USG. The results showed that the SPA can screen out the four characteristic wavelengths related to the measured sample attributes. SIs can be used to improve the performance of constructed prediction models. The best model only involves four spectral variables and 1 SI value, with high accuracy (91.62%), sensitivity (0.9051), and specificity (0.9667). The results reveal that m-SPA-SI can effectively distinguish USG and provide design guidance for 4-wavelength multispectral sensors.
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Affiliation(s)
- Cheng-Bo Yang
- Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, China
| | | | - Qing-Zhi Li
- Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, China
| | - Feng Tang
- Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, China
| | - Jing-Jun Wu
- Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, China
| | - Jia Yang
- Sichuan Science City Hospital, Mianyang, China
| | | | - Bo Li
- Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, China
| | - Ping Yang
- Sichuan Science City Hospital, Mianyang, China
| | - Xin Ye
- Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, China
| | - Li-Ming Yang
- Research Center of Laser Fusion, China Academy of Engineering Physics, Mianyang, China
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Cui Y, Kowalski K, Van Parys M, Miller D, Hansen P, Liang X, Dean B, Chen L. Impact assessment of metabolite instability in the development and validation of LC-MS/MS bioanalytical assays for measurement of rosuvastatin in human plasma and urine samples. Biomed Chromatogr 2024; 38:e5766. [PMID: 37920134 DOI: 10.1002/bmc.5766] [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: 09/11/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 11/04/2023]
Abstract
During bioanalytical assay development and validation, maintaining the stability of the parent drug and metabolites of interest is critical. While stability of the parent drug has been thoroughly investigated, the stability of unanalyzed metabolites is often overlooked. When an unstable metabolite is known or suspected to interfere with measurement of the parent drug or other metabolites of interest through back-conversion or other routes, additional tests with these unstable metabolites should be conducted. Here, the development and validation of two assays for quantification of rosuvastatin, one in human plasma and one in human urine, was reported. To this end, additional sets of quality control samples were added during assay validation to ensure the reliability of the assays. Acid treatment of samples is shown to be necessary for rosuvastatin quantification. In this regard, stability issues caused by the metabolite, rosuvastatin lactone, may have been overlooked if assay development and validation had only considered the parent drug, rosuvastatin. These assays represent a case study for how to develop and validate assays with unstable metabolites. Taken together, unstable metabolites should be included in all applicable stability tests.
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Affiliation(s)
- Yuxiang Cui
- Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, California, USA
| | - Kevin Kowalski
- Labcorp Bioanalytical Services, Indianapolis, Indiana, USA
| | - Michael Van Parys
- Department of Bioanalytical Chemistry, Labcorp Early Drug Development, Madison, Wisconsin, USA
| | - Dennis Miller
- Department of Bioanalytical Chemistry, Labcorp Early Drug Development, Madison, Wisconsin, USA
| | | | - Xiaorong Liang
- Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, California, USA
| | - Brian Dean
- Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, California, USA
| | - Liuxi Chen
- Drug Metabolism and Pharmacokinetics, Genentech Inc., South San Francisco, California, USA
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Tung HT, Liu CM, Huang HS, Lu ZH, Liu CJ. Increased risk of chronic kidney disease in uric acid stone formers with high neutrophil-to-lymphocyte ratio. Sci Rep 2023; 13:17686. [PMID: 37848540 PMCID: PMC10582096 DOI: 10.1038/s41598-023-45034-1] [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: 08/08/2023] [Accepted: 10/14/2023] [Indexed: 10/19/2023] Open
Abstract
Urolithiasis is associated with an increased risk of chronic kidney disease (CKD), irrespective of stone compositions. Chronic inflammation is an important factor for CKD progression. Neutrophil-to-lymphocyte ratio (NLR) has been recognized as a reliable biomarker of inflammation, yet its use in predicting renal deterioration in patients with urolithiasis remains limited. We aimed to explore whether the combination of stone composition and NLR could be useful as a predictor for CKD risk. A total of 336 stone formers with at least one stone submission for analysis were enrolled in the retrospective study. Stones were classified into uric acid and calcium groups. Renal functions were assessed at least one month after stone treatment. Uric acid stone formers had significantly lower estimated glomerular filtration rate (eGFR) compared with calcium stone formers (p < 0.001). NLR was significantly higher in uric acid stone formers (p = 0.005), and a significantly negative correlation (p < 0.001) between NLR and eGFR had been observed only in uric acid stone group. Univariate and multivariate logistic regression analyses showed that higher proportion of uric acid stone composition and higher NLR were both significantly associated with CKD risks. A nomogram integrating independent predictors was generated for CKD prediction, yielding an AUC of 0.811 (0.764-0.858). In conclusion, our study demonstrated that stone formers with higher proportion of uric acid composition and higher NLR levels were associated with higher CKD risk.
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Affiliation(s)
- Hsiu-Ting Tung
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan
| | - Chia-Min Liu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan
| | - Ho-Shiang Huang
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan
| | - Ze-Hong Lu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan.
| | - Chan-Jung Liu
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng Li Road, Tainan, 704302, Taiwan.
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Wang C, Sun W, Dalbeth N, Wang Z, Wang X, Ji X, Xue X, Han L, Cui L, Li X, Liu Z, Ji A, He Y, Sun M, Li C. Efficacy and safety of tart cherry supplementary citrate mixture on gout patients: a prospective, randomized, controlled study. Arthritis Res Ther 2023; 25:164. [PMID: 37679816 PMCID: PMC10483724 DOI: 10.1186/s13075-023-03152-1] [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: 07/05/2023] [Accepted: 08/27/2023] [Indexed: 09/09/2023] Open
Abstract
BACKGROUND Low urine pH, which may be mediated by metabolic syndrome (MetS), is common in gout. Tart cherries are shown to improve MetS symptoms and possess anti-inflammatory properties. However, the efficacy of tart cherry supplements on urine pH has yet to be studied. OBJECTIVES This study aimed to investigate the efficacy and safety of tart cherry supplementary citrate (TaCCi) mixture on urine pH, serum urate (sUA), C-reactive protein (CRP), and gout flares in gout patients initiating urate-lowering therapy (ULT), in comparison to citrate mixture and sodium bicarbonate. METHODS A prospective, randomized (1:1:1), open-label, parallel-controlled trial was conducted among 282 men with gout and fasting urine pH ≤ 6, who were initiating ULT with febuxostat (initially 20 mg daily, escalating to 40 mg daily if serum urate ≥ 360 μmol/L). Participants were randomized to groups taking either sodium bicarbonate, citrate mixture, or TaCCi mixture. All participants were followed every 4 weeks until week 12. Urine pH and sUA were co-primary outcomes, with various biochemical and clinical secondary endpoints. RESULTS Urine pH increased to a similar extent in all three groups. SUA levels declined in all three groups as well, with no significant differences observed between the groups. At week 12, the TaCCi mixture group exhibited a greater reduction in the urine albumin/creatinine ratio (UACR) compared to the other two groups (p < 0.05). Participants taking TaCCi mixture or citrate mixture experienced fewer gout flares than those in the sodium bicarbonate group over the study period (p < 0.05). Additionally, the TaCCi mixture group had a lower CRP level at week 12 relative to the other two groups (p < 0.01). Adverse events were similar across all three groups. CONCLUSION The TaCCi mixture had similar efficacy and safety on urine alkalization and sUA-lowering as the citrate mixture and sodium bicarbonate in patients with gout. However, the TaCCi mixture resulted in greater improvements in UACR and CRP, which suggests that tart cherry supplements may provide additional benefits for renal protection and reduce inflammation in gout, particularly when starting ULT. TRIAL REGISTRATION This project was registered in ChiCTR ( www.chictr.org.cn ), with the registration number: ChiCTR2100050749.
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Affiliation(s)
- Can Wang
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Wenyan Sun
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Zhongjun Wang
- Department of Clinical Laboratory, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xuefeng Wang
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Xiaopeng Ji
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Xiaomei Xue
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Lin Han
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Lingling Cui
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Xinde Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Zhen Liu
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Aichang Ji
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Yuwei He
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China
| | - Mingshu Sun
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China.
- Department of Rheumatology, the Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Changgui Li
- Shandong Provincial Key Laboratory of Metabolic Diseases and Qingdao Key Laboratory of Gout, the Affiliated Hospital of Qingdao University, Qingdao, China.
- Institute of Metabolic Diseases, Qingdao University, Qingdao, China.
- Shandong Provincial Clinical Research Center for Immune Diseases and Gout, Qingdao, China.
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10
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Mitsui Y, Yamabe F, Hori S, Uetani M, Aoki H, Sakurabayashi K, Okawa M, Kobayashi H, Nagao K, Nakajima K. Urine pH and imaging findings of prostate useful predictors of prolonged duration of hematospermia. Transl Androl Urol 2023; 12:1090-1100. [PMID: 37554537 PMCID: PMC10406548 DOI: 10.21037/tau-23-108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/05/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Few investigations regarding hematospermia duration have been reported thus far. The aim of this study was to identify clinical factors associated with the duration of hematospermia. METHODS Clinical data of 198 patients with hematospermia treated at Toho University Omori Medical Center from 2007 to 2022 were retrospectively evaluated. To identify independent predictors of hematospermia duration, uni- and multivariate Cox analyses were performed. Receiver operating characteristic analysis, Kaplan-Meier survival curves, and propensity score matching were applied for statistical evaluations. RESULTS Multivariate analysis of all 198 patients showed urine pH (UpH) level and any abnormal imaging finding of the prostate to be independent predictors of hematospermia duration. Based on the receiver-operating curve of UpH level for hematospermia improvement, the patients were divided into two groups using a threshold of 6.0 (Low-UpH 5.0-6.0, n=128; High-UpH 7.0-9.0, n=70). Kaplan-Meier curves indicated that patients in the High-UpH group or with any abnormal imaging finding had a higher rate of hematospermia persistence (both P<0.05). Even after matching between the groups classified by UpH (n=60 each), multivariate analysis showed that UpH level (hazard ratio 0.75, 95% CI: 0.61-0.92; P=0.006) and any abnormal imaging finding (hazard ratio 1.55, 95% CI: 1.04-2.31; P=0.033) were independent predictors of hematospermia duration. In Kaplan-Meier analysis findings of matched cohorts, High-UpH and presence of any abnormal imaging findings remained significantly correlated with higher rate of hematospermia persistence, while further stratification using a combination of these two factors identified a stepwise reduction in that rate (P=0.019). In addition, the proportion of patients with these two factors present simultaneously was significantly higher in the group with hematospermia for two months or more, and especially with a duration of greater than six months, than in the group with a duration of less than two months. CONCLUSIONS Although further research is needed, both UpH level and imaging findings of the prostate are considered useful biomarkers for predicting prolonged hematospermia.
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Affiliation(s)
- Yozo Mitsui
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Fumito Yamabe
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Shunsuke Hori
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Masato Uetani
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Hiroshi Aoki
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Kei Sakurabayashi
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Mizuho Okawa
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Hideyuki Kobayashi
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Koichi Nagao
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Koichi Nakajima
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
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11
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Stepanova N. Oxalate Homeostasis in Non-Stone-Forming Chronic Kidney Disease: A Review of Key Findings and Perspectives. Biomedicines 2023; 11:1654. [PMID: 37371749 DOI: 10.3390/biomedicines11061654] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Chronic kidney disease (CKD) is a significant global public health concern associated with high morbidity and mortality rates. The maintenance of oxalate homeostasis plays a critical role in preserving kidney health, particularly in the context of CKD. Although the relationship between oxalate and kidney stone formation has been extensively investigated, our understanding of oxalate homeostasis in non-stone-forming CKD remains limited. This review aims to present an updated analysis of the existing literature, focusing on the intricate mechanisms involved in oxalate homeostasis in patients with CKD. Furthermore, it explores the key factors that influence oxalate accumulation and discusses the potential role of oxalate in CKD progression and prognosis. The review also emphasizes the significance of the gut-kidney axis in CKD oxalate homeostasis and provides an overview of current therapeutic strategies, as well as potential future approaches. By consolidating important findings and perspectives, this review offers a comprehensive understanding of the present knowledge in this field and identifies promising avenues for further research.
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Affiliation(s)
- Natalia Stepanova
- State Institution «Institute of Nephrology of the National Academy of Medical Sciences of Ukraine», 04050 Kyiv, Ukraine
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12
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Ahmadi A, Shariatmadari F, Yousefichaijan P, Sarmadian R, Dorreh F, Arjmand Shabestari A. Evaluation of Renal Function and Urinalysis in Children With Simple Febrile Convulsions. Clin Pediatr (Phila) 2022:99228221142127. [PMID: 36476164 DOI: 10.1177/00099228221142127] [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] [Indexed: 12/12/2022]
Abstract
Febrile convulsion (FC) is the most prevalent type of seizure in children. Febrile diseases have been associated with alterations in kidney function and urine indices. Therefore, in this study, renal function and urine analysis were examined in children with simple FC. The study comprised children with simple FC who were referred to the Amirkabir hospital in Arak between 2020 and 2021. Children were examined for urinalysis and kidney function by assessing the estimated glomerular filtration rate (eGFR). A total of 157 patients with FC were admitted. Hematuria, proteinuria, and pyuria were detected in 8.9%, 1.9%, and 5.1% of cases, respectively. The urine cultures of 2 children were positive. Moreover, it was found that in simple FC, eGFR decreases regardless of gender (P > .05), although kidney function decreases more in children older than 24 months. In conclusion, all children with FC must undergo renal function assessments. Furthermore, urinalysis and urine culture are advised to rule out infection.
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Affiliation(s)
| | | | | | - Roham Sarmadian
- Infectious Disease Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Fatemeh Dorreh
- Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran
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