Association Between Ratio of Sodium to Potassium in Random Urine Samples and Renal Dysfunction and Mortality in Patients With Decompensated Cirrhosis

Goulis, John; Arsos, Georgios; Birtsou, Charis; Nakouti, Theodora; Papadopoulou, Sophia; Chalevas, Parthenis; Karakatsanis, K.; Akriviadis, Evangelos

doi:10.1016/j.cgh.2013.02.005

Cited by 11 publications

(11 citation statements)

References 20 publications

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“…The reduction in BUN and BUN: creatinine ratio and the tendency of creatinine to be linearly increased with aflatoxin ingestion may be related to renal damage because high creatinine levels indicate poor kidney function. The decrease in serum Na: K ratio, which has been reported to be an index for renal function [ 28 ], is consistent with potential renal damage. A low BUN: creatinine ratio may also be linked to a diet low in protein and a severe muscle injury called rhabdomyolysis [ 29 ].…”

Section: Discussionsupporting

confidence: 71%

Effect of Folic Acid Supplementation and Dietary Protein Level on Growth Performance, Serum Chemistry and Immune Response in Weanling Piglets Fed Differing Concentrations of Aflatoxin

Wang

Lindemann

Estienne

2020

Toxins

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Effects of folic acid and protein levels on growth and serum chemistry in pigs fed aflatoxin were determined in two experiments. Increasing aflatoxin (250 to 800 ppb) decreased (P < 0.05) weight gain and feed intake for both of the 35-day trials. In Experiment 1, increasing aflatoxin (0, 250, 500 ppb), increased linearly (P < 0.05) aspartate aminotransferase (AST), alkaline phosphatase (ALKP) and ɣ-glutamyl transferase (GGT). Folic acid (0, 2.0, 5.0, 12.5 ppm) increased linearly (P < 0.05) serum K, Ca, P, Mg, and AST with the largest effect observed at 12.5 ppm. Folic acid decreased (P < 0.05) blood urea nitrogen (BUN): creatinine and Na:K. In Experiment 2, aflatoxin (800 ppb) increased (P < 0.05) glucose and GGT, and decreased (P < 0.05) Na:K and albumin:globulin. Increasing protein from 15 to 18% elevated BUN: creatinine (P < 0.05), albumin: globulin (P < 0.05), albumin (P < 0.05) and ALKP (P < 0.05). Folic acid (2 ppm) elevated (P < 0.05) BUN, and interacted with both aflatoxin (P < 0.10) and protein (P < 0.05) on BUN. Adding folic acid to aflatoxin contaminated diets improved some measures of clinical chemistry in Experiment 1 but not traditional growth performance measures. The higher protein level reduced the effects of aflatoxicosis on growth.

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Section: Discussionsupporting

confidence: 71%

Effect of Folic Acid Supplementation and Dietary Protein Level on Growth Performance, Serum Chemistry and Immune Response in Weanling Piglets Fed Differing Concentrations of Aflatoxin

Wang

Lindemann

Estienne

2020

Toxins

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“…Low UNa/K ratio has been associated with the presence of low 24 h natriouresis (i.e. 24UNa < 78mmol/day) and worse renal function in patients with DeCi.…”

Section: Methodsmentioning

confidence: 99%

Comparison of creatinine and cystatin formulae with ⁵¹Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

Ioannidou

Goulis

Chalevas

et al. 2017

J of Gastro and Hepatol

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“…So, we calculated their ratio (UNa/K ratio), which has been associated with the presence of low natriuresis (i.e. 24Una <78 mmoL/day) and outcome [ 19 ]. Finally, we assessed renal function (“true” glomerular filtration rate, GFR) using 51 Chromium-EDTA (51Chr-EDTA) [ 20 ] along with estimated GFR (eGFR) using the creatinine-based 4 variables modification of the diet in renal disease (MDRD) formula [ 21 ] and the chronic kidney disease-epidemiology (CKD-EPI) creatinine-based formula [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

High serum ferritin is associated with worse outcome of patients with decompensated cirrhosis

Oikonomou

Goulis

Σουλαϊδόπουλος

et al. 2016

aog

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BackgroundStudies in patients with decompensated cirrhosis showed a correlation between serum ferritin levels and patients’ prognosis. Besides, red blood cell distribution width (RDW) and mean platelet volume (MPV) have been associated with the severity of hepatic function. The aim of this study was to evaluate the prognostic impact of serum ferritin and RDW/MPV in the outcome [survival, death, or liver transplantation (LT)] of patients with stable decompensated cirrhosis.MethodsConsecutive adult patients with stable decompensated cirrhosis admitted to our department between September 2010 and February 2016 were included. Serum ferritin, RDW and MPV were recorded in every patient. They were followed up and their outcome (alive, death, or LT) was evaluated.Results192 consecutive patients with stable decompensated cirrhosis (142 men, age 54.2±12 years); at the end of follow up [12 (range: 1-64) months] 62 patients remained alive and 130 died or underwent LT. In multivariate analysis, serum ferritin (HR 1.001, 95%CI 1.00-1.002, P=0.005) and GFR (HR 0.96, 95%CI 0.92-0.99, P=0.035) were the only independent factors significantly associated with the outcome. Ferritin had low discriminative ability (AUC: 0.61) to the outcome yielding a sensitivity and specificity of 85.3% and 44.2%, respectively, at the best cut-off point (>55 ng/mL), while patients with ferritin >55 ng/mL (n=145) had a worse outcome compared to those with ferritin ≤55 ng/mL (n=47) (log rank P=0.001). RDW and MPV were not associated with the outcome.ConclusionHigh serum ferritin, but not RDW/MPV, is associated with worse outcome in patients with established decompensated cirrhosis. However, further studies are needed to elucidate better this issue.

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Association Between Ratio of Sodium to Potassium in Random Urine Samples and Renal Dysfunction and Mortality in Patients With Decompensated Cirrhosis

Cited by 11 publications

References 20 publications

Effect of Folic Acid Supplementation and Dietary Protein Level on Growth Performance, Serum Chemistry and Immune Response in Weanling Piglets Fed Differing Concentrations of Aflatoxin

Effect of Folic Acid Supplementation and Dietary Protein Level on Growth Performance, Serum Chemistry and Immune Response in Weanling Piglets Fed Differing Concentrations of Aflatoxin

Comparison of creatinine and cystatin formulae with ⁵¹Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

High serum ferritin is associated with worse outcome of patients with decompensated cirrhosis

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Association Between Ratio of Sodium to Potassium in Random Urine Samples and Renal Dysfunction and Mortality in Patients With Decompensated Cirrhosis

Cited by 11 publications

References 20 publications

Effect of Folic Acid Supplementation and Dietary Protein Level on Growth Performance, Serum Chemistry and Immune Response in Weanling Piglets Fed Differing Concentrations of Aflatoxin

Effect of Folic Acid Supplementation and Dietary Protein Level on Growth Performance, Serum Chemistry and Immune Response in Weanling Piglets Fed Differing Concentrations of Aflatoxin

Comparison of creatinine and cystatin formulae with 51Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis

High serum ferritin is associated with worse outcome of patients with decompensated cirrhosis

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Comparison of creatinine and cystatin formulae with ⁵¹Chromium‐ethylenediaminetetraacetic acid glomerular filtration rate in patients with decompensated cirrhosis