Measurement and Estimation of Kidney Function

Inker, Lesley A.; Levey, Andrew S.

doi:10.1016/b978-0-323-52978-5.00002-1

Cited by 17 publications

(24 citation statements)

References 93 publications

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“…Follow-up data including urinalysis at six months and one year after admission, and DMSA renal scan six months after admission 21 were obtained. Estimated glomerular filtration rate (eGFR) is currently the most common way of assessing the degree of kidney impairment and following the course of a disease 22 . However, eGFR is not routinely examined for febrile patients admitted with UTI at our institution.…”

Section: Methodsmentioning

confidence: 99%

Predictive factors for bacteremia in febrile infants with urinary tract infection

Yoon

Shin

Lee

et al. 2020

Sci Rep

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this study aimed to investigate the predictive factors of concomitant bacteremia occurring in febrile infants who initially presented with pyuria and fever, and were subsequently diagnosed with cultureproven urinary tract infection (UTI). We conducted a retrospective cohort study for January 2010-October 2018 that included infants younger than six months with febrile UTI at a tertiary hospital. The study included 463 patients, of whom 34 had a concomitant bacteremic UTI. Compared to those in the non-bacteremic urinary tract infection (Uti) group, the bacteremic Uti group had a lower mean age; higher levels of C-reactive protein (CRP), delta neutrophil index (DNI, reflects the fraction of immature granulocytes) and blood urea nitrogen (BUn); lower levels of hemoglobin (Hb) and albumin; and a lower platelet count. Vesicoureteral reflux (VUR) was detected nearly twice as often in patients with bacteremic UTI compared to those with non-bacteremic UTI (59.3% vs. 30.6%; P = 0.003). Univariate logistic analyses showed that age ≤90 days; higher DNI, CRP, and creatinine levels; lower Hb and albumin levels; and the presence of VUR were predictors for bacteremic Uti. on multivariate logistic regression analysis, age ≤90 days, higher DNI and CRP levels, and the presence of VUR were independent predictors of bacteremic Uti. the area under the receiver operating characteristic curve of the multivariate model was 0.859 (95% CI, 0.779-0.939; P < 0.001). Age ≤90 days, higher DNI and CRP values may help predict bacteremia of febrile infants younger than 6 months with UTI. Vesicoureteral reflux imaging is also recommended in infants with bacteremic UTI to evaluate VUR.Urinary tract infection (UTI) has been described as the most common serious bacterial infection in febrile infants 1 . The rate of concomitant bacteremia in febrile UTI varies from 5% to 31%, depending on various locations and patient cohorts 2,3 . Although a recent study has shown that outcomes were good among infants with bacteremic UTI 4 , infants with concomitant bacteremic UTI are still prone to adverse outcomes such as prolonged admission, shock, bacterial meningitis, and intensive-care unit admission 5 . Early diagnosis and prompt decision-making on the initial treatment of young febrile infants suspected of having bacteremia are important but not feasible because confirming positive blood cultures is usually time-consuming.Several factors have been previously reported to predict bacteremic UTI in pediatric patients: younger age 3,6 ; clinical presentation such as ill appearance 5,7 and feeding problems 8 ; laboratory parameters including increased creatinine levels 9,10 ; high levels of inflammatory markers such as white blood cell (WBC) count 5 , presence of bands 5 and C-reactive protein (CRP) 7,10,11 ; and genitourinary (GU) tract malformations 8 .However, the clinical signs or symptoms of UTI are usually vague and unspecific in young infants 12 . Clinically determining whether children have serious complications when they may not appear ill is difficult fo...

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Section: Methodsmentioning

confidence: 99%

Predictive factors for bacteremia in febrile infants with urinary tract infection

Yoon

Shin

Lee

et al. 2020

Sci Rep

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“…Serum cystatin C, a non-glycosylated (13.3-kDa) cystatin protease inhibitor, is a promising replacement for serum creatinine in detecting the estimated glomerular filtration rate (eGFR) [10]. Murty et al, [11] showed that serum cystatin C is an ideal marker of renal function in the early stages of acute kidney injury (AKI).…”

Section: Introductionmentioning

confidence: 99%

“…Unlike serum creatinine, it is less affected by age, gender, ethnicity, muscle mass, protein catabolism, or dietetic factors. Other studies showed that serum cystatin C level might be increased by diabetes, inflammation, and TGF-β (a marker of inflammation/endothelial damage/fibrosis) [10,12].…”

Section: Introductionmentioning

confidence: 99%

Differential Renoprotective Actions of Simvastatin and Rosuvastatin in Streptozotocin-Induced Diabetes in Sprague-Dawley Rat

Refaat

El-Deeb

Bakir

et al. 2020

Archives of Pharmaceutical Sciences Ain Shams University

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Diabetic nephropathy (DN) is the most frequent cause of the end-stage renal disease (ESRD) in about 33% of diabetic patients. The present study aimed to explore the renoprotective effects of simvastatin (SV) and rosuvastatin (RSU) on the kidney of streptozotocin (STZ)-induced diabetic Sprague-Dawley (SD) rat model. As a result of induction of diabetes, serum [cystatin C, transforming growth factor-beta (TGF-β), and 8-hydroxy-2'-deoxyguanosine (8-OHdG)] and tissue [interleukin 1 beta (IL-1β), interleukin 10 (IL-10), prostaglandin E2 (PGE2), cytochrome c, malondialdehyde (MDA), glutathione (GSH), glutathione disulfide (GSSG), GSH/GSSG ratio) markers showed significant increase than negative controls except tissue total glutathione (tGSH). Both SV and RSU significantly shifted the levels back toward near non-diabetic values. Both exerted the same renoprotective effect indicated by a significant decrease in cystatin C. However, SV significantly lowered IL-10, GSH/GSSG ratio, MDA, and 8-OHdG than RSU. Similarly, RSU significantly lowered cytochrome c and GSSG than SV. In conclusion, SV and RSU have differential renoprotective effects via alteration of growth factor, inflammatory, oxidative stress, DNA damage, and apoptotic signaling pathways.

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“…Nonetheless, warfarin, a vitamin K antagonist (VKA), is still the best choice of anticoagulant in AFib patients. A large clinical study of warfarin in 2014 showed protection from cardiovascular events without any increased risk of bleeding [9]; however, Nochaiwong in 2016 reported that warfarin actually increased the frequency of bleeding and did not reduce ischaemic events, strokes or the number of deaths [10].…”

Section: Efficacy and Safety Of New Direct Oral Anticoagulants In Chrmentioning

confidence: 99%

“…Renal excreted drugs are cleared through the glomerulus and rarely by tubular secretion. Therefore, reduced GFR results in an increased half time and increased level of drug, which leads to toxicity from supra-therapeutic levels in the body [10]. Consequently, the area under the curve (AUC) increases, requiring an appropriate dose adjustment.…”

Section: Pharmacokinetics Of Drugs In Ckdmentioning

confidence: 99%

Efficacy and safety of new direct oral anticoagulants in chronic kidney disease: AHA 2019 updated guidelines and review of the literature

Stępak¹,

Krasiński²,

A³

et al. 2019

kitp

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Direct oral anticoagulants (DOACs) are the drug of choice for the treatment of atrial fibrillation-associated systemic embolism and reducing the risk of strokes in chronic kidney disease (CKD) patients. DOACs have fewer drug-to-drug interactions as well as fewer side effects, compared to warfarin. This article compiled up-to-date research on the use of DOACs in CKD patients, taking the AHA 2019 guidelines into consideration. The aim of this article was to compare the efficacy and safety of DOACs with warfarin and to assess whether DOACs are a better alternative to warfarin. Among DOACs, apixaban has been shown to have the best outcome compared to other DOACs. As a result, the AHA 2019 updated guidelines have recommended warfarin and apixaban to be the first line agents for CKD patients. This review concluded that DOACs are better option in patients with mild to moderate CKD and excluding apixaban other DOACs are not indicated in patients with CrCl < 25 ml/min.

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Measurement and Estimation of Kidney Function

Cited by 17 publications

References 93 publications

Predictive factors for bacteremia in febrile infants with urinary tract infection

Predictive factors for bacteremia in febrile infants with urinary tract infection

Differential Renoprotective Actions of Simvastatin and Rosuvastatin in Streptozotocin-Induced Diabetes in Sprague-Dawley Rat

Efficacy and safety of new direct oral anticoagulants in chronic kidney disease: AHA 2019 updated guidelines and review of the literature

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