International Journal of Nephrology最新文献

{"title":"The Significance of Exposure to Pregestational Type 2 Diabetes in Utero on Fetal Renal Size and Subcutaneous Fat Thickness.","authors":"Christy L Pylypjuk,&nbsp;Chelsea Day,&nbsp;Yasmine ElSalakawy,&nbsp;Gregory J Reid","doi":"10.1155/2022/3573963","DOIUrl":"https://doi.org/10.1155/2022/3573963","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the relationship between exposure to pregestational type 2 diabetes (T2D) and renal size and subcutaneous fat thickness in fetuses during routine obstetrical ultrasound.</p><p><strong>Methods: </strong>This was a case-control study (January 1, 2019 to December 31, 2019). Routine obstetrical ultrasounds performed between 18 and 22 weeks' gestation at a tertiary-care fetal assessment unit were reviewed. \"Cases\" comprised ultrasounds of fetuses exposed to pregestational T2D in utero. The control group was assembled from ultrasounds of healthy controls. Postprocessing measurements of fetal renal size and abdominal wall thickness from stored images were performed by two independent observers, and findings were compared between groups.</p><p><strong>Results: </strong>There were 54 cases and 428 ultrasounds of healthy controls. The mean maternal age of cases was 32.1 years (SD 6.2) compared to 33.2 years (SD 5.3) for healthy controls, and the majority of ultrasounds were performed in multiparous patients (83%). At the 18 to 22 week ultrasound, there was a significant reduction in renal size amongst fetuses exposed to maternal T2D in utero compared to controls; among cases, the mean renal width was 8.0 mm (95% CI 7.8-8.1) compared to 11.4 mm (95% CI 10.6-12.7) in controls (<i>p</i> < 0.0001); the mean renal thickness among cases was 8.1 mm (95% CI 7.9-8.2) compared to 11.5 mm (95% CI 10.7-12.9) in controls (<i>p</i>=0.001). There was no obvious difference in estimated fetal weight between groups, yet fetuses exposed to maternal T2D had increased subcutaneous abdominal wall fat thickness at this early gestational age (<i>p</i>=0.008).</p><p><strong>Conclusions: </strong>Fetal renal size in cases exposed to pregestational T2D is significantly smaller compared to controls, and subcutaneous abdominal wall fat is significantly thicker. Given emerging evidence about the developmental origins of disease, further study is needed to correlate the association between fetal renal size and fat distribution in the fetus and the long-term risk of chronic renal disease and diabetes in these offspring.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"3573963"},"PeriodicalIF":2.1,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40604229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary Podocyte Excretion Predicts Urinary Protein Selectivity and Renal Prognosis.","authors":"Makoto Abe,&nbsp;Akiko Kaiga,&nbsp;Takehiro Ohira,&nbsp;Toshihiko Ishimitsu,&nbsp;Akihiro Tojo","doi":"10.1155/2022/2702651","DOIUrl":"https://doi.org/10.1155/2022/2702651","url":null,"abstract":"<p><strong>Background: </strong>Urinary podocyte excretion is related to a reduction in glomerular podocyte numbers, glomerulosclerosis, and urinary protein selectivity. To elucidate the role of urinary podocytes in proteinuria and renal prognosis and to identify the factors that cause podocyte detachment, we examined urinary podocytes in 120 renal biopsy patients.</p><p><strong>Methods: </strong>Podocytes were identified in urinary sediments stained with fluorescent-labeled anti-podocalyxin antibodies in ten high power fields. The amounts of protein bands, separated by SDS-polyacrylamide gel electrophoresis, were calculated using an image software program and the correlation with urinary podocytes was analyzed. Podocyte surface pores were observed using a low-vacuum scanning electron microscope. The renal prognosis, including induction of hemodialysis or 30% reduction in eGFR, was investigated.</p><p><strong>Results: </strong>Urinary podocyte excretion showed a higher positive correlation with albumin excretion compared to IgG, prealbumin, and transferrin. There were no significant correlations between urinary podocyte count and low molecular weight proteins, including <i>β</i>2-microglobulin and <i>α</i>1-microglobulin. The number of podocyte surface pores was positively correlated with proteinuria, suggesting enhanced albumin transcytosis. The hemodynamic pressure on the glomerular capillary wall, including products of pulse pressure and pulse rate (water hammer pressure), was positively correlated with urinary podocyte excretion. Urinary podocyte excretion and Tamm-Horsfall protein (THP) were independent risk factors for renal prognosis but were not related to response to treatment.</p><p><strong>Conclusion: </strong>Urinary podocyte excretion was correlated with urinary albumin excretion, indicating specific albumin transport by podocytes. Podocytes were detached from the glomerular capillaries by water hammer pressure and THP was involved in the renal prognosis.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"2702651"},"PeriodicalIF":2.1,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9296344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40529858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dialysis Service in the Embattled Tigray Region of Ethiopia: A Call to Action.","authors":"Ephrem Berhe,&nbsp;Will Ross,&nbsp;Hale Teka,&nbsp;Hiluf Ebuy Abraha,&nbsp;Lewis Wall","doi":"10.1155/2022/8141548","DOIUrl":"https://doi.org/10.1155/2022/8141548","url":null,"abstract":"<p><p>Haemodialysis is extremely limited in low-income countries. Access to haemodialysis is further curtailed in areas of active conflict and political instability. Haemodialysis in the Tigray region of Ethiopia has been dramatically affected by the ongoing civil war. Rapid assessment from the data available at Ayder Hospital's haemodialysis unit registry, 2015-2021, shows that enrollment of patients in the haemodialysis service has plummeted since the war broke out. Patient flow has decreased by 37.3% from the previous yearly average. This is in contrary to the assumption that enrollment would increase because patients could not travel to haemodialysis services in the rest of the country due to the complete blockade. Compared to the prewar period, the mortality rate has doubled in the first year after the war broke out, i.e., 28 deaths out of 110 haemodialysis recipients in 2020 vs. 43 deaths out of 81 haemodialysis recipients in the year 2021. These untoward outcomes reflect the persistent interruption of haemodialysis supplies, lack of transportation to the hospital, lack of financial resources, and the unavailability of basic medications due to the war and the ongoing economic and humanitarian blockade of Tigray in Northern Ethiopia. In the setting of this medical catastrophe, the international community should mobilize to advocate for resumption of life-saving haemodialysis treatment in Ethiopia's Tigray region and put pressure on the Ethiopian government to allow the passage of life-saving medicines, essential medical equipment, and consumables for haemodialysis into Tigray.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"8141548"},"PeriodicalIF":2.1,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Quality in CKD Subjects: A Cross-Sectional In-Hospital Evaluation.","authors":"L Rzayeva,&nbsp;I Matyukhin,&nbsp;O Ritter,&nbsp;S Patschan,&nbsp;D Patschan","doi":"10.1155/2022/9432509","DOIUrl":"https://doi.org/10.1155/2022/9432509","url":null,"abstract":"<p><strong>Methods: </strong>The study was performed in a retrospective and observational manner. All adult (age 18 years or older) in-hospital subjects treated from January until December 2019 were included. CKD was diagnosed according to the KDIGO 2012 CKD Guideline. The following variables were assessed: CKD stage, quantification/analysis (yes/no) of blood pressure, proteinuria, serum phosphate, serum 25-OH-D3, ferritin and transferrin saturation, and blood gas analysis. In addition, recommendations of the following medicines were analyzed (given/not given): ACE inhibitor or sartan, phosphate binder, vitamin D3 (activated or native), iron, erythropoietin, and bicarbonate. It was also evaluated whether discharge letters contained CKD-related diagnoses or not.</p><p><strong>Results: </strong>In total, 581 individuals were included in the study. The majority of aspects related to the monitoring and therapeutic management of CKD were either considered in only a small proportion of affected individuals (e.g., quantification of PTH - 5.5%/25-OH-D3 - 6%/transferrin saturation - 13.6%) or avoided nearly at all (e.g., recommendation of erythropoietin-1%, documentation of CKD-MBD diagnosis-0.3%). A reasonable quality of care was identified concerning the blood pressure monitoring (performed in 100%) and blood gas analysis (55% of the patients received analysis). Serum phosphate was measured in 12.9%, particularly in subjects at higher CKD stages.</p><p><strong>Conclusions: </strong>The current investigation revealed poor quality of care in CKD patients treated at the Brandenburg University Hospital over the period of one year. Quality improvement must be achieved, most likely via a standardized educational program for physicians and a directer access to CKD management guidelines.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"9432509"},"PeriodicalIF":2.1,"publicationDate":"2022-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9246581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40556423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test-Retest Reliability, Validity, and Minimal Detectable Change of the Measurement of Lower Limb Muscular Strength with Handheld Dynamometry in Patients Undergoing Hemodialysis.","authors":"Borja Perez-Dominguez,&nbsp;Aida Lopez-Brull,&nbsp;Maria Plaza-Carrasco,&nbsp;Jose Casaña-Granell,&nbsp;Alicia Garcia-Testal,&nbsp;Josep Benitez-Martinez","doi":"10.1155/2022/5330608","DOIUrl":"https://doi.org/10.1155/2022/5330608","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease is an exponentially growing medical and economic worldwide problem. There are specific elements used to assess patient's functional capacity loss and overall deterioration in order to determine the patient's clinical status, and muscle impairment is one of the most common. It is therefore necessary to develop reliable and applicable methods to determine muscle impairment in patients with chronic kidney disease.</p><p><strong>Methods: </strong>This is a prospective, nonexperimental, descriptive methodological investigation performed in patients undergoing hemodialysis. This study analyzes the reliability and validity of muscle strength assessments performed with handheld dynamometry in patients with chronic kidney disease undergoing hemodialysis.</p><p><strong>Results: </strong>Results show overall high reliability and validity in the assessment of muscle strength of the lower limbs.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to assess handheld dynamometry in patients undergoing hemodialysis, presenting promising results with a relatively affordable and easily applicable method.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"5330608"},"PeriodicalIF":2.1,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9217614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40401626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Low-Flux and High-Flux Dialysis Membranes on Erythropoietin Responsiveness in Hemodialysis Patients.","authors":"Walid A R Abdelhamid,&nbsp;Mohamed M Soliman,&nbsp;Ayman R A El-Hameed","doi":"10.1155/2022/2984193","DOIUrl":"https://doi.org/10.1155/2022/2984193","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is often accompanied by anemia. High-flux membranes contribute to a reasonable removal of uremic toxins which cause anemia in CKD. Inadequate data have described the efficiency of high-flux dialysis in promoting erythropoietin responsiveness in CKD patients in the Middle East. This study was conducted to compare the efficiency of maintaining high-flux hemodialysis versus low-flux dialysis for ≥1 year in promoting erythropoietin responsiveness and to show the factors associated with erythropoietin hyporesponsiveness in Arab chronic hemodialysis patients.</p><p><strong>Methods: </strong>It was a retrospective cohort study that involved 110 subjects who were categorized into group 1 (50 patients receiving low-flux dialysis) and group 2 (60 patients receiving high-flux dialysis). History taking, examination, and laboratory investigations were conducted for all patients every 3 months from January 2021 to January 2022.</p><p><strong>Results: </strong>Group 2 had significantly higher weight and body mass index than group 1 but lower cholesterol and intact parathyroid hormone levels than group 1. Erythropoietin resistance index levels did not differ between the two groups upon repeated measures over a 1-year follow-up. Significant risk factors for erythropoietin hyporesponsiveness on multivariate analysis were lower weight (Odds ratio (OR): 0.966; 95% Confidence interval (CI): 0.94-0.992; <i>p</i>=0.011), longer hemodialysis vintage (OR: 1.172; 95% CI: 1.036-1.325; <i>p</i>=0.012), lower hemoglobin levels (OR: 0.531; 95% CI: 0.362-0.779; <i>p</i>=0.001), and higher neutrophil-to-lymphocyte ratio (OR: 2.436; 95% CI: 1.321-4.493; <i>p</i>=0.004).</p><p><strong>Conclusion: </strong>High-flux dialysis was not superior to low-flux dialysis in improving erythropoietin responsiveness.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"2984193"},"PeriodicalIF":2.1,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Facts Medication Adherence in Transplantation (H-MAT) Study: A Secondary Analysis of Determinants and Outcomes of Medication Nonadherence in Adult Kidney Transplant Recipients.","authors":"Cynthia L Russell,&nbsp;Heather J Gotham,&nbsp;An-Lin Cheng,&nbsp;Suman Sahil,&nbsp;Preethi Yerram","doi":"10.1155/2022/9653847","DOIUrl":"https://doi.org/10.1155/2022/9653847","url":null,"abstract":"<p><strong>Aims: </strong>To explore the relationship between determinants and posttransplant medication nonadherence (MNA) in adult kidney transplant recipients, and to examine the relationship between posttransplant MNA and clinical outcomes.</p><p><strong>Methods: </strong>Using the World Health Organization's model, this retrospective, multicenter, correlational study examined the relationship between determinants, posttransplant MNA, and clinical outcomes in 16,671 adult kidney transplant recipients from the Cerner <i>Health Facts</i> national data warehouse.</p><p><strong>Results: </strong>With 12% MNA, those who were nonadherent were more likely to have the social/economic factors of being younger, single, Caucasian versus Hispanic race, have the condition-related factor of mental health/substance use disorder, and have the healthcare system-related factor of government/health maintenance organization/managed care insurance (<i>p</i>'<i>s</i> < 0.05). Bivariate correlations indicated both age (OR = 1.006, <i>p</i>=0.01) and mental health or substance use disorder diagnosis (OR = 1.26, <i>p</i>=0.04) were significant predictors of MNA. Patients were 0.6% more likely to be medication adherent for each year they increased in age and 26% more likely to be MNA if they were diagnosed with a mental health/substance use disorder. Nonadherent patients were less likely to be readmitted, but more likely to have complications after transplant and medication side effects (<i>p</i>'<i>s</i> < 0.01).</p><p><strong>Conclusions: </strong>Using one of the largest samples of adult kidney transplant patients, our findings support the WHO model and move the body of medication adherence intervention research forward by clarifying the importance of focusing interventions not only on the patient but on multilevel determinants. Consistent with previous studies, MNA negatively impacts transplant outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":"9653847"},"PeriodicalIF":2.1,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9205738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40041954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Comparison of Clinical Presentation and Outcomes of Kidney Transplant Recipients with COVID-19 during Wave 1 versus Wave 2 at a Tertiary Care Center, India","authors":"S. Jasuja, G. Sagar, A. Bahl, Neharita Jasuja, R. Chawla, A. Bansal, M. Kanwar, S. Kansal, N. Modi, A. Ansari, Viny Kantroo, P. Dhar, C. Chatterjee, N. Ghonge, Samir Tawakley, Shalini Verma","doi":"10.1155/2022/9088393","DOIUrl":"https://doi.org/10.1155/2022/9088393","url":null,"abstract":"Data comparing the clinical spectrum of COVID-19 in kidney transplant recipients (KTRs) during the first and second waves of the pandemic in India is limited. Our single-center retrospective study compared the clinical profile, mortality, and associated risk factors in KTRs with COVID-19 during the 1st wave (1st February 2020 to 31st January 2021) and the second wave (1st March-31st August 2021). 156 KTRs with PCR confirmed SARS-CoV-2 infection treated at a tertiary care hospital in New Delhi during the 1st and the second waves were analyzed. The demographics and baseline transplant characteristics of the patients diagnosed during both waves were comparable. Patients in the second wave reported less frequent hospitalization, though the intensive care unit (ICU) and ventilator requirements were similar. Strategies to modify immunosuppressants such as discontinuation of antinucleoside drugs with or without change in calcineurin inhibitors and the use of steroids were similar during both waves. Overall patient mortality was 27.5%. The demographics and baseline characteristics of survivors and nonsurvivors were comparable. A higher percentage of nonsurvivors presented with breathing difficulty, low SpO2, and altered sensorium. Both wave risk factors for mortality included older age, severe disease, ICU/ventilator requirements, acute kidney injury (AKI) needing dialysis, Chest Computerized Tomographic (CT) scan abnormalities, and higher levels of inflammatory markers particularly D-dimer and interleukin-6 levels. Conclusions. KTRs in both COVID-19 waves had similar demographics and baseline characteristics, while fewer patients during the second wave required hospitalization. The D-dimer and IL-6 levels are directly correlated with mortality.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48441133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Laboratory Diagnosis of Urinary Tract Infections Based on Leukocyte and Bacterial Parameters Using Standardized Microscopic and Flow Cytometry Methods","authors":"Priskila Christy, H. Sidjabat, Anggia Augustasia Lumban Toruan, E. Moses, N. Mohd Yussof, Yessy Puspitasari, M. R. Fuadi, Aryati, F. R. Marpaung","doi":"10.1155/2022/9555121","DOIUrl":"https://doi.org/10.1155/2022/9555121","url":null,"abstract":"Background Rapid and reliable tests are essential for the diagnostic laboratory confirmation of urinary tract infections (UTIs). Until now, UTI has been confirmed by the microbiology culture of urine, requiring at least 48-hour turnaround time (TAT), with a standardized microscopic method being widely favored. Automated urine flow cytometry, however, has recently been used to improve the rapid TAT by analyzing the urine sediment. This study therefore aimed to compare the diagnostic value of the Shih-Yung conventional microscopic and urine flow cytometry methods in the detection of leukocyte and bacterial parameters of patients with UTIs in an outpatient clinic. Methods A cross-sectional study was conducted on a total of 100 patients. Seventy urine samples were positive for leukocytes and nitrite chemistry, and 30 were negative for both. The measurements of urine leukocytes and bacteria were compared between Sysmex UF-5000 urine flow cytometry and the Shih-Yung method. The diagnostic value was obtained from ROC analysis of urine flow cytometry and the culture. Results A leukocyte cutoff value of 87.2/μL had a sensitivity and specificity of 98.33% and 95%, respectively, and 98.33% sensitivity and 75% specificity at a bacterial cutoff of 582.22/μL. Interestingly, our study identified strong and consistent agreement of leukocyte and bacterial parameters between urine flow cytometry and Shih-Yung (k = 0.959, p < 0.001 and k = 0.939, p < 0.001, respectively). Furthermore, through analyzing the dominance angle of the scattergram, a strong agreement was obtained with the culture result (k = 0.880, p < 0.001). Conclusions The Shih-Yung method showed consistent agreement with urine flow cytometry for the detection of leukocytes and bacteria. The use of certain cutoffs for bacterial and leukocyte parameters in urine flow cytometry demonstrated very good performance in detecting acquired symptomatic UTIs.","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44932771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Infusion of Iohexol to Monitor Perioperative Glomerular Filtration Rate.","authors":"Kjellbjørn Jakobsen, Bjørn O Eriksen, Ole M Fuskevåg, Stephen J Hodges, Lars M Ytrebø","doi":"10.1155/2022/8267829","DOIUrl":"10.1155/2022/8267829","url":null,"abstract":"<p><p>Continuous monitoring of the glomerular filtration rate (GFR) in the perioperative setting could provide valuable information about acute kidney injury risk for both clinical and research purposes. This pilot study aimed to demonstrate that GFR measurement by a continuous 72 hrs iohexol infusion in patients undergoing colorectal cancer surgery is feasible. Four patients undergoing robot-assisted colorectal cancer surgery were recruited from elective surgery listings. GFR was determined preoperatively by the single-sample iohexol clearance method, and postoperatively at timed intervals by a continuous iohexol infusion for 72 hrs. Plasma concentrations of creatinine and cystatin C were measured concurrently. GFR was calculated as (iohexol infusion rate (mg/min))/(plasma iohexol concentration (mg/mL)). The association of the three different filtration markers and GFR with time were analysed in generalized additive mixed models. The continuous infusion of iohexol was established in all four patients and maintained throughout the study period without interfering with ordinary postoperative care. Postoperative GFR at 2 hours were elevated compared to the preoperative measurements for patients 1, 2, and 3, but not for patient 4. Whereas patients 1, 2, and 3 had u-shaped postoperative mGFR curves, patient 4 demonstrated a linear increase in mGFR with time. We conclude that obtaining continuous measurements of GFR in the postoperative setting is feasible and can detect variations in GFR. The method can be used as a tool to track perioperative changes in renal function.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2022 1","pages":"8267829"},"PeriodicalIF":1.7,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9155923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41340962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}