• Title/Summary/Keyword: Urine protein-creatinine ratio

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Can prosthetic limbs made too quickly cause kidney damage?: a pilot study

  • Petrofsky, Jerrold S.;Browne, Mary;Jamshidi, Mahyar;Libo-on, Anthony;Lee, Haneul
    • Physical Therapy Rehabilitation Science
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    • v.3 no.2
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    • pp.119-124
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    • 2014
  • Objective: The use of chemicals for building prosthetic sockets present the possibility of being hazardous and unsafe due to off-gassing. The purpose of the present study was to investigate if freshly made materials used in prosthetic sockets causes off-gassing that would penetrate the skin and cause damage to the kidneys or blood. Design: Cross-sectional study. Methods: In this research, the off-gassing effects during the initial curing process of styrene monomer, vinyl ester resin, epoxy methacrylate resin, benzene-1, 3-dimethaneamine, trimethylhexanedlamine, and paratertiarybutylphenol were analyzed. Acid detection strips were placed inside newly fabricated mock-prosthetic sockets and left overnight in a closed environment to find out if acid was present in the invisible fumes. The plastic was worn by 9 subjects and urinalysis was made after 48 hours to test for any kidney or blood toxicity of the resins. Results: After wearing the plastic cuff for 48 hours, the ratio of protein to creatinine in the urine was raised to an abnormal level in five out of nine subjects. Four out of the nine subjects showed normal protein to creatinine ratios after wearing the device. The results showed that damage to the kidney occurred from wearing the resins after curing in half of the subjects. Conclusions: It is very important to conduct patient intakes which includes the assessment of renal function. Off-gassing in vented chambers may be needed to protect both prosthetists and patients.

A Study of Predicting the Severity Following Glufosinate Ammonium Containing Herbicide Poisoning Experienced in Single Emergency Medical Institution (단일 응급의료기관에서 경험한 글루포시네이트 암모니움 포함 제초제 중독 후 중증도 예측에 관한 연구)

  • Lee, Doo Sung;Choi, Kyoung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.17 no.1
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    • pp.7-13
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    • 2019
  • Purpose: Owing to the increased agricultural use of the herbicide glufosinate ammonium (GLA), the incidence of GLA poisoning has recently increased. Therefore, we investigated the possible predictive factors associated with severe complications following GLA poisoning. Methods: A retrospective analysis of medical records was conducted based on 76 patients who had visited our regional emergency medical center with GLA poisoning from 2006 to 2017. Severe complications were defined as respiratory failure requiring intubation, systolic blood pressure less than 90 mmHg, Glasgow Coma Scale (GCS) less than 8, and presence of seizure. Results: Age, ingested amount and ingested amount per weight were significantly greater in the severe group (p<0.001). PSS grade 2 or higher was more common in the severe group (p<0.001), and In addition, the APACHE II score was significantly higher in the severe group (p<0.001), as were the SOFA scores (p=0.002). Serum ammonia levels were significantly higher in the severe group (p=0.007), while MDRD-GFR was smaller in the severe group (p=0.002). The spot urine protein levels were significantly higher in the severe group (p=0.005), as was the urine protein to creatinine ratio (p=0.001). Upon multivariate analysis, the amount ingested per weight and PSS grade 2 or higher were identified as significant predictors. Conclusion: Our study showed that MDRD-GFR was significantly lower in the severe group after GLA poisoning. PSS grade 2 or higher and ingested amount per weight may be useful to evaluate the severity of complications after GLA poisoning.

A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

  • Lee, Mi-ji;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • v.23 no.1
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    • pp.53-57
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    • 2019
  • Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

Effects of replacement of para-grass with oil palm compounds on body weight, food intake, nutrient digestibility, rumen functions and blood parameters in goats

  • Buranakarl, C.;Thammacharoen, S.;Semsirmboon, S.;Sutayatram, S.;Chanpongsang, S.;Chaiyabutr, N.;Katoh, K.
    • Asian-Australasian Journal of Animal Sciences
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    • v.33 no.6
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    • pp.921-929
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    • 2020
  • Objective: The aim of the present study was to investigate the beneficial effects of dietary supplementation with oil palm frond (leaf) (OPF) with and without oil palm meal (OPM) on nutrient intake and digestibility, ruminal fermentation and growth performance in goats. Methods: Six female crossbred goats were fed for 28 days of 3 diet treatments; 100% para-grass (T1); 50% para-grass + 50% OPF (T2), and 30% para-grass + 50% OPF + 20% OPM (T3). Body weight, rectal temperature, respiratory rate, and urine volume, food intake, dry matter intake and water intake were measured daily. Nutrient digestibility was determined from five consecutive days of last week in each diet. Ruminal fluid, urine and blood were collected at the end for determination of rumen protozoa and volatile fatty acid contents, urinary allantoin excretion, blood cell count and chemistry profiles. Results: Goats fed T2 and T3 showed higher dry matter and nutrients intakes while protein digestibility was suppressed compared with those for T1. Crude fat digestibility declined in T2 but maintained after adding the OPM (T3). High fat intake by giving OPF and OPM corresponded to a higher ruminal acetate/propionate ratio (C2/C3) and serum cholesterol level. An increased urinary allantoin/creatinine ratio was found in T2 and T3 compared with T1, implying an increased number of ruminal microbes. Conclusion: Increased dry matter intake in T2 and T3 suggested that oil palm by-products are partly useful as a replacement for para-grass in goats. Replacement with the by-products increased plasma cholesterol level, which suggested that these products are a useful energy source. Changes in rumen parameters suggested an increased microbial number and activity suitable for acetate production. However, the limited digestibility of protein implies that addition of high protein feeds may be recommended to increase body weight gain of goats.

Effects of different levels of dietary crude protein on growth performance, blood profiles, diarrhea incidence, nutrient digestibility, and odor emission in weaning pigs

  • Hongjun Kim;Haewon Shin;Yoo Yong Kim
    • Animal Bioscience
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    • v.36 no.8
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    • pp.1228-1240
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    • 2023
  • Objective: This experiment was conducted to evaluate the effects of different levels of dietary crude protein (CP) on growth performance, blood profiles, diarrhea incidence, nutrient digestibility, and odor emission in weaning pigs. Methods: A total of 240 weaning ([Yorkshire×Landrace]×Duroc) pigs (8.25±0.050 kg body weight [BW]) were assigned to six treatments based on sex and initial BW, with five replicates of eight pigs per pen in a randomized complete block design. Experimental diets with different crude protein levels for early and late weaning phases were as follows: i) CP16, corn-soybean-based diet containing 16%/15% CP; ii) CP17, corn-soybean-based diet containing 17%/16% CP; iii) CP18, corn-soybean-based diet containing 18%/17% CP; iv) CP19, corn-soybean-based diet containing 19%/18% CP; v) CP20, corn-soybean-based diet containing 20%/19% CP; and vi) CP21, corn-soybean-based diet containing 21%/20% CP. Results: In the early weaning period, average daily feed intake increased when the dietary CP level decreased (linear, p<0.05). During the entire experimental period, average daily gain and the gain to feed ratio decreased when the dietary CP level increased (linear, p<0.01). Additionally, a decrease in dietary CP level resulted in a linear increase in final BW (linear, p<0.05). In the early and late weaning periods, blood urea nitrogen (BUN) decreased when the dietary CP level decreased (linear, p<0.01). There were no significant differences in creatinine, glucose, total protein, triglyceride or insulin-like factor-1 levels over the experimental period. The concentrations of immunoglobulin A (IgA) and IgG were not significantly affected by dietary CP levels during the experimental period. In the early weaning period, fecal and urine N decreased when the dietary CP level decreased (linear, p<0.01). No differences in nutrient digestibility among the treatments during the early weaning period were found. Throughout the whole experimental period, when the dietary CP level decreased in the weaning pig diet, the diarrhea incidence decreased linearly (linear, p<0.01). Throughout the whole experimental period, when the dietary CP level decreased in the weaning pig diet, ammonia, amines and hydrogen sulfide decreased linearly (linear, p<0.01). Conclusion: Reducing dietary CP could decrease diarrhea incidence, the concentration of BUN in serum and odor emission in manure. Furthermore, it could improve N excretion in feces and urine and growth performance in weaning pigs.

Intraoperative fluid therapy for video-assisted ovariohysterectomy in dogs

  • Oliveira, Marilia Teresa de;Feranti, Joao Pedro Scussel;Coradini, Gabriela Pesamosca;Chaves, Rafael Oliveira;Correa, Luis Felipe Dutra;Linhares, Marcella Teixeira;Thiesen, Roberto;Silva, Marco Augusto Machado;Brun, Mauricio Veloso
    • Journal of Veterinary Science
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    • v.22 no.3
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    • pp.44.1-44.15
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    • 2021
  • Background: Intraoperative fluids are still poorly studied in veterinary medicine. In humans the dosage is associated with significant differences in postoperative outcomes. Objectives: The aim of this study is to verify the influence of three different fluid therapy rates in dogs undergoing video-assisted ovariohysterectomy. Methods: Twenty-four female dogs were distributed into three groups: G5, G10, and G20. Each group was given 5, 10, and 20 mL·kg-1·h-1 of Lactate Ringer, respectively. This study evaluated the following parameters: central venous pressure, arterial blood pressure, heart rate, respiratory rate, temperature, acid-base balance, and serum lactate levels. Additionally, this study evaluated the following urinary variables: urea, creatinine, protein to creatinine ratio, urine output, and urine specific gravity. The dogs were evaluated up to 26 h after the procedure. Results: All animals presented respiratory acidosis during the intraoperative period. The G5 group evidenced intraoperative oliguria (0.80 ± 0.38 mL·kg-1·h-1), differing from the G20 group (2.17 ± 0.52 mL·kg-1·h-1) (p = 0.001). Serum lactate was different between groups during extubation (p = 0.036), with higher values being recorded in the G5 group (2.19 ± 1.65 mmol/L). Animals from the G20 group presented more severe hypothermia at the end of the procedure (35.93 ± 0.61℃) (p = 0.032). Only the members of the G20 group presented mean potassium values below the reference for the species. Anion gap values were lower in the G20 group when compared to the G5 and G10 groups (p = 0.017). Conclusions: The use of lactated Ringer's solution at the rate of 10 mL·kg-1·h-1 seems to be beneficial in the elective laparoscopic procedures over the 5 or 20 mL·kg-1·h-1 rates of infusion.

Urinary Protein and Enzyme Excretion of Spot Urine in Children with Vesicoureteral Reflux (방광요관 역류증 환아의 단회뇨에서 요단백 및 효소 배설 측정)

  • Yoon, Jung-Rim;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.56-62
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    • 2009
  • Purpose : The aim of this study was to evaluate the clinical usefulness of measurement of ${\beta}_2$ microglobulin (${\beta}_2$ MG), N-acetyl-$\beta$-D-glucosaminidase (NAG) of spot urine samples as indices of renal tubular damage and microalbumin of spot urine samples as a parameter of glomerular damage in children with vesicoureteral reflux (VUR) or renal defects. Methods : We studied 91 children with previous UTI. The children were classified as 62 children without VUR and renal defects (group I), 10 children with VUR, without renal defects (group II), and 19 children with VUR and renal defects (group III). Patients having VUR were separated according to the degree of VUR (mild VUR: VUR grade I-III, severe VUR: VUR grade IV-V). Urinary excretion of ${\beta}_$ microglobulin (${\beta}_2$ MG), microalbumin, N-acetyl-$\beta$-D-glucosaminidase (NAG), creatinine were measured in samples of morning urine specimens. Children with VUR or renal defects detected by voiding cystourethrography (VCUG) and DMSA renal scan were investigated. Results : Microalbumin/Cr ratio of spot urine was significantly increased in group III compared group I ($42.3{\pm}27.2\;mg/gCr$ vs $25.2{\pm}10.9\;mg/gCr$, P<0.05). NAG/Cr ratio of spot urine was significantly increased in group II compared group I ($3.70{\pm}23.4\;mg/gCr$ vs $18.7{\pm}12.7\;mg/gCr$, P<0.05). There was no statistically significant difference of ${\beta}_2$ MG/Cr ratio among three groups. Conclusion : Urinary microalbumin excretion of morning urine sample may be a simple and reliable clinical indicators for early identification of renal damage in children with VUR and renal defects. Urinary microalbumin excretion may be useful marker to predict the the severity of VUR.

Effect of renin inhibition on an experimental glomerulonephritis - a preliminary report (레닌 억제제가 실험적 사구체 콩팥염에 미치는 효과 - 예비 보고)

  • Kang, Ju-Hyung;Heo, Jae-Kyung;Lee, Young-Sook;Han, Ji-Young;Ha, Il-Soo
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.938-943
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    • 2009
  • Purpose : We performed this study in order to investigate the effect of direct renin inhibition on an experimental animal model with nephrotoxic serum nephritis and tried to give useful information for clinical research and renin inhibitor treatment. Methods : Thirty BALB/c 6-week-old male mice were divided into 4 groups: control group (CO, n=5), control-treatment group with aliskiren (CT, n=5), disease group (DO, n=10), and disease treatment group with aliskiren (DT, n=10). Nephritis was induced by an intravenous injection of 0.25 mg/g weight of rabbit anti-GBM immunoglobulin G. Model 2002 Alzet mini-osmotic pumps (Durect Corp.) for aliskiren infusion were implanted into CT and DT. Each group strain was sacrificed serially one at a time on day 14. We estimated the protein-creatinine ratio in 12-hour-collected urine (UP/Cr) and measured the mesangial matrix score in the PAS-stained kidney of each strain. Results : One strain at CT and DT died on day 6 and 7, respectively. Each group strain was sacrificed serially at a time on day 10 because DO were seriously ill. The UP/Cr of each group is as follows: CO, $31.24{\pm}6.54mg/mg$, CT, $23.38{\pm}13.60mg/mg$, DO, $112.72{\pm}10.97mg/mg$, DT $114.07{\pm}32.30mg/mg$. There was no significant difference between DO and DT. The mesangial matrix score of each group was CO, $0.23{\pm}0.10$; CT, $0.13{\pm}0.03$; DO, $1.90{\pm}0.48$; and DT, $1.28{\pm}0.41$, respectively, and there was a significant difference between DO and DT in the extent of mesangial matrix expansion (P=0.008). Conclusion : We found that renin inhibition was able to suppress the mesangial matrix expansion in experimental mice with acute nephritis, although there were no significant differences in UP/Cr.

Comparison of the Therapeutic Efficacy of Methylprednisolone Pulse Therapy and Oral Steroid Therapy in Children with IgA Nephropathy and HSP Nephritis Combined with Proteinuria (단백뇨를 동반한 IgA 신병증 및 HSP 신염을 가진 소아에서 메틸프레드니솔론 충격요법과 경구 스테로이드 요법의 비교)

  • Ahn, Ji Young;Moon, Jung Eun;Hwang, Young Ju;Choi, Bong Seok;Ko, Cheol Woo;Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.18 no.1
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    • pp.24-28
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    • 2014
  • Purpose: The purpose of this study was to assess the therapeutic efficacy of methylprednisolone pulse therapy in children with IgA nephropathy and Henoch- Sch$\ddot{o}$nlein Purpura (HSP) nephritis combined with proteinuria. Methods: We retrospectively reviewed the clinical records of 21 patients who were diagnosed with IgA nephropathy and HSP nephritis based on percutaneous renal biopsy. Of the 21 patients, 15 were diagnosed with IgA nephropathy and 6 were diagnosed with HSP nephritis. They had mild to severe proteinuria at the time of diagnosis or during follow-up. Group 1 (n=7) received methylprednisolone pulse therapy three times every couple of months, and Group 2 (n=14) received oral steroid therapy. The follow-up periods for Group 1 and 2 were 14.0 (9-54) months and 26.5 (14-34) months, respectively. There was no significant difference in the follow-up duration between the two groups. Results: The average age at diagnosis and biopsy was lower in Group 1 compared to Group 2, but it was not significantly different. At admission, all patients in both groups had hematuria and 5 patients (71.4%) of Group 1 and 14 patients (100 %) of Group 2 had proteinuria. Before treatment, there was no significant difference of spot urine protein/creatinine ratio between the two groups. During followup, 7 patients of Group 1 (100%) and 10 patients of Group 2 (71.4%) showed complete improvement of proteinuria and the spot urine protein/creatinine ratio in Group 1 was significantly lower than Group 2. Conclusion: In patients with IgA nephropathy and HSP nephritis with proteinuria, methylprednisolone pulse therapy was more effective than oral steroid therapy in the reduction of proteinuria. To investigate the effects on long-term prognosis, large-scale prospective studies are needed.

Severe Nephritic-nephrotic Syndrome with Small Bowel Perforation in a Child with $Henoch-Sch\ddot{o}nlein$ Purpura (신염-신증후군과 소장 천공을 동반한 $Henoch-Sch\ddot{o}nlein$ 자반증 1례)

  • Kim, Gun-Ha;Shin, Hye-Kyung;Yim, Hyung-Eun;Hong, Young-Sook;Lee, Joo-Won;Won, Nam-Hee;Yoo, Kee-Hwan
    • Childhood Kidney Diseases
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    • v.11 no.1
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    • pp.106-111
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    • 2007
  • [ $Henoch-Sch\ddot{o}nlein$ ] Purpura(HSP) is a form of vasculitis that typically affects small arteries in the skin, joints, intestinal tract and kidneys. It usually resolves spontaneously but sometimes can cause serious problems in the kidneys and intestinal tract. A 6-year-old girl with purpura, arthralgia and abdominal pain for 2 weeks was admitted. She also showed gross hematuria, generalized edema and decreased urine output. Blood pressure was in the upper normal range. Initial laboratory findings showed hypoalbuminemia, hyperlipidemia, microhematuria and nephrotic-range proteinuria(27.2 g/day). Initially, she was treated with pulse methylprednisolone, azathioprine, albumin and furosemide. Her renal biopsy revealed diffuse mesangial proliferation with strong IgA deposition. There were no crescents. On the third hospital day, she complained of severe abdominal pain and free peritoneal air was seen on abdominal X-ray. Primary repair of small bowel was performed and two pin-point sized holes were found. One week later, she still showed heavy proteinuria. Therefore, we added an ACE inhibitor and dipyridamole, and changed azathioprine to cyclosporine. One month later, the urine protein/creatinine ratio was decreased to 17.8 from 57, but heavy proteinuria has been still persisted. Here we report a rare case of a patient with HSP who had both severe nephrritc-nephrotic syndrome and small bowel perforation.

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