GFR, glomerular filtration rate Dotaz Zobrazit nápovědu
Determinations of renal clearance of fluorescein isothiocyanate (FITC)-inulin were used for assessing the glomerular filtration rate (GFR) in rats and to characterize factors influencing the glomerular filtration capacity. In anesthetized rats, GFR develops after birth up to day 30. Thereafter, GFR remains relatively constant for up to 3 months of age and drops continuously until the 8th month. GFR can be determined in utero, already one day before birth, however, only at a very low level. It increases significantly on the first day of life. Even at this time the effect of furosemide on GFR can be proven. After reduction of renal mass, GFR is decreased in dependence on the extent of kidney tissue removal. However, within 2 days after unilateral nephrectomy (NX) or one week after 5/6 NX, GFR reaches values about 3/4 of the controls with two intact kidneys. Furthermore, the compensation of GFR after renal ischemia reaches 80% of baseline values after one week. On the other hand, GFR is enhanced after bile duct ligation as a model of hepato-renal failure. It has been shown in previous experiments that pretreatment with hormones can stimulate renal tubular transport processes. Pretreatment with dexamethasone or triiodothyronine after 5/6 NX improves glomerular filtration capacity whereas in animals with ligated bile ducts dexamethasone seems to prevent the increase in GFR. After subchronic treatment with epidermal growth factor (EGF) GFR is significantly reduced. A continuous infusion of amino acids does not change GFR in the controls but enhances the filtration capacity in EGF-treated rats. But immediately after bolus injection of amino acids GFR also increases significantly in the controls. Diuretics such as furosemide, most nephrotoxic agents (cyclosporine A [CsA], heavy metals) and imidazole reduce the GFR significantly. Diltiazem reported to act nephroprotectively in CsA nephrotoxicity in human beings was without beneficial effect in rats. This could be due to species differences in GFR because the rat is one of the species with the highest glomerular filtration capacity.
- MeSH
- cyklosporin toxicita MeSH
- druhová specificita MeSH
- fluorescein-5-isothiokyanát MeSH
- hodnoty glomerulární filtrace * MeSH
- inulin MeSH
- kinetika MeSH
- kovy toxicita MeSH
- krysa rodu Rattus MeSH
- ledviny patofyziologie chirurgie MeSH
- lidé MeSH
- nefrektomie MeSH
- nemoci ledvin chemicky indukované patofyziologie MeSH
- potkani Wistar MeSH
- stárnutí * MeSH
- uremie patofyziologie MeSH
- zvířata MeSH
- Check Tag
- krysa rodu Rattus MeSH
- lidé MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cyklosporin MeSH
- fluorescein-5-isothiokyanát MeSH
- inulin MeSH
- kovy MeSH
BACKGROUND: The aim of the study is to compare measured glomerular filtration rate by technetium radiolabled diethylene tiamine pentaacetic acid (mGFR DTPA) to estimated GFR (eGFR). Glomerular filtration rate (GFR) is estimated from serum creatinine (eGFRcreatinine), serum cystatin C (eGFRcystatin C) and by combined equation (eGFRcreatinine+cystatin C). This study focuses on oncology patients considered for treatment with cisdiamminedichloroplatinum (cisplatin). We evaluated the impact of different GFR methods on the reduction of cisplatin dose. PATIENTS AND METHODS: The study population consisted of 112 consecutive oncology patients from oncology center treated in the town of Zlin in the Czech Republic, who were considered for cisplatin treatment. mGFR DTPA was performed by dynamic renal 99mTc scintigraphy method using diethyltriaminepentaacetic acid. Creatinine and cystatin C were determined by newly standardized tests. Estimation of GFR was calculated using The Chronic Kidney Disease Epidemiology (CKD EPI) equations which were established in 2009 and 2012. RESULTS: The median (interquartile range) of mGFR DTPA was 1.335 ml/s/1.73 m2 (1.070-1.725). The median of eGFRcystatin C 1.195 ml/s/1.73 m2 (0.885-1.625) was lower than mGFR DTPA (p<0.05). The median of eGFRcreatinine 1.460 ml/s/1.73 m2 (1.210-1.660) was higher than mGFR DTPA (p<0.05). Correlation analysis and Bland Altman plots show high individual differences between mGFR DTPA and all eGFRs. CONCLUSIONS: Oncology patients are a very special group of patients who dif-fer from general population. There are significant individual differences between mGFR DTPA and all eGFRs, impacting detection rate of CKD and potential drug dosage adjustment.
- MeSH
- antitumorózní látky terapeutické užití MeSH
- cisplatina terapeutické užití MeSH
- cystatin C krev MeSH
- hodnoty glomerulární filtrace * MeSH
- kreatinin krev MeSH
- lidé MeSH
- nádory farmakoterapie patofyziologie MeSH
- technecium 99mTc pentetát MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antitumorózní látky MeSH
- cisplatina MeSH
- cystatin C MeSH
- kreatinin MeSH
- technecium 99mTc pentetát MeSH
The effect of revascularization on decreased glomerular filtration rate (GFR) was studied in 18 patients with renovascular hypertension (RVH) for a period of 5 to 74 months after operation. Renal artery stenosis (SRA) was present unilaterally in 3 patients, bilaterally in 13 patients, and in two patients with one kidney. Following surgical correction, the GFR increased or normalized in 6 patients, decreased in 2, and did not change in 10 patients. The blood pressure of almost 90% of the operated patients normalized or improved. The results support the assumption that severe hypertension is indicated for surgery, irrespective of the magnitude of GFR decrease. Revascularization effected a reversal of renal insufficiency only in a third of the patients.
- MeSH
- aorta chirurgie MeSH
- arteria renalis chirurgie MeSH
- dospělí MeSH
- hodnoty glomerulární filtrace * MeSH
- ledviny krevní zásobení MeSH
- lidé středního věku MeSH
- lidé MeSH
- metody MeSH
- následné studie MeSH
- nefrektomie MeSH
- obstrukce renální arterie chirurgie MeSH
- předoperační péče MeSH
- renální hypertenze chirurgie MeSH
- renovaskulární hypertenze chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
According to some findings [Ross et al. 1987], the plasma concentration of creatinine (Pcr) is an inaccurate reflection of the glomerular filtration rate (GFR) in renal graft recipients with stabilized renal function, treated with cyclosporine A (CyA). In this study, we sought to determine whether the inaccuracy of GFR assessment on the basis of Pcr or creatinine clearance (Ccr) in these individuals is greater than in patients suffering from various chronic renal diseases untreated by any drugs during the examination. The study was performed in 30 renal graft recipients, treated with CyA in combination with azathioprine and prednisone. Further, 51 patients suffering from a chronic renal disease, mostly chronic glomerulonephritis or tubulointerstitial nephritis, were investigated. GFR was evaluated on the basis of polyfructosan clearance (CPF). A significant linear relation between Ccr and CPF (r = 0.829, p less than 0.001) was demonstrated in individuals with a transplanted kidney graft treated with CyA. A relationship of the same character was observed in the group of patients suffering from chronic renal diseases (r = 0.935, p less than 0.001). There is no statistically significant difference between the regression lines characterizing these relationships in both groups. A significant correlation of hyperbolic character between Pcr and CPF was found in both groups investigated (r = 0.693, p less than 0.001, and r = 0.741, p less than 0.001, respectively). The hyperbolic relationship noted in the studied groups did not differ significantly. These findings confirm a normal, or a mildly raised Pcr can be associated with a marked decrease in GFR, in some cases to a value as low as a third of the normal one.(ABSTRACT TRUNCATED AT 250 WORDS)
- MeSH
- chronické selhání ledvin krev moč MeSH
- cyklosporin farmakologie terapeutické užití MeSH
- dospělí MeSH
- fruktany * MeSH
- hodnoty glomerulární filtrace účinky léků MeSH
- kreatinin krev metabolismus moč MeSH
- lidé středního věku MeSH
- lidé MeSH
- transplantace ledvin * fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Názvy látek
- cyklosporin MeSH
- fruktany * MeSH
- kreatinin MeSH
- polyfructosan MeSH Prohlížeč
BACKGROUND: The aim of the study was to analyze the degree of obesity and its associations with age, gender, inflammation, an estimated glomerular filtration rate (eGFR), and liver function in type 2 diabetes mellitus (T2DM) patients. METHODS: A total of 874 consecutive adult Caucasian T2DM patients from outpatient diabetic clinic were included in the study. The relative fat mass (RFM) and body mass index (BMI) were used as obesity markers. Serum creatinine and cystatin C were used for the GFR estimation. Serum high-sensitive C-reactive protein (hsCRP) was used as the indicator of inflammation. RESULTS: The median, interquartile range (IQR) of RFM in females was higher than that in males (44.8 (42.3-47.2) % vs 31.3 (28.8-34.1) %, respectively; P < .0001). The median (IQR) of BMI in females was no higher than that in males (30 (27-34) kg/m2 vs 30 (27-34), respectively; P = .5152). The obesity prevalence was 99% in males and 98% in females according to RFM. BMI recognized obesity in 51% males and 53% females. RFM was positively associated with hsCRP in both males (rs = .296, P < .0001) and females (rs = .445, P < .0001). ALT was positively correlated with eGFRcys in both males (rs = .379, P < .0001) and females (rs = .308, P < .0001). CONCLUSION: The RFM equation leads to higher obesity prevalence compared to BMI. Women have higher RFM compared to men. The kidney function was positively correlated with ALT serum concentrations.
- Klíčová slova
- abdominal fat, adipose tissue, alanine transaminase, body mass index, cystatin C, diabetes mellitus, glomerular filtration rate, inflammation, kidney diseases, obesity,
- MeSH
- C-reaktivní protein analýza MeSH
- chronická renální insuficience etiologie patofyziologie MeSH
- diabetes mellitus 2. typu komplikace patofyziologie MeSH
- hodnoty glomerulární filtrace * MeSH
- index tělesné hmotnosti MeSH
- jaterní testy MeSH
- lidé středního věku MeSH
- lidé MeSH
- průřezové studie MeSH
- retrospektivní studie MeSH
- senioři MeSH
- tuková tkáň * patofyziologie MeSH
- zánět etiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Názvy látek
- C-reaktivní protein MeSH
Serum BTP measurement is sometimes believed to be an alternative marker of glomerular filtration rate (GFR) assessment. The aim of the present work was to investigate the correlation between creatinine, cystatin C, and BTP values in sera and to compare the diagnostic efficacy for serum BTP and cystatin C with the glomerular filtration rate estimate. 25 individuals were tested. GFR was estimated from creatinine clearance, serum cystatin C and BTP and urine alpha-1 microglobulin, albumin, GMT and creatinine were measured. BTP values correlated with cystatin C (r = 0.75; p < 0.01), creatinine (r = 0.73, p < 0.01), GFR (r = -0.46; p = 0.02), urine alpha-1-microglobulin (r = 0.66; p < 0.01). The diagnostic efficacy of BTP for reduced GFR was insufficient and the calculation of GFR with BTP was not included in the regression model.
- MeSH
- biologické markery krev MeSH
- cystatin C MeSH
- cystatiny krev MeSH
- dospělí MeSH
- hodnoty glomerulární filtrace * MeSH
- intramolekulární oxidoreduktasy krev MeSH
- kreatinin krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- lipokaliny MeSH
- mladiství MeSH
- nemoci ledvin diagnóza MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- biologické markery MeSH
- CST3 protein, human MeSH Prohlížeč
- cystatin C MeSH
- cystatiny MeSH
- intramolekulární oxidoreduktasy MeSH
- kreatinin MeSH
- lipokaliny MeSH
- prostaglandin R2 D-isomerase MeSH Prohlížeč
Twenty-four hours after 90 min clamping of the left renal artery in dogs, the glomerular filtration rate (GFR) was decreased in the whole kidney (0.34 ml.min-1g KW-1 [KW = Kidney weight] vs 0.64 in contralateral unclamped kidney) just as in the single nephron (SNGFR, 19.7 vs 51.8 nl.min-1). Renal blood flow (RBF) did not change; single nephron glomerular blood flow (SNGBF) was decreased by 9% only. After injection of Lissamine green into the renal artery, brief diffuse tinting of the whole kidney surface was observed. Thereafter, patchy coloration - corresponding to passage of the dye through patient tubuli - took place in approximately one-quarter to one-third of the kidney surface. Micropuncture measurements were carried out in these areas. The values of hydraulic pressure in peritubular capillaries and proximal convolutions were not different from those found in controls; directly measured glomerular capillary pressure was decreased (48.7 vs 59.5 mmHg). The ultrafiltration coefficient(Kf) was significantly depressed (2.7 vs 3.8 mmHg.nl-1.min). Total kidney and arteriolar resistances remained unchanged but afferent resistance (RA) was elevated (11%) and efferent resistance (RE) was lowered (23%) compared with those of controls. Ninety-seven percent of proximally microinjected 3H-inulin was recovered from the control kidney but only 85% from the kidney rendered ischaemic. In conclusion, the typical findings at 24 h after 90 min ischaemia are low GFR and SNGFR with normal RBF and almost normal superficial SNGBF values. This phenomenon is mainly due to a decrease in Kf and a decrease in RE with a simultaneous increase in RA; back-leak through damaged tubuli seems to play only a minor role.
- MeSH
- cévní rezistence účinky léků fyziologie MeSH
- hodnoty glomerulární filtrace fyziologie MeSH
- inulin aplikace a dávkování MeSH
- ischemie patofyziologie MeSH
- ledviny krevní zásobení účinky léků fyziologie MeSH
- mikroinjekce MeSH
- nefrony krevní zásobení účinky léků fyziologie MeSH
- psi MeSH
- regionální krevní průtok účinky léků MeSH
- tritium MeSH
- zvířata MeSH
- Check Tag
- mužské pohlaví MeSH
- psi MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- inulin MeSH
- tritium MeSH
BACKGROUND: Serum cystatin C (Scyst) has an obvious advantage in recognizing the initial stages of renal impairment. However, several recent studies suggest that Scyst may also be affected by some nonglomerular factors such as thyroid dysfunction, glucocorticoid administration or metabolic status of the diabetic patient. The aim of this study was to evaluate whether obesity could affect Scyst. PATIENTS AND METHODS: The study was performed in 33 patients (mean age 49.1 +/- 6.3 years) with chronic renal disease (Scr = 227 +/- 118 micromol/l) and BMI = 35.6 +/- 1.8 kg/m2, and in 78 patients (mean age 43.4 +/- 5.1 years) with chronic renal disease (Scr = 245 +/- 111 micromol/l) and BMI = 24.0 +/- 1.8 kg/m2. Glomerular filtration rate (GFR) was determined using renal inulin clearance (Cin) under conditions of stabilized plasma concentrations and water loading. Scyst was measured using immunonephelometry. For statistical evaluation, linear regression analysis and receiver-operating characteristic (ROC) curve analysis were used. RESULTS: A significant correlation (r = 0.956, p < 0.001) between l/Scyst and Cin was demonstrated in patients with BMI > or = 30 kg/m2 (Group A). Similarly, a significant correlation (r = 0.900, p < 0.001) between l/Scys and Cin was found in patients with BMI < 30 kg/m2 (Group B). There was no significant difference between the regression straight lines characterizing these relationships. ROC curve analysis (using a cut-off value for Cin = 30 ml/min/1.73 m2) did not show significant differences in AUC, sensitivity and specificity for Scyst between obese and nonobese patients. CONCLUSION: The results suggest that evaluation of GFR based on Scyst in obese patients need not differ from that in nonobese ones.
- MeSH
- chronická nemoc MeSH
- cystatin C MeSH
- cystatiny krev MeSH
- dospělí MeSH
- hodnoty glomerulární filtrace * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nemoci ledvin krev komplikace patofyziologie MeSH
- obezita komplikace patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- CST3 protein, human MeSH Prohlížeč
- cystatin C MeSH
- cystatiny MeSH
Individuals after orthotopic liver transplantation (OLT) often show renal dysfunction, which may substantially affect the post-OLT course. Renal function after OLT is commonly assessed by means of serum creatinine (S(cr)) concentration or renal creatinine clearance (C(cr)). A glomerular filtration rate (GFR) estimate based on S(cr) level is not accurate enough because even a more marked decrease in GFR need not be associated with an increase in S(cr) level, especially in jaundiced patients. The study intends to try to estimate GFR in individuals after OLT by means of determining serum cystatin C (S(cyst)) concentrations. In 58 individuals (mean age, 49 +/- 7 years; 31 men, 27 women) at various intervals from OLT (mean, 14 +/- 10 months), GFR was estimated by using simultaneous determinations of S(cyst), S(cr), C(cr), and renal inulin clearance (C(in)). In most subjects (91.3%), C(in) was decreased to less than the lower limit of normal (80 mL/min/1.73 m(2)). A significant correlation (r = 0.70; P <.001) was found between 1/S(cyst) and C(in). Receiver operating characteristic analysis was performed on S(cyst) and S(cr) using a C(in) cutoff value of 80 mL/min/1.73 m(2). The area under the curve for S(cyst) was 0.912 +/- 0.044, and that for S(cr), 0.899 +/- 0.049. There was no statistically significant difference between these values. The sensitivity for a S(cyst) level of 1.20 mg/L (upper limit of normal value) to detect a decrease in GFR (measured as C(in)) below the lower limit of normal (80 mL/min/1.73 m(2)) was 96.1%. The sensitivity of S(cyst) level was significantly greater (P <.01) than the sensitivity of S(cr) level for men and at borderline significance for women (P =.05). Findings support the assumption that a S(cyst) level less than 1.2 mg/L indicates with a high degree of probability (P <.001) that GFR is not decreased to less than the normal limit. S(cyst) assessment in individuals after OLT could be proposed as a confirmatory test of a decrease in GFR in individuals with normal S(cr) levels.
- MeSH
- cystatin C MeSH
- cystatiny krev MeSH
- dítě MeSH
- dospělí MeSH
- hodnoty glomerulární filtrace * MeSH
- inulin metabolismus MeSH
- kreatinin krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- pooperační období MeSH
- ROC křivka MeSH
- senzitivita a specificita MeSH
- transplantace jater fyziologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- CST3 protein, human MeSH Prohlížeč
- cystatin C MeSH
- cystatiny MeSH
- inulin MeSH
- kreatinin MeSH
Our study aimed to establish the best prediction equation for different age ranges in estimating Glomerular Filtration Rate (GFR) in clinical practice in Slovakia. The GFR by 24-hour creatinine clearance (Ccr) and the estimated GFR (eGFR) using the Cockcroft-Gault (CG), the four-variable Modification of Diet in Renal Disease (MDRD4) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were obtained in adults aged 30-80 (n = 433, 10-years intervals). The correlation between these prediction equations and Ccr was evaluated. Errors in prediction equations were detected by moving average and by comparisons of the formulas for GFR < 1.5 ml/s and > 1.5 ml/s. The best correlations were established between Ccr and MDRD4 for women (r = 0.7790) and men (r = 0.8009), and between Ccr and CKD-EPI for women (r = 0.7780) and men (r = 0.8002) in the 60-69 age range. High correlation was also established between Ccr and CG (r = 0.8655) and MDRD4 (r = 0.8713) for men in the 40-49 age range. With the exception of the 30-40 age range, a low prediction error was observed for each age range in both genders when GFR was < 1.5 ml/s. We recommend utilization of the MDRD4 and CG equations for men (40-49 years) and MDRD4 and CKD-EPI for women and men (60-69 years), as preferred substitutes for Ccr.
- MeSH
- chronická renální insuficience diagnóza patofyziologie MeSH
- dospělí MeSH
- hodnoty glomerulární filtrace fyziologie MeSH
- kreatinin krev moč MeSH
- lidé středního věku MeSH
- lidé MeSH
- prediktivní hodnota testů MeSH
- senioři MeSH
- věkové rozložení MeSH
- vyšetření funkce ledvin metody MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Slovenská republika MeSH
- Názvy látek
- kreatinin MeSH