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Estimation of Burden of kidney Dysfunction in HIV-Infected Pediatrics and Adolescents by Use of Urinary Neutrophil Gelatinase-Associated Lipocalin: A Single Center Experience in kenya

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Infectious Diseases & Immunity 2022年第1期2卷 9-14页

作者： Anne P.Lomole William M.Macharia Mary S.Limbe Doris W.kinuthia samuel k.kabinga Aga khan University Medical College East AfricaAga Khan University HospitalNairobiKenya University of Nairobi East African Kidney InstituteNairobiKenya

Background:About 75%of patients infected with human immunodeficiency virus(HIV)live in sub-Saharan *** kenya,about 1.5 million kenyans are living with HIV,of whom almost 100,000 are children and *** active antiretroviral therapy(HAART)has converted HIV infection to a chronic illness with its attendant *** disease is a common complication of HIV infection and its *** disease in HIV-infected persons can be asymptomatic,insidious onset and may lack specific clinical *** can only be detected on active *** urine albumin-to-creatinine ratio and estimated glomerular filtration rate(eGFR)using serum creatinine are not sensitive in identification of early kidney *** neutrophil gelatinase-associated lipocalin(uNGAL)has been used as marker of early kidney ***:This cross-sectional study used uNGAL and serum creatinine to determine the prevalence of kidney dysfunction in HIVinfected children and adolescents with HAART at Gertrude’s Children’s Hospital,Nairobi,kenya,from March 2016 to February *** samples were assayed for uNGAL using the Bio Porto®enzyme-linked immunosorbent *** creatinine was assayed using the Jaffe reaction in the Cobas®6000 biochemistry analyzer and eGFR calculated using the Schwartz *** plot of eGFR against log uNGAL levles was performed by Statistical Package for Social Sciences and Pearson correlation coefficeint between log uNGAL levles and eGFR was ***:Ninety-three patients were *** mean age was 11.8±3.6 years and the median duration on HAART was 72.6 *** were 47(50.5%).The prevalence of kidney dysfunction using uNGAL was 15.1%(95%CI 7.6%–22.5%)and 5.4%(95%CI 1.8%–12.1%)by *** mean eGFR was 131±25mL·min1·1.73m2 and median uNGAL was 10 ng/*** every one ng/mL increase in uNGAL value above the normal value,eGFR decreases by 4.8mL·min1·1.73m2(P=0.038).Patients with elevated uNGAL were older when co

关键词： HIV Estimated glomerular filtration rate Highly active antiretroviral therapy kidney disease Serum creatinine uNGAL

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Concordance between bio-impedance analysis and clinical score in fluid-status assessment of maintenance haemodialysis patients: A single centre experience

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World Journal of Nephrology 2022年第4期11卷 127-138页

作者： kamiti Muchiri Joshua k kayima Elijah N Ogola Seth McLigeyo Sally W Ndung’u samuel k.kabinga Clinical Medicine and Therapeutics University of NairobiNairobi+254Kenya Department of Clinical Medicine and Therapeutics University of NairobiNairobi+254Kenya Department of Public Health University of NairobiNairobi+254Kenya East African kidney Institute University of NairobiNairobi+254Kenya

BACkGROUND The burden of chronic kidney disease(CkD)is rising rapidly *** overload(FO),an independent predictor of mortality in CkD,should be accurately assessed to guide estimation of the volume of fluid to be removed during haemodialysis(HD).Clinical score(CS)and bio-impedance analysis(BIA)have been utilized in assessment of FO and BIA has demonstrated reproducibility and accuracy in determination of fluid status in patients on *** is need to determine the performance of locally-developed CSs in fluid status assessment when evaluated against *** To assess the hydration status of patients on maintenance HD using BIA and a CS,as well as to evaluate the performance of that CS against BIA in fluid status *** This was a single-centre,hospital-based cross-sectional study which recruited adult patients with CkD who were on maintenance HD at kenyatta National *** patients were aged 18 years and above and had been on maintenance HD for at least 3 *** with pacemakers,metallic implants,or bilateral limbs amputations were *** on the patients’clinical history,physical examination,and chest radiograph findings were *** was performed on each of the study participants using the Quantum®II bio-impedance analyser manufactured by RJL Systems together with the BC 4®*** evaluating the performance of the CS,BIA was considered as the gold standard test.A 2-by-2 table of the participants’fluid status at each of the CS values obtained compared to their paired BIA results was constructed(either++,+-,--or-+for FO using the CS and BIA,respectively).The results from this 2-by-2 table were used to compute the sensitivity and specificity of the CS at the various reference points and subsequently plot a receiver operating characteristic(ROC)curve that was used to determine the best cut-off *** above and below the best CS cut-off point as determined by the ROC were classified as being positive and negative for FO

关键词： Bio-impedance analysis Clinical score Chronic kidney disease Maintenance haemodialysis Fluid overload Concordance

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