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South China Journal of Cardiology 2021年第2期22卷 89-95页

作者： CHEN Hai-min FAN Jia-jia CHEN Yong-chi Guangdong Provincial Geriatrics Institute Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhou 510080GuangdongChina

Background Acute kidney injury(AKI)was a risk factor for poor outcomes in patients with ST-segment elevation myocardial infarction(STEMI).Whether postoperative serum creatinine(SCr)level measured at early time(24 hours)after percutaneous coronary intervention(PCI)had prognostic role in elderly patients with STEMI was *** SCr was measured within 24 hours after PCI.A total of 883 elderly patients(≥60 years)with STEMI were finally included and divided into three group according to the tertiles of postoperative SCr level(umol/L):120 umol/L had a sensitivity of 66.7%and specificity of 79.2%for predicting in-hospital death[area under the curve(AUC)=0.768,95%CI:0.697-838,P120 umol/L was an independent risk factor for in-hospital mortality even after adjusting for the baseline renal dysfunction[estimated glomerular filtration rate(e GFR)120 umol/L had a higher one-year mortality than those without(Log-rank test:57.8,P<0.001).Conclusions SCr level measured within 24 hours after PCI could serve as an early and powerful marker for predicting in-hospital and one-year mortality in elderly patients with STEMI.

关键词： elderly ST-segment elevation myocardial infarction serum creatinine

Cystatin C and serum creatinine in estimating acute kidney injury of shock patients

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World Journal of Emergency Medicine 2010年第3期1卷 185-189页

作者： Qiang Li Jie-yu Fang Wei-ping Wang Jiang-hui Liu Ke-ke Wang Department of Surgery FirstAf liated HospitalSun Yat-sen UniversityGuangzhou 510080China

BACKGROUND： serum creatinine （SCr） is the most commonly used parameter to estimate renal function impairement, but there are some shortcomings. Many factors including age, gender, drug, diet, muscle mass and metabolic rate can in？ uence SCr, leading to an inaccurate estimation of kidney impairment. Studies have shown that cystatin C （CysC） is not affected by factors such as muscle mass, age, gender, diet, in？ ammation or tumor. The present study was undertaken to compare the sensitivity of CysC and SCr in evaluating renal function impairment at early stage of ***： Seventy-one patients aged 38.3±21.4 years, who had been treated at the Emergency Medicine Department of the First Affiliated Hospital, Sun Yat-sen University between February 2006 and June 2007, were studied. They were divided into groups A, B, C, and D according to the shock time. serum sample was drawn from each patient at 1, 2, 3, 4 hours after shock to determine SCr and CysC. CysC and SCr were determined again at 72 hours and 7 days after ***： CysC increased earlier than SCr in the 71 patients, and CysC decreased slower than SCr when shock was corrected. CysC increased at 1 hour after shock. There was a negative correlationship between CysC, SCr and glomerular filtration rate （GFR）, especially at early stage of ***： There is renal injury at early stage of shock. CysC is more sensitive than SCr in assessing renal function at the early stage of shock.

关键词： Cystatin C serum creatinine Shock Acute kidney injury

Exploring the Role of serum Cystatin C in Early Detection of Acute Kidney Injury among On-Pump Cardiac Surgery Patients: A Single-Center Investigation in Bangladesh

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World Journal of Cardiovascular Diseases 2024年第6期14卷 363-373页

作者： Md. Ahaduzzaman Md. Abir Tazim Chowdhury Munama Magdum Md. Saiful Islam Khan Satyajit Sharma Monoj Tiwari Md. Abul Bashar Maruf Md. Alauddin Omar Sadeque Khan Md. Mostafizur Rahman Mirza Md. Nazmus Saquib Department of Cardiothoracic and Vascular Surgery Evercare Hospital Dhaka Dhaka Bangladesh Department of Preventive and Social Medicine National Institute of Preventive and Social Medicine Dhaka Bangladesh Department of Cardiothoracic Anesthesia Evercare Hospital Dhaka Dhaka Bangladesh Department of Cardiac Surgery National Heart Foundation Hospital & Research Institute Dhaka Bangladesh Department of Cardiovascular and Thoracic Surgery B.P. Koirala Memorial Cancer Hospital Bharatpur Chitwan Nepal Department of Cardiac Surgery United Hospital Limited Dhaka Bangladesh Department of Cardiac Surgery Bangabandhu Sheikh Mujib Medical University Dhaka Bangladesh Department of Cardiac Surgery Ibrahim Cardiac Hospital & Research Institute Dhaka Bangladesh

Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of BSMMU in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, serum creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analy

关键词： Acute Kidney Injury (AKI) On-Pump Cardiac Surgery serum Cystatin C serum creatinine Diagnostic Biomarkers Early Detection Cardiopulmonary Bypass Single-Center Study Bangladesh

Values of Donor serum Lipids and Calcium in Predicting Graft Function after Kidney Transplantation:A Retrospective Study

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当代医学科学(英文) 2023年第3期43卷 514-519页

作者： Hui-bo SHI Yuan-yuan ZHAO Yu LI Yi LI Bin LIU Nian-qiao GONG Sheng CHANG Dun-feng DU Lan ZHU Jing XU Xiao-qin LI Meng-jun ZENG Shang-xin DONG Zhi-shui CHEN Ji-pin JIANG Institute of Organ Transplantation Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyKey Laboratory of Organ TransplantationMinistry of EducationMinistry of Public HealthChinese Academy of Medical SciencesWuhan430030China The Organ Procurement Organizations Ofice Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Objective Delayed graft function(DGF)and early graft loss of renal grafts are determined by the quality of the kidneys from the deceased ***“non-traditional”risk factors,serum biomarkers of donors,such as lipids and electrolytes,have drawn increasing attention due to their effects on the postoperative outcomes of renal *** study aimed to examine the value of these serum biomarkers for prediction of renal graft *** The present study consecutively collected 306 patients who underwent their first single kidney transplantation(KT)from adult deceased donors in our center from January 1,2018 to December 31,*** correlation between postoperative outcomes[DGF and abnormal serum creatinine(SCr)after 6 and 12 months]and risk factors of donors,including gender,age,body mass index(BMI),past histories,serum lipid biomarkers[cholesterol,triglyceride,high-density lipoprotein(HDL)and low-density lipoprotein(DL)],and serum electrolytes(calcium and sodium)were analyzed and ***(1)Donor age and pre-existing hypertension were significantly correlated with the incidence rate of DGF and high SCr level(≥2 mg/dL)at 6 and 12 months after KT(Pserum lipids,merely the low level of serum HDL of the donor was correlated with the reduced incidence rate of high SCr level at 12 months after KT[Pserum calcium of the donor was associated with the reduced incidence rate of high SCr level at 6 and 12 months after KT[Pserum HDL and calcium of the donor may serve as predictive factors for the postoperative outcomes of renal grafts after KT,in addition to the donor’s age,BMI and pre-existing hypertension.

关键词： delayed graft function serum creatinine serum high-density lipoprotein serum calcium kidney transplantation

Relationship of Transforming Growth Factor-β1 and Arginase-1 Levels with Long-term Survival after Kidney Transplantation

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Current Medical Science 2018年第3期38卷 455-460页

作者： Xiao-xiao DU Yu-liang GUO Min YANG Yan YU Sheng CHANG Bin LIU Lan-jun CAI Zhong-Hua Klaus Chen Institute of Organ Transplantation Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Key Laboratory of Organ Transplantation Ministry of Health and Key Laboratory of Organ Transplantation Ministry of Education Wuhan 430030 China Department of Otolaryngology-Head and Neck Surgery Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430030 China

In this study, we compared the serum levels of transforming growth factor-β1 （TGF-β1）, interleukin-10 （IL-10）, and arginase-1 in long-term survival kidney transplant recipients （LTSKTRs） with those in short-term survival kidney transplant recipients （STSKTRs）. We then evaluated the relationship between these levels and graft function. Blood samples were collected from 50 adult LTSKTRs and 20 STSKTRs （graft survival approximately 1-3 years post-transplantation）. All patients had stable kidney function. The samples were collected at our institution during the patients＇ follow-up examinations between March 2017 and September 2017. The plasma levels of TGF-β1, IL- 10, and arginase- 1 were analyzed using enzyme-linked immunosorbent assays （ELISA）. The levels of TGF-β1 and arginase-1 were significantly higher in the LTSKTRs than in the STSKTRs. The time elapsed since transplantation was positively correlated with the levels of TGF-β1 and arginase-1 in the LTSKTRs. The estimated glomerular filtration rate was positively correlated with the TGF-β1 level, and the serum creatinine level was negatively correlated with the TGF-β1 level. Higher serum levels of TGF-β1 and arginase-1 were found in LTSKTRs than in STSKTRs, and we found that TGF-β1 was positively correlated with long-term graft survival and function. Additionally, TGF-β1 and arginase-1 levels were positively correlated with the time elapsed since transplantation. On the basis of these findings, TGF-β1 and arginase- 1 may play important roles in determining long-term graft survival. Thus, we propose that TGF-β1 and arginase-1 may potentially be used as predictive markers for evaluating long-term graft survival.

关键词： transforming growth factor β1 arginase-1 long-term survival kidney transplant recipients estimated glomerular filtration rates serum creatinine

EFFECTS OF PROSTAGLANDIN E1 ON THE PROGRESSION OF ARISTOLOCHIC ACID NEPHROPATHY

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Chinese Medical Sciences Journal 2005年第1期20卷 67-69,页

作者： DongSun Jiang-minFeng Yan-lingZhao TaoJin Li-ningWang DepartmentofNephropathy theFirstAffiliatedHospitalChinaMedicalUniversityShenyang110001

Objective To investigate the effects of prostaglandin E1 (PGE1) on the progression of aristolochic acid nephropathy (AAN). Methods Twenty-four patients diagnosed as AAN with serum creatinine (Scr) between 1.5 mg/dL and 4 mg/dL during September 2001 to August 2003 were randomly divided into 2 groups. All patients had ingested long dan xie gan wan con-taining aristolochic acid (0.219 mg/g) for at least 3 months. Twelve patients were injected with Alprostadil (10 μg/d for 10 days in one month, summing up to 6 months). Except for PGE1, the other therapy was same in both groups. Renal function was assessed using reciprocal serum creatinine levels (1/Scr). Results The level of Scr and serum hemoglobin (Hgb) was similar in both groups prior to therapy. During follow-up, 1/Scr levels in PGE1 group were significantly higher than control group (P < 0.01), and Hgb levels in PGE1 group were sig-nificantly increased compared with control (P < 0.05).Conclusion PGE1 can slow the progression of renal failure and increase Hgb level of AAN patient.

关键词： prostaglandin E1 aristolochic acid nephropathy serum creatinine hemoglobin

Acute kidney injury in patients with chronic liver disease

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World Journal of Hepatology 2015年第7期7卷 993-1000页

作者： Nicolas Rognant Nephrology Department Centre Hospitalier Lyon-Sud

Acute kidney injury(AKI) is a frequent clinical event in patients with liver disease, compounding their prognosis. Furthermore, it is likely that the occurrence of AKI has a detrimental impact on the subsequent renal function and the long-term survival of these patients. Recently, some authors advocated the use of new diagnostic criteria for detecting acute kidney injury in patients with cirrhosis. These criteria are based on the rapidity and extent of the creatinine increase comparing to the basal creatinine and also on the kinetics of diuresis decrease. Although their validity in this population requires further studies to be clearly established, these new criteria could have two advantages:(1) to allow earlier diagnosis of AKI and, thus, hepatorenal syndromefor which earlier intervention could improve patients' survival; and(2) to promote more intensive monitoring of renal function in these patients with high risk of AKI. Finally, recent practice guidelines about the prevention and treatment of general AKI have been published which should be useful in optimising the management of AKI in cirrhotic patients.

关键词： Acute kidney injury Cirrhosis Hepatorenalsyndrome serum creatinine RIFLE/AKIN classification

Prophylaxis and Therapy of Isaria felina on Acute Renal Failure Induced by Glycerin in Rats

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Chinese Herbal Medicines 2012年第4期4卷 319-323页

作者： YANG Xi-hua2,3,ZHANG Sheng-wan1,REN Lian-sheng3,BAI Xi-hua3 1.College of Life Science,Shanxi University,Taiyuan 030006,China 2.College of Chemistry and Chemical Engineering,Shanxi University,Taiyuan 030006,China 3.Department of Comparative Medicine,Shanxi Cancer Institute,Taiyuan 030013,China College of Chemistry and Chemical Engineering Shanxi University Taiyuan 030006 China Department of Comparative Medicine Shanxi Cancer Institute Taiyuan 030013 China College of Life Science Shanxi University Taiyuan 030006 China

Objective To evaluate the prophylaxis and therapy of Isaria felina(IF) on glycerin-induced acute renal failure(ARF) in *** Forty male Wistar rats were divided into control,model,Uremic Clearance Granule(UCG,positive control),high-and low-dose IF *** in the high-and low-dose IF groups were ig administered with 200 and 100 mg/kg IF,respectively,while rats were ig administered with 3.6 g/kg UCG successively for 7 d to establish UCG *** rats in model,control,and drug-treated groups were im injected with 8 mL/kg 50% glycerin after drinking was quitted for 24 h to induce ARF in *** drugs were continued to give *** level of blood urea nitrogen(BUN) and serum creatinine(SCr) were determined 24 and 72 h after the injection of glycerin,also the kidney was dissected for pathology *** Im injection with 8 mL/kg 50% glycerin could successfully induce ARF in *** dose of 200 mg/kg IF could reduce the high levels of BUN and SCr,and ameliorate the pathological damage of the *** IF has good protective and therapeutic effects on ARF and it is a potential and valuable Chinese herb for ARF.

关键词： acute renal failure blood urea nitrogen glycerin Isaria felina serum creatinine

Instructions for Authors

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Chinese Medical Journal 2016年第1期 119-126页

Chinese Medical Journal （ CMJ） is published semimonthly in English by the Chinese Medical Association, and is a peer reviewed general medical journal for all physicians, doctors, medical researchers, and health workers. The journal reports the advances and progress in current medical sciences and technology. It also serves the objective of international academic exchange.

关键词： Acute Kidney Injury Critically Ill Mortality serum creatinine Urine Output

Value of Kidney Disease Improving Global Outcomes Urine Output Criteria in Critically III Patients： A Secondary Analysis of a Multicenter Prospective Cohort Study

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Chinese Medical Journal 2016年第17期129卷 2050-2057页

作者： Jun-Ping Qin Xiang-You Yu Chuan-Yun Qian Shu-Sheng Li Tie-He Qin Er-Zhen Chen Jian-Dong Lin Yu-Hang Ai Da-Wei Wu De-Xin Liu Ren-Hua Sun Zhen-Jie Hu Xiang-Yuan Cao Fa-Chun Zhou Zhen-Yang He Li-Hua Zhou You-Zhong An Yan Kang Xiao-Chun Ma Ming-Yan Zhao Li Jiang Yuan Xu Bin Du Medical Intensive Care Unit Peking Union Medical College Hospital Beijing 100730 China Department of Critical Care Medicine Beijing Tongren Hospital Capital Medical University Beijing 100730 China Department of Critical Care Medicine First Affiliated Hospital Xinjiang Medical University Urumqi Xinjiang 830054 China Department of Emergency Medicine and Medical Intensive Care Unit The First Affiliated Hospital of Kunming Medical University Kunming Yunnan 650032 China Department o1 Critical Care Medicine Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei 430030 China Department of Critical Care Medicine Guangdong General Hospital Guangzhou Guangdong 510080 China Department of Emergency Medicine Ruijin Hospital Shanghai Jiao Tong University Shanghai 200025 China Department of Critical Care Medicine The First Affiliated Hospital of Fujian Medical University Fuzhou Fujian 350005 China Department of Critical Care Medicine Xiangya Hospital Central South University Changsha Hunan 410008 China Department of Critical Care Medicine Qilu Hospital Shandong University Jinan Shandong 250012 China Department of Emergency and Critical Care Medicine The Second Hospital of Jilin University Changchun Jilin 130041 China Department of Critical Care Medicine Zhejiang Provincial People's Hospital Hangzhou Zhejiang 310014 China Department of Critical Care Medicine Hebei Medical University Fourth Hospital Shijiazhuang Hebei 050011 China Department of Critical Care Medicine Affiliated Hospital of Ningxia Medical University Yinchuan Ningxia 750004 China Department of Emergency and Intensive Care Medicine The First Affiliated Hospital Chongqing Medical University Chongqing 400016 China Department of Critical Care Medicine Hainan Provincial People's Hospital Haikou Hainan 570311 China Department of Critical Care Medicine The Affiliated Hospital of Inner Mongolia Medical College Hohhot Inner Mongolia 010050 China Department of C

Background： Urine output （UO） is an essential criterion of the Kidney Disease Improving Global Outcomes （KD1GO） definition and classification system tbr acute kidney injury （AKI）, of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria （KDtGOLro） could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria （KDIGOscr）.Methods： We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group （CCCCTG）, which was a 2-month prospective cohort study （July 1,2009 to August 31,2009） involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China. AKI was diagnosed and classified separately based on KDIGOt,o and KDlGOsc,. Hospital mortality of patients with more severe AKI classification based on KDIGOvo was compared with other patients by univariate and multivariate regression analyses. Results： The prevalence of AKl increased from 52.4% based on KDIGOscr to 55.4% based on KD1GOsc~ combined with KDIGOuo. KDIGOv~~ also restllted in an upgrade of AKI classification in 7.3% of patients, representing those with more severe AK1 classification based on KDIGOvo. Compared with non-AKI patients or those with maximum AKI classification by KDIGOscr, those with maximum AKI classification by KDIGOuo had a significantly higher hospital mortality of 58.4% （odds ratio [OR]： 7.580, 95% confidence interval [CI]： 4.141-13.873, P 〈 0.001）. In a multivariate logistic regression analysis, AKI based on KDIGOuo （OR： 2.891, 95% CI： 1.964-4.254, P 〈 0.001）, but not based on KDIGOscr （OR： 1.322, 95% CI： 0.902-1.939, P = 0.152）, was an independent risk factor for hospital mortality. Conclusion： UO was a criterion with additional value beyond creatinine criterion for AKI diagnosis and classification, which can help identify a group of patients with high risk of death.

关键词： Acute Kidney Injury Critically Ill Mortality serum creatinine Urine Output