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glomerular filtration rate is Associated with Hemorrhagic Transformation in Acute Ischemic Stroke Patients without Thrombolytic Therapy

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Chinese Medical Journal 2018年第14期131卷 1639-1644页

作者： Ming-Su Liu Yan Liao Guang-Qin Li Department of Neurology First Affiliated Hospital of Chongqing Medical University Chongqing 400016 China Chongqing Key Laboratory of Neurobiology Chongqing 400016 China Department of Neurology Chengdu 363 Hospital of Southwest Medical University Chengdu Sichuan 610000 China

Background： Whether there is a relationship between glomerular filtration rate IGFR） and hcnlorrhagic transformation （HT） after acute ischemic stroke （A1S） is still under debate. The aim of our study was to determine whether the GFR level is a predictor of HT in AIS patients without thrombolytic therapy （TT）. Methods： Consecutive A IS patients without TT were included in this prospective study fiom January 2014 to December 2016 in the First Affiliated Hospital of Chongqiug Medical University. We divided them into two groups （HT and non-HT group） and meticulously collected baseline characteristics and laboratory and imaging data of interested individuals. Multivariate regression analysis was performed to assess the correlation between GFR and HT in stroke patients without TT. Results： Among 426 consecutive patients, 74 （17.3%） presented HT （mean age： 65 ± 12 years, number of male patients： 47） on the follow-up scans. In multivariate regression analysis, HT was significantly associated with low GFR （odds ratio [OR] = 3.708, confidence interval [CI] = 1.326-10.693, P = 0.013）, atrial fibrillation （AF; OR = 2.444, CI= 1.087-5.356, P = 0.027）, large cerebral inthrction （OR = 2.583, CI= 1.236-5.262, P= 0.010）, and hypoalbuminemia （HA OR = 4.814, CI= 1.054 22.153, P = 0.037） for AIS patients without TT. Conclusions： The present study strongly showed that lower GFR is an independently predictor of HT： in addition, large inlhrct volume, AF, and HA are also important risks of HT for AIS patients without TT, which offered a practical information that risk factors should be paid attention or eliminated to prevent HT for stroke patients though the level of evidence seems to be unstable.

关键词： glomerular filtration rate Hemorrhagic Transformation Nonthrombolytic Treatment： Stroke

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Changes in body composition in relation to estimated glomerular filtration rate and physical activity in predialysis chronic kidney disease

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Chronic Diseases and Translational Medicine 2022年第4期8卷 305-313页

作者： Prathiksha R.Bhat Asna Urooj Srinivas Nalloor Department of Studies in Food Science and Nutrition ManasagangotriUniveristy of MysoreMysuruKarnatakaIndia Department of Nephrology Apollo BGS hospitalsMysuruKarnatakaIndia

Background: Early body composition changes, associated with physical inactivity and disease advancement are devastating for patient-related outcomes in predialysis chronic kidney disease (CKD), thus warranting a detailed analysis of body composition beyond conventional measures.Methods: The study included 40 subjects diagnosed with CKD;recruited between January to May 2021. Body composition was measured using the multifrequency analyzer, InBody 770. International Physical Activity Questionnaire-Short Form was used to assess physical activity. Suitable statistical analyses were performed using SPSS 21.0.Results: The mean age of the subjects was 58.68 ± 12.24 years. Sarcopenic obesity was prevalent in 62.5% of the subjects. Body mass index under identified obesity by 15% compared to percent body fat, especially in subjects with low muscle mass. The decline in a unit of estimated glomerular filtration rate (eGFR) significantly correlated with a decrease in weight (p = 0.02), body fat mass (p = 0.05), visceral fat area (p = 0.05), and phase angle (p = 0.01) with marginal changes in waist–hip ratio and extracellular water/total body water. The effect of physical activity on skeletal muscle mass was homogeneous between low and moderate levels, but significantly different from high activity level.Conclusion: Changes in fat and fluid compartment were associated with eGFR decline, whereas higher physical activity positively affected body composition.

关键词： body composition electric impedance exercise glomerular filtration rate malnutrition

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Long-term effects of various types of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on changes in glomerular filtration rate in Korea

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Frontiers of Medicine 2019年第6期13卷 713-722页

作者： Seo Yeon Baik Hyunah Kim So Jung Yang Tong Min Kim Seung-Hwan Lee Jae Hyoung Cho Hyunyong Lee Hyeon Woo Yim Kun-Ho Yoon Hun-Sung Kim Department of Medical Informatics College of MedicineThe Catholic University of KoreaSeoul 06591Republic of Korea College of Pharmacy Sookmyung Women’s UniversitySeoul 04310Republic of Korea Division of Endocrinology and Metabolism Department of Internal MedicineSeoul St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoul 06591Republic of Korea Clinical Research Coordinating Center Catholic Medical CenterThe Catholic University of KoreaSeoul 06591Republic of Korea Department of Preventive Medicine College of MedicineThe Catholic University of KoreaSeoul 06591Republic of Korea

Few long-term follow-up studies have compared the changes in renal function according to the type of statin used in Korea.We compared the long-term effects of statin intensity and type on the changes in the glomerular filtration rate(GFR).We extracted data of patients who took statin for the first time.We analyzed whether or not different statins affect the changes in GFR at 3 months after baseline and 4 years after.We included 3678 patients and analyzed the changes in GFR.The GFR decreased by 3.2%±0.4%on average 4 years after the first statin prescription,indicating statistically significant deterioration(from 83.5±0.4 mL/min/1.73 m2 to 79.9±0.4 mL/min/1.73 m2,Prate that decreased by<60 mL/min/1.73 m2 was significantly lower than that of atorvastatin.Regarding long-term statin intake,GFR changed with the type of statin.This work is the first in Korea to compare each statin in terms of changes in the GFR after the statin prescription.

关键词： statin glomerular filtration rate HMG-CoA reductase inhibitor chronic kidney disease

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Dynamic changes of estimated glomerular filtration rate are conversely related to triglyceride in non-overweight patients

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World Journal of Clinical Cases 2022年第31期10卷 11371-11380页

作者： Si-Qi Liu Xiu-Jun Zhang Yuan Xue Rui Huang Jian Wang Chao Wu Yi-Shan He Ya-Ru Pan Long-Gen Liu Changzhou Clinical Medical College Nanjing Medical UniversityChangzhou 213000Jiangsu ProvinceChina Institute of Hepatology The Third People’s Hospital of ChangzhouChangzhou 213000Jiangsu ProvinceChina Department of Infectious Diseases Nanjing Drum Tower HospitalNanjing 210008Jiangsu ProvinceChina

BACKGROUND Correlation between Triglyceride(TG)and estimated glomerular filtration rate(eGFR)remains largely unknown in overweight and non-overweight patients.AIM To investigated the dynamic changes of eGFR and lipid profiles during 3-year tenofovir disoproxil fumarate(TDF)treatment in patients with chronic hepatitis B(CHB)and overweight.METHODS A total of 202 CHB patients who received TDF treatment at the Third People's Hospital of Changzhou(Changzhou,China)and Nanjing Drum Tower Hospital(Nanjing,China)between January 2016 and May 2018 were retrospectively enrolled.According to the body mass index(BMI)at the initiation of TDF treatment,CHB patients were divided into overweight(BMI≥25 kg/m^(2))and nonoverweight(BMI0.05).More patients in non-overweight group achieved alanine aminotransferase normalization compared with those in overweight group(χ^(2)=11.036,P<0.01).In non-overweight patients,the eGFR significantly declined in the 1^(st) year(P<0.01),then remained at a relatively lower level.TG significantly declined in the 2^(nd) year(P=0.02)and increased in the 3^(rd) year.Moreover,TG was negatively correlated with GFR at the four-time points(P=0.002,0.030,0.007,0.008,respectively).In overweight patients,eGFR and TG remained relatively stable during the 3-year treatment,and eGFR showed no significant relationship with TG.Moreover,multivariate analysis showed that age[P<0.01,95%CI(0.97-1.005)]and baseline eGFR[P<0.01,95%CI(5.056-33.668)]were independent risk factors for eGFR<90 mL/(min·1.73 m^(2))at the 3^(rd) year.CONCLUSION Dynamic changes in renal function were conversely related to TG during TDF treatment in patients with CHB and normal BMI,but not with overweight.

关键词： Tenofovir disoproxil fumarate Hepatitis B virus glomerular filtration rate Overweight Body mass index

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Relative performance of two equations for estimation of glomerular filtration rate in a Chinese population having chronic kidney disease

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Chinese Medical Journal 2012年第4期125卷 599-603页

作者： Li Jiang-tao Xun Chen Cui Chun-li Wang Hui-fang Wu Yi-tai Yun Ai-hong Jiang Xiao-feng Ma Jun Tongji Univ Tongji Hosp Dept Nephrol Sch Med Shanghai 200065 Peoples R China

Background The new Chronic Kidney Disease Epidemiology Collaboration （CKD-EPI） equation was developed to address the systematic underestimation of glomerular filtration rate （GFR） by the Modification of Diet in Renal Disease （MDRD） Study equation in patients with relatively well-preserved kidney function.Performance of the new equation in the Chinese population is unknown.The goal of the present study was to compare performance of these two equations in Chinese patients with chronic kidney disease （CKD）.Methods We enrolled 450 Chinese patients （239 women and 211 men） with CKD in the present study.The renal dynamic imaging method was used to measure the referenced standard GFR （rGFR） for comparison with estimations using the two equations.Their overall performance was assessed with the Bland-Altman method and receiver-operating characteristics （ROC） analysis.Performance of the two equations in lower and higher estimated GFR （eGFR） subgroups was further investigated.Results Both eGFRs correlated well with rGFR （r=0.88,0.81,P〈0.05）.In overall performance,the CKD-EPI equation showed less bias,higher precision and improved accuracy,and was better for detecting CKD.In the higher-eGFR subgroup,the CKD-EPI equation corrected the underestimation of GFR by the abbreviated MDRD equation.Conclusions The CKD-EPI equation outperformed the abbreviated MDRD equation not only in overall performance but also in the subgroups studied.For the present,the CKD-EPI equation appears to be the first-choice prediction equation for estimating GFR.

关键词： chronic kidney disease glomerular filtration rate abbreviated modification of diet in renal disease equation Chronic Kidney Disease Epidemiology Collaboration equation

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Prediction of contrast-induced nephropathy in diabetics undergoing elective percutaneous coronary intervention： role of the ratio of contrast medium volume to estimated glomerular filtration rate

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Chinese Medical Journal 2011年第6期124卷 892-896页

作者： HAO Guo-zhen JIANG Yun-fa FAN Wei-ze LI Shi-qiang Department of Cardiology Second Hospital of Hebei Medical University Shijiazhuang Hebei 050000 China

Background Diabetic patients undergoing percutaneous coronary intervention （PCI） have a higher incidence of contrast-induced nephropathy （CIN） than nondiabetic patients, and no pharmacological approach has been demonstrated to offer consistent protection. Therefore, identifying individuals who are at increased risk becomes essential. This study was designed to assess the predictive role of the ratio of contrast medium volume to estimated glomerular filtration rate （CMV/eGFR） in diabetic patients undergoing elective PCI who developed ClN.Methods We retrospectively investigated clinical factors associated with the development of CIN in 114 diabetic patients who had undergone elective PCI. The risk factors for CIN included age, gender, body mass index （BMI）, left ventricular ejection fraction （LVEF）, hemoglobin （Hb）, fasting plasma glucose （FPG）, hemoglobin A1c （HbA1c）, volume of contrast medium, basic levels of serum creatinine （Scr）, the number of treated vessels and the number of stents used.We conducted a stepwise regression analysis to evaluate the predictive role of these risk factors in the incidence of CIN.Results The incidence of CIN was 18.4% （21/114）. There were no significant differences in age, gender, BMI, LVEF, Hb,FPG, HbA1c, and incidence of hypertension and number of acute myocardial infarction （AMI） in patients between the CIN （n=21） and the non-CIN （n=93） groups. However, the eGFR was significantly lower （（72.0±12.5） ml·min-1·1.73 m-2 vs.（82.0±16.5）ml·min-1·1.7m-2, P=0.010）, and the basic serum creatinine level （（1.07±0.12） mg/dl vs.（0.97±0.19） mg/dlP=0.014） was significantly higher in the CIN group. In addition, the volume of contrast medium was significantly larger （（253±75）ml vs. （211±71）ml, P=0.017） and the CMV/eGFR ratio was significantly greater （3.64±1.26 vs.2.70±1.11, P=0.001） in the CIN group. Stepwise regression analysis showed that the CMV/eGFR ratio was a significant independent predictor for the development of CIN （P=0.001）. At a cut-off point of 〉3.1, the CMV/eGFR ratio exhibited 71%

关键词： contrast-induced nephropathy diabetes mellitus contrast media glomerular filtration rate percutaneous coronary intervention

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Relationship between Vesicoureteral Reflux and glomerular filtration rate in Children

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Current Medical Science 2020年第5期40卷 845-850页

作者： Wei ZHANG Hui-ming YI Xiao-le ZHANG Yong-hong YI Jian-hua ZHOU Li-ru QIU Department of Ultrasound Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Pediatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

Vesicoureteral reflux(VUR)is one of the most common urinary tract anomalies in children and causes renal damage and studies focusing on the effect of VUR on renal function are rare.We recruited 35 primary VUR patients with recurrent urinary tract infection(UTI)and 10 non-VUR patients with recurrent UTI.Contrast-enhanced voiding urosonography(ceVUS)was performed for VUR grading,and renal dynamic imaging was used for evaluating glomerular filtration rate(GFR,mL/min).Standardized GFR(sGFR),namely GFR/BSA(mL·min-1·m-2),was calculated based on the body surface area(BSA).Total sGFR(tsGFR,mL·min-1·m-2)was obtained from the sum of sGFR on the left and right sides of all the children.The risk of renal regurgitation was equal in the unilateral reflux group.The sGFR of children with grade Ⅳ(45.74±18.05mL·min-1·m-2)and grade V(49.67±23.63mL·min-1·m-2)reflux was significantly lower than that in children with grade Ⅱ(77.69±22.21 mL·min-1·m-2).The renal function compensation of contralateral non-reflux kidney increased in unilateral reflux group,which was higher than that in the control group and level Ⅱ,Ⅳ and Ⅴ of reflux group respectively.In VUR group of the same grade,sGFR decreased with the age at diagnosis.In unilateral grade V refux group,the tsGFR was lower than that in the unilateral grade I reflux group(133.51±48.21 vs.186.87+53.49mL·min-1·m-2).The patients with VUR of unilateral grade Ⅱ were significantly older than those with VUR of unilateral grades Ⅱ and Ⅳ.This study indicates that severe VUR is significantly associated with decreased renal function.Therefore,VUR should be diagnosed early and managed individually.

关键词： vesicoureteral reflux renal dynamic imaging glomerular filtration rate renal damage children

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Study on the accuracy of glomerular filtration rate formulas by double plasma method as "gold standard"

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Journal of Hainan Medical University 2019年第19期25卷 42-47页

作者： Tan Ru-Yu Wu Wei-Hua Li Ying Liu Qi Ou San-Tao Department of Nephrology Affiliated Hospital of Southwest Medical University Luzhou Sichuan 646000 China

Objective: To evaluate the accuracy of glomerular filtration rate formula by comparising the CKD-EPI 2009 formula and the modified Modified MDRD formula with the 99mTc-DTPA double-phase plasma method as "gold standard" respectively. Methods: Totally 166 patients diognosed as chronic kidney disease (CKD) were enrolled. The 99mTc-DTPA double-plasma method (rGFR) was used as the "gold standard". The CKD-EPI 2009 formula and the modified MDRD formula were used to calculate eGFR. Statistical software was used to analyze the correlation between the calculated values of the two formulas and the gold standard value and the bias. Then we evaluated the accuracy of the two GFR formulas. Results: Among the CKD stage 1 patients, the bias of the CKD-EPI 2009 formula was smaller than that of the Modified MDRD formula (13.9911.45;20.1815.90);both formulas were weakly correlated with the gold standard (correlation coefficients were 0.216, 0.229, Prately correlated with the gold standard (correlation coefficients were 0.568, 0.581, P<0.01, respectively);The probability that the bias of the calculated value of the CKD-EPI 2009 formula less than 15%, 30%, and 50% of the gold standard value is smaller. Among the CKD stage 3 patients, the bias of the CKD-EPI 2009 formula was smaller than that of the Modified MDRD formula (12.6410.27;12.8810.97), and both formulas were strongly correlated with the gold standard (correlation coefficients were 0.664, 0.670, P<0.01, respectively);The probability that the bias of the calculated value of the Modified MDRD formula less than 15%, 30%, and 50% of the gold standard value is smaller. Among the CKD stage 4 to 5 patients, the bias of the CKD-EPI 2009 formula was small

关键词： CKD-EPI 2009 formula Modified MDRD formula 99mTc-DTPA double-plasma method glomerular filtration rate

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WASP Neuronet Activated by Bipolar-Sigmoid Functions and Applied to glomerular-filtration-rate Estimation

WASP Neuronet Activated by Bipolar-Sigmoid Functions and App...

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第26届中国控制与决策会议

作者： Yunong Zhang Sitong Ding Xun Liu Jinrong Liu Mingzhi Mao School of Information Science and Technology Sun Yat-sen University Division of Nephrology Department of Internal MedicineThe Third Affiliated Hospital of Sun Yat-sen University

By combining two fast training methods, i.e., the weights-direct-determination（WDD） method and Levenberg-Marquardt method, this paper proposes a novel training algorithm called weights and structure policy（WASP）for the three-layer feedforward neuronet, in addition to the algorithm of weights and structure determination（WASD）.Note that the pruning-while-growing and second-pruning techniques are developed and exploited in the WASP algorithm with the aim of achieving a neuronet with a simple and economical structure. In order to verify the WASP efficacy and to address the problem of chronic kidney disease（CKD） for clinical applications in China, numerical experiments about estimating glomerular filtration rate（GFR） by the WASP neuronet and traditional GFR-estimation equations are conducted and compared. The experiment results show that the WASP training speed is fast and that the estimating accuracy via the WASP neuronet is around 20% higher than those via traditional GFR-estimation equations. The WASP efficacy is thus demonstrated with a significant value in GFR estimation of CKD for clinical applications.

关键词： Weights Direct Determination Levenberg-Marquardt Algorithm Weights and Structure Policy Chronic Kidney Disease glomerular filtration rate

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Reference intervals for serum creatinine with enzymatic assay and application of three equations to estimate glomerular filtration rate in a healthy Chinese adult population

Reference intervals for serum creatinine with enzymatic assa...

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中华医学会第九次全国检验医学学术会议暨中国医院协会临床...

作者： Wang xuejing,GuoBing Xu,HaiXia Li, Yan Liu,Fang Wang The First Hospitao of Beijing University 100034

Background With the promotion of enzymatic assays to determine serum creatinine(Scr), reference interval(RI) needs to be established for Chinese;the performance of Scr based equations to estimate glomerular filtration... 详细信息

关键词： creatinine standardization Reference intervals glomerular filtration rate equation

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