Dialysis with high-flux membranes significantly affects plasma levels of neutrophil gelatinase-associated lipocalin

Dialysis with high-flux membranes significantly affects plasma levels of neutrophil gelatinase-associated lipocalin. Mean plasma concentrations of NGAL increased by 9.1 ± 24.4 % at the end of low-flux dialysis, indicating that low-flux polysulfone did not remove NGAL. Treatments with high-flux membranes decreased plasma NGAL significantly (P < 0.0001). The reduction ratio of NGAL was higher after hemodiafiltration (52.1 ± 26.7 %) than after high-flux dialysis (26.6 ± 26.1 %, P = 0.053)

Body Composition Analysis Allows the Prediction of Urinary Creatinine Excretion and of Renal Function in Chronic Kidney Disease Patients

The aim of this study was to predict urinary creatinine excretion (UCr), creatinine clearance (CCr) and the glomerular filtration rate (GFR) from body composition analysis. Body cell mass (BCM) is the compartment which contains muscle mass, which is where creatinine is generated. BCM was measured with body impedance analysis in 165 chronic kidney disease (CKD) adult patients (72 women) with serum creatinine (SCr) 0.6-14.4 mg/dL. The GFR was measured ((99m)Tc-DTPA) and was predicted using the Modification of Diet in Renal Disease (MDRD) formula. The other examined parameters were SCr, 24-h UCr and measured 24-h CCr (mCCr). A strict linear correlation was found between 24-h UCr and BCM (r = 0.772). Multiple linear regression (MR) indicated that UCr was positively correlated with BCM, body weight and male gender, and negatively correlated with age and SCr. UCr predicted using the MR equation (MR-UCr) was quite similar to 24-h UCr. CCr predicted from MR-UCr and SCr (MR-BCM-CCr) was very similar to mCCr with a high correlation (r = 0.950), concordance and a low prediction error (8.9 mL/min/1.73 m²). From the relationship between the GFR and the BCM/SCr ratio, we predicted the GFR (BCM GFR). The BCM GFR was very similar to the GFR with a high correlation (r = 0.906), concordance and a low prediction error (12.4 mL/min/1.73 m²). In CKD patients, UCr, CCr and the GFR can be predicted from body composition analysis

Predicted and Measured Creatinine Clearance for the Estimation of Renal Graft Function: New Tools from Body Composition Analysis

Aim of this study was to evaluate, in Renal Transplant Recipients (RTR), a new method to predict Creatinine Clearance (Ccr) from Plasma Creatinine (Pcr) and from the value of Body Cell Mass (BCM). The values of BCM were obtained, from body impedance analysis (BIA) using an impedance plethysmograph, in 87 RTR with different graft function. The ratios of 24-hour Urinary Creatinine Excretion (Ucr) over BCM were calculated in 30 RTR. In the remaining 57 RTR, Ccr was predicted from Pcr and individual values of BCM (BCM Ccr), using the mean ratio Ucr/BCM found in the first group of patients. In the same patients, Ccr was predicted according to Cockcroft and Gault (CG Ccr). The mean of triplicate measurement of 24-hour Ccr (24 h Ccr), obtained by the standard formula Ucr x Vol/min/Pcr, was used as the reference value of renal graft function. BCM Ccr had a better agreement with 24 h Ccr than CG Ccr, particularly in patients with graft failure. Thanks to its simplicity, accuracy and reproducibility, BCM Ccr is more suitable than 24-hour Ccr to estimate graft function. In the meantime, the body composition data gives useful information for the evalutation of nutritional status and of the equilibrium of body fluid compartments

Vertical ground displacement since Graeco-Roman Period desumed from new geoarchaeological and morphosedimentary data in the site of Sinuessa in Campania, southern Italy

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Urinary β-trace protein: A unique biomarker to screen early glomerular filtration rate impairment

The screening for chronic kidney disease (CKD) patients needs the measurement of serum markers like creatinine. Our previous results indicated that urinary excretion of β-trace protein (BTP), a low-molecular-weight protein (23-29 kDa), is increased in CKD patients from stage 2. The aim of this study was to assess the major determinants of urinary excretion of BTP and to evaluate its feasibility as noninvasive marker of glomerular filtration rate (GFR) impairment.We studied 355 CKD patients (198 males), aged 15 to 83 years, in stable clinical conditions, classified in the different stages of CKD on the basis of GFR (renal clearance of Tc-diethylenetriamine penta-acetic acid). At the same time, we measured serum and urinary creatinine and BTP, and urinary albumin. Urinary excretion of BTP and albumin was expressed as mg/g urinary creatinine. Fractional clearance of BTP was calculated as the ratio of BTP clearance to creatinine clearance (%).Urinary excretion of BTP is mainly determined by its serum concentration and by the level of GFR, and to a lower extent by urinary albumin excretion. In fact, urinary BTP (U-BTP) and fractional clearance of BTP progressively and significantly increased along with the reduction of GFR and the concurrent rise in serum BTP (S-BTP). The relationship of U-BTP with GFR was very similar to that of S-BTP with GFR: U-BTP mirrors S-BTP. The accuracy of U-BTP to screen patients with GFR <90 mL/min/1.73 m was good (area under the curve 0.833), its sensitivity was 76.9%, specificity 80%, and positive predictive value 84.9%. Sensitivity of U-BTP was quite similar to that of S-BTP and serum creatinine.The major determinants of urinary excretion of BTP are S-BTP and GFR. U-BTP may be a suitable noninvasive marker to screen the general population for detection of GFR <90 mL/min/1.73 m

Estimation of Urinary Creatinine Excretion and Prediction of Renal Function in Morbidly Obese Patients: New Tools from Body Composition Analysis.

Background/Aims: In obese subjects the accuracy of prediction of renal function is quite low. The aim of this study was to obtain a more accurate estimate of urinary creatinine excretion (UCr), creatinine clearance (CCr), and GFR from body cell mass (BCM). Methods: Seventy-three adult morbidly obese patients (BMI 35.2-64.5 kg/m2) were examined. BCM was calculated from body impedance analysis. CCr was measured (mCCr) and was predicted from BCM and antropometric data (MR-BCMCCr), with Cockcroft and Gault (C&GCCr) and Salazar and Corcoran (S&CCCr) formulas. GFR was predicted from BCM (BCM GFR) and with MDRD and CKD-EPI formulas. Results: Multiple regression (MR) indicated a strict linear correlation between UCr, BCM and anthropometric data. UCr predicted from MR equation (MR-BCMUCr) was very similar to measured UCr. MR-BCMCCr (168±46 mL/min) and mCCr (167±51 mL/min) were also similar, while significant differences were found between mCCr, C&GCCr and S&CCCr. The correlation and the agreement between MR-BCMCCr and mCCr were closer and prediction error was lower than the other formulas. BCM GFR (125±32 mL/min) had close correlations and agreements with MDRD GFR and CKD EPI formulas. Conclusions: In morbidly obese patients the measurement of BCM meliorates the prediction of UCr and CCr, and allows the prediction of GFR

High-Resolution Lightning Detection and Possible Relationship with Rainfall Events over the Central Mediterranean Area

Lightning activity is usually associated with precipitations events and represents a possible indicator of climate change, even contributing to its increase with the production of NOx gases. The study of lightning activity on long temporal periods is crucial for fields related to atmospheric phenomena from intense rain-related hazard processes to long-term climate changes. This study focuses on 19 years of lightning-activity data, recorded from Italian Lightning Detection Network SIRF, part of the European network EUCLID (European Cooperation for Lightning Detection). Preliminary analysis was dedicated to the spatial and temporal assessment of lightning through detection in the Central Mediterranean area, focusing on yearly and monthly data. Temporal and spatial features have been analyzed, measuring clustering through the application of global Moran\u2019s I statistics and spatial local autocorrelation; a Mann\u2013Kendall trend test was performed on monthly series aggregating the original data on a 5 7 5 km cell. A local statistically significant trend emerged from the analysis, suggesting possible linkage between surface warming and lightning activity

β-trace protein is highly removed during haemodialysis with high-flux and super high-flux membranes

Background: Serum β-trace protein (βTP, MW 23-29 kDa) is a marker of GFR impairment in renal patients. Recent papers propose to predict residual renal function (RRF) in maintenance haemodialysis (MHD) patients from serum concentrations of βTP and other small proteins, avoiding the collection of urine. Few data are available on the removal of βTP in patients treated with dialysis membranes with different flux characteristics. The aim of this study was to evaluate the effects of haemodialysis with low-flux, high-flux and super high-flux membranes on serum concentrations of ßTP in MHD patients with null RRF. Methods: Serum ßTP concentrations were measured before and after the first dialysis of the week in 51 MDH patients treated by low-flux (n = 24), high-flux (n = 17), or super high-flux (n = 10) membranes. The removal of β2-microglobulin (β2M, MW 11.8), cystatin C (Cys, MW 13.3), urea and creatinine was also analyzed. Results: Low-flux membranes did not remove βTP, β2M and Cys whose concentration increased at the end of dialysis. High-flux membrane removed more efficiently β2M and Cys than ßTP. Super high-flux membrane had the highest efficiency to remove ßTP: mean reduction ratio (RR) 53.4%, similar to β2M (59.5%), and Cys (62.0%). Conclusions: In conclusion, the plasma clearance of small proteins and particularly of βTP is dependent from the permeability of the dialysis membranes Therefore, the reliability of the formulas proposed to predict RRF from serum βTP and other LMWP may be affected by the different permeability of the dialysis membranes