Glomerular filtration rate determination by creatinine and cystatin-C in patients with acute pyelonephritis

Background: Measurement of glomerular filtration rate (GFR) and monitoring of it in any patient on nephrotoxic drugs is very important. Recently, cystatin C (cys-C) has been introduced as a better marker for determining and monitoring renal function than creatinine especially in a mild decrease of GFR. This study was done to assess the change of GFR measurement based on serum Cys-C and creatinine and their comparison in children with acute pyelonephritis on amikacin. Methods: All children with acute pyelonephritis who were admitted in Nephrology ward were enrolled in this study. Serum creatinine, serum cys-C and the GFR calculation based on them were measured in patients on the day of admission (day zero) and then on days 3 and 7 after the start of treatment with amikacin and p-value less than 0.05 was considered significant. Results: Among the 70 children, 61 patients were females and the others were males. Mean age was 42.66±41.53 months. Estimated GFR based on creatinine on day 0 (before amikacin administration), 3 and 7 were 72.41±20.89 ml/min/1.73 m2, 78.42±21.15 ml/min/1.73 m2 and 80.5±22.43 ml/min/1.73 m2, respectively. Moreover, GFR based on cys-C during these days were 116.23±58.9 ml/min/1.73 m2, 116.49±53.31 ml/min/1.73 m2 and 108.37±51.02 ml/min/1.73 m2, respectively (p<0.05). Conclusions: According to this study, decrease of GFR calculation based on Cys-C was seen and estimated GFR was not changed according to creatinine. So, we recommend the use of cys-C for the monitoring of renal function in any patient treated with nephrotoxic drugs such as amikacin

Efficacy of potassium polycitrate on renal stone and microlitiasis predisposed by metabolic disorders in children less than two years

Background: According to high prevalence of renal stone in children, we evaluated the efficacy of treatment with potassium citrate and its correlation with metabolic disorders in children less than two years of age with renal stone and microlithiasis. Methods: In this cross- sectionaly study, 100 patients (less than 2 years old) with renal stone or microlitiasis were evaluated for metabolic disorders. They were treated with potassium citrate and followed-up by ultrasonography every 3 months. Then response to treatment was evaluated according to the fresence metabolic disorders (A p-alue<0.05 was significant). Results: According to this study, hyperuricosuria and hypercalciuria were the two major metabolic disorders (40-33%). Seventy three patients had complete response, and also there as not a significant difference (p<0.05) in the efficacy of treatment due to types of metabolic disorders. There was significant difference between relative response to treatment in children who had metabolic disorders and patient without any metabolic disorders. Conclusion: Based on our results the use of potassium citrate in all children less than 2 years with renal stone or microlithiasis especially those with metabolic disorders, are recommended

Evaluation of Vitamin D Level in Children With Febrile Seizure Referred to Amirkola Children’s Hospital, Babol

Objective. This study aim to evaluate the level of vitamin D with the incidence of febrile seizure. Method. This case-control study was conducted on 90 febrile children referred to Amirkola Children’s Hospital from 19 February to 21 August 2021. Febrile children with and without seizures were considered as case and control groups, respectively. Vitamin D, calcium, phosphorus, and alkaline phosphatase were evaluated. Results. The mean level of vitamin D was not significant between the 2 groups ( P  = .62), but the mean level of alkaline phosphatase was higher in the case group, statistically ( P  = .04). 46.75% and 15.6% of case group, 28.9% and 26.7% of control group had deficiency and insufficiency levels of vitamin D, respectively ( P  = .17). Conclusion. In this study the mean level and deficiency of Vitamin D were not significant between the 2 groups. No correlation was also found between Vitamin D levels and the incidence of Febrile Seizure