Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in applica...Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in application due to complicated detection steps.By detecting the expression of serum Cystatin C(Cys C),Ccr and urinary micro-albumin(UMA),this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum.Methods:We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones,and got the expression of Cys C,Ccr(was calculated by Cockcroft-Gault equation) and UMA,then analyzed whether there were differences for Cys C,Ccr and UMA in those patients;for patients with mildly impaired renal function(Ccr between 50-75 mL/min),whether there were differences for Cys C and UMA before and after chemotherapy with platinum.Results:There was statistical significance for Ccr,Cys C and UMA in patients who receiving platinum-containing protocols(85.01 ± 28.40) vs(76.79 ± 26.63) mL/min,(1.49 ± 0.50) vs(1.80 ± 0.84) mg/L and(14.30 ± 9.15) vs(16.90 ± 10.95) mg/L,P = 0.00,0.00 and 0.01),and no statistical significance for those receiving non-platinum-containing ones(89.45 ± 29.69) vs(86.78 ± 27.96) mL/min,(1.51 ± 0.78) vs(1.63 ± 0.73)mg/L and(17.31 ± 10.46) vs(16.59 ± 8.33) mg/L,P = 0.45,0.07 and 0.57);and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy(1.68 ± 0.55) vs(2.04 ± 0.68) mg/L,P = 0.03),while no statistical significance for UMA for the same ones(21.11 ± 10.06) vs(21.22 ± 8.81) mg/L,P = 0.93).There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group,but the AUC for Ccr and Cys C is greater than that for UMA(P < 0.02).Conclusion:Cys C and UMA can both access renal dysfunction early after chemotherapy,but Cys C is more sensitive than UMA in reflecting early renal dysfunction,so Cys C can replace Ccr and become a reliable indicator in the assessment of renal function for cancer patients before and after chemotherapy especially with platinum.展开更多
Although high-dose methotrexate(HD-MTX)is the most effective drug against primary CNS lymphomas(PCNSL),outcome-de-termining variables related to its administration schedule have not been defined.The impact on toxicity...Although high-dose methotrexate(HD-MTX)is the most effective drug against primary CNS lymphomas(PCNSL),outcome-de-termining variables related to its administration schedule have not been defined.The impact on toxicity and outcome of the area under thecurve(AUC(MTX)),dose intensity(DI(MTX))and infusion rate(IR(MTX))of MTX and plsamatic creatinine clearance(CL(crea))was investigated in a retrospective series of 45 PCNSL patients treated with three different HD-MTX-basedcombinations.Anticon-vulsants were administered in 31 pts(69%).Age>60 years,anticonvulsant therapy,slow IR(MTX)(</=800 mgm(-2)h(-1)),and reduced DI(MTX)(</=1000 mgm(-2)wk(-1))were significantly correlated with low AUC(MTX)values.Seven pa-展开更多
Objective:To investigate the diuretic and renal effects of Silybum marianum L.and Cistus ladaniferus L.in normal rats.Methods:Four groups of rats were used in each experiment.The first group received water,the second ...Objective:To investigate the diuretic and renal effects of Silybum marianum L.and Cistus ladaniferus L.in normal rats.Methods:Four groups of rats were used in each experiment.The first group received water,the second group received Cistus ladaniferus L.extract(100 mg/kg b.wt),the third group received Silybum marianum L.extract(100 mg/kg b.wt),and the fourth group received furosemide(10 mg/kg b.wt).Variables including urine volume,plasma and urine sodium,potassium and creatinine,and creatinine clearance were measured.Two experiments were conducted.A single dose of each intervention was used and the variables were measured during 24 h,and the interventions were given daily for a total of 8 d and the variables were measured during various intervals.Results:The single dose of each plant extract increased urine volume at all-time intervals and increased urine sodium and potassium excretion without affecting plasma sodium and potassium(P<0.05).On the day 8 after daily administration,the plant extracts induced a significant diuresis and natriuresis without affecting serum electrolytes(P<0.05),while furosemide caused hypokalemia.Both plant extracts significantly increased creatinine clearance(P<0.05).Conclusions:Silybum marianum L.and Cistus ladaniferus L Increase creatinine clearance and have a significant diuretic effect without affecting serum electrolytes.Silybum marianum L.is more potent than furosemide or Cistus ladaniferus L.展开更多
Glomerular filtration rate （GFR） is considered as the best marker of kidney function. Evaluation of various prediction equations to estimate GFR is rare in our population. The aim of this study was to compare GFR es...Glomerular filtration rate （GFR） is considered as the best marker of kidney function. Evaluation of various prediction equations to estimate GFR is rare in our population. The aim of this study was to compare GFR estimated by various prediction equations with GFR by creatinine clearance （GFRer） in Bangladeshi population. Serum creatinine and 24 hours urinary creatinine concentrations were measured in 216 adult Bangladeshi subjects （100 males and 116 females）. Creatinine clearance rate was calculated and adjusted for body surface area to obtain GFRcr. GFR was also calculated by CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffe, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations and compared with GFRcr. Results were expressed as mean ＋ SD and compared by two-tailed paired t-test, precision （r2） and receiver-operating characteristic curve. Mean ± SD of age of the total subjects was 57.15 ±10.96 years. The mean GFILzr was 42.41 ± 22.95 mL/min/1.73m2. Estimated GFR （eGFR） by CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffc 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations were 8.19 ± 13.80, 5.30 ±13.61, 11.54 ± 16.86, 8.66± 18.64, 17.25 ± 19.98, 10.86 ± 22.48, 14.60 ± 17.92, 12.18 ± 16.42, 39.86 ± 21.96 and 20.47 ± 20.49 mL/min/1.73m2 higher than GFR, （P 〈 0.001）. The precision （r2） of eGFRs were 0.7114, 0.6924, 0.6431, 0.4802, 0.5048, 0.5921, 0.6286, 0.6158, 0.1635, and 0.5586 for CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffe 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations, respectively. The area under receiver-operating characteristic curve was the lowest for MDRD4 equation. This study revealed that GFR estimated by standardized MDRD4 variables equation is closer to creatinine clearance rate in the study population.展开更多
Introduction: The utility of estimates of glomerular filtration rate based on creatinine and cystatin C serum levels to assess renal function in older surgical patients remains to be determined. Objective: To determin...Introduction: The utility of estimates of glomerular filtration rate based on creatinine and cystatin C serum levels to assess renal function in older surgical patients remains to be determined. Objective: To determine whether 2h-creatinine clearance (CrCl-2h) can be an adequate substitute for glomerular filtration rate estimates obtained by measuring serum cystatin C and creatinine in the elderly at preoperation. Methods: A total of 102 consecutive elder patients undergoing pre-anesthesia evaluation for routine surgeries were included. Study subjects were allocated into three groups: Group 1 (G1)—hypertensive diabetic patients, Group 2 (G2)—hypertensive patients, and Group 3 (G3)—non-hypertensive and non-diabetic patients. Two-hour urine collection was performed and CrCl-2h adjusted for ultrasonic residual bladder volume was estimated. GFR was estimated based on creatinine and cystatin C serum levels. Bland-Altman analysis was used to compare methods. Results: The mean difference between the evaluated methods and CrCl-2h was ·min-1·1.73 m-2 for Cys-GFR, and >20 mL·min-1·1.73 m-2 for Cr-GFR in all groups. CrCl-2h adjusted for ultrasonic residual bladder volume did not differ from non-adjusted CrCl-2h in none of the groups. Conclusion: Two-hour creatinine clearance was not an adequate substitute for GFR estimates based on creatinine and cystatin C serum levels in older patients at preoperation. The ultrasonic assessment of residual bladder volume had no significant influence on the calculation of two-hour creatinine clearance.展开更多
文摘Objective:Chemotherapy drugs such as platinum may cause damage to the renal function,creatinine clearance(Ccr),as a "golden standard" indicator in clinical evaluation of renal function,was limited in application due to complicated detection steps.By detecting the expression of serum Cystatin C(Cys C),Ccr and urinary micro-albumin(UMA),this study was designed to analyze and discuss their roles and status in renal function evaluation for cancer patients before and after chemotherapy with platinum.Methods:We retrospectively reviewed 110 patients who receiving platinum-containing protocols or non-platinum-containing ones,and got the expression of Cys C,Ccr(was calculated by Cockcroft-Gault equation) and UMA,then analyzed whether there were differences for Cys C,Ccr and UMA in those patients;for patients with mildly impaired renal function(Ccr between 50-75 mL/min),whether there were differences for Cys C and UMA before and after chemotherapy with platinum.Results:There was statistical significance for Ccr,Cys C and UMA in patients who receiving platinum-containing protocols(85.01 ± 28.40) vs(76.79 ± 26.63) mL/min,(1.49 ± 0.50) vs(1.80 ± 0.84) mg/L and(14.30 ± 9.15) vs(16.90 ± 10.95) mg/L,P = 0.00,0.00 and 0.01),and no statistical significance for those receiving non-platinum-containing ones(89.45 ± 29.69) vs(86.78 ± 27.96) mL/min,(1.51 ± 0.78) vs(1.63 ± 0.73)mg/L and(17.31 ± 10.46) vs(16.59 ± 8.33) mg/L,P = 0.45,0.07 and 0.57);and there were also significant differences for Cys C for patients with mildly impaired renal function before and after chemotherapy(1.68 ± 0.55) vs(2.04 ± 0.68) mg/L,P = 0.03),while no statistical significance for UMA for the same ones(21.11 ± 10.06) vs(21.22 ± 8.81) mg/L,P = 0.93).There were statistical significance both for Cys C and UMA before and after chemotherapy in platinum-containing group,but the AUC for Ccr and Cys C is greater than that for UMA(P < 0.02).Conclusion:Cys C and UMA can both access renal dysfunction early after chemotherapy,but Cys C is more sensitive than UMA in reflecting early renal dysfunction,so Cys C can replace Ccr and become a reliable indicator in the assessment of renal function for cancer patients before and after chemotherapy especially with platinum.
文摘Although high-dose methotrexate(HD-MTX)is the most effective drug against primary CNS lymphomas(PCNSL),outcome-de-termining variables related to its administration schedule have not been defined.The impact on toxicity and outcome of the area under thecurve(AUC(MTX)),dose intensity(DI(MTX))and infusion rate(IR(MTX))of MTX and plsamatic creatinine clearance(CL(crea))was investigated in a retrospective series of 45 PCNSL patients treated with three different HD-MTX-basedcombinations.Anticon-vulsants were administered in 31 pts(69%).Age>60 years,anticonvulsant therapy,slow IR(MTX)(</=800 mgm(-2)h(-1)),and reduced DI(MTX)(</=1000 mgm(-2)wk(-1))were significantly correlated with low AUC(MTX)values.Seven pa-
文摘Objective:To investigate the diuretic and renal effects of Silybum marianum L.and Cistus ladaniferus L.in normal rats.Methods:Four groups of rats were used in each experiment.The first group received water,the second group received Cistus ladaniferus L.extract(100 mg/kg b.wt),the third group received Silybum marianum L.extract(100 mg/kg b.wt),and the fourth group received furosemide(10 mg/kg b.wt).Variables including urine volume,plasma and urine sodium,potassium and creatinine,and creatinine clearance were measured.Two experiments were conducted.A single dose of each intervention was used and the variables were measured during 24 h,and the interventions were given daily for a total of 8 d and the variables were measured during various intervals.Results:The single dose of each plant extract increased urine volume at all-time intervals and increased urine sodium and potassium excretion without affecting plasma sodium and potassium(P<0.05).On the day 8 after daily administration,the plant extracts induced a significant diuresis and natriuresis without affecting serum electrolytes(P<0.05),while furosemide caused hypokalemia.Both plant extracts significantly increased creatinine clearance(P<0.05).Conclusions:Silybum marianum L.and Cistus ladaniferus L Increase creatinine clearance and have a significant diuretic effect without affecting serum electrolytes.Silybum marianum L.is more potent than furosemide or Cistus ladaniferus L.
文摘Glomerular filtration rate （GFR） is considered as the best marker of kidney function. Evaluation of various prediction equations to estimate GFR is rare in our population. The aim of this study was to compare GFR estimated by various prediction equations with GFR by creatinine clearance （GFRer） in Bangladeshi population. Serum creatinine and 24 hours urinary creatinine concentrations were measured in 216 adult Bangladeshi subjects （100 males and 116 females）. Creatinine clearance rate was calculated and adjusted for body surface area to obtain GFRcr. GFR was also calculated by CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffe, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations and compared with GFRcr. Results were expressed as mean ＋ SD and compared by two-tailed paired t-test, precision （r2） and receiver-operating characteristic curve. Mean ± SD of age of the total subjects was 57.15 ±10.96 years. The mean GFILzr was 42.41 ± 22.95 mL/min/1.73m2. Estimated GFR （eGFR） by CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffc 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations were 8.19 ± 13.80, 5.30 ±13.61, 11.54 ± 16.86, 8.66± 18.64, 17.25 ± 19.98, 10.86 ± 22.48, 14.60 ± 17.92, 12.18 ± 16.42, 39.86 ± 21.96 and 20.47 ± 20.49 mL/min/1.73m2 higher than GFR, （P 〈 0.001）. The precision （r2） of eGFRs were 0.7114, 0.6924, 0.6431, 0.4802, 0.5048, 0.5921, 0.6286, 0.6158, 0.1635, and 0.5586 for CKD-EPI, MDRD4, Cockcroft-Gault, Jelliffe 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations, respectively. The area under receiver-operating characteristic curve was the lowest for MDRD4 equation. This study revealed that GFR estimated by standardized MDRD4 variables equation is closer to creatinine clearance rate in the study population.
文摘Introduction: The utility of estimates of glomerular filtration rate based on creatinine and cystatin C serum levels to assess renal function in older surgical patients remains to be determined. Objective: To determine whether 2h-creatinine clearance (CrCl-2h) can be an adequate substitute for glomerular filtration rate estimates obtained by measuring serum cystatin C and creatinine in the elderly at preoperation. Methods: A total of 102 consecutive elder patients undergoing pre-anesthesia evaluation for routine surgeries were included. Study subjects were allocated into three groups: Group 1 (G1)—hypertensive diabetic patients, Group 2 (G2)—hypertensive patients, and Group 3 (G3)—non-hypertensive and non-diabetic patients. Two-hour urine collection was performed and CrCl-2h adjusted for ultrasonic residual bladder volume was estimated. GFR was estimated based on creatinine and cystatin C serum levels. Bland-Altman analysis was used to compare methods. Results: The mean difference between the evaluated methods and CrCl-2h was ·min-1·1.73 m-2 for Cys-GFR, and >20 mL·min-1·1.73 m-2 for Cr-GFR in all groups. CrCl-2h adjusted for ultrasonic residual bladder volume did not differ from non-adjusted CrCl-2h in none of the groups. Conclusion: Two-hour creatinine clearance was not an adequate substitute for GFR estimates based on creatinine and cystatin C serum levels in older patients at preoperation. The ultrasonic assessment of residual bladder volume had no significant influence on the calculation of two-hour creatinine clearance.
