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Background: This retrospective study examines the relationship between admission Blood Urea Nitrogen (BUN) levels and clinical outcomes in patients with sepsis from two separate cohorts in the Czech Republic and the United States., Methods: The study included 9126 patients with sepsis between January 2014 and December 2018. Kaplan-Meier survival curves and Cox regression were used to analyse the data. An optimal cut-off was calculated by means of the Youden-Index., Results: BUN at ICU admission was categorized as 10-20, 20-40 and >40 mg/dL. Comparing the group with the highest BUN levels to the one with lowest levels, we found HR for 28 days mortality 2.764 (CI 95% 2.37-3.20; P<0.001). We derived an optimal cut-off for prediction of 28 days mortality of 23 mg/dL. The association between BUN and 28 days mortality remained significant after adjusting for potential confounders - for APACHE IV (HR 1.374; 95%CI 1.20-1.58; P<0.001), SAPS2 (HR 1.545; 95%CI 1.35-1.77; P<0.001), eGFR (HR 1.851; 95%CI 1.59-2.16; P<0.001) and several other variables in an integrative model., Conclusions: Our findings support the BUN level as an independent and easily available predictor of 28 days mortality in septic critically ill patients admitted to an ICU., Competing Interests: The authors report no conflicts of interest in this work.

Aims: Heart failure (HF) is one of the leading causes for hospitalization and mortality. After first admission with acute decompensated HF, some patients are in high risk for short-term and long-term mortality. These patients should be identified, closely followed up, and treated. It has been observed that blood urea nitrogen (BUN) on admission is a predictive marker for short-term mortality. Recently, it has been shown that higher BUN levels on discharge are also a bad prognostic predictor. However, the prognostic value of BUN alteration during hospital stay was not investigated; therefore, we aimed to investigate the effect of BUN variation during hospitalization on mortality., Methods and Results: A retrospective study included patients with first hospitalization with the primary diagnosis of HF. The patients were divided into four groups on the basis of the values of BUN on admission and discharge, respectively: normal-normal, elevated-normal, normal-elevated, and elevated-elevated. Four thousand seven hundred sixty-eight patients were included; 2567 were male (53.8%); the mean age was 74.7 ± 12.7 years. The 90 day mortality rate in the normal-normal group was 7% lower than that in the elevated-normal (14.6%) and normal-elevated (19.3%) groups; P value < 0.01. The 90 day mortality in the elevated-elevated group (28.8%) was significantly higher than that in the other groups; P < 0.001. During the 36 month follow-up, these results are maintained. While sub-dividing BUN levels into <30, 30-39, and >40 mg/dL, higher BUN levels correlated with higher 90 day mortality rate regardless of creatinine levels, brain natriuretic peptide, or age. Moreover, BUN on admission and on discharge correlated better with mortality than did creatinine and glomerular filtration rate at the same points., Conclusions: The BUN both on admission and on discharge is a prognostic predictor in patients with HF; however, patients with elevated levels both on admission and on discharge have the worst prognosis. Moreover, worsening or lack of improvement in BUN during hospitalization is a worse prognostic predictor. To the best of our knowledge, this is the first trial to discuss the BUN change during hospitalization in HF., (© 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Background and Purpose: The Microcirculatory Shock Occurrence in Acutely Ill Patients (micro-SOAP) study investigated associations of microcirculation and mortality. Risk stratification in critically ill patients is of utmost interest. Established score such as APACHE2 (Acute Physiology And Chronic Health Evaluation 2) are relatively complex and might therefore be of limited use. Blood urea nitrogen (BUN) was described to be associated with mortality in various diseases. We therefore aimed (i) to evaluate BUN for prediction of mortality in a cohort of critically ill patients and (ii) to investigate associations of BUN with microcirculation., Methods: 412 patients were included in our post-hoc analysis of the prospective multicenter microSOAP study. Assesment of the sublingual microcirculation (Sidestream Dark Field (SDF) imaging) and collection of laboratory values were performed on the same day in this point prevalence study. Evaluation of associations with mortality was done by logistic regression analysis. An optimal BUN cut-off was calculated by means of the Youden Index., Results: Median BUN was 9.0 mmol/L. BUN was associated with in-hospital-mortality in a logistic regression analysis (HR 1.03; 95% CI 1.01-1.05; p < 0.001). Per quartile (BUN 0-5.4 mmol/L, 5.4-9.0 mmol/L, 9.0-15.9 mmol/L and above 15.9 mmol/L) in-hospital mortality increased by as much as 51% (HR 1.51; 95% CI 1.23-1.85; p < 0.001). ROC analysis was done (AUC 0.63 95% CI 0.58-0.67) and the statistically optimal cut-off calculated by means of the Youden Index: 9.7 mmol/L. This cut-off was associated with a significant 3-fold increase in mortality (HR 2.97 95% CI 1.88-4.70; p < 0.001) and remained robustly associated with adverse outcome after correction for APACHE2 (HR 2.71 95% CI 1.61-4.59; p < 0.001), renal function as expressed by creatinine (HR 2.63 95% CI 1.59-4.33; p = 0.001), as well in an integrative model (MAP<60 mmHg, tachycardia (heart rate >90/min), lactate above 1.5 mmol/L, age above 80 years; HR 2.43 95% CI 1.50-3.92; p < 0.001). Parameters of microvascular perfusion were associated neither with BUN nor mortality., Conclusions: BUN is associated with hospital mortality and a combination of BUN and clinical signs might constitute a powerful but easy-to-use tool for risk stratification in critically ill patients and help improve their outcome. BUN was not associated with parameters of microcirculation which were not associated with mortality.

Objectives: The American College of Gastroenterology's 2016 clinical guidelines for treating lower gastrointestinal (GI) tract bleeding recommends evaluating of nasogastric tube aspiration and the ratio of blood urea nitrogen (BUN) to creatinine to differentiate upper from lower GI bleeds. However, the evidence base to support recommending these 2 diagnostic variables is low. This study aimed to evaluate the diagnostic utility of nasogastric tube aspiration and the BUN-to-creatinine ratio for distinguishing between upper and lower GI bleeding., Material and Methods: We conducted a systematic review of the literature to find studies reporting the diagnostic precision of the BUN-to-creatinine ratio and nasogastric aspiration in patients with GI bleeding without hematemesis., Results: The sensitivity of both methods is low for detecting upper GI bleeding. Both blood in the aspirate and an elevated BUN-to-creatinine ratio significantly increase the probability of finding an upper GI source. The positive likelihood ratio varies from positive 2 to 11. However, the sensitivity of both tests for a diagnosis of upper GI bleeding is very low (negative likelihood ratio of 0.6)., Conclusion: A negative result on either of the 2 diagnostic tests provides little useful information and does not firmly rule out an upper GI bleed. Nasogastric tube aspiration cannot be recommended for distinguishing between upper and lower GI bleeding. If the diagnosis is in doubt, endoscopic exploration of the upper GI tract is necessary.

Background: Serum creatinine values of patients tend to change as a result of the use of different blanks used for creatinine determinations on the Advia 1650. After upgrading the analyzer to the Advia 1800, creatinine values tended to be more reproducible. As part of a quality assurance investigation to test the reproducibilities of creatinine values, we determined serial creatinine values in the sera of 13 patients whose initial values were either in the reference range or elevated (range 0.58-7.8 mg/dl). These values were determined concurrently with serum blood urea nitrogen (BUN) determinations (range 6.0-84.4 mg/dl) as these two analytes are used together in evaluation of renal function., Methods: We determined BUN and creatinine values, using the glutamate dehydrogenase lined enzyme assay system and the Jaffe method, respectively., Results: We find that all values for creatinine on samples stored at 4 °C were reproducible as were the corresponding BUN values, which is revealed by low values for the coefficients of variation (CVs), that is, mean CV of 4.55% for creatinine and 2.52% for BUN. One sample with relatively high CV (10.6%) for creatinine was found to have an initial value of 1.1 mg/dl, in the reference range; but, on repeat determinations, the obtained levels were as high as 1.5 mg/dl, above the reference range. BUN values for this sample remained in the reference range, suggesting that no renal disease was present., Conclusion: We conclude that creatinine and BUN determinations are stable, but occasional spurious creatinine values can occur on the Advia 1800 analyzer., (© 2013 Wiley Periodicals, Inc.)

Background: Infected (peri)pancreatic necrosis (IPN) in acute pancreatitis (AP) is associated with organ failure (OF) and high mortality. There are no established early markers of primary IPN. This study aimed to assess the association of simple parameters with primary IPN in AP., Methods: We retrospectively studied 281 patients with AP admitted to Mayo Clinic hospitals and identified those with microbiologically confirmed infections in (peri)pancreatic necrosis and collections. We defined primary IPN as infection of (peri)pancreatic necrotic tissue that developed before interventions. We recorded admission hematocrit, BMI, BUN, serum creatinine, SIRS score and development of persistent organ failure within 48 h of admission; and performed serial SIRS and BUN calculations for at least 48 h. We used univariate and multivariable analysis to assess associations and expressed results as odds ratio (OR)[95% CI]., Results: 27 (9.6%) patients developed IPN, of which 21 (77.7%) had primary IPN. 38.1% had Gram positive, 9.5% Gram negative and 52.3% mixed bacterial infections. Five (23.8%) of the patients with IPN had fungal infection. On univariate analysis, SIRS ≥ 2 at admission, rise in BUN by 5 mg/dL within 48 h of admission, persistence of SIRS for 48 h and development of persistent OF within 48 h of disease had significant association with development of primary IPN with OR (95% CI) of 4.12 (1.53-11.15), 10.25 (3.95-26.61), 1.19 (1.69-10.39) and 7.62 (2.58-21.25) [2-tailed p = 0.004, <0.0001, 0.002 and <0.0001] respectively. On multivariable analysis, only rise in BUN by 5 mg/dL within 48 h of admission was associated with primary IPN (p = 0.007)., Conclusions: Rising BUN within 48 h of admission can be used to predict development of primary IPN in AP., (Copyright © 2013 IAP and EPC. Published by Elsevier B.V. All rights reserved.)

Background: Sodium butyrate (SB) used to increase oxidative stress was reduced and the glutathione redox pathway was boosted. It inhibits proliferation, induction of differentiation, and induction or repression of gene expression and it has also anti-inflammatory action. This is endorsed for suppression of nephrotic symptoms. Objectives: The present study was carried out to evaluate the nephroprotective activity of SB on gentamicin-induced nephrotoxicity in rats. Materials and Methods: Present research work was designed to estimate pharmacological potential of SB in gentamicin-induced nephrotic disorder. The pharmacological prospective was estimated in gentamicin-induced rats through the oral administration of SB formulation 200 mg/kg and 300 mg/kg BW. Results: The study observed that the SB significantly protects the kidneys from gentamicin-induced nephrotic disorders. Gentamicin 100 mg/kg for 7 days was used for induction of nephrotoxicity in Wistar rats by intraperitoneal administration. The administration of SB was observed to decrease the occurrence of glomerular congestion, vascular congestion, epithelial desquamation, inflammatory cell build-up, and kidney cell necrosis induced by gentamicin. The dose of SB maintained the gentamicin-induced increased creatinine (0.62±0.05), serum urea (18.10±0.79), uric acid (2.10±0.28), and blood urea nitrogen (BUN) (17.56±0.55) levels. This fact is further sustained by the histopathological examinations. Conclusion: Sodium butyrate formulation with antinephrotic activity in maintaining uremic solutes such as urea, uric acid, creatinine, BUN, ketone, urobilinogen, glucose, specific gravity, and urine pH in Wistar rats with gentamicin-induced glomerulonephritis (GN). The SB was administered to the animals at doses of 200 and 300 mg/kg body weight. Pretreatment with the drug showed promising results in maintaining elevated parameters in nephritic rats within a short duration. [ABSTRACT FROM AUTHOR]

A urea quantification method integrated with a pipette-tip-based biosensor and a smartphone was developed for the on-site diagnosis of blood urea nitrogen. When a sample solution containing phenol red is drawn into a pipette tip with urease immobilized on its inner wall, the color of the solution changes owing to an enzymatic reaction. The urea concentration can be quantified by photographing the pipette tip with a smartphone and quantifying the color intensity of the solution. In actual urea measurements, the detection limit (3σ) was estimated to be 1.3 mg/dL, indicating that the method has sufficient performance to quantify urea in serum. Furthermore, the method was found to reduce sample consumption and analysis time to 1/10 and 1/3, respectively, compared with conventional methods using microwell plates. This method requires only a micropipette and a smartphone to carry out measurements and does not require bench-top precision equipment or special training. Therefore, the method is expected to develop into a practical analytical platform for biomarker diagnostics that can be used in the field. [ABSTRACT FROM AUTHOR]

To identify subclasses of acute pancreatitis (AP) patients in the intensive care unit (ICU) by analyzing blood urea nitrogen (BUN) trajectories. Methods: AP patients in West China Hospital System (development cohort) and three public databases in the United States (validation cohort) were included. Latent class trajectory modelling was used to identify subclasses based on BUN trajectories within the first 21 days after ICU admission. Clinical characteristics and outcomes were compared, and results were externally validated. Results: The study comprised 2971 and 930 patients in the development and validation cohorts, respectively, with five subclasses: Class 1 ("Moderate-azotemia, slow decreasing"), Class 2 ("Non-azotemia"), Class 3 ("Severe-azotemia, slow decreasing"), Class 4 ("Moderate-azotemia, rapid increasing"), and Class 5 ('Moderate-azotemia, slow increasing) identified. Azotemia patients showed significantly higher 30-day mortality risk in development and validation cohorts. Specifically, Class 4 patients exhibited notably highest mortality risk in both the development cohort (HR 5.32, 95% CI 2.62– 10.82) and validation cohort (HR 6.23, 95% CI 2.93– 13.22). Regarding clinical characteristics, AP patients in Class 4 showed lower mean arterial pressure and a higher proportion of renal disease. We also created an online early classification model to further identify Class 4 patients among all patients with moderate azotemia at baseline. Conclusion: This multinational study uncovers heterogeneity in BUN trajectories among AP patients. Patients with "Moderate-azotemia, rapid increasing" trajectory, had a higher mortality risk than patients with severe azotemia at baseline. This finding complements studies that solely rely on baseline BUN for risk stratification and enhanced our understanding of longitudinal progression of AP. [ABSTRACT FROM AUTHOR]

Polyethylene terephthalate nanoplastics (PET-NPs) are utilized in the production of medical bionic materials and the packaging of beverages. Betaine is a ubiquitous natural constituent present in organisms such as plants, animals, and microorganisms. So, the current investigation tries to find out if PET-NPs could seriously harm mice's kidneys and whether betaine could have any ameliorative effects. In this study, a total of 40 mice were separated into four groups (ten mice in each): Group I (performed as the control group), Group II (received 1000 mg/kg betaine intraperitoneally), Group III (received 200 mg/kg PET-NPs orally), and Group IV (was given betaine first, and after 1 hour, PET-NPs were given at dosages that were the same as those given to groups II and III, respectively) daily for a month. Serum and kidney samples were collected and processed for biochemical and histological assessments. The current study found that PET-NPs significantly increased blood urea nitrogen (BUN), creatinine, and malondialdehyde levels (MDA), while reducing glutathione (GSH) levels. The histological examination revealed multiple histopathological alterations. The PET-NPs-exposed group demonstrated renal corpuscle hypotrophy, a loss of cellular structure in some proximal convoluted tubules (PCT) and distal convoluted tubules (DCT). The renal medulla exhibits hyalinization, congestion, and degeneration of collecting tubules. Conversely, the pre-administration of betaine results in a decline in BUN, creatinine, and MDA concentrations. Furthermore, there is a rise in GSH levels and the group pretreated with betaine showed significant improvement in kidney architecture, with the renal cortex showing almost normal architecture and the collecting tubules in the renal medulla slightly improving. In conclusion, betaine showed a promising nephroprotective effect against PET-NP-induced toxicity. [ABSTRACT FROM AUTHOR]

Objective: To identify the association between the changes in intestinal microflora and renal function in patients with chronic renal failure (CRF). Methods: This retrospective case-control study included 50 patients with CRF (study group), admitted to the Clinical Laboratory Department of Shenzhen People’s Hospital from March 2021 to May 2022, and 50 healthy individuals (control group). The association between the distribution of intestinal microflora and the glomerular filtration rate (GFR), levels of serum creatinine (SCr), blood urea nitrogen (BUN), and serum cystatin C (CysC) were analyzed. Results: Intestinal microflora of CRF patients had significantly higher levels of Enterococci compared to the control group (p-Value <0.05), while the levels of Bifidobacterium spp. and Escherichia coli were lower in the study group (p-Value <0.05). GFR was lower, and the levels of BUN, SCr, and CysC were higher in the study group compared to the control group (all p-Value <0.05). GFR, BUN, SCr and CysC levels in the study group negatively correlated with the levels of Bifidobacterium spp. and Lactobacillus spp. (r<0, P<0.05), and positively correlated with the abundance of Enterococcus spp. and Escherichia coli (r>0, P<0.05) in the intestinal microflora. Conclusions: Changes in intestinal microbiota are associated with a significant decrease in GFR and a marked increase in serum levels of renal function indicators, and alterations in the balance of intestinal microbiota may lead to further aggravation of the renal function damage in patients with CRF. [ABSTRACT FROM AUTHOR]

Introduction: Acute mesenteric ischemia (AMI) is a severe clinical condition that leads to intestinal ischemia and necrosis due to acute blockage of the mesenteric arteries. The mortality rate of AMI is still high, and early diagnosis and treatment are lifesaving. This study provides an overview of the biochemical parameters used to determine the prognosis of AMI patients. Methods: This was an observational and single-center study. Demographic data, vital signs, comorbidities, laboratory tests, operative status, length of hospital stay, and outcome information of patients diagnosed with AMI were recorded. Results: Twenty-eight (41.2%) female and 40 (58.8%) male patients were included in the study. Of the patients diagnosed with AMI, 45 (66.2%) underwent surgery. Twenty-six patients (38.2%) had a fatal outcome. The area under the curve (AUC) values for blood urea nitrogen (BUN)/albumin [0.850 (0.743-0.925)] and lactate/albumin [0.753 (0.633-0.849)] were statistically significant (p<0.001) for the outcome. The AUC analysis for C-reactive protein/albumin [0.654 (0.529-0.765)] indicated a significant relationship for surgical settings (p<0.05). In the intensive care unit setting, all ratios were statistically significant. Conclusion: This study shows that the BUN/albumin ratio is a robust prognostic indicator of patients with AMI and guides clinicians' decision-making. However, further studies are required to confirm these data. [ABSTRACT FROM AUTHOR]

Kidneys are critical in the clearance and maintenance of active metabolites. One of the medical properties of Salep is treating bladder and kidney inflammation. Due to the widespread use of Salep in traditional medicine and the food industry, and since the effects of Salep on kidney function have not been studied, the present study aimed to investigate the impact of Salep on kidney function. In this experimental study, 48 male rats were divided randomly into six groups as control, sham, and four experimental groups receiving different doses of Salep intraperitoneally (80, 160, 320, and 640 mg/kg). On day 29, after weighing the animals, blood samples were taken from the heart, and serum blood urea nitrogen (BUN), uric acid, and creatinine were analyzed and compared in different groups. All the animal's kidneys were exposed after dissection, and tissue sections were prepared for histopathological evaluation. From day 28 to 29, rats were kept in metabolic cages to collect urine samples and measure water intake and urine volume. The serum concentration of BUN and uric acid in the groups receiving Salep at all doses decreased non-significantly compared to the control group. Furthermore, a significant reduction was seen in creatinine serum levels in groups receiving 320 and 640 mg/kg of Salep extract (P<0.05). No evidence of damage to renal tissue was observed in this study. In conclusion, Salep could decrease serum BUN, uric acid, and creatinine levels due to its antioxidant properties and had no devastating effect on kidneys. [ABSTRACT FROM AUTHOR]

Blood urea nitrogen (BUN) was an important biomarker for the development and prognosis of many diseases. Numerous studies had demonstrated that BUN had a strong relationship with long-term mortality, survival and the prevalence of some diseases. The diagnosis and treatment, prognosis and long-term survival rate of cancer were the focus of clinical research at present. However, the relationship between BUN level and cancer prevalence was not clear. To investigate the relationship between BUN level and cancer prevalence, we performed a statistical analysis of population data from the National Health and Nutrition Examination Survey (NHANES) database. The results of the study showed that BUN level were positively correlated with cancer prevalence, and the correlation was more pronounced in breast cancer. [ABSTRACT FROM AUTHOR]

Whether renal health biomarkers can benefit from resveratrol supplements is unknown. Thus, we conducted a systematic review and meta-analysis to summarize evidence from randomized controlled trials investigating the effect of resveratrol supplementation on renal health biomarkers. We hypothesized that resveratrol supplementation is associated with improved renal health biomarkers. Four electronic databases, including PubMed, Scopus, and Institute for Scientific Information Web of Science, and Cochrane Central, were searched for relevant articles up to February 2023. The pooled effect sizes were estimated using a random effects model and expressed as weighted mean difference (WMD) and 95% CI. In total, 32 articles were eligible for inclusion in the current meta-analysis. The pooled results indicated that resveratrol significantly decreased blood urea nitrogen (weighted mean difference [WMD]= –0.84 mg/dL; 95% CI, –1.48 to –0.20; P =.01; I 2 = 64.4%) and creatinine levels (WMD = –1.90 µmol/L; 95% CI, –3.59 to –0.21; P =.03; I 2= 52.1%), and increased glomerular filtration rate (WMD = 7.58 mL/min/1.73 m2; 95% CI, 5.25–9.91; P <.001; I 2 = 0%). The favorable change of blood urea nitrogen was significant in studies with short follow-up duration (12 weeks or less), with lower doses of resveratrol (less than 500 mg/d), and those conducted in patients with diabetes. However, higher doses of resveratrol are needed to observe significant reductions in creatinine. No significant change was observed in albumin, total protein, and uric acid concentrations. This meta-analysis provides a low certainty of evidence indicating a mild renal protective effect of resveratrol in adults. Further high-quality evidence in patients with impaired renal function and estimates of mortality risk in these patients is required before resveratrol can be advocated as an adjuvant therapy. This current meta-analysis of 32 RCTs disclosed that resveratrol supplementation significantly decreased BUN and creatinine levels and increased GFR. However, no significant change was observed in albumin, total protein, and uric acid concentrations. The resveratrol supplementation may have a potential renal protective effect in adults, by improving BUN, creatinine, and GFR levels. BUN, blood urea nitrogen; GFR, glomerular filtration rate; RCT, randomized controlled trial. [Display omitted] [ABSTRACT FROM AUTHOR]

Acute kidney injury is associated with increased risk of heart failure and mortality. This study demonstrates that acute kidney injury induces remote cardiac dysfunction, damage, injury, and fibrosis via a galectin-3 (Gal-3) dependent pathway. Gal-3 originates from bone marrow-derived immune cells. Cardiac damage could be prevented by blocking this pathway.

Acute kidney injury is associated with increased risk of heart failure and mortality. This study demonstrates that acute kidney injury induces remote cardiac dysfunction, damage, injury, and fibrosis via a galectin-3 (Gal-3) dependent pathway. Gal-3 originates from bone marrow-derived immune cells. Cardiac damage could be prevented by blocking this pathway.

The specialized herds of the high tropics of Nariño are characterized by semi-intensive breeding models, that is, feeding based on grazing and supplementation. The objective was to analyze the milk production of grazing Holstein cows under conditions of the high tropics, taking into account the energetic and protein metabolites, and their relationship with the dry matter intake (CMS/Kg/d), the body condition (BC), and the reproductive variables. Three periods of lactation were evaluated, thus, between 4-10 days (P1), 45-55 days (P2), and between 185-200 days (P3). The investigation was carried out in four dairy production farms. The forage supply consisted of a mixture of Lolium hybridum, Cenchrus clandestinus Hoschst ex Chiov, Holcus lanatus and Trifolium repens, plus commercial concentrate. A total of 24 Holstein animals (six per productive system) from three births onwards were used, from which blood samples were obtained to determine: non-esterified fatty acids (NEFA), beta-hydroxybutyrate (BHB), triglycerides, cholesterol, glucose, total protein (PT), and blood urea nitrogen (BUN). The results showed that milk production during P1 is influenced by CC and body weight (Kg) by +0.04 liters of milk per unit of change in this variable. In P2, the positive incidence variables were PT, BUN, glucose, NEFA, BHB, triglycerides, and cholesterol, and in P3, the increase in CMS made it possible to show that as lactation progresses in more than 180 days, the animals substantially improve their body condition; likewise the NEFA and BHB indicators are related to a better reproductive response.

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Background: Serum creatinine and blood urea nitrogen (BUN) are the common markers of renal function and also one of the known predictors of adverse outcomes of acute coronary syndrome (ACS). The aim of this study is to assess the impact of elevated BUN on in-hospital outcome of ACS patients and superiority of BUN over creatinine for the assessment of in-hospital outcome in our setting. Methods: This prospective observational study with purposive sampling of a total of 184 patients was conducted from October, 2009 to September, 2010. Based on normal cut off values (BUN and serum creatinine was <20 mg/dl and <1.4 mg/dl respectively) all the patients were divided into four groups; group I- both BUN and serum creatinine are normal, group-II- normal BUN and high serum creatinine, group-III- high BUN and normal serum creatinine, group-IV- - both BUN and serum creatinine are high. In-hospital data like hemodynamic conditions, heart failure, arrhythmias, conduction abnormalities, death etc. were noted. Assessment of in-hospital outcome of ACS patients and comparison to elevated serum creatinine and elevated BUN was done. Results: ACS patients with only raised BUN level had more occurrence of cardiogenic shock (p=0.008), left ventricular failure (p=0.020), ventricular Tachycardia (p=0.022), ventricular fibrillation (P=0.037) and complete AV block (p=0.022) than those with only raised serum creatinine. In hospital mortality and hospital stay was also increased in ACS patients with elevated BUN than elevated serum creatinine (p value is 0.022 and 0.007 respectively). Conclusion: Incidence of in-hospital death, cardiogenic shock, left ventricular failure, arrhythmia and duration of hospital stay were significantly (p<0.05) higher in patients who had raised BUN than raised serum creatinine. It is observed that elevated BUN is a better predictor of in-hospital outcome of ACS patients than elevated creatinine. [ABSTRACT FROM AUTHOR]

Introduction: Despite increasing reports of laparoscopy for strangulated small bowel obstruction (SSBO), there is no consensus on outcomes in patients with SSBO. We evaluated the safety and utility of laparoscopy for SSBO and investigated the preoperative risk factors for laparotomy. Methods: This retrospective study included 107 patients who underwent emergency surgery for SSBO over a period of 6 years. Patients' characteristics and surgical parameters were compared between 27 patients undergoing laparoscopy alone (group L) and 80 patients undergoing laparotomy (group O, including conversion). Univariate and multivariate analyses were performed to determine risk factors for laparotomy. Results: Compared with group L, group O had significantly shorter operation time (59 vs 115 minutes, P <.001), shorter postoperative hospital stay (6 vs 10 days, P <.001), and fewer complications (3 vs 40 cases, P <.001). Age ≥ 68 years (odds ratio [OR] 3.970, P =.021), blood urea nitrogen (BUN) ≥ 14.6 mg/dL (OR 4.360, P =.012), and lactate ≥2.80 mmol/L (OR 12.90, P =.023) were independent risk factors for laparotomy. Conclusion: Prognosis was better in patients with SSBO undergoing complete laparoscopy than in patients undergoing laparotomy; however, age, BUN, and lactate were independent preoperative risk factors for laparotomy. [ABSTRACT FROM AUTHOR]

Aim: Increased serum blood urea nitrogen (BUN) level is an indicator of neurohormonal and renal dysfunction, and is associated with the major adverse cardiovascular events (MACE). Chronic total occlusion (CTO) is a typical coronary artery disease diagnosed by coronary angiography. We established and tested the hypothesis that there might be a relationship between serum BUN level and long-term prognosis in patients with CTO. Materials and Methods: The study consisted of 124 patients diagnosed with CTO. The patients were followed up for a mean of 9.2 (7.4-9.5) years, and all-cause mortality was determined. Results: Patients were divided into two groups according to mortality outcome. During the follow-up, 38 of 124 patients died. Univariate Cox analysis showed that age (p=0.002), BUN (p=0.001), and serum creatinine levels (p=0.039) were associated with mortality. BUN level (OR: 1.074; 95% CI: 1.018-1.134; p=0.009) and age (OR: 1.043; 95% CI: 1.001-1.087, p=0.043) were independently associated with mortality in multivariate Cox analysis. In the ROC analysis, the AUC values for BUN and estimated glomerular filtration rate were 0.689 (p=0.002) and 0.650 (p=0.001), respectively. When the cutoff value for BUN level was considered >16 mg/ dL, the sensitivity was 68%, and the specificity was 53% (OR:1.38) to predict mortality. When the cutoff value was considered >20 mg/ dL, the sensitivity diminished to 40%, while the specificity increased to 90% (OR:3.9). Conclusion: In patients with CTO, BUN level is associated with increased all-cause mortality during long-term following. This relationship is independent of renal dysfunction. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease -19 (COVID-19) is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV2). The angiotensin converting enzyme 2 (ACE2) can play a vital role in regulating the pathological changes of various diseases, including COVID-19. The aim of this study was to analyze the expression of the ACE2 gene in Turkish COVID-19 patients. Materials and Methods: Eighty COVID-19 PCR test positive patients and 80 PCR test negative healthy volunteers were included in the study. RNA isolation was carried out from all samples. The RT-PCR device was used to analyze the expression of the ACE2 gene. Results: A significant difference was found in the age, Lactate dehydrogenase (LDH), ferritin and C-reactive protein (CRP) levels of the COVID-19 patients compared to the healthy volunteers. Based on the gene expression results, it was found that ACE2 gene expression was significantly higher in COVID-19 patients compared to healthy volunteers. In patients with COVID-19, a significant difference was found between the expression of the ACE2 gene and the levels of Blood urea nitrogen (BUN), Hemoglobin (HGB), Hematocrit (HCT) and CRP. Conclusion: ACE2 gene expression was high in the COVID-19 patients and showed differences based on clinical data. Thus, the expression of ACE2 can have paradoxical effects that support the pathogenicity of SARSCoV2 but, conversely, limit viral infection. The availability of ACE2 receptors may increase the susceptibility and / or disease course of COVID-19. [ABSTRACT FROM AUTHOR]

Background: This study was conducted to evaluate certain hemato-biochemical changes during Xylazine-Ketamine (X-K) and Xylazine-Thiopentone (X-T) anesthesia in dogs. Methods: For this, six dogs of 18 to 25 kg BW were selected and divided into two groups: Group I (X-K) and Group II (X-T). Atropine sulfate @ 0.05 mg/kg BW (IM) was used for premedication in both groups. Dogs in Group I (n=3) were anesthetized with Xylazine HCl @ 1.1 mg/kg BW (IM) and Ketamine HCl @ 5.5 mg/kg BW (IM), whereas Xylazine HCl @ 1.1mg/kg BW (IM) and Thiopentone sodium @ 20 mg/kg BW (IV) were used for anesthesia in Group II (n=3). In both groups, peripheral blood samples were collected from the dogs before induction of anesthetic agents (control) and thereafter on 10, 20, 30, and 40 minutes of post-induction and again after complete recovery from anesthesia to evaluate hematological changes in Total Erythrocyte Count (TEC), Hemoglobin (Hb) and Packed Cell Volume (PCV). In addition, serum biochemical changes in Total Serum Protein (TSP), Blood Urea Nitrogen (BUN), Creatinine, Sodium (Na), Potassium (K), and Chloride (Cl) were also assessed in both groups. Results: TEC, Hb, and PCV were altered significantly (P<0.05) in most of the cases, TSP was decreased significantly (P<0.05) but BUN was increased significantly (P<0.05), and creatinine was also increased in both groups during the experiment. There were mild alterations in Na, K, and Cl values after induction, and found near to the baseline (control) after recovery. Conclusions: These findings ascertained that the anesthetic combinations of X-K and X-T assert some definite hemato-biochemical changes in dogs which should be carefully judged by the veterinarians during surgical interventions to avoid anesthesia-related risks and complications. [ABSTRACT FROM AUTHOR]

Abstract Aims Heart failure (HF) is one of the leading causes for hospitalization and mortality. After first admission with acute decompensated HF, some patients are in high risk for short‐term and long‐term mortality. These patients should be identified, closely followed up, and treated. It has been observed that blood urea nitrogen (BUN) on admission is a predictive marker for short‐term mortality. Recently, it has been shown that higher BUN levels on discharge are also a bad prognostic predictor. However, the prognostic value of BUN alteration during hospital stay was not investigated; therefore, we aimed to investigate the effect of BUN variation during hospitalization on mortality. Methods and results A retrospective study included patients with first hospitalization with the primary diagnosis of HF. The patients were divided into four groups on the basis of the values of BUN on admission and discharge, respectively: normal‐normal, elevated‐normal, normal‐elevated, and elevated‐elevated. Four thousand seven hundred sixty‐eight patients were included; 2567 were male (53.8%); the mean age was 74.7 ± 12.7 years. The 90 day mortality rate in the normal‐normal group was 7% lower than that in the elevated‐normal (14.6%) and normal‐elevated (19.3%) groups; P value 40 mg/dL, higher BUN levels correlated with higher 90 day mortality rate regardless of creatinine levels, brain natriuretic peptide, or age. Moreover, BUN on admission and on discharge correlated better with mortality than did creatinine and glomerular filtration rate at the same points. Conclusions The BUN both on admission and on discharge is a prognostic predictor in patients with HF; however, patients with elevated levels both on admission and on discharge have the worst prognosis. Moreover, worsening or lack of improvement in BUN during hospitalization is a worse prognostic predictor. To the best of our knowledge, this is the first trial to discuss the BUN change during hospitalization in HF.

Increased intracranial pressure is a further effect of brain injury due to structural damage and osmotic and water imbalances (edema). Mannitol works in the proximal tubules and mannitol in the absorption of tubular cells by the mechanism of pinocytosis. The fluid transfer will draw fluid into the intracellular, so that the cell will be switched and broke. This phenomenon is referred to as the phenomenon of "Nephrosis Osmotic", in which mannitol administration may occur as a result of accumulation of drugs in the kidneys due to prolonged exposure to mannitol in the kidney and given dosage. The effects of osmotic diuresis occurring plus the dose and duration of mannitol administration are reported to cause renal function disorders (Scr and BUN). The aim of this study was to analyze changes in serum creatinine and BUN in patients with brain injury from before receiving mannitol therapy and during mannitol treatment. From the results of the study the number of patients who met the inclusion criteria, 32 patients. Serum creatinine, the initial average of 0.85±0.17 mg/dl and the last day of the mean SCr 0.74±0.30 mg/dl. While the mean BUN (Blood Urea Nitrogen) was 11.27±2.75 mg/dl and the mean last day was 17.08 mg/dl±8.59 mg/dl. From Serum Creatinine and BUN data it can be concluded that there is no significant change. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the kidney function tests in rats experimentally infected with E. coli with monitoring signs of UTI. Forty female rats were divided into two groups, infected (20 rats) and control (20 rats). The infected group were inoculated intraurethral by 108 suspension of E. coli. The animals were monitored for presence of signs. E. coli urine bacterial demonstration were done at 1 week before infection and 24hrs., 48hrs, 96hrs, 6 days, 12 days and 24 days after infection. Blood samples were collected at zero, 24hrs, 3 days, 6 days, 14 days and 24 days. Blood samples for serum BUN and creatinine were collected. The findings suggested that the E.coli isolation has been continuous 24 days since experimentation started. After 24 hrs. post infection, infected rats were suffering from UTIs sings, including frequent urination, pain on urination, foul smelling, diarrhea, poor appetite, and fever. Also, the current results showed that at zero time, all rats present normal value of serum urea and creatinine, Post-infection with E. coli, A significant increase in BUN and creatinine was shown by the infected group at 24 hours, 3 days, 6 days, 14 days and 24 days, as opposed to the control group. In conclusion, E. coli can induce UTI in rats manifested by increase BUN and Creatinine. [ABSTRACT FROM AUTHOR]

Dehydration, electrolyte disturbance, and acid-base imbalance are the most significant consequences of diarrhea in calves. We aimed to determine blood gas, hematological, electrolyte, and biochemical values and investigate the relationship between the physical status and blood parameters in Korean native calves (KNCs) with diarrhea. One hundred eighty KNCs with diarrhea (age < 75 days) were investigated. Blood samples were collected from the external jugular vein and analyzed using a portable clinical blood gas analyzer. The measured parameters were statistically compared according to the status of physical activity, dehydration, or prognosis. The mean values of parameters in the Calves with diarrhea showed metabolic acidosis, hyponatremia, and azotemia. The mean values of potassium, chloride, hematocrit, and hemoglobin were in the upper limit of their reference ranges. More than 75% of the calves had metabolic acidosis caused by bicarbonate loss, and 63.6% had high blood urea nitrogen (BUN) values. Moreover, BUN showed the highest correlation with the physical activity status and dehydration. pH, base excess of the extracellular fluid (BE), anion gap, potassium, hematocrit, bicarbonate, and hemoglobin were closely correlated with physical deterioration and dehydration (p < 0.001). BUN, pH, BE, and anion gap were closely correlated with physical deterioration and dehydration. These correlations between clinical symptoms and blood gas parameters can be clinically relevant in predicting the status of parameters according to clinical symptoms. [ABSTRACT FROM AUTHOR]

Background: Chronic Kidney Disease of unknown etiology (CKDu) is prevalent in North Central Province (NCP) of Sri Lanka. Consumption of un-boiled dug well water has been identified as one of the causative factors. This in-vivo study was performed to investigate some of the suspected factors associated with the pathogenesis of CKDu mediated via ground water.Method: Rats were given water, collected from high and low disease prevalent areas from the NCP of Sri Lanka and the results compared with those obtained from previously identified low disease prevalent area; Colombo. Blood Urea Nitrogen, creatinine, urinary microalbumin:creatinine ratio together with ALT and AST levels were analyzed and results were compared using one-way ANOVA and paired t-Test. Histopathology was analyzed using non-parametric method.Results: Rats that ingested water from New Town Medirigiriya (NTM) from high disease prevalent NCP reported significantly elevated microalbumin:creatinine ratios compared to other water sources after 8 months, whilst boiled water from NTM had been able to significantly reduce it. Histopathological findings after the 14 months experimental period revealed significantly high tubular lesion index in rats that ingested water from NCP compared to Colombo. Rats that ingested water from high disease prevalent Divuldamana (DD) from NCP showed the highest kidney lesion index though the fluoride content was relatively low in this area compared to other water sources from high disease prevalent NCP. Rats that ingested boiled and un-boiled water from NTM also developed severe lesions whilst the group from Colombo reported the lowest. Low disease prevalent area from NCP, Huruluwewa (HW) also reported elevated liver enzymes and altered renal histopathology. Association of Na+:Ca2+ ratio in the disease progression was not reflected by the current study. Compared to Colombo, high fluoride, calcium and sodium contents were observed in water from high disease prevalent areas. All the water samples were negative for heavy metals.Conclusions: Though Fluoride is a known kidney toxic agent it cannot be the sole reason for CKDu in NCP, Sri Lanka. Various toxic elements present in NCP water may contribute to different grade of kidney and liver lesions in Wistar rats. [ABSTRACT FROM AUTHOR]

Background: Salidroside, an active component from Traditional Chinese Medicine Rhodiola rosea L., has various pharmacological functions including anti-inflammatory, anti-cancer and anti-oxidative properties. However, whether salidroside plays a beneficial role in diabetic nephropathy is still unclear.Purpose: The objective of this work was to investigate the potential roles of salidroside against diabetic nephropathy and the underlying molecular mechanisms.Methods: Streptozocin was given to obese mice to generate diabetic nephropathy animal model. Salidroside was administered to these mice and proteinuria, podocyte integrity, renal morphology and fibrosis, mitochondrial biogenesis were examined.Results: Our results showed that salidroside treatment greatly attenuates diabetic nephropathy as evidenced by decreased urinary albumin, blood urea nitrogen and serum creatinine. Morphological analysis indicated that salidroside improves renal structures in diabetic nephropathy. The decreases in nephrin and podocin expression were markedly reversed by salidroside. Moreover, kidney fibrosis in diabetic nephropathy mice was largely prevented by salidroside. Mechanistically, in salidroside-treated mice, the mitochondrial DNA copy and electron transport chain proteins were significantly enhanced. Meanwhile, the reduced Sirt1 and PGC-1α expression in diabetic nephropathy was almost completely counteracted in the presence of salidroside.Conclusions: Our data showed that salidroside plays a beneficial role against diabetic nephropathy in mice, which probably via Sirt1/PGC-1α mediated mitochondrial biogenesis. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify the levels of Blood Urea Nitrogen (BUN) and its relation to the reproductive efficiency and serum progesterone concentration in lactating Holstein Friesian dairy cattle. Data were obtained by stratified random sampling from population to get 18 dairy cows, which divided into three groups. The first, second, and third groups each with milk yield of less than 17, between 17-21, and over 21 liters/day, and with calving interval of less than 365, between 365-450 and more than 450 days. Blood was collected from the coccygeal vein at the time of insemination (D0), 7 day (D+7) and 22 days (D+22) after insemination. BUN and progesterone concentration were measured. Data analysis showed no significant difference (P>0.05) on the observed parameters. Data regrouping based on BUN concentration showed that the mean of services per conception (S/C) was lower and conception rate (CR) was higher (P<0.05) in dairy cattle having BUN<18 than those of with BUN>18 mg/dL. The mean of progesterone concentration at D+22 was higher (P<0.05) than those at D0 and D+7 in pregnant dairy cows and with BUN<18 mg/dL, as well as those at D+22 in non-pregnant dairy cows with BUN>18 and BUN<18 mg/dL. This study concluded that high BUN concentration affect the reproductive efficiency of dairy cows by decreasing CR and increasing progesterone serum concentration. [ABSTRACT FROM AUTHOR]

Patients with chronic heart failure (CHF) are often accompanied with varying degrees of renal diseases. The purpose of this study was to identify rs37369 polymorphism of AGXT2 specific to the renal function of CHF patients. A total of 1012 southern Chinese participants, including 487 CHF patients without history of renal diseases and 525 healthy volunteers, were recruited for this study. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used to determine the genotypes of AGXT2 rs37369 polymorphism. Levels of blood urea nitrogen (BUN) and serum creatinine (SCr) were detected to indicate the renal function of the participants. BUN level was significantly higher in CHF patients without history of renal diseases compared with healthy volunteers ( p = 0.000). And the similar result was also obtained for SCr ( p = 0.000). Besides, our results indicated that the level of BUN correlated significantly with SCr in both the CHF patients without renal diseases ( r = 0.4533, p < 0.0001) and volunteers ( r = 0.2489, p < 0.0001). Furthermore, we found that the AGXT2 rs37369 polymorphism could significantly affect the level of BUN in CHF patients without history of renal diseases ( p = 0.036, AA + AG vs GG). Patients with rs37369 GG genotype showed a significantly reduced level of BUN compared to those with the AA genotype ( p = 0.024), and the significant difference was still observed in the smokers of CHF patients without renal diseases ( p = 0.023). In conclusion, we found that CHF might induce the impairment of kidney and cause deterioration of renal function. AGXT2 rs37369 polymorphism might affect the renal function of CHF patients free from renal diseases, especially in patients with cigarette smoking. [ABSTRACT FROM AUTHOR]

Eighty-two healthy and recently calved crossbred cows from seven dairy farms were subjected to monthly blood and milk sampling for a four-month period for blood and milk urea nitrogen (BUN/MUN) assessment. The fertility parameters like calving to first estrus interval, calving to first service interval, calving to conception interval, services per pregnancy and percent animal conceived were recorded. The cows with high BUN or MUN had similar number of days to exhibit estrus and to first service compared to their counterparts (p>0.05). The cows with low BUN or MUN had lesser number of days to conceive than those with high BUN (p<0.05) or MUN (p>0.05). The percent animals conceived followed a similar trend in both BUN and MUN groups; low level groups had higher (p<0.05) conception rates. The number of services per conception was less among cows having low BUN or MUN. In brief, high BUN/MUN have deleterious effects on fertility of lactating crossbred cows. [ABSTRACT FROM AUTHOR]

Dietary or caloric restriction confers various clinical benefits. Short-term fasting of mice is a common experimental procedure that may involve systemic metabolic remodeling, which may significantly affect experimental outputs. This study evaluated adaptive cellular responses after 1- or 2-day fasting in 13 mouse tissues by quantitative PCR using 15 marker primer sets for the activation of ubiquitin–proteasome ( Atrogin-1 and MuRF1 ), autophagy–lysosome ( LC3b , p62 and Lamp2 ), amino acid response ( Asns , Trib3 , Herpud1 , xCT , and Chop ), Nrf2-mediated antioxidant ( HO-1 and Gsta1 ), and amino acid transport ( Slc38a2 , Slc7a5 , and Slc7a1 ) systems. Differential activation profiles obtained in seven highly (thymus, liver, spleen, and small intestine) or mildly (stomach, kidney, and colon) atrophied tissues as well as in six non-atrophied tissues (brain, eye, lung, heart, skeletal muscle, and testis) suggested tissue-specific active metabolic remodeling. [ABSTRACT FROM AUTHOR]

• The use of mixed and hydrolyzable tannins reduced methanogen relative abundance compared to a control. • The use of mixed and hydrolyzable tannins increased the relative abundance of propionate concentration in the rumen. • The use of mixed and hydrolyzable tannins reduced blood urea nitrogen content compared to a control. • Reductions in both methanogen relative abundance and increased propionate concentration, as well as less blood urea nitrogen content, are likely to reduce heifers environmental effects. The objective of this pilot study was to begin to evaluate the effect of feeding a mix of condensed and hydrolyzable tannins to heifers on rumen fermentation patterns, blood urea nitrogen (BUN), and amino acid profile. Four growing Holstein-Friesian × Jersey heifers with a mean live weight of 319.5 ± 8.38 kg and a mean body condition score of 4 ± 0.17 out of 10 were used in a cross-over design. Heifers were either orally administered the mixed tannin treatment at 0.15% of daily DMI or a control dose of water whilst consuming perennial ryegrass baleage and soybean meal for 12 days in a cross-over trial. Administration of mixed tannins reduced non-glucogenic volatile fatty acid (VFA) production by 2%, the acetate to propionate (A:P) ratio by 13%, and the relative abundances of specific methanogenic archaea – i.e., Methanobrevibacter and Methanosarcina. The tannin treatment also reduced BUN concentration by 12% in comparison with the control dose of water, which indicates associated reductions in daily urinary nitrogen excretion and therefore environmental impact. The effects of ingestion of mixed tannins on rumen function in this study would be expected to result in a reduction of both methane and urinary nitrogen excretion and thereby reducing the environmental impact of heifers consuming conventional feeds. [ABSTRACT FROM AUTHOR]

Background: Few studies have assessed the relation of Serum creatinine and serum blood urea nitrogen (BUN) level with the severity of coronary artery disease (CAD). This study investigated the association between high uric acid BUN levels with the presence of Coronary artery disease. Materials and Methods: This study was designed as an observational cohort study. The study was composed of 170 patients admitted at our institution due to symptoms related to CAD. Patients having angiographic evidence of stenosis in coronary artery were as case group and without stenosis control group. Patients with high serum creatinine were defined as serum creatinine concentration with in 80-105 μmol/L and BUN level with in 10-20 μmol/L. The presence of CAD has been defined as the Gensini score being >1. Results: Patients with or without CAD were similar in terms of age (45.22±6.80 years vs. 52.87±9.31 years, p<0.01) and significant age difference was found between patients. Male gender (p<0.001) and smoking habit (p=0.003) were more frequent and statistically significant in patients with CAD. There was a statistically significant difference between the mean serum creatinine levels (92.89±20.82 μmol/L vs 108.68±23.62 μmol/L respectively, p<0.05) and serum blood urea nitrogen level (10.59±6.15 μmol/L vs. 20.37±6.73 μmol/L respectively, p<0.01) of patients with or without CAD. While looking at the correlation coefficient of Gensini score with different factors; S. creatinine, ejection fraction and BUN were significantly correlated at<0.001 and <0.04 and <0.01 level respectively. Increased serum creatinine levels were found to be independent risk factors for the presence of CAD (for serum cretinine hazard ration 3.9, p<0.001 and in case BUN hazard ration 2.08, p<0.001). Conclusion: In conclusion, a significant association has been found between serum creatinine & BUN level and the presence of CAD. In addition to the evaluation of conventional risk factors in daily clinical practice, the measurement of serum creatinine and BUN level might provide significant prognostic benefits in terms of global cardiovascular risk and management of the patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: Exposure to chromium compounds can result in nephrotoxicity. The administration of potassium dichromate (K2Cr2O7), a hexavalent chromium compound, results in impairment in functions of renal brush border membrane (BBM). Methods: The effect of vitamin C (ascorbic acid) on K2Cr2O7-induced nephrotoxicity, changes in BBM enzymes, Pi transport and the anti-oxidant status of rat kidney were studied. Animals were divided into 4 groups and were intraperitoneally given saline (control), vitamin C alone, K2Cr2O7 alone and vitamin C plus K2Cr2O7. Nephrotoxicity was evaluated by urea and creatinine levels in the serum. Anti-oxidant status was evaluated in kidney homogenates. Results: A single dose of K2Cr2O7 (15 mg/kg body weight) resulted in an increase of serum urea nitrogen and creatinine levels, increase in lipid peroxidation and decrease in total sulfhydryl groups. However, prior treatment with a single dose of vitamin C (250 mg/kg body weight) protected the kidney from the damaging effects of K2Cr2O7. It greatly ameliorated the K2Cr2O7-induced nephrotoxicity and reduction in Pi transport, activities of catalase, Cu–Zn superoxide dismutase and BBM enzymes. This was accompanied by decrease in lipid peroxidation and recovery of sulfhydryl content of renal cortex. Conclusions: Vitamin C is an effective chemoprotectant against K2Cr2O7-induced acute renal failure and dysfunction of the renal BBM in rats. [Copyright &y& Elsevier]

Shea nut color, obtained from nuts of the shea tree (Butyrospermum parkii), is used as a food-coloring agent. Flavonoid pigments are considered to be the responsible constituents. As there have been no reports of toxicological evaluation, a 13-week subchronic toxicity study was performed in Wistar Hannover rats at dose levels of 0 (control), 0.07, 0.31, 1.25 and 5% in powdered basal diet. The average of daily shea nut color intake was 51.3, 226.1, 986.8 and 3775.5 mg/kg/day for males and 56.4, 272.9, 1166.7 and 4387.7 mg/kg/day for females, respectively. During the administration period, daily observation of clinical signs and weekly measurement of body weights and food consumption were performed. After the end of the treatment, hematology, serum biochemistry, organ weight and histopathological examinations were conducted. No significant toxicological changes were observed in any parameters in this study. Hence, the no adverse effect dose of shea nut color was estimated to be greater than 5.0% for both sexes (3775.5 mg/kg/day for males and 4387.7 mg/kg/day for females). [Copyright &y& Elsevier]

: ObjectivesWe sought to evaluate the efficacy of the antioxidant acetylcysteine in limiting the nephrotoxicity after coronary procedures.: BackgroundThe increasingly frequent use of contrast-enhanced imaging for diagnosis or intervention in patients with coronary artery disease has generated concern about the avoidance of contrast-induced nephrotoxicity (CIN). Reactive oxygen species have been shown to cause CIN.: MethodsWe prospectively studied 121 patients with chronic renal insufficiency (mean [±SD] serum creatinine concentration 2.8 ± 0.8 mg/dl) who underwent a coronary procedure. Patients were randomly assigned to receive either acetylcysteine (400 mg orally twice daily) and 0.45% saline intravenously, before and after injection of the contrast agent, or placebo and 0.45% saline. Serum creatinine and blood urea nitrogen were measured before, 48 h and 7 days after the coronary procedure.: ResultsSeventeen (14%) of the 121 patients had an increase in their serum creatinine concentration of at least 0.5 mg/dl at 48 h after administration of the contrast agent: 2 (3.3%) of the 60 patients in the acetylcysteine group and 15 (24.6%) of the 61 patients in the control group (p < 0.001). In the acetylcysteine group, the mean serum creatinine concentration decreased significantly from 2.8 ± 0.8 to 2.5 ± 1.0 mg/dl (p < 0.01) at 48 h after injection of the contrast medium, whereas in the control group, the mean serum creatinine concentration increased significantly from 2.8 ± 0.8 to 3.1 ± 1.0 mg/dl (p < 0.01).: ConclusionsProphylactic oral administration of the antioxidant acetylcysteine, along with hydration, reduces the acute renal damage induced by a contrast agent in patients with chronic renal insufficiency undergoing a coronary procedure. [Copyright &y& Elsevier]

: BackgroundIntraoperative oliguria is common during laparoscopic operations. The objective of this study was to evaluate the effects of prolonged pneumoperitoneum during laparoscopic gastric bypass (GBP) on intraoperative urine output and renal function.: Methods104 patients with a body mass index between 40 and 60 kg/m2 were randomly assigned to laparoscopic (n = 54) or open (n = 50) GBP. Intraoperative urine output was recorded at 30-min intervals. Blood urea nitrogen and creatinine levels were measured at baseline and on postoperative days 1, 2, and 3. Levels of antidiuretic hormone, aldosterone, and plasma renin activity were also measured in a subset of laparoscopic (n = 22) and open (n = 24) GBP patients at baseline, 2 hours after surgical incision, and in the recovery room.: ResultsThe laparoscopic and open groups were similar in age, gender, and body mass index. There was no significant difference in amount of intraoperative fluid administered between groups (5.4 ± 1.6 L, laparoscopic versus 5.8 ± 1.7 L, open), but operative time was longer in the laparoscopic group (232 min versus 200 min, p < 0.01). Urinary output during laparoscopic GBP was 64% lower than during open GBP at 1 hour after surgical incision (19 mL versus 55 mL, p < 0.01) and continued to remain lower than that of the open group by 31–50% throughout the operation. Postoperative blood urea nitrogen and creatinine levels remained within the normal range in both groups. Serum levels of antidiuretic hormone, aldosterone, and plasma renin activity peaked at 2 hours after surgical incision with no significant difference between the two groups.: ConclusionProlonged pneumoperitoneum during laparoscopic gastric bypass significantly reduced intraoperative urine output but did not adversely alter postoperative renal function. [Copyright &y& Elsevier]