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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.

Background/Aim: Early identification of patients with COVID-19 who will develop severe or critical disease symptoms is important for delivering proper and early treatment. We analyzed demographic, clinical, immunological, hematological, biochemical and radiographic findings that may be of utility to clinicians in predicting COVID-19 severity and mortality. Methods: Electronic medical record data from patients diagnosed with COVID-19 from November 2020 to June 2021 in the COVID-19 Department in the Galilee Medical Center, Nahariya, Israel, were collected. Epidemiologic, clinical, laboratory and imaging variables were analyzed. Multivariate stepwise regression analyses and discriminant analyses were used to identify and validate powerful predictors. The main outcome measure was invasive ventilation, or death. Results: The study population included 390 patients, with a mean age of 61 ± 18, and 51% were male. The non-survivors were mostly male, elderly and overweight and significantly suffered from hypertension, diabetes mellitus type 2, lung disease, hemodialysis and past use of aspirin. Four predictive factors were found that associated with increased disease severity and/or mortality: age, NLR, BUN, and use of high flow oxygen therapy (HFNC). The AUC or diagnostic accuracy was 87%, with a sensitivity of 97%, specificity of 60%, PPV of 87% and NPP of 91%. The cytokine levels of CXCL-10, GCSF, IL-2 and IL-6 were significantly reduced upon the discharge of severely ill COVID-19 patients. Conclusions: The predictive factors associated with increased mortality include age, NLR, BUN, and use of HFNC upon admission. Identifying those with higher risks of mortality could help in early interventions to reduce the risk of death.

Xin Yang, Jun Fan, Yingzhi Wu, Jie Lin, Chongling Qian, Jing Li Department of Laboratory Medicine, Kongjiang Hospital, Shanghai, 200093, People’s Republic of ChinaCorrespondence: Xin YangDepartment of Laboratory Medicine, Kongjiang Hospital, No. 480 Shuangyang Road, Yangpu District, Shanghai, 200093, People’s Republic of ChinaTel/Fax +86 2165434597 Ext8136Email xinyang_2021@21cn.comObjective: To investigate the clinical value of sodium dodecyl sulfate–agarose gel electrophoresis (SDS-AGE) of urinary proteins combined with several biochemical indices in the detection of hypertensive nephropathy.Material and Methods: In this study, 210 patients with hypertensive nephropathy were recruited as the kidney disease group, 100 patients with simple hypertension were recruited as the hypertension group, and another 100 healthy participants were recruited as the control group. We conducted SDS-AGE of urinary proteins and urinary microalbumin (mAlb), β2-microglobulin (β2-MG), retinol-binding protein (RBP), serum cystatin C (CysC), blood urea nitrogen (BUN), and creatinine tests at the same time.Results: The results showed that the urinary mAlb levels in the hypertension group and hypertensive nephropathy group were higher than in the control group (P< 0.05). The biochemical index detection results showed that β2-MG, RBP, serum CysC, BUN, and creatinine were higher in the hypertensive nephropathy group than in the control group and hypertension group (P< 0.05). The total positive rates of urinary protein SDS-AGE and urinary mAlb, urinary β2-MG, blood CysC, blood RBP, BUN, and creatinine in 210 patients with essential hypertension nephropathy were 100.0%, 98.6%, 32.8%, 98.6%, 21.0%, 2.0%, and 20%, respectively. The total positive rate of SDS-AGE urinary protein was higher than that of the other six biochemical indices.Conclusion: SDS-AGE of urinary proteins, combined with urinary mAlb, β2-MG, serum CysC, RBP, BUN, and creatinine, could improve the detection sensitivity, which would be helpful for the early and accurate diagnosis of kidney damage.Keywords: hypertension, kidney damage, sodium dodecyl sulfate–agarose gel electrophoresis, urinary mAlb, β2-MG, serum CysC, RBP, BUN, pathological proteinuria

Background/objective The blue honeysuckle berry (Lonicera caerulea var. edulis L.) is a small deciduous shrub belonging to the Caprifoliaceae family that is native to Russia, China, Japan, and Korea. The berry of this shrub is edible, sweet and juicy and is commonly known as the blue honeyberry (BHB). This study examined the anti-diabetic potential of BHB on high-fat-diet-induced mild diabetic mice. The hypoglycemic, and nephroprotective effects of the 12-week oral administration of blue honeyberry extract were analyzed. Materials/methods The hypoglycemic effects were based on the observed changes in insulin, blood glucose, and glycated hemoglobin (HbA1c). Furthermore, the changes in the weight of the pancreas, including its histopathology and immunohistochemical investigation were also performed. Moreover, the nephroprotective effects were analyzed by observing the changes in kidney weight, its histopathology, blood urea nitrogen (BUN), and serum creatinine levels. Results The results showed that the high-fat diet (HFD)-induced control mice showed a noticeable increase in blood glucose, insulin, HbA1c, BUN, and creatinine levels. Furthermore, growth was observed in lipid droplet deposition related to the degenerative lesions in the vacuolated renal tubules with the evident enlargement and hyperplasia of the pancreatic islets. In addition, in the endocrine pancreas, there was an increase in the insulin-and glucagon-producing cells, as well as in the insulin/glucagon cell ratios. On the other hand, compared to the HFD-treated mice group, all these diabetic and related complications were ameliorated significantly in a dose-dependent manner after 84 days of the continuous oral administration of BHBe at 400, 200 and 100 mg/kg, and a dramatic resettlement in the hepatic glucose-regulating enzyme activities was observed. Conclusions By assessing the key parameters for T2DM, the present study showed that the BHBe could act as a potential herbal agent to cure diabetes (type II) and associated ailments in HFD-induced mice.

BACKGROUND: Acute renal failure (ARF) is a serious disease characterised by a rapid loss of renal functions due to nephrotoxic drug or ischemic insult. The clinical treatment approach such as dialysis techniques and continuous renal enhancement have grown rapidly during past decades. However, there is yet no significant effect in improving renal function. Hypoxia-preconditioned mesenchymal stem cells (HP-MSCs) have positive effects on the in vitro survival and stemness, in addition to angiogenic potential. AIM: In this study, we aimed to analyse the effect of HP-MSCs administration in improving renal function, characterised by blood urea nitrogen (BUN) and creatinine level. METHODS: A group of 15 male Wistar rats weighing 250 g to 300 g were used in this study (n = 5 for each group). Rats were randomly distributed into 3 groups: Vehicle control (Veh) as a control group, HP-MSCs and normoxia MSCs (N-MSCs) as the treatment group. Renal function was evaluated based on the BUN and creatinine levels using the colourimetric method on day 5 and 13. The histological analysis using HE staining was performed on day 13. RESULTS: The result showed there is a significant decrease in BUN and creatinine level (p < 0.05). The histological analysis of renal tissue also showed a significant decrease between Veh and treatment group (p < 0.05). CONCLUSION: Based on this study, we conclude that HP-MSCs have a superior beneficial effect than N-MSCs in improving renal function in an animal model of gentamicin-induced ARF.

Background The coronavirus disease 2019 (COVID-19) is an emerged respiratory infectious disease with kidney injury as a part of the clinical complications. However, the dynamic change of kidney function and its association with COVID-19 prognosis are largely unknown. Methods In this multicenter retrospective cohort study, we analyzed clinical characteristics, medical history, laboratory tests, and treatment data of 12,413 COVID-19 patients. The patient cohort was stratified according to the severity of the outcome into three groups: non-severe, severe, and death. Findings. The prevalence of elevated blood urea nitrogen (BUN), elevated serum creatinine (Scr), and decreased blood uric acid (BUA) at admission was 6.29%, 5.22%, 11.66%, respectively. The trajectories showed elevation of BUN level and Scr level, as well as a reduction of BUA level during 28 days after admission in death cases. Increased all-cause mortality risk was associated with elevated baseline levels of BUN and Scr, and decreased level of BUA. Conclusion The dynamic changes of the three kidney function markers were associated with different severity and poor prognosis of COVID-19 patients. BUN showed close association and high potential for predicting adverse outcomes in COVID-19 patients for severity stratification and triage., Graphical Abstract, Highlights ● A cohort of 12,413 COVID-19 patients was retrospectively investigated ● Elevated baseline levels of BUN and Scr correlated with high risk of COVID-19 mortality ● Decreased BUA level on admission was associated with high risk of COVID-19 mortality, Liu et al. show that among 12,413 cases of COVID-19, an elevation of baseline BUN level and Scr level, and a decrease of baseline BUA level were associated with adverse outcomes in patients. These findings may help the risk stratification and triage of COVID-19 patients according to kidney function indicators.

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.

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.

INTRODUCTION[|]Diabetes Mellitus (DM) is a significant cause of mortality and morbidity and may lead to microvascular and macrovascular complications. This can be prevented through early diagnosis of diabetes and achieving glycemic control. Measurement of the fasting glucose, random glucose, oral glucose tolerance test (OGTT) and HbA1C levels have been adopted in the diagnosis of diabetes. This study has searched for DM diagnosis rate using HbA1C measurements in the inpatient population.[¤]METHODS[|]This retrospective study included all inpatients whose HbA1C levels were measured at the Internal Diseases Clinic of Fatih Sultan Mehmet Training and Research Hospital in 2015. Glucose, blood urea nitrogen (BUN), creatinine, fasting glucose levels, age, gender and primary causes of admission of the patients were recorded. The patients, who had HbA1C value of 6.5 or more, were defined as newly diagnosed DM. Before this study, the patients were included in three groups as patients with a previous diabetes diagnosis, patients with a new diabetes diagnosis and patients with no diabetes diagnosis.[¤]RESULTS[|]Among 1057 patients included in this study, 29.7% had past diabetes diagnosis (Group 1), 7.5% were newly diagnosed diabetes, while 62.8% patients have no diabetes. No statistically significant difference was found concerning age and gender distribution. No significant difference was found between the HbA1C, fasting glucose and random glucose levels of Group 1 and Group 2. BUN levels of the patients in Group 3 were lower than those in Group 1. Creatinine levels of Group 1 were higher than in Group 3. No significant difference was identified concerning the duration of hospital stay and mortality between the groups.[¤]DISCUSSION AND CONCLUSION[|]New DM diagnosis rate was 7.5% among the patients admitted to the internal diseases clinic within a year. Besides, in the high-risk population of inpatients, the routine HbA1C measurement may lead to early diagnosis by increasing the undiagnosed patient rate.[¤]

Visual Abstract, Highlights • In 2 different mouse models, AKI increased Gal-3 expression and induced cardiac dysfunction, cardiac and systemic inflammation, cardiac macrophage infiltration, and fibrosis. • Cardiac consequences of AKI were dependent on the Gal-3 pathway and were prevented using Gal-3 knockout mice or modified citrus pectin as a pharmaceutical inhibitor. • Cardiac Gal-3 expression resulted from bone marrow-derived immune cells recruitment after AKI. • In critically ill patients, development of AKI is associated with increased plasma Gal-3 levels and increased biomarkers of cardiac injury and damage., Summary 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.

Low-dose aspirin (75-100 mg/day) is a long-term platelet antiaggregation therapy for certain coronary heart disease (CHD) patients. This study aims to evaluate the long-term use of aspirin on kidney function by examining the changes in the levels of serum creatinine, blood urea nitrogen (BUN), and creatinine clearance of CHD patients. The research method used was a prospective observational cohort analysis. The number of study subjects was 37 CHD patients who took 80 mg/day of aspirin and never experienced kidney disease. Serum creatinine and BUN levels were examined in the 1st and 3rd month of the study. Patient creatinine clearance values were calculated using the Cockcroft-Gault equation. The results of the study showed that the mean levels of serum creatinine, BUN, and creatinine clearance on the 1st and 3rd month were 1.03 ± 0.27 mg/dL and 1.03 ± 0.29 mg/dL; 13.05 ± 4.10 mg/dL and 14.65 ± 4.44 mg/dL; 73.16 ± 18.14 mL/min and 72.92 ± 19.76 mL/min, respectively. The paired t-test results showed that the differences in the mean of creatinine serum, BUN, and creatinine clearance on the 1st and 3rd month were not statistically significant (p > 0.05). The One Way ANOVA test results on the effect of the duration of aspirin use on kidney function were also not statistically significant (p > 0.05) however there is a tendency to decrease creatinine clearance and increase in serum creatinine and BUN. Long-term use of low-dose aspirin has the potential to cause a decrease in kidney function that is seen from a decrease in creatinine clearance as well as an increase in serum creatinine and BUN.

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.

The purpose of this research was to develop anti-cytokine-based treatment using extract of Plectranthus amboinicus applied to gout arthritis (GA) patients. The research was quasi experimental, with a pretest-posttest randomized control group design. The samples were GA patientsin the Outpatient Installation of Internal Medicine in General Hospital Haji,Surabaya. The sample was comprised of 30 respondents. The respondents were divided into a treatment group and a control group. The treatment group was asked to take medicine from the hospital, coupled with Plectranthus amboinicus extract capsules, for 7 days, during which time patients' joint inflammation was observed. The control group was provided with only medication from the hospital, and their joint inflammation was likewise observed. Blood samples were taken before and after treatment, to measure the levels of blood urea nitrogen (BUN) and creatinine, as well as the concentrations of TNF-α; and IL-1β. There was a decrease in BUN and creatinine levels in the control group, but it was not significant, decreasing by 3% and 8%, respectively. The treatment group also showed elevated levels of BUN and creatinine, which also was not significant at 3% and 7%, respectively. There was a decrease in the concentration of TNF-α in the control group by 9% and 22%. The concentration of IL-1β in the control group increased by 18%, whereas,in the treatment group,it decreased by3%; however,the decreases in bothgroups were not significant.

Kemoterapi paklitaksel-karboplatin merupakan salah satu terapi untuk kanker serviks. Toksisitas kemoterapi pada ginjal dapat dinilai menggunakan nilai Blood Urea Nitrogen (BUN) dan serum kreatinin. Pada penelitian potong lintang prospektif ini diperoleh 6 pasien kanker serviks yang memenuhi kriteria penelitian. Pemeriksaan kadar BUN dan serum kreatinin dilakukan sebelum kemoterapi pertama dan sesudah kemoterapi seri ketiga. Rentang waktu kemoterapi pertama ke kemoterapi ketiga adalah tiga minggu. Pengambilan sampel penelitian menggunakan consecutive sampling . Data penelitian dianalisis menggunakan paired test dengan interval kepercayaan 95% dengan SPSS 17.0. Hasil evaluasi nilai BUN dan serum kreatinin sebelum dan sesudah kemoterapi menunjukkan tidak terdapat perbedaan yang bermakna antara sebelum kemoterapi pertama dengan sesudah kemoterapi ketiga (p>0,05). Hasil penelitian ini dapat digunakan dokter sebagai pertimbangan untuk memberikan kemoterapi dengan regimen paklitaksel-karboplatin sesuai prosedur yang berlaku karena terbukti tidak menimbulkan penurunan fungsi ginjal pada pasien kanker serviks skuamosa. Kata kunci: BUN, kanker serviks, kemoterapi, paklitaksel-karboplatin, serum kreatinin Evaluation of Blood Urea Nitrogen and Serum Creatinine in Squamous Cell Cervical Cancer Patients Stadium IIb-IIIb Who Receiving Paclitaxel- Carboplatin Chemotherapy Paclitaxel-carboplatin chemotherapy is one of cervical cancer therapy. Renal toxicity from chemotherapy can be assessed using the value of Blood Urea Nitrogen (BUN) and serum creatinine. In a prospective cross sectional study was obtained 6 cervical cancer patients who met the research criterias. Examination of BUN and serum creatinine performed before first and after third chemotherapy with the interval time of 3 weeks. Sampling method using consecutive sampling. Data were analyzed using paired test with 95% confidence intervals using the SPSS 17.0. BUN and serum creatinine before and after chemotherapy values obtained p>0.05. BUN and serum creatinine values showed no significant difference between before the first chemotherapy to after third chemotherapy. The doctor may consider using this combination chemotherapy in accordance with the procedures in force due to chemotherapy using paclitaxel- carboplatin shown to be effective and not cause renal toxicity in squamous cervical cancer patients. Key words: BUN, cervical cancer, chemotherapy, paclitaxel-carboplatin, serum creatinine

Background Global epidemic of diabetes is a serious health care concern because of its complications and consequently reduced life expectancy and increased morbidity. However, the bone turnover and thus bone health may be affected or even compromised by diabetes and its complications. The aim of this study was to assess whether bone turnover markers are associated with diabetes micro-vascular complications. Methods A total of 204 type 2 diabetes patients (104 patients with diabetic micro-vascular complications (retinopathy and/or nephropathy) as a case group and 100 patients without retinopathy and/or nephropathy) as a control group were recruited in this case–control study. The biochemical and metabolic parameters and bone turnover markers were assessed in all patients. Results Our findings showed serum levels of osteocalcin (OC) (p = 0.0001) and, carboxy-terminal collagen crosslinks (CTX) (p = 0.006) were higher in diabetic patients with both diabetic retinopathy and nephropathy compared with control group. However, there was no significant difference in serum levels of procollagen I aminoterminal propeptide (P1NP) between diabetic patients with diabetic retinopathy (DR) and/or diabetic nephropathy (DN) compared with control. In diabetes patients with complications, there were significant negative correlation between OC and CTX with estimated-glomerular filtration rate (e-GFR) and also positive correlation between each bone marker (OC and CTX) and PTH levels (p = 0.0001) and BUN (p = 0.0001). In a general linear model, after adjusting for age, sex and BMI, and microvascular complications, there was not any significant association between three bone turnover markers and metabolic markers including fasting glucose, insulin, and lipid profile. Among kidney markers, there were significant positive associations between serum levels of CTX and OC with BUN (p

International audience; The glomerulus is a highly specialized capillary tuft, which under pressure filters large amounts of water and small solutes into the urinary space, while retaining albumin and large proteins. The glomerular filtration barrier (GFB) is a highly specialized filtration interface between blood and urine that is highly permeable to small and midsized solutes in plasma but relatively impermeable to macromolecules such as albumin. The integrity of the GFB is maintained by molecular interplay between its 3 layers: the glomerular endothelium, the glomerular basement membrane and podocytes, which are highly specialized postmitotic pericytes forming the outer part of the GFB. Abnormalities of glomerular ultrafiltration lead to the loss of proteins in urine and progressive renal insufficiency, underlining the importance of the GFB. Indeed, albuminuria is strongly predictive of the course of chronic nephropathies especially that of diabetic nephropathy (DN), a leading cause of renal insufficiency. We found that high glucose concentrations promote autophagy flux in podocyte cultures and that the abundance of LC3B II in podocytes is high in diabetic mice. Deletion of Atg5 specifically in podocytes resulted in accelerated diabetes-induced podocytopathy with a leaky GFB and glomerulosclerosis. Strikingly, genetic alteration of autophagy on the other side of the GFB involving the endothelial-specific deletion of Atg5 also resulted in capillary rarefaction and accelerated DN. Thus autophagy is a key protective mechanism on both cellular layers of the GFB suggesting autophagy as a promising new therapeutic strategy for DN.

Cisplatin is one of platinum cytostatic drug for the medication of solid cancers, one of which is head and neck cancer. Adverse event that resulted during drug treatment was acute or chronic nephrotoxicity. Cisplatin concentration in proximal tubular epithelial cells is about 5 times the serum concentration. Platinum exposure on renal tubular cells bonding covalent complex which stimulate production of inflammatory factors that lead to apoptosis and necrosis cell. Cisplatin nephrotoxicity can be prevented by aggressive hydration or alternate method of administration. The aim of this study was to analyze the effectiveness of NaCl-Mannitol hydration on renal function of head and neck cancer patients receiving cisplatin 100 mg/m2 chemotherapy combination with 5FU or paclitaxel. This was a cohort, prospective, and observational study to analyze renal function of head and neck cancer patients receiving cisplatin 100 mg/m2 chemotherapy combination with 5FU or paclitaxel. Inclusion criteria were BUN 7-18 mg/dl and serum creatinine < 2 mg/dl of any cycle. All patients received infuse NaCl-Mannitol hydration with term that provided in Surgeon Departement of Dr. Soetomo General Hospital. Data obtained were BUN, SCr, and eClCr Cockroft-Gault, each was measured pre- and post-hydration. In cisplatin and 5FU chemotherapy combination value BUN pre-hydration (11,99 + 4,62) mg/dl, value BUN post-hydration (12,14 + 4,74) mg/dl and value serum creatinine pre-hydration (0,97 + 0,34) mg/dl, value serum creatinine post-hydration (1,02 + 0,37) mg/dl. Meanwhile to the combination of cisplatin and paclitaxel chemotherapy, value BUN pre-hydration (10,19 + 2,58) mg/dl, value of BUN post-hydration (10,43 + 2,31) mg/dl and value of serum creatinine post- hydration (0,98 + 0,26) mg/dl. In conclusion, NaCl-Mannitol hydration administration is adequate which is shown by BUN and serum creatinine in pre- and post-hydration data within normal limits.

Despite intensive therapy, the mortality rate in acute renal failure still exceeds 30% [1]. Advanced age, multiple organ failure, oliguria and high blood urea nitrogen (BUN) at the time of diagnosis are associated with a poorer prognosis [2]. Rapid diagnosis and prompt treatment are critical to prevent death and irreversible renal failure. Renal biopsy remains the golden standard for diagnosis. Glucocorticoids and cyclophosphamide are the cornerstones in the treatment of rapidly progressive glomerulonephritis; they dramatically ameliorate glomerular injury and induce remission in 75–80% of cases [3]. We present a patient with remarkable biochemical derangement, especially high BUN (Table 1). A case like this has not previously been seen in our department, nor described in the literature.

As aflatoxinas, embora principalmente hepatotóxicas, já foram descritas como nefrotóxicas em várias espécies animais. Neste trabalho, a patologia clínica veterinária foi utilizada para avaliar as alterações renais na aflatoxicose experimental em cães. Utilizaram-se quatro grupos de 5 cães, com colheitas diárias de sangue e urina, durante 12 dias consecutivos; nos quais realizaram-se dosagens séricas de uréia, creatinina e proteína total, e urinálise. O experimento foi dividido em três períodos, sendo o período 0 (dias l a 3) referente a colheita de dados para controle, período 1 (dias 4 a 8) considerando o tempo de administração da toxina e período 2 (dias 9 a 12) ao tempo após a intoxicação. As doses de aflatoxina usada foram de 100, 200, 400, e 600mg/kg/dia, respectivamente para os grupos I, II, III, IV, por via oral, misturada ao alimento, pelo período de cinco dias. As taxas de uréia e creatinina variaram dentro do intervalo normal dos valores de referência da literatura consultada. A proteína total e a densidade urinária estiveram próximas ou acima dos valores máximos de referência devido a hemoconcentração. A análise estatística evidenciou uma diminuição progressiva nos valores de uréia, creatinina e densidade urinária, com relação ao aumento da dose usada em cada grupo. Este fato foi atribuído à maior ingestão de água. Através dos resultados obtidos, concluiu-se que as doses aplicadas não foram suficientes para detectar lesão renal. Aflatoxins, although primary hepatotoxic agents, were injurious to kidney in several animal species. Veterinary clinical pathology was used to determine renal changes in canine experimental aflatoxicosis. Four groups of five dogs were used. Blood and urine samples were coilected for the twelve following days. BUN, creatinine, total serun protein and urinalysis were done. The experiment was divided in three periods: period 0 (days 1 to 3) refered to the control data, period 1 (days 4 to 8) to the aflatoxin administration days, and period 2 (days 9 to 12) the days after the poisoning. 100, 200, 400 and 600mg/kg/day of aflatoxin for the I, II, III and IV groups respectively, by oral pathway, mixed to the food, were used for five days. BUN and creatinine were within the normal ranges. Total serun protein and urine specific gravity were near or above upper limits due to hemoconcentration. Statistics showed a diminution of BUN, creatinine and urine specific gravity values according to the increased af latoxin doses applied in each group. This was attributed to an increase of water intake. According to the results of this investigation, the conclusion is that the doses used were not sufficient to determine renal damage.

Background Venoveno bypass (VVB) has been used to achieve hemodynamic stability and decrease the incidence of renal dysfunction. However, VVB has many complications. The purpose of this study is to verify the safety of total clamping of the suprahepatic inferior vena cava (IVC) without VVB during orthotropic liver transplantation (OLT) in terms of anesthetic management. Methods Twenty-five patients without preoperative renal dysfunction who underwent primary OLT were enrolled in this study. Hemodynamic data and blood gas measurements were collected 1 hour after incision, 30 minutes after IVC total clamping and 30 minutes after reperfusion. Postoperative laboratory data, including blood urea nitrogen (BUN), creatinine (Cr) and glomerular filtration rate (GFR), were assessed at postoperative day (POD) 0-7, 30, 90, 180 and 1 year. Results Mean blood pressure was well maintained during IVC total clamping with infusion of inotropics. There was no case of severe acidosis (pH < 7.2) during the anhepatic period. The immediate postoperative Cr and GFR were not significantly different from those of the preoperative values. BUN increased from POD 1 and decreased after POD 6, while Cr increased at POD 90 only. Conclusions In patients without preoperative renal dysfunction, when IVC was totally clamped, VVB does not need to be routinely performed to maintain hemodynamics during the anhepatic phase and renal function after OLT.

Rhabdomyolysis, a potentially life-threatening syndrome, is not an uncommon condition with around 38,000 cases been reported in the USA in 2000. The risk of developing acute renal failure in the initial days of presentation can be as high as 40% and approximately 28–37% of patients require short-term hemodialysis. This report discusses a case of rhabdomyolysis after seizures in which blood urea nitrogen (BUN), creatinine, and BUN/creatinine levels were examined during the course of illness in the hospital. We found that the BUN/creatinine ratio is not a reliable indicator of renal function in rhabdomyolysis. Potassium levels can be a better marker for the early recognition of acute renal failure and an indication for prompt treatment with dialysis, which is crucial to prevent fatal complications.

Diabetes mellitus has been reported as the most critical factor causing visual loss. Among the various complications of diabetes mellitus in the eyes, diabetic retinopathy has been regarded as the most common cause of visual loss.1-3 Diabetes mellitus is also known as an important risk factor for cataracts. In epidemiologic studies published in European countries, factors such as a long duration of diabetic disease, advanced age at the time of clinical diagnosis, advanced retinopathy, treatment with diuretics, and poor control of blood sugar level are reported as risk factors for cataract in diabetics.4-11 However, reports about the prevalence and risk factors of cataract in diabetes are limited for Korean patients.12 Most diabetes mellitus cases in Korea are type 2, with a shorter duration than in European countries. The incidence and prevalence of type 1 diabetes mellitus and juvenile-onset diabetes mellitus is lower in Korea than that of European populations.13 Accordingly, it is expected that the incidence and risk factors for cataracts in diabetes mellitus are different. Furthermore, recent studies have reported that various complications such as cardiovascular, nephrologic, and ophthalmologic diseases could be prevented by controlling glucose in diabetic patients. Therefore, we conducted research on the frequency and risk factors of cataracts in Korean patients with diabetes. From January 2004 to December 2005, 850 patients with type 2 diabetes mellitus of the Diabetes Center of Eulji Medical Center at Eulji Medical University were evaluated retrospectively. All patients underwent an ophthalmologic evaluation including slit lamp biomicroscopy and indirect ophthalmoscope fundus examination. Three hundred and forty-two patients (40.2%) were male and the mean age of all patients was 50.87±8.60 years. A diabetic patient was defined as one who had a serum glucose concentration of more than 120 mg/dl while fasting more than twice or who had greater than 200 mg/dl when measured within two hours after a meal more than twice. The diabetic period was defined from the diagnosis of diabetes mellitus to the day of the indirect ophthalmoscope fundus examination. The fasting serum glucose concentration used in this analysis was the one examined closest to the day of the fundus examination. In addition, we investigated HbA1c, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, BUN, and creatinine. Each patient underwent best-corrected distance visual acuity measurement with a Snellen chart. Visual acuity was defined as the average value of the corrected visual acuity of both eyes before examination. An ophthalmic examination was performed with slit lamp biomicroscopy and indirect ophthalmoscope fundus examination after the pupil was maximally dilated with 1.0% tropicamide (Mydriacyl) and 2.5% phenylephrine hydrochloride (Neosynephrine). Diabetic patients were classified into a cataract group and a control group without cataracts. We compared clinical data and ophthalmologic results between the cataract group and the control group. Risk factors for cataracts, including sex, age, the diabetic period, blood sugar in fasting, HbA1c, and presence of diabetic retinopathy, were evaluated. To analyze how the risk factors affected the occurrence of cataracts, chi-square analysis was used. To compare the difference of biochemical examination between the two groups, Student's t-test was used. Multiple regression analysis was performed to investigate the relationship between various variables and the degree of lens opacity. A p-value

Renal ischemia as a course of renal transplantation is a common cause of renal dysfunction as renal failure. The purpose of this study was to investigate the influence of ascorbic acid on blood urea nitrogen (BUN), creatinine (Cr) and resistive index (RI) for dog models with renal ischemia-reperfusion (I/R) injury. Renal ischemia was induced on 6 Beagle dogs. The left kidney was exposed to normothermic ischemia for a short period at 30 min followed by reperfusion. On the blood Cr level and RI, there was no significant difference comparing both groups. 14 days after I/R injury a significant reduction on the blood BUN level was observed in the vehicle group (34.06 mg/dl) compared to that of ischemia induced treated group (10.3mg/dl) (p < 0.05). In conclusion, administration of ascorbic acid for renal ischemic-reperfusion injury had influence on blood BUN level, but it was not revealed the influence on blood Cr and RI.