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Abstract This study analyzed the relationship between urine concentrations of phthalate metabolites (UCOM) and personal care products (PCPs) used in adults and examined the change in UCOM according to the usage frequency of PCPs based on raw data from the 3rd Korean National Environmental Health Survey conducted between 2015 and 2017. The relationship between PCP use frequency and UCOM was analyzed using multiple regression analysis, adjusting for baseline factors. The regression model consisted of a Crude Model with log-transformed UCOM before and after adjustment for urine creatinine concentrations. Model 1 was additionally adjusted for age, sex, and obesity, while Model 2 was additionally adjusted for smoking, alcohol consumption, pregnancy history, average monthly income of the household, and PCP exposure within the past 2 days. PCP usage frequency was significantly associated with the UCOM without adjustment for urine creatinine and correlated with demographic characteristics, urine creatinine concentration, and PCP exposure within the past 2 days. This study on exposure to urinary phthalates will play a crucial role in Korean public health by aligning with the fundamentals of research priorities and providing representative data on phthalate exposure for conducting population-level studies.

A paper-based analytical device (PAD) with an integrated composite electrode has been designed and fabricated for non-enzymatic creatinine sensing. Reduced graphene oxide (rGO) was employed to modify the PAD so that it could function as a solid-contact transducer. A new macrocyclic pyrido-hexapeptide derivative was made and used as a special ionophore in the creatinine membrane sensor. The synthesized PAD showed a detection limit of 1.0 µM (S/N = 3) and a potentiometric response towards creatinine throughout a log-linear range of 2.0 µM–10 mM (R2 = 0.9998). The sensor shows significant selectivity for a few related substances, including ephedrine, codeine, ketamine, caffeine, urea, urate, carbinoxamine, and dextromethorphan. It has been established that the testing method is appropriate for the direct potentiometric detection of creatinine in a variety of human urine sample types. When an indicating electrode and a reference electrode are put on the same flexible disposable, this lets applications with a small sample volume be done. For point-of-care creatinine measurement, the developed paper-based analytical equipment is a good choice because it is affordable, easily accessible, and self-pumping (especially when combined with potentiometric detection). [ABSTRACT FROM AUTHOR]

This study analyzed the relationship between urine concentrations of phthalate metabolites (UCOM) and personal care products (PCPs) used in adults and examined the change in UCOM according to the usage frequency of PCPs based on raw data from the 3rd Korean National Environmental Health Survey conducted between 2015 and 2017. The relationship between PCP use frequency and UCOM was analyzed using multiple regression analysis, adjusting for baseline factors. The regression model consisted of a Crude Model with log-transformed UCOM before and after adjustment for urine creatinine concentrations. Model 1 was additionally adjusted for age, sex, and obesity, while Model 2 was additionally adjusted for smoking, alcohol consumption, pregnancy history, average monthly income of the household, and PCP exposure within the past 2 days. PCP usage frequency was significantly associated with the UCOM without adjustment for urine creatinine and correlated with demographic characteristics, urine creatinine concentration, and PCP exposure within the past 2 days. This study on exposure to urinary phthalates will play a crucial role in Korean public health by aligning with the fundamentals of research priorities and providing representative data on phthalate exposure for conducting population-level studies. [ABSTRACT FROM AUTHOR]

IntroductionBiomarkers of acute kidney injury (AKI) are often indexed to urine creatinine (UCr) or urine osmolarity (UOsm) to control for urine concentration. We evaluated how these approaches affect the biomarker-outcome association in patients with AKI.MethodsThe Assessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury Study was a cohort of hospitalized patients with and without AKI between 2009 and 2015. Using Cox proportional hazards regression, we assessed the associations and predictions (C-statistics) of urine biomarkers with a composite outcome of incident chronic kidney disease (CKD) and CKD progression. We used 4 approaches to account for urine concentration: indexing and adjusting for UCr and UOsm.ResultsAmong 1538 participants, 769 (50%) had AKI and 300 (19.5%) developed composite CKD outcome at median follow-up of 4.7 years. UCr and UOsm during hospitalization were inversely associated with the composite CKD outcome. The associations and predictions with CKD were significantly strengthened after indexing or adjusting for UCr or UOsm for urine kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), and monocyte chemoattractant protein-1 (MCP-1) in patients with AKI. There was no significant improvement with indexing or adjusting UCr or UOsm for albumin, neutrophil gelatinase-associated lipocalin (NGAL), and chitinase 3-like 1 (YKL-40). Uromodulin's (UMOD) inverse association with the outcome was significantly blunted after indexing but not adjusting for UCr or UOsm.ConclusionUCr and UOsm during hospitalization are inversely associated with development and progression of CKD. Indexing or adjusting for UCr or UOsm strengthened associations and improved predictions for CKD for only some biomarkers. Incorporating urinary concentration should be individualized for each biomarker in research and clinical applications.

Background This study aimed to determine the accuracy of CYFRA 21-1 using urine creatinine correction (CYFRA/Cr) as a biomarker of endometriosis. Methods This study includes 73 patients from the Indonesian population, with 38 endometriosis and 35 non-endometriosis patients based on laparoscopy. Urine detection of CYFRA 21-1 was done by ELISA method and corrected by urine creatinine constant factor (CYFRA/Cr). Urine creatinine us detected using the ECLIA method. Results The CYFRA/Cr ratio was identified in the proliferative and secretory phases. CYFRA 21-1 and CYFRA/Cr levels were significantly higher in endometriosis and were higher in the proliferative phase compared to the secretory phase. The best accuracy was obtained in CYFRA which was corrected with urine creatinine in the proliferative phase with a sensitivity value, specificity, and cutoff value of 94.7%, 94.4%, and of 3,547.99 ng/gr, respectively, compared to CYFRA 21-1 urine levels without correction of creatinine. Conclusions The CYFRA to creatinine urine ratio detected in the proliferative phase showed the optimum sensitivity and specificity compared to CYFRA 21-1 spot urine. It has the potential to be a biomarker of endometriosis.

Urine albumin concentration and albumin–creatinine ratio are important for the screening of early-stage kidney damage. Commutable urine certified reference materials (CRMs) for albumin and creatinine are necessary for standardization of urine albumin and accurate measurement of albumin–urine ratio. Two urine CRMs for albumin and creatinine with certified values determined using higher-order reference measurement procedures were evaluated for their commutability on five brands/models of clinical analyzers where different reagent kits were used, including Roche Cobas c702, Roche Cobas c311, Siemens Atellica CH, Beckman Coulter AU5800, and Abbott Architect c16000. The commutability study was conducted by measuring at least 26 authentic patient urine samples and the human urine CRMs using both reference measurement procedures and the routine methods. Both the linear regression model suggested by the Clinical and Laboratory Standard Institute (CLSI) guidelines and log-transformed model recommended by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Commutability Working Group were used to evaluate the commutability of the human urine CRMs. The commutability of the human urine CRMs was found to be generally satisfactory on all five clinical analyzers for both albumin and creatinine, suggesting that they are suitable to be used routinely by clinical laboratories as quality control or for method validation of urine albumin and creatinine measurements. [ABSTRACT FROM AUTHOR]

• Urine creatinine measurements ≤2 mmol/L are underestimated on the Siemens Vista. • This may affect spot urine biomarkers reporting. • Laboratories may be at risk of delivering incorrect results. While considerable efforts have been accomplished to standardize the measurement of plasma creatinine (PCr), urine creatinine (UCr) has not been subject to the same scrutiny. UCr is importantly used when measuring biomarkers in spot urines, to assess urine output and variable dilution of urine samples. Here, we report underestimation of Jaffe UCr measurements on the Siemens Dimension Vista® analyzer, critically affecting samples with UCr ≤2 mmol/L. We demonstrate that this error is caused by automatic urine pre-dilution by the Vista's « urine mode », and that UCr measured in « plasma mode » without pre-dilution does not present this error. In the absence of a comprehensive solution proposed by Siemens, we propose simple formulae that can be easily implemented in a laboratory to correct these low UCr measurements. Importantly, the observed UCr underestimation can significantly influence reported results for biomarkers/UCr ratios measured in spot urine. Indeed, these results can be overestimated up to +84.4 % before correction using our formulae. This can sometimes lead to misclassification according to clinical thresholds, e.g. Kidney disease: improving global outcomes (KDIGO) guidelines for urine albumin/creatinine. This highlights the need for every clinical laboratory to assess the detection limits of their assays, including for lesser-discussed parameters such as UCr. Indeed, the error we reported here may affect other urine assays performing systematic urine pre-dilution and could have significant repercussions on the clinical management of patients. [ABSTRACT FROM AUTHOR]

Objective: To study the uric acid-lowering and renal protective effects of Portulaca oleracea to provide reference for clinical research. Methods: Male ICR mice were randomly divided into 5 groups. Blank group (CON), model group (HUA), allopurinol positive drug control group (ALLOP, 0.02 g/kg/d), purslane high-dose group (PO-H, 1.48 g/kg/d), Portulaca low-dose group (PO-L, 0.5 g/kg/d). Each group was given the corresponding dose for 21 d continuously, starting from the 7th day, except for the blank group, each group was intraperitoneally injected with hypoxanthine (HX, 0.3 g/kg) combined with potassium oxazine (OAPS, 0.3 g/kg) to establish a hyperuricemia model. Observe serum uric acid (SUA) and malondialdehyde (MDA) levels in mice, collect liver to detect xanthine oxidase (XOD) and superoxide dismutase (SOD) levels, collect kidney to detect glutathione (GSH), glutathione peroxidase (GSH-PX) level. 24 hours urine was collected the day before the end of the experiment to detect urine uric acid (UUA) and urine creatinine (UCr) levels, pathological observation of mouse kidney HE staining was performed. Results: Compared with the CON group, the HUA group significantly (P

Purpose Loss of muscle mass and strength are associated with long‐term adverse health outcomes in older adults. Urine creatinine concentrations (Ucr; mg/dl) are a measure of muscle tissue mass and turnover. This study assessed the associations of a spot Ucr level with muscle mass and with risk of hospitalization, mortality, and diabetes mellitus in older adults. Methods: We examined 3424 participants from the Cardiovascular Health Study who provided spot urine samples in 1996–1997 and who were followed through June 2015. All participants underwent baseline measurement of grip strength. In a sub‐cohort, 1331 participants underwent dual energy X‐ray absorptiometry (DEXA) scans, from which lean muscle mass was derived. Participants were followed for a median of 10 years for hospitalizations and mortality, and 9 years for diabetes mellitus. Results: In linear regression analysis, a one standard deviation higher Ucr concentration (64.6 mg/dl) was associated with greater grip strength (kg force) β = 0.44 [0.16, 0.72]; p = 0.002) and higher lean muscle mass (kg) (β = 0.43 [0.08, 0.78]; p = 0.02). In Cox regression analyses, each standard deviation greater Ucr concentration was associated with lower rates of hospitalizations (0.94 [95% confidence interval, 0.90, 0.98]; p < 0.001) and lower mortality risk (0.92 [0.88, 0.97]; p < 0.001), while a one standard deviation increase in muscle mass derived from DEXA had no such significant association. Ucr levels were not associated with incident diabetes mellitus risk (0.97 [0.85, 1.11]; p = 0.65). Conclusion: A higher spot Ucr concentration was favorably associated with muscle mass and strength and with health outcomes in older community‐living adults. The ease of obtaining a spot Ucr makes it an attractive analyte to use for gauging the health of older adults. [ABSTRACT FROM AUTHOR]

Abstract Background Urine concentration (UC) provides clinically useful information concerning hydration status and renal function of animals. Objectives To characterize the clinical performance of urine specific gravity measured by optical refractometry (USG‐R) or Multistix‐SG urine reagent dipstick (USG‐D), urine electrical conductivity using an OAKTON Con 6 conductivity handheld meter (UEC), urine color (UColor) using a custom‐designed 8‐point color chart, and urine creatinine concentration (UCreat) for assessing UC in dairy cattle. Animals 20 periparturient Holstein‐Friesian cows. Methods Urine was obtained by perineal stimulation or urethral catheterization and urine osmolality (UOsm, reference method), USG‐R, USG‐D, UEC, UColor, and UCreat determined. Diagnostic test performance was evaluated using Spearman's rho and logistic regression to determine the area under the receiver operating curve (AUC) and optimal cut point for diagnosing hypohydration (UOsm ≥800 mOsm/kg). P

Increased urine albumin concentration (UALB) or urine albumin-to-creatinine ratio (UACR) at admission has been associated with systemic disease and increased morbidity and mortality in critically ill canine patients. The objective of this study was to assess the prognostic value of UALB and UACR for the survival, as well as for the development and duration of systemic inflammatory response syndrome (SIRS) in puppies with canine parvoviral enteritis (CPVE). Unvaccinated puppies, aged 1-12 months with confirmed CPVE, hospitalized for ≥5 days were included. Urine was collected at admission via cystocentesis; albumin was measured immunoturbidimetrically and creatinine spectrophotometrically. The presence of SIRS was daily evaluated. Statistical analysis was conducted using R language. Twenty-six dogs were enrolled; 12/26 (46%) developed SIRS during hospitalization, while 5/26 (19%) died. A significant correlation was found between UALB and UACR (ϱ=0.868, p0.05). SIRS duration was significantly correlated with UACR (ϱ=0.427, p=0.030), but not with UALB (ϱ=0.386, p=0.052). The non-survivors had higher median UALB [0.6 (0.1-12.7) mg/dL] and UACR [19.6 (0.7-2,093) mg/g] compared to survivors [UALB= 0.2 (0-1.5) mg/dL, UACR= 2.3 (0-16.9) mg/g], but the differences were non-significant (p>0.05). UACR appears to be a prognostic indicator of SIRS duration in puppies with CPVE. However, a large-scale study is warranted to confirm the usefulness of UALB and UACR for clinical risk assessment in puppies with CPVE.

Background: Serum creatinine concentrations are higher in Greyhounds when compared with nonsighthound breeds. Greyhounds might also have higher urine creatinine concentrations compared with other breeds, which could affect urine protein‐to‐creatinine ratio (UPC) references. Objectives: We aimed to determine the UPC reference intervals (RIs) in healthy nonracing Greyhounds and compare this with UPC values in a group of healthy nonsighthounds and with the current International Renal Interest Society (IRIS) guidelines. Methods: The study used an observational cross‐sectional design, involving clinically healthy, nonracing Greyhounds (n = 98) and nonsighthound dogs of similar weight, age, and sex (n = 24). Packed cell volumes, total solids, urine protein concentrations, serum and urine creatinine concentrations, urine specific gravity (USG) measurements, and UPCs were determined. Linear regression was used to compare urine creatinine and urine protein concentrations, relative to the USG measurements, between Greyhound and nonsighthound groups. Greyhound UPC RIs were determined using nonparametric methods and compared with UPC values in nonsighthounds and current IRIS guidelines. Results: Mean urine creatinine concentrations, adjusted for USGs, were approximately 22% higher in Greyhounds compared with nonsighthounds (P =.002). Mean urine protein concentration (P =.46) and UPC (P =.1) were not significantly different between Greyhounds and nonsighthounds. The upper limit of the Greyhound UPC RI was 0.20 or 0.42, depending on whether strict or moderate exclusion criteria were applied, respectively. Conclusions: Greyhounds have higher urine creatinine concentrations than nonsighthounds. Although the suggested RI for UPCs in Greyhounds is slightly lower than the cut‐offs recommended in generic canine IRIS guidelines, this difference is not likely to be clinically significant. [ABSTRACT FROM AUTHOR]

Assays of urine biomarkers often use urine creatinine to account for urinary dilution, even though creatinine levels are influenced by underlying physiology and muscle catabolism. Urine osmolality—a measure of dissolved particles including ions, glucose, and urea—is thought to provide a more robust marker of urinary dilution but is seldom measured. The relationship between urine osmolality and creatinine is not well understood. We calculated correlation coefficients between urine creatinine and osmolality among 1375 members of a subcohort of the Danish Diet, Cancer, and Health Cohort, and within different subgroups. We used linear regression to relate creatinine with osmolality, and a lasso selection procedure to identify other variables that explain remaining variability in osmolality. Spearman correlation between urine creatinine and osmolality was strong overall (ρ = 0.90; 95% CI: 0.89–0.91) and in most subgroups. Linear regression showed that urine creatinine explained 60% of the variability in urine osmolality, with another 9% explained by urine thallium (Tl), cesium (Cs), and strontium (Sr). Urinary creatinine and osmolality are strongly correlated, although urine Tl, Cs, and Sr might help supplement urine creatinine for purposes of urine dilution adjustment when osmolality is not available.

Background In this study, researchers investigated non-invasive methods for analyzing creatinine levels by using saliva to address the need for frequent phlebotomy in chronic kidney disease (CKD) patients, which can damage their veins due to repeated blood withdrawals for creatinine level assessments. Methods This is a cross-sectional study in a tertiary healthcare setting conducted on 50 patients diagnosed with CKD. After collecting serum and salivary creatinine, we used Pearson correlation to assess the correlation between the two factors. Results The mean age of the patients was 50 years with a standard deviation of ± 15.32 years. 33 (66%) patients were males and 17 (34%) were females. Most patients were in the age group of 51 - 70 years, comprising 26 (52%) of the sample. The serum creatinine and salivary creatinine values ranged between 7.26-12.00 and 0.45-0.98, respectively. The median values were 9.72 and 0.75, respectively. There was a very weak positive linear relationship between serum and salivary creatinine levels; however, there was no significant association between them (p = 0.52). Nonetheless, a statistically significant, moderately negative linear correlation exists between serum urea and serum albumin (r = -0.36; p = 0.01). Additionally, there is a statistically significant weak negative linear correlation between serum chloride and serum urea (r = -0.3; p = 0.03). Comparing serum chloride and serum sodium reveals a statistically significant, moderately positive linear relationship (r = 0.4; p = 0.004). Serum phosphorus and serum creatinine display a statistically significant moderate positive linear relationship (r = 0.44; p = 0.001). Moreover, estimated glomerular filtration rate (eGFR) and serum creatinine exhibit a statistically significant strong negative linear correlation (r = -0.79; p < 0.001), while eGFR and serum phosphorus demonstrate a statistically significant weak negative linear correlation (r = -0.30; p = 0.03). Conclusion The study found no significant association between salivary and serum creatinine levels. Further multicentric studies on a larger population must be conducted to find the potential correlation between serum and salivary markers., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Chacko et al.)

Background: Urine concentration (UC) provides clinically useful information concerning hydration status and renal function of animals. Objectives: To characterize the clinical performance of urine specific gravity measured by optical refractometry (USG‐R) or Multistix‐SG urine reagent dipstick (USG‐D), urine electrical conductivity using an OAKTON Con 6 conductivity handheld meter (UEC), urine color (UColor) using a custom‐designed 8‐point color chart, and urine creatinine concentration (UCreat) for assessing UC in dairy cattle. Animals: 20 periparturient Holstein‐Friesian cows. Methods: Urine was obtained by perineal stimulation or urethral catheterization and urine osmolality (UOsm, reference method), USG‐R, USG‐D, UEC, UColor, and UCreat determined. Diagnostic test performance was evaluated using Spearman's rho and logistic regression to determine the area under the receiver operating curve (AUC) and optimal cut point for diagnosing hypohydration (UOsm ≥800 mOsm/kg). P < .05 was considered significant. Results: The best performing test for diagnosing hypohydration was USG‐R (AUC = 0.90) at an optimal cut point ≥1.030. The second‐best performing test was UEC (AUC = 0.82) at a cut point of ≥23.7 mS/cm, followed by UCreat (AUC = 0.76) at a cut point of ≥95.3 mg/dL, and UColor (AUC = 0.74) at a cut point of ≥4 on an 8‐point scale. Urine specific gravity measured by dipstick performed poorly (AUC = 0.63). Conclusions and Clinical Importance: USG‐R and UEC provide practical and sufficiently accurate methods for measuring UC in dairy cattle. Urine color had moderate clinical utility as a no‐cost cow‐side method for assessing UC, whereas dipstick refractometry is not recommended for assessing UC. [ABSTRACT FROM AUTHOR]

Abstract Background The clinical importance of random urine creatinine concentration in CKD population remains undetermined. Earlier studies found that lower 24-h urine creatinine excretion was associated with the risk of ESRD and all-cause mortality among CKD patients. Methods We modeled the longitudinal trajectories of serial random urine creatinine among 4689 CKD patients enrolled in a national registry-based pre-ESRD program between 2003 and 2015 at a tertiary medical center. Other biochemical parameters including kidney function and serum albumin were regularly evaluated. Primary study outcomes were ESRD requiring maintenance dialysis and all-cause mortality. Results By group-based trajectory modeling, the urine creatinine trajectories were characterized into three patterns: (1) stable low; (2) medium; and (3) high-declining. The adjusted hazard ratio of incident ESRD and all-cause mortality increased by 6% (95% CI: 1–12%) and 9% (95% CI: 2–17%), respectively, for each 20 mg/dL reduction in baseline random urine creatinine concentration. Consistently, there was a significant inverse linear dose-response relationship between baseline random urine creatinine and incident ESRD, but not all-cause mortality. Compared to patients with "medium" and "high-declining" urine creatinine trajectories combined, the adjusted hazard ratio for incidental ESRD among patients with a "stable-low" trajectory who had serial random urine creatinine concentrations stably below 100 mg/dL was 1.46 (95% CI: 1.00–2.12) after considering the competing risk of death. Conclusions Random urine creatinine not only serves as a common urinary concentration corrector but has its own clinical significance in risk stratification and outcome prediction in patients with advanced CKD. Highlights • The prognostic role of random urine creatinine(U-Cr) in chronic kidney disease (CKD) is unknown. • Prior evidence supports 24-h U-Cr is associated with the dialysis risk and mortality in CKD. • CKD Patients with longitudinal U-Cr stably below 100 mg/dL have a significant risk of dialysis. [ABSTRACT FROM AUTHOR]

Background: Interpretation of the different aerobic and anaerobic metabolism, training, and anthropometric indices of sportspersons from different sports discipline can aid in improving sports performance. This study sought to evaluate the association between urine creatinine concentration (UCR) and percentage body fat (%BF), body mass index (BMI), and duration of training (DOT) among University of Ghana sportspersons. Methods: A cross-sectional study design was used. Information on background characteristics, body weight, height, %BF, and sporting activity profiles were gathered on a convenient sample of 101 University of Ghana sportsmen and women across all levels of study. BMI and %BF were determined using the Omron Fat Loss Monitor™. Creatinine concentration in 24-h urine samples was analyzed using Jaffe's reaction, and absorbance read spectrophotometrically at 530 nm. Results: Mean age was 22 ± 3 years. Thirty-one percent (31%) of the participants played football, whereas 69% took part in other sports (handball, volleyball, rugby, and baseball). Average daily DOT of 113.6 ± 44 min (males) and 95.1 ± 54 min (females) was reported by the participants. Mean BMI and %BF were 23.1 ± 3.7 Kg/m2 and 23.2 ± 9.0%, respectively. The mean BMI was within normal range as per the WHO standards, whereas %BF exceeded required limits for each sports discipline. UCR was higher for males (1.2 ± 0.5 g/d) as compared to females (0.8 ± 0.5 g/d). There was a weak positive correlation between UCR and BMI (r = 0.123; P = 0.22) and between UCR and DOT (r = 0.074; P = 0.46). %BF and UCR were inversely related (r = −0.114, P = 0.26). There was no association between UCR and type of sports (P = 0.24). There was a significant association between the type of sports and BMI (P = 0.002). Conclusion: There was a weak positive correlation between creatinine and BMI as well as training duration. Type of sports played is a significant predictor of sportspersons' BMI.

OBJECTIVE: To study elderly hypertensive patients with trace albuminuria (urine albumin to creatinine ratio (UACR)) and the relationship between the occurrence of new cardiovascular events, to provide a basis for early prevention in elderly patients with high blood pressure. PATIENTS AND METHODS: A total of 3564 elderly patients with high blood pressure were enrolled in the study. Based on UACR, patients were divided into four groups (group A: 0.05-3.20 mg/g; group B:3.21-10.04 mg/g; group C: 10.05-19.33 and group D: 19.34-30.00 mg/g). All patients underwent follow-up for an average period of 3.8 years. Four groups were compared for new cardiovascular events and they were correlated with UACR. RESULTS: Through multivariate Cox proportional hazards regression analysis, the relative risk of cardiocerebrovascular events, cerebral infarction and acute myocardial infarction (mi), in group D was 1.74 times (p < 0.05), 1.66 times (p < 0.05) and 2.48 times (p < 0.05), respectively. UACR level in females and those with higher age, body mass index, systolic blood pressure, fasting blood glucose, TG, TC, LDL-C levels and lower HDL-C were higher. During follow-up, patients from group D with sudden cardiac death, acute myocardial infarction, cerebral hemorrhage, cerebral infarction occurrence was significantly higher than group A (x2 = 79.3, p = 79.3) CONCLUSIONS: According to UACR level, we can perform early prevention for elderly patients with high blood pressure, thus reducing the occurrence of cerebral infarction and myocardial infarction. [ABSTRACT FROM AUTHOR]

Objectives: The database on cadmium (Cd) concentration in children is limited, especially in China. The present study aimed at evaluating the body burden of Cd and to propose reference values for urine Cd in young children, who lived in areas with no point sources of metal exposure. Methods: Overall, 1170 children aged from 1 month to 17 years old were enrolled in the study. A questionnaire was used to obtain essential information about age, gender, etc. Urine samples were collected to determine urinary Cd and urine creatinine. Results: A total of 1070 children, 544 males and 526 females, were included in the analysis. Based upon their age, the population was divided to three age groups (0 to 5 years, 6 to 11 years, and 12 to 17 years). The reference value of urinary Cd for children without disease and Cd exposure was as follows: 0 to 5 years < 0.56 μg/L, 6 to 11 years < 0.65 μg/L, and 12 to 17 years < 0.74 μg/L. The reference value of urinary Cd adjusted by urine specific gravity was as follows: 0 to 5 years < 0.83 μg/L, 6 to 11 years < 0.01 μg/L, and 12 to 17 years < 1.15 μg/L. The reference value of urinary Cd corrected by urinary creatinine was as follows: 0 to 5 years < 2.17 μg/L, 6 to 11 years < 1.23 μg/L, and 12 to 17 years < 1.25 μg/L. Conclusions: In this study, we determined urine cadmium levels in children from non-polluted areas in china. The reference intervals could be used to offer recommendations for clinical work. [ABSTRACT FROM AUTHOR]

Aim: To investigate microalbuminuria in patients with Parkinson's disease (PD) and to determine its relationship with the stages of the disease. Parkinson's disease (PD) is a chronic neurodegeneration of dopaminergic neurons in the substantia nigra. The reason for the death of these neurons is still unclear; however, studies have demonstrated the potential involvement of mitochondria, endoplasmic reticulum in contributing to cellular oxidative stress. Material and Methods: Thirty-two PD patients who admitted to Neurology Clinic of Kirikkale University's Medical Faculty and 30 healthy volunteers whose age and sex-matched were included in the study. Urine creatinine and urine albumin levels were determined in patient and healthy groups. The disease duration and Hoehn and Yahr stages were recorded. Results: There was no statistically significant difference between urine creatinine, microalbumin, and urine creatinine/albumin ratios when PD patient results compared with the healthy volunteers'. There was no significant correlation among urine creatinine, microalbumin, and urine creatinine/albumin ratio between the disease duration and Hoehn and Yahr staging in patients with PD. Conclusion: Microalbuminuria is an indirect finding of oxidative stress in urine. In the current study, microalbuminuria was not detected in PD patients at various stages of the disease. It is an important finding that microalbuminuria, a marker of oxidative stress in the urine in PD, a disease in which oxidative stress plays a significant role in etiopathogenesis, is not found. [ABSTRACT FROM AUTHOR]

INTRODUCTION: human immunodeficiency virus (HIV) infection is a global healthcare problem. Some diseases and physiological states may be altered in HIV-infected individuals. Our objective was to evaluate urine creatinine and factors that influence urine creatinine in treatment-naïve HIV subjects in Nigeria. METHODS: this was a cross-sectional study involving treatment-naïve HIV subjects in a tertiary hospital in Nigeria. Creatinine in spot and 24-hour urine samples and other relevant investigations were performed. Low urine creatinine or dilute urine was defined as 24-hour urine creatinine (24HUCr) =300mg, normal urine creatinine as 24HUCr 300-3000mg and high urine creatinine or concentrated urine as 24HUCr=3000mg.Theassociation of low urine creatinine and high urine creatinine with potentialrisk factors was determined.

INTRODUCTION: proteinuria is a common marker of kidney damage. This study aimed at determining predictors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria. METHODS: this was a cross-sectional study involving 136 subjects, consecutively drawn from Federal Medical Centre (FMC), Owerri, Nigeria. Relevant investigations were performed, including 24-hour urine protein (24HUP). Correlation and multivariate linear regression analysis were used to determine the association and strength of variables to predict proteinuria. Proteinuria was defined as 24HUP e"0.300g and impaired renal filtration function as creatinine clearance (ClCr) 90mls/min. P=0.05 was taken as statistically significant. RESULTS: mean age of subjects was 38.58 '11.79 years. Female/male ratio was 3:1. High 24-hour urine volume (24HUV) (p=0.001), high spot urine protein/creatinine ratio (SUPCR) (p=0.001), high 24-hour urine protein/creatinine ratio (24HUPCR) (p=0.001), high 24-hour urine protein/osmolality ratio (24HUPOR) (p=0.001), low 24-hour urine creatinine/osmolality ratio (24HUCOR) (p=0.001), and low spot urine protein/osmolality ratio (SUPOR) (p=0.001), predicted proteinuria in this study. CONCLUSION: the risk factors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria, included 24HUV, SUPCR, 24HUPCR, 24HUPOR, 24HUCOR and SUPOR. Further research should explore the relationship between urine creatinine and urine osmolality, and how this relationship may affect progression of kidney damage, with or without impaired renal filtration function.

Introduction: Proteinuria is a common marker of kidney damage. This study aimed at determining predictors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria. Methods: This was a cross-sectional study involving 136 subjects, consecutively drawn from Federal Medical Centre (FMC), Owerri, Nigeria. Relevant investigations were performed, including 24-hour urine protein (24HUP). Correlation and multivariate linear regression analysis were used to determine the association and strength of variables to predict proteinuria. Proteinuria was defined as 24HUP =0.300g and impaired renal filtration function as creatinine clearance (ClCr) <90mls/min. P<0.05 was taken as statistically significant. Results: Mean age of subjects was 38.58 ±11.79 years. Female/male ratio was 3:1. High 24-hour urine volume (24HUV) (p<0.001), high spot urine protein/creatinine ratio (SUPCR) (p<0.001), high 24-hour urine protein/creatinine ratio (24HUPCR) (p<0.001), high 24-hour urine protein/osmolality ratio (24HUPOR) (p<0.001), low 24-hour urine creatinine/osmolality ratio (24HUCOR) (p<0.001), and low spot urine protein/osmolality ratio (SUPOR) (p<0.001), predicted proteinuria in this study. Conclusion: The risk factors of proteinuria in subjects without impaired renal filtration function in Owerri, Nigeria, included 24HUV, SUPCR, 24HUPCR, 24HUPOR, 24HUCOR and SUPOR. Further research should explore the relationship between urine creatinine and urine osmolality, and how this relationship may affect progression of kidney damage, with or without impaired renal filtration function. [ABSTRACT FROM AUTHOR]

Background For many environmental chemicals, concentrations in spot urine samples are considered valid surrogates of exposure and internal dose. To correct for urine dilution, spot urine concentrations are commonly adjusted for urinary creatinine. There are, however, several concerns about the use of urine creatinine. While urine osmolality is an attractive alternative; its characteristics and determinants in the general population remain unknown. Our objective was to describe the determinants of urine osmolality and to contrast the difference between osmolality and creatinine in urine. Methods From the National Health and Nutrition Examination Survey (NHANES) (2009–2010), 10,769 participants aged 16 years or older with measured urine osmolality and creatinine were used in the analysis. Very dilute and very concentrated urine was defined as urine creatinine lower than 0.3 g/l and higher than 3 g/l, respectively. Linear and logistic regression analyses were performed to investigate the associations of interest. Results Urine osmolality and creatinine were highly correlated (Pearson correlation coefficient=0.75) and their respective median values were 648 mOsm/kg and 1.07 g/l. The prevalence of very dilute and very concentrated urine samples was 8.1% and 3.1%, respectively. Factors associated in the same direction with both urine osmolality and urine creatinine included age, sex, race, body mass index (BMI), hypertension, water intake, and blood osmolality. The magnitude of associations expressed as percent change was significantly stronger with creatinine than osmolality. Compared to urine creatinine, urine osmolality did not vary by diabetes status but was affected by daily total protein intake. Participants with chronic kidney disease (CKD) had significantly higher urine creatinine concentrations but lower urine osmolality. Both very dilute and concentrated urine were associated with a diverse array of sociodemographic, medical conditions, and dietary factors. For instance, females were approximately 3.3 times more likely to have urine over-dilution than male [the adjusted odds ratios (95% CI)=3.27 (2.10–5.10)]. Conclusion Although the determinants of urine osmolality were generally similar to those of urine creatinine, the relative influence of socio-demographic and medical conditions was less on urine osmolality than on urine creatinine. Protocols for spot urine sample collection could recommend avoiding excessive and insufficient water intake before urine sampling to improve urine adequacy. The feasibility of adopting urine osmolality adjustment and water intake recommendations before providing spot urine samples for environmental biomonitoring merits further investigation. [ABSTRACT FROM AUTHOR]

Abstract: Background: The evaluation of microalbumin, creatinine and albumin–creatinine ratio is very important in patients with diabetes for the early detection of kidney disease and the identification of patients at risk for complications from diabetes or hypertension. Methods: A total of 88 spot urine samples previously analyzed using the Vitros 5,1 FS (creatinine) and Beckman Coulter Immage (microalbumin) located in the central laboratory and having microalbumin and creatinine values within the Afinion and DCA Vantage reportable ranges were run on 2 point of care ( POC) instruments (Siemens DCA Vantage and Axis-Shield Afinion). Results: The mean values for the DCA Vantage were: 42.6mg/l for albumin, 10.3mol/l for creatinine, and 5.4mg/mol for ACR. For the Afinion AS100, the mean values were: 48.5mg/l for albumin, 9.5mol/l for creatinine, and 6.7mg/mol for ACR. The mean values obtained for CL were: 40.8mg/l for albumin, 10.0mol/l for creatinine, and 5.4mg/mol for ACR. All POC analyzers showed good correlation to the central laboratory tests for microalbumin, creatinine and albumin creatinine ratio (ACR) for Afinion (R2 =0.954, 0.974, and 0.964, respectively) and DCA Vantage (R2 =0.989, 0.987, and 0.991, respectively). With the exception of the DCA Vantage ACR (p=0.53), the levels of microalbumin, creatinine and ACR obtained for the Afinion and DCA Vantage instruments as compared to the CL were statistically different (p<0.05). The inter and intraday imprecision for both POC instruments was <2.9% and total imprecision <8.7%. Conclusions: The 2 instruments evaluated in this study were in good agreement with the quantitative laboratory results and thus can be used for microalbumin, creatinine and ACR assays at the POC. However, facilities using Afinion will have to use different normal range for ACR. [Copyright &y& Elsevier]

Abstract: Cadmium is a well-known nephrotoxicant; chronic exposure increases risk for chronic kidney disease. Recently, however, associations between urine cadmium and higher creatinine-based estimated glomerular filtration rate (eGFR) have been reported. Analyses utilizing alternate biomarkers of kidney function allow evaluation of potential mechanisms for these observations. We compared associations of urine cadmium with kidney function measures based on serum cystatin C to those with serum creatinine in 712 lead workers. Mean (standard deviation) molybdenum-corrected urine cadmium, Modification of Diet in Renal Disease (MDRD) eGFR and multi-variable cystatin C eGFR were 1.02 (0.65)μg/g creatinine, and 97.4 (19.2) and 112.0 (17.7)mL/min/1.73m2, respectively. The eGFR measures were moderately correlated (r s =0.5; p<0.001). After adjustment, ln (urine cadmium) was not associated with serum cystatin-C-based measures. However, higher ln (urine cadmium) was associated with higher creatinine-based eGFRs including the MDRD and an equation incorporating serum cystatin C and creatinine (beta-coefficient=4.1mL/min/1.73m2; 95% confidence interval=1.6, 6.6). Urine creatinine was associated with serum creatinine-based but not cystatin-C-based eGFRs. These results support a biomarker-specific, rather than a kidney function, effect underlying the associations observed between higher urine cadmium and creatinine-based kidney function measures. Given the routine use of serum and urine creatinine in kidney and biomarker research, additional research to elucidate the mechanism(s) for these associations is essential. [Copyright &y& Elsevier]

Introduction. The purpose of this study was to determine normal reference values for urine calcium-creatinine (Ca/C) ratio in Iranian children of Jahrom, in south-east of Iran. Materials and Methods. A total of 1068 school-age children were included by stratified clustered random sampling from primary schools of Jahrom, Iran, between March 2008 and May 2008. Nonfasting random urine specimens from each subject were analyzed for calcium and creatinine concentrations. Results. The mean ratio of urine Ca/C in all children was 0.123 ± 0.106 (range, 0.01 to 2.25), and the 95th percentile value was 0.25. Nonfasting Ca/C ratios were not significantly different between the boys and the girls. The Ca/C ratio was highest in 9-year-old children (mean, 0.132 ± 0.11). Based on the 95 percentile value of urine Ca/C (> 0.25) in the present study, 5.1% of the children in Jahrom were hypercalciuric. The prevalence of hypercalciuria differed with age (P = .06), and the most prevalent rate was observed in 9-year-old group (9.3%). Conclusions. We provided a reference value for urine Ca/C ratio in south-east Iranian children. A child's age and ethnicity should be taken into consideration when assessing the urinary solutecreatinine ratios. [ABSTRACT FROM AUTHOR]

Abstract: Twenty-one patients who received intravenous colistimethate sodium (CMS) for at least 7 days for the treatment of multidrug-resistant Gram-negative bacterial infections were included in a prospective cohort study at ‘Henry Dunant’ Hospital in Athens, Greece. The mean (± standard deviation) and median daily doses, cumulative doses and duration of treatment of intravenous CMS were, respectively, 5.5 (± 1.9) and 6 million IU, 90.2 (± 52.0) and 72 million IU, and 17.7 (± 11.7) and 15 days (range 7–54 days). Three patients (14.3%) developed nephrotoxicity during treatment with CMS. The cumulative dose of administered CMS was statistically correlated with the difference in values of serum creatinine between the end and start of CMS treatment (r =0.6, P =0.004 by Spearman''s test). [Copyright &y& Elsevier]

Glomerular filtration rate (GFR) and urine and serum concentrations of cystatin C and creatinine were measured in 40 boys and 42 girls. The fractional excretion of cystatin C (FE Cyst C) increased in proportion to the decrease in GFR. Since serum creatinine concentration (S-Creatinine) in the numerator of the fractional excretion equation and serum cystatin C concentration (S-Cystatin C) in the denominator have similar numerical values, they cancel out. The result is an equation in which the FE Cyst C is equal to the ratio of urinary cystatin C to urinary creatinine (u[cystatin-C/Cr]). The ratio of u[cystatin Cl Cr] was compared with GFR. Using a receiving operating characteristic (ROC) plot, the data showed that a ratio of u[cystatin C/Cr]*I00 that is ≥0.100 has a sensitivity of 90.0% for identification of children with GFR ≤60 ml/min per 1.73 m². The false-positive rate is 16.1%. The u[cystatin C/Cr] ratio is a reliable screening tool for detecting decreased GFR that does not require a serum sample. [ABSTRACT FROM AUTHOR]

Assays of urine biomarkers often use urine creatinine to account for urinary dilution, even though creatinine levels are influenced by underlying physiology and muscle catabolism. Urine osmolality—a measure of dissolved particles including ions, glucose, and urea—is thought to provide a more robust marker of urinary dilution but is seldom measured. The relationship between urine osmolality and creatinine is not well understood. We calculated correlation coefficients between urine creatinine and osmolality among 1375 members of a subcohort of the Danish Diet, Cancer, and Health Cohort, and within different subgroups. We used linear regression to relate creatinine with osmolality, and a lasso selection procedure to identify other variables that explain remaining variability in osmolality. Spearman correlation between urine creatinine and osmolality was strong overall (ρ = 0.90; 95% CI: 0.89–0.91) and in most subgroups. Linear regression showed that urine creatinine explained 60% of the variability in urine osmolality, with another 9% explained by urine thallium (Tl), cesium (Cs), and strontium (Sr). Urinary creatinine and osmolality are strongly correlated, although urine Tl, Cs, and Sr might help supplement urine creatinine for purposes of urine dilution adjustment when osmolality is not available. [ABSTRACT FROM AUTHOR]