<strong>Backgrounds:</strong> Cardiovascular diseases are still the prominent cause of death in cases of end-stage renal disease, cardiac troponin I (cTnI) can be used for detecting cardiac involvement in ...<strong>Backgrounds:</strong> Cardiovascular diseases are still the prominent cause of death in cases of end-stage renal disease, cardiac troponin I (cTnI) can be used for detecting cardiac involvement in asymptomatic cases of end-stage renal disease on hemodialysis. <strong>Aim:</strong> Determine the direct cardiac consequence of dialysis treatments in children on hemodialysis by measuring high-sensitive troponin-I as a marker of myocardial injury. <strong>Subjects and Methods:</strong> This case-control study included thirty children with end-stage renal disease on regular hemodialysis;the study group was selected from the nephrology hemodialysis unit of Al-Zahraa Hospital, Al-Azhar University. Another group of thirty healthy children matches age and sex with the patient’s group as a control. Highly Sensitive cTnI (hsTnI) was measured pre and post hemodialysis with a sensitive assay;moreover, ECG, lipid profile including cholesterol, triglyceride, low and high-density lipoprotein (HDL) in the same line with routine investigations for those patients, we used bioimpedance for dry weight assessment in the hemodialysis (HD) group. <strong>Results:</strong> Children on (HD) have a significantly higher (hsTnI) pre-dialysis (0.250 ± 0.069 ng/ml) compared to post-dialysis (0.187 ± 0.004 ng/ml) with (p, 0.001). With no significant difference between post HD (0.187 ± 0.004 ng/ml) and the control group (0.189 ± 0.005) with (p, 0.090). cTnI is detected in (73.3%) of children pre-dialysis above the cut-off value compared to (3.31%) had a high-level post-dialysis. cTnI is positively correlated with systolic, diastolic blood pressure and heart rate with (r. 0.333, p, 0.001: r. 0.343, p, 0.001: r. 0.276, p, 0.033) respectively and (hsTnI) is negatively correlated with Hb and HDL (r. -0.333, p, 0.009: r. 0.324, p, 0.011). Meanwhile (hsTnI) is positively correlated with serum urea, creatinine, ph, PTH, serum ferritin and positively correlated with QT interval and QTC. <strong>Conclusion:</strong> cTnI levels rise significantly before hemodialysis, so those patients are exposed to silent myocardial injury pre HD, and fortunately, it is not persistent after hemodialysis except for a few of them had a high level. We strongly advised not to delay dialysis appointments;the nephrology team should aggressively treat those patients to prevent further myocardial damage.展开更多
Background: Despite recent advances in perinatal and neonatal care in respiratory distress syndrome (RDS) prevention and treatment, a considerable number of these neonates suffer from acute kidney injury (AKI), and it...Background: Despite recent advances in perinatal and neonatal care in respiratory distress syndrome (RDS) prevention and treatment, a considerable number of these neonates suffer from acute kidney injury (AKI), and it is associated with poor outcome as an independent risk factor. KIM-1 mRNA and protein are expressed at a low level in normal kidney but are increased in post ischemic kidney. Aim: The aim is to detect the value of urinary KIM-1 measurement as an early predictor marker of acute kidney injury in preterm neonates with respiratory distress syndrome. Patients and methods: The study included 30 preterm newborn with (RDS) ≤36 weeks during the period from October 2014 to March 2015. Also the study included 30 apparently healthy newborn ≤36 weeks as controls. They were selected from NICU of Manshiate Elbakry hospital Cairo, Egypt. uKIM-1 along with serum creatinine levels and eGFR were assessed in days 1 of life for both groups and in day 3 for cases. Results: In day one of life, we found a significant increase in uKIM-1 levels in preterm newborn with RDS compared to their controls (2.88 ± 1.01 ng/ml and 0.95 ± 0.52 ng/ml respectively (p = 0.001)). There is no significant difference between both groups regarding serum creatinine and eGFR. In day 3 of life, preterm with RDS had significant decrease in uKIM-1 levels compared to day 1 of life with significant increase in non-survivor compared to survivor group ( 2.30 ± 1.56 ng/ml and 1.30 ± 0.90 ng/ml respectively (p = 0.03)). The sensitivity and specificity of uKIM-1 and serum creatinine was calculated (100.00%, 86.67% and 33.33%;95.00%) respectively. Conclusion: Preterm neonate with RDS is at high risk of developing AKI. Early and serial uKIM-1 measurements can be used as a non-invasive indicator of kidney injury in premature newborn with RDS.展开更多
文摘<strong>Backgrounds:</strong> Cardiovascular diseases are still the prominent cause of death in cases of end-stage renal disease, cardiac troponin I (cTnI) can be used for detecting cardiac involvement in asymptomatic cases of end-stage renal disease on hemodialysis. <strong>Aim:</strong> Determine the direct cardiac consequence of dialysis treatments in children on hemodialysis by measuring high-sensitive troponin-I as a marker of myocardial injury. <strong>Subjects and Methods:</strong> This case-control study included thirty children with end-stage renal disease on regular hemodialysis;the study group was selected from the nephrology hemodialysis unit of Al-Zahraa Hospital, Al-Azhar University. Another group of thirty healthy children matches age and sex with the patient’s group as a control. Highly Sensitive cTnI (hsTnI) was measured pre and post hemodialysis with a sensitive assay;moreover, ECG, lipid profile including cholesterol, triglyceride, low and high-density lipoprotein (HDL) in the same line with routine investigations for those patients, we used bioimpedance for dry weight assessment in the hemodialysis (HD) group. <strong>Results:</strong> Children on (HD) have a significantly higher (hsTnI) pre-dialysis (0.250 ± 0.069 ng/ml) compared to post-dialysis (0.187 ± 0.004 ng/ml) with (p, 0.001). With no significant difference between post HD (0.187 ± 0.004 ng/ml) and the control group (0.189 ± 0.005) with (p, 0.090). cTnI is detected in (73.3%) of children pre-dialysis above the cut-off value compared to (3.31%) had a high-level post-dialysis. cTnI is positively correlated with systolic, diastolic blood pressure and heart rate with (r. 0.333, p, 0.001: r. 0.343, p, 0.001: r. 0.276, p, 0.033) respectively and (hsTnI) is negatively correlated with Hb and HDL (r. -0.333, p, 0.009: r. 0.324, p, 0.011). Meanwhile (hsTnI) is positively correlated with serum urea, creatinine, ph, PTH, serum ferritin and positively correlated with QT interval and QTC. <strong>Conclusion:</strong> cTnI levels rise significantly before hemodialysis, so those patients are exposed to silent myocardial injury pre HD, and fortunately, it is not persistent after hemodialysis except for a few of them had a high level. We strongly advised not to delay dialysis appointments;the nephrology team should aggressively treat those patients to prevent further myocardial damage.
文摘Background: Despite recent advances in perinatal and neonatal care in respiratory distress syndrome (RDS) prevention and treatment, a considerable number of these neonates suffer from acute kidney injury (AKI), and it is associated with poor outcome as an independent risk factor. KIM-1 mRNA and protein are expressed at a low level in normal kidney but are increased in post ischemic kidney. Aim: The aim is to detect the value of urinary KIM-1 measurement as an early predictor marker of acute kidney injury in preterm neonates with respiratory distress syndrome. Patients and methods: The study included 30 preterm newborn with (RDS) ≤36 weeks during the period from October 2014 to March 2015. Also the study included 30 apparently healthy newborn ≤36 weeks as controls. They were selected from NICU of Manshiate Elbakry hospital Cairo, Egypt. uKIM-1 along with serum creatinine levels and eGFR were assessed in days 1 of life for both groups and in day 3 for cases. Results: In day one of life, we found a significant increase in uKIM-1 levels in preterm newborn with RDS compared to their controls (2.88 ± 1.01 ng/ml and 0.95 ± 0.52 ng/ml respectively (p = 0.001)). There is no significant difference between both groups regarding serum creatinine and eGFR. In day 3 of life, preterm with RDS had significant decrease in uKIM-1 levels compared to day 1 of life with significant increase in non-survivor compared to survivor group ( 2.30 ± 1.56 ng/ml and 1.30 ± 0.90 ng/ml respectively (p = 0.03)). The sensitivity and specificity of uKIM-1 and serum creatinine was calculated (100.00%, 86.67% and 33.33%;95.00%) respectively. Conclusion: Preterm neonate with RDS is at high risk of developing AKI. Early and serial uKIM-1 measurements can be used as a non-invasive indicator of kidney injury in premature newborn with RDS.
