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Prediction of pre-eclampsia
Published in Pankaj Desai, Pre-eclampsia, 2020
Over a period of time, many biomarkers have been used singly or in combination with other markers as well as in combination with uterine artery indices for prediction of pre-eclampsia. The number of markers studied seems to be growing by the day. In a review article published in 2015, a total of six biomarker algorithms, for the prediction of pre-eclampsia were studied. Several algorithms were based on placental biomarkers such as pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PlGF) and s-FLT-1. The algorithms containing these biomarkers showed a high prediction rate for early onset PE, ranging from 44% to 92% at 5% false-positive rate. New biomarkers suggest an alternative model based on free foetal haemoglobin (HbF) and the heme scavenger alpha-1-microglobulin (A1M) with a prediction rate of 69% at an false-positive rate of 5%. They found that this model performs well even without uterine artery Doppler PI.36
Hydroxyethyl starch or gelatin, which is safer for the kidneys?
Published in Elida Zairina, Junaidi Khotib, Chrismawan Ardianto, Syed Azhar Syed Sulaiman, Charles D. Sands, Timothy E. Welty, Unity in Diversity and the Standardisation of Clinical Pharmacy Services, 2017
D.W. Shinta, J. Khotib, M. Rahmadi, B. Suprapti, E. Rahardjo, J.K. Wijoyo
Although colloid fluids can effectively increase the intravascular volume, its risk on kidney function cannot be ignored. HES potentially induces kidney damage due to an increase in plasma oncotic pressure and accumulation in tissues. Studies on the safety aspects of HES administration on renal function have been performed, but the results are still contradictory. A study conducted by Kumle et al. (1999) on the use of HES (6% HES 70/0.5 and 6% HES 200/0.5) and gelatin 35000D in the perioperative period of geriatric patients showed no difference in the increase in a significant marker of kidney damage. Three fluid regimens are determined to be safe to administer (Kumle et al. 1999). Guidet et al. (2012) also examined the effectiveness and safety of HES compared with NS in patients with severe sepsis. From these studies, it was stated that HES does not induce acute kidney injury (AKI) and damage to tubular and glomerular function, observed through urine biomarkers, alpha-1-microglobulin, N-acetyl-beta-glucosaminidase (NAG), and neutrophil gela-tinase-associated lipocalin (NGAL). In addition, there was no significant change in serum creatinine compared with baseline values, with peak serum creatinine levels observed at 1.757 ± 1.230 mg/dL (HES group) and 1.722 ± 1.195 mg/dL (group NS) (Guidet et al. 2012).
Physical activity and kidney function in health and disease
Published in Roy J. Shephard, Physical Activity and the Abdominal Viscera, 2017
Techniques involving paper electrophoresis[106] and the use of immune antisera[111] have allowed identification of the various proteins and thus to infer glomerular and tubular contributions to the observed protein loss.[112] Glomerular proteinuria yields a urine with a high proportion of plasma constituents and is commonly assessed in terms of albumin loss. A normal albumin excretion but an increased excretion of alpha-1-microglobulin suggests that the disorder is of tubular origin.[91] Tubular proteinuria usually reflects a saturation of reabsorption mechanisms by a high rate of glomerular protein leakage, with the urine containing a large fraction of normally reabsorbed low molecular weight proteins such as lysozymes and the beta-2 microglobulins.[113] Defects of tubular reab sorption can be demonstrated by examining the changes in proteinuria following lysine perfusion; lysine blocks the normal tubular reabsorption of protein.[114, 115]
Renal dysfunctions/injury in adult epilepsy patients treated with carbamazepine or valproate
Published in Expert Review of Clinical Pharmacology, 2018
Sherifa A. Hamed, Tarek A. Rageh, Amany O. Mohamad, Suzan M. Abou Elnour
In general, new kidney injury markers are classified into three groups: 1) enzymes released from damaged tubular cells, 2) low-molecular-weight proteins and proteins produced in the kidney and associated with the development of kidney injury, and 3) structural and functional proteins of renal tubules. They are more sensitive in detecting mild renal injury than serum creatinine and blood urea nitrogen (BUN) which are traditionally used to assess renal function. The new renal markers also help to distinguish between various types of kidney insults (glomerular, proximal tubular and distal tubular functions), determine the duration and severity of injury, predict the clinical outcome, and help to monitor response to treatment [43,44]. NAG and alpha 1-microglobulin are among the new markers of kidney injury, they are excreted in very low concentrations in urine and marked elevation of these markers occurs with injury of renal proximal tubules [43,44]. Among the new markers of kidney injury is the kidney injury molecule type 1 (KIM-1). The latter is a type I cell membrane glycoprotein and its structure has adhesion molecule properties. KIM-1 is a marker for renal proximal tubular damage. KIM-1 functional role is to confer on epithelial cells the ability to recognize and phagocytose dead cells that are present in the kidney and contribute to the obstruction of the renal tubule lumen. KIM-1 is very low or is not detectable in healthy individuals and higher concentrations in urine become detectable within few hours of ischemic acute tubular necrosis. KIM-1 can also be measured from other body fluids (serum or plasma) [45,46].
Renal involvement in paroxysmal nocturnal hemoglobinuria: an update on clinical features, pathophysiology and treatment
Published in Hematology, 2018
Styliani I Kokoris, Eleni Gavriilaki, Aggeliki Miari, Αnthi Travlou, Elias Kyriakou, Achilles Anagnostopoulos, Elissavet Grouzi
There is a number of other circulating proteins that can also scavenge free heme in plasma [38], such as alpha-1-microglobulin [36] and high- and low-density lipoproteins [39]. The binding of alpha-1-microglobulin to heme can neutralize its pro-oxidant effects, suggesting that alpha-1-microglobulin acts as a heme scavenger in circulation. Nevertheless, it is still unclear if alpha-1-microglobulin holds a protective role against heme’s toxicity under pathophysiologic conditions.