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Metabolic Laboratory Data
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
An elevated BUN can be caused by excessive amino acid catabolism, even when renal function is normal. We actually see this in some patients when we give high levels of amino acids in the PN. Although, this is more often the case when the patient has both a high amino acid load and mild renal insufficiency.
A critical look at orthodox medical approaches
Published in Geraldine Lee-Treweek, Tom Heller, Hilary MacQueen, Julie Stone, Sue Spurr, Complementary and Alternative Medicine: Structures and Safeguards, 2020
Tom Heller, Dick Heller, Gavin Yamey
The kidneys’ function is to rid the body of the unwanted by-products of metabolism. Without working kidneys there would be a fatal build-up of metabolic products in the body. A (biochemical) marker of this build-up is creatinine, which is a breakdown product of muscle. Increased blood levels of creatinine indicate deteriorating kidney (or renal) function. It was not until the second half of the 20th century that scientific experimental inquiry led to the development of artificial ways to remove waste products such as creatinine from the body: renal dialysis was born. Using techniques developed in the experimental laboratory, the patient’s blood could now be passed over specially produced, semi-permeable membranes and the waste products filtered out. This is obviously a very shorthand way of describing a major technical advance! Later it was discovered that it was possible to surgically replace a kidney. The main problem with this procedure is that placing the kidney of another person (either a living relative or someone who has recently died) into a person with renal failure could trigger a reaction – an immune response – when the body recognises the new kidney as being foreign. In turn, this causes the new kidney to be rejected and stop working. However, the developing science of immunology led to the identification of drugs that could largely prevent this immunological rejection.
Obstructing congenital anomalies of the urinary tract: ureteropelvic junction obstruction, ureterocele, megaureter, and posterior urethral valves
Published in J Kellogg Parsons, E James Wright, The Brady Urology Manual, 2019
Renal function: Severe bilateral hydronephrosis and renal dysplasia are typicalImpaired renal tubular function is often irreversible and results in reduced concentrating ability and polyuria.
The blood urea nitrogen/creatinine (BUN/cre) ratio was U-shaped associated with all-cause mortality in general population
Published in Renal Failure, 2022
Song Shen, Xudong Yan, Biao Xu
BUN and Cre are the end products of nitrogen metabolism in human body, whose change reflect the renal function, nutritional and metabolic status. BUN/Cre ratio is one of the common indices used to separate pre-renal azotemia and acute tubular necrosis, with a threshold of 20 [11]. Previous studies have found that a higher BUN/Cre ratio was associated with the worse prognosis in HF [4,12], stroke [13], upper gastrointestinal bleeding [14], hemodialysis [15], and septic shock [8]. Recently, it was reported that BUN/Cre ratio was a predictor of disease severity and survival of COVIPD-19 patients [9,16]. In general population, BUN/Cre ratio was negatively associated with the incidence of stroke [17]. Yuya et al reported that the median BUN/Cre ratio in the general population was 15.0 (12.9–17.6) [12]. We have found a U-shape association between BUN/Cre ratio and all-cause mortality in general population. When BUN/Cre ratio was between 11.43 and 14.64, it was associated with the lowest risk of mortality. This range may represent an ideal protein intake and metabolism in human. Higher levels of BUN/Cre reflect a more active neurohormonal system, contributing to adverse prognosis [18]. While low BUN/Cre ratio levels may be related to inflammation, oxidative stress and endothelial dysfunction after acute renal injury [19].
Prediction of drug-induced kidney injury in drug discovery
Published in Drug Metabolism Reviews, 2021
The levels of an ideal DIKI biomarker should be very sensitive to the changes in normal renal cell physiology and unaffected by diet, demographic, and other non-renal physiological changes in the body. An ideal DIKI biomarker should also be able to provide information about the affected segment of the kidney tubule (e.g. proximal tubule, distal tubule, glomerulus, etc.). Serum creatinine (Van Biesen et al. 2006) and blood urea nitrogen (BUN) (Waikar and Bonventre 2006) have been traditionally used as in vivo biomarkers of renal injury. However, both serum creatinine and BUN have limitations as renal injury biomarkers (Griffin et al. 2019). Serum creatinine is affected by nonrenal factors like muscle mass, dietary and nutritional status, demographic factors, infectious diseases, and medications that interfere with creatinine renal secretion. Generally, there is a delay between renal injury mediated glomerular filtration rate changes and serum creatinine level changes (Griffin et al. 2019). BUN is also affected by factors not related to renal function like dietary status, medications (e.g. steroids), and gastrointestinal bleeding (Griffin et al. 2019).
Initial-onset symptoms of preeclampsia and their relation to pregnancy outcomes
Published in Journal of Obstetrics and Gynaecology, 2020
Xu Zhuang, Jun Shi, Dong-Rui Deng, Wei-She Zhang, Xing-Hui Liu, Jian-Hua Lin
The 19 cases of patients with impaired renal function were exclusively in the renal dysfunction IOS group. Different countries have varying boundary values of PE renal function damage. Chinese guidelines assert renal function as compromised when Scr exceeds 106 μmol/L (CSOG 2015). This value is higher than ACOG guidelines which cite 1.1 mg/dL (1 mg/dL = 88.4 μmol/L). Using the ACOG guideline may have led to a greater number of patients diagnosed with renal impairment in our cohort. Patients with renal dysfunction as IOS also presented with more severe hypertension, proteinuria and thrombocytopenia than other groups, and the incidence of maternal complications was also higher in these cases. That may be due to an elevated glomerular filtration rate (GFR) and lower Scr than in the normal population due to the ultrafiltration state of the kidneys during pregnancy (Zhuang et al. 2015). Due to the lack of an agreed-upon creatinine threshold for normal pregnant women, renal damage may occur before Scr reaches 106 μmol/L, which would aggravate maternal disease.