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Tubular Function
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Creatinine is filtered by the renal tubule and is not reabsorbed. Creatinine clearance is used routinely as a method of estimating GFR. However, a small amount of creatinine is secreted by the tubules into the lumen so that the creatinine clearance is slightly greater than the true GFR. There are several limitations of the use of creatinine clearance to estimate GFR: (i) plasma creatinine only begins to rise when only 50% renal function (GFR) is lost, so that a significant reduction in GFR can be present before the plasma creatinine is outside the normal reference range for the laboratory and (ii) plasma creatinine can lie within the normal range in the presence of marked reduction of renal function in patients with low muscle mass (e.g., elderly females). Thus age, weight and sex affect creatinine clearance. To obviate these issues, a number of nomograms have been devised. The best known formula used is the Cockcroft and Gault formula:
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.
Computer Applications in Clinical Pharmacokinetics and Pharmacodynamics
Published in Hartmut Derendorf, Günther Hochhaus, Handbook of Pharmacokinetic/Pharmacodynamic Correlation, 2019
Dennis Mungall, Joe Heissler, Mattieu Kaltenbach
Creatinine clearance — Creatinine clearance in adults with stable or changing renal function can be calculated. Creatinine clearance for neonates under 2 weeks of age can also be estimated. Changes in CrCl over time can be modeled vs. drug renal clearance. The CrCl is assumed to be stable up until the first serum creatinine value. Then the program performs a linear interpolation between each value of CrCl.
Clinical characteristics and outcomes of exertional rhabdomyolysis after indoor spinning: a systematic review
Published in The Physician and Sportsmedicine, 2023
Yoshio Masuda, Rachel Wam, Benjamin Paik, Clara Ngoh, Andrew MTL Choong, Jun Jie Ng
Apart from the study by Mong et al [44]., 21 studies [10–12,26–43] reported serum CK levels on initial presentation. CK levels ranged from more than 11,000 to 261,177 U/L and had a combined mean of 80,627.8 ± 64,774.4 U/L. Six studies [12,29,34–36,43] reported serum myoglobin levels on initial presentation ranging from 1000 to more than 20,000 ng/ml, with a combined mean of 11,154.5 ± 5575.5 ng/ml. Nine studies [26,28–30,34–36,40,41] reported serum lactate dehydrogenase (LDH) levels on initial presentation that ranged from 1446 to 62,970 U/L, with a combined mean of 5246 ± 10,063 U/L. Fourteen studies [12,27,29–32,34–38,40,41,43] reported serum aspartate aminotransferase (AST) levels on initial presentation. The values of AST ranged from 249 to 3380 U/L, with a combined mean of 1121.1 ± 639.9 U/L. Twelve studies [12,27,30,31,34–38,40,41,43] reported serum alanine aminotransferase (ALT) levels on initial presentation, which ranged from 64 to 656 U/L, with a combined mean of 318.2 ± 169.8 U/L. Five studies [31,35,40,41,43] reported serum blood urea nitrogen (BUN) levels on initial presentation ranging from 7.2 to 61.4 mg/dL, with a combined mean of 11.5 ± 7.8 mg/dL. Finally, ten studies [12,26,31,32,35,38,40–43] had reported serum creatinine levels on initial presentation. Creatinine levels ranged from 0.5 to 7.4 mg/dL with a combined mean of 0.9 ± 1 mg/dL. A summary of laboratory testing at initial presentation is provided in Table 2.
Phytochemical analysis, in silico study and toxicity profile of Cycas pectinata Buch.-Ham seed in mice
Published in Drug and Chemical Toxicology, 2023
Chuckles Ch. Marak, Brilliant N. Marak, Ved Prakash Singh, Guruswami Gurusubramanian, Vikas Kumar Roy
The kidney histological analysis after acute toxicity showed the deteriorated changes along with increase serum creatinine levels (although it is a non-significant increase). Creatinine levels have been considered as important markers for kidney dysfunction (Mukinda and Eagles 2010, Chebaibi et al. 2019). Thus, these results suggested possible kidney toxicity of CPFE at a single higher dose, whereas a dose of 100 mg/kg and 300 mg/kg for 28 days did not show any change in creatinine levels and kidney histology, therefore, it may be suggested that a small dose would be safer for chronic use of CPFE. It has also been reported that organs weight may be very important for toxicity assessment for any chemicals (Ugwah-Oguejiofor et al. 2019). The organs weight after the treatment either increase due to hypertrophy or decrease due to necrosis or degeneration (Teo et al. 2002). Our results showed the vital organs did not cause any change in their weight after acute and sub-acute toxicity assessment. Except for an increase in WBC count in 3000 mg/kg of acute toxicity study, all other hematological parameters were also unaffected after an acute and sub-acute dose of CPFE. It has been suggested that an increase in WBC after treatment of herbal extract may show its immune modulation effect (Tousson et al. 2011). However, further study would be required to support this hypothesis in the case of CPFE.
The paradox of the role of resistin in early-onset obesity hypertension: A comparative study among four Chinese adult subgroups
Published in Clinical and Experimental Hypertension, 2021
Ou Wu, Jian Hang Leng, Fen Fang Yang, Hu Zhang, Xing Yu Zhang, Jia Jia Li, Xi Lu
In addition to the significantly negative relationships between serum resistin level and BMI and/or blood pressure, SCR and ALB were also found to be statistically significantly positively correlated with serum resistin level in this study. Creatinine is filtered by the healthy kidneys and is the chemical waste product of creatine that is produced and stored by the liver. The serum albumin test is part of a standard panel of liver tests and can be used in the detection and diagnosis or tracking of progress of several health conditions such as liver disorders, kidney diseases and chronic pancreatitis (58).Serum resistin level was found positively associated with urinary albuminuria (calculated as the urine albumin-to-creatinine ratio) in elderly patients with essential hypertension (59). A statistically significantly positive relationship between serum creatinine (r = 0.311, P = .007) and resistin was also found in elderly patients with essential hypertension, in the untreated non-diabetic patients with stage I–II essential hypertension, in patients with coronary artery disease, and in elderly patients with non-diabetic chronic kidney disease (59–62). These findings suggest that resistin is involved in the progression of kidney or liver damage, or that resistin metabolism is strongly dependent on kidney or liver function, which are related to hypertension. Resistin was also previously found to enhance p65 mRNA and protein expression in the liver (63).