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Pinsino, A., A. Masoumi, J. Radhakrishnan, R. T. Demmer, E. A. Royzman, M. Mabasa, D. L. Brunjes i in. "Creatinine versus Cystatin C Based Equations for Estimation of Renal Function in Left Ventricular Assist Device Patients". Journal of Heart and Lung Transplantation 37, nr 4 (kwiecień 2018): S377. http://dx.doi.org/10.1016/j.healun.2018.01.972.
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Fuhrmann, Markus, Amauri Schwaeble Santamaria, Renee Scott, Jeffrey W. Meeusen, Marianna Fernandes, John Venz, Victoria Rothe, Frank Stämmler, Jochen Ehrich i Eric Schiffer. "Analytical Validation of GFRNMR: A Blood-Based Multiple Biomarker Assay for Accurate Estimation of Glomerular Filtration Rate". Diagnostics 12, nr 5 (30.04.2022): 1120. http://dx.doi.org/10.3390/diagnostics12051120.
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Accurate and precise monitoring of kidney function is critical for a timely and reliable diagnosis of chronic kidney disease (CKD). The determination of kidney function usually involves the estimation of the glomerular filtration rate (eGFR). We recently reported the clinical performance of a new eGFR equation (GFRNMR) based on the nuclear magnetic resonance (NMR) measurement of serum myo-inositol, valine, and creatinine, in addition to the immunoturbidometric quantification of serum cystatin C, age and sex. We now describe the analytical performance evaluation of GFRNMR according to the Clinical and Laboratory Standards Institute guidelines. Within-laboratory coefficients of variation (CV%) of the GFRNMR equation did not exceed 4.3%, with a maximum CV% for repeatability of 3.7%. Between-site reproducibility (three sites) demonstrated a maximum CV% of 5.9%. GFRNMR stability was demonstrated for sera stored for up to 8 days at 2–10°C and for NMR samples stored for up to 10 days in the NMR device at 6 ± 2°C. Substance interference was limited to 4/40 (10.0%) of the investigated substances, resulting in an underestimated GFRNMR (for glucose and metformin) or a loss of results (for naproxen and ribavirin) for concentrations twice as high as usual clinical doses. The analytical performances of GFRNMR, combined with its previously reported clinical performance, support the potential integration of this NMR method into clinical practice.
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Pochetti, Patrizia, Danila Azzolina, Beatrice Ragnoli, Paolo Amedeo Tillio, Vincenzo Cantaluppi i Mario Malerba. "Interrelationship among Obstructive Sleep Apnea, Renal Function and Survival: A Cohort Study". International Journal of Environmental Research and Public Health 17, nr 14 (8.07.2020): 4922. http://dx.doi.org/10.3390/ijerph17144922.
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Previous studies showed a bidirectional relationship between renal function decline and obstructive sleep apnea (OSA) syndrome. Continuous Positive Airway Pressure (C-PAP) treatment was shown to preserve the kidney function in OSA patients. This study aims to investigate the progression of long-term renal function in OSA patients treated with different PAP strategies (patients were divided into two groups, fixed C-PAP or other PAP—automatic and bilevel pressure). Comorbidities and 10-years survival were also evaluated. We performed a retrospective, observational, single-center, cohort study, including the first 40 consecutive patients enrolled from 2009 in the Respiratory disease Unit at the Vercelli University Hospital database. The patient inclusion criteria were: age ≥ 18 years with OSA syndrome according to AASM (American Academy of Sleep Medicine) guidelines. Creatinine serum levels (mg/dL) and the estimated Glomerular Filtration Rate (eGFR, mL/min calculated by CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration equation)) were measured at 3 different time points: at baseline, 3 years and 8 years after PAP treatment. The Kaplan–Meier survival curves stratified according to PAP treatment and compliance have been reported together with log-rank test estimation. In our study, we found a significant creatinine serum level reduction after 3 years of fixed C-PAP treatment (p value = 0.006) when compared to baseline values. However, we observed that the long-term C-PAP benefit was not significant (p value = 0.060). Our data confirmed the progressive renal function decline in OSA patients, especially in those using other-PAP treatments; nevertheless, OSA treatment with a fixed C-PAP device has shown, in the short term, a significant improvement in renal function. By contrast, in our study, long-term benefits after 8 years are not been demonstrated probably because of the lack of compliance of the patients and the aging effect.
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Byambasukh, Oyuntugs, Michele F. Eisenga, Ron T. Gansevoort, Stephan JL Bakker i Eva Corpeleijn. "Body fat estimates from bioelectrical impedance equations in cardiovascular risk assessment: The PREVEND cohort study". European Journal of Preventive Cardiology 26, nr 9 (21.02.2019): 905–16. http://dx.doi.org/10.1177/2047487319833283.
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Aims To investigate prospectively the association of body fat percentage (BF%) estimates using various equations from bioelectrical impedance analysis (BIA) with cardiovascular events, compared with body mass index (BMI) and waist circumference. Methods and results We used data of 34 BIA-BF%-equations that were used for estimation of BF% in 6486 (men = 3194, women = 3294) subjects. During a median follow-up of 8.3 years, 510 (7.9%) cardiovascular events (363 in men; 147 in women) occurred. In men, the crude hazard ratio (95% confidence interval) for BF% from the best predicting BIA-BF%-equation was 3.97 (3.30–4.78) against 2.13 (1.85–2.45) for BF% from the BIA device's BIA-BF%-equation, 1.34 (1.20–1.49) for BMI and 1.49 (1.40–1.73) for waist circumference per log-1-SD increase of all. In women, the hazard ratios for best predicting BIA-BF%-equation, BIA device estimation, BMI and waist circumference were 3.80 (2.85–4.99), 1.89 (1.57–2.28), 1.35 (1.21–1.51) and 1.52 (1.31–1.75), respectively. After adjustments for age, Framingham cardiovascular disease risk score and creatinine excretion – a marker of muscle mass – BF%s and BMI remained independently associated with cardiovascular events in both men and women, while waist circumference was independently associated with cardiovascular events in men, but not in women. According to discrimination ability (C-index) and additive predictive value (net reclassification index and integrated discrimination index) on obesity measures to the Framingham cardiovascular disease risk score, BF% was superior to BMI and waist circumference in both men and women. Conclusions BF% was independently associated with future cardiovascular events. Body fat estimates from the best-predicting BIA-BF%-equations can be a more predictive measurement in cardiovascular risk assessment than BMI or waist circumference.
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Rotar, O. P., A. S. Alieva, M. A. Boiarinova, K. M. Tolkunova i A. O. Konradi. "Vascular Age Concept: Which Approach Is Preferable in Clinical Practice?" Kardiologiia 59, nr 2 (8.03.2019): 45–53. http://dx.doi.org/10.18087/cardio.2019.2.10229.
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Aim:to compare various approaches to estimation of vascular age in patients from sample of citizens of Saint-Petersburg (SPB) with arterial pressure (AP) above 130 / 80 mm Hg without history of cardiovascular events.Materials and methods.Examination of a population sample of SPB citizens (n=1600) was carried out within framework of the observational epidemiological study ESSE-RF (ЭССЕ-РФ) in 2012–2013. We selected from this sample 477 women and man aged 40–65 years without history of cardiovascular events, diabetes, or chronic kidney disease, and AP >130 / 80 mm Hg. Examination included anthropometry, sampling of fasting blood for measurement of lipids, glucose, creatinine levels, urine sampling for determination of albumin excretion, and AP measurement in ac-cordance with standard methods. The SCORE scale was used of evaluation of 10-year risk of fatal stroke and fatal myocardial infarction. Volume sphygmography (VaSera device) was applied for determination of cardio-ankle vascular index (CAVI) with calculation of vascular age, and ankle-brachial index. ASCORE scale was used for determination of сalculated vascular age was determined with help of the ASCORE scale.Results.Mean age of participants (182 men [38.2 %], 295 women [61.8 %]) was 52.5±6.2 years. Calculated and instrumental methods of determination of vascular age and early vascular aging had low concordance (κ = 0.099). With elevation of cardiovascular risk early vascular aging was more frequently detected by method of its calculation ASCORE than with instrumental method (VaSera). In the absence of achievement of target AP level signs of early vascular aging were significantly more often detected by the method of vascular age calculation than by the instrumental method VaSera.Conclusion.Application of the concept of vascular age and early vascular aging syndrome might be an effective tool for stratification of cardiovascular risk by a physician and improvement of adherence of a patient. This is especially actual for young patients with burdened heredity. One can assume that estimation of virtual risk factor load on blood vessels by the ASCORE method of calculation is more sensitive to detection of premature vascular aging, while requiring less financial and organizational efforts.
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Cepeda, Maria, Demetria Hubbard, Suzanne Oparil, Joseph E. Schwartz, Byron C. Jaeger, Shakia T. Hardy, Julia Medina, Ligong Chen, Paul Muntner i Daichi Shimbo. "Evaluating novel approaches for estimating awake and sleep blood pressure: design of the Better BP Study – a randomised, crossover trial". BMJ Open 12, nr 6 (czerwiec 2022): e058140. http://dx.doi.org/10.1136/bmjopen-2021-058140.
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IntroductionFor many people, blood pressure (BP) levels differ when measured in a medical office versus outside of the office setting. Out-of-office BP has a stronger association with cardiovascular disease (CVD) events compared with BP measured in the office. Many BP guidelines recommend measuring BP outside of the office to confirm the levels obtained in the office. Ambulatory BP monitoring (ABPM) can assess out-of-office BP but is not available in many US practices and some individuals find it uncomfortable. The aims of the Better BP Study are to (1) test if unattended office BP is closer to awake BP on ABPM compared with attended office BP, (2) assess if sleep BP assessed by home BP monitoring (HBPM) agrees with sleep BP from a full night of ABPM and (3) compare the strengths of associations of unattended versus attended office BP, unattended office BP versus awake BP on ABPM and sleep BP on HBPM versus ABPM with markers of end-organ damage.Methods and analysisWe are recruiting 630 adults not taking antihypertensive medication in Birmingham, Alabama, and New York, New York. Participants are having their office BP measured with (attended) and without (unattended) a technician present, in random order, using an automated oscillometric office BP device during each of two visits within one week. Following these visits, participants complete 24 hours of ABPM and one night of HBPM, in random order. Psychosocial factors, anthropometrics, left ventricular mass index and albumin-to-creatinine ratio are also being assessed.Ethics and disseminationThis study was approved by the University of Alabama at Birmingham and the Columbia University Medical Center Institutional Review Boards. The study results will be disseminated at scientific conferences and published in peer-reviewed journals.Trial registration numberNCT04307004.
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Karagöz Özen, Düriye Sıla, Mehmet Maruf Aydın, İpek Genç i Mehmet Derya Demirağ. "The relationship between renal renal resistive index and hypertensive end-organ damage". Journal of Surgery and Medicine 7, nr 1 (22.01.2023): 86–90. http://dx.doi.org/10.28982/josam.7627.
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Background/Aim: The prevalence of hypertension increases with age and one out of every three adults over the age of 40 has hypertension. Hypertensive end-organ damage is an important predictive factor for patient morbidity and mortality. This study aimed to investigate the role of the renal resistive index (RI) in predicting retinopathy and nephropathy in hypertensive patients. Methods: This study was cross-sectional in design. Sixty hypertensive patients who were followed in Samsun Research and Training Hospital Internal Medicine outpatient clinic were included in the study. In all patients, a routine ophthalmological examination, including visual acuity, anterior segment examination, and dilated ocular fundus examination, was performed. Urinary albumin to creatinine ratio (mg/g) was measured in spot urine samples, and a level ≥30 mg/g was accepted as the presence of proteinuria. Renal Doppler ultrasonography was performed using Esaote mylab x 9 model sonography device vovex probe (C1-8) 3.5 MHz. RI values were measured using Xflow Doppler at the level of interlobular or arcuate arteries of both kidneys. First, the patients were divided into two groups (with or without retinopathy). The patients who had retinopathy were then divided into two groups according to their retinopathy degree. Hypertensive retinopathy was graded according to the Scheie classification. The patients were also divided into two groups according to their proteinuria status (with or without proteinuria). Results: The mean of renal RI was 0.59 (0.04) in patients without retinopathy (n=15), 0.63 (0.05) in patients with grade 1 hypertensive retinopathy (n=29), and 0.66 (0.04) in patients with grade 2 hypertensive retinopathy (n=15). The difference between groups was statistically significant (overall P=0.001). It has been shown that proteinuria develops more frequently in cases in which the renal value is above 0.7, and these results were statistically significant (P=0.034). Conclusion: This study indicates that renal RI increase is a valuable tool for estimating retinopathy and proteinuria in hypertensive patients.
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He, Zijian, Hongyu Lu, Xuhua Jian, Guanhua Li, Dengke Xiao, Qingqing Meng, Jimei Chen i Chengbin Zhou. "The Efficacy of Resin Hemoperfusion Cartridge on Inflammatory Responses during Adult Cardiopulmonary Bypass". Blood Purification, 9.06.2021, 1–7. http://dx.doi.org/10.1159/000514149.
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<b><i>Aim:</i></b> This study aimed to evaluate the efficacy of the resin hemoperfusion device (HA380 hemoperfusion cartridge) on inflammatory responses during adult cardiopulmonary bypass (CPB). <b><i>Methods:</i></b> Sixty patients undergoing surgical valve replacement were randomized into the HP group (<i>n</i> = 30) with an HA380 hemoperfusion cartridge in the CPB circuit or the control group (<i>n</i> = 30) with the conventional CPB circuit. The results of routine blood tests, blood biochemical indexes, and inflammatory factors were analyzed at V0 (pre-CPB), V1 (CPB 30 min), V2 (ICU 0 h), V3 (ICU 6 h), and V4 (ICU 24 h). <b><i>Results:</i></b> The HP group had significantly lower levels of IL-6, IL-8, and IL-10. Significant estimation of group differences in the generalized estimating equation (GEE) models was also observed in IL-6 and IL-10. The HP group had significantly lower levels of creatinine (Cr), aminotransferase (AST), and total bilirubin (TBil) compared to the control group. The estimation of differences of Cr, AST, and TBil all reached statistical significance in GEE results. The HP group had significantly less vasopressor requirement and shorter mechanical ventilation time and ICU stay time as compared to the control group. <b><i>Conclusion:</i></b> The HA380 hemoperfusion cartridge could effectively reduce the systemic inflammatory responses and improve postoperative recovery of patients during adult CPB.
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Bashkirtsev, Oleksiy, Vitaliy Sagan, Vira Gaevska i Olena Zimba. "BIOLOGICAL AGE ESTIMATION BASED ON HEART RATE VARIABILITY: A PILOT STUDY". Proceedings of the Shevchenko Scientific Society. Medical Sciences 65, nr 2 (29.12.2021). http://dx.doi.org/10.25040/ntsh2021.02.21.
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Introduction. Biomarkers of biological age (BA) are essential for anti-aging research and practice because of their prediction of life expectancy, detection of premature aging, and estimation of anti-ageing programs' effectiveness. The purpose of this study is a clinical validation of the method of biological age estimation based on the analysis of heart rate variability (HRV), artificial intelligence technologies, and biometric monitoring. Methods. In 51 patients who received wellness and rehabilitation services in the medical center "Edem Medical", biological age was determined based on the analysis of HRV and machine learning algorithms. A comparison was made between the proposed method and other known methods of biological age estimation. Biological age estimation by physicians which is based on the Frailty Index was chosen as a reference method. The second method was DNA methylation age (DNAm PhenoAge). This method predicts biological age based on nine parameters of blood (albumin, creatinine, glucose, C-reactive protein, lymphocytes [%], mean corpuscular volume [MCV], red cell distribution width [RDW], alkaline phosphatase, WBC count). Using the «leave one out» technique, an additional algorithm was created for approximating biological age in view of blood test parameters and ECG signals as input data. Morning HRV assessment was performed on empty stomach and after 10-minute rest in horizontal position. ECG was recorded using Mawi Vital multisensor device. The following statistical tests were used to reveal associations between different methods of biological age estimation: 1. bivariate correlation, 2. mean absolute error (MAE), 3. qualitative binary age estimation. Results. All tested methods of BA evaluation were strongly correlated with the reference method (physician-determined age). HRV based approach was superior in comparison with other methods. In 9 out of 10 cases, the qualitative binary age assessment using HRV coincided with the reference method. The HRV method was the most accurate for biological age estimation (3.62 vs 12.62) based on MAE. Conclusion. The method based on HRV is an affordable and convenient approach to biological age estimation. This method offers opportunities for early stratification of individuals at risk of accelerated aging. It combines well with the paradigm of 3 P medicine which is based on Prevention, Prediction, and Personalized approach to each patient
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Currin, Sean, Mwawi Gondwe, Nokthula Mayindi, Shingirai Chipungu, Bongekile Khoza, Lungile Khambule, Tracy Snyman, Stephen Tollman, June Fabian i Jaya George. "Evaluating chronic kidney disease in rural South Africa: comparing estimated glomerular filtration rate using point-of-care creatinine to iohexol measured GFR". Clinical Chemistry and Laboratory Medicine (CCLM), 12.03.2021. http://dx.doi.org/10.1515/cclm-2020-1882.
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Abstract Objectives The prevalence of chronic kidney disease is rising rapidly in low- and middle-income countries. Serum creatinine and estimation of glomerular filtration rate (GFR) are critical diagnostic tools, yet access to centralised laboratory services remains limited in primary care resource-limited settings. The aim of this study was to evaluate point-of-care (POC) technologies for serum creatinine measurement and to compare their performance to a gold standard measurement using iohexol measured GFR (mGFR). Methods POC creatinine was measured using iSTAT® and StatSensor® devices in capillary and venous whole blood, and laboratory creatinine was measured using the compensated kinetic Jaffe method in 670 participants from a rural area in South Africa. GFR estimating equations Chronic Kidney Disease Epidemiology Collaboration and Modification of Diet in Renal Disease (CKD-EPI and MDRD) for POC and laboratory creatinine were compared to iohexol mGFR. Results Calculated GFR for laboratory and POC creatinine measurements overestimated GFR (positive bias of 1.9–34.1 mL/min/1.73 m2). However, all POC devices had less positive bias than the laboratory Jaffe method (1.9–14.7 vs. 34.1 for MDRD, and 8.4–19.9 vs. 28.6 for CKD-EPI). Accuracy within 30% of mGFR ranged from 0.56 to 0.72 for POC devices and from 0.36 to 0.43 for the laboratory Jaffe method. POC devices showed wider imprecision with coefficients of variation ranging from 4.6 to 10.2% compared to 3.5% for the laboratory Jaffe method. Conclusions POC estimated GFR (eGFR) showed improved performance over laboratory Jaffe eGFR, however POC devices suffered from imprecision and large bias. The laboratory Jaffe method performed poorly, highlighting the need for laboratories to move to enzymatic methods to measure creatinine.
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Kim, Hae Ri, Moo Jun Kim, Jae Wan Jeon, Dae Eun Choi, Ki Ryang Na i Kang Wook Lee. "#4979 MORTALITY AND BIOIMPEDANCE SPECTROSCOPY–BASED DRY WEIGHT MEASUREMENT ERROR IN ELDERLY PATIENTS UNDERGOING HEMODIALYSIS". Nephrology Dialysis Transplantation 38, Supplement_1 (czerwiec 2023). http://dx.doi.org/10.1093/ndt/gfad063c_4979.
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Abstract Background and Aims Dry weight (DW) estimation is important for patients undergoing hemodialysis. Although bioimpedance spectroscopy (BIS) is often employed to evaluate DW, BIS-based DW frequently differs from clinical DW. In this study, the characteristics of elderly patients were evaluated by separating them into groups based on the degree of disparity between the BIS-based DW and the clinically appropriate (DWGAP), and the mortality of each group was compared. Method This retrospective study included patients who underwent hemodialysis at Chungnam National University Hospital from January 1, 2016, to June 2020. All patients were aged ≥60 years. Patients with cancer, recipients of kidney transplant, and patients who dropped out of the study within 3 years were excluded. Body composition was assessed using a portable BIS device (Fresenius Medical Care, Bad Homburg, Germany). The BIS dataset includes extracellular water (ECW), intracellular water (ICW), and total body water level (TBW) as well as the lean tissue index (LTI), fat mass index (FTI), ECW/ICW ratio (E/I), lean tissue mass, fat mass (FAT), adipose tissue mass (ATM), and body cell mass (BCM). The absolute value of the gap between the BIS-based DW and the actual clinically appropriate dry weight was determined (DWGAP). To assess differences in blood chemistry and survival rate, four groups were classified based on the absolute value of DWGAP; Group 1: DWGAP < 0.5 kg, Group 2: 0.5 kg ≤ DWGAP < 1 kg, Group 3: 1 kg ≤ DWGAP < 2 kg, and Group 4: 2 kg < DWGAP. The mortality data of patients up to 3 years after BIS measurement were collected. Results There were 1024 patients in all. The study excluded 29 individuals with cancer, 31 patients with KT, and 249 participants with a loss of follow-up before 36 months. A total of 715 patients were analyzed: Group 1 (n = 236), Group 2 (n = 171), Group 3 (n = 137), and Group 4 (n = 171). The mean age for each group was 71.97, 70.73, 71.58, and 70.4 years, respectively. Groups 1 and 2 had the same survival rates (78%); however, Group 3 had a lower rate (73%) and Group 4 showed a significant decline (59%). In the laboratory test, Group 4 had lower hemoglobin, total protein, albumin, creatinine, and chloride levels than Groups 1, 2, and 3. In the BIS data, ECW and E/I were higher in Group 4 than in Groups 1, 2, and 3. Conclusion In the elderly patient group, mortality increased in the group where the DWGAP was >2 kg. Lower blood albumin levels, total protein levels, and E/I ratios of ≥1 were detected in the group with a gap of ≥2 kg, and these parameters are likely to adversely affect the survival of elderly patients requiring dialysis.
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Sommerfeld, Oliver, Caroline Neumann, Jan Becker, Christian von Loeffelholz, Johannes Roth, Andreas Kortgen, Michael Bauer i Christoph Sponholz. "Extracorporeal albumin dialysis in critically ill patients with liver failure: Comparison of four different devices—A retrospective analysis". International Journal of Artificial Organs, 23.08.2023. http://dx.doi.org/10.1177/03913988231191952.
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Background: Besides standard medical therapy and critical care monitoring, extracorporeal liver support may provide a therapeutic option in patients with liver failure. However, little is known about detoxification capabilities, efficacy, and efficiency among different devices. Methods: Retrospective single-center analysis of patients treated with extracorporeal albumin dialysis. Generalized Estimating Equations with robust variance estimator were used to account for repeated measurements of several cycles and devices per patient. Results: Between 2015 and 2021 n = 341 cycles in n = 96 patients were eligible for evaluation, thereof n = 54 (15.8%) treatments with Molecular Adsorbent Recirculating System, n = 64 (18.7%) with OpenAlbumin, n = 167 (48.8%) Advanced Organ Support treatments, and n = 56 (16.4%) using Single Pass Albumin Dialysis. Albumin dialysis resulted in significant bilirubin reduction without differences between the devices. However, ammonia levels only declined significantly in ADVOS and OPAL. First ECAD cycle was associated with highest percentage reduction in serum bilirubin. With the exception of SPAD all devices were able to remove the water-soluble substances creatinine and urea and stabilized metabolic dysfunction by increasing pH and negative base excess values. Platelets and fibrinogen levels frequently declined during treatment. Periprocedural bleeding and transfusion of red blood cells were common findings in these patients. Conclusions: From this clinical perspective ADVOS and OPAL may provide higher reduction capabilities of liver solutes (i.e. bilirubin and ammonia) in comparison to MARS and SPAD. However, further prospective studies comparing the effectiveness of the devices to support liver impairment (i.e. bile acid clearance or albumin binding capacity) as well as markers of renal recovery are warranted.
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Vendeville, A. C., H. A. H. Kaasjager, R. E. A. Musson i W. Spiering. "P1690Lab-on-a-chip based self-monitoring device for dietary intake of potassium and sodium: the LAB-CHIPS study". European Heart Journal 40, Supplement_1 (1.10.2019). http://dx.doi.org/10.1093/eurheartj/ehz748.0445.
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Abstract Background Dietary sodium restriction and upholding adequate potassium intake is an important lifestyle modification strategy advocated in guidelines for the management of hypertension and for lowering cardiovascular risk in the general population. The gold standard for estimating sodium and potassium intake, 24-hour urine collection (24hUc), is time consuming and cumbersome, but most importantly not a good indicator of dietary habit due to day-to-day variation. New lab-on-a-chip technology has been developed to measure urinary sodium, potassium and creatinine excretion in a single drop of urine using microcapillary electrophoreses combined with conductivity analyses. Self-monitoring can be done at home over a longer period of time. Results are readily available. Purpose To assess agreement between 24hUc and the lab-on-a-chip self-monitoring device for estimating past 24h dietary sodium and potassium intake for single and multiple self-tests by using the Kawasaki, INTERSALT and Tanaka formulae. Methods Healthy participants (n=12) were asked to adhere to three different weekly dietary sodium restriction goals. Participants received verbal and written information to aim between 3.3 and 5.0 grams of sodium intake a day during week 1 (“normal”), >3.3<5.0 grams in week 2 (low) and >5.0 grams during week 3 (high). Weekly measurement instructions consisted of one self-test on day 1 through 6 and multiple self-tests (n=3) combined with a 24hUc on day 7. To estimate 24h sodium and potassium intake, Kawasaki, INTERSALT and Tanaka formulas were used. The Bland-Altman method was used to calculate the agreement. Results The agreement (mg/day) for sodium between 24hUc and a self-test on first morning urine (fmu) (Kawasaki), was −102±804 (normal), −860±592 (low) and 340±1406 (high). For multiple self-tests (n=3) performed on 24hUc days, using the INTERSALT formula, the agreement was: 577±832 (normal), −701±721 (low) and 1788±911 (high). Any combination of same day single or multiple INTERSALT or Tanaka self-tests and fmu Kawasaki did not result in better agreement. For potassium the agreement between 24hUc and fmu (Kawaksaki) was 1071±966 (normal), 1376±678 (low) and 1654±880 (high). Using the Tanaka formula resulted in further underestimation and thus worse agreement for same day self-tests and fmu. Conclusion In this study, agreement between 24hUc and the lab-on-a-chip self-monitoring device for estimating past 24h dietary sodium intake was best for a fmu self-test calculated with the Kawasaki formula. For estimating potassium intake, a fmu self-test with help of the Kawasaki formula overestimated potassium intake considerably. This lab-on-a-chip self-monitoring device has the potential to improve current lifestyle modification strategies.
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Dubey, Venketesh N., Jugal M. Dave, John Beavis i David V. Coppini. "Predicting Diabetic Neuropathy Risk Level Using Artificial Neural Network and Clinical Parameters of Subjects With Diabetes". Journal of Diabetes Science and Technology, 22.10.2020, 193229682096558. http://dx.doi.org/10.1177/1932296820965583.
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Background: A risk assessment tool has been developed for automated estimation of level of neuropathy based on the clinical characteristics of patients. The smart tool is based on risk factors for diabetic neuropathy, which utilizes vibration perception threshold (VPT) and a set of clinical variables as potential predictors. Methods: Significant risk factors included age, height, weight, urine albumin-to-creatinine ratio, glycated hemoglobin, total cholesterol, and duration of diabetes. The continuous-scale VPT was recorded using a neurothesiometer and classified into three categories based on the clinical thresholds in volts (V): low risk (0-20.99 V), medium risk (21-30.99 V), and high risk (≥31 V). Results: The initial study had shown that by just using patient data ( n = 5088) an accuracy of 54% was achievable. Having established the effectiveness of the “classical” method, a special Neural Network based on a Proportional Odds Model was developed, which provided the highest level of prediction accuracy (>70%) using the simulated patient data ( n = 4158). Conclusion: In the absence of any assessment devices or trained personnel, it is possible to establish with reasonable accuracy a diagnosis of diabetic neuropathy by means of the clinical parameters of the patient alone.
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Turgutkaya, Atakan, i Gülay Aşçı. "The association between Hba1c and arterial stiffness among non-diabetic patients with chronic kidney disease". Jornal Vascular Brasileiro 20 (2021). http://dx.doi.org/10.1590/1677-5449.200245.
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Abstract Background Cardiovascular events are seen more frequently after the age of 60 and they are a significant cause of morbidity and mortality. Arterial stiffness is a property that can be expressed by pulse wave velocity and this value is assumed to be a predictor of cardiovascular events. Patients with chronic kidney disease and dysregulated blood sugar have increased atherosclerosis and arterial stiffness, but the relationship between physiological levels of Hba1c and arterial stiffness is less clear in chronic kidney disease patients without diabetes mellitus. Objectives Here, we aimed to investigate the degree of arterial stiffness among non-diabetic, non-dialysis dependent chronic kidney disease patients with physiological HbA1c levels. Methods We enrolled 51 patients who were followed up at Ege University Hospital Nephrology Department between February and June 2015. Non-diabetic, non-dialysis dependent chronic kidney disease patients were included in the study. Blood pressure and pulse wave velocity were measured with an applanation tonometry device (Sphygmocor Vx Software Atcor Medical, Australia). Correlations between pulse wave velocity and the aforementioned parameters were investigated (see below). Results We detected a significant correlation between pulse wave velocity and systolic blood pressure (p=0.0001) and Hba1c (p=0.044) separately. There was an inverse correlation with creatinine clearance (p=0.04). We also detected a significant correlation with serum phosphorus level (p=0.0077) and furosemide use (p=0.014). No correlations were found among the other parameters. Conclusions Arterial stiffness is an important predictor of cardiovascular events and measuring it is an inexpensive method for estimating morbidity and mortality. Our study supports the importance of measuring arterial stiffness and of controlling blood glucose levels, even at physiological Hba1c values, especially for chronic kidney disease patients.