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Showing 111 to 119 of 119 (0.015 seconds)| 111 |
Impact du bicarbonate de sodium sur la prévention de la néphropathie induite par le produit de contraste en chirurgie endovasculaire pour anévrysme de l’aorteBrulotte, Véronique 12 1900 (has links)
Introduction: L’approche endovasculaire pour la réparation d’anévrysmes aortiques s’associe à une utilisation importante de produit de contraste, qui peut causer une néphropathie induite par le produit de contraste (NIC) en postopératoire. L’hydratation intraveineuse peut réduire l’incidence de NIC, mais quel produit utiliser reste incertain. Nous avons évalué le bicarbonate de sodium, comparé au NaCl 0,9%, pour réduire l’incidence de NIC.
Méthode: Nous avons mené une étude prospective, randomisée et contrôlée à double insu chez 34 patients subissant une chirurgie endovasculaire pour anévrysme aortique. Les patients des deux groupes (17 patients par groupe) ont reçu du bicarbonate de sodium ou du NaCl 0,9% à raison de 3 mL/kg/h pour une heure avant l’intervention puis 1 mL/kg/h jusqu’à 6 h après la fin de la chirurgie. Tous les patients ont reçu du N-acétylcystéine. L’objectif principal était l’incidence de NIC, définie comme une élévation de plus de 25% de la créatinine sérique 48 h suivant l’exposition au produit de contraste. Des biomarqueurs précoces de lésion rénale ont été mesurés.
Résultats: Une NIC s’est développée chez 1 patient (5,88%) appartenant au groupe bicarbonate, comparé à aucun patient (0%) dans le groupe NaCl 0,9% (P = 0,31). Les biomarqueurs de lésion rénale étaient significativement augmentés dans les deux groupes après l’exposition au produit de contraste.
Conclusions: Nous avons démontré un faible taux d’insuffisance rénale suivant une chirurgie endovasculaire aortique, que l’hydratation soit effectuée avec du bicarbonate ou du NaCl 0,9%, malgré une élévation des biomarqueurs de lésion rénale. / Background: The endovascular approach for the repair of aortic aneurysm involves the administration of large quantities of contrast media, which can cause contrast-induced nephropathy (CIN) in the post operative period. The only proven strategy to prevent CIN is intravenous hydration, but what type of infusion to use is not clear. We evaluated the efficacy of sodium bicarbonate, compared with NaCl 0.9%, to reduce the incidence of postoperative renal failure.
Methods: We conducted a prospective, controlled, double-blind, randomized study in patients presenting for endovascular aortic aneurysm surgery. Patients in group A (n = 17) received sodium bicarbonate 3 mL/kg/h for 1 h before the procedure and then 1 mL/kg/h until 6 h after surgery, whereas patients in group B (n= 17) received the same amount of NaCl 0.9%. All patients received N-acetylcysteine. The primary end point was CIN, defined by serum creatinine greater than 25 % above baseline 48 h post operatively. Biomarkers of renal injury were measured.
Results: CIN developed in one patient in the bicarbonate group (5,88%), compared with no patient in the NaCl 0,9% group (0%) (difference 5.88%;95% CI -5.3% to 17.06%, P = 0.31). Interleukin-18, N-acetyl-β-D-glucosaminidase and Kidney Injury Molecule-1 increased significantly in both groups after exposure to contrast media.
Conclusions: We demonstrated a low rate of renal failure following endovascular aortic surgery using contrast media, regardless of whether bicarbonate or NaCl 0.9% was used for hydration, despite significant elevation in biomarkers of renal injury.
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\"Alterações na função renal em pacientes HIV/AIDS tratados com esquemas terapêuticos incluindo indinavir\" / Alterations in renal function in HIV/AIDS patients treated with therapeutic regimens including indinavirMargareth da Eira 08 July 2004 (has links)
Complicações renais e urológicas incluindo nefrolitíase, cristalúria, cólica renal e lombalgia, são eventos adversos bem conhecidos do indinavir (IDV), um inibidor de protease (IP) largamente utilizado no tratamento de pacientes infectados com o vírus da imunodeficiência humana (HIV). Prévios estudos em ratos demonstraram que o IDV, um potente IP capaz de provocar uma sustentada supressão da carga viral do HIV, induz vasoconstricção renal, diminui a filtração glomerular (RFG) e reduz a excreção urinária de nitrito (NO2-), sugerindo que a vasoconstricção causada pelo IDV deve ser mediada pelo óxido nítrico (NO). Os objetivos deste estudo foram investigar a ocorrência de insuficiência renal (clearance de creatinina < 80ml/min) em pacientes com infecção pelo HIV tratados com terapia anti-retroviral altamente potente incluindo o inibidor de protease IDV, e mensurar a excreção urinária de nitrato (NO3-) nestes pacientes, comparando-os com outro grupo de pacientes tratados com efavirenz (EFV), um inibidor de transcriptase reversa não-análogo de nucleosídeo (NNRTI). No período compreendido entre março de 2000 e outubro de 2003, estudamos 36 pacientes infectados pelo HIV que estavam em terapia com IDV na dose de 800 mg de 8/8 horas por pelo menos 12 meses. Os pacientes foram avaliados para uma variedade de parâmetros clínicos e laboratoriais: idade, peso, tempo de infecção, tempo de uso de IDV, uso de sulfametoxazol-trimetoprim (SMX-TMP) ou sulfadiazina, exames bioquímicos (colesterol total, triglicérides, magnésio, sódio, potássio e creatinina), exame do sedimento urinário, clearance de creatinina, osmolaridade urinária, volume urinário de 24 h, fração de excreção de sódio (FENa), fração de excreção de potássio (FEK) e fração de excreção de água (FEH2O). NO3 urinário foi mensurado em 18 pacientes recebendo terapia anti-retroviral com IDV e 8 pacientes recebendo terapia com EFV. Leucocitúria ocorreu em 78.8% dos pacientes tratados com IDV. Clearance de creatinina diminuído foi observado em 21 pacientes e foi associado com menor peso e uso de derivados de sulfa. Nestes pacientes com diminuição da função renal, também detectamos menor osmolaridade urinária e uma FEH2O mais alta. A excreção urinária de NO3- foi significativamente menor nos pacientes tratados com IDV (908 ± 181) quando comparados aos pacientes do grupo EFV (2247 ± 648, p<0.01). Nossos resultados mostram que insuficiência renal ocorreu em 58% dos pacientes tratados com IDV e foi associada com menor peso corpóreo e uso de derivados de sulfa. A menor excreção urinária de NO3- e as alterações na osmolaridade e FEH2O sugerem que o IDV diminui a produção de óxido nítrico e causa dano tubular, respectivamente. Sugerimos então que os pacientes em uso de IDV sejam monitorados routineiramente para função renal através do clearance de creatinina. / Renal and urological complications including nephrolithiasis, crystalluria, renal colic and flank pain are significant side effects of the HIV protease inhibitor indinavir (IDV), and IDV has been widely used in the treatment of human immunodeficiency virus (HIV) infection. Previous studies in rats demonstrated that IDV, a potent protease inhibitor that causes profound and sustained supression of HIV replication, also induces renal vasoconstriction, decreases glomerular filtration rate (GFR) and reduces urinary excretion of nitrite (NO2-), suggesting that IDV-vasoconstriction may be mediated by nitric oxide (NO). The objectives of this study were to investigate the occurrence of renal failure (creatinine clearance <80ml/min) in human HIV patients treated with highy active antiretroviral therapy (HAART), including IDV, and to measure urinary excretion of nitrate (NO3-) in those patients, comparing it with that of another group of patients treated with the non-nucleoside reverse-transcriptase inhibitor efavirenz (EFV). From March 2000 through October 2003, we evaluated 36 patients infected with HIV who was receiving IDV 800 mg q8h for at least 12 months. The patients were assessed for a variety of clinical and laboratory parameters including age, body weight, duration of infection, time of IDV treatment, trimethoprim/sulfamethoxazole (TMP/SMX) or sulfadiazine use, biochemistry (total cholesterol, triglycerides, magnesium, sodium, potassium and creatinine), urinalysis, creatinine clearance, urine osmolality, 24-hour urine volume, fractional excretion of sodium (FENa), potassium (FEK) and water (FEH2O). Urinary NO3 was measured in 18 IDV-treated patients and compared with that of 8 EFV-treated patients. Leukocyturia occurred in 78.8% of the IDV-treated patients. Reduced creatinine clearance was observed in 21 patients and was associated with lower body weight and sulfa-derivated use. In these renal failure patients, we also detected a lower osmolality and a higher FEH2O. Excretion of NO3- was significantly lower in IDV-treated patients (908 ± 181) than in EFV-treated patients (2247 ± 648, p<0.01). Our data show that renal failure occurred in 58% of IDV-treated patients and was associated with lower body weight and sulfa administration. The lower NO3- excretion suggests that this drug decreases nitric oxide production, and the alterations in osmolality and FEH2O indicate that it also causes tubular damage. Based on our findings, we suggest that the renal function of patients under IDV treatment should be closely monitored with creatinine clearance.
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Electrochemical Biosensors based on Novel Receptors for Diabetes ManagementKumar, Vinay January 2016 (has links) (PDF)
To address the challenge of accurate, low cost and robust biosensors for diabetes management and early detection of diabetes complications, we have developed novel, robust sensing chemistry (or receptors) for electrochemical POC biosensors. The biosensors have been developed for the bio-markers associated with diabetes management such as glycated haemoglobin (HbA1c), glycated albumin, glucose, biomarkers associated with diabetes complications such as microalbuminuria, urine creatinine and albumin-to-creatinine ratio (ACR) and biomarkers associated with anaemia and malnutrition conditions such as haemoglobin and serum albumin.
For haemoglobin detection, a new POC bio sensing technique has been developed based on Aza-heterocyclic chemicals. The repeatability and accuracy of the biosensor have been tested on real pathology samples. The glycated form of haemoglobin, called glycated haemoglobin or HbA1c, is the gold standard test in diabetes management as it gives the 90-days average blood glucose value. We demonstrate a simple method for electrochemical detection of HbA1c by combining bosonic affinity principle along with aza-heterocyclic receptors. The technique has been verified on the real clinical patient samples.
Albumin is the most abundant protein in the human blood. Human serum albumin (HSA) is either alone or an associative biomarker in several chronic diseases like necrosis, nephrosis, hepatitis, malnutrition, arthritis, immune disorders, cancer, diabetes and in some severe infections. In pathology laboratories, the serum albumin is usually tested on serum samples and not in whole blood samples. Since albumin is not a metalloproteinase, it is very difficult to develop electrochemical POC biosensor. We have developed a novel technique for the electrochemical detection of serum albumin in whole blood samples, by exploiting its binding property with redox active copper salts. The accuracy of technique has been verified on both real human blood plasma as well as whole blood samples. Glycated albumin, which is the glycated form of serum albumin, is emerging as a novel biomarker for diabetes management, as it gives the average blood glucose value of 15-20 days. It is also extremely useful in chronic kidney disease patients and patients with hemoglobinopathies where HbA1c can give the erroneous results. By combining the copper chemistry along with bosonic affinity principle, we present the first ever demonstration of glycated albumin sensing.
Instant blood glucose monitoring is an integral part of diabetes management. Most of the glucometers available in the market are based on glucose oxidase enzyme. We have demonstrated a low cost non-enzymatic electrochemical technique for blood glucose detection using alkaline methylene blue chemistry. The accuracy of the technique has been verified on real human blood plasma samples. Glucometer is one of the most easily available POC biosensor and a useful tool for diabetes population. India has second largest diabetes population in the world. To analyse the accuracy of the POC glucometers which are available in Indian market, a comprehensive study was conducted. The results were compared with clinical accuracy guidelines using exhaustive statistical analysis techniques. The shortcomings of the commercial glucometers are elucidated, regarding different international standards.
Diabetic nephropathy is one of the major diabetes complications and is the primary cause of chronic kidney disease (CKD). The presence of albumin in urine is a well-established biomarker for the early detection of diabetic nephropathy. We have developed a technique for electrochemical detection of microalbuminuria for point of care applications by exploring the binding property of human albumin with electrochemically active molecules like copper and hemin. Methylene blue mediated sensing technique has also been proposed. Urine Albumin-to creatinine ratio (ACR) is another variant of the microalbumuria test that can be done any time and does not suffer from the dilution factor of urine. Iron binding property of creatinine is exploited to develop creatinine biosensor, thus enabling POC ACR tests.
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Предиктивни фактори и показатељи настанка акутног бубрежног оштећења након елективних операција на инфрареналном сегменту аорте / Prediktivni faktori i pokazatelji nastanka akutnog bubrežnog oštećenja nakon elektivnih operacija na infrarenalnom segmentu aorte / Predictive factors and indicators of acute renal injury after elective infrarenal aortic surgeryMaričić Prijić Sanja 12 November 2019 (has links)
<p>Akutno bubrežno oštećenje je česta i ozbiljna komplikacija nakon hirurške rekonstrukcije abdominalne aorte. Ona produžuje, poskupljuje bolničko lečenje i povećava morbiditet i mortalitet bolesnika. Što ranije prepoznavanje bolesnika koji su pod povišenim rizikom uz pomoć prediktivnih faktora, kao i identifikovanje akutnog bubrežnog oštećenja od velikog je značaja za pravovremeno započinjanje preventivnih i terapijskih mera i smanjenje mortaliteta ovih bolesnika. Cilj istraživanja: Utvrditi incidencu akutnog bubrežnog oštećenja, najznačajnije preoperativne i intraoperativne prediktivne faktore za nastanak akutnog bubrežnog oštećenja i utvrditi da li serumski cistatin C ranije i preciznije ukazuje na akutno bubrežno oštećenje u odnosu na serumski kreatinin 72 sata nakon elektivnih operacija na infrarenalnom segmentu aorte. Metodologija: Na Klinici za anesteziju, intenzivnu terapiju i terapiju bola i Klinici za vaskularnu i transplantacionu hirurgiju Kliničkog centra Vojvodine sprovedeno je prospektivno opservaciono istraživanje u trajanju od 18 meseci, od oktobra 2017. do aprila 2019. godine. U istraživanje je uključeno 140 pacijenata koji su podvrgnuti elektivnom operativnom zahvatu na infrarenalnom segmentu aorte. Preoperativni i intraoperativni potencijalni prediktivni faktori identifikovani su iz medicinske dokumentacije: istorije bolesti, protokoli anestezije, dnevne terapijske liste, liste vitalnih parametara i liste laboratorijskih parametara. Nastanak ABO je potvrđivan pomoću AKIN klasifikacionog sistema. Tokom postoperativnog perioda lečenja od 72 sata obraćana je pažnja na vreme i stepen nastanka ABO. Za statističku obradu podataka korišćen je program SPSS, verzija 21 (IBM SPSS, Čikago, Ilinois). Rezultati su predstavljeni tabelarno i grafički, a statistički značajnim su se smatrale vrednosti nivoa značajnosti p<0,05. Podaci su obrađivani standardnim statističkim testovima. Za dobijanje modela predikcije primenjena je multivarijantna logistička regresija. Rezultati: Incidenca akutnog bubrežnog oštećenja nakon elektivnih operacija na infrarenalnom segmentu aorte na Klinici za anesteziju, intenzivnu terapiju i terapiju bola i Klinici za vaskularnu i transplantacionu hirurgiju Kliničkog centra Vojvodine iznosi 28,56%. Prema ROC analizi granična vrednost koncentracije cistatina C od 1,14 mg/l ima najvišu senzitivnost (82,5%), i specifičnost (76%) u diferenciranju bolesnika koji će dobiti akutno bubrežno oštećenje. Kompletan model predikcije ABO nakon elektivnih operacija na infrarenalnom segmentu aorte sadrži sledeće faktore: prisustvo hronične bubrežne slabosti, preoperativna serumska koncentracija cistatina C >1,14 mg/l, primena koloida u volumenu >500 ml u toku operacije, ukupni volumen nadoknade u intraoperativnom periodu >59 ml/kg. Zaključak: Incidenca akutnog bubrežnog oštećenja nakon elektivnih operacija na infrarenalnom segmentu aorte na Klinici za anesteziju, intenzivnu terapiju i terapiju bola i Klinici za vaskularnu i transplantacionu hirurgiju Kliničkog centra Vojvodine je nešto viša u odnosu na literaturne podatke. Cistatin C je bolji prediktor i pokazatelj akutnog bubrežnog oštećenja u odnosu na kreatinin. Bolesnici koji imaju hroničnu bubrežnu slabost, preoperativni nivo cistatina C>1,14 mg/l, koji tokom operacije dobiju preko 500 ml koloidnih rastvora, i ukupni volumen nadoknade >59 ml/kg imaju veću šansu da dobiju akutno oštećenje bubrega u postoperativnom periodu.</p> / <p>Acute kidney injury is frequent and serious complication after aortic surgery which increases length of hospital stay, costs, morbidity and mortality. Earlier recognition of patients at risk by predictive factors and identification of acute kidney injury could have important role on right timing of preventive and therapeutic measures and lower mortality of these patients. Aims: to investigate the incidence of acute kidney injury, the most important preoperative and intraoperative predictive factors for acute kidney injury, and check whether cystatin C indicates acute kidney injury earlier and more accurately than creatinine 72 hours after elective infrarenal aortic surgery. Methodology: This prospective observational study was performed at Clinic of Anesthesia, Intensive Care and Pain Therapy and Clinic of Vascular and Transplantation Surgery, Clinical Centre of Vojvodina, during the period of 18 months, from October 2017 till April 2019. It includes 140 adult patient who underwent elective infrarenal aortic surgery. Potential predictive factors were identified out of medical records such as: patient history, anesthesia lists, daily therapeutic lists, vital parameters and laboratory values lists. The occurrence of acute kidney injury was noted according to AKIN criteria. IBM SPSS version 21 (Chicago, Illinois) was used for statistical analysis. The results were presented in tables and graphs, statistical significance was set at p value of less than 0,05. Standard statistical tests were applied. Multivariate logistic regression model was used for potential predictive factors. Results: The incidence of acute kidney injury at Clinic of Anesthesia, Intensive Care and Pain Therapy and Clinic of Vascular and Transplantation Surgery, Clinical Centre of Vojvodina, was 28,56%. The cut off value of cystatin C serum concentration of 1,14 mg/l has the highest sensitivity (82,5%), and specificity (76%) in the differentiation of patients who will develop acute kidney injury. The final model for predicting acute kidney injury in patients who underwent elective infrarenal aortic surgery contains the following variables: presence of chronic kidney failure, preoperative serum concentration of cystatin C>1,14 mg/l, application of colloid solutions in volume>500 ml during the operation and total intravascular fluid replacement volume>59 ml/kg in intraoperative period. Conclusion: The incidence of acute kidney injury at Clinic of Anesthesia, Intensive Care and Pain Therapy and Clinic of Vascular and Transplantation Surgery, Clinical Centre of Vojvodina, is somewhat higher comparing to world literature data. Patients who are more likely to develop acute kidney injury have: chronic kidney failure, preoperative serum concentration of cystatin C>1,14 mg/l and get colloid solutions in volume>500 ml and total intravascular fluid replacement volume>59 ml/kg during intraoperative period.</p>
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Stanovení vybraných komponent v lidské moči elektroforézou v krátké kapiláře. / Determination of selected components in human urine with electrophoresis in short capillary.Makrlíková, Anna January 2015 (has links)
Capillary zone electrophoresis is frequently used in various analyses. In this diploma thesis a hydrodynamic sample introduction method controlled by pressure pulse has been proposed for short-capillary electrophoresis. The base electrolyte flushes sample from the loop of a six-way sampling valve and is carried to the injection end of the capillary. At the time when the sample zone reached the capillary, a short pressure impulse is generated in the electrolyte stream, which provides injection of the sample into the capillary. Then the electrolyte flow is stopped and the separation voltage is turned on. The amount of sample introduced to the capillary is controlled by the duration of the pressure pulse. This new sample introduction method was tested in the determination of ammonia, histidine, creatinine, uric acid and hippuric acid in human urine and for rapid screening of the contents of the inorganic ions in cerebrospinal fluid and blood plasma. The determination was performed in a capillary with an overall length of 10,5 cm and two base electrolytes was tested - 50 mM MES + 5 mM NaOH (pH 5,10) and 1 M acetic acid + 1,5 mM crown ether 18-crown-6 (pH 2,40). Using dual detection techniques contactless conductivity and UV spectrometric detection, anorganic and organic substances in the sample could...
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Синтез медь(II)-имидазольных каркасов и их применение в качестве электрохимических катализаторов для определения креатинина, глюкозы, мочевины : магистерская диссертация / Copper(II)-imidazole frameworks and their application as electrochemical catalysts for determination creatinine, glucose, ureaБахтина, О. В., Bakhtina, O. V. January 2023 (has links)
Настоящая работа состоит из 3 глав и посвящена бесферментному количественному определению креатинина, глюкозы, мочевины с использованием медь(II)-имидазольных каркасов. В ходе работы проведено формирование электрокаталитически активного слоя на поверхности рабочего электрода. Таким образом, каталитически активный слой с наибольшей чувствительностью сформирован на печатном электроде 3-в-1 с использованием многостенных углеродных нанотрубок (cMWCNT), электроосаждённым золотом и медь(II)-имидазольного каркаса, состоящего из иона меди(II) и 2-меркаптоимидазола и 2-метилимидазола. Проведены исследования селективности полученного каталитически активного слоя. / This work consists of 3 chapters and is devoted to the enzyme-free quantitative determination of creatinine, glucose, urea using copper(II)-imidazole frameworks. In the course of the work, the formation of an electrocatalytically active layer on the surface of the working electrode was carried out. Thus, the catalytically active layer with the highest sensitivity is formed on a 3-in-1 printed electrode using multi-walled carbon nanotubes (cMWCNT) electrodeposited with gold and copper(II)-imidazole framework consisting of copper(II) ion and 2-mercaptoimidazole and 2-methylimidazole. The selectivity of the obtained catalytically active layer has been studied.
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BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASEIssa Al Salmi Unknown Date (has links)
The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood.
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BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASEIssa Al Salmi Unknown Date (has links)
The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood.
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BIRTHWEIGHT AND SUSCEPTIBILITY TO CHRONIC DISEASEIssa Al Salmi Unknown Date (has links)
The thesis examines the relationship of birthweight to risk factors and markers, such as proteinuria and glomerular filtration rate, for chronic disease in postnatal life. It made use of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). The AusDiab study is a cross sectional study where baseline data on 11,247 participants were collected in 1999-2000. Participants were recruited from a stratified sample of Australians aged ≥ 25 years, residing in 42 randomly selected urban and non-urban areas (Census Collector Districts) of the six states of Australia and the Northern Territory. The AusDiab study collected an enormous amount of clinical and laboratory data. During the 2004-05 follow-up AusDiab survey, questions about birthweight were included. Participants were asked to state their birthweight, the likely accuracy of the stated birthweight and the source of their stated birthweight. Four hundred and twelve chronic kidney disease (CKD) patients were approached, and 339 agreed to participate in the study. The patients completed the same questionnaire. Medical records were reviewed to check the diagnoses, causes of kidney trouble and SCr levels. Two control subjects, matched for gender and age, were selected for each CKD patient from participants in the AusDiab study who reported their birthweight. Among 7,157 AusDiab participants who responded to the questionnaire, 4,502 reported their birthweights, with a mean (standard deviation) of 3.4 (0.7) kg. The benefit and disadvantages of these data are discussed in chapter three. The data were analysed for the relationship between birthweight and adult body size and composition, disorders of glucose regulation, blood pressure, lipid abnormalities, cardiovascular diseases and glomerular filtration rate. Low birthweight was associated with smaller body build and lower lean mass and total body water in both females and males. In addition low birthweight was associated with central obesity and higher body fat percentage in females, even after taking into account current physical activity and socioeconomic status. Fasting plasma glucose, post load glucose and glycosylated haemoglobin were strongly and inversely correlated with birthweight. In those with low birthweight (< 2.5 kg), the risks for having impaired fasting glucose, impaired glucose tolerance, diabetes and all abnormalities combined were increased by 1.75, 2.22, 2.76 and 2.28 for females and by 1.40, 1.32, 1.98 and 1.49 for males compared to those with normal birthweight (≥ 2.5 kg), respectively. Low birthweight individuals were at higher risk for having high blood pressure ≥ 140/90 mmHg and ≥ 130/85 mmHg compared to those with normal birthweight. People with low birthweight showed a trend towards increased risk for high cholesterol (≥ 5.5 mmol/l) compared to those of normal birthweight. Females with low birthweight had increased risk for high low density lipoprotein cholesterol (≥ 3.5 mmol/l) and triglyceride levels (≥ 1.7 mmol/l) when compared to those with normal birthweight. Males with low birthweight exhibited increased risk for low levels of high density lipoprotein cholesterol (<0.9 mmol/l) than those with normal birthweight. Females with low birthweight were at least 1.39, 1.40, 2.30 and 1.47 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases respectively, compared to those ≥ 2.5 kg. Similarly, males with low birthweight were 1.76, 1.48, 3.34 and 1.70 times more likely to have angina, coronary artery disease, stroke and overall cardiovascular diseases compared to those ≥ 2.5 kg, respectively. The estimated glomerular filtration rate was strongly and positively associated with birthweight, with a predicted increase of 2.6 ml/min (CI 2.1, 3.2) and 3.8 (3.0, 4.5) for each kg of birthweight for females and males, respectively. The odd ratio (95% confidence interval) for low glomerular filtration rate (<61.0 ml/min for female and < 87.4 male) in people of low birthweight compared with those of normal birthweight was 2.04 (1.45, 2.88) for female and 3.4 (2.11, 5.36) for male. One hundred and eighty-nineCKD patients reported their birthweight; 106 were male. Their age was 60.3(15) years. Their birthweight was 3.27 (0.62) kg, vs 3.46 (0.6) kg for their AusDiab controls, p<0.001 and the proportions with birthweight<2.5 kg were 12.17% and 4.44%, p<0.001. Among CKD patients, 22.8%, 21.7%, 18% and 37.6% were in CKD stages 2, 3, 4 and 5 respectively. Birthweights by CKD stage and their AusDiab controls were as follows: 3.38 (0.52) vs 3.49 (0.52), p=0.251 for CKD2; 3.28 (0.54) vs 3.44 (0.54), p=0.121 for CKD3; 3.19 (0.72) vs 3.43 (0.56), p= 0.112 for CKD4 and 3.09 (0.65) vs 3.47 (0.67), p<0.001 for CKD5. The results demonstrate that in an affluent Western country with a good adult health profile, low birthweight people were predisposed to higher rates of glycaemic dysregulation, high blood pressure, dyslipidaemia, cardiovascular diseases and lower glomerular filtration rate in adult life. In all instances it would be prudent to adopt policies of intensified whole of life surveillance of lower birthweight people, anticipating this risk. The general public awareness of the effect of low birthweight on development of chronic diseases in later life is of vital importance. The general public, in addition to the awareness of people in medical practice of the role of low birthweight, will lead to a better management of this group of our population that is increasingly surviving into adulthood.
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