Catecholamines are stress hormones that are produced and released by a rare tumor called pheochromocytoma. This tumor can cause hypertension which if undiagnosed and untreated leads to death. Since good therapy is available, it is important to find the tumor in time. The most common way to diagnose the tumor is measurement of the biochemical markers; catecholamines and their metabolites, methylated catecholamines. After observation that almost all normetanephrine results for women were higher than the upper reference limit and therefore pathological, the accuracy of the present reference intervals was questioned. Therefore new reference intervals for both urinary catecholamines and methylated catecholamines were developed by analysis of 46 samples using HPLC. Creatinine was analysed in acidified urine in order to see if the results became the same as when analysed in non-acidified urine. Urinary catecholamines and methylated catecholamines were analysed using HPLC. Comparison between measurement of creatinine in acidified urine and non-acidified urine with an enzymatic method was performed using Architect ci 8200, Abbott. As suspected, there was a difference between the present and new intervals. Therefore the new intervals will be used for future diagnosis. There was no difference between the two treatments of creatinine samples wherefore it can be measured in both.In conclusion reference intervals determind in this study will be used and it was shown that creatinine can be measured in acidified urine.

Thesis (Ph. D.)--University of Virginia, 1928.

Thesis (Ph. D.)--University of Virginia, 1928.

Orientador: Helena Redigolo Pezza / Banca: Emanuel Carrilho / Banca: Aline Theodoro Toci / Resumo: O nitrogênio está presente no organismo humano principalmente como constituinte das proteínas e ácidos nucleicos. O catabolismo dessas substâncias forma compostos nitrogenados conhecidos como não - proteicos. Dentre os vários compostos nitroge nados não - proteicos conhecidos, o ácido úrico e a creatinina podem ser utilizados como biomarcadores da função renal em humanos. A creatinina é proveniente da reação não enzimática de desidratação da creatina ou da desfosforilação da fosfocreatina durante o processo de contração muscular; sua concentração é utilizada como marcador clínico para avaliar a função renal. O ácido úrico é formado a partir do metabolismo das bases purínicas, por ser um composto pouco solúvel, sua deposição nas juntas das extremida des ou em outros tecidos moles gera o caso clínico conhecido como gota. Dessa forma, a creatinina e o ácido úrico são constantemente dosados em exames laboratoriais de urina. As metodologias utilizadas para a dosagem desses dois compostos vão desde os méto dos clássicos, até a utilização de HPLC, eletroforese e análise em fluxo, ou seja, técnicas pouco portáteis e algumas de alto custo. Assim, a proposta do trabalho é o desenvolvimento de dispositivos analíticos microfluídicos em papel (μPAD) para a determin ação de creatinina e ácido úrico. Foram selecionados os reagentes cromogênicos para os dois analitos em estudo. Sendo o ácido pícrico em meio alcalino o reagente cromogênico para a creatinina e o Fe 3+ e 1,10 - Fenantrolina para o ácido úrico. As condições ex perimentais das duas reações foram otimizadas utilizando o planejamento fatorial do tipo 2³ e o planejamento composto central. Foram otimizados os fatores concentrações dos reagentes e tempo de aquecimento. A curva de calibração para o ácido úrico foi repe titiva, com equação de reta igual a A = 0,01651 + 0,0003864 C AU, com... / Abstract: Nitrogen is present in human organism mainly as a nucleic acid and proteins constituent. The catabolism of these substances forms nitrogen compounds known as nonproteinaceous. Amon g the many nonproteinaceous nitrogen compounds, uric acid and creatinine can be used as biomarkers of renal function in humans. Creatinine is derived from a non - enzymatic reaction of creatine dehydretion or dephosphorylation of phosphocreatine in the muscl e contraction process; creatinine concentration is used as clinic marker to evaluate the renal function. Uric acid is formed from metabolism of purine bases and, by being a slightly soluble compound, its deposition in the joints of the extremities or other soft tissues creates a case known as gout. In this way, creatinine and uric acid are constantly dosed in urine laboratory exams. The methodologies used to determine these two compounds range from classic methods, to the used of HPLC, electrophoresis and i n flow analysis, in other words, slightly portable techniques and, some of them, very expensive. Thus, this work proposes the development of microfluidic paper - based analytical devices (μPAD) to determinate creatinine and uric acid. Chromogenic reagents we re selected for both analytes in study. Picric acid in alkaline medium was chose for creatinine determination and Fe 3+ and 1,10 - phenantroline were chose for uric acid. Experimental conditions were optimized for both reactions using 2 3 factorial design and a central composite design. The factores optimized were reagents concentration and time of heating. The analytical curve to uric acid were repetitive, with a line equation equal to A = 0,01651 + 0,00038764 C AU, with determination coefficient (R²) equal to 0,997, and limit of detection equal to 16,5 mg L - 1 and limit of quantification equal to 54,9 mg L - 1 . Of the interferents tested, only ascorbic acid was shown to be interfering the reaction and... / Mestre

Orientador: Mary Marcondes / Banca: Suely Regina Mogami Bomfim / Banca: Marcia Dalastra Laurentini / Resumo: O presente estudo teve por objetivos determinar a prevalência de hipertensão arterial sistêmica, bem como caracterizar, por meio de exames laboratoriais e de histopatologia, o tipo de lesão renal em cães naturalmente acometidos por leishmaniose visceral. Foram avaliados 68 cães divididos em dois grupos; G1 constituído por dez cães com síndrome urêmica, e G2 composto por 58 cães com valores séricos de creatinina e uréia dentro da normalidade ou apenas um pouco elevados, sem alterações significativas ao exame físico e ao exame de urina que pudessem caracterizar uma insuficiência renal. Verificou-se uma prevalência de 8,8% de hipertensão arterial sistêmica na população estudada, com 5/10 (50%) cães hipertensos no primeiro grupo e 1/58 (1,7%) no segundo. O estadiamento da doença renal nos animais hipertensos identificou 66,7% dos cães em estágio avançados a doença. Uma proteinúria, evidenciada por meio da P/C U, esteve presente em 77,94% dos cães. Foram observadas alterações glomerulares em 66/68 (97%), intersticiais em 48/68 (70,6%) e tubulares em 27/68 (39,7%) animais. A alteração glomerular mais frequente foi a glomerulonefritemembranoproliferativa, seguida de fibrose e glomerulonefrite membranosa. Dos seis cães em que se identificou hipertensão arterial sistêmica, quatro (66,7%) possuíam glomerulonefrite membranoproliferativa associada à fibrose glomerular em graus variados de lesão, um (16,7%) apresentava glomerulonefrite membranosa de grau intenso, e em outro animal verificou-se uma fibrose glomerular associada a glomerulonefrite proliferativa de grau leve / Abstract: The aim of the present study was to determe the prevalence of hypertension and to characterize, by means of laboratory tests and histopathology, kidney lesions in dogs naturally affected by visceral leishmaniasis. Sixty eight dogs were divided into two groups: G1 consisting of ten dogs with uremic syndrome, and G2 consisting of 58 dogs with normal or slightly elevated serum creatinine and urea, without significant changes on physical examination and on urinalysis that could characterize renal failure. There was a 8.8% prevalence of hypertension in the population, with 5/10 (50%) hypertensive dogs in the first group and 1/58 (1.7%) in the second. The staging of renal disease in hypertensive animals identified 66.7% of the dogs in an advanced stage of the disease. Proteinuria, evidenced by U P/C, was present in 77.94% of the dogs. Glomerular lesions were observed in 66/68 (97%), interstitial lesions in 48/68 (70.6%) and tubular lesions in 27/68 (39.7%) dogs. Membranoproliferative glomerulonephritis was the glomerular lesion most frequently observed, followed by fibrosis and membranous glomerulonephritis. Four out of six (66.7%) dogs with hypertension had membranoproliferative glomerulonephritis associated with glomerular fibrosis in varying degrees of injury, one (16.7%) had intense membranous glomerulonephritis, and in another (16.7%) dog we identified a glomerular fibrosis associated with a mild proliferative glomerulonephritis / Mestre

Il existe des interactions profondes entre les fonctions rénales et cardiaques. Un dysfonctionnement de l'un ou l'autre de ces deux organes entraîne un dysfonctionnement du second. Ces interactions entre coeur et rein sont regroupées sous le terme de syndromes cardio-rénaux. Les biomarqueurs sont, par définition des indicateurs objectivement mesurés d'un processus biologique normal, d'un processus pathologique ou d'une réponse pharmacologique à une intervention thérapeutique. Les marqueurs biologiques dont très utiles à l'exploration des phénomènes pathologiques cardiaques et rénaux. En pratique clinique, la fonction rénale est quotidiennement estimée à partir de biomarqueurs de filtration glomérulaire, la créatinine et la cystatine C en premier lieu. Dans l'exploration des fonctions cardiaques, des évolutions importantes ont eu lieu ces dernières années. Au niveau analytique, des améliorations significatives des performances ont abouti à la mise sur le marché de méthodes dites hypersensibles de mesure de la troponine. De plus de nouveaux marqueurs explorant de nouveaux aspects physiopathologiques de la dysfonction cardiaque sont également intensément étudiés, tels que les marqueurs de fibrose (ST2 soluble, galectine-3). Après une revue de la bibliographie des biomarqueurs rénaux et cardiaques, ce travail s'attache à l'étude de l'optimisation de l'usage des biomarqueurs rénaux et cardiaques, tout d'abord par la maîtrise des procédés analytiques puis dans l'utilisation de ceux-ci en pratique clinique.Dans une première partie consacrée aux marqueurs rénaux, nous cherchons à optimiser l'utilisation des marqueurs permettant d'estimer au mieux le débit de filtration glomérulaire, meilleur index connu de la fonction rénale. En pratique clinique, le débit de filtration glomérulaire est estimé à partir de la créatinine. Au niveau analytique, nous montrons dans ce travail que les méthodes colorimétriques, basées sur la réaction de Jaffé, devraient désormais être abandonnées au profit des méthode enzymatiques. Ces résultats sont illustrés dans différentes populations de patients, une cohortes issue des bases de données hoispitalières ainsi qu'une population de patients cirrhotiques. Chez ces derniers,la créatinine présente d'importantes limites en tant que marqueur de filtration glomérulaire, en particulier en raison d'une diminution de la masse musculaire. La cystatine C représente dans ce contexte une alternative intéressante puisque ce marqueur n'est pas dépendant de la masse musculaire. Des algorithmes utilisant la cystatine C, seule ou en association avec la créatinine ont récemment été proposés dans la litérrature.Dans une seconde partie, nous nous interressons aux marqueurs cardiaques. Les troponines cardiaques sont des protéines présentes au niveau de l'appareil contractile du cardiomyocyte, relarguées dans la circulation en cas de nécrose cellulaire. L'arrivée récente de méthodes capables de mesurer des concentrations circulantes dans une part importante de la population saine a obligé d'une part à un contrôle strict des procédés analytiques par les fabricant et d'autre part à une adaptation des cliniciens afin de tirer partie des nouvelles informations apportées par ces marqueurs dans différentes populations présentant des élévations chroniques (sujets âgés, insuffisants rénaux chroniques) ou aiguës (cinétiques post infarctus du myocarde). Enfin, une étude concernant le ST2 soluble, marqueur émergent de fibrose dans l'insuffisance cardiaque est également présentée.En conclusion, l'optimisation de l'usage des biomarqueurs s'oriente à l'heure actuelle vers des stratégies multimarqueurs, comme l'association créatinine et cystatine C dans l'estimation du débit de filtration glomérulaire ou le développement de scores pronostics associant troponine, peptides natriurétiques et ST2 soluble dans l'insuffisance cardiaque. / Profound interactions exist between cardiac and renal functions. Acute or chronic dysfunction of an organ may induce acute or chronic dysfunction of the other. These complex interactions have been grouped under the term cardiorenal syndrome.A Biomarker is defined as a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention. Biological markers are useful for the exploration of pathological renal and cardiac phenomenon. In clinical practice, renal function is estimated from glomerular filtration markers, mainly creatinine and cystatin C. Much progress has recently been made recently toward exploration of cardiac dysfunction. From an analytical point of vue, improvement in measurement of cardiac troponine led to the so-called hypersensitive cardiac troponin assays. Furthermore, new markers of cardiac dysfunction are under initensive inverstigation. These markers(soluble ST2, galectin-3) provide information regarding specific pathophysiological pathways, such as fibrosis.After a review of the litterature regarding cardiac and renal biomarkers, this work aims at optimize the interpretation of abovementioned biological markers.In the fist part, consacred to renal markers, this work tries to optimize the estimation of glomerular filtration rate, firstly regarding analytical process then in clinical practice. Glomerular filtration rate is in clincal practice derived from creatinine level. Analytically, our work indaicates that compensated Jaffe methods for the measurement of creatinine should be replaced with enzymatic ones, which are muche more performant. These conclusions have been drawn in different populations, from hospital databases and in cirrhotic patients. In this population , creatinine as a filtration marker suffers from important limitations, mainly beacause of the loss of muscle mass observed in these patients. Cystatin C is an alternative filtration marker whose level is independent of muscle mass. Some algorithms predicting glomerular filtration rate from cystatin C, sole or in association with creatinine have recently been proposed.The second part of this work is consacred to cardiac markers. Cardiac troponins , proteins which are part of the contractile apparatus, are released in the blood flow in case of necrosis. The recent improvement of analytical methods, enabling measurement of cardiac troponine levels in at leats 50% of a healthy reference population require a precise control of manufacturing process. Furthermore, hypersensitive troponins require from physician an exact interpretation in patients with chronic (elderly, chronic kidney disease patients) or acute (post myocardial infarction kinetics) elevation. A study regarding soluble ST2, a n emerging marker of cardiac fibrosis, is also presentedOptimization of the use of biomarkers move nowadays toward multimarkers strategies as illustrated by approaches combining cystatin C with creatinine for estimating glomerular filtration rate or the development of scores for predicting mortality risk in heart failure patients based on cardiac troponins, natriuretic peptides and soluble ST2.

No description available.

Thesis (M.Sc. (Physiology))--Mahidol University, 1978.

Made available in DSpace on 2014-06-11T19:23:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-03-05Bitstream added on 2014-06-13T19:09:01Z : No. of bitstreams: 1 braga_et_me_araca.pdf: 626001 bytes, checksum: 6e857013fc0dc12bd561b1176533abb8 (MD5) / O presente estudo teve por objetivos determinar a prevalência de hipertensão arterial sistêmica, bem como caracterizar, por meio de exames laboratoriais e de histopatologia, o tipo de lesão renal em cães naturalmente acometidos por leishmaniose visceral. Foram avaliados 68 cães divididos em dois grupos; G1 constituído por dez cães com síndrome urêmica, e G2 composto por 58 cães com valores séricos de creatinina e uréia dentro da normalidade ou apenas um pouco elevados, sem alterações significativas ao exame físico e ao exame de urina que pudessem caracterizar uma insuficiência renal. Verificou-se uma prevalência de 8,8% de hipertensão arterial sistêmica na população estudada, com 5/10 (50%) cães hipertensos no primeiro grupo e 1/58 (1,7%) no segundo. O estadiamento da doença renal nos animais hipertensos identificou 66,7% dos cães em estágio avançados a doença. Uma proteinúria, evidenciada por meio da P/C U, esteve presente em 77,94% dos cães. Foram observadas alterações glomerulares em 66/68 (97%), intersticiais em 48/68 (70,6%) e tubulares em 27/68 (39,7%) animais. A alteração glomerular mais frequente foi a glomerulonefritemembranoproliferativa, seguida de fibrose e glomerulonefrite membranosa. Dos seis cães em que se identificou hipertensão arterial sistêmica, quatro (66,7%) possuíam glomerulonefrite membranoproliferativa associada à fibrose glomerular em graus variados de lesão, um (16,7%) apresentava glomerulonefrite membranosa de grau intenso, e em outro animal verificou-se uma fibrose glomerular associada a glomerulonefrite proliferativa de grau leve / The aim of the present study was to determe the prevalence of hypertension and to characterize, by means of laboratory tests and histopathology, kidney lesions in dogs naturally affected by visceral leishmaniasis. Sixty eight dogs were divided into two groups: G1 consisting of ten dogs with uremic syndrome, and G2 consisting of 58 dogs with normal or slightly elevated serum creatinine and urea, without significant changes on physical examination and on urinalysis that could characterize renal failure. There was a 8.8% prevalence of hypertension in the population, with 5/10 (50%) hypertensive dogs in the first group and 1/58 (1.7%) in the second. The staging of renal disease in hypertensive animals identified 66.7% of the dogs in an advanced stage of the disease. Proteinuria, evidenced by U P/C, was present in 77.94% of the dogs. Glomerular lesions were observed in 66/68 (97%), interstitial lesions in 48/68 (70.6%) and tubular lesions in 27/68 (39.7%) dogs. Membranoproliferative glomerulonephritis was the glomerular lesion most frequently observed, followed by fibrosis and membranous glomerulonephritis. Four out of six (66.7%) dogs with hypertension had membranoproliferative glomerulonephritis associated with glomerular fibrosis in varying degrees of injury, one (16.7%) had intense membranous glomerulonephritis, and in another (16.7%) dog we identified a glomerular fibrosis associated with a mild proliferative glomerulonephritis

Class of 2015 Abstract / Objectives: To compare and evaluate effects on kidney function of mannitol dieresis versus saline diuresis on kidney function with cisplatin therapy. Methods: Patient charts documented between January 2010 and July 2013 were obtained and reviewed from a database of a university associated medical center. The patient’s lowest creatinine clearance (CrCl) and potassium levels during any time in therapy were compared against the baseline. Statistical testing for primary and secondary outcomes was calculated using the Independent-Samples T-Test. Results: A total of 140 patients were reviewed – 68 patients were included in the mannitol arm, 72 in the saline arm. All baseline characteristics reviewed were not statistically different between groups except for sex, which was skewed towards males in the saline arm of the study. Baseline CrCl was 97.14 ml/min in the mannitol arm, and 93.69 ml/min in the saline arm (p=0.91). The average change in CrCl was found to be -16.72 ml/min (95% CI, -21.85 to -11.59) in the mannitol arm, -14.00 ml/min (95% CI, -18.82 to -9.20) in the saline arm; this was not statistically different (p=0.41). There was an average change of -0.31 mmol/L in blood potassium levels in mannitol patients, and a change of 0.014 mmol/L in saline patients; this was found to be significantly different (p<0.01). Conclusions: In this single-center retrospective study, there appeared to be no benefit in using mannitol diuresis over saline diuresis. The use of mannitol incurs additional cost and place additional restrictions on administration.