• Clinical and Experimental Pediatrics
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• v.63 no.4
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• pp.151-156
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• 2020

Background: Acute kidney injury (AKI) is one of the most significant postoperative complications of pediatric cardiac surgery. Because serum creatinine has limitations as a diagnostic marker of AKI, new biomarkers including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are being evaluated to overcome these limitations and detect AKI at an early stage after cardiac surgery. Purpose: This study aimed to investigate the clinical usefulness of these biomarkers in young children. Methods: Thirty patients with congenital heart diseases who underwent cardiac surgery using cardiopulmonary bypass (CPB) were selected, and their urine and blood samples were collected at baseline and 6, 24, and 48 hours after surgery. Serum creatinine and blood urea nitrogen levels as well as NGAL, KIM-1, and IL-18 levels in urine samples were measured, and clinical parameters were evaluated. Results: Of the 30 patients, 12 developed AKI within 48 hours after cardiac surgery. In the AKI group, 8 of 12 (66.6%) met AKI criteria after 24 hours, and urine KIM-1/creatinine (Cr) level (with adjustment of urine creatinine) peaked at 24 hours with significant difference from baseline level. Additionally, urine KIM-1/Cr level in the AKI group was significantly higher than in the non-AKI group at 6 hours. However, urine NGAL/Cr and IL-18/Cr levels showed no specific trend with time for 48 hours after cardiac surgery. Conclusion: It is suggested that urine KIM-1/Cr concentration could be considered a good biomarker for early AKI prediction after open cardiac surgery using CPB in young children with congenital heart diseases.

• Biomolecules & Therapeutics
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• v.8 no.3
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• pp.241-247
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• 2000

The present study was designed to assess the protective effect of a selective thromboxane $A_2$ receptor antagonist, KT2-962 (KT2) and possible mechanisms of adriamycin(AD)-induced nephrotoxicity in rats. The male Wistar rats were given either of AD (7.5 mg/kg, i.v.) alone in the AD-group (n=5) or in KT2+AD- group (n=5) which is a combination of AD and KT2 (30 mg/kg/day, i.p.) for 10 days from 3 days before and 7 days after AD injection. The body weight, 24-hours urine volume, urine protein and urinary N-acetyl-$\beta$-D-glu-cosaminidase (NAG) activity were measured with an interval of 2 days during 1 week. BUN, serum creatinine and creatinine clearance were measured on the 7th day. KT2 has significantly suppressed AD-induced change of body weight, 24-hours urine volume, urine protein and urinary NAG activity in the KT2+AD-group. The change of BUN, serum creatinine and creatinine clearance were significantly inhibited in the B7T2+AD-group. Based on these results, it is concluded that KT2 prevents AD-induced nephrotoxicity and suggests that endogenous thromboxane A2 may play an important role in AD-induced nephrotoxicity in rats.

• Clinical and Experimental Pediatrics
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• v.53 no.9
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• pp.840-844
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• 2010

Purpose: Microalbuminuria is defined as increased urinary albumin excretion (30-300 mg/day) or microalbumin/creatinine ratio (30-300 mg/g) in a spot urine sample. Although microalbuminuria is a predictor of clinical nephropathy and cardiomyopathy, few studies have investigated microalbuminuria in children with urinary tract infection (UTI). Therefore, we compared the spot urine microalbumin/creatinine ratio in pediatric UTI patients with that of control subjects. Methods: We investigated the correlation between the ratio in children with UTI and age, height, weight, blood pressure, glomerular filtration rate (GFR), hematuria, vesicoureteral reflux, renal parenchymal defect, and renal scar, and its predictability for UTI complications. Results: We studied 66 patients (42 boys, 24 girls) and 52 healthy children (24 boys, 28 girls). The mean microalbumin/creatinine ratio in UTI patients was statistically significantly increased compared to the control group ($340.04{\pm}321.36mg/g$ vs. $225.68{\pm}154.61mg/g$, $P$=0.0141). The mean value of spot urine microalbumin/creatinine ratio ($384.70{\pm}342.22mg/g$ vs. $264.92{\pm}158.13mg/g$, $P$=0.0341) in 1-23 months age patient group showed statistically significant increase compared to control group. Microalbumin/creatinine ratio showed negative correlation to age (r=-0.29, $P$=0.0167), body surface area (BSA) (r=-0.29, $P$=0.0173) and GFR (r=-0.26, $P$=0.0343). The presence of hematuria ($P$=0.0169) was found to be correlated. Conclusion: The spot urine microalbumin/creatinine ratio in children with UTI was significantly greater than that in normal children, and it was positively correlated with GFR. This ratio is a potential prescreening and prognostic marker in UTI patients. Further studies are required to validate the predictability of microalbuminuria in pediatric UTI patients.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.775-780
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• 2012

8-isoprostane (8-$isoPGF_{2{\alpha}}$) is a reliable marker and considered a gold standard for lipid peroxidation. There are very few reports of 8-isoprostane levels in cancer patients, and in patients undergoing chemotherapy. Oxidative stress is however expected and has been observed in patients with cancer. This study measured 8-isoprostane levels in urine by ELISA of 25 patients undergoing chemotherapy for advanced non-small cell lung cancer, at cycles 1, 2, and 3 of treatment. It considers the creatinine clearance of the patients, and correction of 8-isoprostane levels by creatinine clearance, and overnight urine volume methods. The average 8-isoprostane levels in urine increased more than 6 to 12 fold on chemotherapy treatment, from $532{\pm}587$ pg/mL at cycle $1,6181{\pm}4334$ at cycle 2, and $5511{\pm}2055$ at cycle 3. Similar results were obtained if 8-isoprostane levels were corrected for overnight urine volume, giving averages of $285{\pm}244{\mu}g$ at cycle $1,4122{\pm}3349$ at cycle 2, and $3266{\pm}1200$ at cycle 3. No significant difference was seen in average total overnight urine volume or number of urinations between chemotherapy cycles except for a large variation in urine volume between cycle 2 and 3. Creatinine levels were significantly different only between cycles 1 and 2 (p=0.016). In conclusion, cisplatin therapy has been shown to induce high levels of lipid peroxidation in lung cancer patients and can be assessed from the 8-isoprostane marker in overnight urine, with or without urine volume correction.

• Journal of the Korean Chemical Society
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• v.61 no.2
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• pp.51-56
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• 2017

N-nitrosamines are the nitroso compounds which are produced by nitrosation reactions of the secondary amine and nitrite under acidic conditions. Approximately 300 species of N-nitrosamine have been tested for carcinogenicity in laboratory experiments, with 90% of them demonstrated carcinogenic effects different animal species, including higher primates. In 1978, IARC classified NDMA and NDEA as Group 2A, and NDPA, NDBA, NPIP, NPYR and NMOR as Group 2B. In this study, we established pretreatment and analytical method for N-nitrosamines (NDMA, NDEA, NMEA, NDPA, NDBA, NPIP, NPYR and NMOR) in human urine for biological monitoring of N-nitrosamines. The analytes were extracted using solid phase extraction (SPE), then quantitative analysis was performed by LC-(APCI)-MS/MS. The accuracies of the established method were between 85.8~108.7% and precisions were lower than 20%. The limit of detection (LOD) were between 0.0002 (NDBA) and 0.0793 (NDMA) ng/ml. The linearity obtained was satisfying for the 8 N-nitrosamines, with a coefficient of determination ($r^2$) higher than 0.999. The mean concentrations of N-nitrosamines in the urine were 2.645 mg/g creatinine for NDMA, 0.067 mg/g creatinine for NDEA, 0.009 mg/g creatinine for NMEA, 0.011 mg/g creatinine for NDBA, 0.271 mg/g creatinine for NPIP and 0.413 mg/g creatinine for NPYR. NDPA and NMOR were not detected. It can be used as a instrumental methodology for evaluation and risk assessment of human exposure to N-nitrosamines for the further research.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.407-410
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• 2015

Background: Acute kidney injury is an important issue in chemotherapy receiving patients an neutrophil gelatinase-associated lipocalin has been proposed as a novel marker. We here aimed to assess the role of urinary levels for assessment after platin exposure. Materials and Methods: Patients who had treated with cisplatin or carboplatin or oxaliplatin containg regimens were included in this study. Baseline and postchemotherapy serum urea, creatinine, urine neutrophil gelatinase-associated lipocalin and urine creatinine levels were determined. To avoid the effects of hydration during chemotherapy infusion the urinary neutrophil gelatinase-associated lipocalin/urine creatinine ratio was used to determine acute kidney injury. Results: Of a total of 42 patients receiving platin compounds,14 (33.3%) received cisplatin containing regimens, 14 (33.3%) received carboplatin and 14 (33.3%) oxaliplatin. The median age was 60 (37-76) years. Nineteen of the patients (45.2%) had lung cancer, 12 (28.6%) colorectal cancer and 11 (26.2%) others. The median pre and post chemotherapy urine neutrophil gelatinase-associated lipocalin/urine creatinin ratio was 15.6 ng/mg and 35.8 ng/mg (p=0.041) in the cisplatin group, 32.5 ng/mg and 86.3 ng/mg (p=0.004) in the carboplatin group and 40.9 ng/mg and 62.3 ng/mg (p=0.243) in the oxaliplatin group. Conclusions: Nephrotoxicity is a serious side effect of chemotherapeutic agentslike cisplatin and carbopaltin, but only to a lower extent oxaliplatin. All platin compounds must be used carefully and urine neutrophil gelatinase-associated lipocalin measurement seems to be promising in detecting acute kidney injury earlier than with creatinine.

• Journal of Preventive Medicine and Public Health
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• v.13 no.1
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• pp.27-34
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• 1980

Purpose of this study is to find out proper means of estimating the urinary mercury excretion in the normal individuals. Whole void volume was collected every 2 hours beginning from 6 o'clock in the morning until 6 o'clock next morning. Mercury excretion in each urine specimen was measured by NIOSH recommended dithizone colorimetric method (Method No.: P & CAM 145). Urinary concentration of mercury was adjusted by two means: specific gravity of 1.024 and a gram of creatinine excretion per liter of urine comparing the data with the unadjusted ones. Mercury excretion in 24-hour urine specimen was calculated by adding the amounts measured with the hourly collected specimens of each individual. Statistical analysis of the urinary mercury excretion revealed the following results: 1. Frequency distribution curve of mercury excreted in urine of hourly specimens was best fitted to power function expressed in the form of $y=ax^b$. Adjustment of the urinary mercury concentration by creatinine excretion was shown to be superior($y=1674x^{-1.52},\;r^2=0.95$) over nonadjustment($y=2702x^{-1.57},\;r^2=0.92$) and adjustment by specific gravity of 1.024($y=4535x^{-1.66},\;r^2=0.93$). 2. Both log-transformed mercury excretion in hourly voided specimens and mercury excretion itself in 24 hour specimens showed the normal distributions. 3. The frequency distribution of mercury adjusting the urinary concentration of mercury by creatinine excretion was best fitted to a theoretical normal distribution with the sample means and standard deviation than those unadjusted or adjusted with specific gravity of 1.024. 4. Average urinary mercury excretions in 24-hour urine specimen in an individual were as follows: a) Unadjusted mercury excretion mean and standard deviation : $$18.6{\pm}13.68{\mu}gHg/l$$. median : $$16.0\;{\mu}gHg/l$$. range : $$0.0-55.10\;{\mu}gHg/l$$. b) Adjusted with specific gravity mean : $$20.7{\pm}11.76\;{\mu}gHg/l{\times}\frac{0.024}{S.G-1.000}$$ median : $$20.7\;{\mu}gHg/l{\times}\frac{0.024}{S.G-1.000}$$ range : $$0.0-52.9\;{\mu}gHg/l{\times}\frac{0.024}{S.G-1.000}$$ c) Adjusted with creatinine excretion mean and standard deviation : $$10.5{\pm}6.98\;{\mu}gHg/g$$ creatinine/l median : $$9.4\;{\mu}gHg/g$$ creatinine/l range : $$0.0-26.7\;{\mu}gHg/g$$ creatinine/l 5. No statistically significant differences were found between means calculated from 24-hour urine specimens and those from hourly specimens transformed into logarithmic values. (P<0.05).

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.06a
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• pp.286-288
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• 2005

This study was conducted to compare the fluoride concentrations in urine of preschool children aged 3${\sim}$6 years between residing in community water fluoridation area(Kwangju City) and non-fluoridation area(Sungnam City). The acid-diffusible fluoride in the urine and drinking water was isolated by the acid-diffusion technique and measured with a fluoride electrode. The mean daily fluoride excretion to urine of children residing in Kwangju and Sungnam were $1.27{\pm}0.75mgF^-$/g creatinine and $0.87{\pm}47 mgF^-$/g creatinine, respectively. It is concluded from this investigation that the $F^-$concentration in urine sample of kindergarten and drinking water of children living in Kwanju(fluoridated areas) were significantly higher than that of children living in Sungnam(non-fluoridated areas).

• Journal of the East Asian Society of Dietary Life
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• v.15 no.2
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• pp.165-170
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• 2005

The present study was aimed to investigate whether ethanol-extract of Nelumbo nucifera has an ameliorative effect on the renal function in high fructose-diet induced hypertensive rats. The urine osmolality (Uosmel) was decreased in rats with high fructose-diet ($60\%$) during the whole experiment period without change of the urine volume (UV). The urinary excretion of sodium and chloride were decrease significantly in rats with fructose induced hypertensive rats, wheras urinary excretion of potassium was increased. The creatinine clearance (CCr) and solute-free water reabsorption were also decreased by treatment of fructose rich diet. Among these renal functional parameters, CCr was partially restored by the administration of ethanol-extract of Nelumbo nucifera. The Uosmol was also partially restored by the administration ethanol-extract of Nelumbo nucifera at the end of the experimental period. Taken together, ethanol-extract of Nelumbo nucifera has the ameliorative effect on glomerular filtration rate in rats with high fructose-diet induced hypertension.

• Childhood Kidney Diseases
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• v.12 no.2
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• pp.150-156
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• 2008

Purpose : Many results have reported a correlation between the spot urine protein/creatinine ratio(P/C ratio) and 24-hour urinary protein(24UP) amount. This study was designed to evaluated correlation between 24UP amounts and P/C ratio in children and to find the factors that affect this correlation. Methods : 210 patients who visited the Department of Pediatrics in Busan Paik Hospital from september 2003 to december 2007 were included in this study. All the patients were divided into I, II, III/A, B, C group[I:24UP(mg/$m^2$/day)]<100, II: 100$\leq$24UP<1,000, III: 24UP$\geq$1,000, A: Cr excretion(mg/kg)<15, B: 15$\leq$Cr excretion<25, C: Cr excretion$\geq$25)]. Pearson correlation analysis was performed between 24UP and P/C ratio to evaluate the relationship. We defined fractional difference between 24UP and P/C ratio, and then performed multiple regression analysis. Results : There was a strong positive linear correlation between 24UP and P/C ratio in all patients, and the correlation was also good in each group. The factors affecting accurate quantitation of proteinuria using spot urine P/C ratio was creatinine excretion. Conclusion : Spot urine P/C ratio is a useful test to predict proteinuria roughly. Therefore, we expect that urine P/C ratio can be used as parameter instead of 24UP, if we set cutoff value of P/C ratio considered to creatinine excretion according to age and sex in large pediatric population.