• Clinical and Experimental Pediatrics
• /
• 제63권4호
• /
• pp.151-156
• /
• 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
• /
• 제8권3호
• /
• pp.241-247
• /
• 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
• /
• 제53권9호
• /
• pp.840-844
• /
• 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
• /
• 제13권3호
• /
• pp.775-780
• /
• 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.

• 대한화학회지
• /
• 제61권2호
• /
• pp.51-56
• /
• 2017

N-니트로사민은 이차 아민과 아질산이 산성조건 하에서 니트로소화 반응을 통해 생성되는 니트로소 화합물이다. 약 300여종이 존재하며, 그 중 90%가 동물실험을 통해 발암성이 있음이 확인되었다. 1987년 IARC에서 NDMA와 NDEA를 Group 2A로 지정하였고, NDPA, NDBA, NPYR, NPIP, NMOR을 Group 2B로 지정하였다. 본 연구에서는 N-니트로사민류의 생물학적 모니터링을 위하여 소변 중 N-니트로사민류의 분석법을 확립하였다. 소변시료는 고체상추출(Solid phase extraction, SPE)을 통하여 전처리 한 후, LC-(APCI)-MS/MS를 이용하여 정량분석 하였다. 확립된 분석법의 정확도는 85.8~110.2% 이었고, 정밀도는 1.1~10.5%로 나타났다. 검출한계는 0.0002 (NDBA) ~ 0.0793 (NDMA) ng/ml 이었고, 검량선 회귀식의 상관계수($r^2$)은 0.999 이상으로 우수한 직선성을 보여주었다. 실제 소변 중 N-니트로사민류의 평균 농도는 NDMA 2.645 mg/g creatinine, NDEA 0.067 mg/g creatinine, NMEA 0.009 mg/g creatinine, NDBA 0.011 mg/g creatinine, NPIP 0.271 mg/g creatinine, NPYR 0.413 mg/g creatinine 이고, NDPA와 NMOR은 검출되지 않았다. 추후 N-니트로사민류의 인체 노출량 평가 및 위해평가를 위한 기기분석방법으로 활용될 수 있을 것으로 판단된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권2호
• /
• pp.407-410
• /
• 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
• /
• 제13권1호
• /
• pp.27-34
• /
• 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).

• 한국환경보건학회:학술대회논문집
• /
• 한국환경보건학회 2005년도 국제학술대회
• /
• pp.286-288
• /
• 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).

• 동아시아식생활학회지
• /
• 제15권2호
• /
• pp.165-170
• /
• 2005

연근의 에탄올 추출물이 과당 유도 고혈압 백서의 신장 기능에 미치는 영향을 관찰하고자 뇨량과 전해질 배설량, 혈장의 creatinine, creatinine 청소율, 자유-수분 재흡수량 등을 측정하였다. 그 결과 연근은 과당 유도 고혈압 백서에서 나타나는 전해질 배설량의 변화를 개선시키는 효과는 없는 것으로 나타났고 단지 삼투질 농도의 배설량에만 약간의 개선 효과를 보였다. 신장의 가장 중요한 기능중 하나는 여과 기능이고 이를 나타내는 지표는 사구체 여과율인데, 고혈압 백서에서 혈장내 creatinine 농도가 증가하였고, creatinie 청소율이 크게 억제되었으나 연근추출물 투여 후 사구체 여과율의 감소가 회복되었다. 그러므로 연근은 과당으로 유도된 고혈압 흰쥐의 사구체 여과율을 개선시키는 것으로 사료된다.

• Childhood Kidney Diseases
• /
• 제12권2호
• /
• pp.150-156
• /
• 2008

목 적 : 단회뇨를 이용한 단백/크레아티닌 농도 비(P/C ratio)가 24시간 요단백량과 밀접한 상관관계가 있다는 연구결과가 보고되고 있다. 이에 저자들은 소아를 대상으로 하여 24시간 요단백량과 단회뇨의 P/C ratio 사이의 상관관계를 요단백량과 요크레아티닌 배설량에 따라 분석하고 이런 상관관계에 영향을 미치는 요인들에 대하여 알아보고자 하였다.방 법 : 2003년 9월부터 2007년 12월까지 부산 백병원 소아청소년과 신장클리닉에 내원한 환아 210명을 대상으로 24시간 채뇨를 실시하여 단백량 과 크레아티닌 양, 사구체 여과율을 측정하였고, 24시간 채뇨 직후의 단회뇨를 이용하여 P/C ratio 를 측정하였다. 결 과 : 24시간 요단백량과 단회뇨의 P/C ratio는 전체 환자를 대상으로 하였을 때 0.840의 상관계수를 가지는 유의한 양의 상관관계를 보였으며, 24시간 요단백량에 따라 분류된 군과 크레아티닌 배설량에 따라 분류한 각 군에서 모두 유의한 상관관계를 보였다. 24시간 요단백량과 단회뇨의 P/C ratio 사이의 오차에 관여할 수 있는 일일 요단백량, 사구체 여과율, 크레아티닌 배설량, 연령, 성별 등에 대해 다중회귀분석을 실시하였고 요 크레아티닌 배설량만이 통계적으로 유의한 인자로 분석 되었고, 나머지 일일 단백량, 사구체 여과율, 연령, 성별들은 유의하지 않았다. 결 론 : 소아에서 광범위한 조사군을 대상으로 하여 연령이나 성별에 따른 크레아티닌 배설량을 고려하여 P/C ratio의 cutoff치를 설정한다면 단회뇨의 P/C ratio는 24시간 요단백량을 대치할 수 있는 방법으로 사용될 수 있을 것으로 생각한다.