ObjectiveThe aim of the study was to determine whether serum neutrophil gelatinase-associated lip... more ObjectiveThe aim of the study was to determine whether serum neutrophil gelatinase-associated lipocalin (NGAL) can be a possible marker of steroid sensitivity in childhood nephrotic syndrome (NS). Patients and methodsForty patients between the ages of 1 and 18 years of both sexes, diagnosed with idiopathic NS, were enrolled in this study, along with 20 age-matched and sex-matched healthy controls. They were attending the Nephrology Clinic, Abu El Rish Hospital, Cairo University. Patients were categorized into the following subgroups: (a) those with steroid-sensitive nephrotic syndrome (n=13); (b) those with steroid-dependence nephrotic syndrome (n=19); and (c) those with steroid-resistant nephrotic syndrome (n=8). The demographic and clinical data were recorded for all participants. A blood sample was taken from each participant to measure serum NGAL (using sandwich enzyme immunoassay). Serum albumin, serum cholesterol, blood urea nitrogen, and serum creatinine were measured using colorimetric techniques. Renal biopsy was performed on 15 patients. ResultsThe mean serum NGAL level was significantly (P<0.001) higher in steroid-resistant nephrotic syndrome (40.2 ng/ml) than in steroid-dependence nephrotic syndrome patients (29.6 ng/ml), steroid-sensitive nephrotic syndrome patients (16.6 ng/ml), and healthy controls (13.6 ng/ml). NGAL levels demonstrated a significant positive correlation with serum creatinine. ConclusionSerum NGAL may be used as a marker for steroid resistance in NS in children. In addition, NGAL levels correlate with the severity of renal impairment, probably expressing the degree of active renal damage.
Introduction Cardiovascular disease has increased as a complication of chronic kidney disease eve... more Introduction Cardiovascular disease has increased as a complication of chronic kidney disease even in the absence of diabetes or hypertension. Angiopoietin-1 and 2 are 55 kDa antagonistic nonredundant gatekeepers of endothelial activation and thus are potential important factors in accelerated atherosclerosis. Aim of the study The aim of the study was to determine angiopoietin-2 level in patients on hemodialysis (stage 5) and in the predialytic stages (stages 3 and 4) and to find the relationship between angiopoietin-2 levels and glomerular filtration rate in the predialytic stages. Patient and methods We prospectively studied 75 patients divided into three groups and 12 healthy controls. Group 1 included 33 patients on maintenance hemodialysis three times a week; group 2 included 21 patients with stage 3 chronic kidney disease; and group 3 included 21 patients with stage 4 chronic kidney disease. Results We found highly significant ( P P r - 0.858, P r - 0.825, P r - 0.438, P r − 0.468, P r − 0.503, P r 0.456, P < 0.05) in group 3. Conclusion Circulating angiopoietin-2 is a putative marker and potential mediator of atherosclerosis, is inversely related to glomerular filtration rate, and is increased with advanced chronic kidney disease. Normolipidemia in chronic kidney disease patients does not prevent atherosclerotic burden; this is because of the presence of other markers such as angiopoietin-2.
Background: Fetuin-A is a liver-derived plasma protein, mediates the formation and stabilization ... more Background: Fetuin-A is a liver-derived plasma protein, mediates the formation and stabilization of calciprotein particles formation, ensures mineral solubilization, thus preventing pathological calcification, also it promotes insulin resistance. Objective: To study the role of fetuin A as a marker for early diabetic nephropathy in type 2 diabetes mellitus. Subjects and Methods: Cross sectional study including 30 diabetic patients without microalbuminuria (group I), 30 diabetic patients with microalbuminuria (Group II) and age and sex matched 30 healthy subjects served as a control group. All patients and control subjects were thoroughly examined clinically. Fasting and post prandial blood sugar, HbA1c, renal function tests, lipid profile, creatinine clearance, albumin/creatinine ratio and serum fetuin A by ELISA were investigated. Results: Serum Fetuin A increased in diabetic nephropathy patients without microabuminuria compared to those with microabuminuria. Significant negative c...
ObjectiveThe aim of the study was to investigate the relationship between serum E-selectin (as a ... more ObjectiveThe aim of the study was to investigate the relationship between serum E-selectin (as a marker of endothelial activation) and vascular complications in children and adolescents with type 1 diabetes mellitus (T1DM). Participants and methodsThis was a case–control study including 30 children with T1DM (with mean age 10.8 years, disease duration 7.4 years) and 30 matched healthy controls. Serum E-selectin, glycosylated Hb (HbA1c), total cholesterol, and triglycerides (TG) were determined. Blood pressure and anthropometric parameters were also measured. ResultsLevels of serum E-selectin, cholesterol, and TG in patients were significantly higher than in controls; these levels were also higher in metabolically poorly controlled and albuminuric T1DM patients compared with metabolically well-controlled and nonalbuminuric T1DM patients. There was a positive correlation between serum E-selectin and HbA1c (r=0.9, P<0.001), diastolic blood pressure (DBP) Z-score (r=0.5, P<0.01), cholesterol (r=0.7, P<0.001), TG (r=0.6, P<0.001), and duration of diabetes (r=0.4, P<0.03). After adjustment for age, HbA1C, serum cholesterol, serum TG, BMI Z-score, systolic blood pressure Z-score, DBP Z-score, and duration of diabetes, the strongest significant associations were shown between serum E-selectin and glycosylated Hb (HbA1c). ConclusionWe conclude that elevated biological markers of endothelial cell activation, such as serum E-selectin, may be related to vascular complications of DM, such as diastolic hypertension and microalbuminuria, in children with type 1 diabetes.
Arterial stiffness was reported with corona virus disease 2019 (COVID-19). We studied atheroscler... more Arterial stiffness was reported with corona virus disease 2019 (COVID-19). We studied atherosclerosis in COVID-19 directly through duplex ultrasound measurements and their relation to co-morbidities, clinical and laboratory severity markers, and serum interleukin (IL) 6 and 17. Serum IL 6 and 17, average carotid intima-media thickness (cIMT), diameter and peak systolic velocities (PSV) of tibial, ulnar, radial arteries, and ankle brachial index (ABI) were measured in 44 COVID-19 patients and 44 healthy controls. Serum IL6, IL17, PSV, and cIMT were higher while diameter was lower ( P ≤ .01) in cases. Clinical severity index correlated positively with age, co-morbidities, ferritin, IL6, IL17, cIMT, and PSV ( P ≤ .04) and negatively with diameter and ABI ( P = .04). Patients with severe lymphopenia had higher PSV, IL6, and IL17 and lower diameter ( P < .00001). Ferritin positively correlated with PSV and negatively with diameter and ABI ( P ≤ .01). Those who received an IL6 inhibito...
ObjectiveThe aim of the study was to determine whether serum neutrophil gelatinase-associated lip... more ObjectiveThe aim of the study was to determine whether serum neutrophil gelatinase-associated lipocalin (NGAL) can be a possible marker of steroid sensitivity in childhood nephrotic syndrome (NS). Patients and methodsForty patients between the ages of 1 and 18 years of both sexes, diagnosed with idiopathic NS, were enrolled in this study, along with 20 age-matched and sex-matched healthy controls. They were attending the Nephrology Clinic, Abu El Rish Hospital, Cairo University. Patients were categorized into the following subgroups: (a) those with steroid-sensitive nephrotic syndrome (n=13); (b) those with steroid-dependence nephrotic syndrome (n=19); and (c) those with steroid-resistant nephrotic syndrome (n=8). The demographic and clinical data were recorded for all participants. A blood sample was taken from each participant to measure serum NGAL (using sandwich enzyme immunoassay). Serum albumin, serum cholesterol, blood urea nitrogen, and serum creatinine were measured using colorimetric techniques. Renal biopsy was performed on 15 patients. ResultsThe mean serum NGAL level was significantly (P<0.001) higher in steroid-resistant nephrotic syndrome (40.2 ng/ml) than in steroid-dependence nephrotic syndrome patients (29.6 ng/ml), steroid-sensitive nephrotic syndrome patients (16.6 ng/ml), and healthy controls (13.6 ng/ml). NGAL levels demonstrated a significant positive correlation with serum creatinine. ConclusionSerum NGAL may be used as a marker for steroid resistance in NS in children. In addition, NGAL levels correlate with the severity of renal impairment, probably expressing the degree of active renal damage.
Introduction Cardiovascular disease has increased as a complication of chronic kidney disease eve... more Introduction Cardiovascular disease has increased as a complication of chronic kidney disease even in the absence of diabetes or hypertension. Angiopoietin-1 and 2 are 55 kDa antagonistic nonredundant gatekeepers of endothelial activation and thus are potential important factors in accelerated atherosclerosis. Aim of the study The aim of the study was to determine angiopoietin-2 level in patients on hemodialysis (stage 5) and in the predialytic stages (stages 3 and 4) and to find the relationship between angiopoietin-2 levels and glomerular filtration rate in the predialytic stages. Patient and methods We prospectively studied 75 patients divided into three groups and 12 healthy controls. Group 1 included 33 patients on maintenance hemodialysis three times a week; group 2 included 21 patients with stage 3 chronic kidney disease; and group 3 included 21 patients with stage 4 chronic kidney disease. Results We found highly significant ( P P r - 0.858, P r - 0.825, P r - 0.438, P r − 0.468, P r − 0.503, P r 0.456, P < 0.05) in group 3. Conclusion Circulating angiopoietin-2 is a putative marker and potential mediator of atherosclerosis, is inversely related to glomerular filtration rate, and is increased with advanced chronic kidney disease. Normolipidemia in chronic kidney disease patients does not prevent atherosclerotic burden; this is because of the presence of other markers such as angiopoietin-2.
Background: Fetuin-A is a liver-derived plasma protein, mediates the formation and stabilization ... more Background: Fetuin-A is a liver-derived plasma protein, mediates the formation and stabilization of calciprotein particles formation, ensures mineral solubilization, thus preventing pathological calcification, also it promotes insulin resistance. Objective: To study the role of fetuin A as a marker for early diabetic nephropathy in type 2 diabetes mellitus. Subjects and Methods: Cross sectional study including 30 diabetic patients without microalbuminuria (group I), 30 diabetic patients with microalbuminuria (Group II) and age and sex matched 30 healthy subjects served as a control group. All patients and control subjects were thoroughly examined clinically. Fasting and post prandial blood sugar, HbA1c, renal function tests, lipid profile, creatinine clearance, albumin/creatinine ratio and serum fetuin A by ELISA were investigated. Results: Serum Fetuin A increased in diabetic nephropathy patients without microabuminuria compared to those with microabuminuria. Significant negative c...
ObjectiveThe aim of the study was to investigate the relationship between serum E-selectin (as a ... more ObjectiveThe aim of the study was to investigate the relationship between serum E-selectin (as a marker of endothelial activation) and vascular complications in children and adolescents with type 1 diabetes mellitus (T1DM). Participants and methodsThis was a case–control study including 30 children with T1DM (with mean age 10.8 years, disease duration 7.4 years) and 30 matched healthy controls. Serum E-selectin, glycosylated Hb (HbA1c), total cholesterol, and triglycerides (TG) were determined. Blood pressure and anthropometric parameters were also measured. ResultsLevels of serum E-selectin, cholesterol, and TG in patients were significantly higher than in controls; these levels were also higher in metabolically poorly controlled and albuminuric T1DM patients compared with metabolically well-controlled and nonalbuminuric T1DM patients. There was a positive correlation between serum E-selectin and HbA1c (r=0.9, P<0.001), diastolic blood pressure (DBP) Z-score (r=0.5, P<0.01), cholesterol (r=0.7, P<0.001), TG (r=0.6, P<0.001), and duration of diabetes (r=0.4, P<0.03). After adjustment for age, HbA1C, serum cholesterol, serum TG, BMI Z-score, systolic blood pressure Z-score, DBP Z-score, and duration of diabetes, the strongest significant associations were shown between serum E-selectin and glycosylated Hb (HbA1c). ConclusionWe conclude that elevated biological markers of endothelial cell activation, such as serum E-selectin, may be related to vascular complications of DM, such as diastolic hypertension and microalbuminuria, in children with type 1 diabetes.
Arterial stiffness was reported with corona virus disease 2019 (COVID-19). We studied atheroscler... more Arterial stiffness was reported with corona virus disease 2019 (COVID-19). We studied atherosclerosis in COVID-19 directly through duplex ultrasound measurements and their relation to co-morbidities, clinical and laboratory severity markers, and serum interleukin (IL) 6 and 17. Serum IL 6 and 17, average carotid intima-media thickness (cIMT), diameter and peak systolic velocities (PSV) of tibial, ulnar, radial arteries, and ankle brachial index (ABI) were measured in 44 COVID-19 patients and 44 healthy controls. Serum IL6, IL17, PSV, and cIMT were higher while diameter was lower ( P ≤ .01) in cases. Clinical severity index correlated positively with age, co-morbidities, ferritin, IL6, IL17, cIMT, and PSV ( P ≤ .04) and negatively with diameter and ABI ( P = .04). Patients with severe lymphopenia had higher PSV, IL6, and IL17 and lower diameter ( P < .00001). Ferritin positively correlated with PSV and negatively with diameter and ABI ( P ≤ .01). Those who received an IL6 inhibito...
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