Evaluation of GFR Estimating Equations in the General Community

Clark, William F.; Macnab, Jennifer; Chen, Salina J.; Suri, Rita S.; Moist, Louise; Garg, Amit X.

doi:10.2215/cjn.00140106

Cited by 12 publications

(7 citation statements)

References 31 publications

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“…The confounder between eGFR and specific gravity is that those with higher eGFRs (i.e., better kidney function) would be expected to concentrate their urine to a higher specific gravity after 8 hours of fasting. This interpretation is consistent with the fact that the quartile with the highest specific gravity consists of those who are significantly younger, as noted in Table 1 of their study; in particular, age is associated with progressive decline in kidney function [2]. Additionally, they noted higher eGFR is negatively associated with diabetes mellitus and proteinuria, which agrees with the well-known associated risk of lower eGFR due to decreased kidney function, as noted in Table 2 of their study [2].…”

supporting

confidence: 87%

“…This interpretation is consistent with the fact that the quartile with the highest specific gravity consists of those who are significantly younger, as noted in Table 1 of their study; in particular, age is associated with progressive decline in kidney function [2]. Additionally, they noted higher eGFR is negatively associated with diabetes mellitus and proteinuria, which agrees with the well-known associated risk of lower eGFR due to decreased kidney function, as noted in Table 2 of their study [2]. However, in defense of their hypothesis, they note a highly significant correlation between eGFR and SGU after multivariate adjustment in their study, which is one of the largest observational studies of postulated sub-morbid dehydration associated hyperfiltration.…”

supporting

confidence: 87%

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Is high fluid intake good for the kidney?

Clark

2019

Kidney Res Clin Pract.

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supporting

confidence: 87%

supporting

confidence: 87%

Is high fluid intake good for the kidney?

Clark

2019

Kidney Res Clin Pract.

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“…Under in vitro conditions, cytokine effects on the endothelial barrier reach a maximum after 12-24 h, indicating that a considerable fraction of this effect is mediated by transcriptional regulation (393,428). TNF-induced inhibition of endothelial barrier function has been shown to be in part dependent on NF-B activation and protein synthesis, but the underlying mechanisms are poorly understood (92,93). Activation of NF-B by TNF in endothelial cells can also lead to disruption of tight junctions (31,92).…”

Section: Tnf/interleukin-1/lpsmentioning

confidence: 99%

Passing the Vascular Barrier: Endothelial Signaling Processes Controlling Extravasation

Wettschureck

Strilić

Offermanns

2019

Physiological Reviews

221

203

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A central function of the vascular endothelium is to serve as a barrier between the blood and the surrounding tissue of the body. At the same time, solutes and cells have to pass the endothelium to leave or to enter the bloodstream to maintain homeostasis. Under pathological conditions, for example, inflammation, permeability for fluid and cells is largely increased in the affected area, thereby facilitating host defense. To appropriately function as a regulated permeability filter, the endothelium uses various mechanisms to allow solutes and cells to pass the endothelial layer. These include transcellular and paracellular pathways of which the latter requires remodeling of intercellular junctions for its regulation. This review provides an overview on endothelial barrier regulation and focuses on the endothelial signaling mechanisms controlling the opening and closing of paracellular pathways for solutes and cells such as leukocytes and metastasizing tumor cells.

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“…Of the 2253 people screened, 1861 had urine creatinine levels within the sex-adjusted reference limits. 4,5 They comprised 1199 who had neither proteinuria nor polyuria, 445 who had proteinuria without polyuria, 4 who had polyuria without proteinuria and 213 who had proteinuria with polyuria. Unexpectedly, in this last group, who had proteinuria (protein excretion > 0.20 g in 24 hours), polyuria (urine volume > 2.9 L in 24 hours) and seemingly normal kidney function (creatinine clearance rate > 60 mL/min per 1.73 m 2 ), 4 we found 100 participants (4.4% of the community sample) who had no explanation for their proteinuria.…”

mentioning

confidence: 99%

Excessive fluid intake as a novel cause of proteinuria

Clark

Kortas²,

Suri³

et al. 2008

Canadian Medical Association Journal

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W e are currently conducting a longitudinal population cohort study in the community of Walkerton, Ontario, to determine health outcomes after the municipal water supply was contaminated with Escherichia coli O157:H7 and Campylobacter in 2000.1 Our study cohort of 4496 people represents about 50% of the community, and their demographic characteristics are similar to those of the whole community. 2As part of our initial assessment in 2002, we measured urine protein levels in 24-hour collections of urine from 2253 adults who later attended a follow-up clinic annually between 2003 and 2005. We measured the protein levels with a Vitros 950 autoanalyzer (Ortho-Clinical Diagnostics Inc., Rochester, New York) using the pyrocatechol dye procedure, 3 with a coefficient of variation for the low control below 3.5% and a lower limit of sensitivity of 0.05 g/L. Of the 2253 people screened, 1861 had urine creatinine levels within the sex-adjusted reference limits.4,5 They comprised 1199 who had neither proteinuria nor polyuria, 445 who had proteinuria without polyuria, 4 who had polyuria without proteinuria and 213 who had proteinuria with polyuria. Unexpectedly, in this last group, who had proteinuria (protein excretion > 0.20 g in 24 hours), polyuria (urine volume > 2.9 L in 24 hours) and seemingly normal kidney function (creatinine clearance rate > 60 mL/min per 1.73 m 2 ), 4 we found 100 participants (4.4% of the community sample) who had no explanation for their proteinuria. These 100 people had no evidence of kidney disease, diabetes mellitus, hemolytic uremic syndrome or psychogenic polydipsia by self-report or medical chart audit. None had received lithium or diuretics, 6 and only 28 had hypertension.The 100 participants had urine protein concentrations from 0.07 to 0.15 g/L, well above our lower limit of detection. In the 24-hour collections of urine, the mean amount of protein excreted was 0.43 g (standard deviation [SD] 0.21 g, 95% confidence interval [CI] 0.36-0.49 g), and the mean volume of urine was 3.7 L (SD 1.2 L, 95% CI 3.3-4.1 L). This group was similar to the overall cohort of 2253 adults in terms of age (mean 47 [range 15-72] and 47 [range 15-92] years, respectively), sex (68% and 61% women), history of hypertension (28.0% and 35.2%) and gastroenteritis (61.0% and 60.4%).We attempted to discern the cause of the unexplained proteinuria and polyuria. Of the 100 people, 63 agreed to confirmatory 24-hour urine collection to measure protein excretion, followed by a urine osmolality measurement after overnight water deprivation. The 24-hour confirmatory urine samples had a mean protein content of 0.40 g (SD 0.29 g, 95% CI 0.30-0.49 g) and a mean volume of 3.6 L (SD 1.8 L, 95% CI 3.0-4.2 L). After the overnight water-deprivation test, we found that 39 of the 63 participants had a urine osmolality of more than 450 mOsm/kg. Of the 24 whose urine was not concentrated to this level, 17 returned after another voluntary overnight water-deprivation test to undergo 8 hours of observed water deprivation. By the end of th...

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Evaluation of GFR Estimating Equations in the General Community

Cited by 12 publications

References 31 publications

Is high fluid intake good for the kidney?

Is high fluid intake good for the kidney?

Passing the Vascular Barrier: Endothelial Signaling Processes Controlling Extravasation

Excessive fluid intake as a novel cause of proteinuria

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