Microalbuminuria in the intensive care unit: Clinical correlates and association with outcomes in 431 patients*

Gosling, Peter; Czyz, John; Nightingale, Peter; Manji, Mav

doi:10.1097/01.ccm.0000228914.73550.bd

Cited by 70 publications

(63 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…LPS induces albuminuria within 24 hours after injection in mice, which correlates with podocyte cytoskeletal remodeling and FPE (30). These changes are reversible, similar to findings in humans exposed to LPS, who show transient albuminuria (31). Of note, LPS has also been shown to induce filter barrier damage in SCID mice, suggestive of a B cell-and T cell-independent, podocyte-specific role for LPS (23).…”

Section: Trpc5 Localizes To the Kidney Filtersupporting

confidence: 58%

Inhibition of the TRPC5 ion channel protects the kidney filter

et al. 2013

View full text Add to dashboard Cite

An intact kidney filter is vital to retention of essential proteins in the blood and removal of waste from the body. Damage to the filtration barrier results in albumin loss in the urine, a hallmark of cardiovascular disease and kidney failure. Here we found that the ion channel TRPC5 mediates filtration barrier injury. Using Trpc5-KO mice, a small-molecule inhibitor of TRPC5, Ca 2+ imaging in isolated kidney glomeruli, and live imagining of podocyte actin dynamics, we determined that loss of TRPC5 or its inhibition abrogates podocyte cytoskeletal remodeling. Inhibition or loss of TRPC5 prevented activation of the small GTP-binding protein Rac1 and stabilized synaptopodin. Importantly, genetic deletion or pharmacologic inhibition of TRPC5 protected mice from albuminuria. These data reveal that the Ca 2+ -permeable channel TRPC5 is an important determinant of albuminuria and identify TRPC5 inhibition as a therapeutic strategy for the prevention or treatment of proteinuric kidney disease.

show abstract

Section: Trpc5 Localizes To the Kidney Filtersupporting

confidence: 58%

Inhibition of the TRPC5 ion channel protects the kidney filter

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Although it is possible that this variable influenced the statistical analysis independent of NO, this is an unlikely scenario. First, the use of a ratio between a biomarker and urine Cr is a standard method to adjust for urinary dilution (28)(29)(30)(31). Second, in multivariate analyses that included estimated GFR, baseline urine NO/Cr remained highly predictive of better outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The Cr results obtained were also used to evaluate urine desmosine in these patients; those results have been reported elsewhere (27). The ratio of urine NO to urine Cr (NO/Cr) was used in the statistical analyses to control for urine dilution, a standard method when evaluating urine biomarkers (28)(29)(30)(31). Analyses using urine NO without Cr correction were performed for comparison.…”

Section: No and Cr Measurementsmentioning

confidence: 99%

Higher Urine Nitric Oxide Is Associated with Improved Outcomes in Patients with Acute Lung Injury

McClintock

Ware

Eisner

et al. 2007

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: Nitrogen oxide (NO) species are markers for oxidative stress that may be pathogenic in acute lung injury (ALI). Objectives: We tested two hypotheses in patients with ALI: (1 ) higher levels of urine NO would be associated with worse clinical outcomes, and (2 ) ventilation with lower VT would reduce urine NO as a result of less stretch injury. Methods: Urine NO levels were measured by chemiluminescence in 566 patients enrolled in the National Heart Lung and Blood Institute Acute Respiratory Distress Syndrome Network trial of 6 ml/kg versus 12 ml/kg VT ventilation. The data were expressed corrected and uncorrected for urine creatinine (Cr). Results: Higher baseline levels of urine NO to Cr were associated with lower mortality (odds ratio, 0.43 per log(10) increase in the ratio), more ventilator-free days (mean increase, 1.9 d), and more organ-failure-free days (mean increase, 2.3 d) on multivariate analysis (p Ͻ 0.05 for all analyses). Similar results were obtained using urine NO alone. NO to Cr levels were higher on Day 3 in the 6 ml/kg than in the 12 ml/kg VT group (p ϭ 0.04). Conclusions: Contrary to our hypothesis, higher urine NO was associated with improved outcomes in ALI at baseline and after treatment with the 6 ml/kg VT strategy. Higher endogenous NO may reflect less severe lung injury and better preservation of the pulmonary and systemic endothelium or may serve a protective function in patients with ALI.

show abstract

“…We did not measure serum markers of inflammation, such as CRP or procalcitonin [36], or look for microalbuminuria, a marker of endothelial dysfunction [37]. Such testing may allow a more precise estimation of this potentially detrimental process.…”

Section: Discussionmentioning

confidence: 99%

The Burden of the Systemic Inflammatory Response Predicts Vasospasm and Outcome after Subarachnoid Hemorrhage

2008

View full text Add to dashboard Cite

Introduction: Subarachnoid hemorrhage (SAH) can trigger immune activation sufficient to induce the systemic inflammatory response syndrome (SIRS). This may promote both extra-cerebral organ dysfunction and delayed cerebral ischemia, contributing to worse outcome. We ascertained the frequency and predictors of SIRS after spontaneous SAH, and determined whether degree of early systemic inflammation predicted the occurrence of vasospasm and clinical outcome.

show abstract

Microalbuminuria in the intensive care unit: Clinical correlates and association with outcomes in 431 patients*

Cited by 70 publications

References 42 publications

Inhibition of the TRPC5 ion channel protects the kidney filter

Inhibition of the TRPC5 ion channel protects the kidney filter

Higher Urine Nitric Oxide Is Associated with Improved Outcomes in Patients with Acute Lung Injury

The Burden of the Systemic Inflammatory Response Predicts Vasospasm and Outcome after Subarachnoid Hemorrhage

Contact Info

Product

Resources

About