Assessment of glomerular filtration rate (GFR) is essential for calculating safe dosages of renally cleared drugs. Formulae for estimating reliable GFRs assume that plasma creatinine concentrations are stable. This study evaluates the variability of plasma creatinine (PCr) concentrations in patients admitted acutely to hospital. From 2,293 newly admitted patients, those in whom a subsequent clinically significant change (> 20%) in PCr had occurred were identified. Median age was 81.1 years. Median baseline PCr was 90 umol/l (eGFR 60 ml/min). In total, 46.3% of the patients had a PCr that varied > 20% from baseline three to seven days following admission. A 10-year increase in age increased the odds of a rise in PCr over the next week by 11.1% (odds ratio = 1.11, 95% confidence interval = 1.03, 1.20; p = 0.007). Overall, baseline creatinine was a poor predictor of subsequent variation in PCr. GFR formulae for calculating renally-cleared drug dosages should be used with caution in elderly patients admitted acutely to hospital.
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http://dx.doi.org/10.7861/clinmedicine.10-6-540 | DOI Listing |
Heliyon
January 2025
Clinical Laboratory, Chest Hospital, Tianjin University, Tianjin, 300222, China.
Objective: The aim of this paper is to discover differentially expressed genes related to ferroptosis (DEFRGs) in patients with ST-segment elevation myocardial infarction (STEMI) and to construct a reliable prognostic signature that incorporates key DEFRGs and easily accessible clinical factors.
Methods: We did a systematic review of Gene Expression Omnibus datasets and picked datasets SE49925, GSE60993, and GSE61144 for analysis. We applied GEO2R to find DEFRGs and overlapped them among the picked datasets.
Lipids Health Dis
January 2025
Department of Cardiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Background: Homocysteine (Hcy) and the proprotein convertase subtilisin/kexin type 9 (PCSK9) significantly contribute to atherosclerosis (AS) as well as coronary lesion severity. Our previous work demonstrated that Hcy upregulates PCSK9, accelerating lipid accumulation and AS. A PCSK9 antagonist reduces plasma Hcy levels in ApoE mice.
View Article and Find Full Text PDFJ Vet Med Sci
January 2025
Laboratory of Veterinary Clinical Pathology, Joint Faculty of Veterinary Medicine, Kagoshima University.
Apoptosis, an important pathological event associated with kidney disease progression, is expected to be a therapeutic target in chronic kidney disease (CKD). However, its role in naturally occurring CKD in aged cats remains unclear. Therefore, here, we investigated kidney tissues from aged cats (≥10 years) with or without azotemic CKD to evaluate apoptotic events using a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling (TUNEL) assay.
View Article and Find Full Text PDFBr J Clin Pharmacol
January 2025
Department of Medical Microbiology, Haaglanden Medisch Centrum, The Hague, The Netherlands.
Aims: The beta-lactam antibiotic temocillin is increasingly used to treat extended-spectrum beta-lactamase (ESBL-producing) strains; however, its protein binding is complex. This study aims to predict unbound temocillin concentrations in various participant groups to determine its impact on the probability of target attainment (PTA) and to improve dosing recommendations.
Methods: The plasma pharmacokinetics were analysed using non-linear mixed-effects modelling.
Front Nutr
January 2025
Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University and Beijing Tuberculosis and Tumor Research Institute, Beijing, China.
Background: As a state of metabolic and nutritional derangements, protein-energy wasting (PEW) is highly prevalent and associated with increased morbidity and mortality in hemodialysis patients. Fibroblast growth factor-23 (FGF-23) and Klotho have been proven to contribute to chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients undergoing hemodialysis. Previous evidence suggested that FGF-23 and Klotho may also contribute to the malnutritional status among these patients; however, the inter-relationship between the FGF-23-Klotho axis and PEW remains unclear.
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