Female ; Humans ; Hyperbilirubinemia, Neonatal ; physiopathology ; urine ; Infant, Newborn ; Kidney Tubules ; physiopathology ; Male ; beta 2-Microglobulin ; urine

OBJECTIVETo investigate the renal function in newborns with birth asphyxia or intrauterine distress in the first week of life.

METHODSSixty full-term newborns born between June 2002 and February 2003 were assigned into three groups: Control group (healthy newborns), Intrauterine distress group (Apgar score > 7), and Birth asphyxia group without intrauterine distress (12 mild asphyxia and 8 severe asphyxia) (n=20 each). Urinary levels of alpha1-microglobulin (alpha1-MG), beta2-microglobulin (beta2-MG) and albumin (Alb) were detected by radioimmunoassay at 0-2, 3-4 and 6-7 days after birth.

RESULTSThe urinary levels of alpha1-MG, beta2-MG and Alb in the Asphyxia group were significantly higher than those in the Control group at all time points (P < 0.05), peaking at 3-4 days after birth. Statistically significant differences were found between the severely and mildly asphyxiated newborns for the urinary levels of alpha1-MG, beta2-MG and Alb at all time points (P < 0.05). There were no significant differences in the urinary levels of alpha1-MG, beta2-MG and Alb between the Intrauterine distress and the Control groups at each time point.

CONCLUSIONSBirth asphyxia may lead to renal glomerular and tubular impairments and it is speculated that the most serious impairment occurs at the 3rd and 4th days of life. The severity of renal impairments is associated with the degree of asphyxia. The renal function of the newborn appears to be normal following intrauterine distress.

Albuminuria ; urine ; Alpha-Globulins ; urine ; Asphyxia Neonatorum ; physiopathology ; Fetal Distress ; physiopathology ; Humans ; Infant, Newborn ; Kidney ; physiopathology ; beta 2-Microglobulin ; urine

Renal damage is one of the most common complications and cause of death in patients with multiple myeloma (MM). The studies have pointed out that early renal impairment is risk factor for progress of this disease, timely diagnosis and prompt intervention therapy are very important to improve the prognosis and survival of MM patients. Therefore, the diagnosis of early renal damage is crucial for clinical treatment. The progress on detection of early renal damage parameters and their value are reviewed in this article.
Alpha-Globulins ; urine ; Humans ; Kidney ; physiopathology ; Multiple Myeloma ; diagnosis ; physiopathology ; Proteinuria ; Retinol-Binding Proteins ; urine ; beta 2-Microglobulin ; urine

OBJECTIVETo estimate the biological exposure limit (BEL) using benchmark dose (BMD) based on two sets of data from occupational epidemiology.

METHODSCadmium-exposed workers were selected from a cadmium smelting factory and a zinc product factory. Doctors, nurses or shop assistants living in the same area served as a control group. Urinary cadmium (UCd) was used as an exposure biomarker and urinary beta2-microgloburin (B2M), N-acetyl-13-D-glucosaminidase (NAG) and albumin (ALB) as effect biomarkers. All urine parameters were adjusted by urinary creatinine. Software of BMDS (Version 1.3.2, EPA.U.S.A) was used to calculate BMD.

RESULTSThe cut-off point (abnormal values) was determined based on the upper limit of 95% of effect biomarkers in control group. There was a significant dose response relationship between the effect biomarkers (urinary B2M, NAG; and ALB) and exposure biomarker (UCd). BEL value was 5 microg/g creatinine for UB2M as an effect biomarker, consistent with the recommendation of WHO. BEL could be estimated by using the method of BMD. BEL value was 3 microg/g creatinine for UNAG as an effect biomarker. The more sensitive the used biomarker is, the more occupational population will be protected.

CONCLUSIONBMD can be used in estimating the biological exposure limit (BEL). UNAG is a sensitive biomarker for estimating BEL after cadmium exposure.

Acetylglucosaminidase ; urine ; Albuminuria ; urine ; Biomarkers ; urine ; Cadmium ; toxicity ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Occupational Exposure ; Spectrophotometry, Atomic ; beta 2-Microglobulin ; urine

OBJECTIVETo analyze the clinical features of mild chronic cadmium poisoning induced by different causes.

METHODSA total of 90 patients with mild chronic cadmium poisoning, who were hospitalized in our center from 2008 to 2011 and had complete clinical data, were divided into two groups according to the causes of poisoning: environmental pollution group (n = 45) and occupational poisoning group (n = 45). The clinical symptoms, signs, laboratory indices, and treatment outcomes of all patients were analyzed.

RESULTSCompared with the environmental pollution group, the occupational poisoning group had more bone pain, less bone injury (based on imaging findings), and significantly increased abnormal rate of urinary retinol-binding protein (RBP) (P < 0.05); there were no significant differences in urinary &beta;-2 microglobulin (MG) and urinary microalbumin between the two groups (P > 0.05). Urinary cadmium, urinary RBP, and urinary &beta;-2 MG had no linear correlation between each other in the two groups. Both groups showed significant changes in urinary cadmium levels after treatment (P < 0.05).

CONCLUSIONThe clinical features of mild chronic cadmium poisoning induced by various causes are different, and active nutritional support therapy plays a positive role in improving prognosis.

Cadmium ; urine ; Cadmium Poisoning ; therapy ; urine ; Environmental Exposure ; Environmental Pollutants ; urine ; Humans ; Nutritional Support ; Occupational Exposure ; Retinol-Binding Proteins ; urine ; beta 2-Microglobulin ; urine

OBJECTIVEBased on two sets of data from occupational epidemiology, Benchmark dose (BMD) was applied to estimate biological exposure limit (BEL).

METHODSCadmium exposed workers were selected from a cadmium smelting and a zinc products factory and control group was selected from doctors or nurses and staff from shops living in the same area; Urinary cadmium (UCd) was used as exposure biomarker and urinary beta(2) microglobulin (UBM), NAG (UNAG) and albumin (UALB) were as effect biomarkers. All urine parameters were adjusted by urinary creatinine. Software of BMDS (Version 1.3.2, EPA.U.S) was used to calculate BMD.

RESULTSCalculated abnormal prevalence was based on the upper limit of 95% of effect biomarkers in control group; There are significant dose response relationship between the prevalence of effect biomarkers (UBM, UNAG and UALB) and exposure biomarker (UCd); BEL was 5 microg/g creatinine for UBM as effect biomarker, It consists with the recommendation of WHO; BEL was 3 microg/g creatinine for UNAG as effect biomarker; BEL can be estimated by using the method of BMD; the more sensitive biomarker would used, the more occupational people would protected.

CONCLUSIONThe application of BMD in estimating biological exposure limit (BEL) is proper. UNAG is suggested as most sensitive biomarker to be used to estimate BEL for cadmium exposure.

Acetylglucosaminidase ; urine ; Albuminuria ; urine ; Biomarkers ; urine ; Cadmium ; adverse effects ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Occupational Exposure ; Reference Values ; beta 2-Microglobulin ; urine

OBJECTIVETo observe the clinical therapeutic effect of acupuncture on early metaphase diabetic nephropathy.

METHODSFifty-four cases of diabetes were randomly divided into an acupuncture group (n=30) and a control group (n=24). The patients in the two groups were all treated by oral administration of Gliguidon or subcutaneous injection of insulin with acupuncture at Ganshu (BL 18), Weiwanxiashu (EX-B 3), Shenshu (BL 23), Guanyuan (CV 4) and other acupoints added in the acupuncture group, for 30 days.

RESULTSThe total effective rate was 93.3% in the acupuncture group and 66.7% in the control group. After treatment, blood beta2-microglobulin (beta2-MG), and urine beta2-MG in the acupuncture group decreased significantly with a significant difference as compared with those in the control group; total cholesterol (TC) and triglyceride (TG) significantly decreased and high density lipoprotein (HDL) significantly increased in the acupuncture group with significant differences compared with the control group.

CONCLUSIONAcupuncture can improve lipid metabolism and protect the renal function of the patient with early metaphase diabetes.

Acupuncture Therapy ; Aged ; Diabetic Nephropathies ; blood ; therapy ; urine ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; beta 2-Microglobulin ; urine

OBJECTIVETo use the data of occupational epidemiology to estimate the benchmark dose (BMD) of renal dysfunction induced by lead.

METHODSBlood lead was considered as an exposure biomarker, while urinary total protein (TP), urinary beta(2)-microglobulin (beta(2)-MG) and urinary N-Acetyl-beta-D-glucosaminidase (NAG) were considered as effect biomarkers reflecting the damage of renal function. The dichotomized (binary) data was used as effect endpoints. The BMD and BMD lower limit (BMDL) of blood lead were estimated at the 10% benchmark response using BMDS version 1.3.1.

RESULTSThere was an increased prevalence of hyper-TP-uria, hyper-beta(2)-MG-uria and hyper-NAG-uria with an increasing blood lead concentration. There was obviously dose-response relationship between blood lead and TP, beta(2)-MG and NAG, respectively. The BMD and BMDL of blood lead affecting renal function were estimated to be 323.6 - 754.3 microg/L and 274.2 - 541.5 microg/L. The BMDL of blood lead was ranged from low to high as NAG, TP and beta(2)-MG. The urinary NAG activity might be served as a sensitive biomarker in detecting early renal dysfunction.

CONCLUSIONIt should be feasible to use the BMD approach to set up the reference dose (RfD) and reference concentration (RfC). BMD approach might provide a new and better way for setting up the RfD/RfC.

Acetylglucosaminidase ; urine ; China ; epidemiology ; Clinical Chemistry Tests ; methods ; standards ; Humans ; Lead ; blood ; Lead Poisoning ; blood ; epidemiology ; urine ; Occupational Exposure ; analysis ; Prevalence ; Proteinuria ; urine ; beta 2-Microglobulin ; urine

OBJECTIVETo examine the nephrotoxicity induced caused by combined effect of arsenic and cadmium in exposed workers.

METHODSUrinary cadmium and arsenic were used as the exposure biomarkers of cadmium and arsenic. Urinary beta2-microglobulin (Ubeta2-MG), albumin (UALB) and N-acetyl-beta-D-glucosaminidase (UNAG) were measured as the effective biomarkers of tubular and glomerular dysfunction induced by cadmium and arsenic.

RESULTSThe combination of cadmium and arsenic induced more severe renal injury than that caused by either of the chemicals given alone. There were positive correlations and significant dose-effect among the concentrations of urinary cadmium, arsenic and levels of Ubeta2-MG, UALB, UNAG (P<0.05, P<0.01).

CONCLUSIONCadmium combined with arsenic may have additive effect on renal dysfunction in workers exposed to arsenic and cadmium.

Adult ; Albuminuria ; chemically induced ; Arsenic ; toxicity ; urine ; Cadmium ; toxicity ; urine ; Dose-Response Relationship, Drug ; Female ; Humans ; Kidney ; drug effects ; Male ; Middle Aged ; Occupational Exposure ; beta 2-Microglobulin ; urine

OBJECTIVETo investigate the urinary neutrophil gelatinase-associated lipocalin (NGAL) concentration in children with idiopathic nephrotic syndrome (INS) and its clinical significance.

METHODSThirty-four children newly diagnosed with INS received oral prednisone for 4 weeks. Patients whose urinary protein did not become negative were classified as steroid-resistant nephrotic syndrome (SRNS) group, while those whose urinary protein did become negative were classified as steroid-sensitive nephrotic syndrome (SSNS) group. Morning midstream urine specimens were collected from all patients before use of prednisone and after 1, 2, 3, and 4 weeks of treatment with prednisone. Enzyme-linked immunosorbent assay was used to measure the urinary NGAL concentration. Meanwhile, urinary creatinine (Cr) concentration was measured, and urinary NGAL concentration in a single urine collection was adjusted according to the urinary Cr excretion. The two groups were compared in terms of urinary NGAL/Cr ratio.

RESULTSCompared with the SRNS group, the SSNS group had significantly decreased urinary NGAL/Cr ratios after 3 and 4 weeks of prednisone treatment (P < 0.05). Compared with the SRNS group, the SSNS group had a significantly decreased urinary &beta;2-MG/Cr ratio after 4 weeks of prednisone treatment (P < 0.05). In both groups, urinary NGAL/Cr ratio was positively correlated with urinary protein/Cr ratio (r = 0.510, P < 0.01). The results of ROC curve analysis showed when diagnostic cut-off point of urinary NGAL/Cr was 0.043 by 3 weeks after treatment, sensitivity and specificity achieved 100% and 79.2% respectively.

CONCLUSIONSUrinary NGAL/Cr ratio remains high in children with SRNS, while this ratio decreases gradually during prednisone treatment in children with SSNS, and it falls ahead of urinary &beta;2-MG/Cr ratio. These results suggest that dynamic monitoring of urinary NGAL/Cr ratio is useful for early judgment of response to prednisone in patients with INS.

Acute-Phase Proteins ; urine ; Child ; Child, Preschool ; Creatinine ; urine ; Female ; Humans ; Lipocalin-2 ; Lipocalins ; urine ; Male ; Nephrotic Syndrome ; drug therapy ; urine ; Prednisone ; therapeutic use ; Proto-Oncogene Proteins ; urine ; beta 2-Microglobulin ; urine