Background: Obesity increases the risk of many pathologies, including cardiovascular and renal diseases. This study aimed to determine the association between obesity and proteinuria as well as GLOMERULAR hemodynamic changes (an early marker of kidney damage) in obese children and its relationship with metabolic syndrome.Methods: This case-control study included 112 overweight and obese male and female patients aged 7 - 16 years, and 35 age- and gender-matched healthy controls. The obese patients were divided into 4 subgroups according to BMI: normal weight (control group), overweight, obese, morbidly obese. The GLOMERULAR FILTRATION RATE was estimated using classical and adjusted formulas based on the various body size descriptors of Leger, Schwartz, Filler, and Zappitelli, and chronic kidney disease formulas in all patients and controls. Creatinine, cystatin C, 24-hour urine protein, and the estimated GLOMERULAR FILTRATION were compared between groups.Results: Blood pressure, creatinine, and 24-hour urine protein values were significantly higher in the overweight and obese patient subgroups (P<0.05). The estimated GLOMERULAR FILTRATION RATE, which was calculated using creatinine or cystatin C, was higher in the obese patients and subgroups than in the control group (P<0.05). In contrast, the estimated GLOMERULAR FILTRATION RATE measured using both classical and adjusted formulas was significantly lower in the obese patients than in the controls (P<0.05).Conclusions: Early indicators of renal damage are elevated urine protein and renal function test results compatible with impaired renal function. As such, obese pediatric patients should be routinely monitored for blood pressure, renal function, and proteinuria.

Introduction. Chronic Kidney Disease (CKD) is of high clinical importance due to cost of outcomes such as kidney transplantation. However, CKD is an overlooked disorder among commercial drivers. The present study aimed to evaluate hypertension and GLOMERULAR FILTRATION RATE (GFR) among commercial drivers. Methods. In this cross-sectional study, a total of 903 commercial drivers referred for obtaining their health license were recruited. After obtaining informed consent, a questionnaire consisted of demographic characteristics was completed. Blood pressure, level of lipid profile, blood sugar, blood urea nitrogen, and plasma creatinine were measured. Chi-square and independent T-test were used for data analysis. Results. All participants were male. The mean ( ± SD) age and Body mass index were 42 ± (10) years and 27 ± (4) kg/m2, respectively. Of 903 studied cases 40 (4%) had GFR < 60. Increased age and high blood pressure had a significant association with reduced GFR (P <. 0001). The ones with sleep apnea were more likely to have GFR < 60, however, the association was not statistically significant after adjusting for related risk factors. Conclusion. Older age and hypertension are considered as risk factors for CKD among commercial drivers. Obstructive sleep apnea also should be kept in mind as a possible risk factor that requires further elucidation and management.

Background and Aims: Overweight and obesity are significant risk factors for chronic kidney disease (CKD). GLOMERULAR FILTRATION RATE (GFR) is the best index of renal function. We evaluated the accuracy of the Cockroft-Gault, MDRD and modified MDRD formulae in predicting GFR in overweight and obese subjects and also determined the relationship between Body Mass Index (BMI), weight and GFR.Methods: Healthy volunteers with BMI ³23kg/m² were recruited and subjected to blood and urine investigations, renal ultrasonography and 99mTc-DTPA renal scan. The correlation, accuracy and precision of the eGFR derived from each formula were compared with reference GFR as determined by 99mTc-DTPA. Results: A total of 101 subjects with a median weight of 74.0kg (68.0-84.7) and median BMI of 29.6 kg/m2 (27.2-33.2) were recruited. Their mean GFR 99mTc-DTPA was 120.3± 24.5ml/mm/1.73m². Although the eGFRs derived from all formulae correlated with GFR 99mTc-DTPA, only those derived from the MDRD and modified MDRD had small biases and better precision in estimating GFR. While GFR significantly correlated with the subjects’ weight (p=0.036), it didn’t with their BMI (p=0.302).Conclusions: The MDRD-based formulae were better in estimating GFR in overweight and obese Malaysian subjects. GFR correlated with subjects’ weight rather than BMI.

Background: We aimed to estimate the GLOMERULAR FILTRATION RATE (GFR) in women with polycystic ovary syndrome (PCOS) and to determine the relationship between GFR with C-reactive protein (CRP) and uric acid.Materials and Methods: In this cross-sectional study, one-hundred and forty PCOS women and 60 healthy subjects were evaluated. The study was carried out at Endocrinology Outpatient Clinic, Erzurum Training and Research Hospital, Erzurum, Turkey, from December 2010 to January 2011. GFRs were estimated by Modification of Diet in Renal Disease (MDRD) formula. CRP, urinary albumin excretion (UAE) and uric acid levels were also measured.Results: GFRs were significantly higher in PCOS group than control (135.24±25.62 vs. 114.92±24.07 ml/min per 1.73 m2). CRP levels were significantly higher in PCOS patients (4.4±3.4 vs. 2.12±1.5 mg/l). The PCOS group had significantly higher serum uric acid levels (4.36±1.3 mg/dl vs. 3.2±0.73 mg/dl). There was also significantly higher proteinuria level in PCOS patients.Conclusion: Even though PCOS patients had higher GFR, serum uric acid and UAE values than control patients, the renal function was within normal limits. Increased GFR in PCOS women positively correlates with elevated serum CRP and uric acid.

Background: GLOMERULAR FILTRATION RATE (GFR) is the best indicator to assess renal function; however, it is difficult to perform it, especially in neonates. Serum creatinine is the most commonly used marker of GFR; nevertheless, it has some limitations since it can be affected by factors other than renal function. Cystatin C, another endogenous marker used to estimate GFR, is not affected by non-renal factors. The results of some studies suggest that serum cystatin C levels are more accuRATE tests of kidney function than serum creatinine levels. This study aimed to estimate GFR with cystatin C-based formulas among neonates and determine the correlations between these methods and the Schwartz formula. Methods: The population of this research consisted of 99 neonates whose serum creatinine and cystatin C levels were measured concurrently. Moreover, the GLOMERULAR FILTRATION RATE was estimated using the Schwartz formula and 14 cystatin C-based formulas sepaRATEly. Results: Based on the findings, all GFR values based on cystatin C formulas correlated significantly with each other (P<0. 05); however, with one exception, none of these values correlated with Schwartz GFR (P>0. 05). The only cystatin C formula that yielded values correlating with the Schwartz formula was CysCrEq, which used serum cystatin C and creatinine concomitantly. Conclusion: It can be concluded that since all GFR values based on cystatin C correlated significantly and cystatin Cwasindependent of non-renal factors, cystatin C reflected the real GFR more accuRATEly than serum creatinine. Nonetheless, further studies with gold standard techniques are required to verify the usefulness of cystatin C-based formulas.

Background and purpose: Serum creatinine and its derived formulae in estimating GLOMERULAR FILTRATION RATE is not accuRATE in cirrhotic patients because of decreased muscle mass and secretion and excretion functional impairment of liver. This study aimed at investigating the accuracy of serum cystatin C in determining GFR and examining the relationship between synthetic and excretory liver function with GLOMERULAR FILTRATION RATE in cirrhotic patients. Materials and methods: In this cross-sectional study، 35 patients with cirrhosis and 35 age and sex matched healthy controls enrolled. Serum creatinine، LFT، FBS، LDL، HDL، cholesterol، triglycerides، albumin، globulin، and cystatin C and also 24-hour urinary urea and creatinine were measured. GFR was estimated by three measurement methods and the relationship between GFR and Child score was evaluated. Results: The mean age of participants was 39. 15± 13. 93 years and male patients included 48. 57%. The most common cause of cirrhosis was autoimmune cirrhosis. GFR based on creatinine in two different formulas was higher than that in control group but the GFR based on cystatin C was significantly lower in cirrhotic group (p<0. 001). The secretory and excretory functions of liver were not significantly correlated with GFR in cirrhotic patients (p>0. 05). Correlation coefficient between GFR (based on cystatin C) and Child-square was 0. 199 (p= 0. 251). Conclusion: GFR based on cystatin C is more accuRATE in cirrhotic patients. On the other hand، there was a modeRATE negative correlation between GFR (based on cystatin C) and Child-square that can be helpful in prediction and early detection of renal dysfunction in cirrhotic patients.

Cystatin C is a 13 KD basic protein that is a member of the cystatin super-family of cysteine protease inhibitors. The cystatin C gene seems to be a house keeping gene, which is compatible with a stable production RATE of cystatin C by most cells. This protein is freely filtered through the glomerulus and almost completely reabsorbed and catabolized by proximal tubular cells. Because of these characteristics cystatin C is assumed to be a better marker of GLOMERULAR FILTRATION RATE than other markers. 115 new cases of renal disease aged between 14 and 88 years and 121 healthy subjects, aged between 11 and 78 years were studied. In all of the subjects serum cystatin C and creatinine were determined and creatinine clearance was determined only in patients. Cystatin C was determined by a particle-enhanced turbidimetric assay and creatinine was measured by Jaffe's method. In addition, to assess the diagnostic efficiency of serum cystatin C in comparison to that of serum creatinine and creatinine clearance in predicting changes in GFR, we performed Tc99m - DTPA clearance on 53 subjects including controls and patients. A linear relationship was found between Tc99m - DTPA clearance and 1/ serum cystatin C (r= 0.712, p-value <0.001), 1/serum creatinine (r= 0.709, pvalue < 0.001) and creatinine clearance (r= 0.777, p- value <0.001). Diagnostic accuracy in the identification of reduced GFR measured as area under the receiver-operating characteristic plot was 0.878±0.050 (Mean±SE) for cystatin C, 0.866±0.051 for creatinine and 0.866±0.051 for creatinine clearance. The serum cystatin C reference values (mean±1.96 SD) determined was 0.83 - 0.88 mg/L. A cutoff cystatin C concentration of 0.82 mg/L had 92% sensitivity and 79% specificity for detecting abnormal GFR. There was no significant correlation between cystatin C and age (p- value <0.219) and weight (p- value <0.193). This study demonstRATEs that serum cystatin C has an increased diagnostic accuracy for reduced GFR when compared with serum creatinine and creatinine clearance. Hence, cystatin C seems to be an alternative for the estimation of GFR.