American journal of kidney diseases : the official journal of the National Kidney Foundation
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Hypothermia is defined as a core body temperature of less than 35 degrees C and is divided further into mild, moderate, and severe depending on the temperature level. Several active internal rewarming modalities have been described in the management of moderate-to-severe accidental hypothermia. ⋯ The patient was switched to hemodialysis that brought his temperature from 30.2 degrees C to 36.7 degrees C during a 3.5-hour dialysis with an average rise of 1.9 degrees C/h. Hemodialysis is a rapid and efficient modality of rapid internal rewarming for moderate-to-severe accidental hypothermia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cystatin C is not more sensitive than creatinine for detecting early renal impairment in patients with diabetes.
This study evaluated serum cystatin C as a potential new marker of glomerular filtration rate (GFR) in 49 patients who had steady-state diabetes with early renal impairment. We determined the correlation between GFR measured by chromium 51-labeled EDTA and levels of serum cystatin C, serum creatinine, serum beta(2)-microglobulin, endogenous creatinine clearance, and Cockcroft formula. Sensitivity and specificity for the diagnosis of renal failure, defined as a GFR less than either 80 or 60 mL/min/1.73 m(2), were calculated by receiver operating characteristic (ROC) curves for creatinine, cystatin C, and beta(2)-microglobulin. ⋯ With patients classified into two groups (GFR > or < 80 mL/min/1.73 m(2)), mean values for each parameter were statistically different (P < 0.001). Sensitivity, specificity, and positive and negative predictive values for serum creatinine and serum cystatin C levels were very close for both definitions of renal failure. Serum cystatin C is not better than serum creatinine or serum beta(2)-microglobulin levels for estimating GFR in patients with steady-state diabetes using ROC curves or other validation tests.