Clinical biochemistry
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Clinical biochemistry · Jul 2015
Arginine, dimethylated arginine and homoarginine in relation to cardiovascular risk in patients with moderate chronic kidney disease.
Arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), arginine/ADMA ratio and homoarginine could potentially affect nitric oxide production and have been studied in relation to cardiovascular risk (CVR) in various clinical populations. Prospective studies on the CVR associated with arginine/ADMA ratio and homoarginine in patients with moderate chronic kidney disease (CKD) are still scarce. We have studied how arginine, homoarginine and dimethylated arginine can predict cardiovascular events in such a population. ⋯ This study demonstrates a negative association between arginine/ADMA ratio and CVR in CKD patients and a positive association between P-homoarginine and CVR. The latter is in contrast to what has been demonstrated by others.
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The aim of this study was to evaluate whether the addition of red blood cell distribution width (RDW) improves the prognostic value of current intensive care unit (ICU) scoring systems, namely APACHE III. ⋯ RDW was an independent predictor of mortality. The addition of RDW to APACHE III improved its mortality prediction marginally. The underlying mechanism of RDW elevation warrants further investigation.
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Clinical biochemistry · Apr 2015
Observational StudyClinical, operational and economic outcomes of point-of-care blood gas analysis in COPD patients.
Arterial blood gas analysis is relevant in chronic obstructive pulmonary disease (COPD) management. The aim of this study was to evaluate whether the use of a blood gas analyzer in pulmonology departments improves the clinical, operational and economic outcomes when compared with clinical laboratory measurements. ⋯ The use of a blood gas analyzer in a pulmonology office improves clinical, operational and economic outcomes when compared with clinical laboratory.
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Clinical biochemistry · Apr 2015
Plasma fibroblast growth factor 23 concentration and iron status. Does the relationship exist in the elderly population?
Fibroblast growth factor 23 (FGF23) is a phosphaturic agent involved in calcium-phosphate homeostasis. Recent findings show that iron deficiency and inflammation regulate FGF23 release and/or biodegradation. Iron deficiency is frequently observed in the elderly, therefore the aim of this study was to find out if iron deficiency is independent from low grade inflammatory factors affecting both forms of FGF23 that are detectable in circulation in a large population-based study of elderly subjects. ⋯ Low iron levels are associated with increased levels of both cFGF23 and iFGF23, independent of low grade inflammation. A similar analysis of cFGF23 and iFGF23 does not suggest enhanced biodegradation of iFGF23 induced by iron deficiency.
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Clinical biochemistry · Mar 2015
ReviewUse and interpretation of high sensitivity cardiac troponins in patients with chronic kidney disease with and without acute myocardial infarction.
It is well known that the population with chronic kidney disease (CKD) is at greater risk for cardiovascular disease and death than the general population. The use and interpretation of high sensitivity cardiac troponin (hs-cTn) assays have been particularly challenging in these patients with the majority having elevated levels at baseline. The diagnostic accuracy of acute myocardial infarction (AMI) may be decreased in patients with CKD when using these newer troponins. ⋯ The purpose of the review is to evaluate hs-cTn in patients with CKD for the diagnosis of AMI and for the prognostic significance of elevated levels in CKD patients without AMI. Although the underlying etiology of persistently elevated cTn in the CKD population remains unclear, the review will also evaluate studies attempting to explain whether the source of cTn is from increased cardiac production versus decreased renal clearance. Further longitudinal studies are required in order to bridge the gap between the prognostic importance of elevated cTn and clinical management to prevent symptomatic cardiac disease.