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1.
Impact of Chronic Lead Exposure on Selected Biological Markers   总被引：1，自引：0，他引：1  
Lead poisoning remains a major problem in India due to the lack of awareness of its ill effects among the clinical community. Blood lead, δ-aminolevulinic acid dehydratase (δ-ALAD) and zinc protoporphyrin (ZPP) concentrations are widely used as biomarkers for lead toxicity The present study was designed to determine the impact of chronic lead exposure on selected biological markers. A total of 250 subjects, of both sexes, ranging in age from 20 to 70 years, were recruited. On the basis of BLLs, the subjects were categorized into four groups: Group A (BLL: 0–10 μg/dl), Group B (BLL: 10–20 μg/dl). Group C (BLL: 20–30 μg/dl) and Group D (BLL: 30–40 μg/dl) having BLLs of 3.60 ± 2.71 μg/dl, 15.21 ± 2.65 μg/dl, 26.82 ± 2.53 μg/dl and 36.38 ± 2.83 μg/dl, respectively. Significant changes in biological markers due to elevated BLLs were noted. The relation of BLL and biological markers to demographic characteristics such as sex, habits, diet and substances abuse (smoking effect) were also studied in the present investigation. Males, urban population, non-vegetarians, and smokers had higher blood lead levels. δ-ALAD activity was found to be significantly lower with increased BLL (P < 0.001), while the ZPP level was significantly higher with increased BLL (P < 0.001). Further, BLL showed a negative correlation with δ-ALAD (r = −0.425, P < 0.001, N = 250) and a positive correlations with ZPP (r = 0.669, P < 0.001, N = 250). Chronic lead exposure affects the prooxidant-antioxidant equilibrium leading to cellular oxidative stress.  相似文献   

2.
Lead poisoning is well documented in persons occupationally exposed to lead. What is less known is, that even in persons working in lead based industries, the effect of lead and the appearance of signs and symptoms of lead poisoning is genetically determined. Three genes related to lead metabolism, exhibiting polymorphism have already been demonstrated-δALA-dehydratase, Vitamin D receptor gene and Hemochromatosis gene. These alleles determine the susceptibility of the individuals to lead. We present here a case of a lead acid battery worker, who presented without any signs and symptoms of lead poisoning except for a very high level of blood lead (82.8μg/dl and 47.5μg/dl 9 months later)  相似文献   

3.
Blood zinc protoporphyrin (ZPP), serum total protein (TP), and total cholesterol (TC) levels in automobile workshop workers in relation to lead toxicity were analysed. In the present study, automobile workshop workers (healthy male workers at an age between 28 and 35 from four major automobile workshops in Kottayam, Kerala State, India) and the control (male healthy adults at an age between 28 and 35 residing at Aymanam, a distant village at Kottayam District, Kerala having reduced or no chance of lead exposure) displayed significant difference in blood lead (BPb) and blood ZZP (BZPP) level. The mean value of BPb in automobile workshop workers was 15.76±0.33 μg/dl, while in the control it was 8.20±0.15 μg/dl. In automobile workshop workers, the mean value of BZPP was 34.2±0.62 μg/dl. The control group exhibited a mean of 11.5±0.22 μg/dl. Automobile workshop workers exhibited significant increase in BZPP was corresponding to the increase in BPb level. The total protein levels estimated in automobile workshop workers showed significant decrease compared to control individuals, but was within the reference range of healthy individuals. The mean value of TP level in automobile workshop workers and control was 6.9±0.13 g/dl and 7.71±0.18 g/dl, respectively. There was no significant difference in blood haemoglobin (BHb) level among the automobile workshop workers and control. The serum TC level in automobile workshop workers showed significant decrease compared to the control individuals, but was with in the reference range of healthy individuals. The mean level of serum TC in automobile workshop workers was 162.00±3.44 mg/dl and the same in control was 172.86±4.32 mg/dl. The present study affirms occupational lead toxicity in automobile workshop workers and its effect on serum protein and cholesterol levels.  相似文献   

4.
Short-chain acyl-CoA dehydrogenase (ACAD) deficiency is an extremely rare inherited mitochondrial disorder of fat metabolism. This belongs to a group of diseases known as fatty acid oxidation disorders. Screening programmes have provided evidence that all the fatty acid oxidation disorders combined are among the most common inborn errors of metabolism. Mitochondrial beta oxidation of fatty acids is an essential energy producing pathway. It is a particularly important pathway during prolonged periods of starvation and during periods of reduced caloric intake due to gastrointestinal illness or increased energy expenditure during febrile illness. The most common presentation is an acute episode of life threatening coma and hypoglycemia induced by a period of fasting due to defective hepatic ketogenesis. Here, the case of a 4 month old female patient who had seizures since the third day of her birth and persistent hypoglycemia is described. She was born to parents of second degree consanguinity after 10 years of infertility treatment. There was history of delayed cry after birth. Metabolic screening for TSH, galactosemia, 17-OHP, G6PD, cystic fibrosis, biotinidase were normal. Tandem mass spectrometric (TMS) screening for blood amino acids, organic acids, fatty acids showed elevated butyryl carnitine (C4) as 3.40 μmol/L (normal <2.00 μmol/L), hexanoyl carnitine (C6) as 0.92 μmol/L (normal <0.72 μmol/L), C4/C3 as 2.93 μmol/L (normal <1.18 μmol/L). The child was started immediately on carnitor syrup (carnitine) 1/2 ml twice daily. Limitation of fasting stress and dietary fat was advised. Baby responded well by gaining weight and seizures were controlled. Until now, less than 25 patients have been reported worldwide. The limited number of patients diagnosed until now is due to the rarity of the disorder resulting in under diagnosis.  相似文献   

5.
Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty non-pregnant women served as control. About 77 (47.24%) of the pregnant women were followed up for any subsequent development of preeclampsia during the pregnancy. Fibronectin levels in plasma were measured by ELISA assay and serum total protein, urea and creatinine were determined spectrophotometrically. The mean plasma FN concentration of non-obese pregnant women in first trimester was lower than those of the non-pregnant women by 24%, but however, increased to the non-pregnant level in second and third trimesters. Obese/overweight pregnant women had significantly (P < 0.05) higher values than non-obese pregnant women in second and third trimesters. FN in obese/overweight pregnant women correlated positively with mean arterial blood pressure (MAP: r = 0.414, P = 0.04). About 28.57% of the pregnant women with FN above cut off point of 330 μg/ml at 18–24 weeks of gestation developed preeclampsia. This value increased to 40.0% when only the obese/overweight women were considered. On analysis of both fibronectin >330 μg/ml and MAP > 90, the predictive value increased to 66.7%. We therefore conclude that elevated FN may be regarded as a risk factor of preeclampsia especially among the obese women.  相似文献   

6.
A number of preparations are available in Ayurved for treatment of anemia and iron deficiency. This study was designed to evaluate efficacy of some of them. Six most commonly used Ayurvedic iron containing preparations (Navayasa Curna, Punarnavadi Mandura, Dhatri Lauha, Pradarantaka Lauha, Sarva-Juara-Hara Lauha and Vrihat Yakrdari Lauha) were given in a dose of 250 mg b.d. for 30 days to six groups of iron deficient anemic patients; each group consisting of 20 patients. A control group was given Allopathic preparation—Irex-12, (containing—ferrous fumarate, vitamin C, folic acid and vitamin B12); 1 capsule daily for 30 days for comparison. All hematological and iron parameters were determined before and after completion of treatment. The results showed that there was statistically significant rise (p<0.001) in all of them—Hb, PCV, TRBC, MCV, MCH, MCHC and plasma iron, percent saturation and plasma ferritin. Total iron binding capacity decreased significantly (p<0.001). The response of most of Ayurvedic preparations was better than Allopathic preparation and there was no side effect as observed with iron salts The Hb regeneration rate was 0.10 g/dl/day for Allopathic preparation; while it was above this value for all Ayurvedic preparations exceptPradarantaka Lauha which was least effective.Sarva-Juara-Hara Lauha was the drug of choice as Hb regeneration with it was highest 0.16 g/dl/day. Upon analysis of Ayurvedic drugs, these results were found to be consistent and correlated with iron content of the preparation.  相似文献   

7.
Lead interferes with a variety of body processes and is toxic to many organs and tissues including the heart, bones, intestines, kidneys, and reproductive and nervous systems. Routes of exposure to lead include contaminated air, water, soil, food, and consumer products. The possibility of lead exposure in humans is therefore of great significance from health point of view. Occupational exposure is a common known cause of lead poisoning in adults but current status of adults exposed otherwise is not known. School teachers representing wide local population were selected and asked to furnish information regarding possible lead exposure. Blood lead level (BLL) was estimated using anodic stripping voltammetry. The mean BLL was 6.89 ± 9.5 μg/dl (<3.5–>65 μg/dl) in representative adult population. Out of the total 16 % were found to be having BLL >10 μg/dl which has significantly decreased from leaded gasoline era. Those with increased BLL (>10 μg/dl) were found to have common determinants like usage of old metallic pipes for plumbing, water consumption without any purification system, usage of cosmetics and Ayurvedic/herbal medicines.  相似文献   

8.
WHO-Tropical Disease Research scheme highlighted the need for development of new anti-filarial drugs. Certain antibiotics have recently been found effective against Wolbachia, co-existing symbiotically with filarial parasites. Inflammatory response entails oxidative mechanism to educe direct anti-microbial effect. In the present study microfilariae were maintained in vitro in medium supplemented with varying concentrations of tetracycline, doxycycline (20–100 μg/ml) or ciprofloxacin (50–250 μg/ml) separately to find out any involvement of oxidative mechanism in the anti-filarial effect of these antibiotics. Loss of motility of the microfilariae was measured after 48 h and correlated with the levels of MDA, nitric oxide and protein-carbonylation. Significant loss of microfilarial motility was recorded with increasing concentration of tetracycline and doxycycline but with ciprofloxacin the effect was not marked. Agents with high antifilarial activity revealed significant association with oxidative parameters in a dose dependent manner. The result suggests that oxidative effect might be exploited to design novel antifilarial drug candidate.  相似文献   

9.
The study was designed to evaluate the antioxidant activity and effect of Cymbopogon martinii (Roxb.) Wats. (Poaceae) leaves on the activity of monoamine oxidase and kinetics of enzyme inhibition. Ethanol extract of C. martinii and rat brain mitochondrial monoamine oxidase preparation ware used to study the kinetics of enzyme inhibition using double reciprocal Lineweaver–Burk plot. The DPPH was used as a source of free radical to evaluate antioxidant potential. It is observed that, the ethanolic extract of C. martinii inhibits the monoamine oxidase activity with competitive mode of inhibition. The V max (0.01 mM/min) remained constant while, K m varied from 21.00 ± 1.1, 43.33 ± 1.5 and 83.33 ± 1.4 mM for 100–500 μg/ml concentration of C. martinii. The K i values were calculated to be 90.00 ± 0.87, 75.00 ± 0.69, 68.18 ± 0.68 μg for 100–500 μg/ml concentration of C. martini. It also shows a significant DPPH (1,1-diphenyl-2-picryl hydrazine) radical scavenging (IC50 = 0.34 ± 0.05 mg/ml) and reducing activity (IC50 = 0.70 ± 0.22 mg/ml). The C. martini can be considered as a possible source of MAO inhibitor used in the treatment of depression and other neurological disorders.  相似文献   

10.
The effect of the antitubercular drugs isoniazid (10 μg/ml), ethambutol (10 μg/ml), rifampicin (0.5 μg/ml) and streptomycin (1 μg/ml) on the calmodulin like protein (CAMLP) content ofMycobacterium tuberculosis H37Rv andM. tuberculosis H37Ra was investigated. The drugs were added to actively growing cells at their mid log phase of growth (14 days) and after 12 more hours of incubation, CAMLP was estimated. In both the mycobacteria, all the four antitubercular drugs CAMLP.  相似文献   

11.
A study was undertaken for evaluating the hypoglycemic and hypolipidemic effects of an ayurvedic medicine “Rajanyamalakadi” containing Curcuma longa, Emblica officinalis and Salacia oblonga in type II diabetic patients over a period of 3 months. Ethical committee consent for the study was given by the Director, Indian Systems of Medicine, Kerala. A total of 43 patients with established diabetes mellitus as adjudged from clinical features and FBS values, appeared for the camp (Age group 35–75 yrs). An informed consent for the study was obtained from each patient. The clinical proforma was given to each patient to collect data such as height, weight, diet pattern, previous history of illness etc. The ongoing antidiabetic medications were stopped under medical supervision and the patients were provided with ‘Rajanyamalakadi’ tablets (dose 1–2 tablets each weighing 500mg). The dosage of the drug was decided by the supervising medical officer on a case to case basis, taking note of the clinical conditions and responsiveness of the patients. The patients were monitored for three months, who were divided into 6 groups based on their age and again into two groups, 5 & 6, based on their mean FBS values. ie; Normal Persons, Diabetics of age groups 35–45yrs, 46–55yrs, >55yrs and those with FBS < 145.9 mg% and > 145.9 mg%. The Ayurvedic medicine “Rajanyamalakadi” has showed significant antidiabetic, hypolipidemic and antioxidant effects. In addition to that significant ameliorating effects on the elevated serum AST and ALT activities were also demonstrated by the treatment. The nutraceuticals present in the drug like Terpenoids, Polyphenols, Curcumin etc are responsible for the medicinal effects.  相似文献   

12.
For the estimation of copper, diethyldithiocarbamate method is most commonly employed in various laboratories where atomic absorption spectrophotometer is not available. The prevalence rate of gastrointestinal malignancies is very high in Kashmir as compared to other parts of the world. We could find high serum copper levels in gastrointestinal tract cancer. Intake of salted tea, prepared in copper vessel, is very common in Kashmir. Such tea samples showed copper value as 3168.9 (S.D. 700.5) μg/dl estimated by diethyldithiocarbamate method. When these samples analysed by atomic absorption spectrophotometer, the copper levels were just 9% as reported by colorimetric method. Various black salted tea samples were prepared in the laboratory in glass vessel. The mean copper was 1115.0 (S.D. 350.4) μg/dl. After addition of milk, the values were reduced by 50%. Nine phenolic compounds showed varying amount of copper by colorimetric method and no copper could be detected by atomic absorption spectrophotometer. Phenolic compounds present in tea leaves interfere in the estimation of copper by diethyldithiocarbamate method. It is suggested that diethyldithiocarbamate colorimetric method for copper estimation is not suitable for solutions containing phenolic compounds.  相似文献   

13.
Lead poisoning presents a common acquired as well as congenital environmental threat to children’s health today. An unusual case of severe lead poisoning in breast fed male infant is presented here. The objective of the study is to describe a patient who developed clinical lead intoxication with an uncommon source of poisoning. A 6 months old male baby presented with gradual loss of weight, not feeding well and persistent vomiting. Laboratory investigation revealed that he was having anemia (Hb level 5.4 gm/dl), abnormal liver enzymes (including elevated transaminase activity) and high blood lead value (83 μg/dl). RBC morphology showed basophilic stippling with cabot ring, suggestive of a case of lead poisoning. A course of chelation treatment using calcium versenate (EDTACaNa2) was prescribed following which a radical solution for mobilization of lead from his systems was observed.  相似文献   

14.
Heat stable fraction (HSF) of alkaline phosphatase (ALP) was evaluated as an adjunct to CA 125 as a tumour marker for epithelial ovarian cancer in a follow-up study. In our study group 63.4% of patients had elevated HSF levels (≥10U/L) and 93.3% had elevated CA 125 levels (>35U/mL). The sensitivity of CA 125 and HSF was 93.3% and 63.3% respectively. The decline in the activity of HSF, over the pre-op levels was highly significant after the first (p=0.001) chemotherapy cycle and significant after the second and third cycles (p<0.029). Thereafter, HSF activity was almost undetectable. The decrease in CA 125 levels over the pre-op levels was significant after the first, second, third (p<0.001) and fourth (p<0.034) chemotherapy cycle. HSF can be used alone or as an adjunct to CA 125 in screening and monitoring patients of ovarian carcinoma especially in remote areas where sophisticated facilities are not available and in patients in which CA 125 levels are not raised preoperatively.  相似文献   

15.
Till date no community based data on plasma homocysteine is available in North Eastern Region. Hence, the present study was conducted to analyze and correlate the plasma homocysteine level with some life style factors like diet, alcohol intake, smoking habit and body weight, in a cross-section of population. 12 h fasting samples of 970 apparently healthy, Assamese population of both genders in the age group of 35–86 years, mostly from the urban area of Assam were tested for plasma total homocysteine level over a period of 3 years. Out of 970 volunteers, hyperhomocysteinemia was detected in 533 (55%) individuals with a mean value of 18.41 μmol/l. Of that hyperhomocysteinemia, 89.1% were in the range of moderately high and rest 10.9% were intermediate high. Another finding was that males had a tendency towards greater value (mean = 20.36 μmol/l) than females (mean = 16.37 μmol/l). It was observed that the relationship of homocysteine levels to gender and some of the life style factors were also significant.  相似文献   

16.
The present study was conducted to assess correlation of ammonia levels with valproate levels in epileptic patients presenting with valproate toxicity and also whether liver enzymes and ammonia levels could serve as biochemical marker of valproate toxicity. 100 patients with epilepsy who had received valproate therapy for more than 12 months and had presented with valproate toxicity and 100 controls were included in the study. The serum valproate, ammonia and liver enzymes were measured in these subjects. In patients with valproate toxicity, the mean level of serum valproate was 110.91 ± 28.68 mg/dL (therapeutic range 50–100 mg/dL). Serum ammonia was higher (86.37 ± 39.90 μg/dL) in patients with valproate toxicity compared to controls (68.73 ± 30.07 μg/dL). Out of 100 patients, only 37 patients had serum valproate level > 120 mg/dL and 22 patients had raised levels of valproate as well as ammonia. Age < 30 years and serum ammonia > 69 μg/dL is risk factors for valproate toxicity. Serum ammonia, liver enzymes should be regularly investigated in patients on valproate therapy for early diagnosis of valproate toxicity.  相似文献   

17.
The antioxidants are essential molecules in human system but are not miracle molecules. They are neither performance enhancers nor can prevent or cure diseases when taken in excess. Their supplemental value is debateable. In fact, many high quality clinical trials on antioxidant supplement have shown no effect or adverse outcomes ranging from morbidity to all cause mortality. Several Chochrane Meta-analysis and Markov Model techniques, which are presently best available statistical models to derive conclusive answers for comparing large number of trials, support these claims. Nevertheless none of these statistical techniques are flawless. Hence, more efforts are needed to develop perfect statistical model to analyze the pooled data and further double blind, placebo controlled interventional clinical trials, which are gold standard, should be implicitly conducted to get explicit answers. Superoxide dismutase (SOD), glutathione peroxidase and catalase are termed as primary antioxidants as these scavenge superoxide anion and hydrogen peroxide. All these three enzymes are inducible enzymes, thereby inherently meaning that body increases or decreases their activity as per requirement. Hence there is no need to attempt to manipulate their activity nor have such efforts been clinically useful. SOD administration has been tried in some conditions especially in cancer and myocardial infarction but has largely failed, probably because SOD is a large molecule and can not cross cell membrane. The dietary antioxidants, including nutrient antioxidants are chain breaking antioxidants and in tandem with enzyme antioxidants temper the reactive oxygen species (ROS) and reactive nitrogen species (RNS) within physiological limits. Since body is able to regulate its own requirements of enzyme antioxidants, the diet must provide adequate quantity of non-enzymic antioxidants to meet the normal requirements and provide protection in exigent condition. So far, there is no evidence that human tissues ever experience the torrent of reactive species and that in chronic conditions with mildly enhanced generation of reactive species, the body can meet them squarely if antioxidants defense system in tissues is biochemically optimized. We are not yet certain about optimal levels of antioxidants in tissues. Two ways have been used to assess them: first by dietary intake and second by measuring plasma levels. Lately determination of plasma/serum level of antioxidants is considered better index for diagnostic and prognostic purposes. The recommended levels for vitamin A, E and C and beta carotene are 2.2–2.8 μmol/l; 27.5–30 μmol/l; 40–50 μmol/l and 0.4–0.5 μmol/l, respectively. The requirement and recommended blood levels of other dietary antioxidants are not established. The resolved issues are (1) essential to scavenge excess of radical species (2) participants in redox homeostasis (3) selective antioxidants activity against radical species (4) there is no universal antioxidant and 5) therapeutic value in case of deficiency. The overarching issues are (1) therapeutic value as adjuvant therapy in management of diseases (2) supplemental value in developing population (3) selective interactivity of antioxidant in different tissues and on different substrates (4) quantitative contribution in redox balance (5) mechanisms of adverse action on excess supplementation (6) advantages and disadvantages of prooxidant behavior of antioxidants (7) behavior in cohorts with polymorphic differences (8) interaction and intervention in radiotherapy, diabetes and diabetic complications and cardiovascular diseases (9) preventive behavior in neurological disorders (10) benefits of non-nutrient dietary antioxidants (11) markers to assess optimized antioxidants status (12) assessment of benefits of supplementation in alcoholics and heavy smokers. The unresolved and intriguing issues are (1) many compounds such as vitamin A and many others possessing both antioxidant and non-antioxidant properties contribute to both the activities in vivo or exclusively only to non-antioxidant activity and (2) since human tissues do not experience the surge of FR, whether there is any need to develop stronger synthetic antioxidants. Theoretically such antioxidants may do more harm than good.  相似文献   

18.
In order to determine whether the screening of lipid profile is justified in patients with hypothyroidism we estimated serum lipids in cases having different levels of serum TSH. 60 patients of hypothyroidism in the age group of 20 to 60 yrs were studied for thyroid profile over a period of one year. On the basis of serum TSH level the cases were divided into three groups: In the first group TSH concentration was 8.8±2.99 μlU/ml, 95% confidence interval (Cl) 8.8±1.07, whereas serum total cholesterol and LDL-chol levels were 196±37.22 and 126±29.17 mg/dl respectively. The statistical analysis of these two groups showed a significant correlation between raised TSH levels and serum total cholesterol and LDL-chol (P<0.05 & P<0.01) respectively. We conclude that hypothyrodism is associated with changes in lipid profile.  相似文献   

19.
Aim is to study the antidiabetic effect of a compound GII purified earlier from the water extract of fenugreek (Trigonella foenum graecum) seeds by Murthy and his colleagues (patented in India and USA) in diabetic rabbits. Diabetes was induced in rabbits by injecting 80 mg/kg bw of alloxan intravenously into rabiits. Rabbits were subdivided into subdiabetic [fasting blood sugar (FBG) up to 120 mg/dl with abnormal glucose tolerance in glucose tolerance test (GTT)], moderately diabetic (FBG below 250 mg/dl) and severely diabetic (FBG above 250 mg/dl). Blood glucose and glycosylated hemoglobin (HbA1C) were estimated by procedures in the kits of Stangen Immunodiagnostics, Mumbai using, respectively, glucose oxidase method and absorbance at 415 nm. Serum insulin was estimated by the ELISA method as described in the kit of Boehringer Mannheim Immunodiagnostics, Mumbai, India. GII was found to improve blood glucose utilization in GTT and reduced FBG and HbA1C. In the present communication detailed studies were carried out with GII in the subdiabetic, moderately diabetic and severely diabetic rabbits. GII at a dose of 50 mg/kg bw per day brought down the elevated FBG levels in the untreated subdiabetic (FBG 96.6 ± 7 mg/dl), moderately diabetic (150.1 ± 14 mg/dl) and severely diabetic rabbits (427 ± 46 mg/dl) to normal in 12, 15 and 28 days of treatment. It improved serum HbA1C and insulin levels also in these rabbits. Intermittent therapy once a week for 6 weeks with GII at the same dose brought down the FBG values to normal in the subdiabetic (FBG 96.0 ± 2 mg/dl) and in the moderately diabetic rabbits to 133.0 ± 12 mg/dl. After stopping therapy of the subdiabetic and moderately diabetic rabbits whose FBG values came to normal after treatment with GII 50 mg/kg bw, the values remained normal for 1 week and showed a tendency to increase only after 15 days. If these animal studies are applicable to humans these results indicate that a diabetic person need not take GII daily when once the FBG value comes to normal or near to normal. Patients might be able to take GII only when the FBG value shows tendency to increase. So, intermittent therapy is possible with the potent product GII of the fenugreek seeds which is of a great advantage.  相似文献   

20.
Serum creatinine (SCr) levels are frequently used as a screening test to assess impaired renal function; however, patients can have significantly decreased glomerular filtration rate (GFR) with normal SCr values and making the recognition of kidney dysfunction more difficult. Hence, this study was designed to determine the extent of misclassification of the patients who have significantly reduced GFR as calculated by reexpressed four variable modification of diet in renal disease (MDRD) equation but, normal range of SCr. The study included 1040 in and out patients referred by physicians for serum creatinine measurement. When an exclusion criterion was applied 928 patients were qualified for the study. SCr was measured in 928 patients by a Roche kinetic compensated Jaffe’s assay. GFR was calculated using reexpressed four variable MDRD study equation. Of the 928 patients 270 (29.1%) had renal dysfunction on the basis of eGFR (<60 ml/min/1.73 m2). However, with SCr only 162 (17.5%) patients had abnormal renal function (>1.5 mg/dl) and SCr values misrepresented (108) 11.6% patients with impaired kidney function. In addition, more females, about 15% were failed to detect by SCr method in contrast to males of 9%. This study documented that, a large proportion of patients with impaired renal function are not diagnosed if clinicians rely solely on normal SCr as evidence of normal renal function. Inclusion of eGFR calculated by re-expressed 4 variable MDRD equation may facilitates the early identification and intervention of patients with renal impairment.  相似文献   

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