Urinary retinol excretion and kidney function in children with shigellosis

Amal K. Mitra, Jose O. Alvarez, Lisa Guay-Woodford, George J. Fuchs, M. A. Wahed, Charles B. Stephensen

Research output: Contribution to journalArticle

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Abstract

Background: Acute infections, including diarrhea, are associated with an increased risk of vitamin A deficiency. Urinary retinol excretion during such infections may contribute to this risk. The mechanism accounting for urinary retinol loss has not been clearly defined. Objective: This study attempted to determine whether urinary retinol loss in children with acute infection is associated with impaired kidney function, particularly impaired tubular protein reabsorption. Design: Urinary retinol excretion and kidney function were examined in 66 hospitalized children 5 mo to 5 y of age with acute Shigella dysentery. Results: Urinary retinol loss occurred in 59% of children and was substantial (>0.1 μmol/d) in 8% of them. Children with more severe disease excreted higher concentrations of urinary retinol; those with a body temperature ≥40°C excreted a mean of 0.10 ± 0.18 μmol/d compared with 0.005 ± 0.008 μmol/d for other children (P < 0.0001). Children with more severe disease also had impaired tubular reabsorption of low-molecular- weight proteins [β2-microglobulin and retinol binding protein (RBP)], although other measures of tubular and glomerular function were not similarly impaired. In multiple regression analysis, severity of disease indicators were the best predictors of tubular reabsorption of β2-microglobulin (R2 = 0.53) whereas tubular reabsorption of β2-microglobulin and RBP were found to be the best predictors of urinary retinol loss (R2 = 0.69). Conclusions: A significant amount of retinol was excreted in the urine in children with shigellosis: 8% excreted >0.10 μmol/d (15% of the daily metabolic requirement). Impaired tubular reabsorption of low-molecular-weight proteins, such as RBP transporting retinol, appeared to be the cause of this urinary retinol loss.

Original languageEnglish (US)
Pages (from-to)1095-1103
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume68
Issue number5
StatePublished - Nov 1998

Fingerprint

shigellosis
Bacillary Dysentery
renal function
Vitamin A
vitamin A
excretion
Kidney
Infection
infection
Vitamin A Deficiency
Hospitalized Child
vitamin A deficiency
Body Temperature
body temperature
Diarrhea
diarrhea
Proteins
proteins
Molecular Weight
molecular weight

Keywords

  • α-acid glycoprotein
  • Albuminuria
  • C-reactive protein
  • Children
  • Fever
  • Kidney function
  • Malnutrition
  • Retinol
  • Retinol binding protein
  • Shigella dysenteriae
  • Shigellosis
  • Urinary excretion

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Food Science

Cite this

Mitra, A. K., Alvarez, J. O., Guay-Woodford, L., Fuchs, G. J., Wahed, M. A., & Stephensen, C. B. (1998). Urinary retinol excretion and kidney function in children with shigellosis. American Journal of Clinical Nutrition, 68(5), 1095-1103.

Urinary retinol excretion and kidney function in children with shigellosis. / Mitra, Amal K.; Alvarez, Jose O.; Guay-Woodford, Lisa; Fuchs, George J.; Wahed, M. A.; Stephensen, Charles B.

In: American Journal of Clinical Nutrition, Vol. 68, No. 5, 11.1998, p. 1095-1103.

Research output: Contribution to journalArticle

Mitra, AK, Alvarez, JO, Guay-Woodford, L, Fuchs, GJ, Wahed, MA & Stephensen, CB 1998, 'Urinary retinol excretion and kidney function in children with shigellosis', American Journal of Clinical Nutrition, vol. 68, no. 5, pp. 1095-1103.
Mitra AK, Alvarez JO, Guay-Woodford L, Fuchs GJ, Wahed MA, Stephensen CB. Urinary retinol excretion and kidney function in children with shigellosis. American Journal of Clinical Nutrition. 1998 Nov;68(5):1095-1103.
Mitra, Amal K. ; Alvarez, Jose O. ; Guay-Woodford, Lisa ; Fuchs, George J. ; Wahed, M. A. ; Stephensen, Charles B. / Urinary retinol excretion and kidney function in children with shigellosis. In: American Journal of Clinical Nutrition. 1998 ; Vol. 68, No. 5. pp. 1095-1103.
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abstract = "Background: Acute infections, including diarrhea, are associated with an increased risk of vitamin A deficiency. Urinary retinol excretion during such infections may contribute to this risk. The mechanism accounting for urinary retinol loss has not been clearly defined. Objective: This study attempted to determine whether urinary retinol loss in children with acute infection is associated with impaired kidney function, particularly impaired tubular protein reabsorption. Design: Urinary retinol excretion and kidney function were examined in 66 hospitalized children 5 mo to 5 y of age with acute Shigella dysentery. Results: Urinary retinol loss occurred in 59{\%} of children and was substantial (>0.1 μmol/d) in 8{\%} of them. Children with more severe disease excreted higher concentrations of urinary retinol; those with a body temperature ≥40°C excreted a mean of 0.10 ± 0.18 μmol/d compared with 0.005 ± 0.008 μmol/d for other children (P < 0.0001). Children with more severe disease also had impaired tubular reabsorption of low-molecular- weight proteins [β2-microglobulin and retinol binding protein (RBP)], although other measures of tubular and glomerular function were not similarly impaired. In multiple regression analysis, severity of disease indicators were the best predictors of tubular reabsorption of β2-microglobulin (R2 = 0.53) whereas tubular reabsorption of β2-microglobulin and RBP were found to be the best predictors of urinary retinol loss (R2 = 0.69). Conclusions: A significant amount of retinol was excreted in the urine in children with shigellosis: 8{\%} excreted >0.10 μmol/d (15{\%} of the daily metabolic requirement). Impaired tubular reabsorption of low-molecular-weight proteins, such as RBP transporting retinol, appeared to be the cause of this urinary retinol loss.",
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AU - Mitra, Amal K.

AU - Alvarez, Jose O.

AU - Guay-Woodford, Lisa

AU - Fuchs, George J.

AU - Wahed, M. A.

AU - Stephensen, Charles B.

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N2 - Background: Acute infections, including diarrhea, are associated with an increased risk of vitamin A deficiency. Urinary retinol excretion during such infections may contribute to this risk. The mechanism accounting for urinary retinol loss has not been clearly defined. Objective: This study attempted to determine whether urinary retinol loss in children with acute infection is associated with impaired kidney function, particularly impaired tubular protein reabsorption. Design: Urinary retinol excretion and kidney function were examined in 66 hospitalized children 5 mo to 5 y of age with acute Shigella dysentery. Results: Urinary retinol loss occurred in 59% of children and was substantial (>0.1 μmol/d) in 8% of them. Children with more severe disease excreted higher concentrations of urinary retinol; those with a body temperature ≥40°C excreted a mean of 0.10 ± 0.18 μmol/d compared with 0.005 ± 0.008 μmol/d for other children (P < 0.0001). Children with more severe disease also had impaired tubular reabsorption of low-molecular- weight proteins [β2-microglobulin and retinol binding protein (RBP)], although other measures of tubular and glomerular function were not similarly impaired. In multiple regression analysis, severity of disease indicators were the best predictors of tubular reabsorption of β2-microglobulin (R2 = 0.53) whereas tubular reabsorption of β2-microglobulin and RBP were found to be the best predictors of urinary retinol loss (R2 = 0.69). Conclusions: A significant amount of retinol was excreted in the urine in children with shigellosis: 8% excreted >0.10 μmol/d (15% of the daily metabolic requirement). Impaired tubular reabsorption of low-molecular-weight proteins, such as RBP transporting retinol, appeared to be the cause of this urinary retinol loss.

AB - Background: Acute infections, including diarrhea, are associated with an increased risk of vitamin A deficiency. Urinary retinol excretion during such infections may contribute to this risk. The mechanism accounting for urinary retinol loss has not been clearly defined. Objective: This study attempted to determine whether urinary retinol loss in children with acute infection is associated with impaired kidney function, particularly impaired tubular protein reabsorption. Design: Urinary retinol excretion and kidney function were examined in 66 hospitalized children 5 mo to 5 y of age with acute Shigella dysentery. Results: Urinary retinol loss occurred in 59% of children and was substantial (>0.1 μmol/d) in 8% of them. Children with more severe disease excreted higher concentrations of urinary retinol; those with a body temperature ≥40°C excreted a mean of 0.10 ± 0.18 μmol/d compared with 0.005 ± 0.008 μmol/d for other children (P < 0.0001). Children with more severe disease also had impaired tubular reabsorption of low-molecular- weight proteins [β2-microglobulin and retinol binding protein (RBP)], although other measures of tubular and glomerular function were not similarly impaired. In multiple regression analysis, severity of disease indicators were the best predictors of tubular reabsorption of β2-microglobulin (R2 = 0.53) whereas tubular reabsorption of β2-microglobulin and RBP were found to be the best predictors of urinary retinol loss (R2 = 0.69). Conclusions: A significant amount of retinol was excreted in the urine in children with shigellosis: 8% excreted >0.10 μmol/d (15% of the daily metabolic requirement). Impaired tubular reabsorption of low-molecular-weight proteins, such as RBP transporting retinol, appeared to be the cause of this urinary retinol loss.

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KW - Kidney function

KW - Malnutrition

KW - Retinol

KW - Retinol binding protein

KW - Shigella dysenteriae

KW - Shigellosis

KW - Urinary excretion

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