Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A retrospective analysis of 60 patients with Acquired Immune Deficiency Syndrome (AIDS) seen between 1981-1985 was performed to determine the genitourinary manifestations of this disease. Twenty-two per cent were found to have significant proteinuria, while 7 per cent had nephrotic syndrome which was associated with an extremely rapid demise. Renal insufficiency occurred in 27 per cent and renal biopsy results, when abnormal, revealed focal and segmental glomerulosclerosis. Pyuria was found in 52 per cent of patients, and urinary tract infections occurred in 20 per cent. Atypical pathogens including Candida, Salmonella, Acinetobacter calcoaticus, and cytomegalovirus were encountered.
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PMID:Urologic manifestations of AIDS. 367 77

Twelve patients with acquired immunodeficiency syndrome were treated with a natural product, highly purified human interleukin-2. Doses ranged from 250 to 250,000 units. No clinical responses were seen. Minimal toxicity was noted and consisted of mild prolongation of partial thromboplastin time and proteinuria. Immunologic changes during the study included a decrease in the number of circulating T8 lymphocytes, increased skin test reactivity, and a decline in serum immunoglobulin levels.
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PMID:Use of interleukin-2 in patients with acquired immunodeficiency syndrome. 633 38

Ten patients with clinical and laboratory features of acquired immune deficiency syndrome (AIDS) underwent renal ultrasonography prior to biopsy because of proteinuria, azotemia, or uremia. Four patients had a history of intravenous heroin abuse and were considered separately so as to exclude it as a cause of nephropathy. Histological examination revealed focal segmental glomerulosclerosis (FSGS), which in patients with AIDS is characterized by rapid progression to severe uremia (though FSGS can also occur in several other forms of renal disease). The authors recommend that AIDS-associated FSGS be considered as a cause of type I parenchymal disease and suggest that serial sonograms may be useful in monitoring progressive renal involvement.
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PMID:Renal ultrasound in acquired immune deficiency syndrome. 638 12

Between January 1982 and December 1983, 75 patients with the acquired immunodeficiency syndrome were identified in our hospitals: 35% used intravenous drugs, 50% had proteinuria in excess of 0.5 g/dL, and 10% were nephrotic. Glomerular changes seen at autopsy in 36 patients included frequent mesangial lesions and deposits associated with mild asymptomatic proteinuria. Focal and segmental glomerular sclerosis was found in 5 patients and 4 of these had the nephrotic syndrome. Whereas reversible episodes of acute renal failure were not uncommon, terminal episodes of acute renal insufficiency occurred in 14 patients. The short survival of these patients may prevent the development of chronic renal failure.
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PMID:Glomerular lesions in the acquired immunodeficiency syndrome. 647 32

To determine the nature and frequency of renal disorders in AIDS we reviewed the records of thirty-two patients hospitalized over a twenty-two month period. Group I, including all patients with AIDS who demonstrated proteinuria and/or renal insufficiency, numbered thirteen patients, in ten of whom renal tissue was available. Renal abnormalities included proteinuria in twelve patients, which exceeded two grams per day in seven. The glomerular histologic lesions included focal glomerulosclerosis, diffuse mesangial hypercellularity, diffuse proliferative glomerulonephritis, and membranoproliferative glomerulonephritis. The nonglomerular histologic lesions included acute tubular necrosis, nephrocalcinosis, focal interstitial nephritis, and one case each of intrarenal cryptococcal infection and renal cell carcinoma. Nine of these thirteen patients developed renal insufficiency, and four of them required dialysis. Their mortality by the end of the study period was eleven of thirteen patients (85 percent), significantly worse in the short term than AIDS patients without renal problems. The patients in Group I were compared to the nineteen AIDS patients without renal abnormalities in Group II. The Group I patients had a higher incidence of oral and esophageal candidiasis, other fungal infections, and infections with Mycobacterium avium-intracellulare. They also had a higher incidence of exposure to aminoglycoside antibiotics and amphotericin B, and experienced more clinical shock than their Group II counterparts. It is concluded that patients with AIDS may demonstrate renal abnormalities on the basis of immune, hemodynamic, infectious, and neoplastic derangements.
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PMID:Renal disease in patients with AIDS: a clinicopathologic study. 673 86

The constellation of nephrotic proteinuria, FSGS, and rapid loss of renal function in a patient infected with HIV-1 has been sufficiently widespread and well documented to justify identification as a specific renal syndrome, HIV-associated nephropathy. The position paper of the National Kidney Foundation-National Institutes of Health task force estimated in 1990 that 10,000 to 15,000 persons will develop renal disease in association with AIDS [94]. Management of these patients is complex, and many will reach ESRD and require dialysis treatment, posing additional care problems. Greater understanding of the pathogenesis of the renal disease should lead to treatments which will forestall the development of HIVAN and possibly other forms of fibrotic renal disease. The ultimate eradication of AIDS will consign this renal syndrome to an interesting footnote in the history of nephrology. Since that time is still far in the future, nephrologists will continue to be faced with the need to diagnose and treat HIV-1-infected patients with renal involvement.
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PMID:Human immunodeficiency virus-associated glomerulosclerosis. 756 98

Albumin excretion, Analysis of urinary proteins by polyacrylamide gel electrophoresis (PAGE), and clinical evaluation were performed in 90 HIV-infected patients to assess subclinical renal involvement in HIV infection. Thirteen percent of all patients showed an albumin excretion > 20 mg/liter. Seven of four homosexual patients had albuminuria. Albuminuria occurred exclusively with T4 cell counts below 200/mm3. Polyacrylamide gel electrophoresis indicated glomerular lesions and showed no tubular proteinuria in patients with increased albumin excretion. It is concluded that subclinical renal involvement is not uncommon in HIV infection with T4 cell counts > 200/mm3. HIV-associated nephropathy and heroin-associated nephropathy may not be the main causes of renal involvement. In some cases, opportunistic viral infections may be the cause of microalbuminuria.
AIDS Res Hum Retroviruses 1994 Jun
PMID:Albuminuria in HIV-infected patients. 791 29

Several renal pathologic entities have been reported to be associated with human immunodeficiency virus (HIV) infection. The most common is focal glomerulosclerosis, but several different types of glomerulonephritis have been observed in patients with HIV infection and the acquired immunodeficiency syndrome. The mechanisms involved in the pathogenesis of the kidney disease remain obscure. We studied an HIV-infected patient treated with interferon-alpha who had developed proteinuria and membranoproliferative glomerulonephritis to determine whether the renal disease was associated with HIV infection or with chemotherapy. Circulating HIV antibodies were assessed by enzyme-linked immunosorbent assay; circulating immune complexes (CICs) were measured by C'1q assay and isolated by polyethylene glycol precipitation, then subjected to gel electrophoresis and immunochemical analysis. Renal biopsy tissue underwent acid elution, and the eluates were analyzed similarly. In addition the eluted antibody and the antibody from the CIC were assessed by immunodiffusion with eluate and immune complex antigens. A single CIC was detected, which was composed of an immunoglobulin G antibody complexed to a 26-kd protein antigen that was shown to be interferon-alpha. Eluate from the renal biopsy tissue demonstrated identical material, which cross-reacted with the components of the isolated CIC. Immune complex renal diseases, such as membranoproliferative glomerulonephritis, may be related to biologic response modifying agents in patients with HIV infection. The relative roles of their biologic response modification and the disordered immunoregulation seen in such patients in the pathogenesis of the renal disease is unclear. Renal biopsy is necessary to assess the etiology of the renal disease in HIV-infected patients.
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PMID:Membranoproliferative glomerulonephritis in a patient treated with interferon-alpha for human immunodeficiency virus infection. 797 30

A distinct form of renal disease has been described in patients at various stages of HIV infection that is becoming increasingly important as a cause of morbidity and mortality. Black race and intravenous drug abuse appear to predispose one to its development. The HIV-associated nephropathy is characterized by nephrotic-range proteinuria, rapid progression to end-stage renal disease, a diffuse sclerosing glomerulopathy with significant tubulo interstitial disease seen on light microscopy, and tubuloreticular inclusions seen via electron microscopy. The entity can be separated from heroin-associated nephropathy. The pathogenesis is unclear. Possibilities include direct invasion of the virus, effects of other viruses, genetic factors, immune factors, and multiple growth factors. Not all patients with HIV infection and renal disease have HIV-associated nephropathy. Because of prognostic and therapeutic implications, it is crucial to differentiate these lesions. Some reports suggest a possible beneficial effect of zidovudine therapy, but more study is required. Patient survival is dependent on the stage of HIV infection. Dialysis therapy does not appear to substantially prolong life in most patients with AIDS and irreversible renal failure. Therefore, a number of ethical issues have arisen that deal with medical futility.
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PMID:Human immunodeficiency virus-associated nephropathy: current concepts. 816 Jul 12

Analysis of pediatric AIDS surveillance revealed that 395 cases of pediatrics AIDS have been registered in Spain until the end of 1992. This accounts for about 3% of all cases of AIDS, a percentage higher than the cumulative pediatric percentage of 2% observed in USA and the rest of Europe. Although renal diseases is not considered a common clinical manifestation of AIDS, approximately 10% of the adults and 7% of pediatric AIDS patients are affected. To assess the situation of childhood HIV-associated nephropathy (HIVAN) in Spain, a survey of Spanish divisions of Pediatric Nephrology was undertaken in 1990. Three children with renal disease were identified. To know the actual prevalence of renal disease in HIV-infected children two years later, a new survey to 15 Spanish hospitals with divisions in Pediatric Nephrology was performed. The questionnaire included a retrospective analysis of their experience with HIV infected children and renal manifestations. The fourteen centers (93%) that responded to the questionnaire controlled 694 HIV-infected children (Class P-O: 454, Class P-1: 98, Class P-2: 142). Ten of them had screening program to detect renal disease in HIV infected children since 1989. Only two centers reported two new cases, one each, with clinical manifestations of HIV infection and renal disease, but without histologic confirmation one of them. They were two white girls, 24 and 2 months old respectively with proteinuria but without hematuria, chronic renal failure neither hypertension. Both patients died from infectious cause eleven months after and at the time of diagnosis respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[HIV-related nephropathy in children: the situation in Spain]. 816 1


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