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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To clarify the time dependency of risk factors for the development of diabetic nephropathy, we applied Poisson regression to the analysis of 7167 person-year data in 1447 patients with non-insulin-dependent diabetes mellitus (NIDDM) who were initially free of proteinuria. Significant predictors were found to be annual mean fasting blood glucose (FBG) level, male gender, duration, and age at diagnosis. Hyperglycemia was more influential, while duration was less in the previous year of development of proteinuria than at the initial visit. When more information during longer-year data was used as average, the contribution of FBG level was enhanced. Current age was less associated than was age at diagnosis. Thus, Poisson regression seems to be useful for the analysis of risk variables in chronic diseases.
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PMID:Risk factors for development of proteinuria in NIDDM analyzed by Poisson regression. 177 19

In 1974 a cross-sectional study was conducted on 4591 out-patients (2095 males and 2496 females) aged 18-67 years, with diabetes of 1-10 years duration, and cardiovascular fatalities followed for 10 years. A multiple logistic regression was then performed on total cardiovascular deaths, deaths from ischaemic heart disease, and from stroke on selected baseline variables related to the course and control of diabetes, selected symptoms of macroangiopathy, and other risk factors, separately for insulin-treated and non-insulin-treated patients. Hyperglycaemia, proteinuria, arterial hypertension, various symptoms of ischaemic heart disease, age, and current cigarette smoking were found to be important predictors of cardiovascular mortality, more so in non-insulin-treated than in insulin-treated patients. Proteinuria and arterial hypertension carried a greater risk in females than males, but the opposite was true for the signs and symptoms of ischaemic heart disease. Relative body mass was found to correlate inversely with probability of cardiovascular death among insulin-treated males but not in non-insulin-treated males, whereas duration of diabetes was a significant factor only among non-insulin-treated females.
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PMID:Risk factors of cardiovascular death in diabetic patients. 182 45

Three weeks after initiation of griseofulvin treatment for dermatophytosis (40 mg/kg of body weight, q 12 h), an 8-yr-old domestic shorthair cat developed depression, vomiting, and pyrexia. Abnormalities found during physical examination included bilateral mydriasis, visual impairment, grade-II/V systolic murmur and multiple areas of alopecia. The cat was pancytopenic; serum biochemical abnormalities included hyperbilirubinemia, hyperglycemia, hyponatremia, and hypokalemia, and urinalysis revealed proteinuria, glycosuria, and bilirubinuria. Examination of a bone marrow aspirate revealed profound hypoplasia of all precursors. Griseofulvin toxicosis was diagnosed on the basis of the temporal relationship of drug administration with onset of clinical, hematologic, and biochemical abnormalities and failure to identify an infective or neoplastic cause for the bone marrow hypoplasia. The condition was refractory to treatment and the cat was euthanatized. Pathologic changes in the bone marrow were consistent with severe hypoplasia of all bone marrow precursors.
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PMID:Bone marrow hypoplasia in a cat treated with griseofulvin. 201 Mar 36

Epidemiologic data on the incidence of gross proteinuria in people with diabetes are important in medical counseling, in projecting estimates of needs and costs of health care, and for developing approaches to prevent renal complications. We performed a population-based incidence study in southern Wisconsin of insulin-taking diabetic persons diagnosed before 30 years of age. The presence of gross proteinuria (greater than or equal to 0.30 g/L) was determined by means of a reagent strip. The incidence of proteinuria in a 4-year interval was 14.4% (95% confidence interval, 11.7% to 17.0%). The relative risk of developing proteinuria after 4 years for those with glycosylated hemoglobin levels in the highest quartile compared with those in the lowest quartile was 3.0 (95% confidence interval, 1.6 to 5.3). The incidence of proteinuria was also associated with higher diastolic blood pressure, being male, taking more insulin, and having more severe retinopathy at the baseline examination. The relationship between glycosylated hemoglobin level and the incidence of proteinuria was significant even after controlling for these other risk variables. These data suggest that hyperglycemia, as measured by glycosylated hemoglobin level, is a significant risk factor for the development of gross proteinuria.
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PMID:The incidence of gross proteinuria in people with insulin-dependent diabetes mellitus. 206 75

In patients with diabetic nephropathy, near-normalization of blood pressure (BP) and blood sugar may have a beneficial impact on changes in kidney function, but visually impaired patients may face difficulties when striving for optimal control of hypertension and hyperglycemia. In a prospective feasibility study, we followed a group of nine blind Type I (insulin-dependent) diabetic patients (mean age 30 +/- 4 years) with overt diabetic nephropathy and uncontrolled hypertension. All patients received intensified insulin therapy after a structured diabetes treatment and teaching program, and adapted their antihypertensive drug treatment to self-monitored BP values. At recruitment, HbA1c values were 5.8 +/- 0.6%, and remained stable at 6.3 +/- 1.7% after a mean observation period of 27 months. BP pressure decreased from 150 +/- 14/99 +/- 14 mmHg to 130 +/- 17/86 +/- 10 mmHg after 1 year, and to 140 +/- 14/92 +/- 9 mmHg at the last examination, (p less than 0.05). Serum creatinine and creatinine clearance remained stable over the observation period at 165 +/- 56 mumol/L and 0.8 +/- 0.4 ml/s/1.72m2 at recruitment, and 152 +/- 47 mumol/L and 1.0 +/- 0.5 ml/s/1.72m2 at the final examination. Proteinuria decreased from 3.2 to 1.4 g/24 h (p less than 0.05). No patient needed renal replacement therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Near-normotension and near-normoglycemia in blind type I diabetic patients with overt diabetic nephropathy. 215 Dec 31

Thirty-six male Lewis rats rendered diabetic using alloxan received syngeneic pancreaticoduodenal grafts. Seven days prior to and 7, 30, and 90 days posttransplantation, the animals were housed in metabolic cages for periods of 48 hours. During this time, body weight, water intake, food intake, urine output, and fecal output were recorded every 24 hours. Blood sugar, plasma insulin, glucosuria, and proteinuria were determined at 3-month intervals prior to the transplant and at monthly intervals posttransplantation. These parameters were also concurrently recorded for diabetic control rats. Pancreaticoduodenal transplantation produces immediate relief of hyperglycemia, glucosuria, polyuria, polyphasia, and polydypsia, resulting in good health of the animals until the time of sacrifice. A significantly increased insulin level was also recorded. The transplanted animals showed a weight gain reflecting that of a normal growth curve.
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PMID:Metabolic effect of pancreas transplantation on long-term diabetic rats. 219 25

The natural history of renal lesions in nonobese diabetic mice was assessed. This strain develops a spontaneous overt insulin-dependent diabetes that has a female predominance and an autoimmune pathogenesis. We compared mice that had a normal glucose tolerance test with mice that had a diabetes of 2 to 15 weeks' duration. The glomerular surface area was increased in all diabetic mice regardless of the duration of hyperglycemia. There was an increase in the albumin/creatinine ratio in the urine of diabetic mice. Finally, nonobese diabetic mice all showed mesangial sclerosis that was more pronounced in the diabetic mice. This suggests that this strain is susceptible to glomerulosclerosis and that the occurrence of hyperglycemia results in an increase of glomerular size, mesangial sclerosis, and proteinuria, soon after glycosuria is first demonstrated.
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PMID:Glomerular lesions in nonobese diabetic mouse: before and after the onset of hyperglycemia. 219 27

A population-based prospective study of insulin-dependent diabetics between the ages of 14-30 southern Wisconsin examined the relationship between oral contraceptive use and presence and severity of diabetic retinopathy, hypertension and glycosylated hemoglobin (HbA1). HbA1 is a measure of overall control of hyperglycemia. Out of 10,135 diabetic patients of 452 physicians in an 11-county area of Wisconsin, 432 were women between 14-30, and were followed from 1980-1986. The exit interview and exam consisted of pupil dilatation, stereoscopic fundus photographs, blood glucose by Chemstrip, blood pressure and determination of HbA1 with a resin microcolumn. 384 of these women provided oral contraceptive use history at follow-up. 170 ever used pills, 62 for 1yr, 59 for 2-4 yr, and 49 for 5 or more years. There was a trend toward current pill use with less severe diabetic retinopathy. There was no evidence of an association between ever using pills and the severity of diabetic retinopathy, controlling for age, duration of diabetes, systolic or diastolic blood pressure, HbA1, proteinuria or body mass index. Duration of diabetes, diastolic blood pressure, proteinuria and HbA1 were significantly associated with severity of retinopathy, while age, systolic blood pressure and body mass were not. Current, prior or duration of use of pills did not show significant effects on severity of retinopathy. Number of daily doses of insulin were inversely significantly related to HbA1.
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PMID:Oral contraceptives in women with diabetes. 220 28

These studies examine the effect of cholesterol feeding in normal rats and in rats with streptozotocin-induced diabetes mellitus. Four groups were studied: normal rats fed either a standard rat chow or a standard rat chow supplemented with cholesterol and diabetic rats fed standard chow or standard chow plus cholesterol. Diabetic rats fed a standard diet excreted more creatinine and urea in the urine, had higher levels of blood urea nitrogen, and lower serum albumin levels than rats fed standard diet plus cholesterol. Blood glucose levels were similar in the two groups; however, diabetic rats given cholesterol had a greater body weight at the end of the study than diabetic rats eating standard chow. Urine volumes and sodium and potassium excretion in the urine were greater in diabetic rats fed a standard diet than in those fed a high cholesterol diet. Diabetic rats fed a standard diet had distinctive renal lesions characterized by swelling of tubular epithelial cells with clearing of cytoplasm. The nephron segments involved by this striking vacuolar change were the distal convoluted tubule and the thick limbs of Henle's loop. These lesions were identical to those described by Armanni-Ebstein in severely glycosuric patients. These lesions were not observed in any of the animals of the other three groups (including diabetic rats fed a high cholesterol diet). Glomeruli were normal in animals of all groups. Thus, cholesterol administration prevents the development of the Armanni-Ebstein lesions in diabetic rats despite persistent hyperglycemia. The mechanism by which cholesterol administration prevents the accumulation of glycogen in distal tubule cells has not been elucidated. It is suggested that glycogen accumulation in distal tubular segments may explain the greater urine volumes, natriuresis, kaliuresis, and proteinuria observed in diabetic animals fed a standard diet when compared with rats fed the same diet plus cholesterol.
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PMID:A high cholesterol diet ameliorates renal tubular lesions in diabetic rats. 235 86

The risk of developing persistent proteinuria was studied prospectively in 376 patients, enrolled in the Diabetic Retinopathy Study, who did not have proteinuria at entry to the study. The subjects had insulin-dependent diabetes with onset before age 30, more than 5 years duration of diabetes, and a median of 3 years of follow-up for proteinuria. Persistent proteinuria developed in 55 patients, giving an overall incidence rate of 61/1000 person-years; however, the incidence rate decreased markedly after 20 years of diabetes, from 117/1000 to 23/1000 person-years. Regardless of duration, it also decreased after age 40. Among those with less than 20 years of diabetes, it decreased from 126/1000 to 28/1000 person-years; and among those with duration 20 or more years, it decreased from 44/1000 to 7/1000 person-years. High mean blood pressure quadrupled the risk of persistent proteinuria among patients with high plasma glucose levels but had little effect on the risk in patients with glucose levels below the median for the group. In conclusion, hypertension predicts the development of nephropathy particularly in those with poorly controlled diabetes. This is consistent with our hypothesis that, in individuals with predisposition to hypertension, severe hyperglycemia interacts with some mechanism underlying that predisposition and causes injury to the kidneys. The marked decrease in risk after age 40 suggests that the development of diabetic nephropathy may be limited to a window of vulnerability. While the mechanisms for these associations remain unclear, these findings have important implications for managing patients with Type I diabetes to prevent renal failure.
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PMID:Elevated blood pressure predicts the development of persistent proteinuria in the presence of poor glycemic control, in patients with type I diabetes. 261 16


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