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)

It has been suggested that tubular-interstitial damage may be the main cause of Legionnaires disease (LD) associated acute renal failure (ARF). However, this hypothesis has rarely been examined. In China we firstly describe four patients with LD-ARF, who had proteinuria, hematuria, Leukocyturia and cylindruria. Two patients had nephrotic syndrome indicating acute glomerular injure, one of them was histopathologically proven to be rapidly progressive glomerulonephritis. Scr, UNa, RFI and FENa are markedly increased. Our results suggest that both tubular-interstitial and glomerular damage may be the important causes of LD-ARF in Chinese LD patients. To confirm this hypothesis further investigation are needed.
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PMID:[Legionnaires disease associated with acute renal failure]. 208 96

Kidney biopsy (KB) is controversial in the elderly because it is generally felt that the risks exceed the potential therapeutic benefits. In this review of our personal experience and the literature reports, we discuss the risks of this diagnostic procedure and its use in the four main circumstances of patient referral. On the one hand, KB does not seem to be more hazardous in the elderly, provided that it is not performed in patients in poor condition or with atrophic kidneys or suspected vascular lesions. On the other hand, KB is clearly useful in a number of elderly patients either to assess the diagnosis of a systemic disease involving the kidney or to select the appropriate treatment. 1. In patients with non nephrotic proteinuria, KB should be performed if the proteinuria is associated with extra-renal signs suggestive of systemic disease or with deterioration of renal function. 2. Nephrotic syndrome without evidence of amyloidosis and diabetes, should lead to KB to identify patients with minimal change disease (MCD) requiring steroid treatment. Indeed, MCD can rarely be suspected on clinical grounds as the resulting nephrotic syndrome is rarely "pure" at this age. 3. In acute renal failure, KB seems to be essential and urgent in patients with rapidly progressive glomerulonephritis and in those with renal failure of dubious origin to select the most appropriate treatment according to the etiology and the type of renal lesions (sclerotic or "active"). 4. KB is useless and hazardous in chronic renal failure, except in case of unexplained rapid worsening of renal function in patients with previously moderate renal failure.
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PMID:[For or against renal biopsy after 65 years]. 209 Sep 64

We describe findings in 188 patients with Berger's disease, the most frequent primary glomerulopathy in our renal biopsy material (25%). Diagnosis was made by finding IgA and dense mesangial deposits with immunofluorescence and electronmicroscopy, respectively. Patient's age ranged from 3 to 64 years (mean 27), 72 were females. Five degrees of the disease were recognized: I, minimal changes, 29 patients (15%); II, minor lesions, 37 (20%); III, focal and segmental lesions, 92 (49%); IV, diffuse proliferation of mesangial cells and/or glomerulo-capsular adhesions, 22 (12%), and V, diffuse sclerosing glomerulonephritis, 8 (4%). Clinical findings at the time of renal biopsy included isolated hematuria in 61%, nephrotic syndrome or proteinuria 11%, hypertension 16%, chronic renal failure 7%, acute renal failure or nephritic syndrome 3% and rapidly progressive glomerulonephritis 2%. Berger's disease was found in 10 clinically healthy donors (13% of living-related donors). Progression of lesions was shown by serial biopsy in 12 patients. Progressive Berger's disease was demonstrated in 5 transplanted patients, requiring dialysis in one. Thus, Berger's disease leads to varying degrees of renal damage, severe extramembranous nephropathy and crescentic glomerulopathy being less frequent.
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PMID:[Primary nephropathy due to mesangial deposits of IgA (Berger's disease)]. 215 10

We reviewed case reports of patients who developed acute renal failure and/or nephrotic range proteinuria in the course of receiving treatment with nonsteroidal anti-inflammatory agents (NSAIA). Those cases that contained information sufficient to confirm the diagnosis of acute interstitial nephritis with glomerulopathy (AING), including a suggestive clinical syndrome with appropriate renal biopsy findings, were further analyzed to achieve a more complete description of this clinical entity and its responsiveness to steroid treatment. Analysis of the cases that fulfilled the inclusion criteria confirmed that the disorder is twice as common in women and occurs mainly in elderly people, usually after long-term use of NSAIAs for musculoskeletal problems. Fenoprofen was implicated in 47% of the cases. Evidence of systemic hypersensitivity was uncommon. Two thirds of the cases displayed clinical and/or histological evidence of both acute interstitial nephritis and increased glomerular permeability. These findings strongly suggest that this condition is distinct from other drug-induced "allergic" acute interstitial nephritides. In the absence of complicating factors, all patients improved following discontinuation of the offending agents. No evidence was found to suggest that steroid therapy altered the clinical course of this process.
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PMID:Acute interstitial nephritis with glomerulopathy due to nonsteroidal anti-inflammatory agents: a review of its clinical spectrum and effects of steroid therapy. 218 4

Reported was an aged woman (80-year-old) of minimal change nephrotic syndrome which was complicated with reversible oliguric acute renal failure. The patient presented massive proteinuria, anasarca, and severe azotemia. She recovered conservatively from the acute renal failure and subsequently remitted from the nephrotic syndrome after the treatment which comprised albumin infusion, diuretics, adrenocorticosteroid hormones (including the pulse therapy), antiplatelet drug, and anticoagulants. The histopathologic findings of renal biopsy were compatible with minor glomerular abnormalities and acute tubular necrosis with many tubular casts. The previously reported cases older than 80-year-old which remitted from minimal change nephrotic syndrome complicated with reversible acute renal failure, were very rare. The present case was the second case among the literatures.
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PMID:[An aged woman with minimal change nephrotic syndrome complicated with reversible acute renal failure]. 219 Nov 62

In order to determine the frequency of acute renal failure (ARF) induced by drugs, to identify the agents responsible for it and to define its semiological characteristics, a prospective study was carried out between 1 October 1987 and 30 September 1988, in Sfax and southern Tunisia. Three Departments of Medicine and one Hemodialysis Center participated in this study. Twelve cases of drug-induced ARF were identified among the 73 cases of ARF reported, i.e., a frequency of 16%. Anti-inflammatory non-steroidal drugs (AINS) were implicated in 5 cases and antibiotics in 2. Symptoms of hypersensitivity were observed in 4 patients, 2/3 without oliguria. Renal insufficiency was usually marked: plasma creatinine was 523 +/- 425 mumol/l; proteinuria greater than 1 g/24 h was seen in 2 patients. Hypovolemia and/or hypotension (6 cases) and diabetes mellitus (4 patients) were found to favor ARF. Renal function returned to normal in 9 patients, whereas mild renal failure persisted in the remaining 3 patients. Drug-induced ARF occurs often. AINS are the most frequently incriminated agents and hypersensitivity symptoms without oliguria are the most common manifestations. Drug-induced ARF can be prevented by close monitoring of high-risk patients, i.e., those taking AINS.
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PMID:[Acute renal insufficiency caused by drugs or iodinated contrast media. Results of a prospective and multicenter study in south Tunisia]. 219 14

Although many reports have been made on the effectiveness of plasma exchange (PE) in active systemic lupus erythematosus (SLE), but there are no clear-cut criteria of indication for lupus nephritis (LN). In order to determine the criteria for indication of LN, 35 patients with LN treated by PE were studied with respect to renal function (F), proteinuria (P), immunological activity (A) and renal histology. The patients were divided into 4 groups according to the severity of renal function: F1 (stable chronic renal failure (CRF) or stable renal function n = 13), F2 (relapse type n = 9), F3 (rapidly progressive LN; creatinine clearance (Ccr) less than 40 ml/min n = 7) and F4 (acute renal failure; Ccr less than 10 ml/min n = 6). Proteinuria was also studied in 4 groups: P1 & P2 (without nephrotic syndrome (NS], P3 (acute type NS n = 15), and P4 (chronic type NS n = 7). These patients were divided into 3 groups to study immunological activity: A1 (chronic stage n = 6), A2 (relapse stage n = 12) and A3 (active stage n = 17). Comparison was made in each parameter. Renal histological classification according to WHO criteria of LN, activity score (AS) and chronicity score (CS) were evaluated and compared. As a result, the following indication was obtained. 1) ABSOLUTE INDICATION: 1. Rapidly progressive LN with high immunological activity; elevated serum creatinine (SCr) greater than 1.0 mg/dl/month or decreased Ccr from normal renal function to less than 40 ml/min within 1-2 months after onset. 2. Acute type NS within 1 year after onset. 3. histological AS greater than 20. 2) RELATIVE INDICATION: 1. Relapse LN with moderate immunological activity, decreased Ccr from normal function to 40-50 ml/min within 3-6 months, the rise in SCr of greater than 1.0 mg/dl/month. 2. Proteinuria is 1.0-3.5 g/day within 1 year after onset. 3. Such complication as CNS, serositis, thrombocytopenia and leukopenia, steroid resistance and/or severe side effects of steroid. 3) NO INDICATION: 1. CRF or stable renal function (Ccr greater than 50 ml/min). 2. Chronic type NS over 1 years with past history of NS and/or edema. 3. Low immunological activity and mild renal histology.
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PMID:[The criteria for indication of plasma exchange on lupus nephritis]. 221 18

Oliguric acute renal failure occurs in some adult patients with minimal change glomerulopathy. To look for clinical and pathologic factors that increase the risk for developing acute renal failure, 21 adults with minimal change glomerulopathy and a serum creatinine greater than 177 mumol/L (mean, 486 mumol/L; range, 194 to 1,344 mumol/L) (greater than 2.0 mg/dL [mean, 5.5 mg/dL; range, 2.2 to 15.2 mg/dL]) were compared with 50 adults with minimal change glomerulopathy and a serum creatinine less than 133 mumol/L (mean, 88 mumol/L; range, 53 to 124 mumol/L) (less than 1.5 mg/dL [mean, 1.0 mg/dL; range, 0.6 to 1.4 mg/dL]). Minimal change glomerulopathy patients with acute renal failure were older (59.5 v 40.3 years, P less than 0.001), and had higher systolic blood pressure (158 v 138 mm Hg, P = 0.001), more proteinuria (13.5 v 7.9 g/24 h, P = 0.01), and more arteriosclerosis in the renal biopsy specimen (1.7 + v 0.7 + on a scale of 0 to 4+, P = 0.005). Tubular epithelial simplification identical to that observed with ischemic acute renal failure (acute tubular necrosis) was observed in 71% of the patients with serum creatinine greater than 177 mumol/L (greater than 2.0 mg/dL) and 0% of those with less than 133 mumol/L (less than 1.5 mg/dL). All 18 patients with renal failure for whom follow-up data were available had recovery of function (mean creatinine, 539 +/- 301 mumol/L [6.1 +/- 3.4 mg/dL] at the time of biopsy and 106 +/- 27 mumol/L [1.2 +/- 0.3 mg/dL] at last follow-up), but sometimes only after weeks of dialysis support.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Adult minimal change glomerulopathy with acute renal failure. 223 33

The low osmolality iodinated contrast agents (ICA), ionic or non ionic are now suggested too replace the usual high osmolality ICA. The main arguments are the better clinical tolerance and a lower renal toxicity. Recent experimental studies have clearly demonstrated that the low osmolality ICA presents a lower renal toxicity. On the rat, we have confirmed that the in vivo renal toxicity of low osmolality ICA, is lower than the high osmolality ICA toxicity. It is clearly demonstrated on man than the enzyme urinary excretion and proteinuria are little or not modified by the low osmolality ICA, but both are increased by high osmolality ICA. These changes are found with a normal glomerular filtration flow. No difference are noted in the creatinine concentration and clearance follow-up. However it is possible that the necessary population of patient to get statistically significative differences between both agents can be superior to the number of patients studied. In clinical practice, we think, that low osmolality ICA must be used for patients presenting one or several risk factors of acute renal failure.
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PMID:[Renal tolerance of iodinated low osmolality contrast agents. Clinical and experimental aspects]. 225 74

A case is described in which atheroembolic renal disease was associated with nephrotic range proteinuria, sub-acute renal failure, severe hypertension and microhematuria, in the absence of typical peripheral stigmata of atheroemboli. Nephrotic range proteinuria has not been previously reported in atheroembolic renal disease. With sustained aggressive treatment of hypertension there was diminution and eventual clearing of the proteinuria accompanied by marked improvement in renal function. The histopathology, the indications for renal biopsy, and possible causes of proteinuria are discussed.
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PMID:Reversible nephrotic range proteinuria and renal failure in atheroembolic renal disease. 229 99


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