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)

The degree of fusion of glomerular epithelial cell foot processes was quantitated by determining the mean number of inter-process slip pores along 10 mum of basement membrane of peripheral capillary walls in 45 children with steroid-responsive nephrotic syndrome and minimal lesion glomerulopathy. Fusion was present in all biopsies performed when the child had proteinuria, but after remission the number of slit pores increased progressively towards normal over the next 4 weeks. There was a close correlation between the degree of fusion and the amount of proteinuria in those biopsied before remission.
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PMID:Relationship between proteinuria and epithelial cell changes in minimal lesion glomerulopathy. 76 75

Association of membranous glomerulonephropathy with crescentic glomerulonephritis is apparently extremely rare. We report three patients who had this combination. One patient had biopsy-proven membranous glomerulonephropathy thirteen months prior to sudden and rapid decline in renal function necessitating hemodialysis. A repeat renal biopsy showed a superimposed crescentic nephritis and antiglomerular (GBM) antibodies were demonstrable in the serum. A second patient had proteinuria of unknown duration and then developed renal failure. Renal biopsy showed crescentic nephritis with a fine granular glomerular immunofluorescence for IgG typical of membranous glomerulonephropathy. Anti-GBM antibodies were present in this patient's serum. The third patient presented with acute renal failure of moderate severity. A renal biopsy revealed crescentic nephritis, granular deposits of immunoglobulins, and epimembranous electron-dense deposits typical of membranous glomerulonephropathy. Although his creatinine clearance improved spontaneously, nephrotic syndrome has persisted and a repeat renal biopsy showed a progression of the membranous glomerulonephropathy with the disappearance of the crescentic lesions. The reason for this peculiar association of membranous glomerulonephropathy and crescentic glomerulonephritis is unclear. It is possible that deposition of immune-complexes along glomerular basement membrane may render the glomerulus more susceptible to additional injury from a variety of other agents. Alternatively, depostis formed in one disease could initiate release of normal or altered basement membrane material and lead to formation of anti-GBM antibodies and subsequent development.
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PMID:Association of crescentic glomerulonephritis with membranous glomerulonephropathy: a report of three cases. 78 51

Percutaneous renal biopsies from 56 patients with systemic lupus erythematosus were studied to determine the relationship between renal function and the light microscopic, electron microscopic and immunofluorescent antibody findings. The glomerular lesions were classified into 5 major groups: diffuse membranoproliferative glomerulonephritis (34%), diffuse proliferative glomerulonephritis (26.8%), membranous nephropathy (12.5%), minimal lesion ('nil') and minimal lesion with increased mesangial matrix and/or cells (21.4%) and focal and segmental glomerulonephritis (5.3%). Minimal lesions and focal and segmental glomerulonephritis were invariably associated with normal renal function. Patients with moderate to severe renal involvement and the nephrotic syndrome had predominantly diffuse membranoproliferative and diffuse proliferative glomerulonephritis. Membranous nephropathy was associated with moderate renal involvement and the nephrotic syndrome in 50% of cases. Patients with pure mesangial electron dense deposits had normal renal function or mild renal involvement when the deposits were heavy. Moderate and heavy subepithelial, and intramembranous/subepithelial deposits were associated with moderate to severe renal involvement and the nephrotic syndrome. Renal involvement was most severe with heavy subendothelial deposits. Cytoplasmic tubuloreticular structures measuring approximately 18 to 20 nm in diameter and 80 to 100 nm in length were found in 93% of all biopsies, but bore no relationship to the renal function of the patients. Anti-Hu-IgG fluorescent deposits were found in all the renal biopsies; in 81.3% these were associated with less heavily stained deposits of immunoglobulin IgA, IgD and IgM. Early complement components Clq and C4 were utilized in the complement pathway of activation. Pure mesangial fluorescent deposits were associated with normal renal function or mild proteinuria. Diffuse granular and lumpy deposits along the capillary loops were usually associated with moderate to severe renal involvement and the nephrotic syndrome. In the present series of cases, there was a good correlation between renal function of patients with systemic lupus erythematosus and the glomerular lesions as determined by light, electron microscopic and immunofluorescent microscopic findings.
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PMID:Lupus nephritis: correlation between light, electron microscopic and immunofluorescent findings and renal function. 78 52

Remission followed prednisolone therapy in 9 out of 21 Nigerian children with the nephrotic syndrome who had highly selective proteinuria (CG/CA less than 15%). Of these, 5 patients have remained well off all treatment during a follow-up of nearly 5 years, 4 have relapsed more than once but have responded to further courses of prednisolone. 3 of 21 with less selective proteinuria also remitted but all relapsed and only one of these has responded again. The other two have relapsed and further courses of prednisolone have not totally abolished their proteinuria though they are asymptomatic and in good health. Toxicity (hypertension, sometimes with encephalopathy and infection) was commoner in the patients with less selective proteinuria treated with steroids than in those with highly selective proteinuria. 3 steroid-sensitive patients who had had repeated relapses became free from relapse off all treatment after a course of cyclophosphamide, given during steroid-maintained remission. All but 2 of the renal biopsies taken were regarded as abnormal. The lesions were less severe in those who responded than in those who did not. There is some evidence to suggest that Plasmodium malariae may be a cause of some of the steroid-sensitive disease, as well as the steroid-resistant.
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PMID:Differential protein clearances and response to treatment in Nigerian nephrotic children. 79 39

The myeloma kidney is characterized by casts in the distal and collecting tubules. The glomeruli are hardly affected unless amyloidosis is present. When the glomeruli are involved, the proteinuria is nonselective and, in some cases, the whole paraprotein is excreted in the urine. Nephrocalcinosis may be present and focal myeloma cell infiltration in the interstitium is a characteristic, but inconstant, finding. The nephrotic syndrome is extremely rare; if it exists, amyloidosis should be suspected. In contrast to multiple myeloma, the glomeruli are frequently involved in macroglobulinemia of Waldenstrom. Hyaline intracapillary deposits consisting of pure IgM are a characteristic finding as is infiltration of the kidney with lymphoid cells. No characteristic lesion of the kidney has been described in the heavy-chain diseases. Mixed cryoglobulinemia associated with an IgM paraprotein can produce glomerulonephritis that is due to the deposition in the glomeruli of an immune complex consisting of IgG, IgM, and complement.
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PMID:Renal pathologic findings associated with monoclonal gammopathies. 80 64

Three cases are described showing a seasonal exacerbation of their nephrotic syndrome in association with an atopic trait and grass pollen allergy. The first patient has a history of four consecutive seasonal relapses each requiring steroid therapy. Following a course of desensitization injections he has now been free of relapse for 3 consecutive years. The second patient has also had a recurrent steroid-sensitive nephrotic syndrome often associated with the pollen season and allergic rhinitis. In this patient a course of cyclophosphamide has reduced his tendency to relapse. The third patient who has been on continuous prednisone therapy shows a seasonal increase in proteinuria. Serum changes in the first two patients include: a seasonal rise in total and grass pollen specific IgE; the continued presence of grass pollen specific IgG throughout the year but with a reduction during the pollen season in association with a more pronounced fall in the total IgG level; a depression in the C3 level in association with each major relapse; a mild rise in the I-K titre and a positive result in the Clq test for circulating complexes. A renal biopsy performed on the first patient when in relapse showed minor histological changes only and IgG, IgM, IgA, IgD, IgE, C3 and fibrinogen were undetectable by immunofluorescent examination. The probable mechanism for the development of proteinuria in these patients is discussed.
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PMID:Seasonal nephrotic syndrome. Description and immunological findings. 80 95

Total serum thyroxine (T4), free thyroxine index (FTI), thyroxine binding globulin (TBG) binding capacity, serum albumin, alpha-globulins and urinary protein excretion were measured in 50 patients with chronic renal failure, but without nephrotic syndrome. 25 patients were undergoing chronic hemodialysis. T4 was within the normal range in most patients. There was a tendency to lower T4 values as compared to an age and sex-matched control group, but this did not reach statistical significance. TBG was normal in most patients. 4 patients showed elevated TBG concomitant with elevation of other alpha-globulins. Serum albumin was significantly decreased. No correlation existed between daily protein excretion and TBG or alpha-globulins, but the correlation between serum albumin and proteinuria was highly significant. T4 and proteinuria correlated with borderline significance. A highly significant correlation between T4 and TBG-albumin values was found. No correlation existed between FTI and TBG-albumin levels. The data suggest that T4 and TBG are normal in most patients with renal failure, even in the presence of significant proteinuria. Low T4 values, when found in renal insufficiency, may be secondary to low serum albumin and possibly prealbumin.
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PMID:Serum thyroxine and thyroxine-binding proteins in chronic renal failure without nephrosis. 80 56

In 37 patients of nephrotic syndrome, serum protein levels, protein fractions and urinary levels of proteins and their fractions were determined. The findings of serum levels of proteins and their fractions were compared with an equal number of age and sex matched controls. Twenty three patients showed selective and 14 non-selective proteinuria. Most of the patients with selective proteinuria showed good response to steroids therapy while those with non-selective proteinuria did not respond.
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PMID:A study of protein clearances in patients with nephrotic syndrome. 82 57

Eighty-one adult patients with the idiopathic nephrotic syndrome were treated with prednisone, 60 to 120 mg, on alternate days. Treatment was continued with diminishing drug doses for up to 10 years. Biopsy specimens were categorized as showing lipoid nephrosis 36 per cent, focal sclerosis 12 per cent, diffuse proliferative 22 per cent and membranous nephropathy 30 per cent. Patients with systemic causes of the nephrotic syndrome were excluded. Proteinuria decreased to normal or to less than or equal to 3 g with a greater than or equal to 50 per cent decrease from base line in 83 per cent of the patients with lipoid nephrosis, 30 per cent of the patients with focal sclerosis, 50 per cent of the patients with diffuse proliferative nephritis and 71 per cent of the patients with membranous nephropathy. Improvement occurred in those with focal sclerosis, diffuse proliferative nephritis and membranous nephropathy only after prolonged treatment (14 to 15 months). Stable or improved renal function occurred in 97 per cent of those with lipoid nephrosis, 50 per cent of those with focal sclerosis, 73 per cent of those with diffuse proliferative nephritis and in 83 per cent of those with membranous nephropathy. Death or dialysis occurred in 12 per cent of the patients, and complications coincident with treatment occurred once every 12 patient years. Compared to other series of patients with the idiopathic nephrotic syndrome, therapy of our patients with prolonged alternate day steroids resulted in (1) decreased protein excretion, (2) maintenance of good renal function and (3) decreased number of complications of therapy.
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PMID:Therapy of the idiopathic nephrotic syndrome with alternate day steroids. 83 92

1. In four patients with nephrotic syndrome indomethacin not only reduced proteinuria but also inhibited the natriuretic effect of high doses of frusemide. 2. The inhibition of natriuresis by indomethacin could not be antagonized by albumin infusions. 3. Only the combined use of spironolactone and frusemide induced a natriuresis during indomethacin treatment. Spironolactone alone was ineffective. 4. It is suggested that inhibition of prostaglandin synthesis by indomethacin, in the presence of a stimulated renin-angiotensin system and hyperaldosteronism, may cause this strong tendency to sodium retention.
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PMID:Inhibition of frusemide-induced natriuresis by indomethacin in patients with the nephrotic syndrome. 84 48


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