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)

We analyzed factors associated with the discharge diagnosis of delirium among 1,285 patients admitted to a major teaching hospital during a 2-year period, developed a model to classify the risk of developing delirium on the basis of clinical and diagnostic data, and tested the model on 471 patients admitted during the subsequent year. Using the multivariate technique of recursive partitioning, we identified four factors that distinguished 80% of all cases of delirium: 1) a urinary tract infection at any time during the hospital stay (odds ratio = 3.1; 95% confidence interval = 2.02-4.58); 2) no urinary tract infection, but low serum albumin on admission (odds ratio = 2.4; 95% confidence interval = 1.43-3.99); 3) neither urinary tract infection nor low serum albumin, but elevated white blood cell count on admission (odds ratio = 1.99; 95% confidence interval = 1.18-3.37); 4) none of these risk factors, but proteinuria on admission (odds ratio = 1.82; 95% confidence interval = 1.25-2.66). Patients without any of these four risk factors had the lowest probability of developing delirium during their hospital stay. Among individuals with delirium, in-hospital mortality and hospital charges were higher. The model developed accurately characterized the risk of delirium when it was tested on patients admitted to the same hospital during the subsequent year.
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PMID:Identification of factors associated with the diagnosis of delirium in elderly hospitalized patients. 319 88

Reflux nephropathy is one of the most frequent renal diseases encountered in women of childbearing age. Patients with severe bilateral atrophy are the most likely to develop proteinuria, hypertension, focal glomerular sclerosis and progressive chronic renal failure, and those with persistent vesicoureteral reflux are the most likely to suffer recurrent pyelonephritic episodes. Often the disease is clinically latent and first manifests itself in pregnancy, mainly by urinary tract infection but also by proteinuria, hypertension, pre-eclampsia or renal failure. Pregnancy is most often successful and uneventful whenever renal function is normal or near normal and hypertension is absent at conception. Urinary tract infection accounts for frequent morbidity but rarely results in fetal mortality. By contrast, when renal function is significantly impaired, that is in patients whose plasma creatinine concentration is in excess of 0.18-0.20 mmol/l at conception, especially when hypertension is also present, there is clearly a high risk of severe fetal growth retardation or intrauterine death. Moreover, there is a striking risk of rapid worsening of renal function and hypertension, with accelerated progression towards end-stage renal failure. Thus, women with reflux nephropathy should attempt to conceive before the plasma creatinine concentration has reached 0.18 mmol/l, and patients with values higher than these should be clearly advised of the high risk for both the pregnancy and the progression of the disease.
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PMID:Reflux nephropathy and pregnancy. 333 Apr 95

Vesicoureteral reflux (VUR) is mainly a primary phenomenon due to incompetence of the ureterovesical junction, mostly affecting a pediatric population. During micturition cystourethrography (MCU) reflux into the kidney--intrarenal reflux (IRR)--is occasionally seen. In areas with IRR the kidney surface may subsequently be depressed and the papillae retracted (reflux nephropathy (RN]. VUR may lead to hypertension and/or end-stage renal failure. Most commonly, VUR is discovered during evaluation for urinary tract infection, but it may also be present in patients with hypertension, toxemia of pregnancy, chronic renal failure and proteinuria, and it may be found in siblings of patients with VUR. For the time being VUR is demonstrated at radiographic MCU, whereas RN is diagnosed by demonstration of focal scars and of abnormal parenchymal thickness at urography. In children with VUR and no abnormalities of calyces or parenchymal defects standardized measurement of the parenchymal thickness at three sites may identify kidneys which are likely to develop focal scars. Quantitation of focal scarring should be performed in connection with a measure of the overall kidney size. The occurrence of IRR is dependent of the papillary morphology, intrapelvic pressure and urine flow. There may be an important relationship between renal ischemia and IRR in producing a 'vicious circle of deleterious effects' which, combined with parenchymal extravasation, may lead to RN. Treatment of VUR includes medical and surgical management. Since renal scarring may occur in infancy, prevention should focus on infants and young children. Infants and young children with severe VUR may have normal urograms. Therefore a MCU should also be performed, preferably with the recommended standardized technique.
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PMID:Vesicoureteral reflux and reflux nephropathy. 388 98

We report 3 cases of proteinuria, progressive renal insufficiency and vesicoureteral reflux with no history of urinary tract infection. Renal histology showed focal segmental glomerulosclerosis. These associations are unusual during childhood but they are common in adults. Generally, vesicoureteral reflux is discovered during radiological evaluation of children with recurrent urinary tract infections. Renal parenchymal damage in children typically results from recurrent infection or progressive hydronephrosis. Development of proteinuria with vesicoureteral reflux usually indicates an irreversible glomerular lesion. Antireflux surgery in patients with vesicoureteral reflux and decreased renal function may be beneficial if performed before the onset of proteinuria. We recommend antireflux surgery for children with persistent vesicoureteral reflux or decreased renal function.
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PMID:Vesicoureteral reflux, proteinuria and renal failure. 394 7

Microscopic hematuria is no less significant than gross hematuria, since either may signify such pathology as a neoplastic lesion, urinary tract infection, renal calculus, prostatic disease or glomerulonephritis. Anatomic imaging of the urinary tract with intravenous urography and cystoscopy is often indicated in the evaluation of the patient with hematuria. When hematuria is associated with red blood cell casts and/or heavy proteinuria, think of renal parenchymal lesions, particularly of glomerular origin.
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PMID:Hematuria: a clinical approach. 394 28

A clinical study of 5 children (3 boys and 2 girls) with primary sterile vesicoureteral reflux is presented. Their ages ranged from 8 to 11 years old. During the same period, we saw 14 children (6 boys and 8 girls) with primary infected vesicoureteral reflux. Their ages ranged from 1 to 13 years old. There were several distinctions between these two reflux groups. Manifestations of the infected reflux group were mainly fever attacks, while those of the sterile reflux group were hypertension, proteinuria and enuresis. The duration from onset to diagnosis was longer in the sterile reflux group because their manifestations did not appear to be severe especially in cases of enuresis. The grade of reflux tended to be more advanced in sterile reflux group. The renal scarrings were identified in all involved kidneys in the sterile reflux, while in 65.2% in the infected reflux group. It is difficult to detect sterile reflux early because the manifestations are not related with urinary tract infection. Recently, reflux nephropathy is a subject of frequent discussion and end stage of reflux nephropathy has been sporadically reported. Therefore, an effort should be made for early detection of sterile reflux. Based on our experiences as well as review of the literature, possible clues to detect sterile reflux are abnormal voiding patterns, such as nocturnal enuresis, incontinence, frequency and so on.
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PMID:[Clinical study of children with sterile vesicoureteral reflux]. 408 96

Screening for urinary tract infection was carried out in 27,722 schoolboys aged 5 to 14 using Uricult to perform urine cultures and Hema-combistix to detect hematuria, proteinuria and glycosuria. Cultures of 10(5) colonies per ml or more on two occasions were found in 40 cases (0.14%), but no case was confirmed by the family physician using standard culture techniques.Proteinuria was found in 136 cases (0.49%) and confirmed in 47 (37%) of the 126 children who were seen by their family physician. In this group 8.8% had evidence of pyelonephritic scarring on intravenous pyelograms without a positive urine culture.Hematuria was found in 19 children and confirmed in 10 (59%) of the 17 children who were seen by their family physician. No abnormalities were detected on intravenous pyelography in any case.Glycosuria was found in 12 cases and confirmed in five. Three of these children had renal glycosuria and two had previously undetected diabetes.
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PMID:City-wide screening for urinary abnormalities in schoolboys. 460 40

Screening for urinary tract infection was carried out in 23,427 schoolgirls, aged 5 to 14 years, using Uricult and, for hematuria, glycosuria and proteinuria using Hema-combistix. Cultures of 10(5) colonies per ml. or more on two occasions were obtained in 2.3% and a positive culture was confirmed by the family physician using standard culture techniques in 82.7% of cases, giving an overall incidence of infection of 1.9%. Fifty-eight percent of these children had no previous history of any urinary tract symptoms. Of the infected group 9.5% had pyelonephritic scarring, 58.7% chronic cystitis and 58.7% urethral stenosis. Two additional cases had unilateral ureteropelvic junction obstruction with hydronephrosis. Reflux occurred in 26.6% of those investigated by voiding cystogram. In 58% of cases the urinary tract infection was not accompanied by significant proteinuria, hematuria or pyuria.Proteinuria was detected on two occasions in 1.6% of the children and confirmed by the family physician in 33% of cases, giving an overall incidence of 0.5%. In this group 9.2% had evidence of pyelonephritic scarring without a positive urine culture.Hematuria was detected on two occasions in 0.6% of the children and was confirmed by the family physician in 53%, giving an overall incidence of 0.3%. Only one case with pyelonephritic scarring was seen in this group.Of the 25 cases with pyelonephritic changes only six had been previously diagnosed radiologically.Four previously unrecognized diabetics were also detected.
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PMID:City-wide screening for urinary abnormalities in schoolgirls. 475 69

A study of bacteriuria was conducted among 426 of the 436 children under the age of 13 in a general practice in north-west London. Three girls and one boy were found to have asymptomatic bacteriuria, and a further girl with bacteriuria presented with abdominal pain and fever. The calculated incidence of urinary tract infection was 1.4% per annum. Most of the childhood urinary infections in this practice occurred before the age of 5 years, and the incidence of significant bacteriuria in this age group was 4.9% per annum. Five other children (four girls and one boy) in the practice were known to have had proved urinary tract infection. Of the total of eight children known to have had significant bacteriuria and investigated radiologically, three girls and two boys had radiological abnormalities in the urinary tract.Pyuria and proteinuria did not prove to be useful in the prediction of asymptomatic bacteriuria. Urinary tract infection with renal tract abnormality was found in this practice to be at least five times as common as diabetes in childhood.
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PMID:Study of childhood urinary tract infection in general practice. 544 Feb 35

In the light of present knowledge, the routine screening for renal disease in the pediatric age group is not generally indicated. Asymptomatic proteinuria and microscopic hematuria are common but generally harmless, and only in exceptional cases do they indicate a latent progressive renal disease that could be influenced by early treatment. The finding of asymptomatic bacteriuria in the school age is associated with vesicoureteral reflux and pyelonephritic scars in one-third of the cases. Medical treatment of all cases with bacteriuria in this age group does not, however, seem justified. Screening for urinary tract infection would thus appear sensible only during the first years of life. However, with the presently available methods they are technically difficult and expensive. Examination of the urine is, of course, indicated in all children with suspected infectious disease or failure to thrive, and repeated studies are often advisable.
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PMID:[Screening for kidney diseases in childhood (author's transl)]. 611 Jan 71


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