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 retrospectively analyzed the results of 75 living-related pediatric renal transplants performed at our center between January 1986 and December 1999. The major causes of end-stage renal disease (ESRD) were glomerulonephritis (26%) and nephrolithiasis (16%), while the etiology was unknown in 50%. The mean age of the recipients was 12 yr (range 6-17 yr) and that of the donors was 39 yr (range 20-65 yr). The majority (73%) of donors were parents. Eighty five per cent of donors were one-haplotype matched and the rest identical. Immunosuppression was based on a triple drug regimen. Thirty per cent of recipients were rapid metabolizers of cyclosporin A (CsA) (area under the curve [AUC]: < 6,000 ng/mL/h), while 16% were slow metabolizers (AUC: > 8,000 ng/mL/h). Forty three (57%) children encountered 59 rejection episodes, the majority of which (59%) were recorded in the first month post-transplant. Seventy-four per cent of the rejection episodes were steroid sensitive and the rest, except two, were resolved by therapy with antithymocyte globulin (ATG) or orthoclone thymocyte 3 (OKT3). After a mean follow-up of 37 months, 17 (22%) grafts had chronic rejection and 76% of these recipients had previously experienced acute rejection episodes. The overall infection rate was high, necessitating two hospital admissions/patient/year. The majority (53%) of the infections were bacterial. Urinary tract infections (UTIs) were seen in 17 (23%) recipients. Twelve of these had ESRD as a result of stone disease and eight grafts were lost because of UTIs. Eight per cent of recipients developed tuberculosis (TB), and extra-pulmonary lesions were seen in 50%. Surgical complications were encountered in eight patients. Free medication to all recipients and parental support ensured a compliance rate of 93%. Baseline growth deficit was seen in children of the two groups studied (the 6-12 yr and 13-17 yr age-groups), with Z-scores of - 2.39 and - 2.12, respectively. No growth catch-up was observed at 12 and 24 months in either group. Post-donation complications were seen most commonly in donors > 50 yr of age and included: proteinuria (> 300 mg/24 h, four patients), hypertension (three patients), and diabetes (one patient). Twenty-four grafts were lost, 54% as a result of immunological and the rest as a result of non-immunological causes, and 17 recipients died during the follow-up period. Infections were the main cause of patient and graft loss. Overall 1- and 5-yr graft and patient survival rates were 88% and 65%, and 90% and 75%, respectively.
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PMID:Living-related pediatric renal transplants: a single-center experience from a developing country. 1200 Apr 64

Canine transitional cell carcinoma (TCC) carries a poor prognosis in part due to late disease detection. The measurement of specific tumor markers shed in the urine may aid in sensitive, early disease detection and therefore improved prognosis. A 1-year prospective clinical trial was designed to assess the efficacy, sensitivity and specificity of the first generation Bard BTA test to diagnose TCC in dogs. This test is a qualitative, rapid, latex agglutination, dipstick test run on voided urine, which measures a glycoprotein antigen complex associated with bladder cancer in human patients. Sixty-five dogs were entered in the study: 20 TCC confirmed patients, 19 healthy controls and 26 urologic controls with a variety of conditions including urinary tract infection, crystalluria and proteinuria. Overall test sensitivity was 90% and specificity was 78%. False positive test results were noted in the presence of significant glucosuria (4+), proteinuria (4+), and pyuria or hematuria (> 30-40 WBC or RBC per hpf). Urine parameters that had no effect on efficacy included collection method (cystocentesis or free catch), pH, specific gravity, crystalluria, bilirubinuria, bacteriuria and casts. These data indicated that the Bard BTA test was sensitive for the detection of the bladder tumor-associated antigen complex in canine TCC. As evaluated, this test may serve as a useful adjunct to diagnosis, especially when cytology or biopsy is questionable or impractical. Furthermore, because of the high sensitivity of the test, it may be a practical screening test to rule out TCC in geriatric patients or patients with clinical signs related to the lower urinary tract, particularly before pyuria and hematuria develop which may interfere with test results.
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PMID:Detection of canine transitional cell carcinoma using a bladder tumor antigen urine dipstick test. 1207 35

Asymptomatic haematuria is not an uncommon problem in children and adolescents. Isolated haematuria even when gross is less sinister than haematuria associated with proteinuria. Extensive evaluation is usually not necessary in such cases and they can generally be followed up after careful evaluation to rule out urinary tract infection, hypercalciuria, familial (benign) haematuria, and structural abnormalities (cysts, stones, obstruction, Wilms' tumour). Patients with various forms of glomerulonephrtis usually have associated proteinuria and may require renal biopsy. Intravenous pyelography, cystoscopy and renal angiography should be carried out when very clearly indicated.
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PMID:Asymptomatic haematuria in children. 1220 56

A survey was conducted in asymptomatic aged individuals (> or = 60 years) in The National Capital Territory of Delhi for the prevalence of major health problems like hypertension, diabetes mellitus and respiratory diseases. A total of 200 individuals (100 males and 100 females) were studied over a period of three months in 1998-99. Hypertension was defined as BP > or = 140/90 mmHg (JNC VI criteria), while diabetes mellitus was diagnosed if fasting whole blood sugar was 120 mg/dl or more (WHO criteria). Diagnosis of other health problems was based on relevant history and physical examination. Prevalence of hypertension in the study group was 32.5 per cent (more in males). Of these 18 per cent and 4.2 per cent had isolated systolic and diastolic hypertension, respectively. Prevalence of diabetes mellitus in the same population was 13.0 per cent. Both diseases were more prevalent in urban population. A high prevalence of respiratory disorders was observed (pulmonary tuberculosis 16 per cent, COPD 10 per cent, asthma 4.5 per cent). Cataract was present in 7.5 per cent while 1.5 per cent had symptoms of urinary tract infection. History of Jaundice was present in 3.5 per cent. Three per cent each had a history suggestive of IHD and TIA, respectively. Proteinuria and glycosuria was seen in 22.2 and 7.6 percent, respectively. A large percentage of the study group (34.4 per cent) had asymptomatic ECG abnormalities.
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PMID:A study of prevalence of health problems in asymptomatic elderly individuals in Delhi. 1224 Aug 44

The purpose of the study was to determine whether DNA polymorphisms at the renin-angiotensin-aldosterone (RAS) genes were associated with evolution to renal scar formation and, consequently, with reflux nephropathy (RN) in patients with vesicoureteral reflux (VUR). Some authors have suggested that the DD genotype of the angiotensin-converting enzyme (ACE) gene would be an adverse renal prognosis factor. We recruited 246 patients (aged 3 months to 22 years) from four Spanish hospitals. These included 69 patients with VUR, 110 with RN (determined by absence/presence of renal scarring on dimercaptosuccinc acid scan), 27 with chronic renal failure due to RN, and 40 patients (control group) with urinary tract infection and normal findings on renal ultrasonography and voiding cystoureterogram. The ACE I/D, angiotensin II type 1 receptor AT1 A1166C, angiotensin II type 2 receptor A3123C AT2, and angiotensinogen AGT M235T polymorphisms were determined on the basis of polymerase chain reaction amplification. ACE serum levels were determined by spectrophotometric methods. We found no statistical differences in the distribution of RAS polymorphisms between the different groups. The ACE D allele was linked to higher ACE serum levels. We found no association between ACE I/D polymorphism and presence of hypertension, proteinuria, grade of VUR, or unilateral/bilateral VUR. Patients with the DD genotype had a lower incidence of febrile urinary tract infection as a first symptom of VUR/RN (P<0.05). We conclude that genetic polymorphisms of RAS components are not independent prognostic indicators of renal scarring in patients with VUR.
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PMID:Renin-angiotensin system polymorphisms and renal scarring. 1257 98

Clinical features and risk factors for renal failure in patients with reflux nephropathy (RN) as seen in an adult nephrology service are likely to be different than those seen in a pediatric service. There are only a few studies on adults with vesicoureteric reflux (VUR) and RN and data on RN as seen in developing countries is still evolving. Retrospective analysis of records of patients diagnosed to have VUR by conventional micturating cystourethrogram over a 13 year period, as seen in the adult nephrology services of this tertiary care hospital in north India was carried out. Results are presented as mean +/- 2 SD. Unpaired t-test was used to compare means, chi-square test to define associations, and logistic regression analysis was done to define risk factors. Out of 86 patients diagnosed to have VUR, 69 (80.2%) were males and 22 (25.6%) were children. The mean age at presentation was 24.3 +/- 14.5 years and at onset of symptoms was 19.64 +/- 14.8 years. Sixty-nine (80.2%) patients had chronic renal failure (CRF) at presentation, including 33 (38.4%) patients who already had end stage renal failure (ESRF) at presentation in whom reflux was diagnosed during routine pretransplant evaluation and these constituted 5.5% of all ESRF patients. The clinical features at presentation were hypertension in 51 (59.3%), recurrent urinary tract infection (UTI) in 31 (36.1%), history of stones in 7 (8.1%), and gross hematuria in 4 (4.7%). Patients with history of recurrent UTI were more likely to be females (p < 0.01) and to present without renal failure (p < 0.05). Proteinuria > 1 g/day was significantly associated (p < 0.02) with hypertension at presentation. Patients who presented with renal failure were more likely to be males (p < 0.05), not to have history of recurrent UTI (p < 0.05), have proteinuria > 1 g/day (p < 0.02) and higher grades (grades IV and V) of reflux (p < 0.05). On logistic regression analysis, higher age of onset (odds ratio 4.6, p < 0.03), proteinuria > 1 g/day (odds ratio 3.8, p < 0.05), and male gender (odds ratio 3.5, p < 0.05) were significant risk factors for presentation for the first time with renal failure. The clinical features and course of VUR and RN as seen in India are different from those reported from elsewhere. The vast majority of patients in India are males and almost two thirds do not have a past history of UTI. Renal failure is present in more than three fourths of patients when a diagnosis of reflux is made and one third of all patients present with ESRD. Patients with a prior history of UTI are more commonly females and are less likely to have renal failure at presentation. Higher age of onset of symptoms, proteinuria > 1 g/day and male gender were risk factors for the development of renal failure. It is likely that these asymptomatic patients remain undetected during childhood, presenting late only after having incurred severe renal damage.
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PMID:Vesicoureteric reflux and reflux nephropathy as seen at a tertiary care adult nephrology service in India--an analysis of 86 patients. 1273 24

Ectopic kidneys are frequently associated with primary renal dysplasia or a disturbance of urine transport. Sacral agenesis is defined by the absence of two or more bodies of the lower vertebral and is often associated with a neurogenic bladder dysfunction. A 5-year-old boy with sacral agenesis and a right-sided cake kidney, presented with progredient renal failure caused by recurrent urinary tract infections, incomplete bladder emptying and vesicorenal reflux. After extensive diagnostics, the anatomical situation was explored by laparotomy to find a solution for this complex situation. Despite modern diagnostic tools, the preoperatively estimated renal function of the cake kidney was incorrect. After resecting of the right collecting system and refluxing megaureter out of the cake kidney, anti-refluxive implantation of the left ureter into the bladder was performed and the megacystis was treated by detrusor duplication. After three years, the now 8-year-old boy voids residual free without any signs of urinary tract infection. Renal function and proteinuria have improved. The only medication required is nifedipine (20 mg twice a day) for treatment of the renal hypertension.
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PMID:[Complex malformation: cake kidney with concomitant sacral agenesis]. 1456 43

Ovarian dysfunction, anovulatory vaginal bleeding, amenorrhea, high prolactin levels, and loss of libido are the causes of infertility in women with chronic renal failure. After renal transplantation, endocrine function generally improves after recovery of renal function. In this study we retrospectively evaluated the prepregnancy and postdelivery renal function, outcome of gestation, as well as maternal and fetal complications for eight pregnancies in eight renal transplant recipients between November 1975 and March 2003 of 1095 among 1425. Eight planned pregnancies occurred at a mean of 3.6 years posttransplant. Spontaneous abortion occured in the first trimester in one case. One intrauterine growth retardation was observed with a full-term pregnancy; one intrauterine growth retardation and preterm delivery; one preeclampsia with preterm delivery and urinary tract infection; and one preeclampsia with preterm delivery and oligohydramnios. The mean gestation period was 35.5 +/- 3.0 weeks (31.2 to 38.0). Pregnancy had no negative impact on renal function during a 2-year follow-up. No significant proteinuria or acute rejection episodes were observed. Among the seven deliveries, no congenital anomaly was documented and no postpartum problems for the child and the mother were observed. Our study suggests that successful pregnancy is possible in renal transplant recipients. In cases with good graft function and absence of severe proteinuria or hypertension, pregnancy does not affect graft function or patient survival; however, fetal problems are encountered such as intrauterine growth retardation, low birth weight, and preeclampsia.
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PMID:Pregnancy and renal transplantation. 1501 20

We aimed to assess the utility of a newly developed automated urinary flow cytometer (UFCM) in differentiating the origin of hematuria in the mass screening system for renal diseases in school children. In total, 4,620 children aged 6-14 years with abnormal urinary findings by the screening program in Tokyo were enrolled. Tentative diagnoses were made based on the criteria for this screening program: nephritis in 11, suspected nephritis in 104, hematuria in 771, minimal hematuria in 1,506, proteinuria in 477, urinary tract infection in 83, and healthy in 1,668. Glomerular hematuria, assessed by UFCM, was found in 81.8% of nephritis, 58.7% of suspected nephritis, 59.7% of hematuria, 57.4% of minimal hematuria, 13.4% of proteinuria, and 21.5% of the healthy group. The presence of glomerular hematuria assessed by UFCM had a sensitivity of 61.0%, specificity of 78.5%, positive predictive value of 16.3%, and negative predictive value of 96.7% for the diagnosis of nephritis and suspected nephritis. Thus, our results imply that the absence of glomerular hematuria as assessed by UFCM is highly predictive of the absence of nephritis. If "healthy" children with non-glomerular hematuria by UFCM could be excluded, the total annual cost saving would be approximately 147.4 million JPY, which is equivalent to 5.2% of the current system. In conclusion, a simple, automated and rapid test for glomerular hematuria using UFCM is useful for mass screening. It can precisely predict children with only transient hematuria who do not have any serious illness, and therefore can exclude further unnecessary examinations, resulting in the improvement of cost-effectiveness of the current program.
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PMID:Usefulness of an automated urinary flow cytometer in mass screening for nephritis. 1502 7

Classical urinalysis is extremely useful in the differential diagnosis of diseases of the kidneys and lower urinary tract. Although dipsticks are suitable for orientational purposes, when pathology is indicated, and when renal disease presents, they must be supplemented by urine microscopy or quantitative and qualitative protein electrophoresis to establish the diagnosis. Phase-contrast microscopy can distinguish glomerular from nonglomerular hematuria and thus guide the further diagnosis, and the detection of leukocytes and bacteria confirms the diagnosis of urinary tract infection. In asymptomatic patients microhematuria or proteinuria is detected more frequently with increasing age. A differentiated diagnostic strategy must be adapted to the individual risk of the patient, and must avoid overdiagnosis while not missing potentially serious pathology.
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PMID:[Differential diagnosis of urinary findings]. 1522 97


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