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)

In order to evaluate patients with necrobiosis lipoidica diabeticorum and to compare them with age, sex, and duration of diabetes matched controls, 15 patients with necrobiosis were each matched with 5 control subjects with diabetes mellitus. Complications of diabetes, glycaemic control, and proteinuria were measured. Patients with necrobiosis (mean age 40, range 18-74 years) had a mean duration of diabetes of 14 (range 3-36) years; 8 patients were male, and 7 were female. For necrobiosis versus controls, background retinopathy (67% vs 27%, p = 0.009), proteinuria (53% vs 17%, p = 0.006), and smoking (60% vs 20%, p = 0.003) were all more common with necrobiosis. There were no significant differences between patients with necrobiosis and control patients in the prevalence of vascular disease and neuropathy. Glycosylated haemoglobin concentrations were higher in patients with necrobiosis (p = 0.02). Blood pressure measurements were similar in both groups. We conclude that smoking, proteinuria, and retinopathy were more prevalent in diabetic patients with necrobiosis; the skin lesion may therefore share common aetiological factors which affect the microvascular circulation, leading to damage to basement membranes and vascular endothelial cells.
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PMID:Necrobiosis lipoidica diabeticorum: association with background retinopathy, smoking, and proteinuria. A case controlled study. 826 54

Between 1989 and 1990, 10 HIV-infected patients with renal involvement (proteinuria and/or renal failure) were followed. The 5 men and 5 women black (4 Haitians, 3 Zairians, 2 Congolese and 1 Angolan). Their mean age was 31.7 +/- 4 years. No known risk factor was identified and transmission was probably heterosexual. When renal disease was diagnosed, 4 patients had AIDS, 5 had ARC and 1 was asymptomatic. Kidney biopsies were performed in 7 patients: 4 HIV-associated nephropathies (HIV AN) with segmental and focal hyalinizations, 1 thrombotic angiopathy, and 2 interstitial nephropathies, 1 with proliferative glomerulonephritis. The clinical, biological and radiographic patterns of 2 of the remaining 3 patients were suggestive of HIV AN. Four of the 6 patients with HIV AN developed end-stage renal disease within 5 +/- 2.5 months; renal function in the other 2 remained stable for 25 and 41 months, respectively, while they were receiving zidovudine, but deteriorated rapidly within weeks of withdrawing this drug. Zidovudine may have delayed the evolution of the nephropathies in these patients.
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PMID:[Renal parenchymatous involvements in African and Caribbean patients with human immunodeficiency virus infection. Apropos of 10 cases]. 829 43

Course, prognosis and mortality in Japanese elderly diabetes mellitus were studied using a 7 year follow-up study of 424 elderly diabetics whose ages were 60 years old or more (mean age: 72.6 +/- 6.2, 144 males: 280 females) at baseline. The relationships between clinical findings at baseline and prognosis, causes of death and onset of ischemic heart disease during the follow-up period were also studied. A total of 133 (31%) deaths were observed during the follow-up period. Risk factors present at baseline which significantly influenced the patients' prognosis included age, male gender, previous cerebro-vascular disease, body mass index, pharmacological treatment of diabetes and persistent proteinuria. These factors were also related to the causes of death among the patients. Cardio-vascular disease deaths (n = 66, 50%) tended to increase in patients with a relatively higher age, male gender, previous ischemic heart disease and persistent proteinuria. Malignant neoplasm deaths (n = 28, 21%) tended to increase in patients with relatively higher age and previous cerebrovascular disease. Furthermore, infectious deaths (n = 16, 12%) were relatively increased in patients with a relatively higher age, male gender, previous cerebro-vascular disease, relatively lower body mass index and higher fasting plasma glucose levels. Among various causes for cardio-vascular disease deaths, ischemic heart disease (n = 40) was the leading cause of death.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Course, prognosis and mortality in Japanese elderly diabetes mellitus--a seven year follow-up study]. 831 45

We have previously demonstrated that women who had given birth to large infants had a six-fold increased risk of developing Type 2 (non-insulin-dependent) diabetes mellitus compared with a control group matched for age and parity. However, the patients were extremely obese which explained, in part, the increased risk. In the present investigation we studied whether the delivery of large infants correlated with risk factors for atherosclerotic vascular disease other than obesity and diabetes, and therefore could serve as early markers for syndrome X. The study consisted of 73 women who 20-27 years earlier had given birth to large infants weighing 4,500 g or more. Another group of 73 women matched for age, parity and BMI who had delivered infants weighing less than 4,500 g within a 3-month period served as a control group. Of these 73 patient/control pairs, 48 (66%) were able to participate in the investigation. Mean age was 52.2 years (range 40-66 years). No differences were noted for family history of diabetes and medication prescribed for vascular disease between the groups. An oral glucose tolerance test was performed and glucose, insulin and C-peptide at 0 and 2 h were estimated. Triglycerides, cholesterol, LDL and HDL cholesterol were analysed at baseline. We found no tendency towards hyperinsulinaemia and hyperglycaemia in the patients and both groups had the same relative increase in levels of insulin and C-peptide. No difference between the groups regarding manifest symptoms of vascular disease, either in blood pressure or in proteinuria were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Can the birth of a large infant predict risk for atherosclerotic vascular disease in the mother? 845 25

In Caucasian patients with insulin-dependent diabetes mellitus (IDDM) proliferative diabetic retinopathy (PDR) and persistent proteinuria (PP) are associated, and major risk factors for development of microangiopathy have been identified. The aim of the present study was to evaluate whether these risk factors are also relevant and whether an association exists between the microangiopathic complications in Japanese IDDM-patients. A clinic-based cohort of 324 Japanese IDDM-patients was followed (a mean follow-up of 7 years). Annual examination for development of PDR and PP was performed. Fifty-eight patients developed PDR and 24 developed PP. Development of PDR was associated to high HbA1c-levels, i.e., the 4th quartile (RR 7.9, P < 0.0001), background retinopathy at admission (RR 9.9, P < 0.0001), high age at diabetes onset (RR 2.9, P < 0.0001) and female gender (RR 1.7, P < 0.05). Development of PP was associated to high HbA1c-levels (RR 2.8, P < 0.001) and background background retinopathy at admission (RR 7.9, P < 0.0001). The risk of developing PP was 9 times higher in patients developing PDR than in patients not developing PDR (P < 0.0001). The effect of metabolic control in our cohort was similar to that found in the DCCT and SDIS studies. In conclusion, development of PP is closely associated with PDR, also in Japanese IDDM-patients. The effect of metabolic control is the same as in Caucasian patients. Development of malignant angiopathy in IDDM-patients is not confined to Caucasian IDDM-patients, and the incidence rates are comparable to those found in Caucasian IDDM.
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PMID:Metabolic regulation and microangiopathy in a cohort of Japanese IDDM-patients. 859 14

Increased susceptibility of LDL to oxidation has been shown to be associated with the presence of coronary heart disease and may account for the accelerated vascular disease seen in diabetes. The response of LDL to in vitro oxidative stress has been proposed as a measure of the predisposition of LDL to the in vivo subendothelial oxidative stress. Increased susceptibility to oxidation has been demonstrated recently in diabetic patients with poorly controlled IDDM. Thus, we conducted studies to determine whether the increased susceptibility of LDL to oxidation was secondary to diabetes per se or to the level of glycemic control. Fifteen IDDM patients with good glycemic control and with no evidence of macrovascular disease or proteinuria were compared with healthy age-, sex-, race-, and BMI-matched nondiabetic subjects. Fasting blood glucose levels averaged 12.1 +/- 1.1 (mean +/- SE) vs. 4.9 +/- 0.1 mmol/l in the diabetic versus the control groups, respectively. HbA1c levels averaged 7.7 +/- 0.5 vs. 4.4 +/- 0.2%, reflecting well-controlled diabetes (P < 0.0001). Total, LDL, VLDL, and HDL cholesterol, triglyceride, and lipoprotein(a) levels did not differ between the groups. The particle size, lipid composition, fatty acid content, antioxidant content, and glycation were similar for LDL isolated from both groups. A rapid LDL preparation technique was used to compare LDL susceptibility to oxidation under the following conditions: final LDL cholesterol concentration of 100 microg/ml, 5 micromol/l of CuCl2 at 25 degrees C. There was no difference in the susceptibility to in vitro oxidation of LDL isolated from IDDM patients compared with control subjects. There was no correlation of glycemic control with any of the parameters of the in vitro oxidation of LDL. LDL from patients with well-controlled IDDM does not differ in composition or in susceptibility to in vitro oxidative stress compared with LDL from nondiabetic subjects.
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PMID:LDL from patients with well-controlled IDDM is not more susceptible to in vitro oxidation. 863 50

The pregnancy complication characterized by proteinuric hypertension is called preeclampsia. Preeclampsia, an important cause of maternal and perinatal death, has an onset and progression impossible to predict. Termination of pregnancy is the only cure of preeclampsia. It is indicated when the fetus can survive outside the uterus or when the maternal condition deteriorates to such a condition that continuation would bring greater harm to the mother. The etiology of preeclampsia is unknown. Preeclampsia appears to be linked to abnormal trophoblastic implantation. In normal pregnancies, implantation effects changes in the spiral arteries that supply the intervillous space and fibrin-containing trophoblast, and amorphous matrix replace the endothelium and the internal elastic lamina. These changes do not occur or are limited in pre-eclamptic women. There appears to be a familial tendency to preeclampsia. Impaired formation of blocking antibodies to antigenic sites on the placenta increases the risk of pre-eclampsia. Risk factors are primigravidity, short duration of sexual cohabitation before conception, abundance of trophoblastic tissue (e.g., multifetal and molar pregnancies), and underlying vascular disease as in diabetes. Poor placental perfusion may account for the increase in maternal blood pressure. Preeclampsia can lead to eclampsia, cerebral hemorrhage, coagulopathy, and death. Poor utero-placental circulation retards fetal growth and causes fetal distress and maybe even perinatal death. When the diastolic blood pressure is higher than 110 mmHg, pre-eclamptic women should be administered antihypertensive drugs (e.g., methyldopa, beta-blockers, calcium channel blockers, hydralazine, labetatol, or diazoxide) to prevent maternal complications, but these drugs do not improve utero-placental blood flow nor do they prevent proteinuria. Diuretics should not be administered. Proteinuria indicates that the kidneys have been affected. A large randomized trial shows that aspirin does not effectively prevent preeclampsia. Routine calcium supplementation does appear to prevent it and preterm delivery.
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PMID:Pre-eclampsia. 875 7

The protean clinical manifestations of atheroembolic disease (AED) mimic systemic disorders with kidney involvement. Acute or chronic renal failure develops spontaneously or more frequently after an inciting event in patients with AED. Significant proteinuria and nephrotic syndrome, however, constitute uncommon findings. We present four patients with AED documented histopathologically who developed nephrotic-range proteinuria. The mechanisms of proteinuria are discussed, and it is suggested that AED be considered in the differential diagnosis of nephrotic syndrome in elderly patients with serious vascular disease.
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PMID:Nephrotic-range proteinuria in renal atheroembolic disease: report of four cases. 884 Sep 37

The WHO Multinational Study of Vascular Disease in Diabetes was launched in 1975-77 to investigate international variations in the occurrence of different manifestations of vascular disease in subjects with insulin-dependent and non-insulin-dependent diabetes. A morbidity and mortality follow-up extending until January 1, 1988 was carried out in 10 centres, including five European centres (London, Switzerland, Berlin, Warsaw and Zagreb), two East Asian centres (Hong Kong and Tokyo), two Native American centres (Arizona and Oklahoma) and one Caribbean centre (Havana). Of a total of 4714 diabetic subjects (2310 men and 2404 women) aged between 35 and 55 years at baseline who were successfully followed up, 1266 were classified as having insulin-dependent diabetes and 3448 as having non-insulin-dependent diabetes. There was a large variation between the centres in ischaemic heart disease and cerebrovascular disease mortality rates for both insulin-dependent and non-insulin-dependent diabetic subjects, presumably reflecting in part differences between the background populations in mortality rates from these cardiovascular causes. The lowest ischaemic heart disease mortality rates for diabetic subjects were observed in Hong Kong and Tokyo centres, representing industrialized countries which have continued to have low ischaemic heart disease mortality rates. The importance of raised blood pressure and proteinuria as potentially modifiable cardiovascular risk factors in diabetic subjects was confirmed in this study.
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PMID:International variations in cardiovascular mortality associated with diabetes mellitus: the WHO Multinational Study of Vascular Disease in Diabetes. 886 86

In many reports, the prevalence of target organ damage in renovascular hypertension (RVH) appears to be higher than in essential hypertension (EH). Since in most studies the renal artery stenosis is part of a diffuse atherosclerotic disease, it is not known whether these complications are due to RVH itself or to the vascular disease. We have undertaken a case control study of 92 patients divided into two groups (46 in each), one with RVH and the other with EH and abdominal aortic aneurysm, with a comparable degree of diffuse atherosclerotic vascular disease. The vascular state of the extracranial carotid arteries and abdominal and inferior limb districts was investigated with angiography and sonography. The prevalence of left ventricular hypertrophy (LVH) and ischemic heart disease (IHD) were assessed by electrocardiography. Serum creatinine and urinary protein excretion were employed in the renal evaluation. While the analysis of the results confirmed an even diffusion of atherosclerotic vascular disease between the two groups, a significant difference was found in the prevalence of heart and renal damage. LVH was present in 32.6% of RVH patients versus 10.8% in EH (P = .02). Serum creatinine > 1.4 mg/dL was found in 50% of RVH and in 23.9% of EH, (P = .01). The prevalence of proteinuria in RVH was also higher although not reaching the statistical significance. The results suggest that, in patients with comparable degrees of atherosclerotic vascular disease, RVH is responsible for the higher prevalence of target organ damage in this condition compared to those with EH.
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PMID:Comparison of target organ damage in renovascular and essential hypertension. 893 30


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