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)

Primary chronic glomerulonephritis may emerge clinically as acute nephritis, the nephrotic syndrome as well as asymptomatic hematuria and proteinuria. Therapeutic consequences still depend on the morphological diagnosis. In cases of minor proteinuria [< 3,5 g/24 h] immunosuppressive therapy is not superior to symptomatic therapy. In patients with nephrotic syndrome immunosuppressive therapy depends on the morphological diagnosis. Glucocorticoids are the therapy of choice in minimal changes glomerulopathy and should be tried in focal segmental sclerosing glomerulonephritis. Steroids may be tried in pure mesangial as well as in IgA and IgM nephropathy. Especially Ponticelli claims significant therapeutic success in patients with membranous glomerulonephritis treated with Prednisolone and Chlorambucil. Failures and relapses may be treated with Cyclophosphamide, Chlorambucil or Cyclosporin A. Anticoagulants may be advantageous in the therapy of membranoproliferative glomerulonephritis.
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PMID:[Therapy of primary chronic glomerulonephritis]. 778 93

Idiopathic IgA nephropathy of Berger's disease is characterized by prominent and diffuse IgA deposits in the mesangium. In many countries, it is the most common type of primary chronic glomerulonephritis. Typically, it is revealed by recurrent episodes of gross hematuria in association with ENT infection, but it can progress insidiously with microscopic hematuria and proteinuria. Serum IgA levels are increased in about 50% of cases. IgA nephropathy is not a minor condition: 20% of patients develop end-stage chronic renal failure 10 years after diagnosis and 50% after 20 years. IgA nephropathy can recur in a transplanted kidney suggesting that this disease is a systemic disorder although it has a remarkable tropism for the kidney. Even though many points remain to be elucidated, its pathogenesis appears to be linked to a genetic factor responsible for a lymphocyte dysfunction and an acquired environmental factor such as penetration of an antigen via the mucosa which may give rise to an excessive and inappropriate IgA immune response with the deposition of IgA in the mesangium and the development of progressive renal alterations. No treatment has been shown to be effective but tonsillectomy advised in case of a recurrent tonsillar focal infection is most often accompanied by a decrease in the incidence of gross hematuria. Corticosteroid therapy can be of benefit in cases involving a nephrotic syndrome associated with minimal glomerular lesions. In all cases, control of possible hypertension is of value in slowing the progression of this disease.
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PMID:[Mesangial IgA deposits nephropathy]. 793 58

The authors present a case report of a 62-year old woman, with hypertension for many years. She suffered from weakness, anorexia and weight loss in the last 6 months. On admission, anemia, elevated ESR, haematuria, proteinuria and renal failure were present. Renal biopsy was compatible with chronic glomerulonephritis. The clinical picture and positivity for P-ANCA suggested systemic vasculitis. Later evidence of maxillary sinusitis and nasal mucosae ulcers as well as pneumonitis, although biopsy did not reveal granulomas, suggested the diagnosis of Wegener Vasculitis. Medicated with Cyclophosphamide and Prednisolone, for a year, with improvement. The authors make a brief discussion of the clinical criteria for classification of ANCA-associated systemic vasculitis.
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PMID:[Vasculitis associated with ANCA]. 794 37

The authors evaluate in a retrospective study the effect of prednisone, cyclophosphamide, small doses of acetylsalicylic acid, conventional antihypertensive drugs and ACE inhibitors on the course of primary chronic proliferative types of glomerulonephritis. The group comprised 44 patients, incl. 16 with normal blood pressure and 28 with hypertension. All were at first given prednisone and cyclophosphamide--for an average of 18 months--and the patients with systemic hypertension conventional antihypertensive drugs. At the termination of treatment proteinuria in the whole group was significantly lower, while glomerular filtration was unaltered, i.e. normal. When the results in normotonic and hypertonic patients were evaluated separately, it was obvious that normotonic patients have a significantly lower proteinuria and a glomerular filtration significantly higher than hypertonic patients. After termination of immunosuppression the authors started to administer to all patients acetylsalicylic acid (1/4 tablet Anopyrin in 24 hours) and in hypertensive patients the conventional antihypertensive drugs were replaced by ACE inhibitors, combined in some with Ca channel blockers. Antiaggregation therapy persists now for more than three years, treatment with ACE inhibitors for more than two years. The results at the end of the investigation indicate that there is no significant difference between normotonic and hypertonic subjects. All have proteinuria lower than 2.0 g/24 hours, stabilized glomerular filtration and after 15 years of glomerulonephritis none of the patients suffers from chronic renal failure. The authors assume that combined immunosuppression, antiaggregation therapy and treatment of hypertension with ACE inhibitors can contribute to the stabilization of chronic glomerulonephritis.
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PMID:[Present possibilities of treatment of primary chronic glomerulonephritis]. 807 42

Nephrotic syndrome due to IgA nephropathy was found in a 45-year-old man with psoriasis vulgaris. He was first diagnosed as psoriasis vulgaris at 20 years age and had exhibited proteinuria since 37 years of age. Recently, he developed nephrotic syndrome with unfavorable progression of psoriasis. The conditions of psoriasis and nephrotic syndrome were consistently parallel, and both diseases responded to corticosteroid therapy. The specimens from renal biopsy showed mesangial proliferative glomerulonephritis and sclerosis with mesangial deposition of IgA. Therefore, we diagnosed this case as IgA nephropathy. Twelve cases with chronic glomerulonephritis associated with psoriasis vulgaris have been published. All biopsied specimens from these cases showed mesangial deposition of IgA. Immune abnormalities have been reported in both diseases. The pathogenesis of psoriasis vulgaris and IgA nephropathy may be related through an immune mechanism.
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PMID:[A case of IgA nephropathy associated with psoriasis vulgaris]. 808 81

We evaluated the effect of enalapril on proteinuria in 20 patients with chronic glomerulonephritis (CGN) and renal insufficiency. Patients were accepted into the study according to the following criteria: 1) a serum creatinine (s-Cr) level over 1.5 mg/dl or a creatinine clearance (Ccr) under 70 ml/min; and 2) urinary protein (UP) over 1.0 g/day, expect for the cases with uncontrollable hypertension. We measured total protein (TP), albumin, s-Cr, Ccr, UP, and Ht during the elanapril therapy. After enalapril therapy, UP slowly decreased, and TP and albumin levels increased. The levels of s-Cr and Ccr did not vary. None of the patients required discontinuation of enalapril therapy caused by side effects, such as anemia or hyperkalemia. In conclusion, enalapril has the effect of decreasing in proteinuria and increasing TP and albumin in patients with CGN and renal insufficiency irrespective of the original diseases.
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PMID:The effect of enalapril on proteinuria in patients with chronic glomerulonephritis and renal insufficiency. 813 37

A clinical analysis of the effect of 64 plasmapheresis sessions in combined treatment of 16 chronic glomerulonephritis patients with nephrotic syndrome was made for 7 patients with mesangiocapillary, 1 with mesangioproliferative, 2 with mesangioproliferative with semilunums, 2 with fibroplastic glomerulonephritis. 12 of the patients had failed previous chemotherapy with prednisolone, curantil, cyclophosphamide. Each of the patients underwent 3-5 sessions of plasmapheresis. The domestic-made centrifuge pi phi-05 was employed. Plasmapheresis was combined with prednisolone (1.5 mg/kg/day) as early as session 1 in 6 patients, session 3 in 10 patients (pulse therapy with 1 mg). Plasmapheresis was followed by curantil and chlorbutin administration. The results evaluated 2 months after the treatment start showed that renal function became normal in 4 patients, proteinuria diminished by 50-80% in 9 cases, nephrotic syndrome transformed into the urinary one in 5 patients.
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PMID:[The clinical efficacy of plasmapheresis in the combined therapy of patients with chronic glomerulonephritis and nephrotic syndrome]. 816 Mar 22

Quantitative measures of proteinuria, hematuria, lipoiduria and cylindruria have been studied in 156 patients with chronic glomerulonephritis in the course of long-term survey. The parameters evaluated and their combinations were noted to vary considerably. Proteinuria and/or hematuria not infrequently associated with cylindruria and/or lipoiduria were common in mesangioproliferative, mesangiocapillary and membranous glomerulonephritis. Patients with focal-segmentary glomerulosclerosis-hyalinosis and minimal glomerulonephritis in the stage of remission revealed no pathological changes in urine. Statistically valid correlation was established between the degrees of proteinuria (as well as between those of lipoiduria) and proteinuria while there was no link between proteinuria and hematuria.
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PMID:[The characteristics of the urinary syndrome in patients with chronic glomerulonephritis]. 820 76

The antiproteinuric effect of the angiotensin-I-converting enzyme inhibitor, captopril, was studied in 14 patients (10 men and 4 women, age range of 24 to 60 years) with chronic glomerulonephritis in whom IgA nephritis had been confirmed by renal biopsy. Eight of the 14 patients had received antihypertensive drugs such as calcium channel blockers, diuretics or beta-blockers. Captopril was added to these regimens at 25 mg twice daily in 3 patients, and 37.5 mg in 11 patients. Proteinuria decreased from 2.55 +/- 0.48 g/day to 1.58 +/- 0.35 g/day within three months after the start of administration. In 4 patients (28.6%), the extent of reduction was over 50%, and in 8 patients (57.1%), over 25%. Blood pressure, creatinine clearance and serum creatinine were not changed significantly. There was a positive linear correlation between the extent of reduction of proteinuria and the increase in plasma renin activity (r = 0.93, p < 0.001). We conclude that captopril reduces proteinuria in some patients with IgA nephritis whose plasma renin activity responds to the drug.
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PMID:Effect of the angiotensin converting enzyme inhibitor, captopril, on proteinuria in chronic glomerular disease. 825 7

Our aim was to determine whether a longer period of treatment with a vegetarian soy diet with addition of fish oil supplements would accentuate the beneficial effects on hyperlipidemia and proteinuria of nephrotic patients we found in a previous study. After an 8-week baseline period on free diet, patients were randomly allocated either on soy diet alone (SD) or to SD plus 5 g/day of fish oil (SD + FO) orally for two months. Then they crossed over to the other treatment for two additional months. They finally resumed eating the free diet for 3 months. We selected 20 outpatients with chronic glomerulonephritis, proteinuria in the nephrotic range, fasting serum cholesterol > 250 mg/dl, mean serum creatinine concentrations 1.75 +/- 0.23 mg/dl. Serum lipid profile, urinary protein loss and nutritional parameters were monitored. With the soy diet, we obtained a significant decrease both of hyperlipidemia and of proteinuria. The effect of the soy diet on proteinuria increased over the 4 months. The addition of a moderate amount (5 g/day) of fish oil in a randomized cross-over design had no further beneficial effect. Stability of serum albumin, transferrin and the body mass index documented good nutritional status. In conclusion, the dietary manipulation with our vegetarian soy diet confirmed the beneficial effects on hyperlipidemia and proteinuria of nephrotic patients. Such effects persisted and even ameliorated after 4 months of diet. The addition of moderate oral supplements of fish oil did not potentiate the beneficial effect.
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PMID:Treatment of proteinuric patients with a vegetarian soy diet and fish oil. 829 38


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