Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

32 patients with different histologically proven forms of glomerulonephritis were treated with heparin for an average of 31 days. A dosage of heparin was chosen, which allowed an increase in thrombin time to 20-40 seconds. Histological findings alone do not allow any prediction concerning the therapeutic success of heparin treatment in glomerulonephritis. According to our results and comparable information given in the literature, the following therapeutic scheme can be recommended: Best results are seen in patients with a slow decrease of GFR (i.e. less than 30 ml/min) during the year preceding the beginning of the treatment. In rapid progredient glomerulonephritis, however, as in patients without any changes of GFR during this time, predictions as to the course of illness cannot be made. A high level of fibrin split products in serum may be expected to be the most valuable sign of therapeutic effect, as could be documented in 7 out of 8 successfully treated patients. Hypertension and proteinuria were not influenced by the treatment. Because of severe side effects the heparin treatment of glomerulonephritis should not be initiated in patients with severe hypertension.
 ...
PMID:[Treatment of glomerulonephritis with heparin (author's transl)]. 87 75

Thirty-one patients presenting classical or defined, severe and active rheumatoid polyarthritis (RP) unresolved by most of the usual basic treatments (due to inefficacy or safety problems) were treated with human placental IgG preparations (HPIgG) in an open study. Various therapeutic protocols were tested to determine the most efficacious dosage. Favorable results were noted in 62% of cases. Improvement was generally rapid, often occurring after the first week of treatment. Rheumatoid nodules subsided by more than 50% and were resolved in two of nine cases. A decrease in dosage of analgesics or anti-inflammatories was possible in seven of 31 cases. Remission of RP of duration exceeding six months after withdrawal of HPIgG treatment was noted in six of 18 favorable results (33.3%). Best results were seen with intravenous administration of 1,500 mg per day seven days per month. No clinical or immunological effects were seen in a control group treated with venous globulins (1,500 mg/day for seven days). Safety was very satisfactory: four withdrawals from treatment due to proteinuria (3 cases) or phlebitis (1 case); these adverse reactions subsided rapidly. Immunostimulation of lymphocyte function was seen in all patients treated with HPIgG. The mode of action of HPIgG is currently under study. HPIgG may act as polyspecific antibodies against class II HLA antigens thus opening up the possibility of a new type of therapeutic immunomodulation in man.
 ...
PMID:[Treatment of rheumatoid polyarthritis with IgG eluted from the placenta. Results of an open study on 31 patients]. 378 54

The lumbar spine bone density (BMD) was assessed by single energy quantitative tomography in 16 young patients with non traited Klinefelter's syndrome (19 +/- 2.2 yr) and in 16 age weight- and height-matched control males. The BMD were significantly lower in the patients than in the control group (175 +/- 26 mg/cm3 K2HPO4 vs 204 +/- 26; p < 0.02). The authors found a significant correlation between BMD and plasmatic levels of testosterone and estradiol suggesting the hormonal origin of the osteopenia whereas no correlation was found with serum calcium, phosphorus or prolactin levels or hydroxy-proteinuria. Such osteopenia in young patients with Klinefelter's syndrome supports early androgenic treatment of these patients.
 ...
PMID:[Early spinal bone loss in Klinefelter syndrome. X-ray computed tomographic evaluation in 16 cases]. 816 26

The objective of this study was to determine the accuracy of ward urinalysis and the sensitivity of dipstick testing in the assessment of proteinuria in hypertensive pregnant women. Subjects were 230 consecutive hypertensive pregnant women who were admitted to hospital over a 2-year period. Routine ward urinalyses for protein, obtained on a mid-stream sample before and after a 24-hour urine collection for quantitating proteinuria, were compared with the 24-hour urine protein excretion. As a control for dipstick accuracy, urinalysis was also performed on a mixed aliquot of each of the 24-hour samples by a single observer experienced in urinalysis. True proteinuria was considered as > 300 mg/day. The positive predictive value for urinalysis ranged from 38% (for the precollection test) to 60% (for tests on the aliquot). Negative predictive values were 86-88%. The false negative rates at 'nil' or 'trace' proteinuria ranged from 8-18%. The false positive rates at '3+' (3 g/L) or '4+' (> or = 20 g/L) ranged from 0-17%, at '2+' (1 g/L) from 18-50% and at '1+' (0.3 g/L) from 67-83%. Best results for urinalysis were obtained on the aliquot testing but even under these ideal circumstances there was a high false positive rate (67%) at '1+' (0.3 g/L) urinalysis level. These studies show that in routine clinical practice 'nil' or 'trace' proteinuria will miss significant proteinuria in approximately 1 out of 8 hypertensive pregnant women while '3+' (3 g/L) or '4+' ( > or = 20 g/L) will rarely be a false positive. At urinalysis of '1+' or '2+' a 24-hour urine collection is required to be certain about the presence or absence of proteinuria. Research studies should demand 24-hour urine protein quantitation and not rely solely upon urinalysis results.
 ...
PMID:Inadequacy of dipstick proteinuria in hypertensive pregnancy. 871 55

In many ways there should be no need to classify hypertensive disorders in clinical practice. The very presence of rising blood pressure should alert the clinician to seek evidence for the development of pre-eclampsia and whether there are any emerging abnormalities of fetal growth and/or maternal renal, cerebral, hepatic or coagulation functions which may necessitate specific treatment, including delivery. While such a view may be appropriate for experienced clinicians with an understanding of the pathophysiology of the hypertensive disorders of pregnancy, it is of little help to junior or less experienced medical staff. Moreover, without an agreed international classification system it is impossible to compare truly clinical outcome, intervention or basic research studies from different units as entry criteria to these studies may differ considerably across individual units and certainly across countries. In this chapter we highlight the limitations of the existing classification systems and propose a system that is based on our present understanding of the pathophysiology of pre-eclampsia. The proposed system is not a radical departure from previous classifications, with grouping of hypertensive subjects into gestational hypertension, pre-eclampsia and chronic (usually essential) hypertension. Proteinuria, while remaining a hallmark of pre-eclampsia, is no longer considered a 'sine qua non' for this disorder to be diagnosed, reflecting our greater understanding of the maternal and fetal abnormalities in pre-eclampsia since previous classification systems were developed. This classification system has been compared with the traditional system of diagnosing proteinuric pre-eclampsia in a study of 1183 women with hypertension in pregnancy: diagnosing pre-eclampsia in this new manner still stratifies a high-risk group of pregnant women and the proposed diagnosis of gestational hypertension in this system stratifies a group of women at low maternal and fetal risk, provided that continual maternal and fetal monitoring is employed. We hope that this system of classification can be adopted uniformly, permitting appropriate triage of pregnant women into higher and lower clinical risk groups while allowing us to compare 'apples with apples' in future research studies.
Baillieres Best Pract Res Clin Obstet Gynaecol 1999 Mar
PMID:Classification of hypertension in pregnancy. 1074 91

Fifty per cent of pregnancies are unplanned, and 1-6% of young women have pre-existing hypertension. However, no commonly used antihypertensive agent is known to be teratogenic. ACE inhibitors (and angiotensin-receptor antagonists) should be discontinued due to fetotoxicity. Five to 10% of pregnant women have hypertension, of which pre-existing hypertension is but one type. There is consensus that severe maternal hypertension (blood pressure >or=170/110 mmHg) should be treated to minimize the risk of acute cerebrovascular complications. Parenteral hydralazine may be associated with a higher risk of maternal hypotension, and intravenous labetalol with neonatal bradycardia. There is no consensus that mild-to-moderate hypertension in pregnancy should be treated. Clinical trials indicate that transient severe hypertension, antenatal hospitalization, proteinuria at delivery and neonatal respiratory distress syndrome may be decreased by normalizing blood pressure, but intrauterine fetal growth restriction may be increased. Methodological problems with published trials warrant cautious interpretation of these findings. Methyldopa and beta-blockers have been used most extensively, although atenolol may impair fetal growth in particular and should be avoided.
Best Pract Res Clin Obstet Gynaecol 2001 Dec
PMID:Drugs in pregnancy. Antihypertensives. 1180 May 27

The prevalence of type 2 diabetes mellitus is rising rapidly in all developed countries, particularly in the growing population of persons >50 years of age. As a dangerous consequence, this is accompanied by a proportionate increase in the incidence of chronic renal disease. Evidence-based medicine has shown that tight blood glucose control can delay the onset and retard the progression of diabetic complications, and while it is a challenge to closely manage the complexity of diabetes, it is more difficult to effectively treat the multiple associated comorbidities that develop. Best practice guidelines support early intervention and aggressive treatment of hypertension, hyperglycaemia, proteinuria, hypercholesterolemia, and anaemia. To date, guideline-based management has been proven to be difficult. This article describes the concept of the IRIDIEM studies. The objective of these studies is to endorse and facilitate the use of current best practice guidelines for the management of frequent comorbid diseases and established risk factors in the treatment of type 2 diabetes associated with chronic kidney disease. Additionally, IRIDIEM will assess the impact of this improved disease management model on the progression of chronic kidney disease that can result from electronically prompting clinicians with evidence-based treatment advice.
 ...
PMID:Individualized risk management in diabetics: how to implement best practice guidelines--design and concept of the IRIDIEM studies. 1511 29

Amyloidosis is an uncommon plasma-cell dyscrasia with an incidence of eight patients per million per year. It is often difficult to recognize because of the myriad symptoms and vague nature of the clinical presentation. Symptoms include fatigue, dyspnea, edema, paresthesias, and weight loss. Clinical syndromes at presentation include nephrotic-range proteinuria with or without renal insufficiency, cardiomyopathy, hepatomegaly, symptomatic peripheral neuropathy, and autonomic failure. Recent advances have occurred in evaluation of patients by using the free light chain assay and new prognostic assessments with cardiac biomarkers. Newly developed therapeutic strategies, involving high-dose and intermediate-dose chemotherapy, have evolved in the last 3 years. This paper reviews a diagnostic pathway clinicians can use to diagnose the disorder, assess a patient's prognosis, and logically plan a therapeutic strategy.
Best Pract Res Clin Haematol 2005
PMID:Amyloidosis. 1602 46

Fertility is restored after renal transplantation when good function is achieved. Our aim was to describe the gestations of our transplanted patients, analyzing outcomes and complications as well as long-term evolution of renal function. From 1976 to 2004, 43 gestations occurred in 35 renal transplanted women: their mean age was 31.7 +/- 4.06 years, with a mean time from the transplant to pregnancy of 4.32 years (0.4-13). At conception, all showed normal renal function (SCr 1.05 +/- 0.2 mg/dL). There were 19 abortions (43.8%), 9 of them spontaneous (21%) and 10 therapeutic (six cases for noncompliance with described criteria of European Best Practice Guidelines for Renal Transplantation, especially pregnancy less than 6 months after transplantation). Excluding these six cases of therapeutic abortions, 24 successful pregnancies occurred in 37 women (65.7%), although eight (29.1%) had premature delivery with live fetuses. Arterial hypertension was the most frequently complication (64%). Preeclampsia occurred in nine (37.5%) pregnancies, with proteinuria in five and only two with mild renal function deterioration. The majority of patients received cyclosporine (n = 20) or tacrolimus (n = 19). Since 1996, mycophenolate mofetil and sirolimus were stopped before conception. Birth weight was lower than 2500 g in 33.3% of pregnancies. Every newborn baby was healthy. Afterward, of the 24 patients with successfully pregnancy, 21 (87.5%) have functioning renal transplants at 53.2 months. After delivery, all currently show good renal function (SCr 1.16 +/- 0.35 mg/dL, CrCl 91 +/- 28.45 mL/m). In conclusion, pregnancy in our renal transplant women shows a success rate of 65.6%. However, complications related to arterial hypertension such as preeclampsia are frequent. The incidence of spontaneous abortions was similar to other series (21%). Long-term graft survival does not seem to be negatively affected by pregnancy.
 ...
PMID:Pregnancy in renal transplant recipients. 1638 17

Management of pregnant women with renal disease involves awareness of, and allowance for, physiological changes including decreased serum creatinine and increased proteinuria. For women with systemic lupus erythematosus (SLE), pregnancy increases likelihood of flare. These can occur at any stage, and are more difficult to diagnose, as symptoms overlap those of normal pregnancy. Renal involvement is no more common in pregnancy. Worsening proteinuria may be lupus flare but differential includes pre-eclampsia. In women with chronic renal disease, pregnancy may accelerate decline in renal function and worsen hypertension and proteinuria, with increased risk of maternal (eg, pre-eclampsia) and fetal (eg, IUGR, IUD) complications, strongly correlating with degree of renal impairment peri-conception. Pregnancy success rate varies from 20% to 95% depending on base-line creatinine. Best outcome is obtained if disease was quiescent for >6 months pre-conception. Women on dialysis or with renal transplants can achieve successful pregnancy but have higher maternal and fetal complication rates. Acute on chronic renal failure can develop secondary to complications such as HELLP and AFLP. Management needs to be by a multidisciplinary team involving physicians and obstetricians, ideally beginning with pre-pregnancy counselling. Treatment of flares includes corticosteroids, hydroxychloroquine, azothioprine, NSAIDs and MME Blood pressure is controlled with methyldopa, nifedipine or hydralazine.
 ...
PMID:Lupus nephritis and renal disease in pregnancy. 1663 68


1 2 3 Next >>