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 describe a distinctive and previously undescribed abnormality of the kidney. It consists of a combination of changes in the glomerulus and in the proximal convoluted tubule. The glomerular abnormality consists of a well-localized collection of intracapillary foam cells and marked vacuolation of the adjacent glomerular epithelial cells. The abnormality is always situated in the same position in the glomerular tuft namely adjacent to the origin of the proximal convoluted tubule, with adhesion to Bowman's capsule. The rest of the tuft appears normal by light microscopy but shows foot-process fusion by electron microscopy. The abnormality of the proximal convoluted tubular cells invariably affects the first part of the tubule adjacent to the glomerulus but in some cases involves the tubules more extensively in the cortex. Study of a series of 100 2-micron serial sections from one case indicated that probably every glomerulus had a lesion at the origin of the tubule. A study of 185 renal biopsies nearly all with segmental lesions revealed biopsies from 20 patients with this distinctive abnormality. There were 14 males, age 20-57, median 44 years, and six females age 19-65, median 22 years, all presenting with proteinuria, nearly all with the nephrotic syndrome. All except four were treated with steroids and in all those treated the proteinuria improved. Only one patient not treated with steroids had progressive renal impairment. Four patients died, none from renal failure. This lesion, the glomerular tip lesion, as we have called it, seems to be a well-defined and specific pathological entity. It has some similarities to minimal change nephropathy but there are clear and important differences. Previously it may have been included in series of cases of 'focal glomerulosclerosis' but that term is imprecise and is generally taken to have an unfavourable clinical course. For these reasons it is inappropriate to use 'focal glomerulosclerosis' as a name for the glomerular tip lesion.
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PMID:The glomerular tip lesion: a previously undescribed type of segmental glomerular abnormality. 670 87

There is no specific therapy for primary amyloidosis, and acquired generalised amyloidosis can be treated only if the underlying disease is eliminated. In this study we have investigated the role of colchicine therapy in primary amyloidosis, and dimethylsulphoxide (DMSO) in leprosy associated secondary amyloidosis. No effect on creatinine clearance or 24 h proteinuria could be observed in the patients with primary amyloidosis. In the DMSO group renal function was considerably improved in 3 patients with moderate renal failure but not in those with severe renal impairment (creatinine clearance less than 10 ml/min). Serum SAA determinations were not particularly informative. These findings point to a beneficial effect of DMSO in human secondary amyloidosis when given at an early stage of renal involvement.
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PMID:DMSO and colchicine therapy in amyloid disease. 674 5

In an open crossover trial, 15 patients with evidence of renal impairment, defined by proteinuria, raised serum creatinine or impaired creatinine clearance, were randomly allocated to treatment with either 40 mg frusemide or 40 mg xipamide daily for 7 days. After a 3-day mid-point wash-out period, patients were changed the alternative drug for a further 7 days. Assessment measures involved a wide range of clinical and biochemical parameters. Whilst both drugs significantly reduced oedema, xipamide was more effective than frusemide, and this was associated with a significantly greater effect on sodium excretion with xipamide. With the exception of standing systolic blood pressure where the reduction was significantly more pronounced with xipamide, no significant changes in resting systolic, resting diastolic or standing diastolic pressure were observed to be associated with change of treatment. Three patients noticed minor side-effects during xipamide therapy. There were no adverse reactions inpatients taking frusemide.
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PMID:Effect of xipamide in oedema of renal disease with varying degrees of renal insufficiency: a comparative trial with frusemide. 675 5

Renal function was examined in 25 patients aged 40-64 with homozygous sickle-cell (SS) disease. Investigations included intravenous urography and measurement of blood urea and creatinine concentrations and creatinine and protein excretion in 24-hour collections of urine. Serum creatinine concentrations did not differ significantly from those of 25 other patients with SS disease aged 18-39 years, but serum urea concentrations were significantly higher (p less than 0.001). Intravenous urography showed loss of caliceal cupping (nine patients), irregular renal outline (five), and cystic extension from the calix (one). Six patients had creatinine clearances below the fifth percentile for age and sex. Proteinuria was more common in these patients, and haemoglobin concentrations were much lower than in the 19 patients without renal insufficiency (mean 5.6 v 8.2 g/dl; p less than 0.001). Haemoglobin concentration was strongly correlated with creatinine clearance (r=0.70), particularly with clearances below 100 ml/min/1.73 m2 (r=0.96; p less than 0.001). A possible mechanism of renal insufficiency in SS disease is cortical scarring, which is asymptomatic, not associated with hypertension, and accompanied by only minor proteinuria. A falling haemoglobin concentration is a sensitive and early indicator of renal impairment in SS disease.
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PMID:Renal function in patients over 40 with homozygous sickle-cell disease. 678 25

Circulating immune complexes (CIC), measured by the solid-phase Clq method, were found to be in abnormal concentration in about half of 39 patients with membranoproliferative glomerulonephritis (MPGN). In contrast, they were present, usually in higher concentration, in nearly all patients with active lupus nephritis. Correlations between clinical course and CIC levels in patients with MPGN showed that complexes were always present when the disease was mild or "silent," but when renal impairment developed or was incipient, complexes were nearly always absent. In patients with disease of intermediate severity, characterized by definite proteinuria but without renal impairment, 50% had complexes. The presence of complexes when glomerular abnormality is relatively slight could be interpreted as indicating that the complexes measured were not nephritogenic, or that they program subsequent events that augment glomerular injury in the absence of complexes. The measurement of CIC in MPGN appears to have minimal value both in diagnosis and in determining prognosis.
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PMID:Circulating immune complexes in membranoproliferative glomerulonephritis. 680 70

The treatment records of patients on gold therapy have been studied with particular respect to the development of proteinuria. This was classified as mild (up to 0.3 g/l), moderate (0.4-2 g/l), or heavy (more than 2.0 g/l). Particular attention was paid to the mode of onset and prognosis of the proteinuria and to subsequent gold administration. Twenty-seven patients with moderate or heavy proteinuria were identified. Two were suffering from psoriatic arthropathy, the rest were diagnosed as having rheumatoid arthritis, although three were persistently sero-negative. There was a direct correlation between the degree of proteinuria and its duration. Heavy proteinuria persisted for at least three months, whereas moderate proteinuria cleared within this period. No patient developed permanent renal impairment. Nine of 10 patients with heavy proteinuria had preceding mild or moderate proteinuria during which period gold administration had been continued. Fourteen of 17 patients with moderate proteinuria had their gold injections continued or re-started and none of these subsequently developed heavy proteinuria. It is suggested that moderate proteinuria should lead to cessation of gold therapy until the urine is clear but that subsequently treatment may be safely re-started.
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PMID:Proteinuria with gold therapy: when should gold be permanently stopped? 682 21

Studies were conducted to assess the renal functional state in two recently discovered diabetic chimpanzees. Both were nonobese, adult female animals with the non-insulin-dependent form of impaired glucose tolerance, analogous to the Type II or nonobese, maturity-onset diabetes of humans. Both animals displayed moderate-to-heavy proteinuria and glycosuria in response to intravenous administration of glucose or tolbutamide. Chimpanzee number 333, but not number 1037, had fasting proteinuria and chronic hypertension. Renal function studies, using the inulin clearance method, demonstrated significantly decreased glomerular filtration rates and elevated rates of sodium excretion for both animals. The rate of chloride excretion was also elevated in animal number 1037, but potassium excretion was apparently unaffected in both animals. Abnormal serum biochemical parameters demonstrated for chimpanzee number 333 included elevations in calcium, magnesium, creatinine, urea nitrogen, and uric acid; animal number 1037 had only an elevated serum creatinine. Results are consistent with the occurrence of renal disease similar to the nephropathy that develops in human diabetics. The difference in severity of renal impairment in the two chimpanzees is possibly related to differences in duration and severity of impaired glucose tolerance. A progression of both diabetic and renal disorders is most probable.
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PMID:Impaired renal function in diabetic chimpanzees (Pan troglodytes). 683 45

We describe a new application of high-performance aqueous gel permeation chromatography for the analysis of human proteinuria. Separations of urinary proteins from normal subjects and patients with renal impairment were performed with TSK G 3000 SW columns. The effects of pH and ionic strength of the eluent on the separation of urinary proteins were investigated. Albumins were selectively separated from urine by affinity chromatography on Blue Sepharose CL-6B. According to the results of clinical investigations, urinary protein pattern derived from gel permeation chromatography revealed a good prediction of the site of renal involvement. Predominant excretion of proteins with lower molecular weight than albumin correlated with tubular damage. Albumin and higher molecular weight protein patterns wer associated with glomerular disease. Absorbance measurements of the eluent at 280 nm were used for quantitative determination of total urinary protein. Gel permeation chromatography was compared to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the resulting protein patterns are in good agreement.
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PMID:Urinary protein profiling by high-performance gel permeation chromatography. 710 67

Twenty adult patients with varying degrees of reflux nephropathy and renal impairment were selected for anti-reflux surgery. Following reflux prevention, those patients with symptoms related to recurrent urinary tract infection were greatly improved. However, in those patients with impaired and deteriorating renal function, surgery only occasionally influences this progression. These patients all had significant proteinuria both pre- and post-operatively. Proteinuria appears to be a more significant prognostic indication of renal deterioration than the degree of reflux or reflux nephropathy.
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PMID:The results of reflux prevention in adults with reflux nephropathy. 715 Sep 22

Renal functional status was evaluated in 122 patients with lepromatous leprosy. Renal functions were found to be markedly impaired in patients with erythema nodosum leprosum (ENL) in the active or quiescent phases. Although uncomplicated lepromatous leprosy patients did show significant renal impairment as compared to healthy controls, the degree of impairment was less than that of the reactive cases. Diminished endogenous creatinine clearance and proteinuria were the common abnormalities detected. Serum creatinine was significantly increased only in reactive cases. Blood urea was found to be marginally increased in a few patients although not to a statistically significant degree. Renal involvement did not bear any relation to the duration of illness or to the Bacteriological Index.
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PMID:Renal functional status in lepromatous leprosy. 719 81


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