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)

Smoking may be a risk factor for the development of diabetic nephropathy. Therefore, the urinary excretion of albumin, alpha-1-microglobulin, and N-acetyl-BD glucosaminidase was studied in 24 young adult diabetic patients who smoked. None of these patients had urine samples positive for albumin as determined by the Albustix method (i.e., a urinary concentration of albumin of less than 0.5 g in 24 hr). Control groups were nonsmoking diabetic patients (matched for age and duration of diabetes) and nondiabetic subjects (smokers and nonsmokers). Expired breath carbon monoxide and the urinary nicotine metabolite cotinine were measured as objective markers of smoking load. No significant differences in concentrations of urinary proteins were found among any of the four groups. Therefore, smoking is not associated with the development of an increased urinary excretion of albumin within the "microalbuminuria" range. However, further studies are required to determine whether smoking is a risk factor for the progression of established microalbuminuria to Albustix positive proteinuria in diabetic patients.
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PMID:Urinary excretion of albumin, alpha-1-microglobulin, and N-acetyl-B-D-glucosaminidase in relation to smoking habits in diabetic and nondiabetic subjects. 247 55

The authors present partial results of a prospective study conducted in 65 insulin-dependent diabetics with varying duration of disease in whom development of micro-angiopathic organ alterations is followed in relation to diabetes compensation and development of clinically manifest proteinuria or to albumin excretion (microalbuminuria). The results suggest that the increase in albumin excretion in recent-onset and non-recent-onset patients is in most cases only an expression of changes in renal function due to metabolism and therapy and apparently of little value in predicting the risk of developing diabetic nephropathy. The situation is not so unambiguous in patients with long duration of diabetes and, in case increased albumin excretion remains unchanged or further increases despite intensive insulin therapy, it may serve most likely as a marker of high risk of developing diabetic nephropathy.
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PMID:Microalbuminuria--a marker of the risk of developing nephropathy in insulin-dependent diabetes. 250 76

The factors associated with intermittent microalbuminuria were studied over 7 years in 49 Type I and 53 Type II diabetics who had normal initial albumin clearance. Fasting plasma glucose, HbA1, 24 hour urinary glucose, blood pressure, protein intake (24 hour urinary urea), and the renal clearance of albumin, transferrin, and IgG, as well as total proteinuria, were assessed every 3-6 months. Fifteen Type I and 11 Type II diabetics had 40 and 31 episodes, respectively, of intermittent microalbuminuria, defined as an albumin clearance greater than 11 nl/sec, without progressing to persistent microalbuminuria. Rises in transferrin and IgG clearance paralleled albumin clearance in both Type I and Type II diabetics. There were no significant changes in blood pressure or glycemic control during episodes of intermittent microalbuminuria. However, in Type I diabetics, intermittent microalbuminuria was associated with higher levels of urinary urea excretion. This study raises the possibility that increased protein intake may participate in the development of nephropathy in Type I diabetes.
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PMID:Intermittent diabetic microalbuminuria: association with blood pressure, glycemic control, and protein intake. 252 46

Microalbuminuria is an early marker of prognostic significance in diabetic renal disease. The aim of the present study was to compare methods which do not require radioactive markers for estimating microalbuminuria (20-300 mg l-1) with a radioimmunoassay for albumin estimation. Albumin concentrations of 329 diabetic patients were measured using two laser turbidimetric methods for albuminuria and proteinuria, two semiquantitative tests (Albusure and Albustix), and a routine albumin radioimmunoassay. The four methods in the order laser immunoturbidimetric for albuminuria, laser turbidimetric for proteinuria, Albusure and Albustix gave the following results: sensitivity 0.97, 0.93, 0.97 and 0.81; specificity 0.92, 0.88, 0.94 and 0.55; positive predictive value for microalbuminuria 0.83, 0.75, 0.85 and 0.42; negative predictive value for microalbuminuria 0.99, 0.97, 0.99 and 0.88. We suggest that both laser turbidimetric methods are reliable and can replace methods with radioactive markers, the same being true for the Albusure test.
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PMID:Comparison of methods for determination of microalbuminuria in diabetic patients. 252 77

The present study demonstrates the relationship between urinary albumin excretion rate (AER) and renal structural changes in patients with non-insulin-dependent diabetes mellitus (NIDDM) without clinical proteinuria. Resting AER in 30 control subjects and 67 NIDDM patients were 10.4 +/- 4.8 (mean +/- SD) micrograms/min (range 4.3-21.1 micrograms/min) and 26.4 +/- 32.3 micrograms/min (range 0.4-155 micrograms/min), respectively. Persistent normoalbuminuria (less than 20 micrograms/min) and microalbuminuria (20-200 micrograms/min) were found in 43 (Group A) and 24 (Group B) diabetics. There were significant differences in age, diabetes duration, and frequency of retinopathy (background and proliferative) as well as that of proliferative retinopathy between Groups A and B, but not in the other clinical parameters such as body mass index, HbA1, Ccr, or systolic and diastolic blood pressure (SBP, DBP). When compared with 11 normoalbuminuric patients of similar age and equal diabetes duration to those in Group B, the sole difference in clinical parameters was the existence of proliferative retinopathy in Group B. Renal structural changes were investigated by light microscopy in 14 people in Group A and 13 people in Group B, and additionally in 5 NIDDM patients with both macroalbuminuria (greater than or equal to 200 micrograms/min) and normal or nearly normal renal function (Group C). The diffuse glomerular lesion (Gellman's classification) was grade I or II in A, II or III in B, and III in C.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relationship between urinary albumin excretion rate and renal histology in non-insulin-dependent diabetes mellitus: with reference to the clinical significance of microalbuminuria. 252 62

Two indices of the selectivity of proteinuria, the immunoglobulin G (IgG)/albumin and the IgG/transferrin clearance ratios, were studied cross-sectionally and serially over 7 years in a cohort of 52 Type 1 and 60 Type 2 diabetic patients without established diabetic nephropathy. In Type 1 and Type 2 diabetic patients with albuminuria less than 30 micrograms min-1, both protein clearance ratios were significantly higher than in 27 control subjects. As albuminuria increased, there was a decrease in both protein clearance ratios. However, at albumin clearances above 90 nl s-1, equivalent to albumin excretion rates of greater than 250 micrograms min-1, a positive correlation was found in Type 2 diabetic patients between protein clearance ratios and albuminuria. In individual Type 1 and Type 2 diabetic patients with progressively increasing proteinuria, serial measurements of selectivity showed a decline in both protein clearance ratios with the onset of microalbuminuria. Episodes of transient microalbuminuria were also associated with a fall in the IgG/albumin clearance ratio. The results suggest that the selectivity of proteinuria undergoes a triphasic change with the development of diabetic nephropathy. In the first phase, proteinuria is non-selective with IgG clearance equal to or exceeding transferrin or albumin clearance. As microalbuminuria develops, there is a progressive increase in selectivity reflecting the preferential excretion of transferrin and albumin compared with IgG. In later stages of nephropathy, as shown in Type 2 diabetic patients with macroalbuminuria, there is a return to non-selective proteinuria.
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PMID:Triphasic changes in selectivity with increasing proteinuria in type 1 and type 2 diabetes. 253 35

The authors submit preliminary results of a prospective study in 65 insulin-dependent diabetics with a varying duration of the disease where they followed up the development of microangiopathic organ changes in relation to the compensation of diabetes and the development of clinically manifest proteinuria or albumin excretion (microalbuminuria). From the results ensues that in recent and postrecent patients the increased albumin excretion is as a rule only a manifestation of metabolically conditioned and treatable changes of renal function and is of minor importance for the prediction of the risk of development of diabetic nephropathy. In patients with prolonged duration of diabetes the position is not unequivocal and if the albumin excretion persists or increases despite intensive insulin treatment it is most probably an indicator of a high risk of development of diabetic nephropathy.
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PMID:[Microalbuminuria--a risk indicator for the development of nephropathy in insulin-dependent diabetics]. 259 52

In a study of 1,356 diabetic patients attending a clinic in a 12 month period, 28 (2.1%) were considered to have definite diabetic nephropathy by strict diagnostic criteria. This suggests that the prevalence of overt nephropathy is less than has been previously reported. This may be because many patients with microalbuminuria or early proteinuria do not survive to develop the syndrome of established diabetic nephropathy.
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PMID:How common is diabetic nephropathy? 261 13

Renal disease affects approximately 35% of insulin-dependent diabetic patients with a maximal incidence of approximately 25 per 1 000 patient-years after a duration of about 16 years, declining thereafter to less than 7 per 1 000 patient-years after 35 years of diabetes and suggesting that only a particular subset of patients is at risk. The renal disease is characterized by a triad comprising increased albuminuria, arterial pressure and volume fraction of mesangium and leads to a decline in the glomerular filtration rate and ultimately to end stage renal failure or premature cardiovascular mortality. Individuals at risk can be detected before the development of persistent proteinuria by screening for microalbuminuria which has proven predictive of clinical nephropathy in about 80% of cases. Microalbuminuria is accompanied by subclinical increases in arterial blood pressure and plasma lipids and may be associated with increased glomerular filtration rate. It is not usually apparent within the first five years of diagnosis of diabetes. Microalbuminuria thus appears to be a marker for the presence of early renal disease rather than a predictor of susceptibility to it and its many associations indicate it to be a marker of systemic rather than merely renal disease. Recent evidence suggests that diabetic renal disease may be linked to a familial, possibly genetically determined predisposition to arterial hypertension or to some factor closely related to the risk of hypertension. Such a predisposition may help to explain why clinical renal disease occurs in only a subset of diabetic patients.
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PMID:Hypertension and microalbuminuria as predictors of diabetic nephropathy. 261 17

In this work 45 living related kidney donors (LRD) and 20 healthy sex and age matched controls were examined. Donors were evaluated up to 122 months after donation. Hyperfiltration was observed in the remaining kidney with a mean one-kidney GFR value of 82.9 +/- 36.8 ml/min while the control value was 71.04 +/- 31.5 ml/min. The kidney was significantly larger in the donor group than in the controls. In the LRD group, 3 were hypertensive, 7 showed microscopic haematuria and 5 had mild proteinuria. In the control group 3 were mildly hypertensive, and 2 showed microscopic haematuria. Serum creatinine of the donor group was found to be significantly higher than in the controls, yet it was stable and within the normal range (0.89 +/- 0.28 mg/dl). Examination for microalbuminuria showed that 11% of the donor group excreted higher amounts of albumin, being above the upper limit of the control group. We have concluded that kidney donation will result in minor abnormalities in kidney functions which will not affect the donor morbidity or mortality.
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PMID:Long-term follow-up of the remaining kidney in living related kidney donors. 261 85


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