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)

The renal disease in an adult woman with Type 1 glycogen storage disease (GSD) is reported. Since she was 15 years old, several episodes of gouty arthritis had developed. At the age of 18, proteinuria was pointed out. Hepatomegaly, renomegaly out of proportion to the impairment of renal function, hyperuricemia, hyperlipidemia, fasting hypoglycemia and lactic acidemia were observed. The diagnosis of GSD was established on the basis of a glucose tolerance test, glucagon test and liver biopsy. The findings of renal biopsies performed at the ages of 24 and 27 years old suggested that glomerular damage might have preceded the tubulo-interstitial lesion.
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PMID:Renal disease in an adult with type 1 glycogen storage disease. 203 36

Two unrelated boys with mild persistent proteinuria and underexcretory-type hyperuricemia of more than 9.0 mg/dl (535 mumols/l) are described. The proteinuria was detected at age 10 and 6 years, respectively. The fractional excretion of uric acid in both was low at 2-3%, when the creatinine clearance was decreased by about 50%. Tissue examination revealed focal interstitial fibrosis in both patients and medullary urate crystals in one patient in whom medullary tissue was obtained on biopsy. An immunofluorescence study was negative for immunoglobulins, complements and fibrin. Treatment of hyperuricemia did not prevent further deterioration of their renal function. One of them underwent a renal transplantation and then his serum uric acid level returned to the normal range. Neither patient had a family history of hyperuricemia, gout or inherited progressive renal disease. Both patients are likely to be sporadic cases of familial nephropathy with gout, an autosomal dominant disease, due to a new mutation. Hyperuricemia due to diminished uric acid clearance may be a risk factor or predictor for the development of progressive renal disease in some subjects.
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PMID:Underexcretory-type hyperuricemia, disproportionate to the reduced glomerular filtration rate, in two boys with mild proteinuria. 208 6

The authors have studied 27 cases of Abruptio Placentae (A.P.) (for an observation time of 15 months). These 27 patients where divided into 3 groups: 6 patients without pregnancy follow-up, 5 with a regular follow-up and 16 with an intensive pregnancy follow-up. In this last group following parameters were studied: blood pressure, proteinuria, uricemia, hematocrit, platelet count, FDP, plasma volume, Fetal (umbilical artery) and Maternal (uterine artery velocities with doppler reclude Fetal heart Rate. The total number of intra uterine death and post natal death remained very high: 15 over 27 cases. However this rate was lower in the intensive group, where 10 fetuses with were delivered safely. Studying the evolution of clinical, biological and ultrasonic parameters during the last month before the AP we tried to establish curves of their mean value (every week for the last 4 weeks and every day for the last week). Almost all parameters showed a late significant variation (in the last week). Two of them were modified in the last two days: (FDP and Fetal heart rate acceleration). Two of them were "positive" (in 60 p. 100 of cases) 3 of 4 weeks before the AP: Maternal Plasma volume decrease, Presence of a Notch on the uterine artery doppler curve. In conclusion fetal or neonatal death after AB remains high and even with an intensive follow-up 30 p. 100 of the cases cannot be predicted.
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PMID:[Compared course of clinical, biologic, echographic and speedometric parameters in retroplancetal hematoma]. 251 Jun 32

The antihypertensive effect of enalapril maleate, a new converting enzyme inhibitor, was evaluated in a multiclinic, double-blind, randomized study in patients with mild to moderate essential hypertension. The analyses were done in two ways, with patients who violated the entry criteria of the protocol excluded, and according to the intention to treat principle. Enalapril in dosages of 10 to 40 mg daily administered alone or concomitantly with hydrochlorothiazide was compared to propranolol (80 to 240 mg daily) alone or concomitantly with the diuretic. The study showed that enalapril significantly lowered both systolic and diastolic blood pressure. At each timepoint measured in the course of 26 weeks of therapy, the patients in the enalapril group consistently had greater decreases in blood pressure than patients in the propranolol group although not always significantly. The enalapril treatment group had a decrease in the mean arterial blood pressure of 22.2 mmHg compared to the propranolol group of 17.9 mmHg at the end of the study. These results were similarly independent of the way the data were analyzed. Fewer patients in the enalapril group required the addition of hydrochlorothiazide to maintain optimal control of blood pressure. Enalapril was found to be safe and well tolerated over the long-term of 48 weeks. Side effects such as leukopenia and taste perversions believed to be sulfhydryl-related were not encountered. The occurrence of rash and proteinuria was rare. Thiazide-induced hypokalemia, hyperuricemia and hyperglycemia appeared to be attenuated by enalapril. The favorable efficacy and side-effect profile provide the basis for enalapril to be a drug of choice when initiating antihypertensive therapy.
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PMID:Long-term enalapril--a new converting enzyme inhibitor--in the treatment of mild to moderate essential hypertension, results of a worldwide multiclinic study. Comparing two ways of analyzing data. 300 72

Since their introduction in clinical practice in 1980, ACE inhibitors have been found useful in the treatment of hypertension and CHF. In hypertension, they are effective as monotherapy in 40% to 50% of the patients, and in combination with diuretics or calcium antagonists, they are effective in up to 85% of the patients. They are well tolerated, are not associated with depression, impotence, bronchospasm or metabolic derangements such as hypokalemia, hyperuricemia or hyperglycemia, and do not have adverse effects on the quality of life. As a result, they are preferred in hypertensive patients with CHF, left ventricular dysfunction, mental depression, older age, coronary artery disease, metabolic disorders, chronic destructive pulmonary disease, and peripheral vascular disease. In CHF they cause long-lasting hemodynamic and symptomatic improvement, improve exercise tolerance, and may lower mortality in certain patient subsets. Evolving new indications for ACE inhibitors include the diagnosis of renovascular hypertension, the prediction of surgical success, the treatment of scleroderma renal crisis, the reduction of proteinuria, renal protection, cardioprotection, the improvement of arterial compliance, in Bartter's syndrome and idiopathic edema, etc. ACE inhibitors are usually well tolerated but in some instances they may cause class-specific side effects such as hypotension; usually reversible azotemia or renal failure, especially in patients with renal artery stenosis or with CHF with low blood pressure; cough; angioedema; and hyperkalemia. Differences among ACE inhibitors are emerging and include chemical class (e.g., zinc ligand), biotransformation, potency, pharmacokinetics, prodrugs, tissue effects, additional pharmacologic properties, and drug interactions.
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PMID:Angiotensin converting enzyme inhibitors. II. Clinical use. 305 46

A clinical study was performed in 2 groups of patients with solitary kidneys, followed for 11-146 months. Group 1 had 9 patients (7 males and 2 females, aged between 23 and 68 years) with unilateral renal agenesis. Group 2 had 13 patients (9 females and 4 males, aged between 27 and 70 years) who underwent unilateral nephrectomy for the following reasons: hydronephrosis secondary to ureteropelvic junction stenosis, 7 patients; renal trauma, 4 patients; benign neoplasia, 2 patients. During the follow up, urinary protein excretion of more than 300 mg/day was observed in 9 patients, 3 in group 1 and 6 in group 2. Eleven patients, 8 in group 1 and 3 in group 2, were hypertensive (diastolic blood pressure higher than 95 mm Hg). Hyperuricemia was observed in 14 patients, 10 in group 1 and 4 in group 2. Seven patients, 4 in group 1 and 3 in group 2, had a significant deterioration of renal function. Neither proteinuria nor renal failure were observed before at least 10 years had elapsed since the anatomic condition of solitary kidney had been established. A surgical renal biopsy was performed in 1 patient with unilateral renal agenesis and showed focal glomerular sclerosis. This study adds support to the view that the reduction of 50% of the renal tissue may be a risky situation in humans as well as in animals.
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PMID:Clinical features of patients with solitary kidneys. 351 62

The paper is concerned with the results of a long-term study with clinicomorphological correlations of 86 patients with alcoholic glomerulonephritis (GN), i. e. 12% of all morphologically verified cases of primary GN. GN clinical features in alcoholism were painless microhematuria, moderate hyperuricemia, frequent combination with the alcoholic involvement of the other organs and the elevated blood serum IgA level. An important diagnostic sign in alcoholic GN was a positive clinicolaboratory time course in abstinence. A morphological study showed prevalence of mesangioproliferative GN with deposits containing IgA and C3, often with a noticeable tubulointerstitial component and fibroplastic glomerular transformation. The accumulation of podocytes and nephrocytes of intermediate filaments in the cytoplasm should be regarded as an important morphological feature of alcoholic GN. An unfavorable course of alcoholic GN with an outcome into chronic renal failure was observed in 35% of the patients. Prognostically unfavorable signs were the age under 40, the presence of considerable proteinuria (over 1 g/day), the nephrotic syndrome, the detection of the glomerular immune complexes, a tubulointerstitial component, fibroplastic transformation of mesangioproliferative nephritis as well as the detection of mesangiocapillary, diffuse fibroplastic and extracapillary nephritis.
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PMID:[Clinico-morphological characteristics and prognosis of glomerulonephritis in chronic alcoholism]. 376 53

For the purpose of clinical management, any woman with an acute rise in blood pressure in the latter half of pregnancy must be regarded as having preeclampsia with the possibility of progression to eclampsia. Unfortunately, such diagnoses have been accepted uncritically in the selection of cases for clinical and laboratory studies of preeclampsia, with inevitably erroneous and contradictory conclusions about the disorder. The diagnosis of mild preeclampsia may be correct in roughly one-half of cases, but others may be latent or frank essential hypertension or any of a variety of renal diseases. In selecting cases for research, the diagnostic errors can be greatly reduced by the exclusion of all multiparas and all primigravidas without abundant proteinuria. The primigravidas should have a reliable history of normality or follow-up studies proving it, be aged 25 or less, and have hyperuricemia. The selection of cases for the study of preeclampsia demands far more rigid criteria for diagnosis than does the diagnosis for clinical management.
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PMID:Diagnosis of preeclampsia. 388 67

Diminished glomerular filtration rate, proteinuria, and large hypercellular congested glomeruli with segmental sclerosis are found in late survivors with cyanotic congenital heart disease (CCHD). Hyperuricemia is common, acute gouty arthritis is less common than uric acid levels would predict, and overt tophaceous deposits of uric acid are exceptional. The role of the kidney in causing the basic biochemical disturbances, and the relative importance of impaired urate excretion vs urate overproduction have not been established. Accordingly, we reviewed the courses of two index patients and prospectively studied eight additional CCHD patients from 28 years to 46 years old with mean hematocrits of (62 +/- 10%). Plasma creatinine concentration was normal (0.9 +/- 0.1 mg/dl) yet glomerular filtration rate was mildly reduced to 93 +/- 14 ml/min as measured by creatinine clearance and to 81 +/- 6 ml/min as measured by 111In DTPA. Three patients had significant proteinuria and one was nephrotic. Plasma uric acid concentration was high in all but one (8.2 +/- 2.1 mg/dl), mean 24 hr uric acid excretion was normal (564 +/- 221 mg), and fractional uric acid excretion was relatively low (6.3 +/- 2.6%). The two patients with highest plasma uric acid levels (12.0 and 10.2 mg/dl) had the lowest fractional excretions (2.8% and 4.0%). Both of these patients had diminished capacity to excrete a water load (38% and 27%/4 hr) and to maximally concentrate urine (520 and 635 mOsm/kg after water deprivation and vasopressin). In conclusion, high plasma uric acid levels in late survivors with CCHD are secondary to inappropriately low fractional uric acid excretion, not to urate overproduction.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal function and urate metabolism in late survivors with cyanotic congenital heart disease. 394 50

The authors examined urine specimens from 30 patients with multiple myeloma (MM) to determine the usefulness of cytodiagnostic urinalysis in evaluating such patients. Nine patients had clinical evidence of renal failure. In six of these nine patients (67%), or 20% of all patients, the urine sediment contained unique "MM-casts." These were characterized by a waxy to granular matrix surrounded by reactive, syncytial, giant cells with occasional renal cells embedded in the cast matrix. These casts were not observed in urine specimens from patients with normal renal function. Renal biopsy in two patients with MM-casts confirmed that cytologic diagnosis of "MM-kidney." The patient groups with or without MM-casts were comparable with respect to age, sex, and clinical stage of disease. In contrast, those with MM-casts were more likely to have clinical evidence of renal disease (100% vs. 13%), Bence Jones proteinuria (100% vs. 35%), hypercalcemia (50% vs. 8%), and hyperuricemia (50% vs. 4%). The two groups could not be distinguished reliably by urine physicochemical determinations. However, there were marked differences in the frequency of microscopic abnormalities. All patients with MM-cast formation excreted other pathologic casts as well and had evidence of tubular injury, while five of six had evidence of ischemic necrosis. This compared with 17%, 13%, and 21%, respectively, of those without MM-casts. Thus, cytodiagnostic urinalysis is of value in distinguishing MM-kidney from the numerous other causes of renal failure in patients with MM.
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PMID:The urinary myeloma cast. Frequency of detection and clinical correlations in 30 patients with multiple myeloma. 398 35


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