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 process of intraerythrocytic gelling of haemoglobin S is exacerbated by physiochemical and circulatory conditions which dominate in the renal medulla. In the first few years of life, the sickle cell disturbance is reversible by exchange transfusions. At about the age of 15, this is no longer reversible in homozygotes and is replaced by anatomical lesions which gradually destroy the renal functional capacity for concentrating urine, for excreting H+ and K+ ions and for secreting uric acid. The crises are acute rheological events which temporarily accentuate these disorders which appear to be the combined result of hyperviscosity and vascular occlusions. As the occurrence of hematuria and urinary infections is necessarily organically linked to the parenchymatous lesions, their frequency and severity pose great problems concerning treatment. Recent works emphasize the frequency and severity of renal disorders in sickle cell patients during the period of life which is over 30 years. A preventive disposition must be maintained from childhood: restriction of the use of nephrotoxic drugs, reduction of the frequency of crises, dehydration and urinary infections, and subsequently regular observation of kalemia, uricemia and proteinuria.
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PMID:[Anatomical and pathophysiological bases of renal disorders in sickle cell syndrome patients and carriers of the trait]. 635 9

About a retrospective study turning on 600 bed-rests during 3 years, the writers study 433 confirmed high blood pressures including 389 without therapeutic among which 67 p. 100 labil or limit H.B.P. and 33 p. 100 permanent H.B.P. By light of current ideas and withdrawn informations from complementary explorations done, they try to define a reasonable attitude concerning twenty years old young hypertensive male patients in view of selection. This attitude can be extended to the general field of young H.B.P. people. They establish that a good number of systemically researched elements are without great interest; functional signs, which are more the neurotonia witness than the H.B.P. consequence, heart or renal repercussion, negligible in this age, the too shematic distinction between permanent, labil or limit H.B.P. On the other hand, some parameters deserve to be searched : family antecedents (greater than 60 p. 100), obesity (approximately 20 p. 100), ocular repercussion (approximately 15 p. 100), perturbation of lipidemia, above all hypertriglyceridemia, hyperuricemia and urinary sediment abnomalies. As for I.V.U., in spite of an exact study of vascular times, and second reading by the same observer, it never allowed to display any renovascular H.B.P. Other pathologic uronephrologic established images are all almost associated to urinary sediment anomalies or to proteinuria. More, a few frequent incidents among young people and the price of the exam bring to purpose. I.V.U. only when H.B.P. context is hard or going with urinary signs. Other more specific exams (V.M.A., catecholamines) will be asked according to the context.
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PMID:[The complementary reasonable explorations to consider about young hypertensive patient. (With regard to 389 selection bed-rests in view of national service) (author's transl)]. 708 66

The relation of fetal birth weight to plasma urate concentrations and blood pressure was studied in 71 pregnant women with hypertension. The tendency to low birth weight was markedly increased when maternal plasma urate concentrations were over the normal level, generally in association with preeclampsia. Plasma urate showed a better correlation than either edema or proteinuria by itself with low fetal birth weight. Hypertension in association with elevated levels of plasma urate showed the lowest birth weight. Hyperuricemia in normotensive pregnancies showed similar fetal birth weights as maternal hypertension without other preeclamptic symptoms. These findings suggest that, in terms of fetal development, changes in renal retention of urate may be an additional predicting factor for fetal development as important as hypertension alone.
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PMID:Plasma urate measurements and fetal outcome in preeclampsia. 723 51

Serum and urinary urate concentrations were studied in 44 patients with homozygous sickle cell (SS) disease, and in 27 controls with normal haemoglobin. Hyperuricaemia (>0.39 mmol/l (6.5 mg/100 ml)) occurred in 41% of SS patients and inversely correlated with renal urate clearance but not with indices of bone marrow turnover. Higher serum urate concentrations occurred in patients with proteinuria, probably due to associated tubular damage. Higher serum urate concentrations and lower urate clearance occurred in males compared to females.
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PMID:Serum urate concentrations in homozygous sickle cell disease. 727 21

One hundred and fourteen women presenting during pregnancy with an abnormally high blood pressure and/or proteinuria had a renal biopsy usually on the 8th day following delivery. The pathological specimens were examined by light and/or electron and/or immunofluorescence microscopy. Forty-one cases were studied with all three techniques. The patients could be allocated to six groups on the basis of clinical criteria. The first two groups (52 patients) showed the typical clinical and pathological features of classical preeclampsia. The remaining 62 women (four groups) had isolated hypertension, and, of these, 42 had a renal pathological pattern similar to that of preeclampsia. These 42 patients also had persistent hyperuricemia. Thus in pregnancy, hypertension and persistently elevated uric acid levels are indicative of glomerular lesions of "pregnancy induced nephropathy".
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PMID:Renal lesions in the hypertensive syndromes of pregnancy: immunomorphological and ultrastructural studies in 114 cases. 737 66

The clinical, laboratory and pathologic findings were studied in 62 consecutively autopsied patients with multiple myeloma between 1954 and 1975. All patients were 40 years of age or older. Bone pain was the initial symptom in 2/3 of patients. Anemia (81%), thrombocytopenia (29%), azotemia (41%), hypercalcemia (46%) and hyperuricemia (52%), were common laboratory findings at diagnosis. Ninety-seven percent had a monoclonal protein in serum or urine. Extensive plasma cell replacement of marrow was invariably seen at autopsy although in 15% of patients no abnormality was found on skeletal survey. Extraskeletal spread (67%) was due to direct extension to paraosseous tissue resulting from cortical destruction and to distant organ involvement mainly of splenic red pulp and hepatic sinusoids. The patients were susceptible to bacterial infection, mainly gram-negative, of the lung (56%), urinary tract (35%), and blood (24%). Fungal infection was less frequent and usually consisted of superficial candidal overgrowth of gastrointestinal tract ulcerations (18%). Amyloidosis (10%) was perivascular and associated with light chain proteinuria. Renal failure as a cause of death (21%) was secondary only to infection (52%). Severity of histologic findings in the kidney at autopsy had little correlation to initial BUN concentration. The median survival was 11.5 months with alkylating agent therapy (responders, 29 months; non-responders, 6 months), and 6 months with urethan. Initial azotemia (greater than 80 mg/dl) and hypercalcemia (greater than 12 mg/dl) were important prognostic indicators (median survival, less than 1 month and 3 months, respectively). A good response to alkylating agent therapy, initial BUN less than 40 mg/dl and serum calcium less than 12 mg/dl were favorable to prognostic indicators.
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PMID:Multiple myeloma: a clinicopathologic study of 62 consecutively autopsied cases. 743 54

This study aims to determine the clinical factors that may affect renal function and patient survival in 82 multiple myeloma patients. The patients were divided into 3 groups according to their renal function during the initial 8 weeks after diagnosis: Group I, 54 patients with serum creatinine (S-Cr) < 177 mumol/L; Group II, 11 with S-Cr > or = 177 mumol/L and receiving no dialysis; Group III, 17 undergoing dialysis treatment. Clinical status at diagnosis, subsequent renal function and patient survival were compared. Bence Jones proteinuria (BJP) was found in all patients in Groups II and III, compared to 67% of patients in Group I (p < 0.05, I vs II or III). Hypercalcemia, hyperuricemia and intravenous administration of contrast medium, together with BJP each constituted independent risk factors of renal dysfunction. The incidence of hypercalcemia in Group II was significantly higher than in the other 2 groups. Patient survival was 26.8 +/- 23.7 months in Group I, 8.1 +/- 10.3 in II and 12.1 +/- 16.6 in III (p < 0.05, I vs II or III). Renal function and patient survival depended on the initial renal function. Renal function was likely compromised in the presence of BJP.
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PMID:Renal dysfunction in multiple myeloma. 764 3

Analysis of 2,547 cases of multiple myeloma (MM) reported in China in 1980s showed that the clinical manifestations are characterized by multipliey. High misdiagnosis rate (69%) and multiple complications. While the monoclonal protein had more than 25 immunological type, IgG myeloma was the commonest (43.1%). Light chain subgroup trended to have higher incidence of renal damage (76.9%). Plasma cell leukemia eventually developed in 30 cases. In order to improve diagnosis and avoid misdiagnosis, the key points are 1, to better the recognition of clinical features of MM. 2. patient should receive urine Bence-Jones protein, immunoglobulins, immunoeletrophresis, bone X-ray and multiple site bone marrow puncture whenever one of such manifestations as unexplained anemia, skeletal pain, proteinuria, elevation of ESR, hyperviscosity syndrome, hypercalcemia, hyperuricemia, elevation of alkaline phosphatase, pathological fractures and diffuse osteoporosis. 3. immuno-binding electrophoresis and immunofluorence antibody detection should be done for suspected cases with normal immunoglobulin level.
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PMID:[On the diagnosis of multiple myeloma an analysis of 2,547 domestic cases]. 765 87

A number of laboratory tests are available for the evaluation of the hypertensive gravida. These tests can be used to either predict and/or prognosticate between preeclampsia and other hypertensive disorders of pregnancy. These laboratory tests were evaluated based on published experience with special attention to its ability to facilitate identification of the patient with preeclampsia apart from other hypertensive disorders that co-exist with and occur as a complication of pregnancy. Hypocalciuria and increased cellular plasma fibronectin seem to be good tests to differentiate preeclampsia from chronic hypertension. The management of preeclampsia with its increased risk of perinatal morbidity and mortality renders this differentiation clinically very important. Hyperuricemia, proteinuria, increased serum beta-thromboglobulin concentration, abnormal red blood cell morphology with increased hemoglobin/hematocrit, and increased serum iron individually and collectively reflect the severity of preeclampsia. Platelets and total serum lactate dehydrogenase are the best tests to reflect the severity of HELLP syndrome. Circulating hCG and serum thromboglobulin seem to be the most promising future predictors for preeclampsia.
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PMID:The laboratory evaluation of hypertensive gravidas. 773 26

To evaluate long-term benefits and risks of CyA therapy in renal transplantation, we analyzed the 10-year experience with all 59 patients who had received a first cadaveric renal graft until August 1983 and were immunosuppressed with CyA. We compared their actual graft survival with that of all 213 patients who had received a first cadaveric graft from 1967 until August 1983, but were immunosuppressed initially with azathioprine and prednisone (AzaP). For comparison of p-creatinine, proteinuria, blood pressure, lipids, uric acid and skin malignancies we evaluated the patients staying unchanged on initial therapy for 10 years (CyA = 12, AzaP = 53). RESULTS. (1) Actual graft survival at 10 years was 34% (20/59) with CyA and 27% (58/213) in AzaP treated patients (intention to treat) (P = .09 = ns). At 1 to 5 years, graft survival was 15% superior with CyA, but after 7 years the survival curve of the CyA-group has closely joined the chronic decline seen in the AzaP group. This behaviour could neither be explained by chronic CyA-nephrotoxicity nor by chronic rejection after switching from CyA to AzaP. (2) P-creatinine at 10 years was significantly (P < .03), but mildly elevated under CyA (130 +/- 52; AzaP = 109 +/- 65). (3) Proteinuria (g/d) at 10 years was not significantly different (CyA = 0.41 +/- 0.58, versus AzaP = 0.83 +/- 1.61). (4) Systolic blood pressure was higher at 10 years under CyA (152 +/- 19) than under AzaP (136 +/-) (P < .02), but diastolic pressure was not (89 +/- 10 versus 84 +/- 12; ns). Antihypertensive drug/patient was twice as high under CyA (1.25 versus 0.64 P < .02). (5) Cholesterol, triglyceride, HDL were not different. 75% of the CyA-patients were steroid free at 10 years, none of the AzaP-patients. (6) P-uric acid was not significantly different in both groups (494 +/- 192 vs 400 +/- 124), but 42% of CyA-patients were on uric acid lowering drug (given after at least one gout attack) as compared to 9% under AzaP (P < .006). (7) Seventeen percent of patients under CyA for 10 years had at least one skin cancer, not different from 15% of AzaP-patients. CONCLUSIONS. The main benefit of CyA was the better graft survival up to 5 years and the chance to stay free of steroids. The main risks of CyA were nephrotoxicity, hypertension and symptomatic hyperuricemia. No difference was found for hyperlipidemia and skin-malignancies.
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PMID:Long-term benefits and risks of cyclosporin A (sandimmun)--an analysis at 10 years. 794 Jul 65


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