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)

Ten patients with acquired immunodeficiency syndrome with newly diagnosed cytomegalovirus (CMV) retinitis were treated with an induction regimen of intravenous foscarnet, 60 mg/kg of body weight, administered as a 2-h infusion and repeated every 8 h for 14 days. At the end of induction, 9 of 10 patients had stabilized (no new retinal lesions and stable old lesions [7 patients]) or improved (decreased retinal opacification [2 patients]). All eight patients with CMV in urine or blood upon entry into the study had negative urine and blood cultures at the end of induction. After induction therapy, seven patients continued maintenance foscarnet therapy, 60 mg/kg as a single daily infusion, 5 days/week. In six patients, retinal lesions increased in size after 2 to 32 weeks of maintenance therapy. One was invaluable because a retinal detachment developed. Only 9 of 42 blood and urine cultures obtained during maintenance foscarnet therapy yielded CMV, compared with 7 of 14 obtained prior to the initiation of foscarnet induction therapy (P = 0.04). Foscarnet toxicity was mild and infrequent: elevation in serum creatinine by 0.5 to 1.3 mg/dl over the base line (two patients), muscle twitching (three patients), hemoglobin decrease by 1 mg/dl (two patients), nausea (two patients), absolute neutrophil count decrease by 50% (one patient), rise in serum phosphorus to greater than 5.5 mg/dl (four patients), and proteinuria (two patients). Intermittently administered intravenous foscarnet appears to be an effective, relatively nontoxic therapy for CMV retinitis. Additional studies to determine the optimal dosage for maintenance therapy are needed, as are comparative trials with ganciclovir.
 ...
PMID:Foscarnet treatment of cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome. 254 90

Foscarnet nephrotoxicity has been reported to be associated with acute tubulointerstitial nephritis. Crystals in glomerular capillary lumens have also been observed in patients with acquired immunodeficiency syndrome who were treated with foscarnet for cytomegalovirus disease. We describe a kidney transplant recipient who developed a nephrotic syndrome with microscopic hematuria and nonoliguric acute renal failure within 15 days after starting foscarnet therapy for cytomegalovirus infection. A kidney biopsy specimen showed the presence of crystals in all glomeruli and in proximal tubules. Fourier transform infrared microscopy analysis demonstrated that crystals were made from several forms of foscarnet salts: mixed calcium and sodium salts, and unchanged trisodium foscarnet salts. Renal function and proteinuria spontaneously improved, and a second transplant biopsy performed 8 months after the first one revealed fibrotic organization of half of the glomeruli and of interstitial tissue, and crystal vanishing. We were thus able to provide proof of the possible precipitation of foscarnet in a transplanted kidney.
 ...
PMID:Foscarnet-induced crystalline glomerulonephritis with nephrotic syndrome and acute renal failure after kidney transplantation. 1036 May 95

Renal biopsy plays a central role in the investigational approach of the nephrologist. The technique has significantly improved over the past two decades as a result of the introduction of ultrasonography and automated-gun biopsy devices. Percutaneous renal biopsy has become a relatively safe procedure with life-threatening complications occurring in less than 0.1% of biopsies in recent reports. However, percutaneous kidney biopsy is not without risk. Overt complications occurring in up to 13% of the cases, and 6 to 7% of complications were considered major, needing for an intervention such as transfusion of blood product or invasive procedure (radiographic or surgical). Major complications were apparent in more than 90% of patients by 24 hours. In situations in which the potential benefit of obtaining renal histology outweighs the risks of the procedure, transjugular kidney biopsy or surgical biopsy offers an attractive alternative. At present, we have no definite predictive indicators of postbiopsy bleeding complication, with the exception of age, gender, advanced renal insufficiency and the baseline partial thromboplastin time. Bleeding time is not significantly predictive and has been reported to have substantial limitations as a screening test. The use of the PFA-100 may replace the bleeding time and is now considered as a more valuable screening test for prebiopsy identification and management of patients with impaired haemostasis. Four groups of patients benefit from the findings of renal biopsy: those with a nephrotic syndrome, those with a renal disease in a context of systemic disorder, those with acute renal failure and those with a renal transplant. Some patients with non-nephrotic proteinuria, hematuria and chronic renal failure may also benefit from the procedure.
 ...
PMID:[Renal biopsy: procedures, contraindications, complications]. 1934 74