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)

Macroscopic examination of urine is an integral part of urinalysis, and blood and bile pigments are a common cause of abnormal coloration. Urine SG is a convenient index of urine concentration and should be correlated with the patient's hydration status to determine the ability of the kidneys to concentrate and dilute urine. The pH of urine of dogs and cats normally is dietary dependent, but alkaline urine may suggest that the urinary tract is infected with a urea splitting organism. The dipstick test for proteinuria is convenient but less reliable than the sulfosalicylic acid method. The dipstick test for blood should not be used as a substitute for microscopic examination of urine but is of value in detecting hemoglobinuria and myoglobinuria, when red cells may be absent in the sediment. The finding of glucose, ketones, and bilirubin in urine, when interpreted properly, may indicate the presence of disease processes not associated with the urogenital tract. Microscopic examination of urine sediment must be interpreted in combination with the physical and chemical composition of urine, but excessive numbers of cells, casts, crystals, and bacteria may provide evidence of disease. The absence of these structures in the sediment, however, does not eliminate the possibility of disease. The ability of the kidneys to concentrate urine is dependent on normal kidney function and the production and release of ADH. A urine SG greater than 1.030 in dogs and 1.035 in cats indicates that the functions associated with concentrating urine are adequate. In the evaluation of the patient's ability to form concentrated urine, the status of hydration must be considered; this may require water deprivation tests or administration of ADH. The estimation of blood urea nitrogen concentration, with the use of test strips, may provide a convenient but not specific measure of renal function.
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PMID:Urinalysis and associated laboratory procedures. 267 14

Many areas of information in the epidemiology of diabetic nephropathy are lacking, but multiple studies designed specifically to answer these questions are currently being conducted. In the next 5-10 years, our current understanding of the epidemiology of diabetic nephropathy may either be confirmed or discredited. In the meantime, clinicians should use the data available to make decisions about treatment and should focus on the modifiable factors of glucose and blood pressure control in both IDDM and NIDDM, especially in patients with low-level albuminuria or clinical proteinuria.
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PMID:The epidemiology of diabetic nephropathy. 268 17

Thirty of 45 (67%) streptozotocin-induced male Sprague-Dawley diabetic rats developed microalbuminuria that progressed to overt proteinuria with increased concentrations of IgG in their urine. 33% (15/45) never developed albuminuria or IgG proteinuria. These percentages did not correlate with glucose control since none of the animals were treated with insulin and all demonstrated the same degree of hyperglycemia. Indirect immunofluorescent antibody staining of frozen tissue sections from the kidneys of rats that developed overt proteinuria stained for IgM (67%), C3 (93%), IgG2b (93%) and IgG2c (60%). Non-proteinuric diabetic kidneys stained for IgM (80%), C3 (67%) IgG2b (67%) and IgG2c (87%). Control kidney sections demonstrated no consistent staining pattern. The occurrence and concentration of the different immunoglobulin isotypes, eluted from frozen sections with immune complex dissociating buffers, mimicked that which was observed by immunofluorescence. When urine or serum from the same rat or a rat of a different group was incubated with kidney sections eluted of all immunoglobulin, indirect immunofluorescent staining demonstrated antibody activity corresponding to the original staining pattern observed for each animal group prior to elution. The most consistent observation was that the diabetic rats that developed proteinuria were positive for IgG2b staining in their kidney sections; whereas, those that did not develop proteinuria stained predominantly for IgG2c. From this data, we suggest that the progression of diabetic nephropathy may depend on whether a specific IgG subclass response is elicited.
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PMID:Assessment of the role of the immunoglobulin isotypes in the development of diabetic nephropathy in untreated streptozotocin-induced diabetic rats. 269 1

Low-protein diets in nondiabetic renal failure may slow the progressive loss of renal function in some patients, but few studies have detailed the nutritional consequences of these diets in patients with diabetic nephropathy. We studied 7 patients with insulin-dependent diabetes mellitus and chronic renal insufficiency [mean +/- SEM creatinine clearance (S, U): 28.3 +/- 6.5 ml/min (0.47 +/- 0.11 ml/s x 1.73/A)] for 15 weeks who were prescribed a diet of 0.6 g protein/kg ideal body weight. Midarm muscle circumference (24.1 +/- 1.8 at onset vs. 24.5 +/- 1.5 cm at completion), triceps skinfold thickness (21.6 +/- 3.1 vs. 21.0 +/- 1.5 mm), body weight (71.8 +/- 4.1 vs. 71.2 +/- 4.6 kg), and serum albumin [3.0 +/- 0.1 vs. 3.2 +/- 0.1 g/dl (30 +/- 1 vs. 32 +/- 1 g/l)] remained stable. Based on urinary nitrogen excretion, diet diaries overestimated the degree of dietary protein restriction; there was good adherence to the diet as evidenced by a reduction in urinary urea nitrogen (average 32%). Blood glucose control was maintained despite increased carbohydrate intake. On average, creatinine clearance did not change significantly, but proteinuria diminished slightly (1.8 +/- 0.2 vs. 1.5 +/- 0.6 g/day). These results indicate that 0.6 g/kg/day protein diets did not cause protein depletion in insulin-dependent diabetic patients. Longer-term studies are indicated to assess more fully the efficacy of these dietary regimens in reducing proteinuria or benefiting diabetic nephropathy.
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PMID:Protein-restricted diets in diabetic nephropathy. 271 Feb 67

Low-protein diets are being increasingly used as a treatment for early nephropathy associated with diabetes. Recent research studies have shown a decrease in proteinuria while serum albumin levels and weight have been maintained. A level of 0.6 g protein/kg ideal body weight has been suggested. In structuring these diets, fat should be restricted to approximately 30% of calories, with the remainder supplied as carbohydrate calories after the protein content has been calculated. In some persons, simple sugars need to be included to avoid excessive amounts of high-bulk, high-fiber carbohydrate foods. Insulin and oral agent dosages may need adjustment to compensate for increased glucose levels. Self-monitoring of glucose levels can provide valuable feedback for medication adjustment. Intensive dietary education is needed with these patients, as the diet is sometimes radically different from diets previously used. A hypothetical patient is described and diet calculations provided using the ADA Exchange Lists with accompanying menus.
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PMID:Implementation of low-protein diets for treatment of persons with early diabetic nephropathy. 271 93

The SHR/N corpulent (cp) rat is a genetically obese rat that develops hyperglycemia, hyperinsulinemia, and proteinuria. This study was designed to evaluate the effects of high carbohydrate (CHO) intake on renal function and structure in this animal model and to determine whether the renal effects are related to the type of CHO ingested. Two groups of 5-wk-old obese male SHR/N-cp rats and lean male littermates were fed diets containing 54% CHO in the form of sucrose or starch. After 12 wk, renal function parameters, including creatinine clearance, urinary glucose excretion, and urinary protein excretion, were measured. Renal morphology was evaluated by semiquantitative light and electron microscopy. On either diet, obese rats had significantly higher urinary glucose and protein excretions than their lean littermates. Mean creatinine clearance (ml/min) in obese rats did not differ significantly from values observed in lean rats. When corrected for body weight, creatinine clearance (ml.min-1.kg-1) tended to be lower in obese than in lean rats, but the difference was significant (P less than .02) only for obese and lean sucrose-fed animals. Obese rats fed sucrose compared with their obese counterparts fed starch had higher body weight (+8%, P less than .05), glucose excretion (+63%, P less than .02), and protein excretion (+242%, P less than .005). In obese rats, protein excretion correlated with glucose excretion (r = .71, P less than .01). Glomerular lesions consisting of mesangial expansion and intercapillary nodules were found in obese but not in lean rats. Moreover, obese rats fed sucrose had a significantly greater number of involved glomeruli than obese rats fed starch.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effect of carbohydrate intake on kidney function and structure in SHR/N-cp rats. A new model of NIDDM. 272 22

Groups of 21 male and 21 female Sprague-Dawley (SD) rats were fed diets containing pyriproxyfen at concentrations of 0, 80, 400, 2,000 and 10,000 ppm for 6 months. No death was found in any group. Alopecia in the neck and/or back, and soft feces were noticed in both sexes fed 10,000 ppm. A marked decrease in body weight gain was observed in both sexes fed 10,000 ppm throughout the treatment period, accompanying a decrease in food-consumption and an increase in water-intake during the initial stage of treatment. In terms of urinalysis, proteinuria, increases in K excretion, and, in number, yellowness or browish-yellowness in appearance, were observed in both sexes fed 10,000 ppm. In females fed 10,000 ppm, increases in bilirubin, Na excretion and specific gravity, and a decrease in ketone bodies, were observed. In hematology, decreases in erythrocyte count, hemoglobin concentration and hematocrit value, were observed in both sexes fed 10,000 ppm and in males fed 2,000 ppm. Also, an increase in MCH (in males), decreases in MCHC and platelet count (in females) were observed in 10,000 ppm group. Blood biochemistry revealed increases in total protein, albumin, alpha 2-globulin fraction, blood urea nitrogen, calcium (in both sexes fed 10,000 ppm), A/G ratio (in males fed 2,000 and 10,000 ppm), total cholesterol, phospholipid (in males fed 2,000 and 10,000 ppm, and in females fed 10,000 ppm), sodium (in females fed 2,000 and 10,000 ppm), gamma-glutamyl transpeptidase activity (in males fed 10,000 ppm) and alpha 1-globulin fraction (in females fed 10,000 ppm), and decreases in glucose, GOT (in both sexes fed 10,000 ppm), beta-globulin fraction (in males fed 2,000 and 10,000 ppm, and in females fed 10,000 ppm), GPT (in females fed 2,000 and 10,000 ppm), triglyceride, potassium (in males fed 10,000 ppm), and cholinesterase activity (in female fed 10,000 ppm). In organ weight, increases in liver (in males fed 2,000 ppm and 10,000 ppm, and in females fed 10,000 ppm), kidney (in both sexes fed 10,000 ppm) and thyroid (in females fed 10,000 ppm) and a decrease in pituitary (in females fed 2,000 and 10,000 ppm) were observed. Gross pathology revealed a higher incidence of blackish-brown coloration of the liver, and a lower incidence of accentuated lobular pattern of the liver (in males fed 10,000 ppm). An enlargement of the liver was seen in a few of both sexes fed 10,000 ppm. Histopathological examination showed that the sole effect attributable to treatment of this compound was on slight hypertrophy in the liver of both sexes fed 10,000 ppm, with a higher incidence.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A six-month chronic dietary toxicity study of pyriproxyfen in rats]. 273 65

Twenty-four type 1 and type 2 diabetic patients with obesity and overt nephropathy were studied for 12 months after hypocaloric diet change from 1870 to 1410 kcal/day (without changes of protein:carbohydrate ratio). Several parameters were evaluated: arterial blood pressure, blood glucose, fructosamine, HbA1c, proteinuria, albuminuria, glomerular filtration rate (GFR), creatinine clearance, triglycerides, HDL and total cholesterol. A significant reduction of body weight (body mass index from 33 +/- 1.6 to 26 +/- 1.8 kg/m2, P less than 0.001), concomitantly with a decrease of blood pressure levels (P less than 0.002) was demonstrated at the end of the study. Triglyceride (P less than 0.002), HDL (P less than 0.002), HDL (P less than 0.05) and total cholesterol (P less than 0.01) levels were reduced after diet-therapy, while a mild improvement of glycometabolic profile was observed in the same period. A marked decrease of proteinuria (from 1280 +/- 511 to 623 +/- 307 mg/24 h, P less than 0.01) and albuminuria (from 723 +/- 388 to 492 +/- 170 micrograms/min, P less than 0.01), and an improvement of GFR (from 66 +/- 13 to 81 +/- 11 ml/min/1.73 m2, P less than 0.01) and creatinine clearance (from 79 +/- 14 to 91 +/- 13 ml/min, P less than 0.01) was demonstrated after 12 months of diet-treatment. Our data suggest that body weight reduction by hypocaloric diet may delay the progression of clinical nephropathy in obese diabetic patients.
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PMID:Effects of diet-therapy on urinary protein excretion albuminuria and renal haemodynamic function in obese diabetic patients with overt nephropathy. 274 32

In our previous experiments, a remarkable increase in urinary excretion of glucose was found in rats exposed to 821 ppm trichloroethylene for 12 wk. This was not accompanied with proteinuria, aminoaciduria, phosphaturia and definite histological changes in renal tubular structure. In order to ascertain the mechanism of the increase in urinary glucose excretion, blood glucose level and renal glucose reabsorption were studied in 10 male rats exposed to 783 ppm trichloroethylene for more than 3 wk. Another 10 male rats were studied as control. The following results were obtained: 1. Urine glucose of the trichloroethylene group increased after exposure for 2 wk. All the rats showed glycosuria (above 250 mg/dl) by the 4th week of exposure. 2. Plasma glucose levels were depressed by trichloroethylene to as low as 77% of that of the control group. Glycohemoglobin was similarly decreased. 3. Intravenous glucose tolerance tests (0.5 g/kg load) revealed that decreasing constant of plasma glucose (K value) was elevated by trichloroethylene, suggesting that induced hyperglycemia in the exposed rats improved more rapidly than in the controls. Trichloroethylene did not modify the secretion of insulin after glucose load, regardless of the depression in plasma insulin level before load. 4. Glucose titration tests revealed that tubular transport maximum for glucose (TmG) was decreased by trichloroethylene to as low as 46% of that of the control group. The ratio of TmG to glomerular filtration rate (the theoretical renal threshold for glucose) was also depressed to as low as 55% of that of the control group. The foregoing results indicate that trichloroethylene-induced glycosuria is attributable to deteriorated tubular reabsorption of glucose, and not to hyperglycemia. However, the mechanism for the selective disturbance of renal reabsorption of glucose is yet unknown.
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PMID:[Studies of trichloroethylene-induced glycosuria: blood glucose and renal glucose reabsorption in rats exposed to trichloroethylene]. 275 53

Hypertension, common in diabetic patients, worsens not only the risk of cardiovascular complications, but also that of microangiopathic complications (nephropathy, retinopathy) of diabetes mellitus. It is thus important to ensure the perfect control of even mild hypertension in diabetic patients. However, treatment sometimes becomes difficult given that certain categories of antihypertensive drugs interfere with blood glucose control and/or lipid metabolism, interfere with the symptomatology of hypoglycemia, or promote orthostatic hypotension, a complication of autonomic neuropathy. A study was undertaken to determine the effects of rilmenidine, administered for 16 weeks, in 29 diabetic patients treated with insulin and experiencing mild-to-moderate hypertension (supine diastolic blood pressure, 96.7 +/- 0.5 mmHg). Administered as single-drug therapy, rilmenidine rapidly normalized blood pressure (systolic blood pressure, less than 160 mmHg; diastolic blood pressure, no more than 90 mmHg--supine) in 17 patients; this persisted throughout the trial period. Addition of a diuretic after 12 weeks in the remaining 12 patients led to normalization of blood pressure in nine additional patients. Blood glucose control (evaluated at home by weekly blood glucose measurements and by glycosylated hemoglobin levels) was unaffected by treatment. Plasma levels of cholesterol (total, high-density lipoprotein and low-density lipoprotein), triglycerides and proteinuria (or microalbuminuria) showed no change during the course of the trial. In conclusion, rilmenidine offers an effective and safe treatment for mild-to-moderate hypertension in diabetic patients treated with insulin and does not interfere with their blood glucose control.
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PMID:Treatment of hypertension in diabetic patients. 278 24


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