UMLS:C0033687 - FACTA Search

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Query: UMLS:C0033687 (proteinuria)
24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The distribution of anionic sites within glomerular basement membranes from patients with different glomerulonephritides was examined by the dialyzed colloidal iron (DI) staining technique. The correlation of ultrastructural findings with glomerular disease, renal function, and degree of proteinuria revealed three alterations: 1) speckled DI staining in the lamina densa of patients with decreasing renal function and a proteinuria of greater than 1 g/24 hours; 2) an apparent staining disparity and diminution of DI at the lateral borders of swollen and retracted foot processes with inclination of the foot processes in the direction of the more weakly staining lateral border; and 3) heavy DI reaction on the apical of free surfaces of fused foot processes. Human subjects with a proteinuria of more than 1 g/24 hours display optimal labeling of the endothelial fenestrae, endothelial cell coat, lamina rara interna, and lamina rara externa. The staining observed may be explained either on the basis of direct DI interaction with diffusing plasma proteins secondary to a decrease in the transglomerular charge barrier consequential to a loss of intrinsic anionic sites or on the basis of "unmasking" of anionic moieties within the glomerular basement membrane. Regardless of the mechanism involved, the present study indicates that a threshold proteinuria of 1 g/24 hours is needed to effect staining in the lamina densa.
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PMID:Ultrastructural assessment by colloidal iron of the distribution and localization of anionic sites in human glomerulonephritides. 746 63

The relationship of glomerular anionic sites to proteinuria was examined ultrastructurally in human nephrotic syndrome. The anionic sites were analysed morphometrically in patients with minimal-change nephrotic syndrome (MCNS, 11 patients) and in other glomerulonephritides complicated with nephrotic syndrome (4 patients) by the high-iron diamine-thiocarbohydrazide-silver proteinate method. The anionic sites in MCNS patients in remission (7 patients) were normal. In contrast, the anionic sites in nephrotic patients with MCNS (4 patients) and the other glomerulonephritides were decreased in number. Moreover, smaller and irregularly distributed anionic sites or the greater loss of them from the paramesangial region were observed in the nephrotic patients. The loss of glomerular anionic sites may induce structural alteration of the glomerular basement membrane and mesangial matrix. The loss and structural abnormalities of glomerular anionic sites in nephrotic patients may be one of the mechanisms responsible for massive proteinuria.
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PMID:Ultrastructural alteration of glomerular anionic sites in nephrotic patients. 767 19

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

Experimental work in our laboratory has confirmed the protective activity of vanadium compounds on hyperglycemia and glycosuria in streptozotocin (STZ) diabetes. Furthermore, diabetic cataract has also been partially prevented. Nevertheless, the combination of a natural antioxidant, vitamin E, with Na3 VO4 has not further enhanced this ameliorating effect. Our experimental approach has been an attempt to block the prooxidant activity of both STZ and vanadate, with the purpose of eliciting the best possible antidiabetic protection. More recently, a lipid soluble synthetic antioxidant U-78517F, a 2-methylaminochroman, has been reported to have a significant protective effect against brain injury and ischemia. This compound inhibits the iron-dependent lipid peroxidation 100 times more effectively than vitamin E. This investigation has introduced a combination of the vanadium compound plus the aforesaid lazaroid, as its (-) enantiomer, U-83836E, in order to improve the insufficient protection when vitamin E was used. For twelve weeks, male Wistar rats, rendered diabetic with STZ, were administered Na3VO4 in drinking water along with the lazaroid carried by the food. Four, eight and twelve weeks after the beginning of the protective treatment, fluid and food intake, diuresis and excreted feces, glycosuria and proteinuria were determined on biological samples obtained in metabolic cages; body weight and glycemia were also recorded. At weeks 6 and 12 of the treatment, the opaqueness of the eye lenses was controlled and registered. At the end of the experiment, circulating glycosylated hemoglobin (HbA1c), fructosamine, N-acetyl-beta-D-glucosaminidase (NAG), and fluorescent peroxides were evaluated. Within the first month of treatment, protection by the combination paralleled that elicited by vanadate alone. At subsequent steps, U-83836E significantly improved the protective effect of vanadate alone on polydipsia and polyuria, but especially on hyperglycemia and glycosuria. The further ameliorating effect of the lazaroid was also observed on HbA1c and NAG, and, most important, on the cataract. In conclusion, these findings demonstrate that the lazaroid U-83836E succeeds in further protecting the most important symptoms of diabetes treated with vanadate, and that this antioxidant acts effectively even when it is administered orally in food, in a non invasive manner.
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PMID:Amelioration of diabetes and cataract by Na3VO4 plus U-83836E in streptozotocin treated rats. 782 6

Primary nephrotic syndrome can, although infrequently, cause severe anemia. However, the mechanisms of the anemia remain unknown. We investigated the mechanism of anemia in nephrotic syndrome by measuring parameters of nephrotic syndrome and anemia in 44 nephrotic patients (male: female; 21:23, average age; 43.6 +/- 20.3 years). Nephrotic patients had significantly lower hematocrits than did healthy controls (43.3 +/- 3.7 vs. 46.8 +/- 3.4% in males, 37.4 +/- 3.5 vs. 40.8 +/- 2.8% in females). Serum erythropoietin (Epo) concentrations were correlated inversely with hemoglobin (Hb), hematocrit (Hct), and red blood cell corpuscle (RBC) counts. Furthermore, serum Epo correlated with the serum iron concentration, but not with the other parameters, such as reticulocytes, serum protein and proteinuria. However, the maximum Epo concentration was less than 100 mU/ml in spite of severe anemia, and this was thought to be inappropriate. On the contrary, urine Epo was not detected by the same method of serum Epo determination in spite of aggressive dialysis with distilled water. When four patients with severe anemia were subcutaneously administered recombinant Epo 6,000 unit two times a week, they showed marked improvement in Hb/Hct/RBC. The precise mechanism of anemia in NS was not elucidated by this investigation, but further study should clarify the causes of the inappropriately low concentration of serum Epo in patients with primary nephrotic syndrome.
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PMID:Characteristics of anemia in patients with nephrotic syndrome. 793 64

1. Energy dispersive X-ray spectrometry was used to examine the relationship between proteinuria and increased urinary iron excretion, and structural and functional damage in puromycin nephrosis. 2. After 11-12 days rats treated with puromycin (10 mg/100 g, i.v.i.) had greater proteinuria (211.6 +/- 35.7 mg/day, mean +/- s.e.m.) and urinary iron excretion (15.4 +/- 2.2 micrograms/day) than saline-treated controls (14.5 +/- 1.4 mg/day and 1.1 +/- 0.2 micrograms/day, respectively, both P < 0.001). 3. On day 13, mean lysosomal iron concentration of proximal tubular cells (306.6 +/- 64.5 vs 11.9 +/- 8.6 mg%, P < 0.001), and proximal tubular cell damage assessed semi-quantitatively (1.17 +/- 0.10 vs 0.62 +/- 0.10, P < 0.001) were higher and creatinine clearance (0.15 +/- 0.01 vs 0.29 +/- 0.02 mL/min per g kidney weight, P < 0.001) lower than in control rats. 4. At days 35, 60 and 360 there were no differences in any of the measured parameters between rats treated with puromycin or saline, and in both groups proteinuria, tissue damage and lysosomal iron concentration increased with time. 5. Lysosomal iron accumulation was the only independent predictor of both functional and structural damage. 6. In conclusion, the apparent association between proteinuria and tubulo-interstitial damage in puromycin nephrosis, and with ageing, is best explained by factors associated with accumulation of iron within lysosomes of proximal tubule cells.
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PMID:Lysosomal iron accumulation and tubular damage in rat puromycin nephrosis and ageing. 803 74

Information from the Jamaican Perinatal Mortality Survey was used to identify features of mothers and their pregnancies that were independently associated with perinatal death. Social, biological, environmental, life style and medical aspects of mothers and their pregnancies were collected on two inter-locking subsamples: (1) all births on the island of Jamaica in the 2 months of September and October 1986, the 'cohort months', and (2) all fetal deaths of weight 500 g or more, together with all neonatal deaths, in the 12-month period from 1 September 1986 to 31 August 1987. Singleton survivors from the cohort months were compared with all perinatal deaths in the 12-month period using logistic regression. The first model omitted items concerning past obstetric history, but these were included in the second model. In total, 21 variables entered the first model and 24 the second. The only item that became non-significant when past obstetric history was included was maternal age. The final model compared 1017 perinatal deaths with 7672 survivors. It consisted of the following: union (marital) status (married being at lower risk, P < 0.01), maternal employment status (housewives at lowest risk, P < 0.001), number of adults in household (the more the higher the risk, P < 0.05), the number of children aged < 11 (the more the lower the risk, P < 0.0001), use of toilet facilities (shared with other households increased risk, P < 0.001), maternal height (tall women at reduced risk, P < 0.001), mother's report that she was trying to get pregnant (P < 0.001), maternal alcohol consumption (drinkers had lower risk, P < 0.05), maternal syphilis (higher risk, P < 0.0001), bleeding before 28 weeks (higher risk, P < 0.0001), bleeding at 28 weeks or more (higher risk, P < 0.0001), first diastolic blood pressure (80 mm + at higher risk, P < 0.0001), highest diastolic blood pressure (100 mm + at increased risk, P < 0.0001), highest proteinuria (++ or more at increased risk, P < 0.0001), vaginal discharge/infection (untreated at increased risk, P < 0.001), pre-eclampsia diagnosed in antenatal period (increased risk, P < 0.01), maternal diabetes (increased risk, P < 0.05), start of antenatal care (first trimester at reduced risk, P < 0.01), iron taken (reduced risk, P < 0.0001), type of perinatal care available in parish of residence (reduced risk if consultant obstetricians and paediatricians available at all times, P < 0.0001), number of miscarriages and terminations (the more the higher the risk, P < 0.0001), previous stillbirth (higher risk, P < 0.0001), previous early neonatal death (higher risk, P < 0.001), previous Caesarean section (higher risk, P < 0.01). The implications for reduction in perinatal mortality rates are discussed.
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PMID:The epidemiology of perinatal death in Jamaica. 807 96

All perinatal deaths occurring over a 12-month period on the island of Jamaica were classified using the Wigglesworth schema. In all, there were 584 antepartum fetal deaths (incidence 10.7 per 1000 total births). Comparison of the 558 singleton deaths with 9919 singleton survivors revealed, using logistic regression, strong associations with union (marital) status, maternal employment status, the composition of the household, the sole use of a toilet by the household, the parish of residence, whether the mother was trying to get pregnant and the mother's age (the older the mother the higher the risk). Independent of these factors were strong statistically significant relationships with syphilis, diabetes, maternal anaemia, third-trimester bleeding, highest diastolic blood pressure of 90mm or more and highest proteinuria of ++ or more. Mothers who had taken prophylactic iron were at substantially lower risk compared with those who had not. We conclude that appropriate identification and treatment of syphilis, diabetes, anaemia and hypertension give the best chance of reduction of the high antepartum fetal death rate on the island.
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PMID:The epidemiology of antepartum fetal death in Jamaica. 807 5

This article reviews studies that examine the negative effects of urinary and intestinal schistosomiasis on the following nutritional parameters in humans: urinary and faecal blood and iron loss, anaemia and haemoglobin levels, proteinuria, child growth and adult protein-energy status, physical fitness, physical activity, appetite and symptomatology. The conclusions reached are (1) that community-level treatment and control of schistosomiasis in areas where the infection, protein-energy malnutrition, and anaemia are common are to be encouraged and are likely to improve child growth, appetite, physical fitness and activity levels and to decrease anaemia and symptoms of the infection, and (2) that further studies are needed to determine how much and by what means decreases in and treatment of schistosomal infection may improve nutritional status, cognitive and school performance and attendance, and work capacity and productivity in communities with different amounts of parasitism and malnutrition.
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PMID:The impact of schistosomiasis on human nutrition. 811 76

As nephron population is lost from injury or disease the remaining nephrons undergo functional and anatomic hypertrophy. The compensatory or secondary events responsible for these changes may exert a detrimental effect on the remaining nephrons that ultimately leads to their destruction. Most studies have examined how these alterations cause glomerular injury. Although glomerular injury and functional alterations are the initial result of these events, tubulointerstitial disease may be the major determinate of subsequent nephron loss and progressive renal failure. Proteinuria has been used largely as an indicator of the severity of the glomerular involvement. However, an alternative hypothesis is that the proteinuria, resulting from the glomerular injury, actually perpetuates renal injury as a result of its damaging effect on renal tubules and the surrounding interstitium. Because of being the major protein fraction it has been assumed that albumin is largely, if not solely, responsible for the induction of tubulointerstitial injury. However, with glomerular disease all protein classes can be excreted. One protein of interest is transferrin. In association with the glomerular transferrin leak, iron also would be presented to the tubule fluid. Iron is a transition element capable of catalyzing the Haber Weiss reaction with formation of hydroxyl radicals. Normally, iron is maintained in a nonreactive state in virtually all biologic tissues and fluid. However, at the reduced pH of tubule fluid iron can dissociate from transferrin and assume a reactive state capable of catalyzing hydroxyl radical formation. The kidney in patients with the nephrotic syndrome appears to be unduly susceptible to free radical injury, as documented by its increase iron content in association with depletion of copper and selenium.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Role of iron and oxygen radicals in the progression of chronic renal failure. 831 Oct 72

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