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

A 74-year-old man was admitted to our hospital because of a treatment for his right renal tumor. The abdominal CT scanning revealed a mass in the right kidney, and a right selective renal arteriography demonstrated a hypervascular tumor. On admission, urinalysis revealed proteinuria (3-4 g/day) and microscopic hematuria, and serum electrolytes were normal. Serum creatinine and urea nitrogen levels were 1.6 mg/dl and 30 mg/dl, respectively. A percutaneous right renal biopsy specimens showed crescentic glomerulonephritis. Direct immunofluorescence studies showed strong linear staining for IgG and IgA along the glomerular capillary walls. Electron microscopy showed increased mesangial matrix and swollen epithelial cells, but no dense deposits in the para-mesangial area and in the glomerular basement membrane. The patient underwent right radical nephrectomy. Histologic examination of the resected specimen revealed renal cell carcinoma. Postoperatively, he developed rapidly progressive renal failure and the renal function could not be recovered. Using the indirect immunofluorescence technique, we could not confirm the presence of a serum anti-glomerular basement membrane antibody, although the examination could not be carried out until the initiation of hemodialysis therapy. Some cases of glomerulopathies associated with renal cell carcinoma were previously reported, but the case of crescentic glomerulonephritis was very rare.
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PMID:[A case of renal cell carcinoma associated with rapidly progressive glomerulonephritis]. 228 5

The nephrotic syndrome was induced in uninephrectomized Sprague-Dawley rats using repeated injections of puromycin and protamine sulfate. Preliminary studies demonstrated that the administration of lovastatin (4 mg/kg body weight [BW] subcutaneously [SC] daily) was effective at lowering plasma cholesterol over a 63-day period, although not to normal values. Subsequently, two groups of rats that had been made nephrotic were studied; one group (n = 8) received lovastatin, the other (n = 9) received the vehicle alone. Blood and urine collections were made at days 0, 23, and 60. Clearance studies and renal histology were obtained at day 60. Lovastatin-treated rats had significantly lower cholesterol at day 23 and 60 than vehicle-treated rats (270.5 +/- 39.7 v 501.7 +/- 81.9 and 148.2 +/- 10.7 v 268.2 +/- 40.8 mg/dL, P less than 0.05). Both groups of rats developed equivalent degrees of proteinuria and hypoalbuminemia. At day 60, the lovastatin-treated rats had a lower urea: 18.3 +/- 4.1 v 55.8 +/- 9.6 mmol/L (blood urea nitrogen [BUN] 51.2 +/- 111.5 v 156.2 +/- 27.0 mg/dL, P less than 0.02) and greater unulin clearance (1.83 +/- 0.42 v 0.82 +/- 0.41 mL/min/kg BW, P less than 0.05) than the vehicle-treated rats. Neither group was hypertensive and the blood pressure (BP) was similar in both groups. The percentage of glomeruli showing no changes or minimal histological changes was significantly greater in the lovastatin-treated group (26.5% +/- 5.7% v 8.33% +/- 3.33%, P less than 0.02), and there were more glomeruli with global sclerosis in the vehicle-treated group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Lovastatin ameliorates the development of glomerulosclerosis and uremia in experimental nephrotic syndrome. 229 29

Renal handling of uric acid and clinical prognosis following episodes of macroscopic hematuria (EMH) were examined in 113 patients with IgA nephropathy (IgAN). EMH was observed in 34 out of 113 patients (30.1%). The levels of blood urea nitrogen, proteinuria, serum uric acid, beta 2-microglobulin in sera and the degrees of glomerular sclerosis in renal tissues in macrohematuric patients were significantly decreased than those in patients without EMH. The levels of uric acid clearance (Cua) and fractional excretion of uric acid (FEua) was significantly enhanced in macrohematuric patients (p less than 0.01, p less than 0.05, respectively). There was a significant correlation between the tubular atrophy and the levels of Cua in macrohematuric patients (p less than 0.005). The levels of serum creatinine in macrohematuric patients before and after three years were significantly decreased when compared with microhematuric patients (p less than 0.005). It is concluded that enhanced Cua was related to renal tubular atrophy, and EMH did not clinically influence the glomerular deterioration in patients with IgAN.
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PMID:Evidence of enhanced uric acid clearance in macrohematuric patients with IgA nephropathy: prognostic significance of macrohematuria. 230 69

14 patients (8 male, 6 female), aged 35 to 64 years, with glomerulopathies consisting of membranoproliferative glomerulonephritis (GN) [n = 6], membranous GN (n = 3), focal and diffuse glomerulosclerosis (n = 4), and post-streptococcal GN (n = 1) were studied. Diagnosis was established by renal biopsy in 12 of the 14 patients. All 14 patients had impaired renal function (creatinine clearance = 25 to 55 ml/min) and proteinuria (1.0 to 10.4 g/day). Five normotensive patients received enalapril 20 mg/day, whereas 9 patients with hypertension received 20 to 40 mg/day to control blood pressure. Diuretics were administered concomitantly to 8 patients. Patients attended the clinic every 14 days for 30 months and their diets were closely monitored, with sodium intake limited to between 50 and 100 mEq/day and protein to between 1.0 and 1.2 g/kg/day. Blood pressure was significantly controlled in the patients with hypertension. Serum creatinine, blood urea nitrogen, creatinine clearance and 24-hour urinary protein excretion all significantly improved during the 30-month study. No adverse clinical events were noted. Thus, over a period of time, enalapril therapy may improve the prognosis of patients with glomerulonephritis by maintaining glomerular filtration rates and decreasing proteinuria and blood pressure.
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PMID:Effects of enalapril on renal parameters in patients with primary glomerulopathies associated with chronic renal failure. 234 17

Ten patients (6 men, 4 women, age range 35-64 years) with glomerulopathies were studied. Diagnoses were membranoproliferative glomerulonephritis (GN; n = 4), membranous GN (n = 3), focal and diffuse glomerulosclerosis (n = 2), and poststreptococcal GN (n = 1). These were confirmed by renal biopsy in 8 of the 10 patients. All patients had reduced function (creatinine clearance 15-55 ml/min); proteinuria ranged from 1.0 to 10.4 g/day. Three normotensive patients received enalapril 10 mg once daily. Seven hypertensives received enalapril 10-40 mg once daily to control blood pressure (BP). Concomitant diuretic therapy (furosemide/bumetanide) was administered to 6 patients. There were visits every 14 days for a mean of 15.9 months (range 9-26 months). Diet was monitored, and BP was significantly controlled in the hypertensive patients but not altered in the normotensives. Serum creatinine, blood urea nitrogen, creatinine clearance, and 24-hour urinary protein improved and did not deteriorate progressively. Serum potassium did not change significantly. No adverse clinical events were noted. Enalapril therapy may improve the prognosis for GN over time by maintaining glomerular filtration rate and decreasing proteinuria.
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PMID:Enalapril improved renal function and proteinuria in chronic glomerulopathies. 234 96

These studies examine the effect of cholesterol feeding in normal rats and in rats with streptozotocin-induced diabetes mellitus. Four groups were studied: normal rats fed either a standard rat chow or a standard rat chow supplemented with cholesterol and diabetic rats fed standard chow or standard chow plus cholesterol. Diabetic rats fed a standard diet excreted more creatinine and urea in the urine, had higher levels of blood urea nitrogen, and lower serum albumin levels than rats fed standard diet plus cholesterol. Blood glucose levels were similar in the two groups; however, diabetic rats given cholesterol had a greater body weight at the end of the study than diabetic rats eating standard chow. Urine volumes and sodium and potassium excretion in the urine were greater in diabetic rats fed a standard diet than in those fed a high cholesterol diet. Diabetic rats fed a standard diet had distinctive renal lesions characterized by swelling of tubular epithelial cells with clearing of cytoplasm. The nephron segments involved by this striking vacuolar change were the distal convoluted tubule and the thick limbs of Henle's loop. These lesions were identical to those described by Armanni-Ebstein in severely glycosuric patients. These lesions were not observed in any of the animals of the other three groups (including diabetic rats fed a high cholesterol diet). Glomeruli were normal in animals of all groups. Thus, cholesterol administration prevents the development of the Armanni-Ebstein lesions in diabetic rats despite persistent hyperglycemia. The mechanism by which cholesterol administration prevents the accumulation of glycogen in distal tubule cells has not been elucidated. It is suggested that glycogen accumulation in distal tubular segments may explain the greater urine volumes, natriuresis, kaliuresis, and proteinuria observed in diabetic animals fed a standard diet when compared with rats fed the same diet plus cholesterol.
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PMID:A high cholesterol diet ameliorates renal tubular lesions in diabetic rats. 235 86

The experimental agricultural fungicide N-(3,5-dichlorophenyl)succinimide (NDPS) has been shown to be a nephrotoxicant in Fischer 344 rats. Results of a previous study conducted in our laboratory suggested that glutathione might be an important modulator of NDPS-induced nephrotoxicity. The purpose of this study was to examine the effect of DL-buthionine-(S,R)-sulfoximine (BSO), an inhibitor of glutathione synthesis, on NDPS-induced renal effects. Male Fischer 344 rats received an intraperitoneal (i.p.) injection of BSO (890 mg/kg) in 0.9% saline (10 ml/kg) followed 2 h later by an i.p. injection of NDPS (0.4 or 1.0 mmol/kg) or sesame oil (2.5 ml/kg), and renal function monitored at 24 and 48 h. BSO pretreatment attenuated the diuresis, proteinuria, elevation in blood urea nitrogen (BUN) concentration and kidney weight, and decreases in organic ion accumulation by renal cortical slices induced by NDPS (0.4 or 1.0 mmol/kg) administration. Proximal tubular necrosis induced by NDPS administration also was attenuated by BSO pretreatment. These results indicate that BSO pretreatment attenuates NDPS-induced renal effects and that glutathione is important for modulating acute NDPS-induced nephropathy.
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PMID:Effect of buthionine sulfoximine on acute N-(3,5-dichlorophenyl)succinimide-induced nephrotoxicity in Fischer 344 rats. 235 74

Phensuximide (PSX) is a 2-arylsuccinimide useful in the treatment of absence seizures. PSX is a mild urotoxicant and is structurally related to N-phenylsuccinimide (NPS) and its antifungal derivatives. Since substitution of the phenyl ring of NPS with chloro or tert-butyl groups can produce compounds with enhanced nephrotoxic potential, it was felt that similar substitutions on the phenyl ring of PSX also might produce derivatives with enhanced nephrotoxic potential. Three derivatives of PSX were prepared and tested: 2-(3-chlorophenyl)-N-methylsuccinimide (CPMS); 2-(4-tert-butylphenyl)-N-methylsuccinimide (BPMS) and 2-(3,5-dichlorophenyl)-N-methylsuccinimide (DPMS). In one set of experiments, male Fischer 344 rats were administered a single intraperitoneal (i.p.) injection of a succinimide (0.4 or 1.0 mmol kg-1) or vehicle (sesame oil, 2.5 ml kg-1) and renal function monitored at 24 and 48 h. Only minor changes in renal function were noted with the PSX derivatives. BPMS and DPMS (1.0 mmol kg-1) treatment induced mild renal tubular necrosis and thickening of the glomerular membranes. However, no significant morphological changes were noted in ureters, bladder or liver in any treatment group. In a second set of experiments, rats were pretreated with phenobarbital (75 mg kg-1 day-1, i.p., 3 days) followed by a single i.p. injection of DPMS (0.4 or 1.0 mmol kg-1) or DPMS vehicle. Renal function was monitored as before. Phenobarbital pretreatment did not markedly enhance the functional nephrotoxicity induced by DPMS (0.4 mmol), but tubular necrosis was greater than observed in non-phenobarbital-pretreated rats receiving DPMS (1.0 mmol kg-1). In addition, hepatotoxicity was observed as the appearance of numerous non-staining vacuoles in hypertrophied hepatocytes. In the phenobarbital plus DPMS (1.0 mmol kg-1) treatment group, all rats died by 48 h. Prior to death, rats exhibited increased proteinuria (+3), hematuria (+3) and blood urea nitrogen concentration. At 24 h, kidneys from rats treated with phenobarbital plus DPMS (1.0 mmol kg-1) exhibited extensive proximal tubular necrosis and numerous glomeruli with thickened membranes. Hepatotoxicity was more pronounced than with phenobarbital plus DPMS (0.4 mmol kg-1) at 48 h and urinary bladders had focal areas of erythrocytes pooling below the epithelial lining. These results demonstrate that although NPS and PSX are structural analogs, chemical substitutions that enhance the nephrotoxic potential of NPS do not have a similar effect on PSX. In addition, DPMS can induce urotoxicity in a manner similar to that observed for PSX and probably induces toxicity via one or more metabolites.
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PMID:Acute toxicity induced by 2-aryl-N-methylsuccinimides. 236 80

A comparative clinicopathological study was retrospectively performed in 61 children and 51 adults with IgA nephropathy. Hematuria and/or proteinuria as a chance finding was the most common initial clinical sign, being observed in 82.0% of the children and in 52.9% of the adults. At renal biopsy, hypertension and severe proteinuria were found in 9.8 and 33.3% of the adults and in 0 and 14.8% of the children (both p less than 0.05), respectively. Elevations of blood urea nitrogen and serum creatinine were found at this time of biopsy in 21.6 and 9.8% of the adults, but in none of the children (p less than 0.001 and p less than 0.05, respectively). Histologically, focal glomerulosclerosis and tubular atrophy were found in 52.9% of the adults and in 32.8% of the children (p less than 0.05). However, some features of the disease seen in both groups were similar, including the incidences of IgA nephropathy, sex ratio, the mode of onset, incidences of gross hematuria, and high IgA levels in the sera. Furthermore, the relationships between the severity of proteinuria and renal lesions were similar: mesangial proliferation, glomerulosclerosis, and tubular atrophy increased with the degree of the severity of proteinuria. These results suggest that IgA nephropathy is essentially identical in children and adults, although adult patients tend to be further advanced in their disease course at the time of diagnosis, and that focal glomerulosclerosis with tubular atrophy is correlated with deterioration of renal function.
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PMID:IgA nephropathy in Japanese children and adults: a comparative study of clinicopathological features. 238 80

Vibratory and cooling detection thresholds (VDT and CDT) were determined at both the palmar aspect of the distal phalanx of the right index finger (upper limb) and the plantar aspect of the distal phalanx of the right great toe (lower limb) in 53 consecutive patients with diabetes mellitus (NIDDM), in order to analyze the frequency of the abnormality of each threshold and the relationship between each threshold and the clinical or laboratory findings. VDT in the lower limb was statistically correlated with age, duration of diabetes mellitus, and blood urea nitrogen value of each patient, but not with fasting blood glucose and hemoglobin A1C levels. VDT in the lower limb was significantly greater in the groups of patients with each of the subjective sensory disturbances, peripheral neuropathy (based on our criteria), retinopathy, and proteinuria. Forty-seven per cent of the patients showed clinically peripheral neuropathy, and the frequencies of the abnormality of VDT, CDT and VDT or CDT were 34, 26 and 45%, respectively. VDT and CDT reflect the abnormality of different populations of the peripheral nerve fibers and seem to be affected separately. The determination of both VDT and CDT is useful for the evaluation of the neuropathic state of diabetic patients.
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PMID:[Vibratory and cooling detection thresholds in diabetes mellitus]. 238 92


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