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 effect of AST-120 was examined in the rat model of CRF induced by adriamycin (ADM), which is known to induce focal glomerular sclerosis (GS). ADM (2mg/kg) was injected intravenously twice at a 3-wk interval. After 14 wks, rats were paired with control (C) and AST-120 (A) groups according to levels of BUN and proteinuria. Then, the rats were fed regular rat chow with (A, n = 10) or without (C, n = 10) AST-120. After 28 wks, there were more GS in C. Averaged sclerosis index (SI, 0-4 scale) in C was 1.97 (0.94-3.22), while 1.61 (0.60-2.97) in A. When GS was advanced in C (SI > 2.0), largely ameliorated SI was noted in A (2.61 vs. 1.97, C vs. A, p < 0.05 by paired W-test, n = 5 each). Also, in these rats, BUN, serum creatinine and Ht were all improved in A (p < 0.05). Thus, AST-120 was effective in CRF rats induced by ADM when uremia was advanced. The data also indicates that a reduction of uremic toxins could improve glomerular histology and renal function in CRF.
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PMID:[Effect of oral adsorbent (AST-120) in the rat model of chronic renal failure induced by adriamycin]. 128 5

We studied the clinical and pathological data for 334 patients age 65 or more who underwent renal biopsy for acute renal failure (ARF, n = 55), subacute renal failure (SRF, n = 72), chronic renal failure (CRF, n = 57), proteinuria (n = 137), and hematuria (n = 13). Tissue diagnoses were glomerulopathy (n = 252, 75.4%), acute tubular lesions (n = 18), interstitial nephritis (n = 23), vascular diseases (n = 36, including 14 with cholesterol emboli), and five miscellaneous diagnoses. Of the 55 patients with ARF, 23 had a glomerular lesion, 15 had acute tubular necrosis, and 8 had acute interstitial nephritis. Of 72 patients with SRF, 49 had a glomerulopathy, 12 had a vascular disorder, and six had acute interstitial nephritis. Hence, patients with ARF or SRF exhibited a high potential for reversible lesions. Only 11.3% of patients with CRF had potentially reversible causes. The most common causes of proteinuria were membranous glomerulopathy (34.3%), minimal change disease (14.6%), focal segmental sclerosis (11.7%), and amyloidosis (8.8%). Of the 25 patients with advanced nephrosclerosis, 24 had renal failure, 20 were hypertensive, and 13 had cholesterol emboli. Of 33 patients with diabetes mellitus, 66.7% were found to have lesions not related to diabetes. We conclude that renal biopsy is most useful in older patients with ARF or SRF because of potentially reversible renal disease. Old age alone is not a contraindication to performing a renal biopsy.
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PMID:Renal biopsy in patients 65 years of age or older. An analysis of the results of 334 biopsies. 235 29

Clinical and pathological analyses were performed to evaluate plasma exchange therapy (PEx) in children with severe IgA nephropathy. Values for PEx were obtained in 17 cases (male 13, female 4, 12.2 +/- 4.3 [M +/- SE] years old), whose proteinuria and creatinine clearance (Ccr) were 4.6 +/- 1.8 g/day and 64.4 +/- 31.3 ml/min/1.73 m2, respectively, immediately prior to treatment. Values for proteinuria in children after PEx were significantly higher than those of 151 cases of IgA nephropathy who were not treated by PEx in our unit. Ccr in patients who underwent PEx significantly improved during the first 6 months, whereas serum IgG, IgA and C3 levels returned to pre-PEx levels following a transient reduction at one month. Fourteen out of 17 cases were followed for more than 2 years. Among these patients, 8 (57.1%) progressed to chronic renal failure (CRF, Ccr < 30 ml/min/1.73 m2), and 6 showed improvement in Ccr (non-CRF, Ccr > or = 30 ml/min/1.73 m2). In 4 of these cases, PEx was introduced at an acute clinical phase of glomerulonephritis. Compared to 8 patients with progression (CRF), initial renal histology in these 6 patients revealed a lower percentile of glomerular sclerosis index (GSI) and had a significantly higher percentile of cellular crescents. These results suggest that: 1) PEx is not an adequate method of treatment of IgA nephropathy with advanced glomerulosclerosis, 2) PEx is effective in the acute stage of IgA nephropathy.
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PMID:[Effect of plasma exchange therapy on IgA nephropathy in children--a retrospective study]. 760 11

Metabolic acidosis causes renal growth and proteinuria, and may contribute to the progression of CRF. This study assessed the effects of HCI-induced acidosis on the structure and function of normal kidneys. Acidosis was induced in 12 rats by dietary HCl. After 2 weeks, acidotic animals had higher kidney/body weight ratios (0.47 +/- 0.10 vs. 0.35 +/- 0.10 g%, p < 0.001) and higher kidney protein content (123 +/- 3 vs. 111 +/- 4 mg/kidney, p < 0.05) than controls, but tubular nuclear densities were lower, suggesting tubular hypertrophy. Acidotic animals developed tubular proteinuria (16.4 +/- 2.6 mg/day after 2 weeks of acidosis vs. 2.9 +/- 0.3 mg/day at baseline; p < 0.001), and the pattern of immunohistochemical staining for Tamm-Horsfall protein suggested tubular injury. These data suggest that a tubulotoxic effect of metabolic acidosis may contribute to the progression of CRF.
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PMID:Renal effects of metabolic acidosis in the normal rat. 883 6

In 145 patients with focal segmental glomerulosclerosis (43), membranous glomerulonephritis (72), and membranoproliferative glomerulonephritis (30), 71% with normal renal function (NRF) and 63% with nephrotic syndrome (NS), the proteinuria was evaluated by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and classified into four main patterns: physiological (termed 70 kd), pure glomerular (150 kd), mixed with low molecular weight (LMW) proteins as low as 23 kd (23 kd), and mixed with very LMW proteins (20 to 10 kd; termed 10 kd). The relative frequencies were 70 kd, 0.7%; 150 kd, 1.4%; 23 kd, 61%; and 10 kd, 37%. Therefore, only the two patterns characterized by LMW ("tubular") proteins were compared to determine whether they have different clinical and prognostic significance. The serum creatinine (sCr) values (P < 0.0001), the degrees of proteinuria (P = 0.007), and the tubulointerstitial damage (P = 0.015) were significantly different in the two subgroups of patients with 23-kd and 10-kd LMW proteinuria; the difference for tubulointerstitial damage was at the limit of statistical significance after Bonferroni correction. In 82 patients with NRF at entry (sCr, 1.00 +/- 0.22 mg/dL; range, 0.6 to 1.4 mg/dL) and a follow-up of 46 +/- 22 months (range, 12 to 84 months), the predictive value of the 23-kd and 10-kd SDS-PAGE patterns on functional outcome (chronic renal failure [CRF] or clinical remission) was evaluated. A total of 12.5% of 64 patients with mixed 23-kd proteinuria and 50% of 18 patients with mixed 10-kd proteinuria developed CRF. At this time, the difference between the survival curves was highly significant (P = 0.0001), as it also was after correction for NS (P = 0.0002). When the statistical analysis was limited to 69 patients with sCr < or = 1.2 mg/dL, the difference was still highly significant (P = 0.0016), as after correction for NS (P = 0.0064). Clinical remission developed in 30% of 64 patients with 23-kd proteinuria and in 33% of 18 patients with 10-kd proteinuria; this difference was not significant. In a retrospective analysis of 20 patients (13 focal segmental glomerulosclerosis and seven membranous glomerulonephritis; 10 with the 23-kd pattern and 10 with the 10-kd pattern) treated with steroids alone or with steroids and cyclophosphamide, 80% of the patients with the 23-kd pattern and 30% of the patients with the 10-kd pattern were responsive to treatment (P = 0.025). The SDS-PAGE patterns of 54 patients with NRF at entry were again evaluated after 48 +/- 22 months: 11 patients who developed clinical remission had changed from a prevalent (91%) 23-kd pattern to a prevalent physiological (55%) or glomerular (36%) pattern; eight patients who had developed CRF showed an increase from 37% to 100% of the 10-kd pattern. In 35 patients with normal and stable renal function (sCr from 1.08 +/- 0.20 mg/dL to 1.06 +/- 0.19 mg/dL) who had persistent proteinuria (20 patients) or NS (15 patients), the rate of the 10-kd pattern increased from 6% to 46% (72% in persistent NS), suggesting an impairment of tubular protein reabsorptive function even without a concomitant impairment of glomerular filtration rate, a phenomenon that can be hypothetically attributed to tubular toxicity of persistent proteinuria. The characterization of proteinuria by SDS-PAGE in primary progressive glomerulonephritis is a useful clinical tool: it can be used to identify the main pathophysiologic determinants of excretion of LMW proteins and it has a predictive value on CRF outcome in patients with NRF, reducing the unpredictability of clinical evolution. In focal segmental glomerulosclerosis and membranous glomerulonephritis, it seems to be of predictive value on responsiveness to therapy; monitoring the SDS-PAGE patterns over time may give some insights into the relationship between the persistent protein loss and the progression of the disease.
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PMID:Characterization of proteinuria in primary glomerulonephritides. SDS-PAGE patterns: clinical significance and prognostic value of low molecular weight ("tubular") proteins. 900 27

Some antihypertensive drugs may have a renoprotective effect, that is partially independent of their ability to reduce blood pressure. ACE-inhibitors are safe and effective agents that are capable of reducing proteinuria and preventing CRF progression. The results of the AIPRI extension study suggest that they may also have a long-term renoprotective effect. ACE gene polymorphism may partially influence the response to these agents. Angiotensin II receptor 1 antagonists (AT1RA) are effective in reducing proteinuria, but their clinical impact is still a matter of study. It has been shown that non-dihydropyridine and some dihydropyridine calcium channel blockers (CCBs) reduce proteinuria and are also renoprotective, but there is a lack of large-scale prospective randomised trials. Given that the use of various drugs is usually needed to achieve good blood pressure control in patients with CRF, the possibility that a combination of ACE-inhibitors with CCBs or ATIRAs may have an additive renoprotective effect is intriguing.
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PMID:The renoprotective effect of antihypertensive drugs. 1004

It is well known that renal amyloidosis (RA) leads to ESRD in a few years. This evolution may be accelerated by several factors such as steroids, renal vein thrombosis, infections or surgery. We report 22 patients (14M,8F) mean age = 41.6 years (13-72) with RA in whom surgery revealed or aggravated renal disease. The group I includes 15 patients with no previous history of renal disease and who developed oedema few days after surgery with acute renal failure in 5 of them. Proteinuria was present in all the cases with a nephrotic syndrome in 10. Percutaneous kidney biopsy (KB) showed renal amyloidosis in all patients (AA+ = 8 cases, AA- = 3 cases). Only 9 patients were followed-up (mean period = 40 months): 2 patients are stationary; 1 is on complete remission 2 are on HD and 4 died. The group II includes 7 patients with a previous history of nephropathy (Histologically proven amyloidosis: 3 CRF = 1, Oedema: 3). All these patients developed oedema few days after surgery with acute RF in 4 patients. KB performed in all of them showed RA (AA+ = 33, AA- = 1). 6 patients were followed up for a mean period of 11 months: 5 died, 1 patient is on HD. The influence of surgery on renal amyloidosis is often unforeseeable. It may have no effect on renal disease, but very often it reveals RA and sometimes dramatically aggravates the course of the disease with occurrence of irreversible CRF. The pathogenic role of surgery on RA is discussed.
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PMID:Influence of surgery on renal amyloidosis. 1023 78

CRF increases its incidence and prevalence, with increased social and cost burden, while life expectance decreases, mainly due to cardiovascular comorbidity. Recent clinical studies demonstrated the slowing of the renal damage by low - protein diet and the reduction of proteinuria by lowering blood pressure. A good control of anemia and calcium - phosphate balance reduces the cardiovascular risks. Stopping smoking improves survival but lipid-lowering and anti-inflammatory drugs need more studies. It has been demonstrated that an early intervention of nephrology care reduces morbidity and mortality (illness and death incidence) and reduces costs.
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PMID:[Pharmacological prevention of kidney diseases]. 1285 14

Conservative treatment implies procedures which involve normalization or improvement of metabolic disorders in chronic renal insufficiency and failure by medicamentous and dietary means. Keto amino acids administration can remarkable influence protein synthesis, metabolic acidosis, Ca-P and PTH levels, carbohydrate and lipid disorders, but has no effect on hyperfiltration. Long-term co-administration of rHuEPO and keto amino acids in CRF patients on LPD has accelerated metabolic effect associated with a delay in progression of renal failure and reduction of proteinuria. Also, concomitant administration of ACE inhibitors and angiotensin II AT1 receptor antagonist in CRF patients on LPD with KA was associated with significant decrease of proteinuria, amino-aciduria and, via its glomerulo-tubular action, it had also an effect on progression of CRF.
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PMID:[Present opinions on use of ketoanalog essential aminoacids in a conservative treatment of chronic renal insufficiency]. 1532 64

The purpose of the study was to establish the influence of protein restricted diet supplemented with EAA/KAA on nutritional status of children with CRF. Seven childredn (four girls and three boys), aged from 7 years and eight months to 14 years and two months, with glomerular filtration rate of 42.6-9.2 ml/min/1.73 m2 and proteinuria of 0.025-1.125 g/24 h, who were on conservative treatment and who lived at home, were observed for six months. In prescribing energy value and protein intake WHO recommendations were used for healthly children (age for height). Through food 80-90% of energy and 80-85% of protein needs were provided. The remaining energy and proteins were provided by glucodextrin and EAA/KAA supplements respectevely. Average daily phosphorous intake amounted to about 550-800 mg. The obtained results showed that stunting and kwashiorkor like aminoacid disbalance were the prominent nutritional problems. This dietary regimen had a beneficial effect on all studied parameters. especially on height standard deviation score which increased from 1.71 +/- 2.6 to 1.5 +/- 4.3 (t = 2.809, p < 0.05); total essential/nonessential aminoacid score increased from 0.38 +/- 0.2 to 0.56 +/- 0.2 (t = 2.763, p < 0.05). The ratio between plasma concentration of four nonessential (glycine+serinet glutamine+taurine) to four essential (leucine+isoleucine+valine+methionine) amino acids decreased from 3.82 +/- 1.2 to 2.7 +/- 0.4 (t = 2.528, p < 0.05). Lymphocyte count increased from 1.809 x 10(9) +/- 0.268 x 10(9)/l to 2.314 x 10(9) +/- 0.922 x 10(9)/l (t = 2.431, p < 0.05). No significant changes were found in the values of relative body weight, arm circumpherence, triceps skinfold thickness, total plasma protein, albumin, transferine, complement C3 and plasma valin/glycin and phenylalanine/thyrosine ratio. It should be noted that the significant changes were not found in the results of these latter anthropometric biochemical parameters in relation to their primary almost insignificant values.
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PMID:[The influence of protein and phosphorous restricted diet supplemented with essential aminoacids (EAA) and their alpha-keto-analogues (KAA) on nutritional status of children with chronic renal failure (CRF)]. 1797 83


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