BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with si...BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance.Ten children underwent renal biopsy.Crescents(less than 50%)were demonstrated in five children,while three children had typical diffuse proliferative glomer-ulonephritis.One child had severe acute tubular necrosis,and another had crescentic glomerulonephritis(crescents>50%).The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.CONCLUSION High-degree proteinuria was significantly associated with elevated serum creatinine(>100μmol/L)in children with PSAGN.The majority of children with persistent proteinuria≥2+for more than 2 weeks and the highest recorded serum creatinine>100μmol/L had atypical renal histological findings.展开更多
[Objectives]To evaluate the clinical efficacy and safety of Kunkui Kidney Preserving Paste in the treatment of diabetic kidney disease(DKD)patients with damp-heat stasis syndrome in the clinical proteinuria stage.[Met...[Objectives]To evaluate the clinical efficacy and safety of Kunkui Kidney Preserving Paste in the treatment of diabetic kidney disease(DKD)patients with damp-heat stasis syndrome in the clinical proteinuria stage.[Methods]Retrospective analysis was made on 30 patients with DKD who were diagnosed with damp-heat stasis syndrome in the clinical proteinuria stage from March 2021 to March 2023 in Jiangsu Province Hospital of Chinese Medicine,and who took Kunkui Kidney Preserving Paste continuously for six months.The urinary albumin/creatinine ratio(UACR),urinary complement C3,and urea nitrogen(BUN)of DKD patients before and after treatment were compared,and estimated glomerular filtration rate(eGFR),blood creatinine(Scr),and cystatin C(CysC)were estimated,and the therapeutic effects on renal function and urinary protein were evaluated.[Results]After treatment,UACR significantly decreased(P<0.01),and urinary complement C3 and Scr decreased(P<0.05),while other indicators showed no significant statistical difference(P>0.05).In terms of evaluating the efficacy of urinary protein therapy,8 cases showed recent relief;8 cases showed significant effect;9 cases were effective,and 5 cases were invalid after treatment,with a total effective rate of 83.33%.In terms of renal function efficacy evaluation,8 cases showed significant effect;4 cases were effective;11 cases were stable,and 7 cases were invalid,with a total effective rate of 76.67%.In the safety evaluation,there were no obvious adverse reactions.[Conclusions]The Kunkui Kidney Preserving Past has significant clinical efficacy and safety in treating DKD patients with damp-heat stasis syndrome in the clinical proteinuria period.It has significant advantages in reducing urinary protein and protecting renal function,which is worthy of clinical promotion.展开更多
Objective:To investigate whether urinary dipstick proteinuria or urine protein creatinine ratio(UPCR)could predict leakage in children with dengue virus infection.Methods:This was a prospective cross-sectional study.A...Objective:To investigate whether urinary dipstick proteinuria or urine protein creatinine ratio(UPCR)could predict leakage in children with dengue virus infection.Methods:This was a prospective cross-sectional study.A total of 141 hospitalized patients with confirmed dengue virus infection were enrolled from three hospitals in Thailand.Once daily,complete blood count,serum albumin,and random morning urine dipstick protein were collected from the day of admission to the day after defervescence.Morning UPCR was only measured in patients from one hospital due to logistic reasons.Results:There were 81 and 60 patients in the dengue fever(DF)and DHF groups,respectively.The proportion of patients with proteinuria detected using urine dipstick in the DHF group was higher than that in the DF group from Day-1(one day before defervescence)to Day+1(one day after defervescence).Urine dipstick for proteinuria of≥1+had sensitivity and specificity of 12.8% and 94.4% on Day-1,and 18.9% and 98.6% on Day 0(the day of defervescence)to differentiate DHF from DF.For UPCR,cut-off values of approximately 0.2 g/g from Day-2 to Day+1 yielded a sensitivity of 71.6%-94.4% and a specificity of 55.6%-100% in differentiating between DF and DHF.Conclusions:Dipstick proteinuria of≥1+on Day-1 to Day+1 after defervescence had poor sensitivity but good specificity in differentiating DHF from DF.UPCR performed better but was less convenient and more expensive than urine dipsticks.展开更多
OBJECTIVE: To investigate the effect of the traditional Chinese herbs Astragali and Angelicae Sinensis(A & As) particle [contains Huangqi(Radix Astragali Mongolica), Danggui(Radix Angelicae Sinensis),Huzhanggeng(R...OBJECTIVE: To investigate the effect of the traditional Chinese herbs Astragali and Angelicae Sinensis(A & As) particle [contains Huangqi(Radix Astragali Mongolica), Danggui(Radix Angelicae Sinensis),Huzhanggeng(Rhizoma Polygoni Cuspidati) and Danshen(Radix Salviae Miltiorrhizae)] on proteinuria in glomerulonephritis patients with stage 2 chronic kidney disease.METHODS: A prospective, multi-center, and randomized controlled clinical trial was performed for 24 weeks. From March 2011 to April 2012, 158 patients from nine hospitals in China participated.They were randomized into the A&As group(79 cases, A&As particle 15.2 g/day) and losartan group(79 cases, losartan 50 mg/day). At each follow-up visit, clinical data including blood pressure, urinalysis, 24-h-urinary protein excretion, serum albumin and serum creatinine were collected.RESULTS: All 158 patients completed the follow-up. Proteinuria in the losartan group exhibited a biphasic time-dependent decline with a significant steady reduction from baseline to week 12(P = 0.0014), and a platform level during the remaining 12-week follow-up(P > 0.05). In contrast, there was a continual significant decrease of proteinuria in the A & As group(P < 0.001). When compared with the losartan results, proteinuria in the A & As group from week 16 to week 24 was significantly reduced(P < 0.001). Stable e GFRs and blood pressure were also observed in both groups. Medication side effects were minimal and non-fatal.CONCLUSION: For Chinese glomerulonephritis patients with stage 2 chronic kidney disease, therapy with A & As particles may provide effective anti-proteinuria treatment.展开更多
OBJECTIVE:To investigate the effects of artemisinin against proteinuria and glomerular filtration barrier damage in rats with adriamycin-induced nephropathy,and the potential mechanism underpinned the action.METHODS:F...OBJECTIVE:To investigate the effects of artemisinin against proteinuria and glomerular filtration barrier damage in rats with adriamycin-induced nephropathy,and the potential mechanism underpinned the action.METHODS:Forty adriamycin rats were randomly divided into two groups with the ratio of 1︰3;the small-number group served as control group(n=10),and the rats in the large-number group were treated with adriamycin to induce nephropathy;then they were further randomly assigned into 3subgroups:benazepril group(n=10),artemisiningroup(n=10),and adriamycin group(n=10).The benazepril group and artemisinin group were treated with benazepril suspl(5.0 mg/kg daily)and artemisinin suspl(150 mg/kg daily)respectively after being modeled;those in the control group and adriamycin group were intragastrically administered an equivalent volume of distilled water every day.The treatment after model establishment lasted for a total of 4 weeks.The 24 h uric protein,blood biochemicals,renal pathological changes,renal ultrastrutural changes,Nephrin and Podocin proteins and gene expressions were measured by Coomassie brilliant blue assay,completely automatic biochemical analyzer,light microscope,electron microscopy,Western blot and reverse transcription polymerase chain reaction,respectively.RESULTS:The rats in adriamycin group showed a significant increase in 24 h uric protein excretion,serum total cholesterol(TC),triglyceride(TG),blood urea nitrogen(BUN),serum creatinine(Scr)and decrease in albumin(Alb)(P<0.05 or P<0.01).Compared with adriamycin group,artemisinin could reduce uric protein excretion,decrease the serum TC,TG elevation,increase the serum Alb level,up-regulate the expressions of Nephrin and Podocin(P<0.05 or P<0.01),but no statistical significance effects on the levels of BUN,Scr in artemisinin group(P>0.05).The renal pathological and ultrastrutural observation indicate that artemisinin could attenuate the severity of foot process effacement and fusion in the nephropathic rats.CONCLUSION:Artemisinin might have an effect on the nephropathy in rats caused by adriamycin,which may be at least partly correlated with attenu-ation of the severity of foot process effacement and fusion,up-regulation of the expressions of Nephrin and Podocin in the glomeruli in the rats.展开更多
Objective:To assess if microhaematuria and proleinuria as measured by reagent strips could estimate intensity of Schistosoma haematobium(S.haematobium) infection in endemic areas and evaluate their screening performan...Objective:To assess if microhaematuria and proleinuria as measured by reagent strips could estimate intensity of Schistosoma haematobium(S.haematobium) infection in endemic areas and evaluate their screening performance among children in Benue State,Nigeria.Methods:A lolal of 1124 urine samples were collected,screened for microhaematuria and proteinuria using reagent strips(Combi 9) and results were compared to filtration technique,the gold standard method.Results:A significant correlation was ohserved between microhaematuria(rho= 0.66. P【0.01).proteinuria(rho = 0.71.P【0.01) and intensity of.S.haematobium eggs.Proteinuria had sensitivity of 95.7%and specificity of 67.2%.while microhaematuria had sensitivity of 64.8%and specificity of 89.6%.The proportion of false positive diagnoses was higher in proleinuria(19.2%) than microliaematuria(6.0%).Conclusios:The findings suggest that use of urine reagent strips could potentially estimate intensity of.S.haematobium infection and their performance to screen urinary schistosomiasis agreed with previous observations.展开更多
Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, accor...Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, according to the serum titer of the HBV DNA. 24-h urine protein excretion, and other parameters were measured. Renal biopsy were performed. The association between HBV DNA and the pathological stage of membranous nephropathy was analyzed in 78 patients with HBV-MN. 24-h urine protein excretion was used for the evaluation of the prognosis, and the relationship between HBV DNA and prognosis were analyzed. Results Several findings were demonstrated with the increase of serum HBV DNA： 24-h urine protein excretion, plasma cholesterol, and triglycerides increased significantly（P〈0.05）, while the plasma level of albumin decreased significantly（P〈0.05）; The changes of serum creatinine, C3 and C4 were found but no statistical significance. Glomerular deposition of HBVAg increased, and the pathological injury was more severe. The clinical remission rate was lower in the high replication group after treatment as compared with the low replication group（P〈0.01）. Conclusion With the increase of serum HBV DNA, the urine protein excretion and the kidney injury were more severe, and the clinical remission rate was decreased.展开更多
Objective： To observe the podocyte injury in diabetic nephropathy （DN） patients by identifying the urinary podocytes and the situation of detached podocytes in glomeruli and to demonstrate the correlation between p...Objective： To observe the podocyte injury in diabetic nephropathy （DN） patients by identifying the urinary podocytes and the situation of detached podocytes in glomeruli and to demonstrate the correlation between podocyte excretion and proteinuria, blood glucose, serum creatinine in different phases in DN patients. Methods： Urinary podocytes and the podocalyxin （PCX） expression state of podocytes in glomeruli were identified and observed by indirect immunofluorescent method. The DN patients were divided into three groups according to the volume of proteinuria, namely small, medium and large volume proteinuria groups. The podocytes in the urine of every group were calculated. The DN patients were divided into five groups according to the chronic kidney disease （CKD） phases, then the positive podocytes in urine were calculated. Meanwhile, the 24-hour protein in urine, fasting blood glucose （FBG） and the serum creatinine of DN patients were tested. The correlations among the proteinuria, serum creatinine, FBG and the number of positive podocytes in the urine of DN patients were statistically analyzed. Results： Urinary positive podocytes were found in 88% of the patients with DN, whereas podocytes were found in 0% of patients with minimal changed disease （MCD） and healthy cases. The expression of PCX was absent in DN patients. In contrast, PCX was expressed integrally in MCD patients. The positive podocytes was 1.49±0.95/ml in small-volume proteinuria group, 2.15±0.70/ml in the medium-volume proteinuria group, and 3.48±1.27/ml in the large-volume proteinuria group. There was no significant difference between the small- and medium- volume proteinuria groups, and there were significant differences between other groups （P〈0.05）. The positive podocyte number tended to increase as proteinuria was increased. By Pearson analysis, the correlation between podocyte number and proteinuria was podocytes in urine from different groups of DN patients, CKD pc I sitive statistically. The difference of the number of positive -V group was significant statistically. The correlation between serum creatinine of CKD Ⅰ -Ⅲ group and positive podocytes in urine was positive statistically. The correlation between serumcreatinine of CKD Ⅳ- Ⅴ group and positive podocytes in urine was not significant statistically. The correlation between FBG and positive podocytes in urine was not significant either. Conclusion： The mechanism of the podocyte injury in DN patients is present. The podocyte injury in DN may positively correlate to proteinuria and serum creatinine of CKD Ⅰ -ⅢDN patients, but not to the FBG and serum creatinine of CKD Ⅳ-Ⅴ patients.展开更多
To study the relationship between serum vascular endothelial growth factor (VEGF) and proteinuria in adriamycin induced nephrotic rats, a rat model of adriamycin induced nephrotitis was developed by injection of adr...To study the relationship between serum vascular endothelial growth factor (VEGF) and proteinuria in adriamycin induced nephrotic rats, a rat model of adriamycin induced nephrotitis was developed by injection of adriamycin into a tail vein in a rat. At different time points, 24 h urinary protein excretion was measured by using Coomassie brilliant blue method and the serum VEGF levels detected by using ELISA assay. The interventional effect of VEGF on this model was observed. The results showed that: (1) The adriamycin induced nephrotic syndrome rat model was developed successfully; (2) Serum VEGF levels and proteinuria were significantly increased at 7th day after intravenous injection of adriamycin. There was a positive correlation between serum VEGF levels and 24 h urinary protein excretion ( r=0.67, P <0.05). (3) The 24 h urinary protein excretion was significantly increased in the rats receiving administration of VEGF ( P <0.05). It was concluded that VEGF might play an important role in the pathogenesis of proteinuria in adriamycin induced nephrotic rats.展开更多
In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbumi...In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.展开更多
Tripterygium wilfordii (TW) was reported by LI Lei-shi, et al in 1981 to have marked effect in reducing proteinuria when it was used to treat glomerular nephritis, and the conclusion they worked out has been now accep...Tripterygium wilfordii (TW) was reported by LI Lei-shi, et al in 1981 to have marked effect in reducing proteinuria when it was used to treat glomerular nephritis, and the conclusion they worked out has been now accepted by most of nephrologists in 20-year experimental studies and wide application in clinical practice. Its mechanism, adverse reaction and mutagenesis effects, and dosage in clinical application in the recent years are now briefly reviewed in this paper.展开更多
Controlling blood pressure and reducing proteinuria are common goals in Chronic Kidney Disease associated with hypertension and proteinuria and lead to fewer cardiovascular outcomes. This review summarizes the availab...Controlling blood pressure and reducing proteinuria are common goals in Chronic Kidney Disease associated with hypertension and proteinuria and lead to fewer cardiovascular outcomes. This review summarizes the available literature.展开更多
AIM： To determine whether complement membrane attack complex （C5b-9） has a pathogenic role in tubuloin-terstitial injury in a renal disease model characterized by acute highly selective proteinuria. METHODS： Prote...AIM： To determine whether complement membrane attack complex （C5b-9） has a pathogenic role in tubuloin-terstitial injury in a renal disease model characterized by acute highly selective proteinuria. METHODS： Protein-overload nephropathy （PON） was induced in adult female Piebald-Viral-Glaxo rats with or without complement C6 defciency （C6- and C6＋） by daily intraperitoneal injections of bovine serum albumin （BSA, 2 g/d）, and examined on days 2, 4 and 8.RESULTS： Groups with PON developed equivalent levels of heavy proteinuria within 24 h of BSA injection. In C6＋ rats with PON, the tubulointerstitial expression of C5b-9 was increased and localized predominantly to the basolateral surface of tubular epithelial cells （TECs）, whereas it was undetectable in C6- animals. TEC proliferation （as assessed by the number of BrdU＋cells） increased by more than 50-fold in PON, peaking on day 2 and declining on days 4 to 8. There was a trend for a reduction in the number of BrdU＋ TECs on day 4 in the C6- PON group （ P = 0.10 compared to C6＋） but not at any other time-point. Kidney enlargement, TEC apoptosis （TUNEL＋ cells） and markers of tubular injury （tubule dilatation, loss of TEC height, protein cast formation） were not altered by C6 deficiency in PON. Interstitial monocyte （ED-1＋ cell） accumulation was partially reduced in C6- animals with PON on day 4 （ P = 0.01） but there was no change in myofbroblast accumulation. CONCLUSION： These data suggest that C5b-9 does not mediate tubulointerstitial injury in acute glomerular diseases characterized by selective proteinuria.展开更多
Introduction: Early detection of proteinuria is early detection is a cost-effective method of assessing individuals with and without risk factors for chronic renal disease. Proteinuria is common in adults and may pres...Introduction: Early detection of proteinuria is early detection is a cost-effective method of assessing individuals with and without risk factors for chronic renal disease. Proteinuria is common in adults and may present a clinical challenge in the absence of obvious renal disease or risk factors especially in the tropics. Few studies in Nigeria have assessed the prevalence of proteinuria in adults using the dipstick method. The aim of this study was to document the prevalence of proteinuria among residents of a community in Enugu, south east Nigeria. Methods: This was a cross-sectional descriptive study carried out in an isolated urban slum settlement in Enugu, south east Nigeria. Dipstick testing of freshly voided early morning mid-stream urine samples was done to detect proteinuria. For database management and statistical analyses, SPSS version 23 was used. Results: A total of 262 individuals were recruited for the study, 165 (63%) females and 97 (37%) males. The participants’ age ranged from 18 to 90 years, averaging 43.7 ± 15.5. Trace amounts of protein were detected in urine samples of 225 (85.9%) individuals. Significant proteinuria was detected in 3.8% of the participants and was significantly higher 40 - 49-year-olds (6%). p = 0.02 and 0.02 respectively. Significant correlates of proteinuria were lower diastolic blood pressure and current tobacco use. Lower body mass index weakly correlated with proteinuria. Conclusion: The prevalence of significant early morning proteinuria in a community-based study in Enugu was 3.8%. Significant correlates of proteinuria included low diastolic blood pressure and tobacco use. Community based awareness programs targeted at prevention of chronic renal diseases should be incorporated in public health programs.展开更多
Two pregnant women who initially developed proteinuria alone followed by serious preeclampsia are presented to emphasize that there is no adequate technical term to express the period of proteinuria alone based on the...Two pregnant women who initially developed proteinuria alone followed by serious preeclampsia are presented to emphasize that there is no adequate technical term to express the period of proteinuria alone based on the current criteria of pregnancy-induced hypertension. Case 1 exhibited a urinary protein concentration of 46 mg/dL in the absence of hypertension, and abdominal pain due to placental abruption with hypertension at gestational week (GW) 29–3/7 and 29–4/7, respectively. Case 2 exhibited a urinary protein/creatinine ratio of 2.67, developed hypertension, required cesarean section, and developed posterior reversible encephalopathy syndrome at GW 28–1/7, 29–6/7, and 32–0/7, and on postpartum day 2, respectively. As women with proteinuria alone are not diagnosed as having preeclampsia and as a diagnosis of gestational proteinuria can be made only at 12 weeks postpartum, a prospective technical term applicable to the condition of proteinuria alone is needed to increase physicians’ attention to this condition.展开更多
Background: The prevalence of asymptomatic renal scarring, such as a focal segmental glomerulosclerosis (FSGS), was suggested to be high in women who develop preeclampsia. FSGS is a risk factor for endstage renal dise...Background: The prevalence of asymptomatic renal scarring, such as a focal segmental glomerulosclerosis (FSGS), was suggested to be high in women who develop preeclampsia. FSGS is a risk factor for endstage renal disease. Objective: To document preeclamptic women with proteinuria that developed eight weeks prior to hypertension with confirmed FSGS postpartum. Case: A 20-year-old nulliparous Japanese woman with a negative dipstick test result at gestational week (GW) 18 exhibited proteinuria 1+ on dipstick test at GW 22. Proteinuria determined from the random urine protein to creatinine ratio (P/Cr, g/g) was increased from 3.7 at GW 26 to 4.6 and 8.9 at GW 28 and 30, respectively. She developed hypertension (142/66 mmHg) at GW 30. Due to increased edema, emergency cesarean section was performed at GW 33. She gave birth to an otherwise healthy female small-for-gestational-age infant, weighing 1290 g. Postpartum course was uneventful except for persisting proteinuria: P/Cr of 9.8 just before delivery decreased to 3.6 and 1.7 on postpartum weeks 9 and 17, respectively. Renal biopsy on postpartum week 13 revealed FSGS in this patient. Conclusion: Hidden FSGS may have manifested as preeclampsia in this patient. This case highlighted the need to determine the prevalence of asymptomatic FSGS among women who later develop preeclampsia.展开更多
Objectives: The objectives of this work were to calculate the frequency of arterial hypertension during pregnancy, describe the epidemiological profile, and identify the most common type of hypertension and to establi...Objectives: The objectives of this work were to calculate the frequency of arterial hypertension during pregnancy, describe the epidemiological profile, and identify the most common type of hypertension and to establish fetal prognosis based on uricemia and maternal proteinuria. Methodology: This was a six (6) month descriptive prospective study performed in the Obstetrics and Gynecology Department of Donka National Hospital-CHU Conakry. The study took place from july 1 st to December 31st, 2015. Results: The frequency of arterial hypertension during pregnancy was 8.82% in the service. The epidemiological profile was that of teenagers (32.8%), nulliparous (56%), coming from home (69.2%), not having performed CPN (52%), not schooled (68%) and housewives. The primary factor was the risk factor (52.4%). Gestational age greater than 37 was the most concerned (62%). The reasons for consultation are dominated by headache (76%) and vertigo (68%). The main type of hypertension was pre-eclampsia (48%) followed by Transient HTA (28%). The predominant clinical form during the admission was pre-eclampsia (47.2%) followed by eclampsia (23%). At the first minute, 35.68% of newborns had an APGAR score of less than 7 and the fifth 25.5% had a score of less than 7. Fetal morbidity was dominated by fetal hypotrophy (30.19%), followed by prematurity (23.92%). In 90.90% of hypotrophy, there are ?85.24% of premature babies, 95.55% of SFA, and 80% of MIU;the serum uric acid was greater than 350 mmol. We recorded 204 children born with mothgers with proteinuria greater than or equal to 30 mg/dl, or 80% of children. 30 cases of MFIU and 7 cases of neonatal death out of 255 births, that is 14.50% were noted. Conclusion: The detection of risk factors by a good prenatal follow-up and the regular training of the care providers for adequate and multidisciplinary care (obstetrician, intensive care nephrologist and pediatrician) of hypertensive pregnant women and their newborns can improve the maternal prognosis and fetal.展开更多
Hypertension defined as a systolic blood pressure of ≥140 and a diastolic blood pressure ≥90 is anextremely prevalent condition;and it is responsible for significant mortality and morbidity. NHANESdata from 2005-200...Hypertension defined as a systolic blood pressure of ≥140 and a diastolic blood pressure ≥90 is anextremely prevalent condition;and it is responsible for significant mortality and morbidity. NHANESdata from 2005-2006 found that nearly 30% of adult US population has HTN;and nearly 8% of the population has undiagnosed HTN. HBP mortality in 2008 was 61,005. Any mentioned mortality in 2008 was 347,689 (NHLBI tabulation of NCHS mortality data). More than 20% of patients with systemic hypertension have chronic renal insufficiency (NHANES). Hypertensive nephropathy is a leading cause of end-stage renal disease (ESRD) requiring dialysis or transplantation or leading to death. The incidence of hypertension is high but only a subset of hypertensive patients progress to frank renal failure. A subset of hypertensive patients develop proteinuria during the course of disease and manifest nephrotic syndrome. This syndrome includes marked proteinuria, edema, and low serum albumin. Neither the incidence nor the clinical significance of proteinuria in hypertension without diabetes is known. Progression to chronic renal failure in some patients is preceded by proteinuria as indicated on “dip-stick” analyses of random urine samples. It appears that proteinuria is likely to increase both prior to and during evident loss of glomerular filtration, but this clinical observation has never been formally confirmed. There is a need for large studies to answer these questions. We also need to focus on the roles that genetic and environmental factors play in development and progression of renal disease in the setting of hypertension and proteinuria.展开更多
<strong>Objective:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">To determine the prevalence of proteinuria in children living ...<strong>Objective:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">To determine the prevalence of proteinuria in children living with HIV (CLHIV) and identify associated factors. </span><b><span style="font-family:Verdana;">Patients and methods: </span></b><span style="font-family:Verdana;">This was a cross-sectional, descriptive and analytical study carried out from April to August 2017 in the HIV care centres in Brazzaville and Pointe-Noire. The study included CLHIV with dipstick urinalysis test “Combur</span><sup><span style="font-family:Verdana;">10</span></sup><span style="font-family:Verdana;"> Test</span><sup><span style="font-family:Verdana;">®</span></sup><span style="font-family:Verdana;"> M”. </span><b><span style="font-family:Verdana;">Re</span><span style="font-family:Verdana;">sults: </span></b><span style="font-family:Verdana;">Thirty seven CLHIV on HAART presented a proteinuria, 21.8%. Children were male gender in 21 case</span></span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> (56.8%) and female gender in 16 cases (43.2%). Mean age was 10.9 ± 3.9 years. The children were infected with type 1 virus in 35 cases (94.6%), vertical transmission in all the cases (100%). Children were living with HIV for about 2 to 4 years of average n = 18 (48.6%)</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> and they were WHO clinical stage 2 in 18 cases (48.6%). 13 children (35%) had CD4 level < 200 cells/mm</span><sup><span style="font-family:Verdana;">3</span></sup><span style="font-family:Verdana;">. All CLHIV (100%) were on HAART thus 20 (37.7%) on the combination of zidovudine (AZT), lamivudine (3TC) and nevirapine (NVP). This combination AZT, 3TC, NVP was a protective factor regarding the occurrence of proteinuria (OR: 0.43;IC (95%). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Proteinuria </span><span style="font-family:Verdana;">is less observe</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> in CLHIV on HAART. Systematic screening and early management of proteinuria during follow</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">up of these children improve their survival</span><span style="font-family:Verdana;">.</span>展开更多
In the occurrence and development of glomerulonephritis, proteinuria is themain manifestation, which is easily recurrent but not easily got rid of in a short period of time. It may remain even after disappearance ... In the occurrence and development of glomerulonephritis, proteinuria is themain manifestation, which is easily recurrent but not easily got rid of in a short period of time. It may remain even after disappearance of the general symptoms. In some patients, there are no symptoms and signs at all in the initial stage, except proteinuria, the only distinct manifestation. Prof. Ye Chuanhui, from Chengdu University of Traditional Chinese Medicine, has accumulated rich experience for treating this disorder, which is introduced in the following.……展开更多
文摘BACKGROUND Post-streptococcal acute glomerular nephritis(PSAGN)is mostly a benign condition.The usual sequelae of PSAGN include hypertension,its complications,and acute kidney injury.Severe PSAGN is associated with significant long-term morbidity,and histological abnormalities such as crescentic glomerulonephritis are infrequently reported.PSAGN has also been linked to late-onset chronic kidney disease in some populations due to high levels of proteinuria.METHODS This prospective observational study was conducted at Lady Ridgeway Hospital(Colombo,Sri Lanka)over 15 months.Children with PSAGN were enrolled based on clinical and laboratory criteria.Persistent proteinuria≥2+for 2 weeks and serum creatinine>100μmol/L warranted renal biopsy,assessed via light microscopy and immunofluorescence.Normalization of complement 3(C3)within 6 to 8 weeks was required for inclusion.Data on clinical features,urine protein levels,and renal function were collected from patient records,and potential associations were analysed using Statistical Package for the Social Sciences and R language for statistical computing.Ethical approval was obtained from the Ethical Review Committee,Lady Ridgeway Hospital for Children(Ref No:LRH/ERC/2021/60).RESULTS Forty-four patients were recruited.There were 27(61.4%)male patients and 17(38.6%)female patients.Thirty-seven(84%)of them were above 5 years of age.Twenty(45%)patients had a history of skin sepsis,and eighteen(41%)had a history of throat infection.Among patients with proteinuria≥2+,53%had serum creatinine>100µmol/L,while among those with proteinuria<2+,7%had serum creatinine>100µmol/L.The association of high-degree proteinuria with elevated serum creatinine was significant(χ²=7.8,P=0.005)in PSAGN.The odds ratio of the logistic regression model was 1.049(95%confidence interval:1.003-1.098),indicating a positive direction with statistically significant association(P=0.037).There was no significant association between proteinuria and the degree of hypertension or estimated creatinine clearance.Ten children underwent renal biopsy.Crescents(less than 50%)were demonstrated in five children,while three children had typical diffuse proliferative glomer-ulonephritis.One child had severe acute tubular necrosis,and another had crescentic glomerulonephritis(crescents>50%).The immunofluorescence studies revealed deposition of immunoglobulin G and C3 in all biopsy specimens.CONCLUSION High-degree proteinuria was significantly associated with elevated serum creatinine(>100μmol/L)in children with PSAGN.The majority of children with persistent proteinuria≥2+for more than 2 weeks and the highest recorded serum creatinine>100μmol/L had atypical renal histological findings.
基金Supported by the National Natural Science Foundation of China(82174293,82374355,82004286)Science and Technology Support Program of Jiangsu Province(ZD202208,ZT202206)Postgraduate Research and Practice Innovation Program of Jiangsu Province(SJCX22_0718).
文摘[Objectives]To evaluate the clinical efficacy and safety of Kunkui Kidney Preserving Paste in the treatment of diabetic kidney disease(DKD)patients with damp-heat stasis syndrome in the clinical proteinuria stage.[Methods]Retrospective analysis was made on 30 patients with DKD who were diagnosed with damp-heat stasis syndrome in the clinical proteinuria stage from March 2021 to March 2023 in Jiangsu Province Hospital of Chinese Medicine,and who took Kunkui Kidney Preserving Paste continuously for six months.The urinary albumin/creatinine ratio(UACR),urinary complement C3,and urea nitrogen(BUN)of DKD patients before and after treatment were compared,and estimated glomerular filtration rate(eGFR),blood creatinine(Scr),and cystatin C(CysC)were estimated,and the therapeutic effects on renal function and urinary protein were evaluated.[Results]After treatment,UACR significantly decreased(P<0.01),and urinary complement C3 and Scr decreased(P<0.05),while other indicators showed no significant statistical difference(P>0.05).In terms of evaluating the efficacy of urinary protein therapy,8 cases showed recent relief;8 cases showed significant effect;9 cases were effective,and 5 cases were invalid after treatment,with a total effective rate of 83.33%.In terms of renal function efficacy evaluation,8 cases showed significant effect;4 cases were effective;11 cases were stable,and 7 cases were invalid,with a total effective rate of 76.67%.In the safety evaluation,there were no obvious adverse reactions.[Conclusions]The Kunkui Kidney Preserving Past has significant clinical efficacy and safety in treating DKD patients with damp-heat stasis syndrome in the clinical proteinuria period.It has significant advantages in reducing urinary protein and protecting renal function,which is worthy of clinical promotion.
基金supported by the Ramathibodi Research Fund,Faculty of Medicine Ramathibodi Hospital,Mahidol University(Grant number R11065125),for their contribution to research funding.
文摘Objective:To investigate whether urinary dipstick proteinuria or urine protein creatinine ratio(UPCR)could predict leakage in children with dengue virus infection.Methods:This was a prospective cross-sectional study.A total of 141 hospitalized patients with confirmed dengue virus infection were enrolled from three hospitals in Thailand.Once daily,complete blood count,serum albumin,and random morning urine dipstick protein were collected from the day of admission to the day after defervescence.Morning UPCR was only measured in patients from one hospital due to logistic reasons.Results:There were 81 and 60 patients in the dengue fever(DF)and DHF groups,respectively.The proportion of patients with proteinuria detected using urine dipstick in the DHF group was higher than that in the DF group from Day-1(one day before defervescence)to Day+1(one day after defervescence).Urine dipstick for proteinuria of≥1+had sensitivity and specificity of 12.8% and 94.4% on Day-1,and 18.9% and 98.6% on Day 0(the day of defervescence)to differentiate DHF from DF.For UPCR,cut-off values of approximately 0.2 g/g from Day-2 to Day+1 yielded a sensitivity of 71.6%-94.4% and a specificity of 55.6%-100% in differentiating between DF and DHF.Conclusions:Dipstick proteinuria of≥1+on Day-1 to Day+1 after defervescence had poor sensitivity but good specificity in differentiating DHF from DF.UPCR performed better but was less convenient and more expensive than urine dipsticks.
基金Ministry of Scientific Technology of China Grant(Optimum Proposal of Traditional Chinese Medicine on Proteinuria in Patients with Primary Glomerulonephritis,No.201007005)Shanghai Science&Technology Commission Grant(Clinical Study of Astragali Xiaobai Particle on Proteinuria in Patients with Primary Chronic Glomerulonephritis,No.14401972203)+2 种基金Three Years of Development Project for Traditional Chinese Medicine of Shanghai Municipal Commission of Health and Family Planning(Senior Chinese Integrative Medicine Talent Cultivation Project,No.ZYSNXD012-RC-ZXY003)Three Years of Development Project for Traditional Chinese Medicine of Shanghai Municipal Commission of Health and Family Planning(Effect of Astragali Xiaobai Particle on Proteinuria in Patients with Primary Chronic Glomerulonephritis,No.ZY3-JSFC-2-1029)Innovative Research Team in Universities,Shanghai Municipal Education
文摘OBJECTIVE: To investigate the effect of the traditional Chinese herbs Astragali and Angelicae Sinensis(A & As) particle [contains Huangqi(Radix Astragali Mongolica), Danggui(Radix Angelicae Sinensis),Huzhanggeng(Rhizoma Polygoni Cuspidati) and Danshen(Radix Salviae Miltiorrhizae)] on proteinuria in glomerulonephritis patients with stage 2 chronic kidney disease.METHODS: A prospective, multi-center, and randomized controlled clinical trial was performed for 24 weeks. From March 2011 to April 2012, 158 patients from nine hospitals in China participated.They were randomized into the A&As group(79 cases, A&As particle 15.2 g/day) and losartan group(79 cases, losartan 50 mg/day). At each follow-up visit, clinical data including blood pressure, urinalysis, 24-h-urinary protein excretion, serum albumin and serum creatinine were collected.RESULTS: All 158 patients completed the follow-up. Proteinuria in the losartan group exhibited a biphasic time-dependent decline with a significant steady reduction from baseline to week 12(P = 0.0014), and a platform level during the remaining 12-week follow-up(P > 0.05). In contrast, there was a continual significant decrease of proteinuria in the A & As group(P < 0.001). When compared with the losartan results, proteinuria in the A & As group from week 16 to week 24 was significantly reduced(P < 0.001). Stable e GFRs and blood pressure were also observed in both groups. Medication side effects were minimal and non-fatal.CONCLUSION: For Chinese glomerulonephritis patients with stage 2 chronic kidney disease, therapy with A & As particles may provide effective anti-proteinuria treatment.
基金Supported by the National Natural Science Foundation of China(No.30801504,30901926,81100530,81070590)The Sci-tech Project of Shaanxi Province(No.2012K19-04-01)
文摘OBJECTIVE:To investigate the effects of artemisinin against proteinuria and glomerular filtration barrier damage in rats with adriamycin-induced nephropathy,and the potential mechanism underpinned the action.METHODS:Forty adriamycin rats were randomly divided into two groups with the ratio of 1︰3;the small-number group served as control group(n=10),and the rats in the large-number group were treated with adriamycin to induce nephropathy;then they were further randomly assigned into 3subgroups:benazepril group(n=10),artemisiningroup(n=10),and adriamycin group(n=10).The benazepril group and artemisinin group were treated with benazepril suspl(5.0 mg/kg daily)and artemisinin suspl(150 mg/kg daily)respectively after being modeled;those in the control group and adriamycin group were intragastrically administered an equivalent volume of distilled water every day.The treatment after model establishment lasted for a total of 4 weeks.The 24 h uric protein,blood biochemicals,renal pathological changes,renal ultrastrutural changes,Nephrin and Podocin proteins and gene expressions were measured by Coomassie brilliant blue assay,completely automatic biochemical analyzer,light microscope,electron microscopy,Western blot and reverse transcription polymerase chain reaction,respectively.RESULTS:The rats in adriamycin group showed a significant increase in 24 h uric protein excretion,serum total cholesterol(TC),triglyceride(TG),blood urea nitrogen(BUN),serum creatinine(Scr)and decrease in albumin(Alb)(P<0.05 or P<0.01).Compared with adriamycin group,artemisinin could reduce uric protein excretion,decrease the serum TC,TG elevation,increase the serum Alb level,up-regulate the expressions of Nephrin and Podocin(P<0.05 or P<0.01),but no statistical significance effects on the levels of BUN,Scr in artemisinin group(P>0.05).The renal pathological and ultrastrutural observation indicate that artemisinin could attenuate the severity of foot process effacement and fusion in the nephropathic rats.CONCLUSION:Artemisinin might have an effect on the nephropathy in rats caused by adriamycin,which may be at least partly correlated with attenu-ation of the severity of foot process effacement and fusion,up-regulation of the expressions of Nephrin and Podocin in the glomeruli in the rats.
基金the Local Government chairmen of Katsina-Ala and Buruku Areas and their respective education authorities for granting permission before commencement of the research
文摘Objective:To assess if microhaematuria and proleinuria as measured by reagent strips could estimate intensity of Schistosoma haematobium(S.haematobium) infection in endemic areas and evaluate their screening performance among children in Benue State,Nigeria.Methods:A lolal of 1124 urine samples were collected,screened for microhaematuria and proteinuria using reagent strips(Combi 9) and results were compared to filtration technique,the gold standard method.Results:A significant correlation was ohserved between microhaematuria(rho= 0.66. P【0.01).proteinuria(rho = 0.71.P【0.01) and intensity of.S.haematobium eggs.Proteinuria had sensitivity of 95.7%and specificity of 67.2%.while microhaematuria had sensitivity of 64.8%and specificity of 89.6%.The proportion of false positive diagnoses was higher in proleinuria(19.2%) than microliaematuria(6.0%).Conclusios:The findings suggest that use of urine reagent strips could potentially estimate intensity of.S.haematobium infection and their performance to screen urinary schistosomiasis agreed with previous observations.
基金supported by the Education Department of Shandong Province,China,No.J11LF21
文摘Objective To explore the relationship between HBV DNA and the clinical manifestations, pathological types, injury severity, and prognosis with HBV-GN. Methods 102 patients with HBV-GN were divided into 3 groups, according to the serum titer of the HBV DNA. 24-h urine protein excretion, and other parameters were measured. Renal biopsy were performed. The association between HBV DNA and the pathological stage of membranous nephropathy was analyzed in 78 patients with HBV-MN. 24-h urine protein excretion was used for the evaluation of the prognosis, and the relationship between HBV DNA and prognosis were analyzed. Results Several findings were demonstrated with the increase of serum HBV DNA： 24-h urine protein excretion, plasma cholesterol, and triglycerides increased significantly（P〈0.05）, while the plasma level of albumin decreased significantly（P〈0.05）; The changes of serum creatinine, C3 and C4 were found but no statistical significance. Glomerular deposition of HBVAg increased, and the pathological injury was more severe. The clinical remission rate was lower in the high replication group after treatment as compared with the low replication group（P〈0.01）. Conclusion With the increase of serum HBV DNA, the urine protein excretion and the kidney injury were more severe, and the clinical remission rate was decreased.
文摘Objective： To observe the podocyte injury in diabetic nephropathy （DN） patients by identifying the urinary podocytes and the situation of detached podocytes in glomeruli and to demonstrate the correlation between podocyte excretion and proteinuria, blood glucose, serum creatinine in different phases in DN patients. Methods： Urinary podocytes and the podocalyxin （PCX） expression state of podocytes in glomeruli were identified and observed by indirect immunofluorescent method. The DN patients were divided into three groups according to the volume of proteinuria, namely small, medium and large volume proteinuria groups. The podocytes in the urine of every group were calculated. The DN patients were divided into five groups according to the chronic kidney disease （CKD） phases, then the positive podocytes in urine were calculated. Meanwhile, the 24-hour protein in urine, fasting blood glucose （FBG） and the serum creatinine of DN patients were tested. The correlations among the proteinuria, serum creatinine, FBG and the number of positive podocytes in the urine of DN patients were statistically analyzed. Results： Urinary positive podocytes were found in 88% of the patients with DN, whereas podocytes were found in 0% of patients with minimal changed disease （MCD） and healthy cases. The expression of PCX was absent in DN patients. In contrast, PCX was expressed integrally in MCD patients. The positive podocytes was 1.49±0.95/ml in small-volume proteinuria group, 2.15±0.70/ml in the medium-volume proteinuria group, and 3.48±1.27/ml in the large-volume proteinuria group. There was no significant difference between the small- and medium- volume proteinuria groups, and there were significant differences between other groups （P〈0.05）. The positive podocyte number tended to increase as proteinuria was increased. By Pearson analysis, the correlation between podocyte number and proteinuria was podocytes in urine from different groups of DN patients, CKD pc I sitive statistically. The difference of the number of positive -V group was significant statistically. The correlation between serum creatinine of CKD Ⅰ -Ⅲ group and positive podocytes in urine was positive statistically. The correlation between serumcreatinine of CKD Ⅳ- Ⅴ group and positive podocytes in urine was not significant statistically. The correlation between FBG and positive podocytes in urine was not significant either. Conclusion： The mechanism of the podocyte injury in DN patients is present. The podocyte injury in DN may positively correlate to proteinuria and serum creatinine of CKD Ⅰ -ⅢDN patients, but not to the FBG and serum creatinine of CKD Ⅳ-Ⅴ patients.
文摘To study the relationship between serum vascular endothelial growth factor (VEGF) and proteinuria in adriamycin induced nephrotic rats, a rat model of adriamycin induced nephrotitis was developed by injection of adriamycin into a tail vein in a rat. At different time points, 24 h urinary protein excretion was measured by using Coomassie brilliant blue method and the serum VEGF levels detected by using ELISA assay. The interventional effect of VEGF on this model was observed. The results showed that: (1) The adriamycin induced nephrotic syndrome rat model was developed successfully; (2) Serum VEGF levels and proteinuria were significantly increased at 7th day after intravenous injection of adriamycin. There was a positive correlation between serum VEGF levels and 24 h urinary protein excretion ( r=0.67, P <0.05). (3) The 24 h urinary protein excretion was significantly increased in the rats receiving administration of VEGF ( P <0.05). It was concluded that VEGF might play an important role in the pathogenesis of proteinuria in adriamycin induced nephrotic rats.
文摘In human immunodef iciency virus(HIV)-infected people kidney disease is as an important cause of morbidity and mortality. Clinical features of kidney damage in HIV-infected patients range from asymptomatic microalbuminuria to nephrotic syndrome. The lack of specif ic clinical features despite the presence of heavy proteinuria may mask the renal involvement. Indeed, it is important in HIV patients to monitor renal function to early discover a possible kidney injury. After the introduction of antiretroviral therapy, mortality and morbidity associated to HIV-infection have shown a substantial reduction, although a variety of side effects for longterm use of highly active antiretroviral therapy, including renal toxicity, has emerged. Among more than 20 currently available antiretroviral agents, many of them can occasionally cause reversible or irreversible nephrotoxicity. At now, three antiretroviral agents, i.e., indinavir, atazanavir and tenofovir disoproxil fumarate have a well established association with direct nephrotoxicity. This review focuses on major causes of proteinuria and other pathological f indings related to kidney disease in HIV-infected children and adolescents.
文摘Tripterygium wilfordii (TW) was reported by LI Lei-shi, et al in 1981 to have marked effect in reducing proteinuria when it was used to treat glomerular nephritis, and the conclusion they worked out has been now accepted by most of nephrologists in 20-year experimental studies and wide application in clinical practice. Its mechanism, adverse reaction and mutagenesis effects, and dosage in clinical application in the recent years are now briefly reviewed in this paper.
文摘Controlling blood pressure and reducing proteinuria are common goals in Chronic Kidney Disease associated with hypertension and proteinuria and lead to fewer cardiovascular outcomes. This review summarizes the available literature.
基金Supported by The United States National Institutes of Health(Nos.DK34198 and DK07467)to Dr.CouserThe Don Jacquot Fellowship(Australian and New Zealand Society of Nephrology Travelling Fellowship)+3 种基金The BJ Amos Travelling Fellowships(Westmead Hospital)The Medical Research Fund of Western AustraliaThe Fremantle Hospital Medical Research FoundationThe National Health and Medical Research Council(No.230500)to Dr.Rangan
文摘AIM： To determine whether complement membrane attack complex （C5b-9） has a pathogenic role in tubuloin-terstitial injury in a renal disease model characterized by acute highly selective proteinuria. METHODS： Protein-overload nephropathy （PON） was induced in adult female Piebald-Viral-Glaxo rats with or without complement C6 defciency （C6- and C6＋） by daily intraperitoneal injections of bovine serum albumin （BSA, 2 g/d）, and examined on days 2, 4 and 8.RESULTS： Groups with PON developed equivalent levels of heavy proteinuria within 24 h of BSA injection. In C6＋ rats with PON, the tubulointerstitial expression of C5b-9 was increased and localized predominantly to the basolateral surface of tubular epithelial cells （TECs）, whereas it was undetectable in C6- animals. TEC proliferation （as assessed by the number of BrdU＋cells） increased by more than 50-fold in PON, peaking on day 2 and declining on days 4 to 8. There was a trend for a reduction in the number of BrdU＋ TECs on day 4 in the C6- PON group （ P = 0.10 compared to C6＋） but not at any other time-point. Kidney enlargement, TEC apoptosis （TUNEL＋ cells） and markers of tubular injury （tubule dilatation, loss of TEC height, protein cast formation） were not altered by C6 deficiency in PON. Interstitial monocyte （ED-1＋ cell） accumulation was partially reduced in C6- animals with PON on day 4 （ P = 0.01） but there was no change in myofbroblast accumulation. CONCLUSION： These data suggest that C5b-9 does not mediate tubulointerstitial injury in acute glomerular diseases characterized by selective proteinuria.
文摘Introduction: Early detection of proteinuria is early detection is a cost-effective method of assessing individuals with and without risk factors for chronic renal disease. Proteinuria is common in adults and may present a clinical challenge in the absence of obvious renal disease or risk factors especially in the tropics. Few studies in Nigeria have assessed the prevalence of proteinuria in adults using the dipstick method. The aim of this study was to document the prevalence of proteinuria among residents of a community in Enugu, south east Nigeria. Methods: This was a cross-sectional descriptive study carried out in an isolated urban slum settlement in Enugu, south east Nigeria. Dipstick testing of freshly voided early morning mid-stream urine samples was done to detect proteinuria. For database management and statistical analyses, SPSS version 23 was used. Results: A total of 262 individuals were recruited for the study, 165 (63%) females and 97 (37%) males. The participants’ age ranged from 18 to 90 years, averaging 43.7 ± 15.5. Trace amounts of protein were detected in urine samples of 225 (85.9%) individuals. Significant proteinuria was detected in 3.8% of the participants and was significantly higher 40 - 49-year-olds (6%). p = 0.02 and 0.02 respectively. Significant correlates of proteinuria were lower diastolic blood pressure and current tobacco use. Lower body mass index weakly correlated with proteinuria. Conclusion: The prevalence of significant early morning proteinuria in a community-based study in Enugu was 3.8%. Significant correlates of proteinuria included low diastolic blood pressure and tobacco use. Community based awareness programs targeted at prevention of chronic renal diseases should be incorporated in public health programs.
文摘Two pregnant women who initially developed proteinuria alone followed by serious preeclampsia are presented to emphasize that there is no adequate technical term to express the period of proteinuria alone based on the current criteria of pregnancy-induced hypertension. Case 1 exhibited a urinary protein concentration of 46 mg/dL in the absence of hypertension, and abdominal pain due to placental abruption with hypertension at gestational week (GW) 29–3/7 and 29–4/7, respectively. Case 2 exhibited a urinary protein/creatinine ratio of 2.67, developed hypertension, required cesarean section, and developed posterior reversible encephalopathy syndrome at GW 28–1/7, 29–6/7, and 32–0/7, and on postpartum day 2, respectively. As women with proteinuria alone are not diagnosed as having preeclampsia and as a diagnosis of gestational proteinuria can be made only at 12 weeks postpartum, a prospective technical term applicable to the condition of proteinuria alone is needed to increase physicians’ attention to this condition.
文摘Background: The prevalence of asymptomatic renal scarring, such as a focal segmental glomerulosclerosis (FSGS), was suggested to be high in women who develop preeclampsia. FSGS is a risk factor for endstage renal disease. Objective: To document preeclamptic women with proteinuria that developed eight weeks prior to hypertension with confirmed FSGS postpartum. Case: A 20-year-old nulliparous Japanese woman with a negative dipstick test result at gestational week (GW) 18 exhibited proteinuria 1+ on dipstick test at GW 22. Proteinuria determined from the random urine protein to creatinine ratio (P/Cr, g/g) was increased from 3.7 at GW 26 to 4.6 and 8.9 at GW 28 and 30, respectively. She developed hypertension (142/66 mmHg) at GW 30. Due to increased edema, emergency cesarean section was performed at GW 33. She gave birth to an otherwise healthy female small-for-gestational-age infant, weighing 1290 g. Postpartum course was uneventful except for persisting proteinuria: P/Cr of 9.8 just before delivery decreased to 3.6 and 1.7 on postpartum weeks 9 and 17, respectively. Renal biopsy on postpartum week 13 revealed FSGS in this patient. Conclusion: Hidden FSGS may have manifested as preeclampsia in this patient. This case highlighted the need to determine the prevalence of asymptomatic FSGS among women who later develop preeclampsia.
文摘Objectives: The objectives of this work were to calculate the frequency of arterial hypertension during pregnancy, describe the epidemiological profile, and identify the most common type of hypertension and to establish fetal prognosis based on uricemia and maternal proteinuria. Methodology: This was a six (6) month descriptive prospective study performed in the Obstetrics and Gynecology Department of Donka National Hospital-CHU Conakry. The study took place from july 1 st to December 31st, 2015. Results: The frequency of arterial hypertension during pregnancy was 8.82% in the service. The epidemiological profile was that of teenagers (32.8%), nulliparous (56%), coming from home (69.2%), not having performed CPN (52%), not schooled (68%) and housewives. The primary factor was the risk factor (52.4%). Gestational age greater than 37 was the most concerned (62%). The reasons for consultation are dominated by headache (76%) and vertigo (68%). The main type of hypertension was pre-eclampsia (48%) followed by Transient HTA (28%). The predominant clinical form during the admission was pre-eclampsia (47.2%) followed by eclampsia (23%). At the first minute, 35.68% of newborns had an APGAR score of less than 7 and the fifth 25.5% had a score of less than 7. Fetal morbidity was dominated by fetal hypotrophy (30.19%), followed by prematurity (23.92%). In 90.90% of hypotrophy, there are ?85.24% of premature babies, 95.55% of SFA, and 80% of MIU;the serum uric acid was greater than 350 mmol. We recorded 204 children born with mothgers with proteinuria greater than or equal to 30 mg/dl, or 80% of children. 30 cases of MFIU and 7 cases of neonatal death out of 255 births, that is 14.50% were noted. Conclusion: The detection of risk factors by a good prenatal follow-up and the regular training of the care providers for adequate and multidisciplinary care (obstetrician, intensive care nephrologist and pediatrician) of hypertensive pregnant women and their newborns can improve the maternal prognosis and fetal.
文摘Hypertension defined as a systolic blood pressure of ≥140 and a diastolic blood pressure ≥90 is anextremely prevalent condition;and it is responsible for significant mortality and morbidity. NHANESdata from 2005-2006 found that nearly 30% of adult US population has HTN;and nearly 8% of the population has undiagnosed HTN. HBP mortality in 2008 was 61,005. Any mentioned mortality in 2008 was 347,689 (NHLBI tabulation of NCHS mortality data). More than 20% of patients with systemic hypertension have chronic renal insufficiency (NHANES). Hypertensive nephropathy is a leading cause of end-stage renal disease (ESRD) requiring dialysis or transplantation or leading to death. The incidence of hypertension is high but only a subset of hypertensive patients progress to frank renal failure. A subset of hypertensive patients develop proteinuria during the course of disease and manifest nephrotic syndrome. This syndrome includes marked proteinuria, edema, and low serum albumin. Neither the incidence nor the clinical significance of proteinuria in hypertension without diabetes is known. Progression to chronic renal failure in some patients is preceded by proteinuria as indicated on “dip-stick” analyses of random urine samples. It appears that proteinuria is likely to increase both prior to and during evident loss of glomerular filtration, but this clinical observation has never been formally confirmed. There is a need for large studies to answer these questions. We also need to focus on the roles that genetic and environmental factors play in development and progression of renal disease in the setting of hypertension and proteinuria.
文摘<strong>Objective:</strong> <span style="font-family:;" "=""><span style="font-family:Verdana;">To determine the prevalence of proteinuria in children living with HIV (CLHIV) and identify associated factors. </span><b><span style="font-family:Verdana;">Patients and methods: </span></b><span style="font-family:Verdana;">This was a cross-sectional, descriptive and analytical study carried out from April to August 2017 in the HIV care centres in Brazzaville and Pointe-Noire. The study included CLHIV with dipstick urinalysis test “Combur</span><sup><span style="font-family:Verdana;">10</span></sup><span style="font-family:Verdana;"> Test</span><sup><span style="font-family:Verdana;">®</span></sup><span style="font-family:Verdana;"> M”. </span><b><span style="font-family:Verdana;">Re</span><span style="font-family:Verdana;">sults: </span></b><span style="font-family:Verdana;">Thirty seven CLHIV on HAART presented a proteinuria, 21.8%. Children were male gender in 21 case</span></span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> (56.8%) and female gender in 16 cases (43.2%). Mean age was 10.9 ± 3.9 years. The children were infected with type 1 virus in 35 cases (94.6%), vertical transmission in all the cases (100%). Children were living with HIV for about 2 to 4 years of average n = 18 (48.6%)</span><span style="font-family:;" "=""><span style="font-family:Verdana;"> and they were WHO clinical stage 2 in 18 cases (48.6%). 13 children (35%) had CD4 level < 200 cells/mm</span><sup><span style="font-family:Verdana;">3</span></sup><span style="font-family:Verdana;">. All CLHIV (100%) were on HAART thus 20 (37.7%) on the combination of zidovudine (AZT), lamivudine (3TC) and nevirapine (NVP). This combination AZT, 3TC, NVP was a protective factor regarding the occurrence of proteinuria (OR: 0.43;IC (95%). </span><b><span style="font-family:Verdana;">Conclusion: </span></b><span style="font-family:Verdana;">Proteinuria </span><span style="font-family:Verdana;">is less observe</span></span><span style="font-family:Verdana;">d</span><span style="font-family:Verdana;"> in CLHIV on HAART. Systematic screening and early management of proteinuria during follow</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">up of these children improve their survival</span><span style="font-family:Verdana;">.</span>
文摘 In the occurrence and development of glomerulonephritis, proteinuria is themain manifestation, which is easily recurrent but not easily got rid of in a short period of time. It may remain even after disappearance of the general symptoms. In some patients, there are no symptoms and signs at all in the initial stage, except proteinuria, the only distinct manifestation. Prof. Ye Chuanhui, from Chengdu University of Traditional Chinese Medicine, has accumulated rich experience for treating this disorder, which is introduced in the following.……
