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PubMed2001

[Heterogeneity of causes of proteinuria in patients with non-insulin dependent diabetes mellitus].

AIM: To make a retrospective clinicomorphological (autopsy) study of proteinuria causes. MATERIAL AND METHODS: The records have been analysed for 231 patients with non-insulin-dependent diabetes mellitus (NIDDM) over 60 years of age who died in a general hospital between 1990 and 1999. The choice of patients with diabetic nephropathy (DN) for a further morphological investigation was based on the presence of proteinuria (> 0.5 g/day), normal renal function. 72 patients met the above criteria. Of them 26 were women. RESULTS: Proteinuria occurred more frequently in men (63.4%). A morphological examination of the kidneys revealed diabetic glomerulosclerosis (diffuse and focal) in 48(67%) patients. In 24(33%) patients proteinuria resulted from non-diabetic affection of the kidneys: amyloidosis, atherosclerotic and/or hypertensive nephroangiosclerosis, membraneous and myelomic nephropathy, mesangioproliferative glomerulonephritis. Glomerular changes were not registered in 4 patients. 35(72%) DN patients had diabetic retinopathy which was not found in patients with non-diabetic renal affection. CONCLUSION: Diabetic retinopathy in patients with NIDDM and proteinuria allows to conclude that the latter is consequent to DN. The absence of diabetic retinopathy in such patients promotes a search for other causes of proteinuria.

Age Factors↗
PubMed2003

Plasma viscosity as a cardiovascular risk marker in patients with proteinuria.

Plasma viscosity is a major determinant of capillary blood flow. It has been suggested that alteration in plasma viscosity contributes to impaired blood flow and to increased cardiovascular risk. The aim of this study was to investigate the plasma viscosity levels and its possible role in the cardiovascular risk in patients with low grade nephrotic proteinuria. 20 patients with low-grade nephrotic proteinuria (mean age: 35+/-5 years) and 20 healthy controls (mean age: 33+/-4 years) were participated in the study. Plasma viscosity was measured by Harkness capillary viscometer. Biochemical analysis were measured by commercial enzymatic kits. Plasma viscosity, plasma levels of creatinine, fibrinogen and triglyceride were increased in patients with proteinuria than in the healthy controls (p<0.001, p<0.001, p<0.001, and p<0.001, respectively). The plasma levels of total protein and albumin were significantly lower in patients with low grade nephrotic proteinuria than in healthy controls (p<0.001 and p<0.001, respectively). Plasma viscosity was negatively correlated with plasma albumin (r= -0.835, p<0.001) and total protein (r= -0.862, p<0.001) in proteinuric patients. When the correlation analyses were performed a significant positive correlation was found between plasma viscosity and fibrinogen (r=0.636, p<0.001). In the stepwise multiple regression analysis plasma viscosity was found to be related with plasma total protein (t= -6.456, p<0.001) in the patients. When the stepwise multiple regression analysis were performed in healthy controls, the significant relationship was only found between plasma viscosity and fibrinogen (t= +2.202, p<0.01). These results suggested that altered plasma composition associated with low-grade nephrotic proteinuria may be involving the determination of plasma viscosity. Thus, the plasma viscosity in patients with low-grade nephrotic proteinuria may have a prognostic value in assessing cardiovascular risk in this group.

Adult↗
PubMed2004

[Angiotensin type 1 receptor blocker reduced proteinuria in patients of focal glomerular sclerosis].

We report three cases of focal glomerular sclerosis (FGS) with proteinuria that improved with the administration of angiotensin type 1 receptor blocker (ARB, losartan or valsartan). These three patients were a 41-year-old male (case 1), a 22-year-old male (case 2) and a 47-year-old male (case 3), who showed proteinuria, renal dysfunction, and hyperlipidemia. In case 1, proteinuria and renal dysfunction were improved by losartan administration and low protein diet therapy. In case 2, losartan with steroid and immunosuppressant led to the complete remission of proteinuria, improvement of renal dysfunction and reduction of the glomerular injury score from repeat biopsy specimen by approximately 20%. In case 3, proteinuria was reduced by valsartan administration with steroid and immunosuppressant therapy. ARB treatment with steroid and immunosuppressant might be more effective on the reduction of proteinuria in FGS patients.

Adult↗
PubMed2004

Relationship between predicted creatinine clearance and proteinuria and the risk of developing ESRD in Okinawa, Japan.

BACKGROUND: Chronic kidney disease and a low creatinine clearance (CrCl) are relatively common, particularly in the aged population. However, the renal outcome of a low CrCl is not known. METHODS: Participants in a 1993 mass screening conducted by the Okinawa General Health Maintenance Association in Okinawa, Japan, were investigated. A total of 95,255 subjects (40,157 men, 55,098 women) older than 20 years for whom serum creatinine (SCr) data were available were studied. CrCl was calculated as a surrogate marker of glomerular filtration rate by using the Cockcroft-Gault method. All dialysis patients who were treated in Okinawa were independently registered in the Okinawa Dialysis Study registry. Participants in the 1993 screening who later entered a dialysis program were identified by using the 2 computer registries. The cumulative incidence of end-stage renal disease (ESRD) was calculated according to baseline CrCl level in quartiles. The significance of CrCl for the risk for developing ESRD was evaluated by means of Cox analysis after adjusting for age, sex, blood pressure, and proteinuria. RESULTS: CrCl values were distributed into quartiles: CrCl I, less than 50.2 mL/min (<0.84 mL/s; n = 23,076); CrCl II, 50.2 to 63.9 mL/min (0.84 to 1.07 mL/s; n = 23,039); CrCl III, 64.0 to 79.3 mL/min (1.07 to 1.32 mL/s; n = 23,147); and CrCl IV, 79.4 mL/min or greater (> or =1.32 mL/s; n = 23,036). One hundred eighty-one subjects with data for SCr level were identified in the dialysis registry. Seven-year cumulative incidences of ESRD per 1,000 subjects were 86.8 in CrCl I, 13.6 in CrCl II, 8.3 in CrCl III, and 7.9 in CrCl IV in patients who had proteinuria, whereas they were 1.2, 0.7, 0.04, and 0.13 in those who did not have proteinuria, respectively. As CrCl category decreased, the adjusted hazard ratio for the risk of developing ESRD was 4.353 (95% confidence interval, 3.412 to 5.553; P < 0.0001). CONCLUSION: The prevalence of a low CrCl (CrCl I, <50.2 mL/min [<0.84 mL/s]) was relatively high in the elderly population. Subjects with a low CrCl who had proteinuria were at high risk of developing ESRD. However, the cumulative incidence of ESRD was not as high in patients with a low CrCl not associated with proteinuria. Screening by means of dipstick for proteinuria is useful, particularly among the elderly, to identify subjects in a high-risk population.

Adult↗
PubMed2005

Randomized, controlled study of the effects of losartan versus enalapril in small doses on proteinuria and tubular injury in primary glomerulonephritis.

BACKGROUND: Pharmacological blockade of the renin-angiotensin-aldosteron system ameliorates glomerular and tubulointerstitial damage. For optimal renoprotection, high doses of angiotensin II converting enzyme inhibitors and angiotensin II subtype 1 receptor antagonists are commonly recommended, but cannot always be administered. The aim of this study was to evaluate the effects of low-dose (25 mg) losartan on proteinuria and tubular injury extent. MATERIAL/METHODS: This was an open, randomized, 12-month study on the effects of 25 mg of losartan (n=19) vs. 10 mg of enalapril (n=14) as a control on proteinuria, urinary excretion of N-acetyl-beta-D-glucosaminidase (NAG), and blood pressure in patients with primary glomerulonephritis. The second part of the study was an uncontrolled assessment of the renal effects of 50-mg administration of losartan. RESULTS: There were no significant differences between the groups in the effects on proteinuria and NAG excretion. Losartan and enalapril reduced proteinuria by 32.8% (p<0.029) and 40.9% (p<0.021), respectively, but did not affect NAG excretion. The antiproteinuric effect of losartan, achieved without changes in blood pressure, was particularly evident in subjects with proteinuria >1.5 g/24 h and normal blood pressure. 50 mg of losartan caused a significant decrease in NAG excretion vs. the baseline (p<0.027). CONCLUSIONS: 25 mg of losartan and 10 mg of enalapril equally reduce proteinuria. The significant antiproteinuric effect of losartan was achieved despite no changes in blood pressure. There were no differences between the drugs regarding their influence on tubular injury extent. 50 mg of losartan seems to be the minimal dose to improve tubular status.

Adult↗
PubMed1991

The effect of enalapril on nephrotic proteinuria and determination of serum angiotensin-converting enzyme before and after treatment.

In order to evaluate the effect of an ACE-inhibitor (enalapril) on nephrotic proteinuria in patients with primitive nephropathies, to determine the SACE before and after treatment and to compare the variation of SACE levels with the variations of proteinuria, seventeen patients were studied (5 F, 12 M) aged between 10 and 68 years. All patients were evaluated in basal conditions for creatinine clearance, protidaemia, proteinuria, SACE and serum electrolytes. All but one patient had a renal biopsy. After basal evaluation nine patients received enalapril, 10 mg/die, for two weeks. After one week SACE levels were re-evaluated, while the proteinuria was re-evaluated several times during the two weeks of treatment. The results obtained suggest (1) SACE levels are significantly higher in patients with nephrotic syndrome than in normal patients (21.14 +/- 8.37 nmol/ml/min; N.V.:15.60 +/- 4.73; M +/- s.d.; p less than 0.01); (2) proteinuria is unresponsive to the ACE-inhibitor action (varied from 8.00 +/- 2.70 g/24 h to 7.74 +/- 3.19 g/24 h, p = NS); (3) no correlation exists between the reduction of SACE levels and variations of proteinuria.

Adolescent↗
PubMed2006

Alternate evaluations of proteinuria in the gravid hypertensive patient.

OBJECTIVE: To determine if the 12-hour urine total protein value correlates with the 24-hour value and to evaluate the random protein:creatinine ratio as a predictor of significant proteinuria (> or = 300 mg/24 h) for use in diagnosing preeclampsia. STUDY DESIGN: The study population included 15 patients with hypertensive disorders of pregnancy. The patients' urine was collected over 24 hours in 2 12-hour aliquots. The urine volume, total protein and creatinine were measured. The patients' initial voids were collected and evaluated for random urine protein and creatinine and calculation of the protein:creatinine ratio. The protein:creatinine ratio and 12-hour results were compared to the 24-hour results using simple regression analysis. RESULTS: Of the 15 patients, 6 had no proteinuria, 5 had mild proteinuria, and 4 had severe proteinuria (60% with significant proteinuria). The 12-hour protein results correlated with the 24-hour results for patients with mild disease (p = 0.00007, first 12 hours, and p = 0.012, second 12 hours) and severe disease (p = 0.014 and p = 0.007). The results for no disease were mixed: for the first 12 hours there was a poor correlation, but the results for the second 12 hours correlated well. The protein:creatinine ratio had a significant correlation (p = 0.02), using a cutoff of 0.15, returned specificity of 50%, sensitivity of 100%, positive predictive value of 75% and negative predictive value of 100%. CONCLUSION: Total protein values for 12- and 24-hour urine samples correlate well for the diagnosis of preeclampsia. A protein:creatinine ratio of < or = 0.15 rules out significant proteinuria. In combination, these 2 tests may allow more rapid diagnosis of preeclampsia.

Adult↗
PubMed2006

Clinical implications of proteinuria.

Proteinuria has long been considered a marker for renal disease. New observations are suggesting that proteinuria is also a risk factor for other outcomes as well, such as cardiac events and stroke. This article will review a recommended strategy for proteinuria detection and the associations of proteinuria with the progression of renal disease and cardiovascular disease. It will also review the significance of the development of proteinuria in the elderly population and discuss other common causes of proteinuria apart from those secondary to diabetes and hypertension.

Aged↗
PubMed2006

Renal biopsy in lupus patients with low levels of proteinuria.

OBJECTIVE: Early and accurate detection of kidney involvement in systemic lupus erythematosus (SLE) improves outcomes. Renal biopsy is required for definitive diagnosis of lupus nephritis (LN). In the absence of acute renal failure (ARF), moderate levels of proteinuria (> 1000 mg/24 h) have been recommended by some to justify biopsy. We investigated whether patients with lower levels of proteinuria without ARF have significant renal disease and should be routinely biopsied. METHODS: We retrospectively evaluated 21 SLE patients with 24-h urine protein < 1000 mg who underwent kidney biopsies. Indications for biopsy included new-onset proteinuria, increasing proteinuria, or hematuria (> 5 red blood cells per high power field). No patient had ARF. RESULTS: Sixteen of 21 (77%) biopsies were diagnostic of LN: 3 class II, 10 class III (5 superimposed class V), 2 class IV (one superimposed class V), and one with class V. One patient had thrombotic microangiopathy. The remaining 4 (23%) patients had non-lupus renal disease. Thirteen patients with class III or greater LN required alterations in therapeutic regimen because of biopsy findings. Of 7 patients without hematuria at the time of biopsy, 4 (57%) had class III, IV, or V LN. One patient without hematuria and < 500 mg/24 h proteinuria had class III LN. CONCLUSION: We found significant renal involvement (Class III, IV, or V LN) in SLE patients with < 1000 mg proteinuria with or without hematuria. Our findings suggest that biopsy be strongly considered in this patient population.

Adolescent↗
PubMed2006

[Effects of multi-glycoside of Tripterygium wilfordii Hook. f. on proteinuria and expression of slit diaphragm-associated molecules in rats with anti-thy1.1 glomerulonephritis].

OBJECTIVE: To examine the effect of multi-glycoside of Tripterygium wilfordii Hook. f. (GTW) on proteinuria and expression of slit diaphragm-associated molecules such as nephrin and podocin in glomerulonephritis induced by anti-Thy1.1 antibody (anti-Thy1 . 1 GN). METHODS: Anti-Thy1.1 GN was induced in rats by a single intravenous injection with 500 microg of anti-Thy1.1 mAb 1-22-3. Fourteen rats were randomly divided into 2 groups, the GTW-treated group and vehicle treated group, and sacrificed on day 14 in Experiment 1 or on day 7 in Experiment 2 after induction of Anti-Thy1.1 GN. Daily oral administration of GTW and vehicle as a control was started from 3 days before injection or at the same time of injection to the day of sacrifice in Experiment 1 or 2. Proteinuria was determined during 14 days in Experiment 1 or during 7 days in Experiment 2. From kidneys taken at sacrifice, glomerular morphological changes, glomerular macrophage infiltration, glomerular expression of nephrin and podocin, and its mRNA expression in renal tissue were examined. RESULTS: In Experiment 1, proteinuria and mesangial matrix expansion were significantly attenuated by GTW treatment. No difference in staining intensity of nephrin and podocin in glomeruli was observed between GTW treated group and vehicle treated group on day 14. In Experiment 2, GTW treatment significantly ameliorated proteinuria, mesangial injury and activated macrophage infiltration in glomerulus. In addition, it significantly increased the expression of nephrin and podocin and its mRNA expression in glomeruli on day 7. CONCLUSION: In anti-Thy1.1 GN, the reduced expression of nephrin and podocin may contribute to the development of mesangial injury and proteinuria. The findings suggest that GTW ameliorates not only proteinuria but also mesangial lesions in anti-Thy1 . 1 GN most likely by increasing the expression of nephrin and podocin.

Animals↗
PubMed2002

Prevalence of proteinuria and its clinical implications in type 2 diabetic patients treated at a primary health care centre in Abha City.

The aim of the present study is to describe the prevalence of proteinuria in a series of type 2 diabetic patients registered and followed up in the diabetes clinic of a primary health care center (PHCC) in Abha city, southern Saudi Arabia and to relate the proteinuria to some clinical manifestations. The study involved the files of 208 diabetic patients (118 females and 90 males). They were chosen from 475 files of diabetic patients receiving care in the PHC center of Shamasan in Abha City. The selection was based on the fulfillment of certain criteria: type 2 diabetic patients, registered for at least 12 months and visited the clinic for at least once during that period. For each patient the diabetes duration, the last readings of fasting blood sugar, total cholesterol level, were used. Proteinuria was considered whenever the last and any of the preceding 3 urine analysis revealed it by the dipstick test. Proteinuria is present in more than half the patients (54.3%). The fasting blood sugar shows a considerably high mean of 218.0 +/- 72.0 mg/dl. The total cholesterol level on the other hand showed a slight high average of 233.7 +/- 55.2 mg/dl. The results of the three different types of compliance as scored by the treating physician showed that the poor scores dominate with 74%, 82.7% and 78.4% of patients' diet, drug and appointment compliances. The outcome of the logistic regression model for proteinuria showed that the significant factors were the poor glycemic control with an odds ratio (OR) of 3.13, diabetes duration (OR = 1.08 for every year) and diastolic blood pressure (OR = 6.11). Diabetic patients treated in the PHC level should be regularly monitored for microalbuminuria and not gross proteinuria to prevent progression to overt nephropathy which will eventually lead to ESRD. The risk increases with poorly controlled and hypertensive patients.

Aged↗
PubMed1991

[Proteinuria selectivity index: prognostic value in idiopathic nephrotic syndromes].

In INS, the histological appearance constitutes a classical prognostic element: minimal-change nephropathy (MCN) responds better to treatment than focal glomerulosclerosis (FGS) or IgM nephropathy (IgMN). However, this criterion is not consistent. We evaluated the prognostic value of the proteinuria selectivity index (SI): the ratio of IgG clearance to transferrin (Tf) clearance. Proteinuria was selective for an SI less than or equal to 0.01. In the 39 MCN, the SI ranged from 0.01 to 0.39 (median 0.10) and proteinuria was selective in 21 cases. In the 13 FGS and IgMN, the SI varied from 0.05 to 0.40 (median 0.22) and proteinuria was selective in 1 case (p less than 0.01 between these two groups). The SI ranged from 0.01 to 0.17 (median 0.07) for the 25 corticosensitive (CS) forms and from 0.08 to 0.40 (median 0.20) for the 27 corticoresistant (CR) ones (p less than 0.001). Twenty-four of the 30 MCN patients and 19 of 22 cases of selective proteinuria were CS. Multivariant analysis enabled the identification of variables predictive of the response to steroids. Age, sex and level of proteinuria had no such value. The predictive value of the SI was greater than that of the histological appearance (McFadden's R-square, 47 versus 22%, p less than 0.001). When the histological aspect was known, the SI provided additional precision, but the reverse situation was not true. The predictive curve of CS as a function of the SI was sigmoidal, therefore reflecting a homogeneous distribution, despite their different histological types.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[The effect of captopril on proteinuria in glomerular diseases].

We evaluated the efficacy of an ACE inhibitor captopril (CAP) for the reduction of proteinuria in glomerular diseases, and tried to find the conditions in which urinary protein excretion was significantly decreased by this drug. Renin provocation test by CAP (C-test) was performed, and the result was compared to the effect on proteinuria. In 33 patients with proteinuria, ranging from 1.1 to 14.1 g/day, CAP was administered. Urinary protein excretion was reduced from 3.6 +/- 0.6 to 2.8 +/- 0.4 g/day (mean +/- SEM, p less than 0.01) after 2 weeks. The decrease in urinary protein was significant when renal function was moderately impaired (30 less than or equal to Ccr less than 60 ml/min) or patients were on a salt diet less than 7 g of NaCl daily. Reduction of urinary protein excretion by 2-week treatment of CAP was correlated with the result of C-test (r = 0.874, p less than 0.025). The long-term follow up for more than 6 months also suggested that CAP delayed the deterioration of renal function. Thus, CAP was proved effective in treating proteinuria, and C-test might give us an information of its proteinuria-suppressing effect in an individual case. But its efficacy was observed only in patients with moderately-reduced renal function or on low-salt diet. Therefore, we should select the cases carefully to expect the effect of CAP for the reduction of proteinuria.

Adult↗
PubMedDate not supplied

[Proteinuria after infusion of gelatin. Comparison of Plasmion and Haemaccel].

Modified gelatin are said without deleterious effect on kidney, an important proteinuria as been seen however in surgical patients after gelatin perfusion. A study in 15 patients scheduled for abdominal surgery compared the renal effects of two modified gelatin: Plasmion (gr P) and Haemaccel (gr H) administered in a similar manner. In the two groups proteinuria appears as soon as perfusion begins with at the third hour a peak which may be as high as 6 g/l. In the same time low molecular weight proteinuria (less than 30 kdalton) appears. The beta 2 microglobulinuria (beta 2m) is significatively enhanced (p less than 0,001). Albuminuria is also enhanced but without statistic signification. Comparison between the two groups reveals that in gr P proteinuria is of the same importance, but delayed, with a significatively smaller elimination of beta 2m (1,8 mg/mmol creatininuria versus 8,6,p less than 0,001). Enzymuria increases in a variable fashion. Proteinuria is probably due to tubular reabsorption inhibition of filtered protein induced by gelatin, particularly by amino acids arginine and lysin which become free after gelatin hydrolysis. If this phenomenon is pathologic or not is unclear and gelatin cannot be said absolutely innocuous. However this phenomenon must be known when proteinuria specially beta 2m is to be interpreted.

Aged↗
PubMed1989

Glomerular epithelial detachment, not reduced charge density, correlates with proteinuria in adriamycin and puromycin nephrosis.

To identify the structural change coincident with increased glomerular permeability in both adriamycin (ADR) and puromycin-aminonucleoside (PAN) nephrosis, we explored the temporal correlation between developing proteinuria, the reduction in glomerular polyanions, and the detachment of epithelium from glomerular basement membrane (GBM). Sprague-Dawley rats received a single tail-vein injection of PAN (150 mg/kg), ADR (7.5 mg/kg) or saline. Nephrotic-range proteinuria appeared between days 2 to 5 in the PAN-treated and days 5 to 10 in the ADR-treated rats. The GBM heparan sulfate charge density and epithelial membrane sialic acid (SA) content were determined before, during and after the rise in proteinuria. Polyethyleneimine was used to detect heparan sulfate and the number staining of renal cortical slices was used to detect heparin sulfate and the number of sites/microns GBM in the lamina rara externa were counted on electron micrographs (magnification x60,000). Controls had a regular distribution of polyethyleneimine 20.19 +/- 1.72 sites/microns (X + SD). In ADR rats, the polyethyleneimine density decreased by day 5, 18.61 +/- 1.79 sites/microns (p less than 0.05) which persisted to day 15, 17.38 +/- 1.27 sites/microns (p less than 0.02). PAN rats, by day 1, had significant reduction, 14.94 +/- 1.47 sites/microns (p less than 0.05), which persisted to day 20. The total membrane-bound SA content of isolated glomeruli was analyzed with a modified Warren's method. The SA content in control glomeruli was 46.8 +/- 8.0 nmol/mg glomerular protein (X +/- SD). In ADR rats, there was significant decrease in SA content to 84 +/- 3% of control (p less than 0.01) at day 15. In PAN rats, by day 2, the SA content was decreased to 73 +/- 18% of control (p less than 0.05). In both models, scanning and transmission electron microscopy revealed epithelial foot process fusion, loss of slit diaphragms, and vacuolization before increased proteinuria. Epithelial detachment from the GBM and rupture of vacuoles occurred coincidently with rapid development of nephrotic proteinuria in both models. In summary, reduced GBM heparan sulfate and epithelial SA content do not correlate with the onset of altered glomerular permeability, whereas epithelial detachment is coincident with the development of massive proteinuria in both ADR and PAN nephrosis.

Animals↗
PubMed1989

[Proteinuria in normal pregnancy and in EPH gestosis].

EPH-gestosis (pre-eclampsia-eclampsia) characterized by edema, proteinuria and hypertension occurs primarily in the nullipara, usually after the 20th gestational week. As in normal pregnancy there is striking change in both renal blood flow and glomerular filtration rate a slight increase in urinary protein secretion is not considered abnormal until it exceeds 300 mg/day. Abnormal proteinuria commonly accompanies pre-eclampsia and may be minimal, moderate or severe (even exceeding greater than 25 g/l). Proteinuria was typed mainly of nonselective glomerular origin by using the SDS-disc-electrophoresis. Additionally the clearance ratio of IgG to transferrin in all patients with abnormal proteinuria was evaluated. In none of the patients studied the ratio was less than 0.1 (highly selective). As severe proteinuria is associated with fetal growth retardation, preterm deliveries and prenatal mortality the quantitation and typing of early proteinuria is essential for considering patients who are at risk for developing EPH-gestosis.

Adolescent↗
PubMed1985

Adriamycin-induced chronic proteinuria: a structural and functional study.

Focal, segmental glomerulosclerosis is frequently associated with chronic proteinuria and progressively declining renal function in humans as well as in experimental models of glomerular disease. Although little is known regarding the pathogenesis of this lesion, persistent, massive proteinuria has been associated with a poor prognosis. The administration of adriamycin to rats results in proteinuria of glomerular origin. We used this model to study the glomerular functional and structural alterations associated with proteinuria of 4 to 5 weeks duration. Studies of single nephron function revealed a 34% reduction in nephron plasma flow and a 50% decline in the glomerular ultrafiltration coefficient in rats given adriamycin. Single nephron glomerular filtration rate, however, was only modestly reduced (27%), because of an 8.0 mm Hg elevation of mean transcapillary hydraulic pressure difference (P less than 0.05). Morphologically, glomeruli of adriamycin-treated rats demonstrated significantly increased mesangial matrix and cellularity. In addition, glomerular capillaries frequently appeared enlarged, and epithelial cell bleb formation was evident. Focal glomerulosclerosis, however, was only rarely seen. The functional and morphologic characteristics of chronic adriamycin nephrosis are different from those associated with chronic proteinuria induced by repetitive administration of aminonucleoside of puromycin. Comparison of the two models suggests that the development of focal glomerulosclerosis can be dissociated from proteinuria and elevations of intraglomerular hydraulic pressures.

Animals↗
PubMed1983

Frequency of haematuria and proteinuria among Schistosoma haematobium infected children of two communities from Liberia and Tanzania.

The frequencies of haematuria and proteinuria among children of two rural communities with different Schistosoma haematobium endemicity from Liberia and Tanzania were compared. Although the prevalence and intensity of S. haematobium infections were lower in the Tanzanian community, the frequencies of haematuria and proteinuria were significantly higher when compared to the Liberian community. The semi-quantitative dip stick tests for haematuria and proteinuria showed a comparable, good specificity (haematuria 85%, proteinuria 80%), but a community-specific sensitivity. The dip stick test for haematuria detected 85% (proteinuria 82%) of all S. haematobium infected subjects in Tanzania compared to 68% (proteinuria 57%) in Liberia. The significance of these observations in relation to S. haematobium related morbidity is discussed.

Adolescent↗