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Proteinuria

Proteinurias


Presentation

  • This is the first case of a paraganglioma presenting with massive proteinuria in a child.[ncbi.nlm.nih.gov]
  • Case presentation We describe a 35-year-old man who was taking steroids and diuretics for relapse of minimal change disease who presented after a syncopal event. The patient was hypotensive and had distended neck veins.[ncbi.nlm.nih.gov]
  • A 35-year-old female presented to our clinic with history of small joint pain of 6 months duration. In addition she complained of pedal edema off and on for the last 12 years.[ncbi.nlm.nih.gov]
  • We present the case of a 7-year-old boy with an extremely rare atypical thymic carcinoid accompanied by nephrotic-range proteinuria as PNS. The kidney biopsy was consistent with minimal change disease (MCD).[ncbi.nlm.nih.gov]
  • A young middle-aged female with a long-standing history of diabetes presented to the hospital with worsening proteinuria in her second trimester of pregnancy.[ncbi.nlm.nih.gov]
Splenomegaly
  • The clinical course was marked by persistent fever for 2 months, pleural and pericardial effusion, splenomegaly, lymphadenopathy, pancytopenia, cardiac arrhythmias, multiple organ dysfunction, and proteinuria, with demise after a 2-month hospitalization[ncbi.nlm.nih.gov]
Respiratory Distress
  • Fetal growth restriction, respiratory distress syndrome and sepsis were observed as the level of proteinuria increased, but the result was not statistically significant.[ncbi.nlm.nih.gov]
  • Acute Respiratory Distress Syndrome (ARDS) has been reported rarely in pheochromocytoma, occurring spontaneously or after therapy with 131I-meta-iodobenzylguanidine (131I-MIBG).[ncbi.nlm.nih.gov]
Lymphadenopathy
  • Physical examination did not reveal any lymphadenopathy or lymph oedema. Urine tests revealed nephrotic range proteinuria. A 99m technetium sulphur colloid lymphoscintigraphy confirmed connection between lymphatic vessels and the urinary tract.[ncbi.nlm.nih.gov]
  • The clinical course was marked by persistent fever for 2 months, pleural and pericardial effusion, splenomegaly, lymphadenopathy, pancytopenia, cardiac arrhythmias, multiple organ dysfunction, and proteinuria, with demise after a 2-month hospitalization[ncbi.nlm.nih.gov]
Distended Neck Veins
  • The patient was hypotensive and had distended neck veins. The major laboratory findings were hypoalbuminemia with mild proteinuria.[ncbi.nlm.nih.gov]
Blurred Vision
  • vision, nocturia, edema, low backache, constipation, itchy skin ulcer, and chills.[ncbi.nlm.nih.gov]
Corneal Opacity
  • She had progressive renal dysfunction, proteinuria, corneal opacity, anemia and an abnormal lipid profile.[ncbi.nlm.nih.gov]
Bilateral Flank Pain
  • A 55-year-old man of Indian descent, presented to the emergency department with a 2-year history of passing 'milky' white urine, associated with dysuria, urinary retention, bilateral flank pain and 15 kg weight loss.[ncbi.nlm.nih.gov]

Workup

  • Her admission blood pressure was 193/108 mmHg, she had 8 g proteinuria, normal creatinine, and negative immunological and infectious workup.[ncbi.nlm.nih.gov]
  • This approach, however, is dependent on individual experience and not suitable for the routine workup of a large number of patients.[clinchem.aaccjnls.org]
  • It is associated with good long-term prognosis. [3, 4 , 5] Accompanying findings in patients with glomerular damage may include the following (see Workup ): Active urine sediment - Dysmorphic red blood cells and red cell casts Hypoalbuminemia Lipiduria[emedicine.medscape.com]
Pericardial Effusion
  • The clinical course was marked by persistent fever for 2 months, pleural and pericardial effusion, splenomegaly, lymphadenopathy, pancytopenia, cardiac arrhythmias, multiple organ dysfunction, and proteinuria, with demise after a 2-month hospitalization[ncbi.nlm.nih.gov]
Hypertriglyceridemia
  • Positive assay for Epstein-Barr virus (EBV), marked hyperferritinemia, hypofibrinogenemia, hypertriglyceridemia, elevated anti-nuclear antibody, proteinuria, and decreased circulating NK cells by flow cytometry were compatible with the diagnosis of HLH[ncbi.nlm.nih.gov]

Treatment

  • At the end of the study, 5 cases were lost to follow-up in the treatment group and 1 in the control group. Finally, the statistical data included 103 cases in the treatment group and 36 cases in the control group.[ncbi.nlm.nih.gov]
  • However, since both adverse events may preclude the continuation of treatment, their earlier management may be required.[ncbi.nlm.nih.gov]
  • After 5.5 years of fairly good tolerance of the treatment, proteinuria and painful crural ulcerations appeared.[ncbi.nlm.nih.gov]
  • Urinary protein excretion and renal function will be observed for 24 weeks after the treatment of LDL apheresis.[ncbi.nlm.nih.gov]
  • To study the response of lupus nephritis (LN) patients with persistent proteinuria ( 1 g/day after 6 months corticosteroid and single immunosuppressant treatment, or 3 g/day after 3 months of corticosteroid and single immunosuppressant treatment) to corticosteroid[ncbi.nlm.nih.gov]

Prognosis

  • Although various types of treatment for diabetes, hypertension and dyslipidemia have improved prognosis and quality of life in patients with diabetic nephropathy, there still exist some diabetic patients with severe proteinuria showing poor prognosis.[ncbi.nlm.nih.gov]
  • The study was designed to analyze prognosis of patients receiving liver transplantation as well as to determine predictive performance of perioperative proteinuria.[ncbi.nlm.nih.gov]
  • For diabetic patients, distinguishing nondiabetic renal disease (NDRD) from diabetic nephropathy (DN) is important in choosing treatment modalities and determining renal prognosis.[ncbi.nlm.nih.gov]
  • Mitochondrial nephropathy has a poor prognosis and often progresses to the end-stage renal disease. Renal pathology often is focal segmental glomerulosclerosis (FSGS) and does not respond to steroid therapy or immunosuppressive therapy.[ncbi.nlm.nih.gov]
  • While biomarkers of kidney damage increase during paraquat-induced acute kidney injury (AKI), significant concurrent proteinuria may alter diagnostic thresholds for diagnosis and prognosis to an unknown extent.[ncbi.nlm.nih.gov]

Etiology

  • The aim of this study was to evaluate prevalence, etiology, and outcome of proteinuria during the follow-up of children with renal transplantation.[ncbi.nlm.nih.gov]
  • Protein losses of over 2000mg/24 hours in adults and over 40 mg/24 hours in children usually indicates a glomerular etiology. Preeclampsia (toxemia of pregnancy) causes massive loss of protein in the urine.[rnceus.com]
  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]
  • Etiology Causes can be categorized by mechanism. The most common causes of proteinuria are glomerular disorders, typically manifesting as nephrotic syndrome (see Table: Causes of Proteinuria ).[msdmanuals.com]

Epidemiology

  • GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration equation based on serum creatinine, and RHF was defined as GFR 95th percentile adjusted for sex, age, body size, and diabetes and/or hypertension medication.[ncbi.nlm.nih.gov]
  • Risk factors for CVD were hypertension, diabetes mellitus, dyslipidaemia and the metabolic syndrome. eGFR was evaluated using the Chronic Kidney Disease Epidemiology Collaboration equation.[ncbi.nlm.nih.gov]
  • The volume will cover the epidemiological studies which show that albuminuria is a strong and independent marker of kidney disease progression and cardiovascular events, the molecular details of albumin handling in the kidney at the level of the glomerulus[books.google.ro]
  • Outcomes Reprinted by permission from Macmillan Publishers Ltd: Kidney International Supplements (vol 3, issue 1, January 2013), copyright 2013 In patients with advanced CKD, proteinuria is the strongest predictor of time to end-stage renal disease. [21] Epidemiology[online.epocrates.com]
  • Editors Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering Information All Issues Subjects All Subjects Arrhythmia and Electrophysiology Basic, Translational, and Clinical Research Critical Care and Resuscitation Epidemiology[hyper.ahajournals.org]
Sex distribution
Age distribution

Pathophysiology

  • This volume provides a comprehensive overview of the renal handling of albumin – from basic mechanisms to the pathophysiology of proteinuric diseases.[books.google.ro]
  • However, the pathophysiology of these associations is debated. In chronic kidney disease (CKD), phosphate retention participates in cardiovascular events and increased cardiovascular mortality.[ncbi.nlm.nih.gov]
  • Future studies are needed to better understand the pathophysiologic mechanisms underlying these associations.[ncbi.nlm.nih.gov]
  • There are three different pathophysiological mechanisms that may lead to proteinuria: damage to the glomeruli (glomerular), damage to the tubules (tubular), or overproduction of low-molecular-weight proteins (overflow).[amboss.com]
  • The pathophysiologic mechanisms of proteinuria can be classified as glomerular, tubular or overflow ( Table 2 7 ) .[aafp.org]

Prevention

  • This is a post hoc analysis of the renal substudy of the CSPPT (China Stroke Primary Prevention Trial).[ncbi.nlm.nih.gov]
  • All-cause mortality, a prespecified endpoint of the China Stroke Primary Prevention Trial, was the main outcome in this analysis.[ncbi.nlm.nih.gov]
  • Based on the cases we reported and from the literature, recognition of ADCK4 mutation through early and accurate genetic screening could be helpful in avoiding unnecessary toxicities and in preventing complications arising in mitochondrial nephropathy[ncbi.nlm.nih.gov]
  • Preventing and improving proteinuria may reduce psychological distress in patients with T2DM.[ncbi.nlm.nih.gov]
  • Prompt diagnosis and treatment is very crucial to prevent maternal complications.
.[ncbi.nlm.nih.gov]

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