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chronic proteinuria

Kwame Yeboah, Eric Kyei-Baafour, Daniel A Antwi, Henry Asare-Anane, Ben Gyan, Albert G B Amoah
BACKGROUND: Impaired angiogenesis is amongst the underlining mechanisms of organ damage in diabetes and hypertensive patients. In diabetes and hypertensive patients without proteinuria and overt CVDs, we studied the levels of angiogenic growth factors, angiopoietin (Ang)-1, Ang-2 and vascular endothelial growth factor (VEGF), and the relationship between these angiogenic growth factors and renal function, measured as estimated glomerular filtration rate (eGFR). METHOD: In a case control design, 107 type 2 diabetes (T2DM) patients and 93 non-diabetes controls were recruited into the study...
2016: Journal of Diabetes and Metabolic Disorders
William E Haley, Felicity T Enders, Lisa E Vaughan, Ramila A Mehta, Maxton E Thoman, Terri J Vrtiska, Amy E Krambeck, John C Lieske, Andrew D Rule
OBJECTIVE: To determine whether there is a persistent decline in kidney function after the first kidney stone event. PATIENT AND METHODS: Incident symptomatic stone formers and age- and sex-matched controls underwent 2 study visits 90 days apart to assess kidney function, complete a survey, and have their medical records reviewed. Kidney function was compared between stone formers and controls adjusting for clinical, blood, and urine risk factors. RESULTS: There were 384 stone formers and 457 controls...
October 21, 2016: Mayo Clinic Proceedings
Giorgina B Piccoli, Federica Ventrella, Irene Capizzi, Federica N Vigotti, Elena Mongilardi, Giorgio Grassi, Valentina Loi, Gianfranca Cabiddu, Paolo Avagnina, Elisabetta Versino
Low-protein diets (LPDs) are often considered as contraindicated in diabetic patients, and are seldom studied. The aim of this observational study was to provide new data on this issue. It involved 149 diabetic and 300 non-diabetic patients who followed a LPD, with a personalized approach aimed at moderate protein restriction (0.6 g/day). Survival analysis was performed according to Kaplan-Meier, and multivariate analysis with Cox model. Diabetic versus non-diabetic patients were of similar age (median 70 years) and creatinine levels at the start of the diet (2...
October 21, 2016: Nutrients
Magnolia Cardona-Morrell, Amanda Chapman, Robin M Turner, Ebony Lewis, Blanca Gallego-Luxan, Michael Parr, Ken Hillman
AIM: To investigate associations between clinical parameters - beyond the evident physiological deterioration and limitations of medical treatment - with in-hospital death for patients receiving Rapid Response System (RRS) attendances. METHODS: Retrospective case-control analysis of clinical parameters for 328 patients aged 60 years and above at their last RRS call during admission to a single teaching hospital in the 2012-2013 calendar years. Generalised estimating equation modelling was used to compare the deceased with a randomly selected sample of those who had RRS calls and survived admission (controls), matched by age group, sex, and hospital ward...
October 18, 2016: Resuscitation
Taner Basturk, Ozlem Sari, Yener Koc, Nezaket Eren, Mahmoud Isleem, Ekrem Kara, Mustafa Sevinc, Tamer Sakaci, Elbis Ahbap, Nuri B Hasbal, Feyza B Caglayan, Abdulkadir Unsal
BACKGROUND: Neutrophilgelatinase-associated lipocalin (NGAL) has been proven to be a useful biomarker for early detection of acute kidney injury, but it is not known whether adding NGAL measurements to conventional risk factors will improve the risk assessment in the setting of chronic kidney disease (CKD). The aim of the present study was to examine the correlation of NGAL with early stage renal impairment in CKD and to evaluate its prognostic value in these subjects. METHODS: This is a prospective observational cohort study of 54 patients with early stage (stage 1-2) CKD...
October 21, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
N Gopalakrishnan, R Arul, J Dhanapriya, T Dinesh Kumar, R Sakthirajan, T Balasubramaniyan
Familial lecithin-cholesterol acyltransferase (LCAT) deficiency is a rare autosomal recessive (AR) disease caused by mutation in the LCAT gene. LCAT enzyme esterifies cholesterol molecules in high-density lipoprotein(HDL) and low density-lipoprotein (LDL) particles. This enzyme deficiency is characterised by progressive corneal opacification, glomerulopathy, mild - moderate haemolytic anaemia and very low plasma levels of HDL. We here report a 34 year-old lady who presented with hypertension, nephrotic proteinuria, renal failure, corneal ring opacities, anemia and dyslipidemia...
October 2016: Journal of the Association of Physicians of India
Birong Li, Babitha Haridas, Ashley R Jackson, Hanna Cortado, Nicholas Mayne, Rebecca Kohnken, Brad Bolon, Kirk M McHugh, Andrew L Schwaderer, John D Spencer, Christina B Ching, David S Hains, Sheryl S Justice, Santiago Partida-Sanchez, Brian Becknell
Acquired renal scarring occurs in a subset of patients following febrile urinary tract infections and is associated with hypertension, proteinuria, and chronic kidney disease. Limited knowledge of histopathology, immune cell recruitment and gene expression changes during pyelonephritis restricts the development of therapies to limit renal scarring. Here, we address this knowledge gap using immunocompetent mice with vesicoureteral reflux. Transurethral inoculation of uropathogenic Escherichia coli in C3H/HeOuJ mice leads to renal mucosal injury, tubulointerstitial nephritis, and cortical fibrosis...
October 19, 2016: American Journal of Physiology. Renal Physiology
Mengjing Wang, Jason Chou, Yongen Chang, Wei L Lau, Uttam Reddy, Connie M Rhee, Jing Chen, Chuanming Hao, Kamyar Kalantar-Zadeh
In the management of patients with chronic kidney diseases (CKD), a low-protein diet usually refers to a diet with protein intake of 0.6 to 0.8 grams per kilogram of body weight per day (g/kg/day) and should include at least 50% high-biologic-value protein. It may be supplemented with essential acids or nitrogen- free ketoanalogues if <0.6 g/kg/d. Low-protein diet can reduce proteinuria especially in non-diabetic CKD patients. In hypoalbuminemic patients it may lead to an increase in serum albumin level...
October 19, 2016: Panminerva Medica
Sybille Koehler, Sebastian Brähler, Alexander Kuczkowski, Julia Binz, Matthias J Hackl, Henning Hagmann, Martin Höhne, Merly C Vogt, Claudia M Wunderlich, F Thomas Wunderlich, Frank Schweda, Bernhard Schermer, Thomas Benzing, Paul T Brinkkoetter
Chronic alterations in calcium (Ca(2+)) signalling in podocytes have been shown to cause proteinuria and progressive glomerular diseases. However, it is unclear whether short Ca(2+) peaks influence glomerular biology and cause podocyte injury. Here we generated a DREADD (Designer Receptor Exclusively Activated by a Designer Drug) knock-in mouse line to manipulate intracellular Ca(2+) levels. By mating to a podocyte-specific Cre driver we are able to investigate the impact of Ca(2+) peaks on podocyte biology in living animals...
October 19, 2016: Scientific Reports
Qing-Chun Cai, Shu-Qi Zhao, Tong-Dong Shi, Hong Ren
PURPOSE: To evaluate the association of Chronic hepatitis B virus (HBV) infection and chronic kidney disease (CKD). METHODS: We searched Embase, Grateful Med, Ovid, PubMed, and the China Biological Medicine Database. A meta-analysis was performed to assess whether HBV infection plays an independent impact on the development of CKD in the general population. Relative risks of CKD (defined as reduced glomerular filtration rate or proteinuria) according to HBsAg serologic status were studied...
October 18, 2016: Renal Failure
Jongha Park
Cardiovascular (CV) risk assessment is not easy in chronic kidney disease (CKD) patients. Age, male sex, race, family history of CV disease, smoking status and diabetes should be considered as CV risk factors as the general population. It is also accepted that hypertension (HTN) is associated with the greater risk of CV complications in this population. However, there are some concerns in this issue.First, supporting evidence for specific blood pressure (BP) targets in CKD is scarce. Many observational studies reported a J-shaped association between BP level and CV mortality unlike a linear association in the general population...
September 2016: Journal of Hypertension
Daniel W Jones
Hypertension and Chronic Kidney Disease are both common. The vast majority of patients with chronic kidney disease (CKD) have hypertension. Hypertension can be both a cause and a result of CKD. Many patients with CKD, both diabetic and non-diabetic have overt proteinuria (>300 mg/day). Patients with proteinuria are at higher risk for progression of kidney disease and for atherosclerosis. Because patients with CKD are often excluded from hypertension trials with hard outcomes, there has been until recently less data than ideal to consider in making decisions...
September 2016: Journal of Hypertension
Ran-Hui Cha, Hajeong Lee, Jung Pyo Lee, Chun Soo Lim, Yon Su Kim, Sung Gyun Kim
OBJECTIVE: Blood pressure (BP) control is the most established practice for preventing the progression of chronic kidney disease (CKD). We examined the BP control and nocturnal dipping pattern change in hypertensive patients with CKD and its effects on target organ damages. DESIGN AND METHOD: We recruited 378 hypertensive CKD patients from 4 centers in Korea. They underwent office and ambulatory BP monitoring at the time of enrollment and 1 year after. High office and ambulatory BP was defined as > 140/90 mmHg and > 135/85 mmHg (daytime)/> 120/70 mmHg (nighttime), respectively...
September 2016: Journal of Hypertension
David John Webb
Treatment-resistant hypertension (TRH) is defined as the failure to achieve an office BP target of <140/90 mmHg (<130/80 mmHg in patients with chronic kidney disease (CKD) or diabetes) in patients with hypertension (HT), despite adherence to at least 3 antihypertensive medications at optimal tolerated doses, ideally including a diuretic (Calhoun et al., Circulation 2008). TRH identifies patients with hard-to-treat HT, who might benefit from specialist investigation and treatment. Although some studies put the prevalence of TRH as >10%, these levels may be inflated by white-coat hypertension and poor adherence...
September 2016: Journal of Hypertension
Alberto Zanchetti
The question of BP targets of antihypertensive treatment has been debated in recent guidelines, and reopened by publication of SPRINT. Although interpretation of SPRINT is made difficult by a preferential effect of more intense BP lowering on heart failure rather than stroke and myocardial infarction, and by a different method of BP measurement, recent meta-analyses by my group have shown SBP reduction <130 mmHg can reduce risk of cardiovascular (CV) outcomes further, but absolute benefit is smaller than that achieved across the 140 mmHg cutoff, and treatment discontinuations for adverse events become greater...
September 2016: Journal of Hypertension
Tazeen Jafar
Chronic kidney disease (CKD) defined as reduced estimated glomerular filtration rate (eGFR) or presence of albuminuria, progresses to end stage renal disease (ESRD), needing dialysis or kidney transplant to sustain life, and is associated with increased risks of premature cardiovascular disease (CVD) and mortality. CKD ranked 18 leading (and most rapidly rising cause of mortality by the Global Burden of Disease Study 2010. The social and economic consequences of CKD are far worse in low and middle income countries (LMICs) including India, Pakistan, Bangladesh, and Sri Lanka...
September 2016: Journal of Hypertension
Jia-Ying Zhang, Ying Yin, Li Ni, Quan Long, Li You, Qian Zhang, Shan-Yan Lin, Jing Chen
Low-protein diet plus ketoacids (LPD+KA) has been reported to decrease proteinuria in patients with chronic kidney diseases (CKD). However, the mechanisms have not been clarified. As over-activation of intrarenal renin-angiotensin system (RAS) has been shown to play a key role in the progression of CKD, the current study was performed to investigate the direct effects of LPD+KA on intrarenal RAS, independently of renal haemodynamics. In this study, 3/4 subtotal renal ablated rats were fed 18 % normal-protein diet (Nx-NPD), 6 % low-protein diet (Nx-LPD) or 5 % low-protein diet plus 1 % ketoacids (Nx-LPD+KA) for 12 weeks...
October 18, 2016: British Journal of Nutrition
Effiong Ekong Akpan, Udeme Ekpenyong Ekrikpo, Aniema Isaac Assam Udo
The prevalence of chronic kidney disease (CKD) is increasing the world over, and it is now regarded as a public health problem. The prevalence of CKD in Nigeria remained largely unknown with hospital-based data of 2-8%. However, emerging community studies show a prevalence of 10-26.8%. This study was conducted during the 2013 world kidney day activities in Uyo, Akwa Ibom, State of Nigeria, with an estimated population of 554,906 people. Sensitizations of members of the public were ensured through the media...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Talha H Imam, Karen J Coleman
There is an epidemic of obesity in the USA. Obesity significantly increases the risk of developing chronic kidney disease. Multiple studies have shown overall health and mortalityrelated benefits of medical and surgical weight loss. Renal benefits of bariatric surgery include decrease in proteinuria and hyperfiltration. There have only been a few small studies in patients with abnormally low glomerular filtration rate (GFR) that have shown improvements in GFR postsurgery over a short term. Long-term and larger scale studies are needed to see if renal benefits of weight loss are sustained in post-bariatric surgery patients...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Chrisanna Dobrowolski, Edward G Clark, Manish M Sood
The worldwide prevalence of chronic kidney disease is 10-15 % of the adult population, is rising and increases susceptibility to venous thromboembolism (VTE). In this narrative review we discuss the underlying evidence behind the association of VTE/CKD and examine the role of worsening CKD stage, proteinuria, and the risk of recurrent VTE. As CKD may alter therapeutic options we discuss the role of emerging therapies, the non-vitamin K oral anticoagulants (NOAC), in the treatment of VTE.
October 13, 2016: Journal of Thrombosis and Thrombolysis
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