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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Jack Kit-Chung Ng, Terry King-Wing Ma, Fernand Mac-Moune Lai, Kai Ming Chow, Bonnie Ching-Ha Kwan, Chi Bon Leung, Philip Kam-To Li, Cheuk Chun Szeto
BACKGROUND: The reported causes of nephrotic syndrome (NS) varied between different countries. Less is known about the causes of nephrotic-range proteinuria (NPU). METHODS: In this single-centre, retrospective study of adult patients who underwent renal biopsy between 1983-2015 in a tertiary referral hospital in Hong Kong, we aimed to evaluate the underlying causes of NS and NPU. We also determined the distribution of histopathological diagnoses with regard to the age subgroups and time periods RESULTS: Among 7,456 patients who underwent renal biopsy, 982 and 838 patients had NS and NPU, respectively...
April 20, 2017: Nephrology
Dong Liu, Li-Na Wang, Hong-Xia Li, Ping Huang, Liang-Bo Qu, Fei-Yan Chen
Objective This meta-analysis aimed to investigate the efficacy and safety of pentoxifylline (PTF) plus angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) for proteinuria and kidney function in chronic kidney disease (CKD). Methods CENTRAL, EMBASE, Ovid-MEDLINE, PubMed, and CNKI were searched for relevant, randomized, controlled trials (RCTs). A meta-analysis was performed to review the effect of PTF plus ACEIs/ARBs vs. ACEIs/ARBs alone on proteinuria and kidney function in CKD...
April 2017: Journal of International Medical Research
Chia-Ter Chao, Hung-Bin Tsai, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Although chronic kidney disease (CKD) is associated with functional decline, whether proteinuria alone is associated with functional statuses over the course of acute illnesses independent of CKD is unclear. During 2014, we prospectively enrolled non-dialysis patients aged ≥65 years, and all participants underwent spot dipstick urinalysis on admission, divided into 3 groups according to the results (none, trace to 1 + , and 2 + or higher); functional status was evaluated using the pre-morbid and in-hospital Barthel index (BI) scores...
February 8, 2017: Scientific Reports
Colman Siu Cheung Fung, Eric Yuk Fai Wan, Anca Ka Chun Chan, Cindy Lo Kuen Lam
BACKGROUND: Estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) are renal markers associated with risks of cardiovascular diseases (CVD) and all-cause mortality in diabetic patients. This study aims to quantify such risks in Chinese diabetic patients based on eGFR and UACR. METHODS: This was a territory-wide retrospective cohort study on primary care diabetic patients with documented eGFR and UACR but without baseline CVD in 2008/2009...
February 2, 2017: BMC Nephrology
Ji In Park, Hyunjeong Baek, Bo Ra Kim, Hae Hyuk Jung
Chronic kidney disease (CKD) is usually diagnosed using the estimated glomerular filtration rate (eGFR) or kidney damage markers. The urine dipstick test is a widely used screening tool for albuminuria, a CKD marker. Although the urine albumin:creatinine ratio (ACR) has advantages over the dipstick test in sensitivity and quantification of levels, the two methods have not been compared in the general population. A total of 20,759 adults with urinalysis data in the Korea National Health and Nutrition Examination Survey 2011-2014 were examined...
2017: PloS One
Dawn F Wolfgram, Katelyn Garcia, Greg Evans, Sara Zamanian, Rocky Tang, Thomas Wiegmann, Rajeev Sharma, Ruth Campbell, Jeff Whittle
BACKGROUND: Chronic kidney disease (CKD) is increasingly common and disproportionately affects older adults. The contribution of kidney disease to the functional impairment noted in the elderly CKD population is unclear. METHODS: This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from the Systolic Blood Pressure Intervention Trial. We evaluated estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) as predictors of 3 measures of functional status: EuroQol-5 Dimensional (EQ-5D) score, Falls Efficacy Scale (FES) score, and gait speed...
2017: American Journal of Nephrology
Marion M Mafham, Natalie Staplin, Jonathan Emberson, Richard Haynes, William Herrington, Christina Reith, Christoph Wanner, Robert Walker, Alan Cass, Adeera Levin, Bengt Fellström, Lixin Jiang, Hallvard Holdaas, Bertram Kasiske, David C Wheeler, Martin J Landray, Colin Baigent
BACKGROUND: Estimated albumin excretion rate (eAER) provides a better estimate of 24-h albuminuria than albumin:creatinine ratio (ACR). However, whether eAER is superior to ACR in predicting end-stage renal disease (ESRD), vascular events (VEs) or death is uncertain. METHODS: The prognostic utility of ACR and eAER (estimated from ACR, sex, age and race) to predict mortality, ESRD and VEs was compared using Cox proportional hazards regression among 5552 participants with chronic kidney disease in the Study of Heart and Renal Protection, who were not on dialysis at baseline...
January 14, 2017: Nephrology, Dialysis, Transplantation
Juan Jesús Carrero, Morgan E Grams, Yingying Sang, Johan Ärnlöv, Alessandro Gasparini, Kunihiro Matsushita, Abdul R Qureshi, Marie Evans, Peter Barany, Bengt Lindholm, Shoshana H Ballew, Andrew S Levey, Ron T Gansevoort, Carl G Elinder, Josef Coresh
Current guidelines for chronic kidney disease (CKD) recommend using albuminuria as well as estimated glomerular filtration rate (eGFR) to stage CKD. However, CKD progression is solely defined by change in eGFR with little regard to the risk implications of change in albuminuria. This is an observational study from the Stockholm CREAtinine Measurements (SCREAM) project, a health care utilization cohort from Stockholm, Sweden, with laboratory measures from 2006-2011 and follow-up through December 2012. Included were 31,732 individuals with two or more ambulatory urine albumin to creatinine ratio (ACR) tests...
January 2017: Kidney International
Tong Chen, Ni Xie, Lucia Viglianti, Yabin Zhou, Hui Tan, Ben Zhong Tang, Youhong Tang
Early detection and appropriate management of chronic kidney disease can reduce the progression of kidney failure and cardiovascular disease. The urine albumin to creatinine ratio (UACR) test is a standard urine test for identifying individuals at high risk of developing progressive kidney disease. In this study, IDATPE, a novel fluorescent probe with aggregation-induced emission (AIE) features, is successfully developed for creatinine detection and quantitation. An excellent correlation between fluorescent light intensity and creatinine concentration is achieved...
February 22, 2017: Faraday Discussions
Giuseppe Mulè, Antonella Castiglia, Claudia Cusumano, Emilia Scaduto, Giulio Geraci, Dario Altieri, Epifanio Di Natale, Onofrio Cacciatore, Giovanni Cerasola, Santina Cottone
The kidney is one of the major target organs of hypertension.Kidney damage represents a frequent event in the course of hypertension and arterial hypertension is one of the leading causes of end-stage renal disease (ESRD).ESRD has long been recognized as a strong predictor of cardiovascular (CV) morbidity and mortality. However, over the past 20 years a large and consistent body of evidence has been produced suggesting that CV risk progressively increases as the estimated glomerular filtration rate (eGFR) declines and is already significantly elevated even in the earliest stages of renal damage...
2017: Advances in Experimental Medicine and Biology
Gema Ruiz-Hurtado, Luis M Ruilope, Alex de la Sierra, Pantelis Sarafidis, Juan J de la Cruz, Manuel Gorostidi, Julián Segura, Ernest Vinyoles, José R Banegas
OBJECTIVE: Nighttime blood pressure (BP) and albuminuria are two important and independent predictors of cardiovascular morbidity and mortality. Here, we examined the quantitative differences in nighttime systolic BP (SBP) across albuminuria levels in patients with and without diabetes and chronic kidney disease. RESEARCH DESIGN AND METHODS: A total of 16,546 patients from the Spanish Ambulatory Blood Pressure Monitoring Registry cohort (mean age 59.6 years, 54...
October 2016: Diabetes Care
Anja Schork, Matthias Woern, Hubert Kalbacher, Wolfgang Voelter, Regina Nacken, Marko Bertog, Silke Haerteis, Christoph Korbmacher, Nils Heyne, Andreas Peter, Hans-Ulrich Häring, Ferruh Artunc
BACKGROUND AND OBJECTIVES: Hypervolemia is a common feature of patients with CKD and associated with hypertension. Recent work has shown stimulation of sodium retention by urinary plasmin during nephrotic syndrome. However, it is unclear whether plasminuria plays a role in patients with stable CKD and non-nephrotic proteinuria. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this cross-sectional study, we analyzed the fluid status of 171 patients with CKD consecutively presenting to our outpatient clinic from 2012 to 2013 using bioimpedance spectroscopy (Body Composition Monitor [BCM]; Fresenius Medical Care, Germany) and its associations to the urinary excretion of plasminogen and plasmin from a spot urine sample...
May 6, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Tobias Felix Kröpelin, Dick de Zeeuw, Frank Arjan Holtkamp, David Kenneth Packham, Hiddo J L Heerspink
BACKGROUND: Albuminuria reduction due to angiotensin receptor blockers (ARBs) predicts subsequent renoprotection. Relating the initial albuminuria reduction to subsequent renoprotection assumes that the initial ARB-induced albuminuria reduction remains stable during follow-up. The aim of this study was to assess individual albuminuria fluctuations after the initial ARB response and to determine whether taking individual albuminuria fluctuations into account improves renal outcome prediction...
September 2016: Nephrology, Dialysis, Transplantation
Zhenhong Zhang, Pingsheng Wu, Jiping Zhang, Shunyin Wang, Gengxin Zhang
Conclusive evidence regarding the effect of statins on non-end stage chronic kidney disease (CKD) has not been reported previously. This meta-analysis evaluated the association between statins and microalbuminuria, proteinuria, progression, and all-cause mortality in patients with non-end stage CKD. Databases (e.g., PubMed, Embase and the Cochrane Library) were searched for randomized controlled trials (RCTs) with data on statins, microalbuminuria, proteinuria, renal health endpoints, and all-cause mortality patients with non-end stage CKD to perform this meta-analysis...
March 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Jessica M Sontrop, Amit X Garg, Lihua Li, Kerri Gallo, Virginia Schumann, Jennifer Winick-Ng, William F Clark, Matthew A Weir
BACKGROUND: Multiple first-morning urine samples are recommended for measuring the urine albumin-to-creatinine ratio (ACR); however, this can be challenging in community-based research. METHODS: The objectives of the study are to pilot-test a home urine collection protocol and examine how the average and variance of ACR varied with the number of urine collections and time to laboratory analysis. This is a prospective observational pilot study. This study was conducted in London, Ontario, Canada at the London Health Sciences Centre (2012-2013)...
2016: Canadian Journal of Kidney Health and Disease
Rikke Nielsen, Erik Ilsø Christensen, Henrik Birn
Proximal tubule protein uptake is mediated by 2 receptors, megalin and cubilin. These receptors rescue a variety of filtered ligands, including biomarkers, essential vitamins, and hormones. Receptor gene knockout animal models have identified important functions of the receptors and have established their essential role in modulating urinary protein excretion. Rare genetic syndromes associated with dysfunction of these receptors have been identified and characterized, providing additional information on the importance of these receptors in humans...
January 2016: Kidney International
Masamitsu Ubukata, Takashi Takei, Kosaku Nitta
BACKGROUND: The urinary protein/creatinine ratio [Up/Ucr (g/gCr)] has been used in the clinical management of patients with chronic kidney disease (CKD). However, a discrepancy is often noted between the Up/Ucr and 24-h urinary protein excretion [24hUp (g/day)] in patients with extremes of muscle mass. We examined devised a method for precise estimation of the 24-h urinary protein excretion (E-24hUp) based on estimation of 24-h urinary creatinine output (E-24hCr). METHODS: Three parameters, spot Up/Ucr, 24hUP and E-24hUp (=Up/Ucr × E-24hCr), were determined in 116 adult patients with CKD...
June 2016: Clinical and Experimental Nephrology
Diana-Silvia Zilişteanu, Teodora Atasie, M Voiculescu
BACKGROUND AND AIMS: Sulodexide has been reported to have antiproteinuric and nephroprotective properties. We investigated the effects of long-term low-dose Sulodexide on proteinuria and renal function in patients with chronic kidney disease (CKD) caused by diabetic nephropathy (DN), hypertensive nephropathy (HN) and primary glomerulonephritis (GN). MATERIAL AND METHODS: 100 patients with CKD received low-dose Sulodexide 50 mg/day for 12 months. Treatment efficacy was evaluated as proteinuria reduction compared to baseline; response was defined as a decline in proteinuria below 0...
April 2015: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Chih-Yu Yang, Fu-An Chen, Chun-Fan Chen, Wen-Sheng Liu, Chia-Jen Shih, Shuo-Ming Ou, Wu-Chang Yang, Chih-Ching Lin, An-Hang Yang
BACKGROUND: The usage of urine protein/creatinine ratio to estimate daily urine protein excretion is prevalent, but relatively little attention has been paid to the influence of urine concentration and its impact on test accuracy. We took advantage of 24-hour urine collection to examine both urine protein/creatinine ratio (UPCR) and daily urine protein excretion, with the latter as the reference standard. Specific gravity from a concomitant urinalysis of the same urine sample was used to indicate the urine concentration...
2015: PloS One
Anne Tsampalieros, Greg A Knoll
Proteinuria occurs commonly after kidney transplantation. Because there are no specific guidelines for defining and detecting proteinuria in transplant recipients, its prevalence can vary depending on the methods used. Most often, the same cutoffs for defining proteinuria in the nontransplant population are applied. There are several risk factors for proteinuria, including some transplant-specific diagnoses and immunosuppressive medications. Posttransplantation proteinuria is associated with reduced graft survival as well as an increased risk of cardiovascular events and death...
October 2015: Transplantation
2016-01-15 09:12:03
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