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1.
Methods Mol Biol ; 2292: 3-15, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33651347

RESUMO

Recent reports suggest that urine is a useful noninvasive tool for the identification of urogenital tumors, including bladder, prostate, kidney, and other nonurological cancers. As a liquid biopsy, urine represents an important source for the improvement of new promising biomarkers, a suitable tool to identify indolent cancer and avoid overtreatment. Urine is enriched with DNAs, RNAs, proteins, circulating tumor cells, exosomes, and other small molecules which can be detected with several diagnostic methodologies.We provide an overview of the ongoing state of urinary biomarkers underlying both their potential utilities to improve cancer prognosis, diagnosis, and therapeutic strategy and their limitations.


Assuntos
Biomarcadores Tumorais/urina , Neoplasias/urina , Animais , Ácidos Nucleicos Livres/urina , Exossomos/patologia , Humanos , Biópsia Líquida/métodos , Neoplasias/diagnóstico , Neoplasias/patologia , Ácidos Nucleicos/urina , Proteínas , Proteinúria/diagnóstico , Proteinúria/patologia , Proteinúria/urina , Urinálise/métodos
2.
Methods Mol Biol ; 2292: 115-120, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33651356

RESUMO

The analysis of liquid biopsy as a source of diagnostic, prognostic, and predictive biomarkers is still object of the main research in the prostate cancer field. Many advantages, such as less invasiveness compared to plasma or serum analysis and the rich content, confer to urine a role as an interesting fluid to be analysed especially in urological diseases. Here we report a workflow focused on profile, concentration, and protein surface characterization of EVs from urinary supernatant.


Assuntos
Exossomos/patologia , Neoplasias da Próstata/diagnóstico , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/urina , Humanos , Biópsia Líquida/métodos , Masculino , Neoplasias da Próstata/patologia , Neoplasias da Próstata/urina , Proteínas/análise , Proteinúria/diagnóstico , Proteinúria/patologia , Proteinúria/urina , Coleta de Urina/métodos , Fluxo de Trabalho
3.
Methods Mol Biol ; 2259: 105-141, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33687711

RESUMO

Identification of molecular biomarkers for human diseases is one of the most important disciplines in translational science as it helps to elucidate their origin and early progression. Thus, it is a key factor in better diagnosis, prognosis, and treatment. Proteomics can help to solve the problem of sample complexity when the most common primary sample specimens were analyzed: organic fluids of easy access. The latest developments in high-throughput and label-free quantitative proteomics (SWATH-MS), together with more advanced liquid chromatography, have enabled the analysis of large sample sets with the sensitivity and depth needed to succeed in this task. In this chapter, we show different sample processing methods (major protein depletion, digestion, etc.) and a micro LC-SWATH-MS protocol to identify/quantify several proteins in different types of samples (serum/plasma, saliva, urine, tears).


Assuntos
Proteínas/análise , Proteoma/análise , Proteômica/métodos , Biomarcadores/análise , Biomarcadores/sangue , Biomarcadores/urina , Proteínas Sanguíneas/análise , Humanos , Espectrometria de Massas/métodos , Proteinúria/diagnóstico , Saliva/química , Manejo de Espécimes/métodos , Lágrimas/química
4.
BMJ Case Rep ; 14(1)2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33514619

RESUMO

We report the case of a 43-year-old man, suffering from ankylosing spondylitis and treated with Infliximab 5 mg/kg every 2 months, with an excellent disease control. During a follow-up consultation, an incipient renal insufficiency is detected. A urine analysis showed haematuria and proteinuria and a renal puncture-biopsy revealed an image of IgA nephropathy.Several cases of IgA nephropathy have been reported in the literature associated with ankylosing spondylitis. Some of them occur in patients treated with antitumour necrosis factor, but it is unclear whether this pathology is caused by the treatment or whether treatment failed to prevent its occurrence.Our clinical case highlights the importance of regular monitoring of renal function in patients with ankylosing spondylitis, as well as urinary spotting.The question of whether the disease itself, the treatment or other factors such as immune dysregulation could be held responsible for kidney disease will be addressed in the discussion.


Assuntos
Antirreumáticos/uso terapêutico , Glomerulonefrite por IGA/patologia , Infliximab/uso terapêutico , Espondilite Anquilosante/complicações , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Antirreumáticos/administração & dosagem , Biópsia , Glomerulonefrite por IGA/diagnóstico , Glomerulonefrite por IGA/urina , Hematúria/diagnóstico , Humanos , Infliximab/administração & dosagem , Rim/patologia , Testes de Função Renal/normas , Masculino , Monitorização Fisiológica/normas , Proteinúria/diagnóstico , Remissão Espontânea , Espondilite Anquilosante/tratamento farmacológico
5.
West Afr J Med ; 38(1): 8-14, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33463700

RESUMO

BACKGROUND: Urinary abnormalities detected on routine urinalysis in asymptomatic children may be indicators of underlying kidney diseases. OBJECTIVE: This study was conducted to determine the prevalence and risk factors for asymptomatic proteinuria and haematuria in healthy primary school children in Abuja. METHODS: Using multi-staged sampling method, early morning mid-stream urine was collected from healthy school children from urban and rural primary schools in Gwagwalada Area Council of Abuja, Nigeria for the presence of proteinuria and haematuria using urinalysis strips. Those positive for proteinuria and haematuria were retested after two weeks for persistence abnormalities. Urine microscopy was also done for the persistent haematuria subjects, and biodata collected. RESULTS: Of 861 urine samples analysed, 215 (25%) were from urban schools, and 646 (75%) from rural schools. There were 397 (46.1%) males. Their mean age was 9.5±2.1 years (range 6-12 years), with 9-10 years accounting for 36.4% of the study population. Proteinuria, haematuria, proteinuria+haematuria, persistent proteinuria, and persistent haematuria were seen in 7.0%, 10.6%, 3.6%, 4.2% and 5.5% of the subjects respectively. Microscopic haematuria was also documented in 5.2% subjects with persistent haematuria. Statistical significant association was seen between proteinuria with location of school (c2=9.529, p=0.002), and social class (c2=7.596, p=0.022). Significant association was also seen between haematuria and location of school (c2=14.218, p=0.001), social class (c2=11.290, p = 0.004). CONCLUSION: There was high prevalence of asymptomatic proteinuria and haematuria among healthy primary school children from the study area. This underscores the importance of routine urinary screening program in primary schools for early identification of affected children for intervention.


Assuntos
Hematúria , Microscopia , Proteinúria , Criança , Feminino , Hematúria/diagnóstico , Hematúria/epidemiologia , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Proteinúria/diagnóstico , Proteinúria/epidemiologia , Instituições Acadêmicas , Urinálise
6.
Diabetes Metab Syndr ; 15(1): 187-191, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33383438

RESUMO

BACKGROUND AND AIMS: Renal involvement in Covid-19 infection is varied and can affect glomeruli, tubules, interstitium and can cause acute kidney injury (AKI). AKI is a strong predictor of mortality. Routine urinalysis gives an insight into the renal pathology of the patient. We studied the incidence of urinary abnormalities in hospitalised Covid-19 patients and analysed their impact on development of AKI and mortality. METHODS: Information on 110 hospitalised patients with confirmed Covid-19 was retrospectively collected and analysed. The demographic data such as age, gender, comorbid conditions such as diabetes mellitus, the need for dialysis and laboratory data such as urine for albumin, glucose, RBC and WBC, and serum creatinine were collected. The diagnosis of AKI was based on the KDIGO criteria. The outcomes studied were development of AKI and hospital mortality. RESULTS: Urine abnormalities were seen in 71% of the patients. Proteinuria in 58.2%, haematuria in 17.3%, pyuria in 8.2% of patients and concurrent proteinuria and haematuria was seen in 13.6% of patients. AKI was seen in 28.2% of patients and hospital mortality was 24.5%. AKI was strongly associated with mortality. Proteinuria and haematuria were good predictors of development of AKI, more strongly when they occurred concurrently (p < 0.01). CONCLUSION: Our results suggest that urine analysis is a simple test, which can be used to predict development of AKI and mortality and may be used for risk stratification of Covid-19 patients, especially in low resource settings.


Assuntos
Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/urina , /urina , Lesão Renal Aguda/diagnóstico , Adulto , Idoso , Feminino , Hospitalização/tendências , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Proteinúria/diagnóstico , Proteinúria/epidemiologia , Proteinúria/urina , Estudos Retrospectivos , Urinálise/tendências
8.
Zhonghua Nan Ke Xue ; 26(6): 518-521, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-33356040

RESUMO

Objective: To compare two ELISA methods for the detection of the prostatic exosomal protein (PSEP) in the urine. METHODS: Using the double-antibody sandwich (DAS) method and the indirect method of ELISA, we detected PSEP in the urine samples from 100 IIIA chronic prostatitis (CP) patients and another 100 normal healthy males. Meanwhile, we examined 30 clinical urine samples using the diluent (0.1 mol/L PBS buffer) and the urine matrix standard curves to verify the consistency of the standard diluent with the sample collected. Result: The sensitivities of DAS and indirect ELISA were 89% versus 87% and their specificities 91% versus 90%, with total consistency rates of 90% versus 88.5%, with no statistically significant difference in between. The scatter plot for the results of the PBS diluent and the urine matrix standard curves showed a good linearity (R2 = 0.999). No significant difference was found in the results of detection of the clinical urine samples in different matrices. CONCLUSIONS: Considering the characteristics of PSEP, the indirect ELISA method is more practical and feasible for the clinical detection of PSEP in the urine samples of prostatitis patients.


Assuntos
Ensaio de Imunoadsorção Enzimática/métodos , Exossomos , Prostatite , Proteinúria/diagnóstico , Doença Crônica , Humanos , Masculino , Prostatite/diagnóstico , Proteínas/análise
9.
Ther Umsch ; 77(8): 361-370, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33054650

RESUMO

Incidental Proteinuria - Interpretation and Diagnosis Abstract. The incidental finding of proteinuria is common in daily clinical practice. In most cases, this is the result of a urinary dipstick test. When proteinuria is discovered as a coincidental finding, there are basically two scenarios: The dipstick test can be false or true positive. If the test is a true positive, a distinction needs to be made as to whether the proteinuria incidentally discovered is the result of a benign cause or a cause that requires further examinations or specific therapy. Therefore, in order to avoid unnecessary examinations, false positive results and benign causes such as contamination or extrarenal causes, temporary proteinuria or orthostatic proteinuria should be excluded in a first step. If there is persistent proteinuria with no obvious benign cause, the next step is to distinguish common from rare causes. It should always be explored whether there is diabetes mellitus, arterial hypertension or other cardiovascular risk factors that can explain the appearance of proteinuria. Regardless, when diagnosing persistent proteinuria for the first time, a basic assessment should be carried out, that includes serum creatinine, urinary sediment and sonography of the urinary tract. If the cause remains unclear, a kidney biopsy should be done without hesitation.


Assuntos
Hipertensão , Proteinúria , Creatinina , Humanos , Exame Físico , Proteinúria/diagnóstico , Urinálise
10.
PLoS One ; 15(9): e0239262, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941535

RESUMO

Artificial intelligence is increasingly being adopted in medical fields to predict various outcomes. In particular, chronic kidney disease (CKD) is problematic because it often progresses to end-stage kidney disease. However, the trajectories of kidney function depend on individual patients. In this study, we propose a machine learning-based model to predict the rapid decline in kidney function among CKD patients by using a big hospital database constructed from the information of 118,584 patients derived from the electronic medical records system. The database included the estimated glomerular filtration rate (eGFR) of each patient, recorded at least twice over a period of 90 days. The data of 19,894 patients (16.8%) were observed to satisfy the CKD criteria. We characterized the rapid decline of kidney function by a decline of 30% or more in the eGFR within a period of two years and classified the available patients into two groups-those exhibiting rapid eGFR decline and those exhibiting non-rapid eGFR decline. Following this, we constructed predictive models based on two machine learning algorithms. Longitudinal laboratory data including urine protein, blood pressure, and hemoglobin were used as covariates. We used longitudinal statistics with a baseline corresponding to 90-, 180-, and 360-day windows prior to the baseline point. The longitudinal statistics included the exponentially smoothed average (ESA), where the weight was defined to be 0.9*(t/b), where t denotes the number of days prior to the baseline point and b denotes the decay parameter. In this study, b was taken to be 7 (7-day ESA). We used logistic regression (LR) and random forest (RF) algorithms based on Python code with scikit-learn library (https://scikit-learn.org/) for model creation. The areas under the curve for LR and RF were 0.71 and 0.73, respectively. The 7-day ESA of urine protein ranked within the first two places in terms of importance according to both models. Further, other features related to urine protein were likely to rank higher than the rest. The LR and RF models revealed that the degree of urine protein, especially if it exhibited an increasing tendency, served as a prominent risk factor associated with rapid eGFR decline.


Assuntos
Taxa de Filtração Glomerular , Aprendizado de Máquina , Proteinúria/diagnóstico , Insuficiência Renal Crônica/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Prognóstico , Proteinúria/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/urina
11.
BMC Med Genet ; 21(1): 183, 2020 09 21.
Artigo em Inglês | MEDLINE | ID: mdl-32957924

RESUMO

BACKGROUND: Disorders of the metabolism and absorption of vitamin B12 can lead to decrease in activity of methionine synthetase and methylmalonate coenzyme A mutase (MMUT), which results in increased levels of methylmalonic acid and homocysteine in blood and urine. Often, combined methylmalonic acidemia (MMA) and homocysteinemia is misdiagnosed due to a lack of specific symptoms. The clinical manifestations are diverse, but proteinuria as the initial presentation is rare. CASE PRESENTATION: Two cases of MMA with homocysteinemia in children are reported. Proteinuria were a primary presenting symptom, followed by anemia and neurologic symptoms (frequent convulsions and unstable walking, respectively). Screening of amino acids and acyl carnitine in serum showed that the propionyl carnitine:acetylcarnitine ratio increased. Profiling of urinary organic acids by gas chromatography-mass spectrometry revealed high levels of methylmalonic acid. Homocysteine content in blood was increased. Comprehensive genetic analyses of peripheral blood-derived DNA demonstrated heterozygous variants of methylmalonic aciduria type C and homocystinuria (MMACHC) and amnionless (AMN) genes in our two patients, respectively. After active treatment, the clinical manifestations in Case 1 were relieved and urinary protein ceased to be observed; Case 2 had persistent proteinuria and was lost to follow-up. CONCLUSIONS: Analyses of the organic acids in blood and urine suggested MMA combined with homocysteinemia. In such diseases, reports of renal damage are uncommon and proteinuria as the initial presentation is rare. Molecular analysis indicated two different genetic causes. Although the pathologic mechanisms were related to vitamin B12, the severity and prognosis of renal lesions were different. Therefore, gene detection provides new insights into inherited metabolic diseases.


Assuntos
Erros Inatos do Metabolismo dos Aminoácidos/complicações , Hiper-Homocisteinemia/complicações , Proteinúria/diagnóstico , Adolescente , Erros Inatos do Metabolismo dos Aminoácidos/genética , Aminoácidos/sangue , Sequência de Bases , Carnitina/análogos & derivados , Carnitina/sangue , Pré-Escolar , DNA/sangue , DNA/genética , Cromatografia Gasosa-Espectrometria de Massas , Homocisteína/sangue , Humanos , Hiper-Homocisteinemia/genética , Masculino , Ácido Metilmalônico/urina , Proteinúria/etiologia
12.
PLoS One ; 15(9): e0238177, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881893

RESUMO

INTRODUCTION: Renal hyperfiltration (RHF) has been found to be an independent predictor of adverse cardiovascular outcome. However, it remains uncertain whether it is precursor of chronic kidney disease (CKD) in a healthy population. MATERIALS AND METHODS: To determine relative risks and identify the predictor of incident proteinuria and decline of estimated glomerular filtration rate (eGFR) in subjects with RHF. A total of 55,992 subjects aged ≥20 years who underwent health check-up during 2004-2017 were included. Among them, 16,946 subjects who completed at least two health checkups were analyzed. RESULTS: A total of 949 (5.6%) subjects developed proteinuria and 98 (0.6%) subjects showed ≥ 30% of eGFR decline. The risk of incident proteinuria was significantly higher in those with RHF (RR: 1.644; 95% CI: 1.064-2.541). Those with RHF showed 8.720 fold (95% CI: 4.205-18.081) increased risk for ≥30% decline. ESR, CRP, and monocyte count showed reversed J shaped curve according to the increase of eGFR. The adjusted mean of monocyte count was significantly higher in participants with eGFR ≥90ml/min/1.73m2 or < 60ml/min/1.73m2 compared to that in patients with eGFR 75-89ml/min/1.73m2. Compared to subjects with the lowest tertile of monocyte and no RHF, those with the highest tertile of monocyte count in the RHF group had 3.314-fold (95% CI: 1.893-5.802) higher risk of incident proteinuria and 3.822-fold (95% CI, 1.327-11.006) risk of 30% eGFR decline. CONCLUSIONS: RHF had significantly increased risk of developing proteinuria and CKD in healthy subjects. Higher monocyte count might be used as a predictor of CKD in subjects with RHF.


Assuntos
Insuficiência Renal Crônica/diagnóstico , Adulto , Proteína C-Reativa/análise , Estudos de Coortes , Taxa de Filtração Glomerular , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Proteinúria/diagnóstico , Proteinúria/epidemiologia , Fatores de Risco , Adulto Jovem
14.
Diab Vasc Dis Res ; 17(7): 1479164120945910, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32746630

RESUMO

BACKGROUND: The effect of interarm blood pressure difference on the development of diabetic retinopathy, proteinuria and chronic kidney disease remains unknown. We investigated to determine the impact of interarm blood pressure difference on the prevalence of diabetic retinopathy, proteinuria and chronic kidney disease in patients with type 2 diabetes. METHODS: The study included 563 patients with diabetes, who were evaluated with a simultaneous bilateral blood pressure measurement. The cutoff values for interarm blood pressure difference were 5, 10 and 15 mmHg. Logistic regression analysis was used to explore the relation between interarm blood pressure difference and diabetic retinopathy, proteinuria and chronic kidney disease. RESULTS: Diabetic patients with systolic interarm blood pressure difference ⩾5, ⩾10 and ⩾15 mmHg showed an increased risk of diabetic retinopathy [adjusted odds ratio = 1.48 (95% confidence interval = 1.01-2.18), odds ratio = 1.80 (95% confidence interval = 0.99-3.22), odds ratio = 2.29 (95% confidence interval = 1.00-5.23)] after adjustment. There were significant associations between interarm blood pressure difference ⩾5 and ⩾10 mmHg and proteinuria [odds ratio = 1.68 (95% confidence interval = 1.15-2.44), 1.89 (95% confidence interval = 1.05-3.37)]. CONCLUSION: The association between interarm blood pressure difference and the presence of diabetic retinopathy emerged even for systolic interarm blood pressure difference ⩾5 mmHg without interaction of systolic blood pressure. Systolic interarm blood pressure difference should be considered a surrogate marker for vascular complication in patients with type 2 diabetes.


Assuntos
Pressão Sanguínea , Diabetes Mellitus Tipo 2/fisiopatologia , Retinopatia Diabética/fisiopatologia , Extremidade Superior/irrigação sanguínea , Idoso , Índice Tornozelo-Braço , Estudos Transversais , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/epidemiologia , Nefropatias Diabéticas/diagnóstico , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/fisiopatologia , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prevalência , Proteinúria/diagnóstico , Proteinúria/epidemiologia , Proteinúria/fisiopatologia , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Seul/epidemiologia
15.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1185-1196, July-Aug. 2020. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1131484

RESUMO

Glomerular proteinuria is characterized by the loss of high-molecular-weight proteins (HMWPs), while tubulointerstitial proteinuria is characterized by the loss of low-molecular-weight proteins (LMWPs). The objective was to assess the molecular weight of urinary proteins (MWUP) in dogs with naturally acquired CKD and determine the proportion of HMWPs and LMWPs according to CKD stage. Twenty-eight dogs with CKD were recruited and divided into 4 groups based on serum creatinine (Cr) levels (group1: Cr<1,4, n=8; group2: 1,45,0, n=5). The control group consisted of 5 healthy dogs. The MWUP was determined by SDS-PAGE. The urinary protein-to-creatinine ratio (UP/C) was used to quantitatively assess proteinuria. The electrophoresis pattern revealed a proportionally greater loss of HMWPthan of LMWP in all groups with CKD and an increased loss of LMWP in group 4 (P<0.05). These results suggest a predominance of glomerular injuries throughout all stages of CKD in these dogs and an increase in tubulointerstitial injury towards the end-stage of the disease. The results of the present study support the recommendation of SDS-PAGE as an effective technique for the qualitative assessment of proteinuria, as well as a method for assessing the severity and location of renal injury.(AU)


A proteinúria glomerular é caracterizada pela perda de proteínas de alto peso molecular (PAPM), enquanto a proteinúria tubulointersticial se caracteriza pela perda de proteínas de baixo peso molecular (PBPM). O objetivo do trabalho foi determinar o peso molecular das proteínas urinárias (PMPU) de cães com DRC naturalmente adquirida e a proporção de PAPM e PBPM de acordo com o estágio da DRC. Foram utilizados 28 cães com DRC, divididos em quatro grupos, de acordo com o nível sérico de creatinina (cr) (grupo 1: cr<1,4, n=8; grupo 2: 1,45,0, n=5). O grupo controle era composto por cinco cães saudáveis. O PMPU foi determinado por SDS-PAGE. A relação proteína:creatinina urinária (RPCU) foi utilizada como um método quantitativo de proteinúria. A eletroforese revelou uma perda proporcionalmente maior de PAPM, quando comparada às PBPM, em todos os grupos de DRC, bem como uma perda crescente de PBPM no grupo 4 (P<0,05). Esses resultados sugerem uma predominância de lesão glomerular em todos os estágios de DRC nesses cães e uma progressão crescente na lesão túbulo-intersticial no estágio terminal da doença. Os resultados deste estudo reafirmam a recomendação de que a eletroforese de proteínas urinárias é uma técnica qualitativa efetiva de avaliação da proteinúria, bem como um método que permite avaliar a extensão e a localização da lesão renal.(AU)


Assuntos
Animais , Cães , Proteinúria/diagnóstico , Proteinúria/veterinária , Creatinina/análise , Insuficiência Renal Crônica/veterinária , Eletroforese/veterinária
16.
J Small Anim Pract ; 61(9): 541-546, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32692434

RESUMO

OBJECTIVES: To assess the utility of urine dipstick strips for detection of feline proteinuria when used in combination with urine-specific gravity, compared with urine protein-to-creatinine ratio as the gold standard. MATERIALS AND METHODS: Retrospective analysis of clinical records of comprehensive urine examination obtained from cats presented to a referral hospital. Diagnostic agreement and test accuracy were calculated for the dipstick test alone and in combination with the urine-specific gravity, using different cut-off values for proteinuria. Receiver-operating characteristic curves were also calculated. RESULTS: A total of 121 urine samples were included. The diagnostic agreement between dipstick and urine protein-creatinine ratio was poor. A dipstick result of equal or greater than "Trace" (0.1-0.3 g/L) had a sensitivity of 81% and a specificity of 31% to detect proteinuria. Grouping the samples by urine-specific gravity did not increase dipstick agreement with the urine protein-creatinine ratio and only resulted in a slight improvement in the accuracy of detecting proteinuria. CLINICAL SIGNIFICANCE: The dipstick test was not accurate for detecting proteinuria when combined with urine-specific gravity in cats. Clinicians should not rely on this test and, regardless of the urine concentration, other appropriate quantitative methods such as urine protein-creatinine ratio should always be performed to detect proteinuria in cats.


Assuntos
Doenças do Gato , Fitas Reagentes , Animais , Doenças do Gato/diagnóstico , Gatos , Creatinina , Proteinúria/diagnóstico , Proteinúria/veterinária , Estudos Retrospectivos , Sensibilidade e Especificidade , Gravidade Específica , Urinálise/veterinária
17.
Medicine (Baltimore) ; 99(29): e20678, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702818

RESUMO

BACKGROUND: Diabetic nephropathy (DN) is among the common and serious complications of diabetes and is also a major cause of end-stage kidney disease. Early DN is also called diabetic microalbumin period, the main treatment is in the control of blood sugar on the basis of kidney protection and urine lowering protein. There are few effective methods of western medicine treatment, and most of them are accompanied by adverse reactions. But some studies have shown that traditional Chinese medicine has achieved the curative effect and has certain superiority. However, there are few systematic reviews on the treatment of traditional Chinese herbal medicine for early DN currently. Therefore, this study conducted a systematic review of clinical efficacy and safety of Chinese herbal medicine for the treatment of patients with early DN, aim to comprehensively analyze the role of traditional Chinese herbal medicine in the treatment of early DN. METHODS AND ANALYSIS: The protocol of this systematic review and meta-analysis was registered on the INPLASY website (https://inplasy.com/inplasy-2020-4-0139/) and INPLASY registration number is INPLASY202040139. A systematic literature search will be conducted in 3 English database and 4 Chinese databases with a language limitation of English and Chinese. Search for clinical research literature on Chinese herbal medicine treatment of DN published in domestic and foreign biomedical journals. The time is limited from January 2010 to February 2020. We will investigate heterogeneity across studies and publication bias. To assess the risk of bias and quality of the included studies, we will use the Cochrane Collaboration's ROB tool. According to the relevant standards in the Cochrane Intervention System Evaluation Manual, it will be divided into low risk, high risk, and unclear. We will also use the RevMan 5.3 software and Stata 13.0 software for meta-analysis of the effectiveness and symptom scores of DN proteinuria. ETHICS AND DISSEMINATION: The ethical considerations are not required because the systematic review is based on published studies. The systematic review and meta-analysis will be published in a peer-reviewed Journal.


Assuntos
Nefropatias Diabéticas/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa/métodos , Complicações do Diabetes/epidemiologia , Nefropatias Diabéticas/classificação , Nefropatias Diabéticas/complicações , Feminino , Humanos , Falência Renal Crônica/etiologia , Masculino , Proteinúria/diagnóstico , Proteinúria/etiologia , Proteinúria/urina , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Sensibilidade e Especificidade , Resultado do Tratamento
18.
Int J Clin Oncol ; 25(7): 1278-1284, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32347432

RESUMO

BACKGROUND: Proteinuria induced by lenvatinib is a class effect that occurs secondary to VEGFR suppression. Withholding of lenvatinib is required in cases with severe proteinuria. Urine protein-creatinine ratio (UPCR, g/gCre) has recently attracted attention as an alternative to 24-h urine collection for assessing proteinuria. The aim of this study was to examine the correlation between the results of proteinuria assessed by the dipstick test and UPCR, and to investigate the influence of proteinuria grading with UPCR on lenvatinib dose adjustment compared to that with only the dipstick test. METHOD: Three hundred and ten urine samples from 63 patients with advanced thyroid cancer under treatment with lenvatinib, which were tested by both the dipstick test and UPCR were analyzed. Lenvatinib was withheld when there was evidence of CTCAE grade 3 proteinuria, and restarted when it resolved. The frequency of proteinuria, correlation between the results of the dipstick test and UPCR test, and the effect of dose withholding in cases with results of 3 + in the dipstick test were calculated. RESULTS: Proteinuria was seen in 56 (88.9%) patients. Of the 154 dipstick 3 + samples, only 56 (36.4%) were judged as more than 3.5 g/gCre by UPCR (grade 3 proteinuria), although none of the 1 + and only 3.7% of 2 + samples were judged as grade 3 proteinuria. We were able to prevent unnecessary lenvatinib interruption due to proteinuria in 63.6% of dipstick 3 + samples by assessment of UPCR. CONCLUSIONS: Urinalysis by combination of the dipstick test and UPCR assessment might be a better strategy for preventing unnecessary interruption of lenvatinib.


Assuntos
Antineoplásicos/efeitos adversos , Compostos de Fenilureia/efeitos adversos , Proteinúria/induzido quimicamente , Quinolinas/efeitos adversos , Neoplasias da Glândula Tireoide/tratamento farmacológico , Urinálise/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/administração & dosagem , Antineoplásicos/uso terapêutico , Creatinina/urina , Feminino , Humanos , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Compostos de Fenilureia/administração & dosagem , Compostos de Fenilureia/uso terapêutico , Proteinúria/diagnóstico , Quinolinas/administração & dosagem , Quinolinas/uso terapêutico , Neoplasias da Glândula Tireoide/mortalidade , Neoplasias da Glândula Tireoide/urina
19.
Pregnancy Hypertens ; 20: 92-95, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32203727

RESUMO

The diagnosis of preeclampsia superimposed on underlying kidney disease is complicated by physiological changes in renal function, blood pressure and proteinuria during pregnancy. Previous studies have demonstrated a significant increase in proteinuria during pregnancy in women with diabetic nephropathy in the absence of superimposed preeclampsia. There is a paucity of studies addressing changes in proteinuria during pregnancy in other conditions causing chronic kidney disease. A retrospective audit of changes in urine protein:creatinine ratios in 68 pregnancies to women with preconception proteinuria was performed, to determine whether changes in proteinuria may be useful in diagnosing preeclampsia. A 100% or greater increase in proteinuria from baseline increase was regarded as a significant change. In 51 pregnancies (75%) the peak urine protein:creatinine ratio did not rise significantly from values at the start of pregnancy. Where a greater than doubling of urine protein:creatinine ratio was seen, 12 of 17 pregnancies (70%) were judged clinically to have superimposed preeclampsia A significant increase in proteinuria also occurred in 3 women with lupus nephritis, and 2 with diabetic nephropathy, in the absence of preeclampsia. Larger studies of women with chronic kidney disease would be important to determine whether changes in proteinuria during pregnancy may be of diagnostic value for superimposed preeclampsia.


Assuntos
Pressão Sanguínea , Rim/fisiopatologia , Pré-Eclâmpsia/diagnóstico , Proteinúria/diagnóstico , Insuficiência Renal Crônica/diagnóstico , Adulto , Biomarcadores/urina , Creatinina/urina , Feminino , Humanos , Pré-Eclâmpsia/fisiopatologia , Valor Preditivo dos Testes , Gravidez , Proteinúria/etiologia , Proteinúria/fisiopatologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/fisiopatologia , Estudos Retrospectivos , Adulto Jovem
20.
BMJ Case Rep ; 13(3)2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32169983

RESUMO

Chicken pox caused by varicella zoster virus is usually a self-limiting disease causing rare life-threatening complications. Involvement of the kidneys is infrequent during the course of the illness. Literature shows rare reports of acute glomerulonephritis following varicella infection. We report a case of 16-year-old boy presenting with anasarca with characteristic healed rashes of chicken pox. His urinalysis revealed a 'massive' nephrotic range proteinuria (16 g/24 hours), gross hematuria and pyuria. A percutaneous renal biopsy showed membranoproliferative glomerulonephritis. Most cases of post-varicella glomerulonephritis have been described in children, massive proteinuria of this range in an immunocompetent adolescent, being an extremely rare entity. Acute proliferative glomerulonephritis in such cases is usually an immune complex hypocomplementaemic glomerulonephritis in response to the zoster infection. Proteinuria in most patients is benign and self-limiting with few fatal reports of crescentic glomerulonephritis progressing to acute renal failure.


Assuntos
Varicela/complicações , Glomerulonefrite Membranoproliferativa/complicações , Glomerulonefrite Membranoproliferativa/patologia , Proteinúria/etiologia , Administração Oral , Adolescente , Assistência ao Convalescente , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Diagnóstico Diferencial , Diuréticos/administração & dosagem , Diuréticos/uso terapêutico , Quimioterapia Combinada , Edema/etiologia , Glomerulonefrite Membranoproliferativa/tratamento farmacológico , Glomerulonefrite Membranoproliferativa/virologia , Hematúria/etiologia , Herpesvirus Humano 3/isolamento & purificação , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Masculino , Proteinúria/diagnóstico , Piúria/etiologia , Resultado do Tratamento
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