scholarly journals P0293FRACTIONAL EXCRETION OF TOTAL PROTEIN IS AN ACCURATE INDICATOR OF PROTEINURIA IN NPHROTIC PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Shori Takahashi ◽  
Shoichi Shimizu ◽  
Hiroshi Saito ◽  
Tamaki Morohashi ◽  
Ichiro Morioka ◽  
...  
Keyword(s):  
Creatinine Clearance ◽  
Total Protein ◽  
Pediatric Patients ◽  
Fractional Excretion ◽  
Creatinine Ratio ◽  
Heavy Proteinuria ◽  
Glomerular Capillary Wall ◽  
Sieving Coefficient ◽  
Protein Clearance ◽  
Accurate Indicator

Abstract Background and Aims Urinary total protein/creatinine ratio (U-TP/Cr) is a simple and useful indicator of proteinuria. And it had been shown to correlate well with 24-hour urinary protein test (24hr UPT). However, U-TP/Cr is not always accurately reflecting the degree of proteinuria, especially in cases with heavy proteinuria. Proteinuria in nephrotic syndrome could be defined as the result of changed sieving coefficient (SC) of plasma total protein through the glomerular capillary wall. Therefore, we studied fractional excretion of total protein (FETP; total protein clearance/creatinine clearance %) instead of directly unmeasurable SC. The accuracy of the FETP was verified by 24hr UPT in comparison with U-TP/Cr. Method Sixty-three serum and urine samples were collected from 35 pediatric patients with various age (age: 3 − 20 y; mean: 10.3 y, 22 male, 13 female) with hypoproteinemia (TP≦ 5.0 mg/dL), heavy proteinuria (FETP≧ 0.01%), and normal GFR (creatinine clearance ≧ 100 ml/min). The correlations between 24hrUPT and U-P/Cr and FETP were studied using samples obtained the same time and the superiority was statistically examined. Results Mean±SE of 24hUPT, U-TP/Cr and FETP (%) were 5.53±0.71 (g/day), 10.23±1.26 (g/gCr), and 0.12±0.016 (%) respectively. R values for the correlation between 24hrUPT and U-TP/Cr and 24hr UPT and FETP were 0.64 and 0.86 respectively. FETP showed a statistically better correlation with 24hrUPT than with U-TP/Cr (P: 0.0001). Conclusion FETP is an accurate indicator of 24hr UPT for nephrotic patients under conditions of heavy proteinuria and hypoproteinemia in comparison with UTP/CR.

scholarly journals Spot urinary protein/osmolality ratio as a predictor for proteinuria of nephrotic range

1970 ◽  
Vol 33 (2) ◽  
pp. 65-68
Author(s):  
Salma Jahan ◽  
Md. Saiful Islam ◽  
Md. Moazzam Hossain
Keyword(s):  
Total Protein ◽  
Pediatric Patients ◽  
Urinary Protein ◽  
Control Group ◽  
Strong Positive Correlation ◽  
Creatinine Ratio ◽  
Total Proteins ◽  
Spot Urine ◽  
Protein Excretion ◽  
A Prospective Study

A prospective study was carried out on 50 patients (age 1-15 years) with nephrotic range of proteinuria to determine the correlation of 24-hour urinary total protein with spot urinary protein/creatinine ratio and urinary protein/osmolality ratio. Another 50 patients having no proteinuria grouped as control. Twenty-four hours urine and spot urine were collected from each child and were analyzed for total volume, total protein, creatinine and osmolality level. The average 24-hour urinary total proteins in nephritic patient were 2148.6 ± 808.7 mg and the spot urinary protein/creatinine and spot urinary protein/osmolality were 3.2332 ± 0.4293 mg/mg and 3.2418 ± 0.4393 mg/mOsm respectively. There was a strong positive correlation of the 24-hour urinary total protein with spot urinary protein/creatinine and protein/osmolality ratios (r=0.9846 and 0.9870, p= <0.001). But in control group, these ratios did not show any correlation with 24-hour urinary total protein. These results suggest that in pediatric patients with nephrotic range of proteinuria, the spot urinary protein/osmolality ratio can predict the 24-hour  urinary total protein excretion like that of spot urinary protein/creatinine ratios. Keywords: Kidney; Proteinuria; UrinaryDOI: 10.3329/bmrcb.v33i2.1207Bangladesh Med Res Counc Bull 2007; 33: 65-68

scholarly journals The influence of proteinuria on tubular transport of Na+, K+, CL

2002 ◽  
Vol 130 (3-4) ◽  
pp. 64-67
Author(s):  
Dejan Petrovic ◽  
Radmila Obrenovic ◽  
Mileta Poskurica ◽  
Biljana Stojimirovic
Keyword(s):  
Statistical Analysis ◽  
Creatinine Clearance ◽  
Significant Influence ◽  
Fractional Excretion ◽  
T Test ◽  
The Third ◽  
Tubular Transport ◽  
Student’S T ◽  
Student’S T Test

Functional and structural damages of tubulointerstitium are caused by proteinuria. The aim of this study was to assess the influence of different proteinuria levels on Na+, K+, Cl tubular transport. We examined 50 patients (24 males, 26 females), mean age 46.50 ? 13.08 years, with mean creati-nine clearence of 87.29 ? 31.17 mL/min. They were separated in three groups depending on proteinuria value. The first group with proteinuria less than 0.3 g/24h included 19 persons (7 males, 12 females), mean age 45.12 ? 13.28 years, with mean creatinine clearance of 94.27 ? 34.70 mL/min. The second group of 18 patients (8 males, 10 females), mean age 45.39 ? 12.64 years had proteinuria of 0.3-3,0 g/24h and mean creatinine clearance of 90.07 ? 31.89 mL/min. The third group had proteinuria level higher than 3.0g/24h and mean creatinine clearance of 73.25 ? 20.44 mL/min. It included 13 patients (9 males, 4 females), mean age 50.08 ? 13.73 years. As a parameter of proteinuria influence on tubular transport of Na+, K+ and Cl-, fractional excretion of these electrolytes, was studied. Student's T test, Mann Whitney U test and c2 test were used for statistical analysis. No statistically significant influence of proteinuria was found on Na+, K+ and Cl tubular transport.

Urinary C-peptide creatinine ratio to differentiate type 2 diabetes mellitus from type 1 in pediatric patients

2020 ◽  
Vol 179 (7) ◽  
pp. 1115-1120
Author(s):  
Wafaa Elzahar ◽  
Ahmed Arafa ◽  
Amira Youssef ◽  
Adel Erfan ◽  
Doaa El Amrousy
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pediatric Patients ◽  
Creatinine Ratio ◽  
C Peptide

Failure of therapy with 2,3-dihydroxybenzoic acid to modify the course of sepsis-induced lung injury

1990 ◽  
Vol 69 (5) ◽  
pp. 1893-1902 ◽  
Author(s):  
M. D. Sharpe ◽  
R. A. Mustard ◽  
R. R. Finley ◽  
F. S. Rutledge ◽  
W. J. Sibbald
Keyword(s):  
Lung Injury ◽  
Total Protein ◽  
Cecal Ligation ◽  
Microvascular Permeability ◽  
Vehicle Group ◽  
Radical Scavenger ◽  
Dihydroxybenzoic Acid ◽  
Protein Ratio ◽  
Protein Clearance ◽  
Pulmonary Arterial

Oxidant-induced injury of the pulmonary microvasculature reportedly contributes to an increase in microvascular permeability and pulmonary hypertension, both of which are principal features of acute lung injury (ALI). We tested the hypothesis that antioxidant therapy with 2,3-dihydroxybenzoic acid (DHB), initiated in awake sheep after the development of sepsis-induced ALI, would ameliorate the progression of these lesions. DHB has many actions that suggested to us the potential for demonstrating benefit in ALI complicating sepsis; it is a nontoxic hydroxyl-radical scavenger that also inhibits the cyclooxygenase pathway and acts as a weak iron chelator. In preliminary experiments, we demonstrated that pretreatment with DHB prevented an increase in mean pulmonary arterial pressure, plasma thromboxane A2, measured as its metabolite thromboxane B2, and lymph total protein clearance that otherwise followed an infusion of zymosan-activated plasma (ZAP) in sheep. In subsequent experiments, 12 additional sheep were rendered septic by cecal ligation and perforation. Twenty-four to 36 h after cecal ligation and perforation, an increase in lung microvascular permeability was confirmed, because pulmonary lymph flow had increased by 82% while the mean lymph-to-plasma total protein ratio was unchanged from baseline. At this point, six sheep were then treated with parenteral DHB and six with DHB vehicle for the subsequent 24 h. In contrast to the demonstrated benefit of DHB pretreatment in preventing ALI secondary to an infusion of ZAP, the progressive increase in lymph total protein clearance that complicated septic lung injury in the DHB vehicle group throughout this 24-h study period was not ameliorated in the DHB treatment group. However, DHB did prevent a modest increase in mean pulmonary arterial pressures that was demonstrated in the DHB vehicle group throughout this 24-h treatment period. Although pretreatment prevented ALI after a ZAP infusion, we conclude that DHB only incompletely modified disease progression when administered after the onset of sepsis-induced ALI because it ameliorated the pulmonary hypertensive response without concurrently modifying an increase in lung microvascular fluid flux.

Nephrotic syndrome

2018 ◽  
Author(s):  
William G. Herrington ◽  
Aron Chakera ◽  
Christopher A. O’Callaghan
Keyword(s):  
Nephrotic Syndrome ◽  
Diabetic Nephropathy ◽  
Membranous Nephropathy ◽  
Clinical Syndrome ◽  
Minimal Change ◽  
Renal Amyloidosis ◽  
Creatinine Ratio ◽  
Heavy Proteinuria ◽  
Nephrotic Range Proteinuria ◽  
Secondary Causes

Nephrotic syndrome is a clinical syndrome of heavy proteinuria (greater than 3.5 g per 24 hours), oedema, and hypoalbuminaemia, which is associated with hyperlipidaemia and a procoagulant state. Causes of nephrotic syndrome are traditionally classified by their histopathological descriptions. In most cases, the histological picture can have a primary (idiopathic) or secondary cause. Minimal change, membranous nephropathy, and focal segmental glomerulosclerosis account for over 60% of cases. Diabetic nephropathy and renal amyloidosis are common secondary causes of nephrotic syndrome. Nephrotic-range proteinuria will show up as at least 3+ protein on urinalysis. The diagnosis is confirmed by a urinary protein-to-creatinine ratio over 300 mg/mmol, and hypalbuminaemia. In adults, renal biopsy is the diagnostic test. This chapter addresses the causes, diagnosis, and management of nephrotic syndrome in adults.

scholarly journals Biochemical Markers of Renal Hypoperfusion, Hemoconcentration, and Proteinuria after Extreme Physical Exercise

Medicina ◽  
2019 ◽  
Vol 55 (5) ◽  
pp. 154 ◽  
Author(s):  
Wojciech Wołyniec ◽  
Katarzyna Kasprowicz ◽  
Patrycja Rita-Tkachenko ◽  
Marcin Renke ◽  
Wojciech Ratkowski
Keyword(s):  
Physical Exercise ◽  
Statistical Significance ◽  
Blood Perfusion ◽  
Fractional Excretion ◽  
Creatinine Ratio ◽  
Plasma Urea ◽  
Urinary Potassium ◽  
Before And After ◽  
The Mean ◽  
Renal Hypoperfusion

Background and Objectives: Physical exercise increases the blood perfusion of muscles, but decreases the renal blood flow. There are several markers of renal hypoperfusion which are used in the differential diagnosis of acute kidney failure. Albuminuria is observed after almost any exercise. The aim of this study was to assess changes in renal hypoperfusion and albuminuria after a 100-km race. Materials and Methods: A total of 27 males who finished a 100-km run were studied. The mean age of the runners was 38.04 ± 5.64 years. The exclusion criteria were a history of kidney disease, glomerular filtration rate (GFR) <60 ml/min, and proteinuria. Blood and urine were collected before and after the race. The urinary albumin/creatinine ratio (ACR), fractional excretion of urea (FeUrea) and sodium (FeNa), plasma urea/creatinine ratio (sUrea/Cr), urine/plasma creatinine ratio (u/pCr), urinary sodium to potassium ratio (uNa/K), and urinary potassium to urinary potassium plus sodium ratio (uK/(K+Na)) were calculated. Results: After the race, significant changes in albuminuria and markers of renal hypoperfusion (FeNa, FeUrea, sUrea/Cr, u/sCr, urinary Na, uNa/K, uK/(K+Na)) were found. Fifteen runners (55.56%) had severe renal hypoperfusion (FeUrea <35, uNa/K <1, and uK/(Na+K) >0.5) after the race. The mean ACR increased from 6.28 ± 3.84 mg/g to 48.43 ± 51.64 mg/g (p < 0.001). The ACR was higher in the group with severe renal hypoperfusion (59.42 ± 59.86 vs. 34.68 ± 37.04 mg/g), but without statistical significance. Conclusions: More than 50% of the runners had severe renal hypoperfusion after extreme exercise. Changes in renal hemodynamics are probably an important, but not the only, factor of post-exercise proteinuria.

scholarly journals A study of the relationship between albuminuria, proteinuria and urinary reagent strips

2009 ◽  
Vol 46 (3) ◽  
pp. 247-249 ◽  
Author(s):  
Geraldine Collier ◽  
Marie Clare Greenan ◽  
Jennifer J Brady ◽  
Barbara Murray ◽  
Sean K Cunningham
Keyword(s):  
Sensitivity And Specificity ◽  
Total Protein ◽  
Clinical Excellence ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Protein Loss ◽  
Discordant Result ◽  
Nice Guidance ◽  
Reagent Strips ◽  
The Relationship

Background The aims of this study were to examine the relationship between proteinuria and albuminuria and to assess the equivalence between the albumin to creatinine ratio (ACR) and the protein to creatinine ratio (PCR) at the cut-offs recommended by the National Institute for Health and Clinical Excellence (NICE) guidance on chronic kidney disease. The sensitivity and specificity of the reagent strips used in our laboratory for the detection of clinical proteinuria was also assessed. Methods Urine samples ( n = 117) were screened for protein using the Bayer Multistix 10SG and read manually. Urinary total protein and creatinine was measured on the Roche P Modular by the benzethonium chloride and kinetic Jaffe methods, respectively. Urinary albumin was measured by immunoturbidimetry on the Roche Cobas Mira. Results The relationship between urinary protein and albumin loss was non-linear ( P < 0.05). As urinary protein loss increased the percentage of albumin to total protein increased. At the NICE guidance recommended cut-offs for clinical proteinuria (ACR ≥30 mg/mmol and PCR ≥50 mg/mmol) there was one discordant result between ACR and PCR (ACR <30 mg/mmol and PCR >50 mg/mmol). The Bayer Multistix 10SG had a sensitivity and specificity of 97% and 62%, respectively, for the detection of clinical proteinuria compared with ACR. Conclusions The proportion of urinary total protein attributable to albumin changes with concentration. There was only one discordant result between ACR and PCR: therefore either ratio may be used for the identification of clinical proteinuria. As a screening test for proteinuria, the Bayer Multistix 10SG had an acceptable sensitivity but poor specificity.

scholarly journals Ocimum gratissimum Ameliorates Gentamicin-Induced Kidney Injury but Decreases Creatinine Clearance Following Sub-Chronic Administration in Rats

2017 ◽  
Vol 22 (4) ◽  
pp. 592-602 ◽  
Author(s):  
Dare J. Ogundipe ◽  
Rufus O. Akomolafe ◽  
Abubakar A. Sanusi ◽  
Christian E. Imafidon ◽  
Olaoluwa S. Olukiran ◽  
...  
Keyword(s):  
Renal Function ◽  
Creatinine Clearance ◽  
Total Protein ◽  
Therapeutic Potential ◽  
Kidney Injury ◽  
Chronic Administration ◽  
Kidney Weight ◽  
Ocimum Gratissimum ◽  
Gentamicin Treatment ◽  
Male Wistar Rats

The effects of aqueous extract of Ocimum gratissimum leaf (AOGL) on the renal function of rats with gentamicin-induced nephrotoxicity were investigated. This study involved the use of forty five (45) adult male Wistar rats (housed in separate metabolic cages) such that graded doses of OAGL were administered to the experimental groups (p.o.) for 28 days after exposure to gentamicin toxicity (100 mg/kg i.p.) for 1 week. At the end of the study, comparisons of some indices of renal function as well as antioxidant status (GSH and TBARS) were made between the control, toxic and AOGL-treated groups at P < 0.05. The result showed that gentamicin treatment caused significant increase ( P < .05) in urine output, urea, creatinine, total protein, relative kidney weight, and TBARS, as well as significant decrease ( P < .05) in urine creatinine and GSH levels. Post-treatment with graded doses of AOGL caused significant increase in food consumption, GSH, urine, and plasma creatinine, as well as significant decrease ( P < .05) in relative kidney weight, TBARS, and urine total protein. There was an appreciable difference in the kidney histology of the AOGL-treated groups when compared with the toxic control. Hence, the extract has therapeutic potential in the management of gentamicin-induced kidney injury, although a risk profile of renal dysfunction is not unlikely from 28 days of administration as evident by the decrease in creatinine clearance.

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