scholarly journals Effects of Metreleptin on Proteinuria in Patients With Lipodystrophy

2019 ◽  
Vol 104 (9) ◽  
pp. 4169-4177 ◽  
Author(s):  
Ho Lim Lee ◽  
Meryl A Waldman ◽  
Sungyoung Auh ◽  
James E Balow ◽  
Elaine K Cochran ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Estimated Glomerular Filtration Rate ◽  
Urinary Albumin ◽  
National Institutes Of Health ◽  
Normal Range ◽  
Open Label ◽  
Partial Lipodystrophy ◽  
Protein Excretion ◽  
High Prevalence ◽  
Excretion Rates

Abstract Context Patients with lipodystrophy have high prevalence of proteinuria. Objective To assess kidney disease in patients with generalized (GLD) vs partial lipodystrophy (PLD), and the effects of metreleptin on proteinuria in patients with lipodystrophy. Design, Setting, Patients, Intervention Prospective, open-label studies of metreleptin treatment in patients with GLD and PLD at the National Institutes of Health. Outcome Measures The 24-hour urinary albumin and protein excretion rates, estimated glomerular filtration rate (eGFR), and creatinine clearance (CrCl) were measured at baseline and during up to 24 months of metreleptin treatment. Patients with increases in medications affecting outcome measures were excluded. Results At baseline, patients with GLD had significantly greater albuminuria, proteinuria, eGFR, and CrCl compared with patients with PLD. CrCl was above the normal range in 69% of patients with GLD and 39% with PLD (P = 0.02). With up to 24 months of metreleptin treatment, there were significant reductions in albuminuria and proteinuria in patients with GLD, but not in those with PLD. No changes in eGFR or CrCl were observed in patients with GLD or PLD during metreleptin treatment. Conclusions Patients with GLD had significantly greater proteinuria than those with PLD, which improved with metreleptin treatment. The mechanisms leading to proteinuria in lipodystrophy and improvements in proteinuria with metreleptin are not clear. Hyperfiltration was also more common in GLD vs PLD but did not change with metreleptin.

Proteinuria and impaired glomerular permselectivity in uninephrectomized fawn-hooded rats

1994 ◽  
Vol 267 (6) ◽  
pp. F917-F925 ◽  
Author(s):  
J. D. Oliver ◽  
J. L. Simons ◽  
J. L. Troy ◽  
A. P. Provoost ◽  
B. M. Brenner ◽  
...  
Keyword(s):  
Enzyme Inhibitor ◽  
Size Selectivity ◽  
Angiotensin I ◽  
Focal And Segmental Glomerulosclerosis ◽  
Protein Excretion ◽  
Angiotensin I Converting Enzyme ◽  
Charge Selectivity ◽  
Glomerular Hypertension ◽  
Excretion Rates ◽  
Enalapril Treatment

Previous studies of glomerular permselectivity have indicated that both size selectivity and charge selectivity changes play a role in the pathogenesis of proteinuria. In this study, we measured Ficoll sieving coefficients, hemodynamic parameters, and urinary protein excretion rates in the FHH strain of fawn-hooded rats. These animals spontaneously develop systemic and glomerular hypertension, proteinuria, and focal and segmental glomerulosclerosis at a relatively young age. Three groups of FHH rats were studied: two-kidney controls (2K), untreated uninephrectomized rats (CON-NX), and uninephrectomized rats treated with the angiotensin I converting enzyme inhibitor enalapril (ENA-NX). CON-NX rats had higher glomerular transcapillary pressures (delta P) and higher urinary excretion rates of both total protein (UpV) and albumin (UaV) than did 2K rats, whereas treatment with enalapril prevented both glomerular hypertension and the increased proteinuria. Ficoll sieving coefficients were significantly higher in both groups of NX rats compared with 2K rats only for Stokes-Einstein radii (rs) < or = 46 A. Fits of sieving data to pore models showed a small increase in the number of large, nonselective pores in NX, which was not prevented by enalapril treatment. Total clearances of Ficoll with rs = 36 A (the size of albumin) in CON-NX and ENA-NX groups were unchanged compared with 2K animals. In contrast, UaV in CON-NX rats was more than six times that of 2K and ENA-NX rats. Across groups, UpV, UaV, and the ratio (UaV)/(UpV) all correlated strongly with delta P.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Safety and Immunogenicity of Standard and Double Doses of Hepatitis B Vaccine in Children after Liver Transplantation: An Open-Label, Randomised Controlled Trial

Vaccines ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 92
Author(s):  
Palittiya Sintusek ◽  
Supranee Buranapraditkun ◽  
Piyaporn Wanawongsawad ◽  
Nawarat Posuwan ◽  
Pattarawat Thantiworasit ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis B ◽  
De Novo ◽  
Controlled Trial ◽  
Geometric Mean ◽  
Interferon Γ ◽  
Specific Response ◽  
Open Label ◽  
High Prevalence ◽  
Randomised Controlled

A high prevalence of hepatitis B (HepB) antibody loss after liver transplantation (LT) and de novo HepB infection (DNH) was documented, hence revaccination to prevent DNH is crucial. This study aimed to compare the safety and immunogenicity of two HepB vaccine regimens in liver-transplanted children. Liver-transplanted children who were previously immunised but showed HepB surface antibodies (anti-HBs) ≤ 100 mIU/mL were randomised to receive a standard three-dose (SD) and double three-dose (DD) vaccine intramuscularly in months 0–1–6. Anti-HBs and T-cell-specific response to the HepB antigen were assessed. A total of 61 children (54.1% male, aged 1.32 ± 1.02 years) completed the study without any serious adverse reaction. The seroprotective rate was 69.6% vs. 60% (p = 0.368) and 91.3% vs. 85% (p = 0.431) in SD and DD after the first and third 3-dose vaccinations, respectively. The geometric mean titre (95% confidence interval) of anti-HBs in SD and DD were 443.33 (200.75–979.07) vs. 446.17 (155.58–1279.50) mIU/mL, respectively, at completion. Numbers of interferon-γ-secreting cells were higher in hyporesponders/responders than in nonresponders (p = 0.003). The significant factors for the immunologic response to HepB vaccination were anti-HB levels prevaccination, tacrolimus trough levels, and time from LT to revaccination. SD and DD had comparative immunogenicity and were safe for liver-transplanted children who were previously immunised.

Normal values of urinary albumin and total protein excretion during pregnancy

1994 ◽  
Vol 171 (4) ◽  
pp. 984-989 ◽  
Author(s):  
Kenneth Higby ◽  
Cheryl R. Suiter ◽  
John Y. Phelps ◽  
Theresa Siler-Khodr ◽  
Oded Langer
Keyword(s):  
Total Protein ◽  
Normal Values ◽  
Urinary Albumin ◽  
Protein Excretion

scholarly journals Characteristic Renal Histology of a 81-Year-Old Patient with a 30-Year History of Diabetes Mellitus: A Case Report

2020 ◽  
Vol 9 (4) ◽  
pp. 338-343
Author(s):  
Natsuki Shima ◽  
Naoki Sawa ◽  
Masayuki Yamanouchi ◽  
Hiroki Mizuno ◽  
Masahiro Kawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Immunofluorescence Microscopy ◽  
Antihypertensive Agents ◽  
Diabetic Glomerulopathy ◽  
Normal Range ◽  
Salt Diet ◽  
Protein Excretion ◽  
Renal Histology ◽  
History Of ◽  
Arteriolar Hyalinosis

Abstract A renal histology of an 81-year-old man with a 30-year history of diabetes mellitus (DM), as well as diabetic retinopathy and neuropathy, was examined. The patient’s blood pressure was controlled within the normal range (less than 140/75 mmHg) using antihypertensive agents including angiotensin receptor blocker. Edematous management was achieved by a strict salt diet (less than 6 g/per day). However, this patient’s glycemic control was poor with HbA1c 8–10%. Serum creatinine was 0.87 mg/dL and estimated globular filtration rate (eGFR) was 64 ml/min/1.73m2. Urinary protein excretion was 1.5 g/day. This patient’s renal biopsy showed linear staining for IgG along the GBM by immunofluorescence microscopy, but light microscopy showed almost intact glomeruli, and the GBM was not thickened as revealed by electron microscopy with a width of 288–368 nm (< 430 nm). While arteriolar hyalinosis was severe, and polar vasculosis was observed around the glomerular vascular pole. This case indicates that long-standing hyperglycemia may induce polar vasculosis by the mechanism of angiogenesis, but diabetic glomerulopathy can become minor change, only when hypertension and edematous management could be controlled strictly.

Proteinuria in health and disease assessed by measuring the urinary protein/creatinine ratio.

1987 ◽  
Vol 33 (2) ◽  
pp. 297-299 ◽  
Author(s):  
J Lemann ◽  
B T Doumas
Keyword(s):  
Kidney Disease ◽  
Urinary Protein ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Protein Excretion ◽  
Daily Excretion ◽  
Normal Mean ◽  
Health And Disease ◽  
Tract Disease ◽  
Excretion Rates

Abstract We measured daily excretion rates for urinary protein and the ratios of urinary protein to creatinine in 24-h urines and in untimed urines in 60 healthy adults, 30 patients with kidney disease, and 22 kidney-transplant recipients. The ratios for urinary protein/creatinine, mg/g, in untimed urines and in 24-h urines from the same subjects were closely correlated (r = 0.97) for rates of protein excretion ranging from normal (mean 44 mg/day) to nephrotic (maximum 19,300 mg/day). Because urinary protein/creatinine in healthy subjects never exceeded 100 mg/g, we propose that a ratio of less than 100 mg/g in untimed urines, obtained in the absence of exercise, fever, or other evidence of urinary tract disease, is a criterion of normal kidney function. Among patients with nephrotic syndrome (urinary protein excretion rate greater than or equal to 4000 mg/day), urinary protein/creatinine ratios always exceeded 2000 mg/g in both 24-h and untimed urines. Intermediate urinary protein/creatinine ratios (100 to 2000 mg/g) may reflect any type of kidney disease.

scholarly journals Effects of Collagen Hydrolysates on Human Brain Structure and Cognitive Function: A Pilot Clinical Study

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 50
Author(s):  
Seiko Koizumi ◽  
Naoki Inoue ◽  
Fumihito Sugihara ◽  
Michiya Igase
Keyword(s):  
Cognitive Function ◽  
Outcome Measures ◽  
Brain Structure ◽  
Short Form ◽  
Gray Matter Volume ◽  
Rank Correlation ◽  
Secondary Outcome ◽  
Open Label ◽  
Associate Learning ◽  
Collagen Hydrolysates

This study investigated the effects of collagen hydrolysates (CH) on language cognitive function and brain structure. In this open-label study, 5 g CH was administered once a day for 4 weeks to 30 healthy participants aged 49–63 years. The primary outcome measures were the brain healthcare quotients based on gray matter volume (GM-BHQ) and fractional anisotropy (FA-BHQ). The secondary outcome measures were changes in scores between week 0 and week 4 for word list memory (WLM) and standard verbal paired associate learning (S-PA) tests as well as changes in the physical, mental, and role/social component summary scores of the Short Form-36(SF-36) quality of life instrument. CH ingestion resulted in significant improvements in FA-BHQ (p = 0.0095), a measure of brain structure, as well in scores for the WLM (p = 0.0046) and S-PA (p = 0.0007) tests, which measure cognitive function. There were moderate correlations between the change in WLM score and the change in GM-BHQ (r = 0.4448; Spearman’s rank correlation) and between the change in S-PA score and the change in FA-BHQ (r = 0.4645). Daily ingestion of CH changed brain structure and improved language cognitive function.

scholarly journals Plant-based dietary approach to stage 3 chronic kidney disease with hyperphosphataemia

2019 ◽  
Vol 12 (12) ◽  
pp. e232080 ◽  
Author(s):  
Thomas M Campbell ◽  
Scott E Liebman
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Estimated Glomerular Filtration Rate ◽  
Office Visit ◽  
Normal Range ◽  
Insulin Requirements ◽  
The Face ◽  
Obesity Hypertension ◽  
Whole Foods

A 69-year-old man with type 2 diabetes, hypertension and stage 3 chronic kidney disease (CKD), hyperphosphataemia and borderline hyperkalaemia presented to an office visit interested in changing his diet to improve his medical conditions. He adopted a strict whole-foods, plant-based diet, without calorie or portion restriction or mandated exercise, and rapidly reduced his insulin requirements by >50%, and subsequently saw improvements in weight, blood pressure and cholesterol. His estimated glomerular filtration rate (eGFR) increased from 45 to 74 mL/min after 4.5 months on the diet and his microalbumin/creatinine ratio decreased from 414.3 to 26.8 mg/g. His phosphorus level returned to the normal range. For individuals with CKD, especially those with obesity, hypertension, or diabetes, a strict, ad libitum whole-food, plant-based diet may confer significant benefit, although one must consider potential limitations of a creatinine-based GFR equation in the face of significant weight loss.

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