Proteinuria

Proteinuric diabetic kidney disease frequently progresses to ESRD. Control of BP delays progression, but the optimal BP to improve outcomes remains unclear. The objective of this analysis was to evaluate the relationship between BP and renal outcomes in proteinuric diabetic kidney disease. BP data from all 1448 randomized participants in the Veterans Affairs Nephropathy in Diabetes Trial were included in a post hoc analysis. The associations of mean on-treatment BP with the primary end point (decline in eGFR, ESRD, or death), renal end point (decline in eGFR or ESRD), rate of eGFR decline, and mortality were measured. The median (25th, 75th percentile) follow-up time was 2.2 (1.2, 3.0) years. There were 284 primary end points. In univariate analyses, both mean systolic and mean diastolic BPs were strongly associated (P<0.001) with the primary end point. After multivariate adjustment, the hazard of developing the primary end point became progressively higher as mean systolic BP ro...

Abstract: Renal diseases may be discovered accidentally during routine urinalysis. This study was done to find out the significance of urinalysis and study the magnitude of abnormal urinalysis in healthy adults with no symptoms of renal disease. In our set up routine urine analysis should be performed in all subjects to identify the presence of unrecognized renal disease which may benefit from simple therapeutic measures. Because of simplicity, routine urine analysis is the best way in early detection of most frequent conditions like proteinuria, haematuria, pyuria and glycosuria. This is useful in selecting asymptomatic patients with renal disease who may benefit from early treatment or who requires long term follow up. Material and Methods: Healthy subjects between age group of 20 and 55 years of age were screened for routine urine analysis in rural health area by conducting health camp periodically during from May 2012 to April 2013. A total of 1000 fresh morning samples of urine...

Proteinuria is a negative prognostic indicator for dogs and cats with chronic kidney disease. A normal dog or cat should excrete very little protein and have a urine protein:creatinine ratio that is less than 0.4 or less than 0.2, respectively; persistent proteinuria above this magnitude warrants attention. Administration of angiotensin converting enzyme inhibitors and/or angiotensin receptor blockers, blood pressure control and nutritional modification are considered a standard of care for renal proteinuria. Renal biopsy and administration of immunosuppressive agents should be considered in animals with glomerular proteinuria that have not responded to standard therapy. Targeted patient monitoring is essential when instituting management of proteinuria.

We investigated the effects of long-term miso soup drinking on salt-induced hypertension in Dahl salt-sensitive (Dahl S) rats. Dahl S rats were divided into four groups that consumed 1) water, 2) a 0.9% NaCl solution, 3) a 1.3% sodium NaCl solution, or 4) miso soup containing 1.3% NaCl. They were followed for 8 wk. Systolic blood pressure and hypertensive organ damage were determined. Systolic blood pressure increased in an age- and dose-dependent manner in Dahl S rats drinking salt solutions. The systolic blood pressure increase was significantly less in the Dahl S rats that drank miso soup, although the ultimate cumulative salt loading was greater than that in the Dahl S rats given the 1.3% NaCl solution. This blood pressure decrease was associated with a morphologic attenuation of glomerular sclerosis in the kidney and collagen infiltration in the heart. Urinary protein excretions were less in the miso group than in the rats given the 1.3% NaCl solution. The fractional excretion of sodium was increased and that of potassium was decreased in Dahl S rats given the 1.3% NaCl solution, and these effects were reversed in rats given miso soup toward the values of the control. We found that long-term miso soup drinking attenuates the blood pressure increase in salt-induced hypertension with organ damage. This may be caused by a possible retardation of sodium absorption in the gastrointestinal tract or by the direct effects of nutrients in the miso soup from soybeans. The decrease was associated with decreases in cardiovascular and renal damage.

The purpose of this cross sectional study was to determine the frequency of under-collected 24 hours urinary samples. Diabetic patients who visited our clinic from June 2012 to November 2012 were explained the procedure for collection verbally in addition to being given written instructions. Adequacy of collection was assessed by measuring creatinine excretion rates. Out of the 112 patients enrolled, 16(14.29%) collected their samples inadequately. The education level (p< 0.001) and urine volume (p= 0.003) were lesser in these 16 patients as compared to others. Inadequate collection was common in the younger patients (22.22% patients aged less than 60 years, 6.90% aged 60 years or older ; p= 0.021). Gender (15.00% men, 12.50% women; p= 0.733) did not impact the collection of samples. Considering the high frequency of under-collections, adequacy of samples should always be checked first before proceeding further with laboratory analysis.