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Proteinuria in Adults

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1. The Impact of Sotagliflozin on Renal Function, Albuminuria, Blood Pressure, and Hematocrit in Adults With Type 1 Diabetes Full Text available with Trip Pro

The Impact of Sotagliflozin on Renal Function, Albuminuria, Blood Pressure, and Hematocrit in Adults With Type 1 Diabetes In people with type 2 diabetes, sodium-glucose cotransporter 2 inhibitors (SGLT2i) reduce cardiovascular risk and progression of diabetic kidney disease. Our aim was to determine whether sotagliflozin (SOTA), a dual SGLT1i and SGLT2i, had favorable effects on clinical biomarkers suggestive of kidney protection in adults with type 1 diabetes.In this 52-week pooled analysis (...) , 1,575 adults enrolled in the inTandem1 and inTandem2 trials were randomized to SOTA 200 mg, 400 mg, or placebo in addition to optimized insulin therapy. Changes in cardiorenal biomarkers were assessed.At 52 weeks, in response to SOTA 200 and 400 mg, the placebo-corrected least squares mean change from baseline in estimated glomerular filtration rate was -2.0 mL/min/1.73 m2 (P = 0.010) and -0.5 mL/min/1.73 m2 (P = 0.52), respectively. Systolic blood pressure difference was -2.9 and -3.6 mmHg (P

2019 EvidenceUpdates

2. Effect of PF-04634817, an Oral CCR2/5 Chemokine Receptor Antagonist, on Albuminuria in Adults with Overt Diabetic Nephropathy Full Text available with Trip Pro

Effect of PF-04634817, an Oral CCR2/5 Chemokine Receptor Antagonist, on Albuminuria in Adults with Overt Diabetic Nephropathy Inflammatory cell recruitment, which is potentially mediated by the monocyte chemoattractant protein 1/C-C chemokine receptor type 2 (CCR2) system and by C-C chemokine receptor type 5 (CCR5) activity, may play a role in the development and progression of diabetic nephropathy. PF-04634817 is a dual chemokine CCR2/5 receptor antagonist that is being developed (...) for the treatment of diabetic nephropathy.We evaluated the efficacy of PF-04634817 compared with matching placebo for reduction of albuminuria after 12 weeks of treatment in subjects with type 2 diabetes who received standard of care (SOC; angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy), in a randomized, double-blind, placebo-controlled, parallel-group phase 2 study.A total of 226 subjects who received SOC with baseline estimated glomerular filtration rates between 20 and 75 ml

2018 Kidney international reports Controlled trial quality: predicted high

3. Fresh fruit consumption and risk of incident albuminuria among rural Chinese adults: A village-based prospective cohort study. Full Text available with Trip Pro

Fresh fruit consumption and risk of incident albuminuria among rural Chinese adults: A village-based prospective cohort study. Recent studies showed that increased fresh fruit consumption is significantly associated with lower risks of diabetes, hypertension, and cardiovascular disease (CVD); other studies suggested that albuminuria is associated with diabetes, hypertension, and CVD. Therefore, we hypothesized that lower fresh fruit consumption is associated with higher risk of incident (...) albuminuria among Chinese adults in rural areas, where fresh fruit consumption level is very low and prevalence of albuminuria is high.We tested the hypothesis in a village-based cohort study of 3574 participants aged ≥ 30 years from the Handan Eye Study conducted from 2006 to 2013. Albuminuria was defined as urinary albumin-to-creatinine ratio ≥ 30 mg/g.Overall, 35.4% of the participants never or rarely consumed fresh fruits, and 33.9, 21.6, and 9.1% consumed fresh fruits 1-3 times/month, 1-2 times/week

2018 PLoS ONE

4. Dipstick proteinuria predicts all-cause mortality in general population: A study of 17 million Korean adults. Full Text available with Trip Pro

Dipstick proteinuria predicts all-cause mortality in general population: A study of 17 million Korean adults. A quantitative basis for the use of dipstick urinalysis for risk assessment of all-cause mortality is scarce. Therefore, we investigated the association between dipstick proteinuria and all-cause mortality in a general population and evaluated the effect of confounders on this association.The study population included 17,342,956 adults who underwent health examinations between 2005 (...) and 2008 under the National Health Insurance System. Proteinuria was determined using a single dipstick urinalysis, and the primary outcome of this study was all-cause mortality. The prognostic impact of proteinuria was assessed by constructing a multivariable Cox model.The mean age of the study population (53.24% male) was 46.06 years; 724,681 deaths from all causes occurred over a median follow-up period of 9.34 years (interquartile range 8.17-10.16), and the maximum follow-up was 12.12 years. After

2018 PLoS ONE

5. Association of estimated dietary acid load with albuminuria in Japanese adults: a cross-sectional study. Full Text available with Trip Pro

of microalbuminuria than those in the lowest quartile for potassium intake.Higher NEAP was associated with albuminuria and its association might negatively relate to potassium intake in an adult Japanese population. (...) Association of estimated dietary acid load with albuminuria in Japanese adults: a cross-sectional study. Acid-base imbalance might promote the progression of chronic kidney disease (CKD), but whether nutrient-derived dietary acid load increases the risk of albuminuria or even high normoalbuminuria is unclear.A Japanese cohort comprising 3250 men and 3434 women aged 40-97 years with urine albumin-to-creatinine ratio (ACR) < 33.9 mg/mmol or estimated glomerular filtration rate ≥ 15 ml/min/1.73 m2

2019 BMC Nephrology

6. Assessment of proteinuria

Assessment of proteinuria Assessment of proteinuria - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of proteinuria Last reviewed: February 2019 Last updated: June 2018 Summary Average daily urinary protein excretion in adults is 80 mg/day, with normal excretion considered to be <150 mg/day. Albumin represents approximately 15% of the daily urinary protein excretion in healthy people, with other plasma (...) eGFR and high albuminuria predict end stage kidney disease and death at all ages. BMJ. 2012 Nov 7;345:e7478. http://www.ncbi.nlm.nih.gov/pubmed/23135200?tool=bestpractice.com Presence of proteinuria is associated with a higher mortality in critically ill patients; Han SS, Ahn SY, Ryu J, et al. Proteinuria and hematuria are associated with acute kidney injury and mortality in critically ill patients: a retrospective observational study. BMC Nephrol. 2014 Jun 18;15:93. http://www.ncbi.nlm.nih.gov/pmc

2018 BMJ Best Practice

7. The comorbidity of increased arterial stiffness and microalbuminuria in a survey of middle-aged adults in China. Full Text available with Trip Pro

The comorbidity of increased arterial stiffness and microalbuminuria in a survey of middle-aged adults in China. Increased arterial stiffness (iAS) and microalbuminuria (MAU), which may occur simultaneously or separately in the general population and share similar risk factors, are markers of macro- and microvascular injuries. Our research investigated the comorbidity of iAS and MAU in the middle-aged population and examined the heterogeneous effects of metabolic risk factors on iAS and MAU.We

2018 BMC Cardiovascular Disorders

8. Increasing Mortality in Adults With Diabetes and Low Estimated Glomerular Filtration Rate in the Absence of Albuminuria. Full Text available with Trip Pro

Increasing Mortality in Adults With Diabetes and Low Estimated Glomerular Filtration Rate in the Absence of Albuminuria. Improved blood pressure control and use of renin-angiotensin-aldosterone system blockers have altered the clinical presentation or phenotype of chronic kidney disease (CKD) in U.S. adults with diabetes. These changes may influence mortality.Data from the National Health and Nutrition Examination Surveys (NHANES) 1988-2006 were used to examine mortality trends in adults (...) with diabetes, defined as physician diagnosis, fasting glucose ≥126 mg/dL, HbA1c >6.5% (48 mmol/mol), or use of glucose-lowering medications. Mortality trends by CKD phenotype (estimated glomerular filtration rate [eGFR] and urine albumin-to-creatinine ratio [ACR] level) were obtained via linkage with the National Death Index through 31 December 2011 while accounting for the complex survey design.From 1988 to 2006, adults with an eGFR <60 mL/min/1.73 m2 and an ACR <30 mg/g increased from ∼0.9 million (95

2018 Diabetes Care

9. Impaired glomerular filtration rate, high grade albuminuria and associated factors among adult patients admitted to tertiary Hospital in Ethiopia. Full Text available with Trip Pro

Impaired glomerular filtration rate, high grade albuminuria and associated factors among adult patients admitted to tertiary Hospital in Ethiopia. Chronic Kidney Disease (CKD), the worldwide Public Health problem, is also one of the rising non-communicable diseases in low and middle-income countries. Its early detection and treatment using readily available, inexpensive therapies can slow or prevent progression to end-stage renal disease. Hence, this study was aimed at assessing impaired (...) estimated glomerular filtration rate (eGFR), high grade albuminuria, and associated factors among adult patients admitted to Jimma University Medical Center in South west Ethiopia.Hospital based cross sectional study was conducted from November 1, 2016 to April 30, 2017. Consecutive sampling method was used to select study participants. Logistic regression analysis was conducted to generate factors associated with impaired estimated GFR and albuminuria. A P-value of < 0.05 was considered statistically

2018 BMC Nephrology

10. Prevalence of Microalbuminuria in Adult Patients with Sickle Cell Disease in Eastern Saudi Arabia Full Text available with Trip Pro

Prevalence of Microalbuminuria in Adult Patients with Sickle Cell Disease in Eastern Saudi Arabia Proteinuria is a common feature of sickle cell nephropathy (SCN) that can progress to renal insufficiency and end stage renal disease. Microalbuminuria (MA) is the earliest manifestation of SCN and precedes the development of overt proteinuria. In addition to the renal consequences, MA is linked to cardiovascular complications. Periodic screening and early detection of MA allow early intervention (...) including age, gender, body mass index (BMI), hemoglobin level, blood pressure, blood transfusion history, pain episodes, and use of hydroxyurea.Urine samples were tested on 72 patients. The mean age of the study cohort was 35 ± 16.9 years. Microalbuminuria was detected in 18 patients (25%). No correlation was found with any of the tested variables.Microalbuminuria is a common finding in patients with SCD in eastern Saudi Arabia. Patients with SCD should be screened for MA, and those with positive tests

2018 International journal of nephrology

11. Dietary Patterns Over Time and Microalbuminuria in Youth and Young Adults With Type 1 Diabetes: The SEARCH Nutrition Ancillary Study. Full Text available with Trip Pro

Dietary Patterns Over Time and Microalbuminuria in Youth and Young Adults With Type 1 Diabetes: The SEARCH Nutrition Ancillary Study. We assessed the association between diet quality and microalbuminuria in youth-onset type 1 diabetes using three indices: a modified Mediterranean diet score for children and adolescents (mKIDMED), the Dietary Approaches to Stop Hypertension (DASH), and the Healthy Eating Index-2010 (HEI).Youth and young adults from the SEARCH (SEARCH for Diabetes in Youth (...) pressure (ORHEI 0.86, P = 0.19). Results were similar for continuous UACR. No significant associations were observed for diet quality characterized by the mKIDMED or DASH indices.Greater adherence to the HEI may be beneficial for kidney health in youth and young adults with type 1 diabetes. Low adherence to the mKIDMED and DASH diets may explain the lack of association with microalbuminuria.© 2018 by the American Diabetes Association.

2018 Diabetes Care

12. Why treat proteinuria in non-diabetic CKD?

Why treat proteinuria in non-diabetic CKD? Chiefs’ Inquiry Corner – 9/9/2019 – Clinical Correlations Search Chiefs’ Inquiry Corner – 9/9/2019 September 9, 2019 2 min read Kidney Disease – Improving Global Outcomes (KDIGO) guidelines recommend treating non-diabetic adults with chronic kidney disease (CKD) and urine albumin excretion greater than 300 mg / day or equivalent with an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB). This recommendation is based (...) on a meta-analysis of 11 randomized controlled trials, including 1860 patients, which found that reduction of proteinuria using an ACE inhibitor or ARB was associated with less progression of CKD, independent of blood pressure control. Unfortunately, the combination of an ACE inhibitor and ARB has not been shown to further reduce proteinuria and prevention of CKD progression. References: Functional mitral regurgitation (MR) refers to valvular insufficiency secondary to a dilated left ventricle

2019 Clinical Correlations

13. Albumin:creatinine ratio testing in the assessment and/or identification of proteinuria in people with chronic kidney disease or primary hypertension

proteinuria and albuminuria. Qjm, 104(8), 663-670. doi:https://dx.doi.org/10.1093/qjmed/hcr026 Ying, T., Clayton, P., Naresh, C., & Chadban, S. (2018). Predictive value of spot versus 24-hour measures of proteinuria for death, end-stage kidney disease or chronic kidney disease progression. BMC Nephrology, 19(1), 55. doi:https://dx.doi.org/10.1186/s12882-018-0853-1 Zhao, Y. F., Zhu, L., Liu, L. J., Shi, S. F., Lv, J. C., & Zhang, H. (2016). Measures of Urinary Protein and Albumin in the Prediction (...) Albumin:creatinine ratio testing in the assessment and/or identification of proteinuria in people with chronic kidney disease or primary hypertension Page 1 of 6 TER005 December 2018 Topic Exploration Report Topic explorations are designed to provide a high-level briefing on new topics submitted for consideration by Health Technology Wales. The main objectives of this report are to: 1. Inform discussions on new topics received by HTW. 2. Determine the quantity and type of evidence available

2019 Health Technology Wales

14. Association of Albuminuria and Estimated Glomerular Filtration Rate with Functional Performance Measures in Older Adults with Chronic Kidney Disease. Full Text available with Trip Pro

Association of Albuminuria and Estimated Glomerular Filtration Rate with Functional Performance Measures in Older Adults with Chronic Kidney Disease. 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.This is a cross-sectional analysis of a hypertensive cohort of people aged ≥75 years from the Systolic Blood Pressure Intervention Trial. We (...) associated with lower EQ-5D (p < 0.001 for both) and slower gait speed (p < 0.001 for both) and worse scores on FES (p = 0.032 and p = 0.039). In the fully adjusted models, higher levels of UACR remained significantly associated with lower EQ-5D scores and slower gait speed (p = 0.011 and p = 0.002, respectively). In contrast, level of eGFR was not associated with any functional outcome measures when accounting for covariates.In individuals aged ≥75 years, albuminuria and eGFR were associated

2017 American journal of nephrology Controlled trial quality: uncertain

15. Dipstick proteinuria level is significantly associated with pre-morbid and in-hospital functional status among hospitalized older adults: a preliminary study Full Text available with Trip Pro

Dipstick proteinuria level is significantly associated with pre-morbid and in-hospital functional status among hospitalized older adults: a preliminary study 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. Of 136 community-dwelling elderly patients enrolled (age 80.7 ± 8.2 years, with 19% having CKD), 17%, 57%, and 26% had no, trace to 1 + , or 2 + or higher proteinuria. Overall pre-morbid, on-admission, and on-discharge BI scores were 50.4 ± 41.9, 38.6 ± 31.8, and 38.7 ± 35.3, respectively with significant

2017 Scientific reports

16. Tubular B7-1 expression parallels proteinuria levels, but not clinical outcomes in adult minimal change disease patients Full Text available with Trip Pro

Tubular B7-1 expression parallels proteinuria levels, but not clinical outcomes in adult minimal change disease patients B7-1 is thought to play a pathogenic role in minimal-change disease (MCD). Recently, however, doubts have arisen regarding the role of B7-1 expression in MCD. Therefore, we aimed to identify the presence and clinical significance of B7-1 expression in MCD patients. The study participants included 28 adult MCD patients for whom kidney specimens were available. The intensity (...) B7-1 expression increased. We also found trends of increasing blood urea nitrogen and serum creatinine levels with increased intensity of tubular B7-1 expression. However, we could not observe definite differences in long- and short-term clinical outcomes depending on the intensity of tubular B7-1 expression. In conclusion, B7-1 was expressed in renal tubular cells but not in glomeruli in adult MCD patients. The intensity of tubular B7-1 expression paralleled proteinuria levels, but not clinical

2017 Scientific reports

17. Burden of Proteinuria and Risk Factors of Chronic Kidney Disease among Adult Population in Urban Puducherry, India Full Text available with Trip Pro

Burden of Proteinuria and Risk Factors of Chronic Kidney Disease among Adult Population in Urban Puducherry, India In the recent times, Chronic Kidney Diseases (CKDs) are emerging as a serious problem all over the world along with diabetes mellitus and hypertension. The presence of proteinuria is considered as an indicator of increased risk of progressive kidney diseases.To determine the prevalence of proteinuria among an adult population of a tertiary care institute of Puducherry, India.A (...) cross-sectional study was carried out in the field practice areas of an urban health centre of a tertiary care institute, in Puducherry, India. A total of 215 study respondents were selected by systematic random sampling. All adults aged above 18 years who were residing for at least a year in Puducherry were included in the study. The study period was from July 2015 to October 2015. All the categorical variables were described as proportions. Chi square test was done to compare between two

2017 Journal of clinical and diagnostic research : JCDR

18. Red cell distribution width predicts incident dipstick albuminuria in Korean adults without chronic kidney disease Full Text available with Trip Pro

Red cell distribution width predicts incident dipstick albuminuria in Korean adults without chronic kidney disease Red cell distribution width (RDW) is an emerging marker of inflammation and a predictor of high cardiovascular morbidity and mortality as well as all-cause mortality. A previous cross-sectional study showed that RDW was associated with microalbuminuria, an indicator of target organ damage. However, the longitudinal association of RDW and development of albuminuria is not known.We (...) in relatively healthy Korean adults without CKD. Further research is needed to verify the role of RDW in the development of albuminuria and renal injury.

2017 Kidney research and clinical practice

19. Comparison of Renal Growth, Proteinuria and Graft Survival between Recipients of Pediatric and Adult Cadaveric Kidney Transplants Full Text available with Trip Pro

Comparison of Renal Growth, Proteinuria and Graft Survival between Recipients of Pediatric and Adult Cadaveric Kidney Transplants The shortage of cadaveric kidney donors has prompted transplant teams to expanding the donor selection criteria. The usage of pediatric cadaveric kidneys is one of those expanded criteria. But the main concern is the probability of hyperfiltration syndrome due to small renal mass of pediatric donors.To compare the graft and patient survivals, post-transplantation (...) complications, rate and severity of proteinuria secondary to hyperfiltration injury and the kidney growth of recipients who underwent transplantation from adult (group 1) and pediatric deceased donors (group 2).In this historical cohort study, each group contains 36 patients. Outcome measures included patient and graft survivals, quality of graft function as assessed by serum creatinine (SCr) and estimated GFR (eGFR), surgical complications, proteinuria that was detected by routine urinalysis

2017 International journal of organ transplantation medicine

20. Absence of HIV-Associated Nephropathy Among Antiretroviral Naive Adults With Persistent Albuminuria in Western Kenya Full Text available with Trip Pro

arteriosclerosis. Focal segmental glomerulosclerosis, acute postinfectious glomerulonephritis, chronic interstitial nephritis, pyelitis, and papillary sickling were seen in 1 patient each.Among ART-naïve adults with persistent albuminuria at a referral center in Western Kenya, we observed no cases of HIVAN. AIN was the most common cause of persistent proteinuria in this setting. (...) Absence of HIV-Associated Nephropathy Among Antiretroviral Naive Adults With Persistent Albuminuria in Western Kenya HIV-associated nephropathy (HIVAN) has been strongly linked to African ancestry. However, studies have demonstrated wide variability in the prevalence of HIVAN in different sub-Saharan African populations. Accurate assessment of the disease burden is important because antiretroviral therapy (ART) is increasingly available and may prevent progression to end-stage renal disease.We

2016 Kidney international reports

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