摘要:

Purpose of reviewIn this review we intend to evaluate the clinical usefulness of measurement of urinary excretion of microproteins and tubular enzymes.Recent findingsStudies of patients with acute tubular necrosis showed that the excretion of some well known enzymes and of new markers such as kidney injury molecule-1 has higher value than classic renal function tests for the early detection of the disease as well as for the prediction of the development of overt acute renal failure. Tubular dysfunction may be detected by measurement of the excretion of tubular enzymes and microproteins not only in workers chronically exposed to heavy metals but also in population exposed to low environmental level below the limits set by the WHO. In chronic glomerulonephritis the excretion of α1-microglobulin is significantly associated with the extent of tubulo-interstitial damage and predicts outcome better than proteinuria/day; in the same diseases NAG excretion is significantly dependent on immunoglobulin G and α1-microglobulin excretion and predicts remission, progression and response to therapy.SummaryThe measurement of urinary excretion of tubular enzymes and microproteins may be clinically useful in several different kidney diseases (such as acute tubular necrosis, glomerulonephritis) both for diagnosis and prediction of fractional outcome.

ISSN:1062-4821    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewTo identify and evaluate recent (2000-2003) published studies employing ambulatory blood pressure monitoring in patients with chronic renal failure, on dialysis, and after renal transplantation.Recent findingsWe discuss several studies that have employed ambulatory blood pressure monitoring to refine the analysis of the link between blood pressure levels, and diurnal alterations, and end-organ damage or patient survival. There is now some evidence that an abnormal diurnal blood pressure profile, although intrinsically not a very reproducible label, has predictive value for patient survival, and that the non-dipping phenomenon is linked to a high incidence of cardiovascular disease and autonomic dysfunction.SummaryAmbulatory blood pressure monitoring remains an important adjunct to the comprehensive cardiovascular evaluation of patients with chronic, end-stage renal failure or after renal transplantation.

ISSN:1062-4821    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewRadionuclide renography has become standard practice but with controversial areas and variations in technique. This review looks at some recent studies to improve usefulness and to assess the current clinical indications for the use of dynamic radionuclide renography and considers some of the recent publications that have contributed to the subject during the past year.Recent findingsTwo important papers attempting to standardize the diuretic renogram and provide normal values for the MAG3 renogram are reviewed together with exercise renography in hypertension and used for the Captopril test.SummaryResearch into renography is not an active area at present but there have been a few important contributions which will improve the clinical value of radionuclide renography.

ISSN:1062-4821    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose of reviewHaemolytic uraemic syndrome (HUS) is a disease of diverse origin. The last year has witnessed the identification of a novel genetic marker of this disease, the description of the frequency of the factor H associated form of HUS in a registry of over 100 patients and a better understanding of the pathophysiology of the disease.Recent findingsIn patients with atypical HUS, heterozygous mutations in the gene coding for the soluble complement regulator factor H are reported and most of the mutations cluster in the C-terminal recognition domain of the protein. A novel genetic marker for HUS has also been identified. Mutations occurring in the gene of the von Willebrand factor cleaving protease,ADAMTS13, which were previously linked to thrombotic thrombocytopenic purpura have now been identified in HUS patients. The frequency of factor H-associated HUS was established as 14% in a registry of German speaking countries and also 16 novel disease associated mutations were reported. The pathophysiology of factor H-associated HUS was analysed. Three analysed mutant proteins show normal complement regulatory activities but display defective recognition functions: reduced binding to surface attached C3b, to heparin/polyanions and to endothelial cells.SummaryThe identification of effector molecules of the complement as well as the coagulation cascade as disease associated molecules indicate a regulatory protein network, which maintains integrity of endothelial cells during stress or infection. Defining the individual components and how their functional interaction causes microangiopathies will identify additional disease markers and will allow the design of proper diagnostic and therapeutic approaches.

ISSN:1062-4821    

出版商:OVID    

年代:2003

数据来源: OVID

ISSN:1062-4821    

出版商:OVID    

年代:2003

数据来源: OVID