Background: Pre-eclampsia has long been considered as a disease that disappears after the removal of the placenta. It has now been shown that its symptoms can persist for months after giving birth. Objectives: To stud...Background: Pre-eclampsia has long been considered as a disease that disappears after the removal of the placenta. It has now been shown that its symptoms can persist for months after giving birth. Objectives: To study the evolution of proteinuria and renal function in women with pre-eclampsia. Patients and Methods: An analytical prospective study was carried out in the Hospitalization Unit of the Gynecology Department of the Teaching Hospital of Cocody (Abidjan) from May 3, 2021 to November 15, 2021. It focused on the follow-up of proteinuria and renal function in 50 women who had pre-eclampsia during their pregnancy, in the three months following their delivery. Results: The average age of the patients was 30.38 ± 6 years (range 18 and 40 years). Thirty-two percent were nulliparous and 62% had no risk factors for pre-eclampsia. The diagnosis of pre-eclampsia was made in 52% of cases before 37 weeks of amenorrhea. Sixty-two percent had Grade 3 arte-rial hypertension. The average proteinuria/creatininuria ratio was 3592.08 ± 7009.57 mg/g and 32% of women had glomerular grade proteinuria. The mean serum creatinine was 13.61 ± 12.62 mg/l. AKI (Acute Renal Failure) was present in 30% of women. All patients had received a central antihypertensive drug of which 88% were a calcium channel blocker. For the delivery mode, a Caesarean section was performed in 88% of cases. In the three months postpartum, 40% of women had persistent hypertension, 58% had persistent proteinuria and 6% had persistent impaired renal function. Prematurity (p = 0.0091), IUGR (intrauterine growth restriction) (p = 0.0012) and IUFD (intrauterine fetal death) (p = 0.0012) were associated with the persistence of proteinuria at M3 postpartum. Conclusion: Symptoms of pre-eclampsia do not automatically disappear after the delivery. Proteinuria and renal failure can persist beyond three months after the delivery and require treatment by a nephrologist.展开更多
Introduction: Early detection of proteinuria is early detection is a cost-effective method of assessing individuals with and without risk factors for chronic renal disease. Proteinuria is common in adults and may pres...Introduction: Early detection of proteinuria is early detection is a cost-effective method of assessing individuals with and without risk factors for chronic renal disease. Proteinuria is common in adults and may present a clinical challenge in the absence of obvious renal disease or risk factors especially in the tropics. Few studies in Nigeria have assessed the prevalence of proteinuria in adults using the dipstick method. The aim of this study was to document the prevalence of proteinuria among residents of a community in Enugu, south east Nigeria. Methods: This was a cross-sectional descriptive study carried out in an isolated urban slum settlement in Enugu, south east Nigeria. Dipstick testing of freshly voided early morning mid-stream urine samples was done to detect proteinuria. For database management and statistical analyses, SPSS version 23 was used. Results: A total of 262 individuals were recruited for the study, 165 (63%) females and 97 (37%) males. The participants’ age ranged from 18 to 90 years, averaging 43.7 ± 15.5. Trace amounts of protein were detected in urine samples of 225 (85.9%) individuals. Significant proteinuria was detected in 3.8% of the participants and was significantly higher 40 - 49-year-olds (6%). p = 0.02 and 0.02 respectively. Significant correlates of proteinuria were lower diastolic blood pressure and current tobacco use. Lower body mass index weakly correlated with proteinuria. Conclusion: The prevalence of significant early morning proteinuria in a community-based study in Enugu was 3.8%. Significant correlates of proteinuria included low diastolic blood pressure and tobacco use. Community based awareness programs targeted at prevention of chronic renal diseases should be incorporated in public health programs.展开更多
Living kidney transplantation is now a widely accepted treatment for end stage renal disease(ESRD) because it provides excellent outcomes for recipients. However, long-term outcomes of living kidney donors have not be...Living kidney transplantation is now a widely accepted treatment for end stage renal disease(ESRD) because it provides excellent outcomes for recipients. However, long-term outcomes of living kidney donors have not been well understood. Because securing the safety of the donor is essential to the continued success of this procedure, we reviewed articles discussing long-term outcomes of living kidney donors. Most studies found no decrease in long-term survival or progressive renal dysfunction in previous kidney donors. Moreover, the prevalence of hypertension was comparable to that expected in the general population, although some did report otherwise. Urinary protein showed small increases in this population and was associated with hypertension and a lower glomerular filtration rate. Quality of life following living kidney donation seems to be better than the national norm. We also encountered several reports of ESRD in previous living kidney donors. Regular follow-up of kidney donors is recommended and future controlled, prospective studies will better delineate risk factors which cause health problems following living kidney donation.展开更多
目的探讨高凝状态与IgA血管炎肾炎(immunoglobulin A vasculitis with nephritis,IgAVN)患儿尿蛋白和肾脏病理损伤之间的关系。方法根据凝血功能结果,将349例IgAV患儿分为高凝组(52例)和非高凝组(297例),比较两组间尿蛋白和肾脏病理特征...目的探讨高凝状态与IgA血管炎肾炎(immunoglobulin A vasculitis with nephritis,IgAVN)患儿尿蛋白和肾脏病理损伤之间的关系。方法根据凝血功能结果,将349例IgAV患儿分为高凝组(52例)和非高凝组(297例),比较两组间尿蛋白和肾脏病理特征,并分析IgAVN患儿高凝状态形成的影响因素。结果高凝组患儿尿红细胞计数、24 h尿蛋白定量、尿蛋白/肌酐、尿免疫球蛋白G/肌酐、尿N-乙酰β-D-氨基葡萄糖苷酶水平高于非高凝组(P<0.05);高凝组患儿肾脏病理分级为Ⅲ~Ⅳ级、弥漫性系膜增生、毛细血管内皮细胞增生、肾小球新月体形成>25%比例高于非高凝组(P<0.05)。多因素logistic回归分析结果显示,毛细血管内皮细胞增生、肾小球新月体形成>25%是IgAVN患儿高凝状态形成的影响因素(P<0.05)。结论伴高凝状态IgAVN患儿的肾损伤更为严重,肾小球新月体形成>25%和毛细血管内皮细胞增生是进一步加重IgAVN高凝状态的重要因素。展开更多
目的:探讨血清胱抑素C(cystatin C,Cys-C)检测在糖尿病肾病(DN)患者肾功能评价中的诊断价值。方法:经临床及肾活检确诊的2型糖尿病、DN患者83例。免疫比浊法测定血清Cys-C浓度。同时测定血肌酐水平(SCr)、BMI数值、肾小管功能指标(NAG酶...目的:探讨血清胱抑素C(cystatin C,Cys-C)检测在糖尿病肾病(DN)患者肾功能评价中的诊断价值。方法:经临床及肾活检确诊的2型糖尿病、DN患者83例。免疫比浊法测定血清Cys-C浓度。同时测定血肌酐水平(SCr)、BMI数值、肾小管功能指标(NAG酶,RBP、尿渗量)、尿蛋白水平、血清白蛋白、尿酸水平、同位素99mTc-DTPA测定肾小球滤过率(GFR)。分析不同肾功能状态下Cys-C,SCr、MDRD公式与ECT-GFR的相关性。进一步根据肾小管功能指标、蛋白尿程度、血清白蛋白水平、代谢指标(血清尿酸、BMI)分组,分析Cys-C、SCr与GFR的相关性差别。以ECT-GFR为标准,作Cys-C、SCr的受试者工作特性曲线(receiver operator characteristic curve,ROC),并求其曲线下面积(area under the curve,AUC)。结果:(1)Cys-C、SCr与ECT-GFR的Pearson相关系数r分别为-0.740和-0.663(P<0.01),Cys-C与GFR的相关性较SCr更好。GFR≤60ml/min时,Cys-C、MDRD-GFR、SCr与GFR的相关系数r分别为-0.798,0.760,-0.716(P<0.01),Cys-C与GFR的相关性优于SCr和MDRD公式;GFR>90ml/min时,Cys-C、SCr与GFR的相关系数r分别为-0.561vs-0.465(P<0.05)。Cys-C与GFR的相关性优于SCr。(2)患者肾小管功能受损状态下:NAG酶>20u/g.cr时,Cys-C、SCr与GFR的相关系数r分别为-0.660vs-0.595(P<0.01);RBP>2mg/L时,r值分别为-0.672vs-0.635(P<0.01);尿渗量≤600mOsm/kg.H2O时,r值分别为-0.696vs-0.663(P<0.01)。Cys-C与GFR的相关性均较SCr更好。(3)尿蛋白>1g/24h时,Cys-C、SCr与GFR的相关系数r分别为-0.704vs-0.649(P<0.01)。血清白蛋白≤35g/L时,r值分别为-0.635vs-0.581(P<0.01)。Cys-C与GFR的相关性均较SCr更好。(4)不同血清尿酸、BMI状态下,Cys-C与GFR的相关系数r值不受影响。ROC中曲线下面积(AUC),Cys-C、SCr分别为0.915vs0.902(P<0.01),仍以Cys-C更灵敏和特异。结论:DN患者各期(包括早期高灌注期、肾功能损害期),Cys-C与GFR之间的相关性优于SCr、MDRD公式。DN患者出现肾小管功能损害时,Cys-C与GFR仍有较好的相关性。DN患者出现蛋白尿、血清白蛋白下降时,Cys-C仍可较好地反映肾功能。而代谢性指标不影响Cys-C与GFR的之间的相关性。Cys-C可作为一个更好的反映DN患者肾功能变化的内源性指标。展开更多
文摘Background: Pre-eclampsia has long been considered as a disease that disappears after the removal of the placenta. It has now been shown that its symptoms can persist for months after giving birth. Objectives: To study the evolution of proteinuria and renal function in women with pre-eclampsia. Patients and Methods: An analytical prospective study was carried out in the Hospitalization Unit of the Gynecology Department of the Teaching Hospital of Cocody (Abidjan) from May 3, 2021 to November 15, 2021. It focused on the follow-up of proteinuria and renal function in 50 women who had pre-eclampsia during their pregnancy, in the three months following their delivery. Results: The average age of the patients was 30.38 ± 6 years (range 18 and 40 years). Thirty-two percent were nulliparous and 62% had no risk factors for pre-eclampsia. The diagnosis of pre-eclampsia was made in 52% of cases before 37 weeks of amenorrhea. Sixty-two percent had Grade 3 arte-rial hypertension. The average proteinuria/creatininuria ratio was 3592.08 ± 7009.57 mg/g and 32% of women had glomerular grade proteinuria. The mean serum creatinine was 13.61 ± 12.62 mg/l. AKI (Acute Renal Failure) was present in 30% of women. All patients had received a central antihypertensive drug of which 88% were a calcium channel blocker. For the delivery mode, a Caesarean section was performed in 88% of cases. In the three months postpartum, 40% of women had persistent hypertension, 58% had persistent proteinuria and 6% had persistent impaired renal function. Prematurity (p = 0.0091), IUGR (intrauterine growth restriction) (p = 0.0012) and IUFD (intrauterine fetal death) (p = 0.0012) were associated with the persistence of proteinuria at M3 postpartum. Conclusion: Symptoms of pre-eclampsia do not automatically disappear after the delivery. Proteinuria and renal failure can persist beyond three months after the delivery and require treatment by a nephrologist.
文摘Introduction: Early detection of proteinuria is early detection is a cost-effective method of assessing individuals with and without risk factors for chronic renal disease. Proteinuria is common in adults and may present a clinical challenge in the absence of obvious renal disease or risk factors especially in the tropics. Few studies in Nigeria have assessed the prevalence of proteinuria in adults using the dipstick method. The aim of this study was to document the prevalence of proteinuria among residents of a community in Enugu, south east Nigeria. Methods: This was a cross-sectional descriptive study carried out in an isolated urban slum settlement in Enugu, south east Nigeria. Dipstick testing of freshly voided early morning mid-stream urine samples was done to detect proteinuria. For database management and statistical analyses, SPSS version 23 was used. Results: A total of 262 individuals were recruited for the study, 165 (63%) females and 97 (37%) males. The participants’ age ranged from 18 to 90 years, averaging 43.7 ± 15.5. Trace amounts of protein were detected in urine samples of 225 (85.9%) individuals. Significant proteinuria was detected in 3.8% of the participants and was significantly higher 40 - 49-year-olds (6%). p = 0.02 and 0.02 respectively. Significant correlates of proteinuria were lower diastolic blood pressure and current tobacco use. Lower body mass index weakly correlated with proteinuria. Conclusion: The prevalence of significant early morning proteinuria in a community-based study in Enugu was 3.8%. Significant correlates of proteinuria included low diastolic blood pressure and tobacco use. Community based awareness programs targeted at prevention of chronic renal diseases should be incorporated in public health programs.
文摘Living kidney transplantation is now a widely accepted treatment for end stage renal disease(ESRD) because it provides excellent outcomes for recipients. However, long-term outcomes of living kidney donors have not been well understood. Because securing the safety of the donor is essential to the continued success of this procedure, we reviewed articles discussing long-term outcomes of living kidney donors. Most studies found no decrease in long-term survival or progressive renal dysfunction in previous kidney donors. Moreover, the prevalence of hypertension was comparable to that expected in the general population, although some did report otherwise. Urinary protein showed small increases in this population and was associated with hypertension and a lower glomerular filtration rate. Quality of life following living kidney donation seems to be better than the national norm. We also encountered several reports of ESRD in previous living kidney donors. Regular follow-up of kidney donors is recommended and future controlled, prospective studies will better delineate risk factors which cause health problems following living kidney donation.
文摘目的探讨高凝状态与IgA血管炎肾炎(immunoglobulin A vasculitis with nephritis,IgAVN)患儿尿蛋白和肾脏病理损伤之间的关系。方法根据凝血功能结果,将349例IgAV患儿分为高凝组(52例)和非高凝组(297例),比较两组间尿蛋白和肾脏病理特征,并分析IgAVN患儿高凝状态形成的影响因素。结果高凝组患儿尿红细胞计数、24 h尿蛋白定量、尿蛋白/肌酐、尿免疫球蛋白G/肌酐、尿N-乙酰β-D-氨基葡萄糖苷酶水平高于非高凝组(P<0.05);高凝组患儿肾脏病理分级为Ⅲ~Ⅳ级、弥漫性系膜增生、毛细血管内皮细胞增生、肾小球新月体形成>25%比例高于非高凝组(P<0.05)。多因素logistic回归分析结果显示,毛细血管内皮细胞增生、肾小球新月体形成>25%是IgAVN患儿高凝状态形成的影响因素(P<0.05)。结论伴高凝状态IgAVN患儿的肾损伤更为严重,肾小球新月体形成>25%和毛细血管内皮细胞增生是进一步加重IgAVN高凝状态的重要因素。
文摘目的:探讨血清胱抑素C(cystatin C,Cys-C)检测在糖尿病肾病(DN)患者肾功能评价中的诊断价值。方法:经临床及肾活检确诊的2型糖尿病、DN患者83例。免疫比浊法测定血清Cys-C浓度。同时测定血肌酐水平(SCr)、BMI数值、肾小管功能指标(NAG酶,RBP、尿渗量)、尿蛋白水平、血清白蛋白、尿酸水平、同位素99mTc-DTPA测定肾小球滤过率(GFR)。分析不同肾功能状态下Cys-C,SCr、MDRD公式与ECT-GFR的相关性。进一步根据肾小管功能指标、蛋白尿程度、血清白蛋白水平、代谢指标(血清尿酸、BMI)分组,分析Cys-C、SCr与GFR的相关性差别。以ECT-GFR为标准,作Cys-C、SCr的受试者工作特性曲线(receiver operator characteristic curve,ROC),并求其曲线下面积(area under the curve,AUC)。结果:(1)Cys-C、SCr与ECT-GFR的Pearson相关系数r分别为-0.740和-0.663(P<0.01),Cys-C与GFR的相关性较SCr更好。GFR≤60ml/min时,Cys-C、MDRD-GFR、SCr与GFR的相关系数r分别为-0.798,0.760,-0.716(P<0.01),Cys-C与GFR的相关性优于SCr和MDRD公式;GFR>90ml/min时,Cys-C、SCr与GFR的相关系数r分别为-0.561vs-0.465(P<0.05)。Cys-C与GFR的相关性优于SCr。(2)患者肾小管功能受损状态下:NAG酶>20u/g.cr时,Cys-C、SCr与GFR的相关系数r分别为-0.660vs-0.595(P<0.01);RBP>2mg/L时,r值分别为-0.672vs-0.635(P<0.01);尿渗量≤600mOsm/kg.H2O时,r值分别为-0.696vs-0.663(P<0.01)。Cys-C与GFR的相关性均较SCr更好。(3)尿蛋白>1g/24h时,Cys-C、SCr与GFR的相关系数r分别为-0.704vs-0.649(P<0.01)。血清白蛋白≤35g/L时,r值分别为-0.635vs-0.581(P<0.01)。Cys-C与GFR的相关性均较SCr更好。(4)不同血清尿酸、BMI状态下,Cys-C与GFR的相关系数r值不受影响。ROC中曲线下面积(AUC),Cys-C、SCr分别为0.915vs0.902(P<0.01),仍以Cys-C更灵敏和特异。结论:DN患者各期(包括早期高灌注期、肾功能损害期),Cys-C与GFR之间的相关性优于SCr、MDRD公式。DN患者出现肾小管功能损害时,Cys-C与GFR仍有较好的相关性。DN患者出现蛋白尿、血清白蛋白下降时,Cys-C仍可较好地反映肾功能。而代谢性指标不影响Cys-C与GFR的之间的相关性。Cys-C可作为一个更好的反映DN患者肾功能变化的内源性指标。
