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Proteinuria

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Hematuria in children --- Proteinuria in children --- Child --- Hematuria --- Infant --- Proteinuria

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A low molecular weight β2-globulin which goes not correspond to any known protein has been isolated from urine of a cadmium-exposed worker with proteinuria. The isolation procedure included chromatography on Sephadex G-75 and DEAE-cellulose, followed by preparative agarose gel electrophoresis.
The purified protein was homogeneous in ultracentrifugation and in electrophoresis in agarose gel. Electrophoresis in polyacrylamide gel containing sodium dodecyl sulphate confirmed the homogeneity of the preparation and suggested a molecular weight of about 21.000. No carbohydrate was detected by the anthrone reaction. Absorbance was maximal at 279 nm. This protein is apparently devoid of cysteine, methionine and histidne. Trace amounts of the protein have been found in normal human urine

Cadmium --- Proteinuria --- Electrophoresis, Polyacrylamide Gel --- Sodium Dodecyl Sulfate --- Molecular Weight

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Pre-Eclampsia --- Proteinuria --- Pregnancy --- Blood Pressure --- Hypertension --- urine

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This study focusing on chronic kidney disease first insists on the importance of an early detection ofthis increasingly incident and undoubtedlyexpensive disease, with details on its step by step assessement and further precisions on the use of Cockroft-Gault and MDRD formulas. It emphasizes the need of protecting renal function, of a comprehensive care (afortioriamongthe elderly), and to beware ofthe increased cardiovascular risk. After reviewing the pharmacology, drug dosing adjustements are developed (sorted by mechanisms in the text, then summarized in a table and a practical sheet). Computerized decision support, involvement of pharmacists and increased accessibility of reference sources are essential tools to strengthen the role of GPs in such a complex disease managing. Ce travail centré sur l’insuffisance rénale chronique parle dans un premier temps de l’importance et des modalités pratiques d’un dépistage précoce de cette pathologie en incidence croissante et incontestablement couteuse (cf. priorité dans les trajets de soins), avec une précision particulière sur l’emploi des formules de Cockroft-Gault et MDRD. On note l’importance de protéger la fonction rénale et d’une prise en charge globale, afortiori chez les personnes âgées, ainsi que du risque cardio-vasculaire majoré. Après un rappel de pharmacologie, les multiples adaptations médicamenteuses requises sont développées (selon les mécanismes dans le texte, puis sous forme d’un tableau récapitulatif et d’une fiche pratique). Un programme informatique performant, une collaboration avec les pharmaciens et l’accessibilité des sources de références sont des outils indispensables afin de renforcer le rôle des généralistes dans cette prise en charge complexe.

Renal Insufficiency, Chronic --- Proteinuria --- General Practice --- Drug Dosage Calculations --- Cardiovascular Diseases