Child ; Glomerulonephritis ; classification ; diagnosis ; therapy ; Humans

Humans ; Child ; Antibodies, Antineutrophil Cytoplasmic ; Glomerulonephritis/therapy*

Glomerulonephritis, IGA ; diagnosis ; therapy ; Humans ; Integrative Medicine ; Risk Assessment

Child ; Early Diagnosis ; Evidence-Based Medicine ; Glomerulonephritis ; diagnosis ; therapy ; Glomerulonephritis, Membranous ; diagnosis ; therapy ; Humans ; Kidney Diseases ; diagnosis ; therapy ; Kidney Glomerulus ; pathology ; Nephrosis, Lipoid ; diagnosis ; therapy ; Renal Replacement Therapy

The effect of captopril on proteinuria was evaluated in twenty patients with various glomerular diseases excreting heavy proteinuria (> 3.0 g/day). Captopril in a daily dose of 37.5 mg was administered orally three times a day to all patients and they were followed for eight weeks. Twenty-four hour urinary excretion of protein, creatinine, sodium, selective protein index (SPI), and blood chemistry including serum electrolytes were measured every two weeks. Twenty-four hour urinary protein excretion per gram creatinine started to fall within two weeks of captopril administration and became nearly stable after four weeks of therapy (p< 0.05). Mean 24-hour urinary protein excretion decreased significantly from a pretreatment value of 9.0 +/- 6.0 gm/gm of cr. to 4.4 +/- 3.5 gm/gm of cr. after eight weeks of captopril treatment. The serum albumin level increased progressively at six and eight weeks after the captopril treatment period and was significantly higher than the pretreatment value (p< 0.05). The decrease in proteinuria did not coincide with a fall in blood pressure or any changes in creatinine clearance. We conclude that captopril does have a significant antiproteinuric effect in patients excreting heavy proteinuria with various glomerular diseases. However, the long term therapeutic efficacy and any renal protective effect of this drug remain to be proven.
Adult ; Aged ; Blood Pressure/drug effects ; Captopril/*therapeutic use ; Female ; Glomerulonephritis/*drug therapy ; Glomerulonephritis, IGA/*drug therapy ; Glomerulonephritis, Membranous/*drug therapy ; Human ; Male ; Middle Age ; Proteinuria/*drug therapy ; Sodium/urine ; Support, Non-U.S. Gov't

OBJECTIVETo observe the differences of curative effect of glomerular pathological proteinuria treated with combined therapy of acupuncture and medicine or simple medicine.

METHODSTwo hundred and forty cases of glomerular pathological proteinuria were divided into a combined therapy of acupuncture and medicine group (combined therapy group), a medicine group I and a medicine group II, 80 cases in each group. In combined therapy group, Pishu (BL 20) and Zhishi (BL 52) were punctured by heat-producing needling; Terazosin Hydrochloride, Bisoprolol Fumarate tablets or compound Reserpinum Triamterene tablet were applied with oral administration when accompanied by high blood pressure, to control the blood pressure within 130/80 mmHg. In medicine group I , Renin-Angiotensin-Aldosterone system (RAAS) interruption method was applied to control blood pressure; Benazepril Hydrochloride and Telmisartan were applied with oral administration to keep blood pressure in satisfying level, below 125-130/75-80 mmHg. In medicine group II, placebo was orally taken, and the medicine therapy which was same as that in combined therapy group was applied when accompanied by high blood pressure. Quality low protein and low salt and fat diet were applied in all groups. The Chinese medicine syndrome score, laboratory indices and curative effect were observed in all groups before and after treatment.

RESULTSThe total effective rate was 86.3% (69/80), 61.3% (49/80) and 17.5% (14/80) respectively in combined therapy group, medicine group I and medicine group II, indicating that the curative effect in combined therapy group was superior to that in other groups (P < 0.01, P < 0.05), and it in medicine group I was superior to that in medicine group II (P < 0.01). The Chinese medicine syndrome score was markedly reduced in combined therapy group (P < 0.01), and there was no obvious change in other groups (both P > 0.05). Urinary albumin (UMA) and urinary protein in 24 hours were notably reduced in combined therapy group and medicine group I (all P < 0.01), and it was more obviously in combined therapy group than that in other groups (P < 0.01, P < 0.05). The blood pressure was markedly reduced in all groups (all P < 0.05) after treatment, and there was no significant change in indices of liver and kidney functions (all P > 0.05).

CONCLUSIONThe curative effect of heat-producing needling method is good for treating glomerular pathological proteinuria, better than that of RAAS interruption method.

Acupuncture Therapy ; Adult ; Aged ; Female ; Glomerulonephritis ; pathology ; therapy ; Humans ; Male ; Middle Aged ; Proteinuria ; pathology ; therapy ; Treatment Outcome

Paraneoplastic nephrotic syndrome can be diagnosed from its clinical and immunological features. The development of several types of glomerular injury in patients with cancer have been recognized, and are considered as paraneoplastic syndrome. Most prominent are the occurrence of membranous glomerulonephritis in patients with carcinomas. We report a case of a 60-year-old-man with small cell lung cancer presenting as nephrotic syndrome. A renal biopsy revealed membranous glomerulonephritis. Six lots of chemotherapy were administerd, which led to a complete tumor response with total resolution of the nephrotic syndrome following treatment.
Biopsy ; Drug Therapy* ; Glomerulonephritis, Membranous* ; Humans ; Nephrotic Syndrome ; Paraneoplastic Syndromes ; Small Cell Lung Carcinoma*

C1q nephropathy is a rare type of glomerulonephritis manifested as the deposition of C1q in the glomerular mesangium during immunofluorescent staining. Systemic lupus erythematosus and type I membranoproliferative glomerulonephropathy need to be excluded in the diagnosis of C1q nephropathy. C1q nephropathy has various manifestations under a light microscope, mainly including minimal change disease, focal segmental glomerulosclerosis, and proliferative glomerulonephritis. This disease is mainly manifested as persistent proteinuria or nephrotic syndrome and occurs more frequently in boys. Currently, glucocorticoids are mainly used for the treatment of this disease. Patients with C1q nephropathy show a good response to immunosuppressant treatment, but have a high rate of glucocorticoid resistance. Therefore, in this case, methylprednisolone pulse therapy or a combination with immunosuppressant treatment helps to achieve a good prognosis.
Complement C1q ; metabolism ; Diagnosis, Differential ; Glomerulonephritis ; diagnosis ; drug therapy ; etiology ; Glucocorticoids ; therapeutic use ; Humans ; Prognosis

Glomerulonephritis, Membranous ; drug therapy ; Humans ; Male ; Middle Aged ; Rituximab ; therapeutic use

Disease Progression ; Glomerulonephritis, IGA ; surgery ; therapy ; Humans ; Steroids ; therapeutic use ; Tonsillectomy ; Vitamin E ; therapeutic use