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Chronic kidney disease (CKD) is a growing health concern in India, especially due to the increased prevalence of chronic diseases such as diabetes mellitus and hypertension (Mk, 1993). This study evaluates the prognostic significance of key biomarkers in CKD patients, including 24-hour urinary protein, estimated glomerular filtration rate (eGFR), and serum uric acid levels, alongside renal pathology and immunofluorescence findings. By assessing the relationships between these indicators, the research aims to enhance prognostic accuracy, predict CKD progression, and improve patient outcomes in the Indian context. The findings emphasize the importance of a comprehensive evaluation of these prognostic indicators in managing CKD effectively. Introduction: Chronic kidney disease (CKD) affects a substantial portion of the population in Indian subcontinent as well as globally, leading to adverse outcomes if not managed effectively. This paper aims to assess the utility of 24-hour urinary protein, eGFR, uric acid levels, renal pathology, and direct immunofluorescence findings as prognostic indicators in CKD. By exploring the relationships between these markers and disease progression, the study seeks to provide insights for personalized treatment strategies and improved patient care. Materials and Methods: This study was conducted as a retrospective, observational cohort study. Data has been collected from medical records of 50 CKD patients attending the nephrology OPD at MGM Medical college and Hospital, Kamothe, Navi Mumbai from the period of January 2022 to July 2023. Results: The study revealed significant correlations between 24-hour urinary protein, eGFR, uric acid levels, and specific renal pathologies. Higher levels of urinary protein and lower eGFR were robust predictors of CKD progression, while serum uric acid levels showed potential as a marker of disease severity. The findings underscored the importance of a comprehensive evaluation of prognostic indicators in CKD management. Conclusion: In conclusion, thisresearch paper underscores the value of incorporating diverse prognostic indicators in CKD management to enhance diagnostic accuracy and treatment planning. By analyzing the interplay between traditional markers, renal pathology, and immunofluorescence findings, clinicians can refine prognostic models, predict CKD progression, and optimize patient outcomes. The study's insights offer valuable guidance for personalized care and improved prognostication in CKD patients. [ABSTRACT FROM AUTHOR]

Abstract This study investigates the expression and significance of urinary protein and coagulation‐fibrinolysis indicators in preeclampsia, categorized into mild preeclampsia (109 cases) and severe preeclampsia (97 cases) based on disease severity. Additionally, 110 patients with gestational hypertension (gestational hypertension group) were included for comparative analysis. General information, laboratory indicators, urinary protein, and coagulation‐fibrinolysis indicator levels were collected for each group. Significant differences were observed in blood pressure among groups (P .05). Total cholesterol, triglycerides, and low‐density Lipoprotein levels in severe preeclampsia were higher than those in mild preeclampsia and gestational hypertension groups, whereas high‐density lipoprotein, albumin, and platelet levels were lower in severe preeclampsia. No significant differences were observed in prothrombin time or D‐dimer levels among groups (P > .05). Urinary protein, urinary protein quantification, activated partial thromboplastin time, thrombin time, and fibrinogen were identified as influencing factors for adverse maternal and infant outcomes in severe preeclampsia patients. The study concludes that urinary protein and coagulation‐fibrinolysis indicators are elevated in preeclampsia, particularly in severe preeclampsia cases, suggesting their potential use as diagnostic influencing factors for severe preeclampsia.

This study investigates the expression and significance of urinary protein and coagulation‐fibrinolysis indicators in preeclampsia, categorized into mild preeclampsia (109 cases) and severe preeclampsia (97 cases) based on disease severity. Additionally, 110 patients with gestational hypertension (gestational hypertension group) were included for comparative analysis. General information, laboratory indicators, urinary protein, and coagulation‐fibrinolysis indicator levels were collected for each group. Significant differences were observed in blood pressure among groups (P <.05), while uric acid, serum creatinine, aspartate transaminase, alanine transaminase, and triglycerides showed no significant differences (P >.05). Total cholesterol, triglycerides, and low‐density Lipoprotein levels in severe preeclampsia were higher than those in mild preeclampsia and gestational hypertension groups, whereas high‐density lipoprotein, albumin, and platelet levels were lower in severe preeclampsia. No significant differences were observed in prothrombin time or D‐dimer levels among groups (P >.05). Urinary protein, urinary protein quantification, activated partial thromboplastin time, thrombin time, and fibrinogen were identified as influencing factors for adverse maternal and infant outcomes in severe preeclampsia patients. The study concludes that urinary protein and coagulation‐fibrinolysis indicators are elevated in preeclampsia, particularly in severe preeclampsia cases, suggesting their potential use as diagnostic influencing factors for severe preeclampsia. [ABSTRACT FROM AUTHOR]

Introduction: Application of Doppler Ultrasound in Nephrology is increasing day by day. A series of articles published during the last two decades indicated the potential of Doppler ultrasound for improving the sonographic assessment of renal dysfunction. Among the Doppler derived indices, resistive index is the most studied parameter for quantifying the alterations in renal blood flow that may occur with glomerular diseases. The diagnostic utility of Doppler in glomerular disease is under debate. Some studies show encouraging results whereas others are disappointing.3 Although Doppler can't substitute renal biopsy, studies have shown that it can be useful in prognostication and to quantitate the severity. Materials and Methods: A Prospective observational study was conducted from January 2015 to December 2016. All patients who are admitted in the Department of Nephrology, King George Hospital with biopsy proven Glomerular diseases were included in study after taking informed consent. Patients with Proteinuria >1 g/day, Proteinuria >0.5g/day with hematuria, hematuria with RBC casts, rapidly worsening renal function were included in the study. Renal Doppler was done to the study population who subsequently underwent renal biopsy. Of 82 patients enrolled 75 patients were included in the study. Rest of seven patients were excluded due to isolated tubulointerstitial component and hypertensive nephrosclerosis on renal biopsy. All patients were enquired regarding the symptoms, detailed history was taken from the patients and complete physical examination of patients was carried out. Results: A total of 75 patients were included in the study [Table 1]. In the present study age of the patients ranged between 16-60 years (mean 33.4±1.29). Serum creatinine ranged from 0.6-5.2 mg/dl (mean 1.81±1.26). Glomerular filtration rate ranged from 7.21-138.74 ml/min (mean 63.96±36.14). Urinary protein excretion ranged from 1.2-9.8 g/day (mean 4.15±2.04). Serum albumin ranged from 1.8-4.2 mg/dl (mean 2.95±0.44). 49(65.33%) patients in the present study were found to have nephrotic range proteinuria. 36(48%) patients presented with renal failure at the time of presentation. MPGN and FSGS were the chief pathological diagnoses [Fig 1]. Conclusion: Nevertheless, the present study suggests that Doppler ultrasonography might be considered as an important diagnostic and prognostic significance in glomerular diseases. Doppler resistive index can be used to predict the presence of tubulo interstitial lesion in glomerular diseases with high sensitivity and specificity. There is good correlation between resistive index and severity of tubulo interstitial injury. Reno vascular resistive index can be considered as a supplementary diagnostic tool in glomerular diseases to asses severity of tubulo interstitial injury. Resistive index and atrophic indices can be useful as a prognostic marker to identify the patients at risk of progression. [ABSTRACT FROM AUTHOR]

Background: The importance of the ratio of creatinine to urinary protein, albumin, and low-molecular weight protein as a urinary marker in chronic kidney disease patients is widely recognized. However, no reference values have hitherto been established for these markers in Japanese children. The present study aimed to establish the reference values for these urinary markers in Japanese children. Methods: The first morning urine was randomly collected from 1712 pupils aged ≥ 3 to < 18 years during school and kindergarten mass urinary screenings. The upper limit of the reference values was set at the 97.5th percentile of the creatinine ratio per marker. Results: The urinary protein-to-creatinine ratio (PCR), urinary albumin-to-creatinine ratio (ACR), urinary beta 2-microglobulin-to-creatinine ratio (BMCR), and urinary alpha 1-microglobulin-to-creatinine ratio (AMCR) showed an age-related decrease at the 50th percentile reflecting an age-related increase in urinary creatinine. The appropriate reference value for the PCR and ACR was 0.12 g/gCr and 35 mg/gCr, respectively, in the entire cohort. The appropriate reference value for the BMCR was 0.5 μg /mgCr for age ≥ 3 to < 6 years and 0.35 μg/mgCr for age 6 years or older. The appropriate reference value for the AMCR was 5.0 μg/mgCr for age ≥ 3 to < 6 years and 3.5 μg /mgCr for age 6 years or older. Conclusion: The present study was the first to determine appropriate reference values for the PCR, ACR, BMCR, and AMCR based on an analysis of the first morning urine samples of a large number of children. [ABSTRACT FROM AUTHOR]

Introduction/aimsThe time span for the approval of nusinersen to treat SMA remains short. Most studies on the efficacy and safety of this drug within clinical trials, are lacking real-world research data. This study is based on real-world studies of SMA patients in children with type II and III SMA and is committed to objectively evaluating the effectiveness and safety of this drug.MethodsA retrospective analysis was conducted on the clinical data of 18 children with type II and III SMA from January 2022 to June 2023. The motor function assessment scale, SMN protein, platelet, liver and kidney function, and other laboratory indicators of all patients before and after treatment were collected for statistical analysis.ResultsAfter load dose treatment (after 64 days of treatment), compared with baseline, the Revised Upper Limb Module (RULM) of SMA patients showed significant improvement (improvement rate: 44%), confirming the short-term effectiveness of the drug. The increase in cerebrospinal fluid SMN protein was greater in patients with significant improvement in motor function than in patients without improvement in motor function. Compared with baseline, there was no significant increase in AST and ALT levels in SMA patients, indicating that the drug had almost no effect on the liver. After each treatment, thrombocytopenia and partial urinary protein positivity may occur, but it could recover before the next treatment. This indicates that nusinersen is potentially harmful to platelet and renal function, although the effect is weak and reversible.DiscussionNusinersen has shown good efficacy and overall safety, but platelets and urinary protein are still indicators that require long-term monitoring. The increase in cerebrospinal fluid SMN protein was greater in patients with significant improvement in motor function than in patients without improvement in motor function.

Southwestern Japan suffered its worst rains in 2018 causing floods and mudslides, claiming 225 lives and forcing millions for evacuations. Referred as "Heisei san-jū-nenshichi-gatsugōu", the disaster was the result of incessant precipitation caused by the interaction of typhoon "Prapiroon" with the seasonal rain front "Baiu". The present epidemiological study aims to investigate disaster-induced health issues in 728 residents of Innoshima island in the Hiroshima Prefecture by comparing their clinical data in pre-disaster (2017) and disaster-hit (2018) years which was obtained from annual health screening. Comparison of data showed a significant increase in the urine protein concentration in victims following the disaster. Probing further into the household conditions, showed that a total of 59,844 households were affected with water outage during the heavy rains, which was accompanied by severe damage of sewerage pipelines with complete recovery process taking two weeks. This two weeks of the crisis forced victims to refrain from using restrooms which in turn led to infrequent urination, thereby explaining the increased urine protein concentration in victims following the disaster. The present study addresses the acute health implications caused by the water crisis and serves as a precautionary measure for disaster management council to provide enhanced aftercare services in victims in further events of natural disasters.

This study evaluated the clinical usefulness of an artificial intelligence-powered smartphone application in reducing the daily salt intake of patients with chronic kidney disease (CKD). This study included 35 patients with CKD who were classified into app users (i.e., 13 outpatients who used the app for 3 months and whose salt intake was evaluated before and after using the app) and app nonusers (i.e., 22 outpatients not using the application; their salt intake was similarly evaluated). The primary outcome was estimated as salt intake after 3 months of using the application and at a 6-month follow-up. Linear mixed model analysis revealed that app users had a significant decrease in estimated salt intake after 3 months (−2.12 g/day; 95% CI, −4.05 to −0.19; p = 0.03) compared with app nonusers but not after 6 months (−0.96 g/day; 95% CI, −3.13 to 1.20; p = 0.38). App users showed a significant decrease in body mass index at 3 months (−0.42 kg/m2 [95% CI, −0.78 to −0.049; p = 0.03]) and 6 months (−0.65 kg/m2 [95% CI, −1.06 to −0.24; p = 0.002]). The application promoted short-term reduction in salt intake. These results provide a strong rationale for future trials.

This paper summarized the literature of application of moxibustion therapy for patients with chronic renal failure. Moxibustion therapy is able to slowing the progression of renal function, improve the regulation of immune function, reduce the urinary protein. As a Traditional Chinese Medicine characteristic nursing technology, the moxibustion therapy shows advantages in slowing the progress of the renal failure. (本研究总结艾灸治疗慢性肾功能衰竭(CRF)的相关研究进展。艾灸可以改善CRF患者肾功能、调节患者免疫反应、减少尿蛋白和延缓肾功能进程, 艾灸的应用体现了中医护理的特色优势, 其在延缓肾功能衰竭进展方面具有积极的临床意义。)

Preeclampsia with severe features (PECsf) is a common disease in pregnant women. let-7a and IFN-gamma (interferon-gamma) are involved in diagnosis and prognosis of preeclampsia. This study explored effects of let-7a and IFN-gamma on PECsf patients. The placental tissue of 21 PECsf, 19 preeclampsia without severe features (PEC), and 20 normal pregnant women were collected, and clinical data were recorded. let-7a and IFN-gamma expressions in placental tissue were detected. The correlation between let-7a/IFN-gamma expression and clinical indexes was analyzed. According to let-7a and IFN-gamma expressions, PECsf patients were assigned into Hlet-7a group (let-7a high expression group), Llet-7a group (let-7a low expression group), HIFN-gamma group (IFN-gamma high expression group) and LIFN-gamma group (IFN-gamma low expression group). The incidence of adverse prognosis was compared. let-7a and IFN-gamma were highly expressed in placental tissue of preeclampsia patients, with significant differences between PEC and PECsf. The high expressions of let-7a and IFN-gamma were positively correlated with mean arterial pressure, lactate dehydrogenase, and 24 h urinary protein in placental tissues of PECsf patients. High let-7a and IFN-gamma expressions were correlated with adverse outcomes of PECsf. High let-7a and IFN-gamma expressions were correlated with clinical features, and could be used as biomarkers for treatment and poor prognosis of PECsf. [ABSTRACT FROM AUTHOR]

Introduction: There is a wide variety of drugs for the clinical treatment of immunoglobulin A (IgA) nephropathy; however, previous studies have failed to clarify the quantitative differences in the efficacy of various drugs. In this study, we aimed to quantitatively compare the clinical efficacy of 6 classes of drugs with different pharmacological mechanisms for the treatment of IgA nephropathy and to identify relevant influencing factors. Methods: Clinical trials of drugs for the treatment of IgA nephropathy were obtained from public databases. The change in daily urinary protein excretion from baseline was used as the efficacy index, and the time–effect model was established using a model-based meta-analysis method. Based on the final model, the typical efficacy was simulated, and the differences in efficacy were compared. Results: A total of 40 studies with 2288 subjects were included in this study. The results showed that the time–effect relationship of the placebo and 6 classes of drugs was consistent with the Emax model. The placebo reduced urinary protein excretion by up to 0.44 g/day, and it took more than 27 months to reach half of its maximum effect. The onset of the 6 classes of drugs were the same; they all reached half of their maximum effect after 5.59 months. More importantly, we found a significant influence of urinary protein baseline on drug efficacy, as indicated by an increase of 0.63 g/day in the theoretical maximum effect of drugs for every 1 g/day increase in urinary protein baseline. After correcting for the urinary protein baseline, the order of efficacy of the 6 classes of drugs was as follows: corticosteroids > immunosuppressants > other drugs > renin–angiotensin system blockers > antiplatelet agents > N-3 fatty acids. Conclusion: This study provides the first comprehensive quantitative analysis of the differences in the efficacy of 6 classes of drugs with different pharmacological mechanisms for treating IgA nephropathy. The results of this study provide an important reference for the rational clinical use of drugs for IgA nephropathy, and also provide a reliable efficacy standard for the development of new drugs for IgA nephropathy. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Restriction of salt intake is advised in the general population to reduce cardiovascular risk. Daily higher salt intake may contribute to high coronary artery disease (CAD) prevalence in the Turkish population, although there is limited data regarding salt intake and urinary sodium (Na) extraction in patients with CAD. In this study, we aimed to assess the relationship between urine Na, potassium (K), protein and creatine levels in patients with CAD. METHODS: One hundred participants, aged 30-65, who underwent coronary angiography under elective conditions were enrolled in this study between May 2019 and August 2019. Patients who had known CAD before, acute coronary syndrome, hypertension, congestive heart failure, diabetes mellitus (DM), structural heart disease, malignancy, renal failure, and severe comorbid states were excluded from the study. Coronary angiograpy revealed CAD in 61 patients and normal coronary arteries in 39 patients who were classified as the control group. Morning urine samples were collected for analysis. The 24-hour urine sodium was calculated using the KAWASAKI method. RESULTS: Spot urinary protein extraction and spot urinary micro-protein/creatinine ratio were significantly higher in the CAD group than in the control group (p=0.035, p=0.031, respectively). Also, serum creatinine (Cr) was found to be higher while glomerular filtration rate (GFR) and Na levels were found to be lower in the CAD group than in the control group (p=0.014, p=0.012, p=0.016 respectively). The logistic regression model was statistically significant, χ² (25)=41.45, p=0.021 and GFR, Na levels, spot urinary micro-protein/creatinine, and HDL levels were assessed as predictive factors for CAD. CONCLUSİON: Urinary Na and K extraction is not affected by the presence of CAD. Also, spot urinary Na/K ratio and 24-hour sodium extraction were similar between patients with and without CAD. However, decreased GFR and increased urinary micro-protein/creatinine ratio could be risk factors for CAD. Furter studies with large samples are needed to assess this relationship (Tab. 6, Ref. 16). [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to investigate the correlation between renal parenchyma hardness and urinary protein components in patients with type 2 diabetes mellitus (T2DM). Methods Our study included 117 patients with T2DM who were hospitalized in our hospital from April to December 2020. Virtual touch tissue quantification (VTQ) was performed in the patients to determine the shear wave velocity (SWV) of renal parenchyma. Meanwhile, the general clinical data from all patients were recorded. including duration of diabetes. age and blood pressure. Routine ultrasound parameters such as left kidney size. renal parenchyma thickness and renal function indexes (including serum creatinine. urea nitrogen and 24-hour urinary protein) were evaluated in all patients. Accordingly, urinary protein components such as αl-microglobulin (al MG).32-microglobulin (32-MG), immunoglobulin, transferrin and microalbuminuria were obtained, and the percentages of various urinary protein components in the total urinary protein were calculated. SPSS 22. 0 soft ware was used for the analysis of data. Results There was a positive correlation between the SMV of renal parenchyma and duration of diabetes (r=0. 304. P<0, 05), while the SWV of renal parenchyma was negatively correlated with serum creatinine, urea nitrogen and 24-hour urinary protein (r=-0. 356. - 0.281. -0. 202.P<0.05). In addition, the SWV of renal parenchyma was negative correlated with the percentages of al-MG and 32-MG (r=-0.611.-0. 578. P<0.05). Conclusion The significant relationship between SWV of renal parenchyma and percentage of low molecular weight proteinuria in patients with T2DM could be observed in our findings. hence. the combination of the two will be able to play an important role in the diagnosis and therapy efficacy evaluation of diabetic nephropathy in clinical practice. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of the present study was to evaluate the association between the histology of active and chronic lesions and urinary protein and serum creatinine (SCr) levels, as common clinical endpoints in clinical trials for lupus nephritis (LN). Methods In total, 119 patients diagnosed with LN class III, IV, and V, as defined by the International Society of Nephrology/Renal Pathology Society, between 1990 and 2015, were enrolled in the present study. Multiple regression analysis was performed to explore semi-quantitative histological variables associated with urinary protein and SCr levels. Results The mean age of the enrolled patients was 45 years, and 79% were female. The mean SCr and mean urinary protein levels at the time of renal biopsy were 0.87 mg/dl and 3.00 g/gCr, respectively. Class IV (71%) was the most common type of LN followed by class III (17%), and class V (13%). Multicollinearity was confirmed between monocellular infiltration (variance inflation factor [VIF] = 10.22) and interstitial fibrosis (VIF = 10.29), and between karyorrhexis (VIF = 4.14) and fibrinoid necrosis (VIF = 4.29). Fibrinoid necrosis and monocellular infiltration were subsequently excluded, and multiple regression analysis revealed that only the urinary protein level was correlated with wire loop lesions (β-coefficient [β]: 1.09 and confidence interval [CI]: 0.35 to 1.83), and that the SCr level was correlated with glomerular sclerosis (β: 1.08 and CI: 0.43 to 1.74). Conclusion As urinary protein and SCr levels were not quantitatively associated with active lesions, they may not accurately reflect the response to remission induction therapy in patients with LN.

Background Major symptoms of progressive chronic kidney disease (CKD) are similar to those of hypothyroidism. Hidden symptoms of hypothyroidism underlying CKD are often observed in clinical practice. This study aimed to ascertain the frequency of hypothyroidism complicated by CKD, and to analyze factors impacting thyroid function. Methods During the period from April 2012 through October 2016, 510 CKD patients at our outpatient clinic were measured thyroid and kidney function for diagnosing hypothyroidism (overt hypothyroidism, OH; subclinical hypothyroidism, SH; non-thyroidal illness, NTI) and evaluating the stage of CKD. All patients were over 15 years of age. Results There were significant differences in age, estimated glomerular filtration rate (eGFR), urinary protein (UP), and serum albumin (Alb) among patients with OH, SH, and NTI compared to the normal group in univariate and multivariate analyses. UP showed the highest odds ratio of OH, SH, and NTI but no differences were recognized in gender in each group. Frequency distribution showed that the prevalence of thyroid dysfunction was greater among more severe stage of CKD with higher amount of UP. OH and SH did not show high positive ratio of anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb). NTI and normal subjects showed higher positive ratio as 50.0% and 42.9% of TgAb and TPOAb than OH and SH. Conclusions Hypothyroidism complicated by CKD exhibited a high prevalence. Age, eGFR, UP, and serum Alb were related to the prevalence of hypothyroidism, whereas gender was not and this was contradicted to the prevalence of hypothyroidism in general population. The prevalence of OH and SH was higher among patients with higher stage of CKD with increased UP. Hypothyroidism complicated by CKD may involve different onset mechanisms unrelated to antithyroid antibodies (ATAb). In CKD patients, assessments of OH and SH, as well as NTI, are needed for proper diagnosis.

IntroductionThere is a wide variety of drugs for the clinical treatment of immunoglobulin A (IgA) nephropathy; however, previous studies have failed to clarify the quantitative differences in the efficacy of various drugs. In this study, we aimed to quantitatively compare the clinical efficacy of 6 classes of drugs with different pharmacological mechanisms for the treatment of IgA nephropathy and to identify relevant influencing factors.MethodsClinical trials of drugs for the treatment of IgA nephropathy were obtained from public databases. The change in daily urinary protein excretion from baseline was used as the efficacy index, and the time–effect model was established using a model-based meta-analysis method. Based on the final model, the typical efficacy was simulated, and the differences in efficacy were compared.ResultsA total of 40 studies with 2288 subjects were included in this study. The results showed that the time–effect relationship of the placebo and 6 classes of drugs was consistent with the Emax model. The placebo reduced urinary protein excretion by up to 0.44 g/day, and it took more than 27 months to reach half of its maximum effect. The onset of the 6 classes of drugs were the same; they all reached half of their maximum effect after 5.59 months. More importantly, we found a significant influence of urinary protein baseline on drug efficacy, as indicated by an increase of 0.63 g/day in the theoretical maximum effect of drugs for every 1 g/day increase in urinary protein baseline. After correcting for the urinary protein baseline, the order of efficacy of the 6 classes of drugs was as follows: corticosteroids > immunosuppressants > other drugs > renin–angiotensin system blockers > antiplatelet agents > N-3 fatty acids.ConclusionThis study provides the first comprehensive quantitative analysis of the differences in the efficacy of 6 classes of drugs with different pharmacological mechanisms for treating IgA nephropathy. The results of this study provide an important reference for the rational clinical use of drugs for IgA nephropathy, and also provide a reliable efficacy standard for the development of new drugs for IgA nephropathy.

Background and Aims: Prior studies have shown an association between positive urinary protein and an elevated risk of long-term mortality in patients with acute ischemic stroke (AIS); however, data on the short-term prognostic significance of urinary protein and urinary ketone bodies in patients with AIS is sparse.Methods and Results: A total of 2842 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. Patients were divided into urinary protein positive and negative, urinary ketone bodies positive and negative by urine dipstick. Cox and logistic regression models were used to estimate the effect of urinary protein and urinary ketone bodies on all cause in-hospital mortality and poor outcome upon discharge (modified Rankin Scale score ≥3) in AIS patients. Patients with positive urinary protein was associated with a 2.74-fold and 1.62-fold increase in the risk of in-hospital mortality (adjusted HR 2.74; 95% CI, 1.54-4.89; P-value = 0.001) and poor outcome upon discharge (aOR, 1.62; 95% CI 1.26-2.08; P-value <0.001) in comparison to negative urinary protein after adjusting for potential covariates. Moreover, Patients with positive urinary ketone bodies was associated with 2.11-fold in the risk of poor outcome upon discharge (aOR 2.11; 95% CI 1.52-2.94; P-value <0.001) but not in-hospital mortality (P-value = 0.066) after adjusting for potential covariates.Conclusions: Urinary protein at admission was independently associated with in-hospital mortality and poor functional outcome at hospital discharge in acute stroke patients and urinary ketone bodies also associated with poor functional outcome at hospital discharge. [ABSTRACT FROM AUTHOR]

Background: Effective follow-up after living kidney donation is important for maintaining the renal function of the donor. We investigated whether the estimated glomerular filtration rate (eGFR) and urinary protein and enzyme levels can provide important information regarding the state of the remaining kidney after donor nephrectomy. Methods: Seventy-five living donations were included (prospective/retrospective) in the study. The following parameters were measured up to 1 year after donor nephrectomy: serum creatinine and cystatin C as markers of the GFR; the high-molecular-weight urinary proteins as markers of glomerular injury; and the low-molecular-weight urinary proteins and urinary enzymes as markers of tubular function. Results: One year after kidney donation, the creatinine and cystatin C values were 1.38-fold increased than their initial values, while the eGFR was 32% lower. At that time, 38% of donors had a moderate or high risk of CKD progression. The biochemical urinary glomerular and tubular kidney markers examined showed different behaviors. After a transient increase, the glomerular proteins normalized. Conversely, the detection of low-molecular-weight urinary proteins and enzymes reflected mild tubular damage at the end of the study period. Conclusions: Our findings suggest that for the evaluation of mild tubular damage, low-molecular-weight marker proteins should be included in the urine diagnostic of a personalized living kidney donor follow-up. [ABSTRACT FROM AUTHOR]

Abstract Background This study aimed to evaluate the value of urinary angiostatin levels for assessing disease severity and progression of IgA nephropathy (IgAN). Methods Urinary angiostatin was identified as one of the distinct proteins in samples of patients with IgAN analyzed by Raybiotech protein array, and further confirmed by enzyme-linked immunosorbent assay (ELISA). Results Urinary angiostatin levels were significantly higher in IgAN patients than that in healthy controls (HC) subjects and lower than in disease controls (DC) patients. The concentrations of angiostatin in urine normalized to urinary creatinine (angiostatin/Cr) were positively associated with proteinuria level. With advancing chronic kidney disease (CKD) stage, urinary angiostatin/Cr levels were gradually increased. Urinary angiostatin/Cr levels in patients with Lee’s grade IV–V were significantly higher than those in Lee’s grade I–II and III. We further compared urinary angiostatin/Cr levels by using Oxford classification and found the expression in patients with mesangial proliferative score 1(M1) was significantly higher than that in M0 (P

Background: Several studies have revealed a relationship between proteinuria and renal prognosis in idiopathic membranous nephropathy (IMN). The benefit of achieving subnephrotic proteinuria (

Background: Diabetic nephropathy (DN) is the most common and serious microvascular complication of diabetes. To date, the gold standard for identifying DN and nondiabetic renal disease (NDRD) is a renal biopsy; however, there is currently no reliable diagnostic marker to identify DN and NDRD in a noninvasive manner. This study aimed to investigate the different glycopatterns in urine specimens of DN patients and NDRD patients for a differential diagnosis. Methods: In total, 19 DN patients and 18 NDRD patients who underwent renal biopsies between March 2015 and March 2016 at the Chinese People's Liberation Army General Hospital were enrolled in this study. A lectin microarray was used to investigate the glycopatterns in the urinary protein of the 37 patients. Ratio analysis and one-way analysis of variance were used to screen altered glycopatterns. Then, the altered glycopatterns between the DN and NDRD groups were verified by a urinary protein microarray among another 32 patients (15 with DN and 17 with NDRD), and receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of the altered glycopatterns in differentiating DN and NDRD. Finally, lectin blotting was used to evaluate the altered glycosylation in protein level. Results: The result of lectin microarrays revealed that the relative abundance of the (β-1,4)-linked N-acetyl-D-glucosamine (GlcNAc) recognized by lectin Datura stramonium agglutinin (DSA) was significantly higher in urinary protein in DN patients than that in NDRD patients (fold change >1.50, P < 0.001). Subsequently, the results of urinary protein microarrays were consistent with lectin microarrays (P < 0.05). Furthermore, the ROC curve showed that glycopatterns could effectively distinguish DN from NDRD patients (area under the ROC curve = 0.94, P < 0.001). DSA lectin blotting showed that glycoproteins, with a molecular weight of approximately 50,000, demonstrated a difference in urine samples between DN patients and NDRD patients. Conclusions: The relative abundance of (β-1,4)-linked GlcNAc recognized by lectin DSA and urinary glycoprotein with a molecular weight of approximately 50,000 are significantly different between DN and NDRD patients, indicating that the glycopatterns could be used as potential biomarkers for a differential diagnosis.

Background: Diagnostic marker to detect chronic kidney disease (CKD) at early stages is important as early intervention can slow the loss of kidney functions. Serum cystatin C (sCysC) is said to be a superior marker for CKD compared to serum creatinine (sCr) and other known markers in the near past period to detect the mild GFR reduction between 60 and 90 ml/min/1.73m2. Objective: To detect fordetecting the role of cystatin C as an early predictor for the assessment of chronic kidney disease patients. Methods:Blood and urine samples from 185 patients suffering from various stages of CKD or subjects under the risk of CKD were taken from Ibn-Sina teaching hospital during the period from 15th of March 2012 to 10th of sept 2013. Serum Urea (sUr), serum uric acid (sUA), serum creatinine (sCr), serum cystatin C (sCysC), 24 hour excreted urine protein and 24 hour excreted urine creatinine where analyzed then compared to corrected creatinine clearance for each patient. Results:Theresults showed that serum CysC started to change from abnormal border line level at stage 2 to clearly abnormal level at stage three of CKD comparing to other assessments which used sCr, sUr, sUA. The results also indicated that the urinary 24h excreted protein was starting to be observed at stage 3 of CKD. Conclusions: The present study indicated that sCysC have the potential benefit for early detection of CKD especially in those with high risk before appearance of the symptoms and before occurrence of the complications.

Major symptoms of progressive chronic kidney disease (CKD) are similar to those of hypothyroidism. Hidden symptoms of hypothyroidism underlying CKD are often observed in clinical practice. This study aimed to ascertain the frequency of hypothyroidism complicated by CKD, and to analyze factors impacting thyroid function. During the period from April 2012 through October 2016, 510 CKD patients at our outpatient clinic were measured thyroid and kidney function for diagnosing hypothyroidism (overt hypothyroidism, OH; subclinical hypothyroidism, SH; non-thyroidal illness, NTI) and evaluating the stage of CKD. All patients were over 15 years of age. There were significant differences in age, estimated glomerular filtration rate (eGFR), urinary protein (UP), and serum albumin (Alb) among patients with OH, SH, and NTI compared to the normal group in univariate and multivariate analyses. UP showed the highest odds ratio of OH, SH, and NTI but no differences were recognized in gender in each group. Frequency distribution showed that the prevalence of thyroid dysfunction was greater among more severe stage of CKD with higher amount of UP. OH and SH did not show high positive ratio of anti-thyroglobulin antibody (TgAb) and anti-thyroid peroxidase antibody (TPOAb). NTI and normal subjects showed higher positive ratio as 50.0% and 42.9% of TgAb and TPOAb than OH and SH. Hypothyroidism complicated by CKD exhibited a high prevalence. Age, eGFR, UP, and serum Alb were related to the prevalence of hypothyroidism, whereas gender was not and this was contradicted to the prevalence of hypothyroidism in general population. The prevalence of OH and SH was higher among patients with higher stage of CKD with increased UP. Hypothyroidism complicated by CKD may involve different onset mechanisms unrelated to antithyroid antibodies (ATAb). In CKD patients, assessments of OH and SH, as well as NTI, are needed for proper diagnosis. [ABSTRACT FROM AUTHOR]

Background The utility of the Columbia classification (Col-class) for focal segmental glomerulosclerosis (FSGS) has not yet been fully proven. Methods We extracted 201 FSGS patients from 10 nephrology centers in Japan and investigated the difference of a composite renal endpoint, defined as doubling of serum creatinine and/or development of end-stage renal disease, in pathological variants. Sensitivity analysis was used to prove the utility of the Col-class to predict renal outcomes. Additionally, the renal protective effects of steroids and/or immunosuppression (steroid/IS) were investigated in patients stratified according to the Col-class. Results The patients were classified into the following variants: not otherwise specified [NOS; n  = 121 (60.1%)], perihilar [ n  = 31 (15.4%)], cellular [ n  = 19 (9.5%)], tip [ n  = 17 (8.5%)] and collapsing [ n  = 13 (6.5%)]. No tip variant patients reached the renal endpoint. The renal outcome in the collapsing variant was significantly poorer than that in the NOS [hazard ratio (HR) 3.71; P = 0.005]. In the sensitivity analysis, the area under the receiver operating characteristic curve for the renal endpoint was increased by adding Col-class to a model including common risk factors (P = 0.021). In a subgroup treated without steroid/IS, the outcome in the cellular variant was worse than that in the NOS (HR 5.10; P =   0.040) but the difference was not observed in the subgroup with steroid/IS (HR 0.54; P =   0.539). Conclusions The Col-class is useful to predict renal prognosis in Japanese patients with FSGS. In addition to good prognosis in the tip variant and poor in the collapsing variant, good clinical course in the cellular variant treated with steroid/IS was suggested. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to evaluate the association between the histology of active and chronic lesions and urinary protein and serum creatinine (SCr) levels, as common clinical endpoints in clinical trials for lupus nephritis (LN).Methods: In total, 119 patients diagnosed with LN class III, IV, and V, as defined by the International Society of Nephrology/Renal Pathology Society, between 1990 and 2015, were enrolled in the present study. Multiple regression analysis was performed to explore semi-quantitative histological variables associated with urinary protein and SCr levels.Results: The mean age of the enrolled patients was 45 years, and 79% were female. The mean SCr and mean urinary protein levels at the time of renal biopsy were 0.87 mg/dl and 3.00 g/gCr, respectively. Class IV (71%) was the most common type of LN followed by class III (17%), and class V (13%). Multicollinearity was confirmed between monocellular infiltration (variance inflation factor [VIF] = 10.22) and interstitial fibrosis (VIF = 10.29), and between karyorrhexis (VIF = 4.14) and fibrinoid necrosis (VIF = 4.29). Fibrinoid necrosis and monocellular infiltration were subsequently excluded, and multiple regression analysis revealed that only the urinary protein level was correlated with wire loop lesions (β-coefficient [β]: 1.09 and confidence interval [CI]: 0.35 to 1.83), and that the SCr level was correlated with glomerular sclerosis (β: 1.08 and CI: 0.43 to 1.74).Conclusion: As urinary protein and SCr levels were not quantitatively associated with active lesions, they may not accurately reflect the response to remission induction therapy in patients with LN. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Hyperuricemia is a known risk factor for end-stage renal disease. Although xanthine oxidase (XO) inhibitors are expected to protect the kidney function, evidence to this end is insufficient at present. Methods: This study was a multi-center, open-labeled, randomized study conducted in Mie Prefecture in Japan. Patients were included if they were between 20 and 80 years old and had a serum uric acid (sUA) level ≥ 7.0 mg/dl with or without gout, estimated glomerular filtration rate (eGFR) of 15–60 ml/min/1.73 m2, and urinary protein creatinine ratio (uPCR) of 0.15–3.5 g/gCr. Patients were randomly assigned to a Topiroxostat or Febuxostat group, and the treatment target for the sUA level was < 6.0 mg/dl. The primary outcome was the change in the uPCR after 24 weeks. Results: The change in the median uPCR after 24 weeks was not statistically significant after treatment in the Topiroxostat or Febuxostat group (0.05 g/gCr and − 0.04 g/gCr, respectively). However, the sUA levels decreased significantly in both groups (Topiroxostat group: 8.6 ± 1.1 at baseline to 6.0 ± 1.1 mg/dl at 24 weeks, Febuxostat group: 8.4 ± 1.1 mg/dl at baseline to 5.9 ± 1.3 mg/dl at 24 weeks). No significant change in the eGFR after 24 weeks was noted in either the Topiroxostat or Febuxostat group (− 0.04 ± 4.59 ml/min/1.73 m2 and 0.31 ± 4.70 ml/min/1.73 m2, respectively). Conclusions: In this study, XO inhibitors did not significantly reduce the uPCR in chronic kidney disease stage 3 and 4 patients with hyperuricemia. [ABSTRACT FROM AUTHOR]

Purpose: To determine expression differences of urine exosomal miR-19b1-5p, 21-5p, 136-3p, 139-5p, 210-3p and concentration differences of urinary BLCA-4, NMP22, APE1/Ref1, CRK, VIM between bladder cancer, follow-up patients, and control samples, to evaluate diagnostic importance of these differences and establish a diagnostic panel for bladder cancer. Methods: Urine samples of 59 bladder cancer patients, 34 healthy controls, and 12 follow-up patients without recurrence were enrolled to this study. Real-time PCR and ELISA were performed to determine urine exosomal miR-19b1-5p, 21-5p, 136-3p, 139-5p, 210-3p expressions and urinary BLCA-4, NMP22, APE1/Ref1, CRK, VIM, creatinine concentrations. Logistic regression analyses were performed to determine the diagnostic panel, the sensitivity, and specificity of the panel assessed by the ROC curve analysis. p values < 0.05 were considered statistically significant. Results: In bladder cancer risk groups, mir-139, -136, -19 and 210 expressions or positivity were found to be different and concentrations of urinary Ape1/Ref1, BLCA4, CRK, and VIM increased by twofold on average compared to healthy controls. Logistic regression and ROC analyses revealed that panel could differentiate bladder cancer patients from healthy controls with 80% sensitivity and 88% specificity (AUC = 0.899), low-risk patients from controls with 93% sensitivity and 95.5% specificity (AUC = 0.976). Despite the low number of samples, our findings suggest that urine exosomal miR-19b1-5p, 136-3p, 139-5p expression, and urinary APE1/Ref1, BLCA-4, CRK concentrations are promising candidates in terms of bladder cancer diagnosis. Conclusions: Although our panel has great sensitivity for early detection of BC, it needs to be validated in larger populations. [ABSTRACT FROM AUTHOR]

Efficacy and safety of the combination of magnesium sulfate, phentolamine and nifedipine in the treatment of patients with hypertensive disorder complicating pregnancy (HDCP) and its effect on hemodynamics and urinary protein level were investigated. One hundred and six patients with HDCP diagnosed at the Affiliated Hospital of Beihua University from February 5, 2016 to May 9, 2017 were retrospectively analyzed. Patients were divided into the magnesium sulfate group and the combination group, according to the therapeutic schemes. The efficacy 1 week later was observed. The general clinical data of the patients were recorded, and data were acquired with respect to hemodynamic indexes before and after treatment [changes of S/D ratio of umbilical artery flow, and cardiac index and total peripheral resistance (TPR)], the 24-h urinary protein level, clinical efficacy and safety [adverse drug reactions (ADR) and maternal and neonatal outcomes]. Before treatment, there was no statistically significant difference between the two groups in terms of S/D ratio of umbilical artery flow (P>0.05), while after treatment the S/D ratio was significantly lower than that before treatment in both groups (P<0.05). Before treatment, there was no statistically significant difference between the two groups in terms of cardiac index (P>0.05). TPR after treatment was significantly lower than that before treatment in both groups (P<0.001). Compared with the magnesium sulfate group, patients in the combination group had significantly lower 24-h urinary protein level after treatment (P<0.001), significantly higher total effective rate (P<0.05), significantly lower incidence rate of ADR (P<0.001), and significantly lower incidence rate of adverse maternal and neonatal outcomes (P<0.001). In conclusion, the combination of magnesium sulfate, phentolamine and nifedipine can significantly improve the hemodynamic indexes, the 24-h urinary protein level, the clinical efficacy, ADR and maternal and neonatal outcomes of patients with HDCP, therefore it is worthy of use in the clinic. [ABSTRACT FROM AUTHOR]

• CD19+CD24hiCD38hi regulatory B cells may be involved in the pathogenesis of Diabetic nephropathy. • Abnormal CD19+CD24hiCD38hi regulatory B cells in patients with diabetic nephropathy can induce proteinuria and changes of glomerular rate. • Hormone therapy can induce CD19+CD24hiCD38hi regulatory B cells reconstruction and improve body injury in Diabetic nephropathy patients. Regulatory B cells participate in the pathogenesis of autoimmune disease. This study aimed to examine the putative contribution of regulatory B cells to the pathogenesis of DN. The number of circulating CD19+CD24hiCD38hi B cells, CD19+CD24hiCD38hiCD5+ B cells, and CD19+CD24hiCD38hiIL-10+ B cells were significantly lower in DN patients (p < 0.05) than the control group. The number of circulating CD19+CD24hiCD38hi B cells was positively correlated with the levels of eGFR and serum IL-10 levels, but negatively correlated with urinary protein levels in DN patients. Treatment significantly increased the number of CD19+CD24hiCD38hi B cells, CD19+CD24hiCD38hiCD5+ B cells, CD19+CD24hiCD38hiIL-10+ B cells, and the levels of serum IL-10 (p < 0.05). We conclude that regulatory B cells may present new targets for intervention of DN. [ABSTRACT FROM AUTHOR]

A total of 30 late onset severe preeclampsia (LS-PE) patients and 30 early onset severe preeclampsia (ES-PE) patients were selected as Experimental group, and 30 normal pregnant were selected as Control group. Expression of S100 calcium-binding protein A8 (S100A8) mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR). Enzyme-linked immunosorbent assay (ELISA) was used to detect expression of S100A8 protein and inflammatory factors. Levels of uric acid (UA) and creatinine (CRE) were measured using an automatic biochemical analyzer. Urinary protein (UPRO) content was measured using biuret colorimetry. S100A8 levels were significantly higher in experimental groups than in control groups at mRNA and protein levels (P < 0.05). Significantly increased contents of tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-12, UA, CRE, and UPRO, and decreased level of IL-10 were found in experimental groups than in control groups (P < 0.05). Compared with patients with ES-PE, significantly higher levels of TNF-α, IL-12, IL-6, UA, CRE, and UPRO, and lower level of IL-10 were found in patients with LS-PE. S100A8 plays pivotal roles in the development of preeclampsia through the interactions with other inflammatory factors. [ABSTRACT FROM AUTHOR]

Introduction/aims: The time span for the approval of nusinersen to treat SMA remains short. Most studies on the efficacy and safety of this drug within clinical trials, are lacking real-world research data. This study is based on real-world studies of SMA patients in children with type II and III SMA and is committed to objectively evaluating the effectiveness and safety of this drug., Methods: A retrospective analysis was conducted on the clinical data of 18 children with type II and III SMA from January 2022 to June 2023. The motor function assessment scale, SMN protein, platelet, liver and kidney function, and other laboratory indicators of all patients before and after treatment were collected for statistical analysis., Results: After load dose treatment (after 64 days of treatment), compared with baseline, the Revised Upper Limb Module (RULM) of SMA patients showed significant improvement (improvement rate: 44%), confirming the short-term effectiveness of the drug. The increase in cerebrospinal fluid SMN protein was greater in patients with significant improvement in motor function than in patients without improvement in motor function. Compared with baseline, there was no significant increase in AST and ALT levels in SMA patients, indicating that the drug had almost no effect on the liver. After each treatment, thrombocytopenia and partial urinary protein positivity may occur, but it could recover before the next treatment. This indicates that nusinersen is potentially harmful to platelet and renal function, although the effect is weak and reversible., Discussion: Nusinersen has shown good efficacy and overall safety, but platelets and urinary protein are still indicators that require long-term monitoring. The increase in cerebrospinal fluid SMN protein was greater in patients with significant improvement in motor function than in patients without improvement in motor function., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Chen, Liu, Fang and Li.)

Background: Several studies have revealed a relationship between proteinuria and renal prognosis in idiopathic membranous nephropathy (IMN). The benefit of achieving subnephrotic proteinuria (<3.5 g/day), however, has not been well described. Methods: This multicenter, retrospective cohort study included 171 patients with IMN from 10 nephrology centers in Japan. The relationship between urinary protein over time and a decrease of 30% in estimated glomerular filtration rate (eGFR) was assessed using time-dependent multivariate Cox regression models adjusted for clinically relevant factors. Results: During the observation period (median, 37 months; interquartile range, 16-71 months), 37 (21.6%) patients developed a 30% decline in eGFR, and 2 (1.2%) progressed to end-stage renal disease. Time-dependent multivariate Cox regression models revealed that lower proteinuria over time were significantly associated with a lower risk for a decrease of 30% in eGFR (primary outcome), adjusted for clinically relevant factors. Complete remission (adjusted hazard ratio [HR], 0.005 [95%CI, 0.0-0.09], p < .001), incomplete remission with <1.0 g/day of urine protein (ICR I) (adjusted HR, 0.01 [95%CI, 0.001-0.20], p = .002), and 1.0 to 3.5 g/day (ICR II) (adjusted HR, 0.12 [95%CI, 0.02-0.64], p = .013) were significantly associated with avoiding a 30% decrease in eGFR, compared to that at no remission. Conclusions: Attaining lower proteinuria predicts good renal survival in Japanese patients with IMN. This study quantifies the impact of proteinuria reduction in IMN and the clinical relevance of achieving subnephrotic proteinuria in IMN as a valuable prognostic indicator for both the clinician and patient. [ABSTRACT FROM AUTHOR]

The association between inflammatory factor expression and blood pressure with urinary protein in the placenta of pregnant women with pregnancy-induced hypertension (PIH) was investigated to provide a new vision for the clinical prevention and treatment of PIH. Rats were used as animal models and were randomly divided into three groups (control, hypertension and treatment groups) on day 15 of pregnancy with 20 rats in each group. The 10% hypoxia-induced PIH group was induced with administration of an anti-hypertensive drug, and the treatment group was giventreprostinil for one week after the 10% hypoxia-induced PIH. On the 21st day, the experiment was terminated and the placenta was taken to measure the mRNA and protein expression levels of IL-6 and TNF-α, respectively. Pearson's correlation analysis demonstrated the correlation between IL-6 and TNF-α with blood pressure and urinary protein. The blood pressure and urinary protein concentrations in the hypertension group were significantly higher than that in the control group, and the expression levels of IL-6 and TNF-α in the hypertension group were significantly higher (P<0.05). The treatment group significantly reduced inflammatory cytokines and blood pressure and urinary protein levels (P<0.05). Pearson's correlation analysis showed that IL-6 and TNF-α were positively correlated with blood pressure and urinary protein concentration. The blood pressure and urinary protein concentration in PIH rats and the expression levels of IL-6 and TNF-α were significantly higher, and IL-6 and TNF-α were positively correlated with blood pressure and urine protein concentration. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Modern Laboratory Medicine is the property of Journal of Modern Laboratory Medicine Editorial Department and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The excretory system is responsible for eliminating post-effort metabolism products. Otherwise, the components of renal parenchyma are subject to additional stress, both, during exercise as a result of the post-ischemic reperfusion process and post-exercise as a result of the elimination of excess metabolic products.The mechanism of inducing proteinuria during exercise is not fully known. nstead, a series of events that occur as a result of physical effort is a cause of the proteinuria phenomenon. The experimental data obtained revealed that in our experimental model the physical effort, induces the increase of urinary protein level in two experimental groups that was studied. This information indicates that from a functional point of view, the excretory system of smokers or non-smokers can suffer functional deterioration as a result of the new physiological requirements imposed by physical effort. Repetitive physical effort has led to the downgrading of the proteinuria phenomenon, a parameter that indicates the state of renal integrity and functional adaptation to physical effort, a physiological aspect that indicates the body's inability to adapt within 7 days to the new demands imposed by physical effort. The physiological response of the excretory system to the physical exertion of the two categories studied is the same. [ABSTRACT FROM AUTHOR]