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Glomerulopathies with Fibrillary Deposits
(Walter de Gruyter GmbH, 2023-07-01)
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The glomerulopathies associated with the deposition of extracellular fibrils in the glomeruli are subdivided into Congo red positive (amyloidosis) and Congo red negative (non-amyloidotic glomerulopathies) based on Congo red staining. The non-amyloidotic glomerulopathies are divided into immunoglobulin-derived and non-immunoglobulin-derived glomerulopathies. The immunoglobulin-derived glomerulopathies: fibrillary glomerulopathy (FGn) and immunotactoid glomerulopathy (ITG) are rare glomerulopathies. The diagnosis of fibrillary-immunotactoid glomerulopathy depends on electron microscopy, which shows the presence of microfibrils in the glomeruli. The microfibrils in FGn are randomly arranged with diameters less than 30 nm. The microfibrils in ITG are larger than 30 nm with a visible lumen (microtubules), focally arranged in parallel bundles. Patients with fibrillary-immunotactoid glomerulopathy present with proteinuria (usually in the nephrotic range), microscopic hematuria, arterial hypertension, and chronic kidney disease that progresses to kidney failure over months to years. Currently, there are no guidelines for the treatment of fibrillary-immunotactoid glomerulopathy, although immunotactoid glomerulopathy could be associated with underlying hematologic disorders with the need for clone-directed therapy.
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RENAL OUTCOME IN PATIENTS DIAGNOSED WITH VESICOURETERAL REFLUX IN CHILDHOOD
(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2017-11)
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Mihajlovska Rendevska A
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Kuzmanovska D
To evaluate the outcome of the renal function and blood pressure in adult patient diagnosed with primary vesicoureteral reflux (VUR) in childhood Material and methods All patients have undergone renal laboratory tests, renal ultrasound, patients high, weight and blood pressure (BP). Results The mean age of the patients was 25 years. In 43 out of 48 patients with color Doppler ultrasound follow-up no renal parenchymal defects were found. In 5 patients were found bilateral and unilateral parenchymal kidney defects. The estimated GFR showed mild damage of the kidney function in 3 patients. Proteinuria was found in 1 patient and high blood pressure was measured in 1 patient. The diastolic blood pressure was lower in those patients with no renal parenchymal scars compared with those patients who had unilateral or bilateral renal scars. Conclusions Renal function was slightly lowered in less than half of the participants. Findings of the participants with unilateral scarring or unscarred kidneys were similar. The patients with bilateral kidney scars had lowered kidney function, proteinuria and hypertension. Follow-up of the renal outcome is needed in those patients diagnosed with VUR in the childhood.
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Value of sodium dodecyl sulfate polyacrilamide gel electrophoresis in evaluation of pediatric urinary tract infections
(SHMSHM/AAMD, 2017)
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Alulovska N.
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Urinary tract infections (UTI) represent frequent health problem, especially in developing countries. Clinical signs are different based on the location of infection. An interesting ethical and professional question arises: how to treat febrile children who previously received antibiotic therapy and have sterile urine culture in presence of pyuria. Is that a pyelonephritis and are further invasive imaging studies needed? Objectives: To analyze the electrophoretic patterns of urinary proteins in children with proximal respectively distal UTI and to evaluate the value of sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) in acute febrile respiratory infections (AFRI) without signs and symptoms of UTI. Material and methods: The study included 79 children aged 1-16 years: 36 with proximal UTI (15 with culture positive APN, respectively 21 with culture negative APN), 23 with cystitis (7 with hemorrhagic cystitis) and 20 children with AFRI without symptoms of UTI. Separation of urinary proteins was performed by SDS-PAGE. Results: Children with culture positive and culture negative APN had incomplete tubular proteinuria (24-67 kDa) which was transient. Hemorrhagic cystitis was characterized by the typical presence of 28 kDa band (apolipoprotein A-1). In the group AFRI without symptoms of UTI, there was no observed pathological electrophoretograms. Conclusions: SDS-PAGE is useful laboratory technique for separating proteins by their molecular size. The presence of incomplete tubular proteinuria indicates the renal origin of the fever. Detection of apolipoprotein A-1 in children with hemorrhagic cystitis allows differentiation in relation to glomerular cause bleeding. Despite these facts, in the literature there are few reports on SDS-PAGE in diagnosis of various renal diseases including urinary tract infections.
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The Spectrum of Kidney Diseases in Children Associated with Low Molecular Weight Proteinuria
(ID Design 2012/Scientific Foundation SPIROSKI, 2018-05-20)
Shpetim Salihu
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Natasa Aluloska
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Proteinuria, in addition to haematuria, is the most important laboratory parameter in patients with nephro-urological diseases. Low molecular weight proteinuria (LMWP) is of particular importance because some diseases genetic and tubulointerstitial are diagnosed based on its presence.

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