Does urinary tract infection cause proteinuria or microalbuminuria? A systematic review

Carter, Joanne L.; Tomson, Charles; Stevens, Paul E.; Lamb, Edmund J.

doi:10.1093/ndt/gfl373

Cited by 79 publications

(52 citation statements)

References 54 publications

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“…There was no association between the development of proteinuria and thromboembolic events, but there was a significant association with increased rates of infections. The increased rates of infection were mostly due to urinary tract infections, and some part of this association may be due to the fleeting increases in urinary protein associated with lower or upper urinary tract infections [37]. Within this analysis we could not determine if individual reports of proteinuria coincided with the urinary tract infections.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Relevance of Proteinuria in Bevacizumab-Treated Patients: Pooled Analysis from Randomized Controlled Trials

Lafayette

McCall²,

Li³

et al. 2014

Am J Nephrol

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Background: This analysis evaluated the incidence of and risk factors for bevacizumab-related proteinuria and assessed for any associated clinical sequelae, including renal function changes. Methods: Patient-level adverse event and laboratory data from a pooled safety database were used to characterize alterations in urine protein excretion following interventional therapy ± bevacizumab in 17 randomized trials across multiple tumor types. Severity of renal function change was assessed using changes in serum creatinine concentration from baseline values. Potential predictors of proteinuria and the association between proteinuria and other adverse events were also investigated. Results: Among 14,548 patients, the incidence of any-grade proteinuria was 8.2% (733/8,917) and 4.6% (257/5,631) in the bevacizumab and control groups, respectively; rates of grade ≥3 proteinuria were 1.4 and 0.2%. Post-baseline proteinuria grade and bevacizumab were associated with increased rates of renal dysfunction. Patients developing proteinuria had an increased rate of any-grade infection but not thromboembolic events. History of diabetes was the only examined risk factor that appeared to have a significant association with proteinuria development. Conclusions: This analysis confirmed a significant increase in the development of proteinuria during bevacizumab treatment. We also observed an increased rate of renal dysfunction associated with bevacizumab treatment and among subjects with proteinuria, although the dysfunction was generally mild. The development of proteinuria was also associated with a modest increase in risk of infection.

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Section: Discussionmentioning

confidence: 99%

Incidence and Relevance of Proteinuria in Bevacizumab-Treated Patients: Pooled Analysis from Randomized Controlled Trials

Lafayette

McCall²,

Li³

et al. 2014

Am J Nephrol

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“…In the samples; urine albumin and creatinine, serum creatinine, blood glucose, total cholesterol, triglycerides, HDLcholesterol, LDL-cholesterol and uric acid concentrations were determined. Albuminuria measurements were excluded in pregnant or menstruating women and in all patients suffering from febrile illness [18].…”

Section: Study Design and Populationmentioning

confidence: 99%

Prevalence, Awareness, Treatment and Control of Hypertension in Adults with Chronic Kidney Disease in Turkey: Results from the CREDIT Study

Altun

Süleymanlar

Utaş

et al. 2012

Kidney Blood Press Res

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Background: In the Chronic REnal Disease In Turkey -CREDIT Study, a large populationbased study on 10,748 adults, the prevalence of chronic kidney disease (CKD) and relationship between CKD and other cardiovascular risk factors had been studied. Methods: This report presents the results of CREDIT study on the prevalence, awareness, treatment, and control of hypertension among CKD patients. Results: The prevalence and awareness of hypertension in CREDIT population was 32.7% and 48.6%, respectively. Of the patients with hypertension, 31.5.% were under treatment, and 16.4% had hypertension under control. Prevalence of CKD was 25.3% in patients with hypertension. Among CKD patients (15.7% of the CREDIT study population), 56.3% had hypertension. The prevalence of hypertension was 34.8% at stage 1, 79.8% at stage 3, and 92.3% at stage 5 CKD. Only 13.4% of patients with CKD have optimal blood pressure. Among CKD patients, 61.9% were aware of hypertension, and 44.2% were under treatment. Overall control rate of hypertension in subjects with CKD was 16.3% with the lowest rate at stage 1 (12.3%) and highest rate at stage 4 (40%). The control rate increased to 28.8% for CKD patients under treatment for hypertension. Conclusion: As a conclusion, hypertension is highly prevalent in subjects with CKD in Turkey with suboptimal awareness, treatment, and control rates. Appropriate health strategies should be implicated to improve prevention, early diagnosis, and treatment of hypertension, which is one of the leading causes of CKD.

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“…Upper urinary tract infection leads to proximal proteinuria and the release of renal enzymes and cellular proteins (68,69) and their presence can be a diagnostic aid to differentiate between upper and lower urinary tract infections. However, while NAG and most other urinary enzymes originate in the proximal tubule, bacteria are initially localised around the distal tubules (70) suggesting that distal tubular biomarkers could be especially sensitive indicators of it.…”

Section: Renal Transplantationmentioning

confidence: 99%

Cell-Specific Biomarkers in Renal Medicine and Research

Shaw¹

2010

Methods in Molecular Biology

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Histopathology is the gold standard for defining renal injury, but it is invasive, time-consuming and expensive, plus it is seldom used in subjects with mild renal injury. Using biomarkers linked to distinct, defined cell types and tissues provides a direct link to histopathology without its drawbacks, plus it provides increased sensitivity, and specificity. The nephron consists of several sections, each with its own specific biomarkers; therefore, by the use of a battery of tests injuries can be localised to distinct areas of it. Using urine samples simplifies repeated sampling from the same subject or animal leading to better defined toxicokinetics and disease monitoring.Serum creatinine is the most widely used renal biomarker in spite of its known shortcomings. Cell-specific biomarkers are more specific and sensitive and have been known for over 40 years, but they are still underused in renal medicine and research. In particular, while many studies have shown cell-specific biomarkers to be valuable in diagnosis, there are few studies where they have been used to guide therapy or linked to quantitative changes in the kidney. Furthermore, the great majority of cell-specific biomarkers are from the proximal tubule, which may have hindered research into the study of conditions where the distal tubules are affected. Recently, the range of biomarkers and their applications has been expanded by the introduction of indicators of cellular regeneration.This chapter will discuss how using biomarkers with a known cellular origin, renal effects may be found earlier and at lower levels of injury. Their use in both renal medicine and drug research will be presented. Knowledge of these existing markers lays the foundation for evaluation, comparison, and characterisation of new markers that will be identified in the future.

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Does urinary tract infection cause proteinuria or microalbuminuria? A systematic review

Cited by 79 publications

References 54 publications

Incidence and Relevance of Proteinuria in Bevacizumab-Treated Patients: Pooled Analysis from Randomized Controlled Trials

Incidence and Relevance of Proteinuria in Bevacizumab-Treated Patients: Pooled Analysis from Randomized Controlled Trials

Prevalence, Awareness, Treatment and Control of Hypertension in Adults with Chronic Kidney Disease in Turkey: Results from the CREDIT Study

Cell-Specific Biomarkers in Renal Medicine and Research

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