Assessment of proteinuria.
ABSTRACT Proteinuria is a strong predictor of adverse cardiovascular and kidney events, and an accurate assessment of proteinuria is important for the evaluation and management of CKD. Total urinary protein can be assessed using dipstick, precipitation, and electrophoresis methods. Urinary albumin, the predominant urinary protein in most proteinuric kidney diseases, can be assessed using an albumin-specific dipstick, immunochemical techniques, and size-exclusion high-performance liquid chromatography. Urine albumin may be immune-reactive, immune-unreactive, fragmented, and biochemically modified, and laboratory techniques have variable abilities to detect different types of albumin. Urine specimen for proteinuria assessment can either be obtained from a timed-collection or a spot urine sample. Spot urine protein- or albumin-to-creatinine ratios are preferred to a 24-hour urine sample in routine practice. Assessment of albuminuria rather than proteinuria is more clinically meaningful in patients with diabetic kidney disease, and proteinuria and albuminuria assessments both have a role in nondiabetic kidney disease and in general population screening. As measurement and sampling procedures for proteinuria assessment have yet not been standardized, it is important for physicians to be aware of different types of urinary proteins, albumins, laboratory techniques, and urine sampling methods.
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ABSTRACT: This study was designed to examine the antioxidative capacity of chlorella in rats oxidatively stressed with dietary cadmium (Cd). Sixty male Sprague-Dawley rats (14 weeks old) were fed diets containing 0, 3 or 5% chlorella, and 0 or 160 ppm Cd for 10 weeks. Activities of antioxidant enzymes and xanthine oxidase (XO), lipid peroxide concentration and superoxide radical generation were examined in blood and liver. Erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase activities were not different among the groups. Cd treatment significantly lowered liver SOD and GPx activities; however, there were no differences induced by the chlorella content. Dietary Cd markedly increased XO activities in plasma and liver. Five percent chlorella-containing diets significantly lowered plasma XO activity, 3% chlorella-containing diets significantly lowered liver XO activity. Plasma malondialdehyde (MDA) concentration of the Cd-3% chlorella group was significantly lower than that of the Cd-0% chlorella group. Liver MDA concentration of the Cd-5% chlorella group was significantly lower than that of the Cd-0% chlorella group. Increased serum and liver superoxide radical generation by Cd was significantly attenuated by chlorella intake. Chlorella could be applied as potential substance for reducing oxidative stress, since XO activity, MDA concentration and superoxide radical generation were decreased by chlorella intake.Annals of Nutrition and Metabolism 03/2009; 54(1):7-14. · 1.66 Impact Factor
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ABSTRACT: Enhancement of immune function has been claimed as a benefit of some natural health products, although few have been subjected to randomized clinical trials. We evaluated the effect of an oral dietary supplement derived from the edible microalga Chlorella pyrenoidosa on immune response after influenza vaccination. We conducted a randomized, double-blind, placebo-controlled community-based clinical trial in a convenience sample of 124 healthy adults at least 50 years of age randomly assigned to receive the study product (200 or 400 mg of a Chlorella-derived dietary supplement) or placebo. Participants took the study product or placebo once daily for 28 days. On day 21, we administered a single dose of a licensed trivalent, inactivated influenza vaccine. We obtained serum specimens to measure hemagglutination inhibition titres before and 7 and 21 days after vaccination. The primary immunological outcomes were the proportion of participants with a 4-fold or greater increase in antibodies and geometric mean antibody titres after vaccination; the proportion of participants reporting adverse events during therapy was the safety outcome. A total of 117 (94%) participants completed all aspects of the study. There were no differences in the proportions of recipients of 200 or 400 mg of the Chlorella-derived dietary supplement or placebo who achieved at least a 4-fold increase in antibodies (proportions for the 3 virus strains ranged from 17.9% to 28.2% for the 200-mg group, from 11.1% to 22.2% for the 400-mg group and from 19.0% to 21.4% for the placebo group; p > 0.05 for all comparisons). Reports of adverse events were similar for recipients of the supplement and placebo, except with regard to fatigue, which was reported more frequently by recipients of 200 mg of the supplement (18/41 or 44%) than by those who received 400 mg of the supplement (8/40 or 20%; p = 0.032) or placebo (8/42 or 19%; p = 0.019). Recipients of 400 mg of the supplement who were 55 years of age or younger had significantly higher geometric mean antibody titres against influenza A/New Caledonia 21 days after vaccination (p = 0.047) and against B/Yamanashi 7 days after vaccination (p = 0.034); the trends were nonsignificant for titres against A/Panama. We also observed similar increases for the proportions of subjects with a 2-fold or greater or a 4-fold or greater increase in antibodies. The Chlorella-derived dietary supplement did not have any effect in increasing the antibody response to influenza vaccine in the overall study population, although there was an increase in antibody response among participants aged 50-55 years. Adverse events were similar among those receiving the supplement and the placebo. Further studies are warranted to explore the range of clinical effects resulting from ingestion of this dietary supplement.Canadian Medical Association Journal 07/2003; 169(2):111-7. · 6.47 Impact Factor
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ABSTRACT: Homeostatic mechanisms regulating mast cell numbers and function in peripheral tissues have largely focused on cytokines, such as stem cell factor, interleukin (IL)-3, IL-4, and IL-10, which regulate mast cell maintenance and proliferation. Despite these advances, little attention has been paid to the mechanisms that mediate mature mast cell turnover, and control of mast cell hyperplasia generated during Th2-mediated responses. These are important issues, as mast cells are now known to be multi-functional effector cells, that have the capacity to mediate both innate and Th2-induced immune responses. Numerous secretagogues may elicit mast cells to release a large number of important mediators that can cause chronic inflammation. Therefore, how mast cell homeostasis is regulated may have significant effects on normal physiology, and contribute to the genesis of inflammatory disease. Our laboratory has characterized an in vitro model of mast cell homeostasis, by which long-term exposure of murine bone-marrow-derived mast cells to the Th2-derived cytokines IL-3, IL-4, and IL-10, will induce downregulation of critical mast cell effector proteins such as Kit and Fcepsilon-RI, followed by mast cell apoptosis. These data offer a novel role for Th2 cytokines, acting to both initiate and resolve mast cell activation and proliferation. Loss of these signals may contribute to a multitude of diseases, such as mastocytosis and allergyImmunological Reviews 03/2001; 179:82-93. · 12.16 Impact Factor