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【文摘发布】无症状尿路感染不能导致蛋白尿或

Asymptomatic urinary tract infection is unlikely to cause proteinuria or microalbuminuria
Lindsay E Nicolle
Nature Clinical Practice Nephrology (2007) 3, 242-243

Background
Guidelines recommend screening for urinary tract infection (UTI) when proteinuria is detected.

Objective
To determine whether symptomatic or asymptomatic UTI causes proteinuria or albuminuria.

Design
For this systematic review, electronic searches were conducted in PubMed (of articles published between 1951 and 31 March 2006) and EMBASE (of articles published between 1974 and 31 March 2006), using various combinations of the terms "proteinuria", "urinary tract infection", "albuminuria" and "pyuria". Two investigators selected articles for full-text retrieval on the basis of the title and abstract; only papers in English were considered. Other articles were obtained from the reference lists of those already identified, and via the authors' specific knowledge and the 'related articles' link on PubMed.

Outcome measures
UTI (pure growth of 105 colony-forming units per ml urine), proteinuria (as detected by nonspecific chemical techniques) and albuminuria (as detected by immunoassay) were the end points.

Results
A total of 80 full-text articles were obtained for review. Ten studies reported an association between proteinuria and asymptomatic UTI, but there was no evidence of a causal relationship. Eight pediatric screening studies conducted in the 1960s and 1970s failed to establish a definite association between asymptomatic UTI and proteinuria. None of these studies was designed to identify a causal relationship between the two conditions, however, and none investigated the effects of antibiotics on proteinuria in children with asymptomatic UTI. Only one of seven studies found evidence that asymptomatic UTI might be associated with albuminuria; no causal relationship was identified. A prospective study found that levels of albuminuria were similar in patients with type 2 diabetes who did or did not have asymptomatic UTI; furthermore, the overall level of albuminuria was unaffected by antimicrobial treatment. With regard to symptomatic UTI, one study in 400 consecutive patients reported that protein urine reagent strip testing had 71% sensitivity and 53% specificity for detection of UTI. A double-blind, multicenter, placebo-controlled study in 166 patients with recurrent UTI found that prophylactic immunotherapy reduced the rate of recurrence and the prevalence of proteinuria. In a study of 61 children with febrile UTI, urine albumin levels were elevated compared with those among children who had other febrile illnesses. Few studies have attempted to characterize the composition of urine protein in patients with UTI. The systematic review found no compelling evidence that UTI had a confounding influence on detection of proteinuria or albuminuria.

Conclusion
Proteinuria often occurs in patients with symptomatic UTI, but is not specific for the condition. Infection should, therefore, be treated before investigation of any proteinuria. There is no need to screen for UTI in patients who have proteinuria or albuminuria if they are asymptomatic. 本人已认领该文编译,48小时后若未提交译文,请其他战友自由认领 本人已认领该文编译,48小时后若未提交译文,请其他战友自由认领。 Asymptomatic urinary tract infection is unlikely to cause proteinuria or microalbuminuria
无症状性尿路感染不可能导致蛋白尿或微量白蛋白尿

Background
Guidelines recommend screening for urinary tract infection (UTI) when proteinuria is detected.
背景:临床治疗指南建议当发现蛋白尿时应筛查是否存在尿路感染(UTI)。

Objective
To determine whether symptomatic or asymptomatic UTI causes proteinuria or albuminuria.
目的:确定症状性或无症状性UTI是否会导致蛋白尿或微量白蛋白尿。

Design
For this systematic review, electronic searches were conducted in PubMed (of articles published between 1951 and 31 March 2006) and EMBASE (of articles published between 1974 and 31 March 2006), using various combinations of the terms "proteinuria", "urinary tract infection", "albuminuria" and "pyuria". Two investigators selected articles for full-text retrieval on the basis of the title and abstract; only papers in English were considered. Other articles were obtained from the reference lists of those already identified, and via the authors' specific knowledge and the 'related articles' link on PubMed.
实验设计:
为进行这次系统回顾,我们使用“蛋白尿”、“尿路感染”、“白蛋白尿”和“脓尿”等术语,以不同组合方式在PubMed(1951 年到2006年3月31日)和EMBASE(1974 年到 2006年3月31日)两个数据库中对此间发表的相关文章进行搜索。两位研究者以题目和文摘为基础进行全文检索(限于以英文撰写的文章)。其它文章来自于已获文章的参考文献列表和PubMed提供的“相关文章”链接。

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作者:admin@医学,生命科学    2011-06-09 16:02
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