NEPHROTIC SYNDROME

A. Physiological Proteinuria

Every day, 10 to 15 kg of serum proteins pass through the kidney, but only 100 to 150 mg are excreted in the urine in 24 hours
The glomerular capillary wall opposes to the filtration effect of these proteins, and the proximal tubule reabsorbs the great amount of filtered proteins
In the normal state, 60% of urinary proteins excreted from plasma proteins: they are mainly low weight proteins molecular (lysozyme, β-2 macroglobulin); the remaining 40% come from the tubular secretion uromodulin (Tamm-Horsfall protein) and urothelium of the urinary tract

BENIGN PROSTATE HYPERPLASIA

Introduction

BPH: Benign and diffuse hyperplasia of prostate

Androgen-dependent

Anatomy review

Prostate lies immediately inferior to the bladder, posterior to the pubic symphysis and anterior to the rectum. It is a gland, consisting of a median lobe (Central lobe) and two lateral lobes (Peripheral lobe), that surrounds the neck of the bladder and the urethra in the male

Diameter of 2 x 4 x 3 cm, and weighing about 15-20 g, and enclosed in a fibrous capsule containing smooth muscle fibers in its inner layer

The gland secretes a thin, opalescent, slightly alkaline fluid that forms part of the seminal fluid. No endocrine function

(Gray's Atlas of Anatomy)

URINARY TRACT INFECTION (UTI)

Definition

To describe urinary tract infections, qualifying: low or high, or primitive Secondary should be avoided; because they are confusing. It's simple to call: complicate and simple
Complicated urinary tract infection
Is a urinary tract infection occurring with risk factor that can make the infection worse and more complex treatment
Risk Factor:
- Pregnancy, elderly (≥ 65 years) associated with disease,
- Organic or functional abnormality of the urinary tract (bladder residue,
reflux, stones, tumor, invasive bladder maneuver)
- Co-morbidity: diabetes, immunosuppression, renal failure

Note: UTI in men is rare to man due to its long urethra and protected by prostatic secretion. Usually accompanied by organic or functional abnormality of the urinary tract
Recurrent cystitis

A recurrent cystitis is described as if there were at least 4 episodes in a year or 2 in 6 months

Urinary Colonization / asymptomatic bacteriuria
It corresponds to the presence of a microorganism in the urine without clinical manifestation associated. Abstention therapeutic is the rule unless the patient is at risk: pregnant, neutropenia, immunosuppression, urological maneuvers