Proteinuria

Proteinuria

Proteinuria (from "protein" and "urine") means the presence of anexcess of serum proteins in the urine. The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine (bilirubinuria), [http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20] retrograde ejaculation, [http://www.medhelp.org/forums/urology/archive/195.html Retrieved 2007-01-20] pneumaturia (air bubbles in the urine) due to a fistula, [GPnotebook|1161101335|Pneumaturia Retrieved 2007-01-20] or drugs such as pyridium. [http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20]

Measurement

Proteinuria is often diagnosed by a simple dipstick test although it is possible for the test to give a false negative even with nephrotic range proteinuria if the urine is dilute. False negatives may also occur if the protein in the urine is composed mainly globulins or Bence-Jones Proteins because the reagent on the test strips, Bromphenol blue, is highly specific for albumin. [http://medlib.med.utah.edu/WebPath/TUTORIAL/URINE/URINE.html Retrieved 2007-01-20] cite journal |author=Simerville JA, Maxted WC, Pahira JJ |title=Urinalysis: a comprehensive review |journal=American family physician |volume=71 |issue=6 |pages=1153–62 |year=2005 |pmid=15791892 |doi= |url=http://www.aafp.org/afp/20050315/1153.html] Traditionally dipstick protein tests would be quantified by measuring the total quantity of protein in a 24-hour urine collection test, and abnormal globulins by specific requests for Protein electrophoresis. [http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20] [http://www.answers.com/topic/protein-electrophoresis Retrieved 2007-01-20]

Alternatively the concentration of protein in the urine may be compared to the creatinine level in a spot urine sample. This is termed Protein/Creatinine Ratio (PCR). The 2005 UK Chronic Kidney Disease guidelines states that PCR is a better test than 24 hour urinary protein measurement. Proteinuria is defined as a Protein:creatinine ratio >45 mg/mmol (which is equivalent to of >30 mg/mmol) with very high levels of nephrotic syndrome being for PCR > 100 mg/mmol. [cite web |title=Identification, management and referral of adults with chronic kidney disease: concise guidelines |url=http://www.renal.org/CKDguide/full/Conciseguid141205.pdf |format=PDF |date= 2005-09-27 |publisher=UK Renal Association - see Guideline 4 Confirmation of proteinuria, on page 9]

Associated conditions

Proteinuria may be a sign of renal (kidney) damage. Since serum proteins are readily reabsorbed from urine, the presence of excess protein indicates either an insufficiency of absorption or impaired filtration. Diabetics may suffer from damaged nephrons and develop proteinuria. The most common cause of proteinuria is diabetes and in any person with proteinuria and diabetes the etiology of the underlying proteinuria should be separated into two categories: diabetic proteinuria versus the field.

With severe proteinuria, general hypoproteinemia can develop which results indiminished oncotic pressure. Symptoms of diminished oncotic pressure may include ascites, edema, and hydrothorax.

Conditions with proteinuria as a sign

Proteinuria may be a feature of the following conditions:cite journal |author=Simerville JA, Maxted WC, Pahira JJ |title=Urinalysis: a comprehensive review |journal=American family physician |volume=71 |issue=6 |pages=1153–62 |year=2005 |pmid=15791892 |doi= |url=http://www.aafp.org/afp/20050315/1153.html]
* Nephrotic syndromes (i.e. intrinsic renal failure)
* Pre-eclampsia
* Eclampsia
* toxic lesions of kidneys
* Collagen vascular diseases(e.g., systemic lupus erythematosus)
* Dehydration
* Glomerular diseases, such as membranous glomerulonephritis, focal segmental glomerulonephritis, minimal change disease (lipoid nephrosis)
* Strenuous exercise
* Stress
*Obsessive Compulsive Disorder
* Benign Orthostatic (postural) proteinuria
* Focal segmental glomerulosclerosis (FSGS)
* IgA nephropathy (i.e., Berger's disease)
* IgM nephropathy
* Membranoproliferative glomerulonephritis
* Membranous nephropathy
* Minimal change disease
* Sarcoidosis
* Alport's syndrome
* Diabetes mellitus
* Drugs (e.g., NSAIDs, nicotine, penicillamine,gold, ACE inhibitors, antibiotics, opiates especially heroin.cite journal |author=Dettmeyer RB, Preuss J, Wollersen H, Madea B |title=Heroin-associated nephropathy |journal=Expert opinion on drug safety |volume=4 |issue=1 |pages=19–28 |year=2005 |pmid=15709895|doi=10.1517/14740338.4.1.19]
* Fabry's disease
* Infections (e.g., HIV, syphilis, hepatitis,post-streptococcal infection)
* Aminoaciduria
* Fanconi syndrome
* Heavy metal ingestion
* Hypertensive nephrosclerosis
* Interstitial nephritis
* Sickle cell disease
* Hemoglobinuria
* Multiple myeloma
* Myoglobinuria
* Organ rejection- kidney transplant patients may have gamma-globulins in their urine if the kidneys start to reject.cite journal |author=Hermann G, Zühlke V, Faul P |title=Gamma globulin fragments in urine of kidney transplant patients in relation to rejection crisis |journal=European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes |volume=2 |issue=1 |pages=55–63 |year=1970 |pmid=4131420 |doi=]
* Ebola hemorrhagic fever
*Nail Patella Syndrome
* Familial Mediterranean fever
* HELLP Syndrome

Conditions with proteinuria consisting mainly of Bence-Jones proteins as a sign

* Waldenstrom's macroglobulinemia
* Chronic lymphocytic leukemia
* Amyloidosis
* Malignancies (e.g., lymphoma, other cancers)
* multiple myeloma

ee also

*Albuminuria
*Microalbuminuria
*List of terms associated with diabetes

Footnotes


Wikimedia Foundation. 2010.

Поможем сделать НИР

Look at other dictionaries:

  • proteinuria — f. urol. Presencia de proteínas en la orina. Medical Dictionary. 2011. proteinuria presencia de proteínas en la orina; albumin …   Diccionario médico

  • Proteinuria — Saltar a navegación, búsqueda Proteinuria Clasificación y recursos externos Aviso médico CIE 10 R 80; r 80 …   Wikipedia Español

  • proteinuria — 1911, Mod.L., from Fr. protéinurie; see PROTEIN (Cf. protein) + URINE (Cf. urine) …   Etymology dictionary

  • proteinuria — [prō΄tē nyoor′ē ə, prō΄tē ə nyoor′ē ə] n. [ModL: see URIA] the presence of protein in the urine …   English World dictionary

  • proteinuria — /proh tee noor ee euh, nyoor , tee euh /, n. Pathol. the presence of abnormally large amounts of protein in the urine, usually resulting from kidney disease but sometimes from fever, excessive exercise, or other abnormal condition. [1910 15; …   Universalium

  • Proteinuria — Excess protein in the urine. Some protein is normal in the urine. Too much means protein is leaking through the kidney, most often through the glomeruli. The main protein in human blood and the key to the regulation of the osmotic pressure of… …   Medical dictionary

  • proteinuria — {{#}}{{LM P44661}}{{〓}} {{[}}proteinuria{{]}} ‹pro·tei·nu·ria› {{《}}▍ s.f.{{》}} {{♂}}En medicina,{{♀}} presencia de proteínas en la orina …   Diccionario de uso del español actual con sinónimos y antónimos

  • proteinuria postural — Véase proteinuria ortostática. Diccionario Mosby Medicina, Enfermería y Ciencias de la Salud, Ediciones Hancourt, S.A. 1999 …   Diccionario médico

  • proteinuria de Bence-Jones — presencia en la orina de la proteína de Bence Jones, observada muy frecuentemente en el mieloma múltiple Diccionario ilustrado de Términos Médicos.. Alvaro Galiano. 2010 …   Diccionario médico

  • proteinuria ortostática — Presencia de proteínas en la orina de algunas personas, especialmente adolescentes, que han estado de pie. Desaparece cuando se tumban y no tiene significado patológico. Diccionario Mosby Medicina, Enfermería y Ciencias de la Salud, Ediciones… …   Diccionario médico

Share the article and excerpts

Direct link
Do a right-click on the link above
and select “Copy Link”