34: Proteinuria, Polyuria Flashcards
three layers of the glomerular filtration barrier + what they keep out
- podocytes: large plasma proteins
- glomerular BM: large plasma proteins
- fenestrated capillary endothelium: cells
normal protein amount in urine
a small amount in urine is normal - LMW proteins, Tamm-Horsfall proteins; nl is <150 mg/day
three types of proteinuria + explain
- glomerular: damaged glomeruli -> albuminuria
- overlow: too much LMW proteins for the kidney to reabsorb (ex: light chains)
- tubulointerstitial: tubular damage -> LMW proteins not reabsorbed
2 downfalls of urinalysis
only detects albumin as protein in urine, only detect >300 mg protein
spot urine albumin:Cr ratio: a pro and a con
pro: detects small amount of albumin
con: only detects albumin
spot urine protein:Cr ratio pro and con
pro: dtecst all proteins
con: not as specific for diabetic nephropathy
gold standard for measuring proteinuria**
24 hour urine protein
four ways to measure proteinuria
UA, spot urine albumin:Cr ratio, spot urine protein:Cr ratio, 24 hour urine protein
two causes of edema in nephrotic syndrome
- underfill theory: low intravascular oncotic pressure
2. overfill theory: renal Na retention
what renal disease is amyloid associated with?
nephrotic syndrome
anti-GBM disease other name
Goodpasture’s disease
what do hyaline casts suggest?
pre-renal azotemia (nonspecific)
what do renal tubular epithelial cells + granular “muddy brown” casts suggest?
ATN
what does WBC casts or urine eosinohpils suggest?
AIN
definition of polyuria
3+ Liters urine in 24 hours
