IRIS - Proteinuri Flashcards
Generellt
Proteinuria is an acknowledged hallmark of glomerular lesions in dogs, but proteinuria is not always attributable to renal, much less glomerular, disease.
Consequently, when proteinuria is detected, it first must be properly assessed to determine its potential clinical significance.
However, proteinuria requires investigation of 3 key elements (localization, persistence, and magnitude), and often it is the identification of persistent renal proteinuria by this investigation that causes a suspicion of glomerular disease to arise.
Nonetheless, persistent renal proteinuria is not always a marker of glomerular disease. Renal proteinuria, albeit of low magnitude, can be caused by tubular lesions alone, and even when proteinuria is largely of glomerular origin, the glomerular lesions are not necessarily caused by an intrinsic glomerular disease.
Glomerular diseases are often secondary to disease processes primarily located in other organ systems, and appropriate problem‐specific investigation of any concurrent extrarenal diseases or abnormalities identified by the minimum evaluations is crucial.
The intent is to identify any disease process that might be incriminated as an underlying secondary cause of a glomerulopathy. This is especially important if effective treatment of the primary disease can reduce or stop its provocation of glomerular injury.
General categories of conditions promoting secondary glomerular injury are infectious and noninfectious inflammatory or vascular conditions, certain endocrine disorders (particularly hyperadrenocorticism), neoplasia (especially disseminated malignancies), and immune‐mediated disorders.
