Lecture 4: Proteinuria and Systemic Disease

Question 1

A “routine” urine dipstick has a threshold for detecting protein (albumin) of what?

Answer 1

Turns + for >300 mg of albumin

Question 2

A urine albumin to creatinine ration of >____ mg/g defines presence of microalbuminuria?

Answer 2

>30 mg/g

Question 3

How can protein in urine be quanitified after a positive dipstick result?

Best if tested when?

Answer 3

• Albumin/Creatinine Ratio (ACR) –> can be done on random (aka “spot”) urine sample
• Preferably 1st morning void

Question 4

What is another method to quantify protein in urine, which also can provide a sample to do electrophoresis to determine which types of protein present?

Answer 4

24-hour urine collections —> protein, albumin, creatinine clearance

Question 5

For a classification of Nephrotic Syndrome you need what 4 findings?

Answer 5

• Nephrotic range proteinuria
• Hyperlipidemia
• Hypoalbuminemia
• Edema

Question 6

For a patient with an established diagnosis of type 2 DM, what is the annual screening recommendation that should be done to assess kidney function?

Answer 6

Annual ACR (albumin/creatinine ratio)

Question 7

Which 2 drug classes can be used to slow the progression of proteinuria?

Answer 7

• ACE inhibitors
• ARB’s

Question 8

What are 2 rheumatologic (autoimmune) causes of nephrotic syndrome?

Answer 8

• SLE
• Rheumatoid arthritis

Question 9

What are 4 infectious agents which can cause nephrotic syndrome?

Answer 9

• HBV and HCV
• HIV
• Syphillis
• Tuberculosis

Question 10

What are 3 legal/illegal drugs which can cause nephrotic syndrome?

Answer 10

• NSAIDs
• Lithium
• IV heroin abuse