Proteinuria

Question 1

Definition.

Answer 1

Urinary protein excretion > 150mg/24h.

Question 2

Classification.

Answer 2

• Glomerular: increased glomerular permeability to proteins
• Tubular: abnormality of tubules
• Overflow: increased productions of small proteins overwhelms the tubules ability to reabsorb them.

Microalbuminuria < 300 mg/24h
Macroalbuminuria > 300mg /24h

Question 3

Importance of microalbuminuria.

Answer 3

It suggest: diabetic nephropathy or hypertensive nephropathy

Question 4

Relation of proteinuria and nephrotic syndrome.

Answer 4

Urine protein excretion rate > 3,5g/ 24hours

Question 5

Treatment.

Answer 5

1. Asyptomatic: treat underlying condition

2. Symptomatic: treat underlying disease, ace inhibitors, diuretics, limited dietary protein sodium.

Question 6

Diagnosis

Answer 6

• Urinalysis (urine dipstick -> rule out transient proteinuria, specific for albumin)
• Sulfocalycilic acid test (detect total urine proteins, not specific albumin)
• 24h urine collection or urine protein to creatinine ratio ( rule out orthostatic proteinuria)
• urine sediment (rule out glomeroular disease)
• electrophoresis (rule out tubulointerstitial diseases and multiple myeloma).