proteinuria Flashcards
What are the normal functions of the kidneys?
Produce urine, make important proteins, regulate blood pressure, acid-base balance, filter blood, remove waste products, excess water, and salt
The kidneys also retain proteins and produce erythropoietin, active vitamin D, and renin.
What is a cardinal sign of kidney disease?
Proteinuria
Who are the patients that might have kidney disease?
50 year old man, 16 year old female, 20 year old woman
Each has different symptoms indicating possible kidney disease.
What does a finding of 2+ or more protein in urine imply?
Intrinsic renal disease
What are the categories of albuminuria based on the albumin/creatinine ratio?
- Normal ACR: less than 3.5
- Microalbuminuria: 3.5 – 30
- Macroalbuminuria: > 30
What should be considered when testing for proteinuria?
- History and examination
- Blood pressure
- Test for diabetes
- Quantify proteinuria
- Check kidney function
- Renal ultrasound
- Possible renal biopsy
True or False: Urinary tract infection causes proteinuria.
False
What is the significance of albuminuria in diabetes mellitus?
It is the earliest clinical feature of diabetic nephropathy.
What is nephrotic syndrome characterized by?
Oedema, heavy proteinuria, hypoalbuminaemia
What are common causes of nephrotic syndrome?
- Glomerulonephritis
- Diabetes
- Infections
- Amyloid
What does the presence of both blood and protein in urine imply?
Glomerular disease and a need for urgent testing of kidney function
What is the relationship between microalbuminuria and cardiovascular disease?
Microalbuminuria is an important risk factor for cardiovascular disease.
Fill in the blank: The nephron is the ________ unit of the kidney.
functional
What is the normal daily filtration rate of the kidneys?
180 litres/day
What is the role of podocytes in the kidney?
They play a key role in the structure and function of the glomerulus.
What does a finding of haematuria indicate?
Potential serious systemic disease requiring urgent diagnosis
What is the significance of measuring urinary albumin excretion?
It is a modifiable risk factor for cardiovascular events.
What are some diseases that can damage the glomerulus?
- Vascular disease
- Inflammation of blood vessels (vasculitis)
- Diabetes mellitus
- Glomerulonephritis
- Deposition diseases (e.g., amyloid)
What should be the response to a finding of proteinuria?
Do NOT send an MSU to exclude infection.
What is the recommended approach when haematuria is present?
Consider other possibilities and do not dismiss it as likely due to infection.
What is the main takeaway regarding albuminuria?
It is a potent, independent cardiovascular risk factor.
