proteinuria Flashcards
what is criteria for proteinuria
> 150 mg protein excretion/day
what is proteinuria an indicator of
- kidney disease
- vascular disease
- independent risk factor in predicting CVD death
what does microalbuminuria indicate within kidney
there is a disruption of glomerular filtration mechanism
how do we know if microalbuminuria is d/t glomerular cause
losing > 2 gm of protein per day
what to check to make sure there is not a false positive with proteinuria
- specific gravity
- Ph
- PNC and sulfa drugs
- post cortis and vaginal secretions
if doing a dip stick, send to lab - hematuria
when do false negatives occur with proteinuria
usually only with very dilute urine or if protein is not an albumin type protein
how to approach differential diagnosis with proteinuria
by pathology- aka where kidney is not working
glomerular vs secondary vs primary vs tubular
proteinuria r/t glomerular disease indication
d/t disruption of glomerular filtration process resulting in larger protein losses
> 2 gm protein/day (24 hr urine)
most common pathology
proteinuria r/t secondary glomerulonephropathies indication
DM, CVD, amyloidosis (build up of amyloid can kill kidneys), infections (UTI), lymphoma, GI/lung CAs
proteinuria d/t primary causes
idiopathic or IGA nephropathy
proteinuria d/t tubular causes
- impairment at proximal tubule
2. HTN nephrosclerosis
how to evaluate proteinuria
repeat urine dipstick 2 - 3x month
after first positive, need UA
24 hr urine needed for large protein loss; always look for cause with large protein loss
when you can stop testing for proteinuria
after repeat testing 2-3 x in a month with all negative results
who gets screened for proteinuria
- pts with DM and HTN to prevent kidney damage and/or identify damage
