Proteinuria

Question 1

Is it always related to Kidney function?

Answer 1

No-can be normal

so often classified alone-from normal to NEPHROTIC symptoms (3g/day-, PCR-300, ACR300)

Question 2

what are symptoms of nephrotic

Answer 2

Patient complain of oedema (painful swollen legs, limit walking), also have proteinuria

Question 3

What is most useful first investigation for proteinuria?

Answer 3

if proteins in urine, must be issue in Kidney somewhere-find where/why.
USS not always useful (except for CKD-small kidney)
Always BIOPSY as best (but need USS before)

Question 4

What does proteinuria always indicate? which is often caused by which diseases?

Answer 4

GLOMERULAR PATHOLOGY

–diabetes, Amyloid, SLE, membranous nephropathy, minimal change disease (need biopsy for last 2)

Question 5

How do you investigate protein uria

Answer 5

quantitate it, serum albumin and chol
creat/egfr, U+E,
glucose, SLE, virology, myeloma scan, immunology

Question 6

How do you manage proteinuria?

Answer 6

Control oedema-low salt, diuretic
Acei/arb-reduce protein 
Treat the cause-/or control the disease
immunosuppression can be used
unchecked will cause need for dialysis need fast