Proteinuria

Question 1

are plasma proteins normally retained or filtered out in the kidneys

Answer 1

normally retained

Question 2

how is proteinuria estimated

Answer 2

with 24-hour urine collection

Question 3

what protein level in the urine suggest significant glomerular damage

Answer 3

protein >150 mg/day

Question 4

describe what the overflow cause of abnormal proteinuria is

Answer 4

when there is excessive production of protein into the blood, so kidney function fine just too much protein
(eg multiple myeloma)

Question 5

describe what the glomerular cause of abnormal proteinuria is

Answer 5

when there is glomerular dysfunction and proteins not retained, proteins lost in urine and so decreased protein in blood
(eg nephrotic syndrome)

Question 6

describe what microalbuminuria is

Answer 6

excretion of albumin in abnormal quantities, but still below level of protein detection by dipstick

Question 7

why is microalbuminuria important clinicallt

Answer 7

earliest sign of diabetic nephropathy, and so detection allows treatment to prevent progression

Question 8

what are the different methods of assessing proteinuria

Answer 8

dipstick, PCR, total protein(urine 24hr), ACR

Question 9

what are PCR and ACR in relation to proteinuria

Answer 9

PCR = protein-creatinine ratio
ACR = albumin-creatinine ratio
(both involve spot urine sample)