Proteinuria Directed Study part 2 Flashcards
when should a renal biopsy be considered?
a renal biopsy should be considered if the proteinuria is on-orthostatic or if the protteinuria is of glomerular origin.
I.e. nephrotic range proteinuria (<3000 mg/24hr) in the absence of systemic disease
what is isolated proteinuria?
what symptoms does it present with?
what is the protein excretion?
Isolated proteinuria is defined as proteinuria without hematuria or a reduction in glomerular filtration rate
it is usually asymptomatic
protein excretion is less than 3 g/day
A known diabetic with no history of proteinuria who presents with proteinuria in the range of 500-3000 mg/24 hr should be investigated for what?
glomerular hematuria, impaired renal function, and circulating immunologic abnormalities.
Transient proteinuria:
clinical setting:
typical levels of proteinuria:
Transient proteinuria
fever, heavy exercise
<1g/d
Persistent orthostatic:
clinical setting
typical level of proteinuria:
Persistent orthostatic:
Occurs in 2-5% of adolescents; uncommon over 30
<1-2 g/d
the patient has primary or secondary glomerular disease with a variable proteinuria (often in the nephrotic range)
these suggest what type of proteinuria?
persistent glomerular
heavy metal intox, autoimmune or medication induced injury. Proteinuria is <3g/day
these suggest what type of proteinuria?
Persistent: Tubular
a urine analysis shows: myeloma (light chains); hemoglobin, or myoglobin.
the level of protein in the urine is variable but can be in the nephrotic range
these suggest what type of proteinuria?
hemolysis, rhabodmyolysis and light chains with a variable level of proteinuria is suggestive of persistent overflow proteinuria
A patient has a history or UTI, nephrolithiasis, or urinary tract neoplasm with a proteinuria <1g/day
these suggest what type of proteinuria?
postrenal
