Proteinuria & Hematuria Flashcards
How can you detect and quantify proteinuria?
- 24 hour urine collection
- dipstick
- urine albumin:creatinine ratio
- urine protein electrophoresis
Why do people get proteinuria?
- increased glomerular permeability
- structural lesion
Is the degree of proteinuria important? What are the different degrees?
- yes
- normoalbuminuria: ratio 20, >300 mg/day
What will the dipstick pick up? Normo/micro/macrobuminuria?
- macroalbuminuria
- can only detect proteinuria of >300 mg/day
What are the three patterns of proteinuria?
- transient
- orthostatic
- persistent
What is the DDx is proteinuria?
- glomerular proteinuria (size/charge)
- tubular proteinuria (Tamm-Horsfall)
- overflow proteinuria (light chains)
- tissue proteinuria (inflammation or tumours)
Heavy proteinuria suggests which type of proteinuria?
- glomerular proteinuria
What are the criteria of nephrotic syndrome?
- massive proteinuria (>3.5 g/day)
- hypoalbuminemia
- hyperlipidemia
- hyperlipiduria
- generalized edema
What is the DDx of nephrotic syndrome?
Primary:
- minimal change disease
- membranous nephropathy
- focal segmental glomerulosclerosis
- membranoproliferative glomerulonephritis
Secondary:
- diabetes
- amyloidosis
How do you treat minimal change disease?
- prednisone
- if steroid-resistant, then biopsy
If an adult presents with nephrotic syndrome, how you do determine the diagnosis?
- renal biopsy
How can you detect and quantify hematuria?
- urine microscopy (RBC casts, dystrophic RBCs)
- dipstick (although can give false positives)
What are the clinical categories of hematuria?
- glomerular hematuria
- urinary tract hematuria
- indeterminate
What are the criteria for nephritic syndrome?
- hematuria (RBC casts, dysmorphic RBCs)
- moderate proteinuria (<3 g/day)
- elevated serum creatinine
- hypertension
- oliguria
What is a medical emergency associated with nephritic syndrome?
- rapidly progressive glomerulonephritis (crescenteric glomerulonephritis)
