Proteinuria
You don't need to be Editor-In-Chief to add or edit content to WikiDoc. You can begin to add to or edit text on this WikiDoc page by clicking on the edit button at the top of this page. Next enter or edit the information that you would like to appear here. Once you are done editing, scroll down and click the Save page button at the bottom of the page.
| Proteinuria Classification and external resources | |
| ICD-10 | R80. |
|---|---|
| ICD-9 | 791.0 |
| DiseasesDB | 25320 |
| eMedicine | med/94 |
| MeSH | D011507 |
|
WikiDoc Resources for Proteinuria | |
|
Articles | |
|---|---|
|
Most recent articles on Proteinuria Most cited articles on Proteinuria | |
|
Media | |
|
Powerpoint slides on Proteinuria | |
|
Evidence Based Medicine | |
|
Clinical Trials | |
|
Ongoing Trials on Proteinuria at Clinical Trials.gov Clinical Trials on Proteinuria at Google
| |
|
Guidelines / Policies / Govt | |
|
US National Guidelines Clearinghouse on Proteinuria
| |
|
Books | |
|
News | |
|
Commentary | |
|
Definitions | |
|
Patient Resources / Community | |
|
Patient resources on Proteinuria Discussion groups on Proteinuria Patient Handouts on Proteinuria Directions to Hospitals Treating Proteinuria Risk calculators and risk factors for Proteinuria
| |
|
Healthcare Provider Resources | |
|
Causes & Risk Factors for Proteinuria | |
|
Continuing Medical Education (CME) | |
|
International | |
|
| |
|
Businness | |
|
Experimental / Informatics | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2] Phone:617-525-7431
Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.
Proteinuria (from protein and urine) means the presence of an excess of serum proteins in the urine.[1] The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine (bilirubinuria),[1] retrograde ejaculation,[1] pneumaturia (air bubbles in the urine) due to a fistula,[1] or drugs such as pyridium.[1]
Measurement
Proteinuria is often diagnosed by a simple dipstick test although it is possible for the test to give a false negative even with nephrotic range proteinuria if the urine is dilute. False negatives may also occur if the protein in the urine is composed mainly globulins or Bence-Jones Proteins because the reagent on the test strips, Bromphenol blue, is highly specific for albumin. [1][1] Traditionally dipstick protein tests would be quantified by measuring the total quantity of protein in a 24-hour urine collection test, and abnormal globulins by specific requests for Protein electrophoresis.[1][1]
Alternatively the concentration of protein in the urine may be compared to the creatinine level in a spot urine sample. This is termed Protein/Creatinine Ratio (PCR). The 2005 UK Chronic Kidney Disease guidelines states that PCR is a better test than 24 hour urinary protein measurement. Proteinuria is defined as a Protein:creatinine ratio >45 mg/mmol (which is equivalent to Albumin:creatinine ratio of >30 mg/mmol) with very high levels of nephrotic syndrome being for PCR > 100 mg/mmol.[1]
| Reference Range | |
| Physiologic protien elimination | <150mg protien/24 hours |
| Proteinuria | >150mg protein/24 hours |
| Microalbuminuria | <30mg albumin/24 hours |
Associated conditions
Proteinuria may be a sign of renal (kidney) damage. Since serum proteins are readily reabsorbed from urine, the presence of excess protein indicates either an insufficiency of absorption or impaired filtration. Diabetics may suffer from damaged nephrons and develop proteinuria.
With severe proteinuria, general hypoproteinemia can develop which results in diminished oncotic pressure. Symptoms of diminished oncotic pressure may include ascites, edema, and hydrothorax.
Conditions with proteinuria as a sign
Proteinuria may be a feature of the following conditions:[1]
- Nephrotic syndromes (i.e. intrinsic renal failure)
- Pre-eclampsia
- Eclampsia
- toxic lesions of kidneys
- Collagen vascular diseases(e.g., systemic lupus erythematosus)
- Dehydration
- Glomerular diseases, such as membranous glomerulonephritis, focal segmental glomerulonephritis, minimal change disease (lipoid nephrosis)
- Strenuous exercise
- Stress
- Benign Orthostatic (postural) proteinuria
- Focal segmental glomerulosclerosis (FSGS)
- IgA nephropathy (i.e., Berger's disease)
- IgM nephropathy
- Membranoproliferative glomerulonephritis
- Membranous nephropathy
- Minimal change disease
- Sarcoidosis
- Alport's syndrome
- Diabetes mellitus
- Drugs (e.g., NSAIDs, nicotine, penicillamine, gold, ACE inhibitors, antibiotics, opiates especially heroin.[1]
- Fabry's disease
- Infections (e.g., HIV, syphilis, hepatitis,post-streptococcal infection)
- Aminoaciduria
- Fanconi syndrome
- Heavy metal ingestion
- Hypertensive nephrosclerosis
- Interstitial nephritis
- Sickle cell disease
- Hemoglobinuria
- Multiple myeloma
- Myoglobinuria
- Organ rejection- kidney transplant patients may have gamma-globulins in their urine if the kidneys start to reject.[1]
- Ebola hemorrhagic fever
- Nail Patella syndrome
- Familial Mediterranean fever
Conditions with proteinuria consisting mainly of Bence-Jones proteins as a sign
- Waldenstrom's macroglobulinemia
- Chronic lymphocytic leukemia
- Amyloidosis
- Malignancies (e.g., lymphoma, other cancers)
- Multiple myeloma
Glomerular Protienuria
- Allergins
- Glomerulonephritis
- Minimal change GN
- Membranous GN
- Focal segmental GN
- Membranoproliferative GN
- Mesangioproliferative GN
- Fibrilary glomerulopathy
- Crescentic GN
- Drugs
- Hereditary
- Anticonvulsants
- Captopril
- Gold
- Heavy metals
- Heroin
- NSAIDs
- Penicillamine
- Infections
- Bacterial
- CMV
- EBV
- Helminthic
- Hepatitis B
- HIV
- Leprosy
- Malaria
- Poststreptococcal glomerulonephritis
- Toxoplasmosis
- Miscellaneous
- Hypothyroidism
- Preeclampsia
- Nephritis of Pregnancy
- Nephritic syndrome
- Diabetes Mellitus
Tubular Proteinuria
- Connatal tulbulopathies
- Hypokalemic nephropathy
- Interstitial nephropathy
- Renal Vein Thrombosis
- Renal tubular acidosis
- Toxic nephropathy
Prerenal and Overflow Proteinuria
- Bence-Jones Proteinuria
- Hemoglobinura
- Increased formation of polyclonal free light chains
- Myoglobinuria
Renal Parenchymal and Post Renal Proteinuria
- Hemmorhage in the urinary tract
- Local infections
- Nephrolithiasis
- Prostitis
- Tamm-Horsfall protein
Miscellaneous Causes for Proteinuria
- Arteriolar nephrosclerosis
- Chronic Pyelonephritis
- Constrictive Pericarditis
- Genitourinary Tuberculosis
- High Fever
- Malignant Hypertension
- Massive Obesity
- Orthostatic proteinuria
- Preeclampsia
- Renal Neoplasm
- Renal Vein Thrombosis
- Tricuspid insufficiency
- Unilateral kidney
See also
References
Abnormal clinical and laboratory findings (R70-R94, 790-796) | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Blood test | |||||||||
| Urine test |
| ||||||||
| Other | Abnormal basal metabolic rate - Latent tuberculosis | ||||||||
de:Proteinurie et:Proteinuuriafr:Protéinurie he:פרוטאינוריה nl:Proteïnurie ja:タンパク尿 fi:Proteinuria
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
