Proteinuria

Revision as of 19:38, 19 January 2009 by Zorkun (talk | contribs)
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search
Proteinuria
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

Review articles on Proteinuria

Articles on Proteinuria in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Proteinuria

Images of Proteinuria

Photos of Proteinuria

Podcasts & MP3s on Proteinuria

Videos on Proteinuria

Evidence Based Medicine

Cochrane Collaboration on Proteinuria

Bandolier on Proteinuria

TRIP on Proteinuria

Clinical Trials

Ongoing Trials on Proteinuria at Clinical Trials.gov

Trial results on Proteinuria

Clinical Trials on Proteinuria at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Proteinuria

NICE Guidance on Proteinuria

NHS PRODIGY Guidance

FDA on Proteinuria

CDC on Proteinuria

Books

Books on Proteinuria

News

Proteinuria in the news

Be alerted to news on Proteinuria

News trends on Proteinuria

Commentary

Blogs on Proteinuria

Definitions

Definitions of Proteinuria

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

Symptoms of Proteinuria

Causes & Risk Factors for Proteinuria

Diagnostic studies for Proteinuria

Treatment of Proteinuria

Continuing Medical Education (CME)

CME Programs on Proteinuria

International

Proteinuria en Espanol

Proteinuria en Francais

Business

Proteinuria in the Marketplace

Patents on Proteinuria

Experimental / Informatics

List of terms related to Proteinuria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

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),[2] retrograde ejaculation,[3] pneumaturia (air bubbles in the urine) due to a fistula,[4] or drugs such as pyridium.[5]

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. [6][7] 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.[8][9]

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.[10]

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:[7]

Conditions with proteinuria consisting mainly of Bence-Jones proteins as a sign

Glomerular Protienuria

  • Drugs
  • Hereditary
  • Infections
  • Miscellaneous

Tubular Proteinuria

  • Connatal tulbulopathies
  • Hypokalemic nephropathy
  • Interstitial nephropathy
  • Renal Vein Thrombosis
  • Renal tubular acidosis
  • Toxic nephropathy

Prerenal and Overflow Proteinuria

Renal Parenchymal and Post Renal Proteinuria

Miscellaneous Causes for Proteinuria

See also

References

  1. The American Heritage Stedman's Medical Dictionary. "KMLE Medical Dictionary Definition of proteinuria". Retrieved 2007-01-20
  2. http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20
  3. http://www.medhelp.org/forums/urology/archive/195.html Retrieved 2007-01-20
  4. Template:GPnotebook Retrieved 2007-01-20
  5. http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20
  6. http://medlib.med.utah.edu/WebPath/TUTORIAL/URINE/URINE.html Retrieved 2007-01-20
  7. 7.0 7.1 Simerville JA, Maxted WC, Pahira JJ (2005). "Urinalysis: a comprehensive review". American family physician. 71 (6): 1153–62. PMID 15791892.
  8. http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20
  9. http://www.answers.com/topic/protein-electrophoresis Retrieved 2007-01-20
  10. "Identification, management and referral of adults with chronic kidney disease: concise guidelines" (PDF). UK Renal Association. 27/9/05. Check date values in: |date= (help) - see Guideline 4 Confirmation of proteinuria, on page 9
  11. Dettmeyer RB, Preuss J, Wollersen H, Madea B (2005). "Heroin-associated nephropathy". Expert opinion on drug safety. 4 (1): 19–28. PMID 15709895.
  12. Hermann G, Zühlke V, Faul P (1970). "Gamma globulin fragments in urine of kidney transplant patients in relation to rejection crisis". European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes. 2 (1): 55–63. PMID 4131420.

Template:Abnormal clinical and laboratory findings Template:SIB

de:Proteinurie et:Proteinuuria he:פרוטאינוריה nl:Proteïnurie fi:Proteinuria


Template:WikiDoc Sources