Proteinuria

Etiologies of Proteinuria

Category

Description

(can be -3 g/d)

Disruption of filtration barrier lose albumin

Glomerulonephritis Nephrotic syndrome

Tubulointerstitial

(usually <1-2 g/d)

i reabsorption of freely filtered proteins lose globulins

ATN AIN

Fanconi's syndrome

Overflow

t production of freely filtered proteins

Multiple myeloma Myoglobinuria

Isolated

By def'n: asx. normal renal fxn, sed. & imaging, no h/o renal disease

Functional (fever, exercise. CHF) Orthostatic (only when upright) Idiopathic (transient or persistent)

• Urine dipstick

1' 30 mg d!.2+ -100 mg dl.3 ♦ -300 mg dl,4+ >2g dl -» interpretation depends on SG; eg. 3 + in very concentrated urine might not indicate heavy proteinuria Insensitive for microalbuminuria and myeloma light chains; false © with contrast

• Spot urine: protein (mg dl) creatinine (mg dl) • g d of proteinuria (NEJM 19833091S43).

Unlike urine dipstick, will detect myeloma light chains.

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