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How to correctly understand proteinuria? (B)

2017-06-30 15:25

How is albuminuria classified?

There are many causes of proteinuria, clinical can be pided into benign proteinuria (ie, temporary proteinuria, postural proteinuria), and pathological proteinuria (persistent proteinuria).

(1) temporary proteinuria: when the patient has dehydration, fever, the weather is too cold, intense exercise, taking painkillers, or high fever, acute disease, pregnancy, high blood pressure, etc., that may occur transient proteinuria.

(2) posture proteinuria: the patient's body position changes are closely related. Posture proteinuria is often found in young people. General patients in the morning urine lack of protein, but after a long time activities, walking, strenuous exercise, standing, or flexion, proteinuria will appear when the patient lying on the measurement, it will disappear. In general, less than 30-year-old patients, urine protein less than 2 grams per day, and Ccr (creatinine clearance) normal, as long as the regular blood pressure and annual tracing can be; if more than three years old, you need regular blood pressure, every six Month to check the urine and renal function.

(3) intermittent proteinuria: recurrent infection of cystitis, pyelonephritis, there will be urine protein, once the infection is controlled, proteinuria will disappear; and high blood pressure, heart failure and other diseases with the disease is good and bad intermittent Urinary eggs.

(4) persistent (pathological) proteinuria: usually when the renal pelvis or renal tubular irreversible damage occurs, there will be persistent proteinuria. Glomerular disease is the most common cause of pathological proteinuria, can be pided into two categories: a. Primary glomerular diseases, including acute glomerulonephritis (acute nephritis), chronic glomerulonephritis. B. Secondary glomerular disease: caused by other diseases of the body caused by glomerular disease, it is called secondary glomerular diseases, such as erythema lupus, scleroderma caused by kidney disease.

What are the diseases in which proteinuria appears?

There are many kinds of proteinuria, due to a variety of kidney disease caused by, and thus appear in different parts of the kidney, the following to specifically understand what happens in those cases of proteinuria. Protein urine refers to urinary protein qualitative examination was positive. Normal urine protein was negative or very negative, 24 hours urine protein content of less than 150mg, according to the pathogenesis of proteinuria can be seen in the following circumstances:

① glomerular proteinuria: glomerular filtration membrane permeability increased, more than the renal tubular reabsorption capacity.

② renal tubular proteinuria: renal tubular defects, although the number of proteins filtered out from the glomerular did not increase, but the renal tubular reabsorption capacity decreased urine protein than normal.

③ spilled proteinuria: also known as renal proteinuria, mainly for abnormal blood protein increased, such as immunoglobulin light chain or hemoglobin content increased.

④ secretory proteinuria: renal tissue itself contains protein-containing substances into the urine, under normal circumstances, renal tubular secretion of small amounts of protein, such as interstitial nephritis, cancer, IgA nephropathy, secretion of protein increased, causing proteinuria.

⑤ tissue proteinuria: normal urine there is a very small amount of soluble tissue decomposition products, such substances are low molecular weight

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