ISSN: 1305-385X
Hakkında: Özel sayılar şeklinde yayınlanır.
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Proteinuria
Dr. İdris ŞAHİNa
aNefroloji BD, Gaziosmanpaşa Üniversitesi Tıp Fakültesi, TOKAT
Proteinuria is a cardinal manifestation of renal disease and can complicate, to different degrees, the vast majority of renal parenchymal disorders. Proteinuria of increasing intensity is a predictor of poor survival in most renal disease. Urinary protein excretion in the normal adult should be less than 150 mg per day. Excretion levels above this (ie, proteinuria) that persist beyond a single measurement should not be ignored and must be evaluated. Persistent proteinuria as detected clinically implies an abnormality in glomerular permeability. Except in patients at high risk (eg, diabetes, hypertension), screening for proteinuria is not generally felt to be cost-effective. Despite this, urinalysis is frequently preformed, and the primary care physician will most commonly identify a patient with proteinuria based upon a positive dipstick result on a routine urinalysis. In this circumstance, it is important to understand how to differentiate between relatively benign (eg, orthostatic proteinuria) or common causes of proteinuria (eg, diabetic proteinuria) and uncommon causes that require nephrology consultation. There are three basic types of proteinuria – glomerular, tubular, and overflow. Only glomerular proteinuria (ie, albuminuria) is identified on a urine dipstick. Most cases of persistent proteinuria encountered in primary care are due to glomerular proteinuria. While albuminuria may be a suitable test for general population screening for renal and cardiovascular disease, it should not replace testing for proteinuria in those with known or suspected renal disease.Keywords: Proteinuria, renal disease, microalbuminuria, dipstick, Tamm-HorsfallTurkiye Klinikleri J Int Med Sci 2006, 2(38):14-20
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