▶️ Watch Dr Anupam Roy Explain about Proteinuria & Hematuria
Presence of protein in the urine is defined as proteinuria.
Normally less than 150 mg of protein appears in urine per day. Massive proteinuria (>3.5
gm/day) is defined as nephrotic syndrome
Symptoms:
Edema (swelling) in the face,
legs, or both; frothing of urine.
Causes:
Primary kidney diseases like IgA
nephropathy, MPGN, Minimal change disease, Membranous glomerulopathy
Conditions like Diabetes, Hypertension,
Renal vasculitis, SLE, Amyloidosis, Post infectious glomerulonephritis can be
associated with nephrotic range proteinuria.
Investigations:
(a) Urine testing —
Dipstick test
A spot urine sample collected at
any time (a common and convenient method).
Urine that has been collected over
24 hours (a more exact but somewhat inconvenient method)
Microscopic examination to see
whether there are cells, crystals, bacteria, or structures called casts.
(b) Blood tests —
Kidney function tests including BUN and creatinine
Specialised immunological tests.
Kidney function tests including BUN and creatinine
Specialised immunological tests.
(c) Kidney biopsy
Management:
Depends on underlying renal or non renal
condition.
Diet: Salt restricted. Protein
restriction is controversial. Some studies indicate that it may slow
progression of disease but concern exists that it may lead to protein
malnutrition. Recommended protein intake is 0.8-1 gm/kg/day.
Control of diabetes/ hypertension.
In case of immune mediated injury,
steroids and other immunosuppressive medications may be required.
Prognosis: depends on cause, degree of proteinuria, and presence/
absence of renal dysfunction.
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Presence of blood in urine is technically known as Hematuria.
Symptoms:
Can be gross (overtly bloody, smoky or tea coloured urine) or detected only on microscopic examination of urine. May be painless or associated with pain.
Causes:
Kidney diseases like IgAN, Thin BM disease, HUS, MPGN, Lupus Nephritis, Alports syndrome etc.
Non glomerular conditions like fever, trauma, strenuous exercise, menstruation, foreign body, UTI, stones, tumours etc can also have associated hematuria.
Investigations:
Urinalysis, urine c/s
BUN, Creatinine, Hematological & coagulation studies, Serological tests like complement level, ANA, dsDNA.
Imaging studies include USG, CT, radionuclide studies
Kidney biopsy may be required
Management:
Hematuria is a sign and not a disease. Treatment is directed at underlying disease process.
Surgery may be needed in conditions like UPJ obstruction, tumours, stone disease.
Disclaimer: Please consult your nephrologist for detailed opinion.
Key words: Proteinuria, protein in urine, nephrotic syndrome
https://docbeans.com/Play?w=aHR0cHM6Ly9kMmRvZXNkZnBuNG5rMi5jbG91ZGZyb250Lm5ldC8xMWFudXBhbXJveS5tcDQ=
Key words: Proteinuria, protein in urine, nephrotic syndrome
https://docbeans.com/Play?w=aHR0cHM6Ly9kMmRvZXNkZnBuNG5rMi5jbG91ZGZyb250Lm5ldC8xMWFudXBhbXJveS5tcDQ=
