n.
The presence of excessive amounts of protein in the urine.
proteinuria
Dictionary:
pro·tein·u·ri·a (prōt'n-ʊr'ē-ə, -yʊr'-, prō'tē-nʊr'-, -nyʊr'-)  |
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| Food and Fitness: proteinuria |
Exercise can produce effects on the human body which, in a sedentary person, may indicate a serious disease. One such effect is proteinuria: the occurrence of abnormally large amounts of protein in the urine. At one time, this was regarded as a very reliable indicator of kidney damage because protein molecules were thought to be too large to pass from blood into the urine unless the kidney was damaged. However, it is now recognized that moderate proteinuria after heavy exertion is common in healthy, young adults. This condition is sometimes called athletic pseudonephritis because the symptoms are similar to those of a very serious kidney disease, glomerular nephritis. Unlike the disease, athletic pseudonephritis is not pathological and is quickly reversed when the exerciser lies down and rests.
| Dental Dictionary: proteinuria |
(prō′tēn-yōō′rē-ə)
n
n
The presence of protein in the urine. Proteinuria is an indication of kidney disease.
| Sports Science and Medicine: proteinuria |
An abnormal presence of serum proteins in the urine. Proteinuria is a feature of renal impairment. Its occurrence after exercise was at one time thought to indicate a serious disturbance of renal function, but it is now recognized that moderate proteinuria is common in healthy young adults after heavy exercise. This condition, unlike pathological conditions, is quickly reversed when the athlete rests in a recumbent posture. See also athletic pseudonephritis, orthostatic proteinuria.
| Veterinary Dictionary: proteinuria |
An excess of serum proteins in the urine; an important indicator of renal disease. It is a constant finding in glomerulonephritis, renal infarction, amyloidosis and nephrosis, but is also common in congestive heart failure and renal ischemia of all kinds. The significance of proteinuria as an indicator of renal disease is greatly enhanced by the presence of renal casts in the urine.
- Bence Jones p. — see bence jones protein.
- neonatal p. — occurs transiently during the period of intestinal absorption of proteins, some of which are small enough to pass the glomerular membrane.
| Wikipedia: Proteinuria |
| ICD-10 | R80. |
|---|---|
| ICD-9 | 791.0 |
| DiseasesDB | 25320 |
| eMedicine | med/94 |
| MeSH | D011507 |
Proteinuria (/prəʊtiː'n(j)ʊəriə/, from protein and urine) means the presence of an excess of serum proteins in the urine. 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),[1] retrograde ejaculation,[2] pneumaturia (air bubbles in the urine) due to a fistula,[3] or drugs such as pyridium.[1]
Contents |
Causes
There are three main mechanisms to cause proteinuria:
1. Due to disease in glomerulus
2. Because of increased quantity of proteins in serum (overflow proteinuria)
3. Due to low reabsorbtion at proximal tubule (fanconi)
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. [4][5] 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.[1][6]
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.[7]
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. The most common cause of proteinuria is diabetes and in any person with proteinuria and diabetes the etiology of the underlying proteinuria should be separated into two categories: diabetic proteinuria versus the field.
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:[5]
- Nephrotic syndromes (i.e. intrinsic renal failure)
- Pre-eclampsia
- Eclampsia
- Toxic lesions of kidneys
- Collagen vascular diseases (e.g. systemic lupus erythematosus)
- Dehydration
- Glomerular diseases, such as membranous glomerulonephritis, focal segmental glomerulonephritis, minimal change disease (lipoid nephrosis)
- Strenuous exercise
- Stress
- Obsessive-compulsive disorder (OCD)
- Benign orthostatic (postural) proteinuria
- Focal segmental glomerulosclerosis (FSGS)
- IgA nephropathy (i.e. Berger's disease)
- IgM nephropathy
- Membranoproliferative glomerulonephritis
- Membranous nephropathy
- Minimal change disease
- Sarcoidosis
- Alport's syndrome
- Diabetes mellitus
- Drugs (e.g. NSAIDs, nicotine, penicillamine, gold and other heavy metals, ACE inhibitors, antibiotics, opiates especially heroin)[8]
- Fabry's disease
- Infections (e.g. HIV, syphilis, hepatitis, post-streptococcal infection)
- Aminoaciduria
- Fanconi syndrome
- Hypertensive nephrosclerosis
- Interstitial nephritis
- Sickle cell disease
- Hemoglobinuria
- Multiple myeloma
- Myoglobinuria
- Organ rejection: Kidney transplant patients may have gamma-globulins in their urine if the kidneys start to reject.[9]
- Ebola hemorrhagic fever
- Nail Patella Syndrome
- Familial Mediterranean fever
- HELLP Syndrome
- Systemic lupus erythematosus
- Wegener's Granulomatosis
- Glycogen Storage Disease Type 1 [10]
-
This list is incomplete; you can help by expanding it.
Conditions with proteinuria consisting mainly of Bence-Jones proteins as a sign
- Waldenstrom's macroglobulinemia
- Chronic lymphocytic leukemia
- Amyloidosis
- Malignancies (e.g., lymphoma, other cancers)
- Multiple myeloma
See also
Footnotes
- ^ a b c URINALYSIS Ed Friedlander, M.D., Pathologist - Retrieved 2007-01-20
- ^ foamy urine - Urology - MedHelpRetrieved 2007-01-20
- ^ Pneumaturia at GPnotebook Retrieved 2007-01-20
- ^ http://medlib.med.utah.edu/WebPath/TUTORIAL/URINE/URINE.html Retrieved 2007-01-20
- ^ a b Simerville JA, Maxted WC, Pahira JJ (2005). "Urinalysis: a comprehensive review". American family physician 71 (6): 1153–62. PMID 15791892. http://www.aafp.org/afp/20050315/1153.html.
- ^ http://www.answers.com/topic/protein-electrophoresis Retrieved 2007-01-20
- ^ "Identification, management and referral of adults with chronic kidney disease: concise guidelines" (PDF). UK Renal Association. 2005-09-27. http://www.renal.org/CKDguide/full/Conciseguid141205.pdf. - see Guideline 4 Confirmation of proteinuria, on page 9
- ^ Dettmeyer RB, Preuss J, Wollersen H, Madea B (2005). "Heroin-associated nephropathy". Expert opinion on drug safety 4 (1): 19–28. doi:. PMID 15709895.
- ^ 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.
- ^ Janice Yang Chou, Dietrich Matern, Brian C. Mansfield, Yuan-Tsong Chen (2002). "Type 1 Glycogen Storage Diseases: Disorders of the Glucose-6-Phosphatase Complex". Current Molecular Medicine 2: 121–143. doi:. PMID 11949931.
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Mentioned in
- orthostatic proteinuria
- nephrotic syndrome
- Eclampsia (in medicine)
- pyuria
