Proteinuria: Difference between revisions
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In [[medicine]], '''proteinuria''' is "the presence of proteins in the urine, an indicator of kidney diseases."<ref>{{MeSH}}</ref> | In [[medicine]], '''proteinuria''' is "the presence of proteins in the urine, an indicator of kidney diseases."<ref>{{MeSH}}</ref> Proteinuria may occur in [[acute kidney injury]] or [[chronic kidney disease]]. | ||
==Diagnosis== | ==Diagnosis== | ||
The standard dipstick test only measures albumin. "A dipstick test result <1+ or less than trace has a high negative predictive value in the general community setting, with minimal risk of a missed diagnosis of macroalbuminuria". Sensitivity for any any abluminuria was 58%.<ref name="pmid21411199">{{cite journal| author=White SL, Yu R, Craig JC, Polkinghorne KR, Atkins RC, Chadban SJ| title=Diagnostic accuracy of urine dipsticks for detection of albuminuria in the general community. | journal=Am J Kidney Dis | year= 2011 | volume= 58 | issue= 1 | pages= 19-28 | pmid=21411199 | doi=10.1053/j.ajkd.2010.12.026 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21411199 }} </ref> In this study any abluminuria was defined as albumin-creatinine ratio >/=30 mg/g and macroalbuminuria was defined as albumin-creatinine ratio >/=300 mg/g. | |||
The sulfosalicylic acid (SSA) test measures all protein. | |||
===Spot protein/creatinine ratio=== | ===Spot protein/creatinine ratio=== | ||
One study found that in the presence of stable renal function, a protein/creatinine ratio:<ref name="pmid6656849">{{cite journal| author=Ginsberg JM, Chang BS, Matarese RA, Garella S| title=Use of single voided urine samples to estimate quantitative proteinuria. | journal=N Engl J Med | year= 1983 | volume= 309 | issue= 25 | pages= 1543-6 | pmid=6656849 | One study found that in the presence of stable renal function, a protein/creatinine ratio:<ref name="pmid6656849">{{cite journal| author=Ginsberg JM, Chang BS, Matarese RA, Garella S| title=Use of single voided urine samples to estimate quantitative proteinuria. | journal=N Engl J Med | year= 1983 | volume= 309 | issue= 25 | pages= 1543-6 | pmid=6656849 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=6656849 }} | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=6656849 }}</ref> | ||
* > 3.5 (mg/mg) suggests [[nephrotic syndrome]] | * > 3.5 (mg/mg) suggests [[nephrotic syndrome]] | ||
* < 0.2 is within normal limits | * < 0.2 is within normal limits | ||
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===Spot urine albumin/creatinine ratio=== | ===Spot urine albumin/creatinine ratio=== | ||
In adults, albuminuria is a more [[sensitivity and specificity|sensitive]] than total protein in detecting [[chronic kidney disease]] from many glomerular diseases.<ref name="pmid11904577">{{cite journal| author=National Kidney Foundation| title=K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. | journal=Am J Kidney Dis | year= 2002 | volume= 39 | issue= 2 Suppl 1 | pages= S1-266 | pmid=11904577 | In adults, albuminuria is a more [[sensitivity and specificity|sensitive]] than total protein in detecting [[chronic kidney disease]] from many glomerular diseases.<ref name="pmid11904577">{{cite journal| author=National Kidney Foundation| title=K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. | journal=Am J Kidney Dis | year= 2002 | volume= 39 | issue= 2 Suppl 1 | pages= S1-266 | pmid=11904577 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11904577 }} | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=11904577 }}</ref> | ||
* <30 mg/g is a normal albumin-creatinine ratio | * <30 mg/g is a normal albumin-creatinine ratio | ||
* 30-300 mg/g is microalbuminuria | * 30-300 mg/g is microalbuminuria | ||
Latest revision as of 22:56, 10 August 2011
In medicine, proteinuria is "the presence of proteins in the urine, an indicator of kidney diseases."[1] Proteinuria may occur in acute kidney injury or chronic kidney disease.
Diagnosis
The standard dipstick test only measures albumin. "A dipstick test result <1+ or less than trace has a high negative predictive value in the general community setting, with minimal risk of a missed diagnosis of macroalbuminuria". Sensitivity for any any abluminuria was 58%.[2] In this study any abluminuria was defined as albumin-creatinine ratio >/=30 mg/g and macroalbuminuria was defined as albumin-creatinine ratio >/=300 mg/g.
The sulfosalicylic acid (SSA) test measures all protein.
Spot protein/creatinine ratio
One study found that in the presence of stable renal function, a protein/creatinine ratio:[3]
- > 3.5 (mg/mg) suggests nephrotic syndrome
- < 0.2 is within normal limits
Spot urine albumin/creatinine ratio
In adults, albuminuria is a more sensitive than total protein in detecting chronic kidney disease from many glomerular diseases.[4]
- <30 mg/g is a normal albumin-creatinine ratio
- 30-300 mg/g is microalbuminuria
References
- ↑ Anonymous (2024), Proteinuria (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ White SL, Yu R, Craig JC, Polkinghorne KR, Atkins RC, Chadban SJ (2011). "Diagnostic accuracy of urine dipsticks for detection of albuminuria in the general community.". Am J Kidney Dis 58 (1): 19-28. DOI:10.1053/j.ajkd.2010.12.026. PMID 21411199. Research Blogging.
- ↑ Ginsberg JM, Chang BS, Matarese RA, Garella S (1983). "Use of single voided urine samples to estimate quantitative proteinuria.". N Engl J Med 309 (25): 1543-6. PMID 6656849.
- ↑ National Kidney Foundation (2002). "K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.". Am J Kidney Dis 39 (2 Suppl 1): S1-266. PMID 11904577.