Proteinuria

Extract

• Proteinuria is often an incidental finding in chemical screening of urine (dipstick testing) or when determining the albumin/creatinine ratio (ACR) in a single urine sample.
• Transient proteinuria is quite common. Resolution of proteinuria must be confirmed by repeat urine tests.
• In the case of persistent proteinuria an attempt should be made to identify the cause. The most common causes are diabetic kidney disease, hypertensive or atherosclerotic nephrosclerosis and glomerulonephritis.
• If erythrocytes are present in the urine sample in addition to protein or if plasma creatinine concentration is increased, the cause of the renal impairment should always be established, in most cases urgently.
• Diagnostic examinations in specialized care are usually indicated, also in asymptomatic patients, if the daily urinary protein excretion exceeds 1 g (urine ACR 60 mg/mmol), even in the absence of any other abnormal findings.
• The cause of nephrotic-range proteinuria (exceeding 3 g/24 h or urine ACR exceeding 180 mg/mmol) should always be sought, and sudden onset nephrotic syndrome Nephrotic syndrome1 requires emergency consultation.
• If proteinuria is detected in a pregnant woman, the possibility of pre-eclampsia should always be investigated Antenatal clinics and specialist care: consultations, referrals, treatment guidelines2

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24 h urine protein, 24-hour urine sample, Albumins, Albuminuria, Diabetic Nephropathies, Hematuria, Internal medicine, N39.1, N39.2, Nephrology, Pregnancy, Proteinuria, R80, Urinalysis, Urine, dipstick test, functional proteinuria, microalbuminuria, paroxysmal proteinuria, transient proteinuria, tubular proteinuria, urinary protein, urine test