Proteinuria Flashcards
Hemorrhagic or inflammatory proteinuria
Most common mechanism. Hemorrhage anywhere in the urinary tract or inflammation causing exudation of plasma proteins into the tract. Magnitude of protein varies but does not lead to hypoalbuminemia
Functional proteinuria
Transient mild increase in urine protein from exercise, fever, seizures, stress
Overload proteinuria
Increased plasma concentration of small proteins that pass through glomerular filtration and exceed capacity for tubular resorption (hemoglobin, myoglobin, etc) Does not lead to hypoproteinemia
Tubular proteinuria
Proximal tubular injury causing failure to reabsorb small proteins usually from acute tubule damage (nephrotoxins, ischemia) Does not result in hypoproteinemia
Glomerular proteinuria
-Damage of glomerular filtration barrier
-Increased permeability to large or negatively charged proteins (albumin is first)
-Often leads to selective hypoproteinemia
Progressive glomerular disease can lead to what
Tubular damage and tubular proteinuria and loss of nephrons-> azotemia, renal failure
Nephrotic syndrome
-Proteinuria
-Hypoproteinemia
-Hypercholesterolemia
-Ascites or edema
What must be ruled out before attributing proteinuria to glomerular tubular disease
-Hemorrhage
-Hemoglobinuria
-Myoglobinuria
-Inflammation
What do you interpret with the urine protein assays (dipstick)
In context of the USG
Urine protein: creatinine ratio
Most useful when pre and postrenal sources of protein ruled out. Used to try to identify source of protein
Healthy UPC
<0.2
When can we rule in proteinuria with UPC
0.4-3(cats) or 0.5-3 (dogs)
What UPC indicates glomerular disease
> 3
