Proteinuria Flashcards
How does a normal kidney handle albumin?
- approximately 4 g/dL albumin is present in plasma
- 2-3 mg/dL is normally filtered by the glomerulus, but is largely reabsorbed by the proximal tubule
- <1 mg/dL albumin is present in the normal urine
What is proteinuria?
presence of any type of protein in the urine - albumin, globulins, mucoproteins, Bence-Jones proteins
What are 3 causes of physiologic proteinuria?
- exercise
- stress
- fever
What are signs of non-urinary pathologies that cause proteinuria?
- Bence-Jones proteins (multiple myeloma)
- myoglobinuria
- hemoglobinuria
What are the 2 classifications of urinary pathologies that cause proteinuria?
- RENAL - glomerular, tubular, parenchymal inflammation
- NONRENAL - lower urinary tract inflammation
What determines persistent proteinuria?
minimum 3 urine samples with protein 2 or more weeks apart
What causes renal proteinuria? 3 examples?
structural or functional lesions within the kidneys
- GLOMERULAR - altered selectivity properties of the glomerular capillary wall
- TUBULAR - impaired tubular recovery of plasma proteins
- INTERSTITIAL - inflammatory lesions or disease processes
What is indicative of tubular proteinuria? What are 4 causes?
UPC 0.5-1.0, sometimes accompanied by normoglycemic glucosuria and excessive urinary loss of electrolytes
- tubular disease
- renal tubular acidosis causes damage
- renal glucosuria
- Fanconi’s acquired from chicken jerky treats from China
What is indicative of glomerular proteinuria?
persistent UPC > 1.0 with inactive sediment (possibly some hyaline)
What are 7 causes of glomerular disease that can lead to proteinuria in dogs?
- amyloidosis
- glomerulosclerosis
- glomerulonephritis (immune, infectious)
- hereditary nephritis
- lupus nephritis
- membranous nephropathy
- idiopathic
In what dogs is glomerular amyloidosis common? Hereditary?
Beagle, Collie, English Foxhound, Walker hound
Shar Pei
In what cats is glomerular amyloidosis hereditary?
- Abyssinian
- Siamese
Diseases reported in association with glomerular diseases in dogs:
Diseases reported in association with glomerular diseases in cats:
Why is proteinuria commonly monitored?
- poor prognostic indicator with CKD and Lyme
- helps assess severity of disease and response to treatment
How does the magnitude of azotemia compare to level of response to proteinuria in dogs?
AZOTEMIC DOGS - intervene with a UPC > 0.5
NONAZOTEMIC DOGS - intervene with a UPC > 2.0