What Are the Different Causes of Proteinuria?
Due to the filtering effect of the glomerular filtration membrane and the reabsorption effect of the renal tubules, the content of protein (mostly proteins with small molecular weight) in the urine of healthy people is very small (the daily discharge is less than 150 mg). Qualitative protein inspection When it was negative. When the protein content in the urine increases, it can be detected by routine urine tests, called proteinuria. If the urine protein content is 3.5g / 24h, it is called a large amount of proteinuria.
- Western Medicine Name
- Proteinuria
- Chinese Medicine Name
- Proteinuria
- English name
- albuminuria
- Affiliated Department
- Internal Medicine-Nephrology
- Disease site
- Glomerulus
- The main symptoms
- Edema,
- The main symptoms
- Hypertension hematuria fatigue
- Multiple groups
- child
- Contagious
- Non-contagious
- Whether to enter health insurance
- Yes
- Due to the filtering effect of the glomerular filtration membrane and the reabsorption effect of the renal tubules, the content of protein (mostly proteins with small molecular weight) in the urine of healthy people is very small (the daily discharge is less than 150 mg). Qualitative protein inspection When it was negative. When the protein content in the urine increases, it can be detected by routine urine tests, called proteinuria. If the urine protein content is 3.5g / 24h, it is called a large amount of proteinuria.
Introduction to proteinuria
Proteinuria formation
- Proteinuria
- 1.Mechanical barrier- filter hole
- The glomerular filtration barrier consists of three layers from the inside out:
- The inner layer is endothelial cells of capillaries. Endothelial cells have many small holes with a diameter of 50-100 nm, called fenestration. Water, various solutes, and macromolecular proteins can pass freely through the window holes; but they can prevent blood cells from passing through and act as a blood cell barrier.
- The middle layer is a non-cellular basement membrane with a microfiber network structure. Larger molecular substances in the plasma, such as proteins, cannot pass through the basement membrane. The basement membrane is the main barrier of the glomerulus to prevent filtration of large molecular proteins.
- The outer layer is the glomerular epithelial cells. Epithelial cells have foot processes, and fissures are formed between the interdigitated foot processes. There is a layer of filtration slit membrane on the fissure, and the membrane has holes with a diameter of 4-14nm. It can prevent the large-molecule proteins filtered out by the inner and middle layers from passing through. Endothelial cells, basement membranes, and fissure membranes together form the glomerular filtration membrane. Filter pores of different sizes on the filtration membrane can only make small molecular substances pass easily, while substances with larger effective radii can only pass through larger pores. Generally speaking, substances with effective radii less than 1.8 nm can be used. Completely filtered. Macromolecular substances with an effective radius greater than 3.6nm, such as plasma albumin (molecular weight of about 69,000), can hardly be filtered.
- 2.Charge barrier-negative charge
- Each layer of the filtration membrane contains many negatively charged substances, so the permeability of the filtration membrane also depends on the charge carried by the filtered substance. These negatively charged substances repel negatively charged plasma proteins, limiting their filtration. Although the effective radius of plasma albumin is 3.5 nm, it is difficult to pass through the membrane due to its negative charge. When various pathological injuries (including primary and secondary injuries) affect the kidney, it will cause local microcirculation disturbance of the damaged kidney, and promote ischemia and hypoxia of renal tissues (functional nephrons). Glomerular capillary endothelial cells were damaged due to ischemia and hypoxia. Once the glomerular capillary endothelial cells are damaged, they will attract the infiltration of inflammatory cells in the blood circulation and release pathogenic inflammatory mediators (IL-1, TNF--, etc.). Pathological damage at this time will cause Inflammation of the damaged kidney. The kidney is in a pathological state, and a series of changes occur in the glomerular basement membrane (GBM): enlarged or blocked filter pores, GBM rupture, damage to the charge barrier, enhanced renal permeability, and negatively charged sugar on the filter The decrease or disappearance of protein will cause a significant increase in negatively charged plasma protein filtration excess than normal. Therefore, proteinuria is formed clinically at this stage.
Proteinuria typing
- Glomerular proteinuria
- This is the most common type of proteinuria. As the glomerular filtration membrane is damaged due to inflammation, immunity, metabolism and other factors, the pore diameter of the filtration membrane increases, ruptures, and / or the electrostatic barrier weakens. Plasma proteins, especially albumin, are filtered out and exceed the proximal renal tubular reabsorption Ability to form proteinuria. If the glomerular damage is severe, globulin and other large molecular weight proteins can also be filtered out. According to the degree of filtration membrane damage and the composition of urine protein, urine protein is divided into 2 categories:
- (1) Selective proteinuria: mainly albumin with a medium molecular weight of 40,000 to 90,000, which can be accompanied by proteins with similar molecular weight, such as antithrombin, transferrin, glycoprotein, etc. 2-M, Fc fragments, etc. No protein with high molecular weight (IgG, IgA, IgM, C3, etc.). Immunoglobulin / albumin clearance is less than 0.1, urinary protein is qualitative 3 + 4 +, quantitative more than 3.5g / 24h, and it is common in nephrotic syndrome.
- (2) Non-selective proteinuria: It reflects the severe rupture and damage of the glomerular capillary wall. Urine protein is mainly composed of relatively large molecular weight and medium proteins, such as IgM, IgG and complement C3, albumin, glycoprotein (TH glycoprotein), secreted IgA (SIgA), and a small amount of mucin secreted by the lower urinary tract. Wait. Immunoglobulin / albumin clearance is greater than 0.5, urinary protein is qualitative 1 + 4 +, and quantitative is 0.5 3.0g / 24h. Non-selective proteinuria is a type of persistent proteinuria that is at risk for developing renal failure and often indicates a poor prognosis. Common in primary or secondary glomerular disease.
- 2. Renal tubular proteinuria
- It refers to proteinuria that is mainly composed of proteins with relatively low molecular weight due to decreased or suppressed reabsorption capacity when the renal tubules are infected, poisoned or damaged by glomerular disease. Urine 2-M and lysozyme increase, urine albumin is normal or slightly increased; urinary protein is qualitative 1 + 2 +, quantitative 1 2g / 24h. It is common in renal tubule damage diseases.
- 3. Mixed proteinuria
- Renal disease involves proteinuria when the glomeruli and tubules are involved simultaneously or successively. It has both characteristics of proteinuria, but the proportion of each component is inconsistent due to different lesions, and may also vary due to the degree of damage to the glomeruli or tubules.
- 4. Spilled proteinuria
- It refers to the proteinuria formed by glomerular filtration and renal tubular reabsorption, which are normal due to relatively low molecular weight or abnormally increased positively charged proteins in the plasma. The abnormally increased proteins include free hemoglobin, myoglobin, lysozyme, and protein of the week. Urine proteins are qualitatively 1 + 2 +. Common in multiple myeloma.
- 5. Tissue proteinuria
- This refers to the proteinuria formed by renal tubular metabolism, tissue destruction and decomposition, inflammation or drugs that stimulate the secretion of the urinary system and enter the urine. It is mainly TH glycoprotein, physiologically about 20mg / d, urinary protein qualitative ± 1 +, quantitative 0.5 1.0g / 24h.
Proteinuria identification
- Pseudoproteinuria? As the name implies, it is not true proteinuria.
- Proteinuria
- Pseudoproteinuria occurs when:
- Blood, pus, inflammation or tumor secretions, menstrual blood, leucorrhea, etc. are mixed in urine, and regular proteinuria qualitative tests can be positive. A large amount of red blood cells, white blood cells, and flat epithelial cells can be seen in this urine sediment, but without tube type, after the urine is centrifuged or filtered, the protein qualitative examination will be significantly reduced or even turned negative;
- After the urine is left for a long time or cooled down, salt crystals can be precipitated, making the urine appear white and turbid, which is easy to be mistaken for proteinuria, but after heating or adding a little acetic acid, the turbid urine can be cleared to help distinguish;
- If urine is mixed with semen or prostate fluid, or lower urinary tract inflammation secretions, urine protein response may be positive. In this case, the patient has symptoms of lower urinary tract or prostate disease, and sperm and more flat epithelial cells can be found in the urine sediment, which can be distinguished;
- Lymphatic urine, which contains less protein, may not be chyle-like;
- Some drugs, such as rifampicin and shandaonian, can make urine color turbid similar to proteinuria when excreted from the urine, but the protein qualitative reaction is negative.
Proteinuria therapy
- Proteinuria is a typical symptom of nephropathy, but how much urine protein leaks out does not reflect the severity of nephropathy. Urine in patients with mild chronic kidney disease
- Proteinuria
- Generally, proteinuria is divided into selective proteinuria and non-selective proteinuria. Selective proteinuria refers to protein electrophoresis characterized by proteins with smaller molecular weight, such as albumin, 1 globulin, transferrin, and globulin. Larger molecular weight proteins, such as 2 globulin, fibrinogen, and lipoprotein, are less abundant.
- In patients with micropathic nephropathy, mild mesangial proliferative nephritis, partial membranous nephropathy and early-stage lesions of membranous proliferative nephritis and focal segmental sclerosing nephritis, most patients present selective proteinuria, indicating that the small network (renal Pellets filtration membranes) are less damaging.
- Non-selective proteinuria refers to protein electrophoresis characterized by the presence of large and small molecular proteins at the same time, indicating that the damage to the small net (glomerular filtration membrane) is more serious.
- Want to ask, is it difficult for patients with a large loss of urine protein to recover?
- Nephrologists analyze that the amount of protein lost is not directly proportional to the severity of the disease. Patients with mild glomerular lesions may not necessarily have less urinary protein, such as micropathic nephritis and mild mesangial proliferative nephritis. The renal lesions are mild, but the daily urine protein amount can reach several grams or even dozens of grams.
- In contrast, some focal sclerosing nephritis and crescentic nephritis have severe pathological damage, but the daily urine protein may be only a few grams. Therefore, the quality of treatment depends mainly on the type of kidney pathology, damage and renal function.
- In addition, it also depends on whether the patient can cooperate with the doctor, whether to pay attention to preventing the occurrence of recurrence causes (such as colds, fatigue, diarrhea, etc.), whether to adhere to treatment, and whether to avoid the use of nephrotoxic drugs.
Proteinuria diet
- A large amount of proteinuria occurs in patients with nephritis, which can generally be supplemented by diet. It is wrong to think that patients with nephritis cannot eat protein-containing foods. One-sidedly, even for patients with chronic nephritis who have advanced to the advanced stage-uremia, they also advocate Eat a high-quality, low-protein diet.
- The daily protein intake should be controlled between 0.6 and 0.8 g / kg of body weight. In uremia patients, during dialysis treatment, especially during peritoneal dialysis, the daily protein intake should increase, about 1.2 to 1.5 g / kg body weight. Patients with nephrotic syndrome who lose a large amount of protein in their urine, such as those with normal renal function, advocate eating a high-protein diet to correct hypoproteinemia, reduce edema, and improve or enhance body resistance.
- If patients with nephritis develop azotemia or early renal insufficiency, limit protein intake. Otherwise it will accelerate the deterioration of renal function. In short, different diets should be used for different conditions.
- When a large amount of proteinuria occurs in patients with renal disease, it is not necessary to panic too much; when a small amount of proteinuria appears, the severity of the disease can not be ignored too much, it is best to diagnose the condition in time and develop a corresponding treatment plan for proteinuria. Completely restore kidney function and eliminate proteinuria from the perspective of kidney pathological damage.
Prognosis of proteinuria disease
- Proteinuria under a microscope
- The clinical significance of proteinuria is very complex. Seeing persistent proteinuria clinically often implies substantial damage to the kidneys. When the proteinuria changes from less to more, it can reflect the improvement of renal disease, or it may be due to the majority of glomerular fibrosis, the decrease of filtered protein, the deterioration of renal function, and the worsening of the disease. Therefore, judging the severity of kidney disease damage can not only be measured by proteinuria. It must be comprehensively considered in terms of the amount and duration of urinary protein. It must also be determined in conjunction with systemic conditions and renal function tests.
- Numerous clinical data indicate that patients with nephrotic syndrome and persistent proteinuria have a poor prognosis. In focal glomerulosclerosis, membranoproliferative glomerulonephritis, membranous nephropathy, IGA nephropathy, diabetic nephropathy, and chronic renal transplant rejection, proteinuria is a significantly unique decision on the progression of kidney disease and increased mortality. factor. In fact, remission of these diseases and reduction of urinary protein excretion, whether spontaneous or caused by active treatment, can improve survival.
Causes of proteinuria
Proteinuria (1) Renal proteinuria
- 1. Glomerular proteinuria
- Found in acute glomerulonephritis, various types of chronic glomerulonephritis, IgA nephritis, occult nephritis.
- Secondary findings in autoimmune diseases such as lupus kidney, diabetic nephropathy, purpuric nephritis, renal arteriosclerosis, etc.
- Proteinuria
- According to the degree of lesion filtration membrane damage and the composition of proteinuria, it is divided into two types:
- Selective proteinuria: mainly albumin, with a small amount of small molecular weight protein, no large molecular weight protein (IgG, IgA, IgM, C3, C4) in urine, semi-quantitative mostly in +++ +++ +, The typical disease is nephrotic syndrome.
- Non-selective proteinuria: it indicates that the glomerular capillary wall has severe damage and rupture, and there are large molecular weight proteins in the urine, such as immunoglobulin and complement; medium molecular weight albumin and small molecular weight proteins, urine protein, and immunoglobulin The protein / albumin ratio is> 0.5, the semi-quantitative value is + ++++, and the quantitative value is between 0.5 3.0g / 24h. It is more common in primary glomerular diseases such as acute nephritis, chronic nephritis, membranous or Membrane proliferative nephritis, etc., and secondary glomerular diseases, such as diabetic nephritis, lupus erythematosus nephritis, etc. The presence of non-selective proteinuria indicates a poor prognosis.
- Vigorous exercise, long marches, high temperature environment, fever, severe cold environment, mental stress, congestive heart failure, etc. can also occur proteinuria.
- 2. Tubular proteinuria
- Interstitial nephritis, renal venous thrombosis, renal arterial embolism, heavy metal salt poisoning and other causes are most common.
- 3 Renal tissue proteinuria
- Also known as secretory proteinuria. Due to the infiltration of proteins produced by renal tubular metabolism during urine formation.
Proteinuria (II) Non-renal proteinuria
- 1. Humoral proteinuria
- Also known as overflow proteinuria, such as multiple myeloma.
- 2. Tissue proteinuria
- Such as malignant tumor protein in urine, host protein produced by viral infection and so on.
- 3 Lower urinary tract protein mixed with urine causes proteinuria
- Found in urinary system infection, urinary tract epithelial cell shedding and urinary tract secretion of mucin.
- (C) the relationship between urine protein and primary glomerulonephritis
- We used silver staining to measure the molecular weight of urine protein, immunohistochemical method to detect the changes of MCP-1 expression in kidney tissue, and observed the relationship between the two, and the relationship between their respective changes in tubulointerstitial and laboratory indicators, to further understand Significance of urinary protein SDS-PAGE typing of primary chronic glomerulonephritis in disease diagnosis, clarify the role of MCP-1 in the pathogenesis of glomerulonephritis, and explore the possible molecular pathology of primary glomerulonephritis Mechanism, with a view to providing some experimental basis for clinical treatment of glomerulonephritis and exploring a new method for clinical treatment. Albumin is often an important part of proteinuria. Currently it has been confirmed that both bovine serum albumin and human serum albumin can Stimulate renal tubular cells to produce a variety of inflammatory mediators, thereby mediating renal interstitial tubule inflammation and fibrosis. However, some scholars have confirmed that the albumin in plasma of patients with nephritis has changed compared to normal people.Also, albumin also changes in urine. May change, not the same in plasma. Therefore, the relationship between albumin in urine and disease of patients with nephritis should be more in line with the true pathophysiological condition. White blood does not exist in normal human blood Protein polymers (urinary albumin polymers, PAs), Doman et al. Found that only when albumin molecules change after leaving the blood circulation, there is a low molecular weight urinary ultrafiltration factor (this ultrafiltration factor has a molecular weight of less than 700d, which is neither a peptide nor an amino acid). , And not fatty acids), and urine specimens must be frozen at -14 ° C for at least 48 hours before urine albumin can be aggregated into PAs. Numerous studies have shown that urine PAs is not a simple anthropogenic phenomenon, but may be from histological and functional levels Biochemical markers reflecting the severity of the disease. To this end, we use immunoblot technology to detect the presence of PAs in the urine of patients with primary glomerulonephritis, and to explore its pathophysiology and clinical significance. Urinary albumin fragment (urinary albumin fragment, uAF) is a molecular fragment that is broken and split by modified albumin in urine after SDS treatment. Yagamem et al believe that it is related to diabetic nephropathy, but the relationship between uAF and primary chronic glomerulonephritis is rarely reported. We studied uAF in the urine of patients with nephritis and explored its relationship with primary chronic glomerulonephritis.
Proteinuria diagnosis
History of proteinuria
- Such as history of edema, history of hypertension, history of diabetes, history of allergic purpura, history of kidney injury drug use, history of heavy metal salt poisoning, as well as history of connective tissue disease, metabolic disease and history of gout.
Proteinuria physical examination
- Pay attention to the situation of edema and serous fluid, examination of bones and joints, degree of anemia and examination of heart, liver and kidney signs.
- Fundus examination, normal or mild vasospasm of acute nephritis, fundus arteriosclerosis, bleeding, exudation, etc. in chronic nephritis, diabetic nephropathy often occurs in diabetic fundus.
Proteinuria laboratory test
- Proteinuria
- 1. Qualitative inspection
- Morning urine is best, morning urine is the strongest, and orthostatic proteinuria can be ruled out. Qualitative inspection is just a screening test, not an accurate indicator of urine protein content.
- 2. Quantitative urine protein test
- 3 Special urine protein test
- Urine protein electrophoresis can distinguish between selective and non-selective proteinuria. Urine protein electrophoresis of multiple myeloma is helpful for typing.
- Nuclide immunoassay is of great help in the diagnosis of early renal tubular impairment.
Differential diagnosis of proteinuria
- Proteinuria
- 2. Chronic glomerulonephritis: Edema starts from the lower limbs and spreads from the bottom to the top. It has a long course of disease and is prone to recurrence. In the later stages, renal function is often impaired. Hypertension occurs first.
- 3, pyelonephritis: symptoms of systemic infection poisoning, back pain, bladder irritation, laboratory tests for pyuriasis and urine are its characteristics.
- 4. Systemic lupus erythematosus: It is an autoimmune disease, hair loss, facial erythema, oral ulcers, migratory arthritis, photosensitivity, Raynaud's phenomenon, and multiple organ damage, especially the heart and kidney. Loss comes first. Its proteinuria is generally more, and some patients appear in the form of nephrotic syndrome.
- 5. Multiple myeloma: Older men are more likely to have anemia and are disproportionate to kidney damage. The disease progresses rapidly, and it is easy to damage kidney function, bone destruction, bone pain, and pathological fracture. Urine protein is spilled proteinuria.
- 6. Others: Trace proteinuria occurs during strenuous exercise, proteinuria occurs during fever, proteinuria caused by renal failure due to heart failure, proteinuria caused by drug poisoning, and general diagnosis is not difficult due to a clear medical history and corresponding physical examination.
Proteinuria hazards
- (1) Mesangial toxicity of proteinuria:
- In the model of renal failure, the accumulation of serum proteins in the mesangium can be observed. The accumulation of these macromolecular substances in the mesangial region can cause mesangial cell damage and increase the synthesis of various mesangial matrices, resulting in renal smallness. Ball hardened. In the model of proteinuria nephropathy, the accumulation of apolipoprotein B of low density lipoprotein (LDL) and very low density lipoprotein (VLDL) and apolipoprotein A in the glomerulus can eventually lead to glomerulosclerosis.
- (2) Toxicity of proteinuria on proximal tubule cells:
- When proteinuria occurs, the amount of protein entering the renal tubular epithelial cells increases, increasing lysosomal activity, suggesting that the protein causes the lysosomal to overflow into the tubular cytoplasm, and subsequent cell damage can stimulate inflammation and scar formation.
- (3) Biological changes of tubule cells caused by proteinuria:
- Many kidney diseases with proteinuria have excessive cell proliferation, which represents a non-adaptive response, leading to renal failure. More and more evidence shows that proteins can directly regulate the function of tubule cells, change their growth characteristics and phenotype expression of cytokines and matrix proteins, can lead to the release of PDGF, FN and MCP-1 on the basal side of tubules, and induce fibrosis.
- (4) Aggravated tubular hypoxia caused by proteinuria:
- Proteinuria reabsorption Each digestion of a large amount of protein requires additional energy, which can cause hypoxia in the tubule cells, causing damage to the tubule cells
Proteinuria
- Now many female friends are very worried about the phenomenon of proteinuria, and they also want to understand the problem of proteinuria in pregnant women. At present, many pregnant women's friends also found symptoms of proteinuria during the examination, which made many female friends very worried.
- Proteinuria is a symptom of various kidney diseases. At present, many pregnant women also have this phenomenon, but many patients do not understand what is going on with proteinuria. If this phenomenon occurs in pregnant women, it is necessary to Treat it early, otherwise it will cause serious consequences and even be fatal. Pregnancy-induced hypertension syndrome, referred to as "pregnancy-induced hypertension," is a condition in which pregnant women develop high blood pressure, edema, and proteinuria in pregnant women after 24 weeks of pregnancy. It is a unique and common disease during pregnancy. It is one of the three leading causes of death for pregnant women in the world. one.
- (1) Hypertension: blood pressure> 130 / 90mmH? Ulcer? Or compared with basal blood pressure, systolic blood pressure> 30mmH, diastolic blood pressure> 15mmH.
- (2) Swelling: After 6 to 8 hours of clinical rest, the swelling does not subside; or the body weight increases by 0.5 kg per week.
- (3) Maternal proteinuria, urine routine protein or urine proteinuria quantification> 0.3 / 24 hours. Pre-eclampsia for blood pressure> 160 / 110mmH
- Experts from the Kidney Diseases Treatment Network said that pregnant women must attach great importance to proteinuria. This symptom is a group of syndromes with systemic arteriospasm as the basic lesion. It is mainly manifested by elevated blood pressure and proteinuria in pregnant women. And edema. Because of systemic arteriolar spasm, peripheral vascular resistance increases, which in turn leads to increased post-cardiac load. The kidneys can develop edema and urinary protein due to glomerular capillary spasm and ischemia and hypoxia, and cerebral blood vessels also spasm, leading to peripheral Vascular resistance increases, which in turn leads to an increase in the afterload of the heart. Due to glomerular capillary spasm and ischemia and hypoxia in the kidney, edema and urinary protein may appear in the patient, and cerebrovascular spasm also occurs, leading to dizziness, headache and vomiting. The problem is that when the brain is in the middle of ischemia and hypoxia, the patient may develop local or systemic convulsions, coma, and even cerebral edema and cerebral hemorrhage.
- Swelling is one of the most common symptoms of proteinuria in pregnant women. After 6-8 hours of clinical rest, the swelling does not subside, or the body weight increases by 0.5 kg per week. The urine protein, urine routine protein, or urine protein of pregnant women is greater than 0.3 / 24 hours. Pre-eclampsia is blood pressure> 160 / 110mmH, with symptoms such as edema, dizziness, chest tightness, dazzling, and eclampsia with convulsions and coma. Patients with pregnancy-induced hypertension should take medicines on time, check on time, and treat actively under the guidance of a doctor. The idea of refusing to take medications for fear of fetal growth is wrong and even more dangerous. The purpose of treating PIH is mainly to relieve systemic arteriolar spasm, reduce blood pressure and diuresis. The medicine prescribed by an obstetric outpatient doctor should be a drug that is safe, clinically proven to have significant effects, and does not have teratogenic effects, taking into account both aspects of maternal and infant well-being.
- The occurrence of proteinuria in pregnant women is a very common symptom. This is a very serious phenomenon that may lead to fatal hypoxia in pregnant women. Therefore, patients must pay attention to this phenomenon. After discovering such symptoms, Be sure to get treatment in time.
Proteinuria test
History of proteinuria
- According to the causes of proteinuria, follow-up history should be focused, such as history of edema, history of hypertension, history of allergic purple epilepsy, history of kidney injury drug use, history of heavy metal salt poisoning, history of connective tissue disease, metabolic disease And a history of gout.
Proteinuria physical examination
- Pay attention to edema and serous fluid, bone and joint examination, degree of anemia, heart and liver and kidney signs examination, fundus examination, normal fundus of acute nephritis, or mild vasospasm, chronic nephritis, fundus arteriosclerotic bleeding, etc. Kidney disease often appears with diabetic fundus,
Proteinuria laboratory test
- First, 24 hour urine protein retention method.
- 1. Urinate on the day of urine retention at 8:00 am. This time urine is generated before 8:00 pm, and should not be discarded.
- After 2.8 o'clock to 8 o'clock the next day, the volume of urination every 24 hours should be kept in a clean container.
- 3. The 8th day of the next day should also actively urinate, this time the urine is produced before 8 o'clock, all must be left.
- 4. Stir the 24-hour urine collection and record the total amount.
- 5. Take 10 ml of the mixed 24-hour urine and send it to the laboratory for 24 hours urine protein quantification, and inform the laboratory 6. The total urine volume of the doctor.
- Second, the urine protein quantitative urine retention precautions
- (1) In hot weather, preservatives should be placed in the urine to prevent the decomposition of urine sugar, fermentation and bacterial reproduction, which will affect the accuracy of the results.
- (2) It is ideal to store urine in a refrigerator.
- (3) There is a relatively simple way to store urine: Just tightly close the container for urine, put it in cold water (Note: change the water every 2 to 3 hours), and then put it in a cooler toilet Yes, there is no need to put preservatives in the refrigerator.
- (4) Put the collected urine in a cool place to prevent bacteria from invading and breeding, so as not to affect the test results. [1]
- Third, urine protein tests can be divided into qualitative and quantitative tests and special tests
- 1. The qualitative test is best when the morning urine is the strongest and can exclude orthostatic proteinuria. The qualitative examination is just a screening test to check the daily urine output of 2000ml. The qualitative "+ 'urine protein amount is more than the 400ml qualitative" +'. Therefore, It is advisable to quantify urine protein if it is not an accurate indicator of urine protein content to determine the effect of the diagnosis of kidney disease.
- 2. There are many quantitative methods for urinary protein testing, including the pasteurization method, double shrinking dolphin method, phosphotungstic acid method, acid-ferric chloride method, and the like. The double shrinking dolphin method is the most accurate and most commonly used. 24h urine protein with less than 1g glomerular disease has less chance. Common CausesPyelonephritis, renal sclerosis, urinary tract obstruction, urinary tract tumors, and stones. The most common cause of urinary protein 1 ~ 3g is primary or secondary glomerular disease. The amount of urinary protein above 3.5g in 24h is seen in primary or secondary renal disease. Syndrome.
Proteinuria special urine protein test
- Common urinary protein electrophoresis tests can distinguish between selective proteinuria and non-selective proteinuria. Multiple urinary protein electrophoresis tests are helpful for typing and can be divided into the following five types: IgGIgAIgEIgD urine radioimmunoassay is a qualitative urine protein Methods The radioimmunoassay can be positive when the urine is negative. The shortcoming of false positive rate is high. The radioimmunoassay of urine 2-mg measurement is helpful for the diagnosis of early renal tubular damage.