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A patient with proteinuria

Educational resources for renal medicine

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Proteinuria comes from the kidney almost exclusively, so there is rarely an 'innocent' explanation for it, as there may be for isolated haematuria.  However moderate to low levels of isolated proteinuria in the absence of other findings (including the absence of haematuria) are relatively unlikely to give a specific renal diagnosis if you biopsy them.  This is very different from the position in nephrotic syndrome.  

By low level, it depends how old you are and therefore perhaps how long you are at risk.  Lower levels of proteinuria are worrying in young people as they have a much longer period in which to develop more severe kidney problems.  1g/day, or a urinary protein/creatinine ratio of >100 mg/mmol, are suggested as a threshold in some guidelines, but this should be interpreted flexibly

Remember

  • Proteinuria indicates significant renal disease
  • There is a quantitative relationship with future risk of losing renal function
  • It is also a prognostic marker for cardiovascular disease
  • If it is accompanied by haematuria there is a strong probability of inflammatory renal disease that may need treatment

All the more important therefore that it is monitored, whether or not you have a specific diagnostic label.  But proteinuria at low level with no other worrying features can be monitored long term, as for isolated haematuria, and investigated further if anything worsens.  At least in six months and then annually, checking

  • Blood pressure
  • Proteinuria
  • Creatinine (GFR)
  • And considering cardiovascular risk

 

Further info

 

 

 
Page last modified 21.06.2012, 08:01 by Neil Turner. edrep and edren are produced by the Renal Unit at the Royal Infirmary of Edinburgh and Univ. Edinburgh. CAUTIONS and Contact us. Note that the information published here is primarily intended for education, not for clinical care.