Proteinuria, (Protein in Urine) A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

This book describes Proteinuria, Diagnosis and Treatment and Related Diseases.
Proteinuria indicates the leakage of protein in the urine.
It is often defined as a quantity in excess of 300 mg per day.
Proteinuria is linked with cardiovascular and renal disease and is an indicator of end organ damage in patients with hypertension.
The detection of a rise in protein excretion is believed to have both diagnostic and prognostic effect in the early detection and confirmation of renal disease
Protein should not normally pass out in the urine in detectable quantities.
Micro-albuminuria
Micro-albuminuria is protein between 30 and 300 mg per 24 hours.
This may occur with diabetes.
Bence-Jones protein

Because it may occur with multiple myeloma, this may also not be detectable on standard dipstick testing.

These are the light chains of immunoglobulins.
Albuminuria
This is often the same as proteinuria:
While plasma contains both albumin and globulin, the latter tends less likely to appear in the urine.
If the filtration system of the glomeruli may be regarded as like a sieve or a mesh then small holes or tears will allow larger particles than normal to pass through.
The smaller rather than the larger of the particles will normally be retained back, unless damage is severe.
With mild or moderate damage, smaller proteins such as albumin will pass and only with severe injury will globulins pass.
Causes
With a healthy kidney, when the body removes waste, protein is kept in the blood stream.
This is because protein in the blood is too large to pass through the tiny holes in the kidney filters.
When the filter is damaged in kidney disease, protein can pass into the urine.
Protein in the urine can be a marker of almost any type of kidney disease, so investigations are always required if the cause of proteinuria is to be confirmed:
1.High blood pressure
2.Infection
3.Reflux nephropathy
4.Diabetes
5.Glomerulonephritis
6.Minimal change nephritis
Some people get more protein into urine while standing than while lying down.
That is called orthostatic proteinuria.
Symptoms
Normally there are no symptoms, but protein can be found by a routine urine test.
Patients with asymptomatic proteinuria normally have no physical signs
In more serious cases (nephrotic syndrome) there may be:
1.Edema,
2.Ascites,
3.Hydroceles
4.Pleural effusions
Diagnosis
A urine sample is analysed the levels of protein and creatinine (protein-creatinine ratio or PCR for short)
It is more usual to test for albumin so the result is an albumin-creatinine ratio (ACR).
An ACR of 3-30 does not normally require action
An ACR of higher than 30 indicate considerable leakage of protein through the kidneys, and the higher the level the more concern, particularly if it is over 100
The size and shape of the kidneys may be measured in the X-ray department with an ultrasound
Finally, to make a firm diagnosis of the cause of proteinuria, it is required to perform a kidney biopsy
Treatment
Proteinuria is not a specific disease.
So its treatment is dependent on identifying and treating its underlying cause.
In mild or temporary proteinuria, no treatment may be required
Medicines are given for high blood pressure:
1.ACE inhibitors
2.ARBs
Treatment is also given for Diabetes to avoid the progressive kidney damage causing the proteinuria
Water retention can be treated by reducing the amount of salt
If proteinuria is high >1.5 g a day, this is likely to need treatment by a specialist from the outset and further investigation may be:
1.Urine microscopy.
2.Glomerular filtration rate.
3.Renal ultrasound.
4.Possible intravenous urography.
5.Possibly renal biopsy

TABLE OF CONTENT
Introduction
Chapter 1 Proteinuria
Chapter 2 Causes
Chapter 3 Sy

• Language: English
• Publisher: Kenneth Kee
• Release date: May 15, 2018
• ISBN: 9780463872505

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

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