2016年3月31日星期四

What Kind of Kidney Disease do You get When You Present Proteinuria (protein in urine)

Many patients are wondering what kind of disease they get when they present proteinuria (protein in urine). Actually, many diseases can lead to proteinuria. We can give the primary diagnosis on the basis of medical history, body examination and laboratory examinations etc.

1. If swelling, high blood pressure, hematuria (blood in urine) and proteinuria occur together, you may probably get primary or secondary glomerulus diseases. Secondary glomerulus diseases always have special clinical manifestations of various secondary diseases. For example, if mass proteinuria(>3.5g/24h), hypoproteinemia, severe swelling and hyperlipidaemia (HLP) occur together, it is Nephrotic Syndrome.

2. If high blood pressure or other organs’ arteriosclerosis are accompanied with proteinuria (protein in urine), it is likely to be glomerular arteriosclerotic diseases.

3. If proteinuria is accompanied with urinary tract irritation, pyuria and bacteriuria, it is likely to be caused by urinary tract infection.

4. If proteinuria (protein in urine) occurs after taking medications like tetracycline, aminoglycoside antibiotics, amphotericin B or analgesics, the disease might be renal tubular interstitial nephritis.

5. Proteinuria which is accompanied with amino acid, urine glucose and mass phosphaturia might be caused by Fanconi Syndrome or Cerebro Oculo Renal Syndrome.

6. If renal region has received radiotherapy and then proteinuria occurs, it might be caused by radiation nephritis.

7. If unexplained Kidney Failure, anemia, hypercalcemia, weight loss or patellofemoral pain are accompanied and the proteinuria is mainly monoclonial immunoglobulin light chains, the disease might be multiple myeloma tumor.

8. Hemolytic anemia might present hemoglobinuria.

9. Polymyositis or extensive injuries might have symptom of myoglobinuria.

10. Besides proteinuria, there is abnormality in eyes and nerve deafness, hereditary nephritis might be considered.

11. If you have numerous cysts in your kidneys, which is inherited from your parents, it is Polycystic Kidney Disease.

What further checks should be done when proteinuria occurs?

1. Blood routine: including hemoglobin, red blood cells, white blood cells, platelet count and WBC differential count.

2. Urine routine: including proteinuria qualitative and 24 hours urine protein quantity.

3. SDS-PAGE: analyzing the contents of proteinuria to be glomerular or tubular.

4. Biochemical Test of Blood: kidney and liver function, electrolyte and blood lipid.


5. Other checks such as B-ultrasound, CT, X-ray, Renal Biopsy and so on.

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