Proteinuria - Causes, Diagnosis and Treatment

Classification

Normally, healthy people can find a small amount of protein - this is a physiological proteinuria. It is often observed in newborn children, which is associated with the immaturity of the renal filter. Also, the children of preschool and school age meet an orthostatic proteinuria, which appears when the child is in a vertical position (the renal vein and blood is shifted) and disappears when it takes a horizontal position.

In some situations, short-term (transient) proteinuria is possible:

  • When overcooling or overheating the body.
  • With nervous overvoltage.
  • With high fever.
  • After prolonged physical exertion, with a long walking (marching proteinuria).
  • After receiving a large number of protein food (alimentary proteinuria).
  • After the doctor's coarse palpation doctor, especially in children.
  • With a pronounced loss of fluid (dehydration proteinuria) with diarrhea, vomiting, sweating.
  • After intensive insolation (Proteinuria Solaris).
  • After an epileptic seizure or concussion of the brain (centrogen proteinuria).

By severity, proteinuria is divided into:

  • Minor - from 150 to 500 mg per day.
  • Moderate - from 500 to 3000 mg per day.
  • Massive - more than 3g per day.

By origin, pathological proteins are:

one. Preenal ("overload"). Associated with a high level in the blood of low molecular weight proteins (paraproteins, monoclonal immunoglobulins) with malignant hematological pathologies or with blood stagnation in renal vessels in heart failure.

2. Renal. The most common option. Increased protein excretion is caused by kidney pathology. Depending on the defeat of a particular department of nephron, renal proteinuria are divided into:

  • The glomerular (glomerular) is typical for diseases with the damage to the glomerular kidney glomerular apparatus (glomerulonephritis, diabetic nephropathy, nephropathy of pregnant women or with arterial hypertension);
  • The channel - is characterized by a violation of the reabsorption of proteins in the renal tubules. It is found in tubulanestial nephritis, taking nephrotoxic drugs, elevated metals, etc.;
  • Mixed - a combination of disorders of filtering and reabsorption of proteins. It may be observed in the deployed stage of almost any organic kidney pathology.

3. Rainted. The reason may be inflammatory or degenerative changes in the urinary tract - pyelonephritis, cystitis, urinary polyposes, bleeding from the urinary system.

Proteinuria in pregnant women

Proteinuria in pregnant women

Causes of Preenal Proteinuria

This type of proteinuria is also called "overload". It occurs in cases where the concentration of low molecular weight proteins in the blood is so high, which passing through the renal filter, they do not have time to reabsorb in the tube of nephron. The degree of excretion of the protein can be both insignificant and pronounced. Preenal proteinuria develops with the following diseases:

  • Monoclonal gammapaty. Pathological proteins (paraproteins) are synthesized by plasma cells in large quantities with multiple myeloma, macroglobulinemia of valdenstrem, diseases of heavy chains, etc.
  • Hemolytic anemia. In case of diseases accompanied by intravascular hemolysis (autoimmune hemolytic anemia, hereditary microspherocyte, hemoglobinopathy), hemoglobin released from erythrocytes associated with a protein haptoglobin and falls into the urine
  • Disintegration of muscle tissue. A similar situation occurs when the muscles are destructed (Rabbomiolesis). Rabbomioliz occurs in the syndrome of long-term compression (crash syndrome), miodasts, medication reception (statins).

In hemolysis and rhabomiolysis of proteinuria, it arises quite quickly and in the overwhelming majority of cases just quickly disappears. With paraprteinemia, it increases slowly, for several years and starts to decline only after chemotherapy courses. Also, very rarely preenal proteinuria can be caused by increased hydrostatic pressure in the gloms, due to the stagnation of pronounced venous stagnation. This is possible with severe chronic heart failure.

Causes of renal proteinuria

Temple proteinuria

This is the most common variety of pathological proteinuria. An increase in protein excretion is associated with damage to the glomerular apparatus (renal glomers). Due to the defect of the renal filter in the urine, a large number of blood plasma proteins are falling primarily albumin. The degree of proteinuria can be very pronounced (more than 3 g / l).

Often proceeds together with other pathological urinary syndromes - hematuria, leukocyteuria. Increased selection with urine protein usually occurs gradually. Proteinuria regresses under the influence of specific anti-inflammatory therapy, but can persist for a long time, it depends on the severity of the disease. Diseases under which the glomerular proteinuria is observed:

  • Primary glomerular pathology: The minimum change disease (often occurs in children), membrane glomerulonephritis, focal glomerosclerosis.
  • Secondary glomerular pathology: Diabetic nephropathy, kidney damage in hypertension, nephropathy with diffuse collagencies (systemic red lolly, systemic sclerodermia), systemic vasculitis (nodule polyarteritis, granulomatosis with polyangeitis, hemorrhagic Purple Schiengine-Genoch).

To more rare etiological factors of glomerular proteinuria include:

Vanalis proteinuria

In this form of proteinuria, blood protein, which normally pass through the gloves, are not rehabilized by kidney channels due to their damage. Therefore, protein losses are most often insignificant - no more than 1 gram per day. The speed of development of proteinuria depends on the cause, it may occur as acute and gradually. Some illnesses are quite difficult to treat, because of which proteinuria is preserved. Protein losses are found with congenital and acquired tubulopathy:

Causes of the starting proteinuria

This type of proteinuria is due to the inflammatory exudate, rich in protein in the urine. This is more often occurring in the infections of the urinary tract (pyelonephritis, cystitis) less often there may be bleeding from MWP, caused by urolithiasis, urinary bubble cancer. Basically, protein loss is insignificant and rarely reach high values. It is often combined with leukocyteuria, bacteriuria or hematuria. In case of infections of the IMP, at the beginning of the antibacterial therapy, proteinuria begins to disappear.

Other reasons

There are also so-called "out-of-seeking proteins", which are found in the following pathological conditions and diseases:

Diagnostics

Detection in the urine of proteins requires immediate appeal to a physician or nephrologist to determine the cause. For the differentiation of physiological and pathological proteinuria, the patient's survey creates that it was preceded by its appearance, for example, high fever, intense physical activity, receiving high-protein food. Anamnestic data is extremely important, such as the presence of a patient diagnosed chronic disease, the use of drugs.

A physical examination is also carried out - measuring blood pressure, checking the skin to peripheral swelling, the symptom of Pasternatsky. In the case of suspicion of autoimmune rheumatological pathology, joints are carefully examined for swelling, redness, limitations or diseases of movements.

Traditionally, with a primary examination, the definition of proteins in the urine is carried out in the framework of the overall analysis of urine. It should be borne in mind that the test strips used in the OAM have some features:

  • With a high pH of urine or reception of the drugs of iodine, a false positive result is possible.
  • The reagent zone of test strips is more sensitive to albumin and is extremely low sensitive to other proteins - beta-2 microoglobulin, immunoglobulin G. Bens-Jones protein, characteristic of multiple myeloma, is not detected by this method at all.

To set the correct diagnosis, studies can be assigned to more accurately determine the type of proteins that excreted with the urine, and the severity of proteinuria:

  • Squirrel of daily urine . This analysis gives more reliable information about the level of protein loss.
  • The ratio of protein / creatinine. Due to the complexity of the collection of urine during the day, this method can serve as a full-fledged analogue, since the concentration in the urine of creatinine is a fairly stable indicator.
  • Albumin / Creatininone ratio. It is used to diagnose microalbuminuria. It is often prescribed to sick diabetes to tracking the development of diabetic nephropathy.
  • Electrophoresis of serum proteins and urine. With this analysis, the proteins are divided into fractions, which makes it possible to estove the prevailing type of protein. The increase in the content of beta-2 Microglobulin testifies to the tubular pathology, alpha-2 macrobulin - about the high-type type of proteinuria. For myeloma disease, an increase in monoclonal immunoglobulins (high M-gradient) is characterized.
  • Definition of Bens-Jones protein. This protein is a light chain of immunoglobulins secreted by tumor plasma cells. Its detection indicates multiple myeloma or macrooglobulinemia of Valdenstrem.
  • Immunofixation of urine proteins. Appointed with suspected paraproteinemia. The study allows you to identify a high concentration of immunoglobulin light chains (gamma, lambda, kappa).
  • Counting index selectivity. To estimate the severity of the glomerular proteinuria, the content of proteins with low (albumin, transferin) and a high molecular weight (immunoglobulin G) is determined. The predominance of high molecular weight proteins indicates a pronounced damage to the glomerular apparatus, which requires more aggressive anti-inflammatory therapy.

Also, the following studies are carried out to clarify the diagnosis:

  • Blood tests. In general blood test, nonspecific signs of chronic inflammation may be observed - a decrease in the level of hemoglobin, leukocytosis, an increase in ESP. In biochemical analysis of blood, the increase in the concentration of urea, creatinine, C-reactive protein is found. For nephrotic syndrome, a decrease in the overall protein, albumin, hyperlipidemia is characterized.
  • General urine analysis. OR OAM indicators, such as hematuria, bacteriuria, leukocyturia often assist in differential diagnosis. With a microscopic examination of the urine sediment, the presence of kidney epithelium cells indicates a renal type of proteinuria, the altered erythrocyte morphology is characteristic of glomerular pathology.
  • Immunological studies. In autoimmune rheumatological diseases in the blood, an increased content of rheumatoid factor and other autoantoantibodes (anticytoplasmic, antibodies to DNA, topoisomerase) is found.
  • Ultrasound / CT kidney. The ultrasound of the CT kidney can be detected in the renal parenchyma, the expansion of the cup-laughter system, the presence of cyst or counters.
  • X-ray. In patients with rheumatic diseases on radiography of affected joints, the narrowing of the articular slit is often noted, the osteoporosis. For myeloma disease on the X-ray of flat bones (especially the bones of the skull), typical areas of osteolysis and osteootestruction are visible.
  • Bone marrow research. If the patient has clinical and laboratory signs of paraproteinemia (ValdenStrema macrooglobulinemia or multiple myeloma), it is necessary to confirm the bone marrow biopsy, at which plasma-cell infiltration, fibrosis, as well as immunophenotyping to assess the expression of tumor markers (CD19, CD20, CD38).
Diagnosis of proteinuria

Diagnosis of proteinuria

Correction

Conservative therapy

Independent methods for correction of protein loss with urine does not exist. It is necessary to treat the main disease. Short-term proteinuria passes independently and does not require any therapy. Ortostatic proteinuria in the overwhelming majority of children disappears when a pubertal period occurs, sometimes persists until 18-20 years.

Patients with diabetes are prescribed a strict diet with a limit of products with a high content of detectable carbohydrates and animal fats. With an interstitial jade, provoked by the reception of nephrotoxic medicines, urgent cancellation is needed. Also, with various pathologies of proteinuria, the following drugs are used:

  • Insulin and Sakharosuining LS. With type 1 type 1, the daily injections of the brief and long-acting insulin are mandatory. When type 2, biguenides (metformin), sulfonylurea derivatives (glyibenklamide), DPP-4 inhibitors (Wildagliptin) are prescribed.
  • Antibacterial drugs. When pyelonephritis, antibiotics of penicillin row (amoxicillin), cephalosporins (ceftriaxone) perform the selection drugs. When cystitis, frarometamol phosphomycin is effective.
  • ACE inhibitors. This group of drugs (leasing, perindopril) has a nephroprotective effect and is prescribed to all patients with nephrotic syndrome, especially patients with diabetic nephropathy.
  • Glucocorticosteroids. Hormonal agents (prednisone, methylprednisolone) have an anti-inflammatory and immunosuppressive effect. They are used in the treatment of glomerulonephritis and almost any rheumatological pathology.
  • Cytostatic. Cytostatic drugs (azatioprine, cyclosporine) are used in severe forms of glomerulonephritis, obscure vasculitis when steroid monotherapy turns out to be ineffective.
  • Chemotherapy. Patients with confirmed paraproteinemia show chemotherapeutic courses. Combinations of alkylating preparations (chlorambucil), analogs of nucleosides (fludarabine) and monoclonal antibodies (rituximab) are prescribed. With the ineffectiveness of the listed funds apply Talidomide, bortezomib.

Surgery

With kidney cancer or polycystosis, the main type of treatment is a surgical operation (laparoscopic or open) - reducing kidney or total nephrectomy. Some patients with macroglobulinemia valdenstrem or multiple myeloma are prescribed transplantation of hematopoietic stem cells.

Forecast

Persistent proteinuria, i.e. The urine detected by more than 2 tests indicates the presence of a serious disease. Therefore, when it discovery should be immediately appreciated for medical advice. The forecast is determined by the main pathology - it is favorable with a light form of an infection of MVP, the disease of minimum changes. An unfavorable outcome is most characteristic of fast-moving forms of glomerulonephritis, oncological diseases, monoclonal gammapaty.

The protein in the urine is a formidable symptom requiring detailed diagnosis.

Proteinuria (albuminuria), or the appearance of protein in the urine is a fairly common phenomenon. Approximately 8% of the population with urine per day is distinguished by 30 mg and more albumin, and 1% suffers from a heavy form of pathology - macroalbuminuria, losing 300 mg of protein with urine per day.

Causes of protein appearance in urine

  • Physiological At which the appearance of protein in the urine is a functional feature of the body's work.
  • Exercise stress , increasing protein metabolism, and eating a large number of products rich in protein. These situations arise among athletes and bodybuilders, especially trying to build muscle in this way.
  • Postural (Ortostatic) Proteinuria It occurs with long standing on the legs or walking in patients suffering from the spinal curvature. The vertebral pillar squeezes the lower hollow vein and disrupt blood pressure in the renal vessels, which leads to the appearance of a protein in the urine.
  • Pregnancy - The protein in the urine is a sign of late toxicosis. However, a small amount of albumin at the later date is not considered dangerous.
  • Supercooling and overheating of the body - In this case, there are failures in the work of the kidneys that pass on their own.
  • Stressful proteinuria arising from psychological loads.

Pathological, caused by the improper work of the urinary system and pathologies of other bodies:

  • Renal - In this case, the appearance of a protein in the urine is caused by the pathologies of the excretory system - jade, which began renal failure, pyelonephritis, urolithiasis, tumors, cystitis, renal tuberculosis, diabetic kidney damage.
  • Preenal - appears at high concentration of protein in the blood, which does not have time to filter the renal structures. The frequent causes of such a state are malignant bone marrow tumors, the destruction of red blood cells, myopathy (muscle disorder), leukemia.
  • Outperture - Appears in the urine for diseases, affecting not only the kidneys, but also the whole organism. Albuminuria may appear in heart failure, intoxications, infections, hypertensive disease, metabolic disorders.

To reveal the reason that caused the proteinuria, you need to refer to the urologist, which will conduct a survey. In some cases, you need consultation of other specialists - gynecologist, oncologist, hematologist, therapist, phthisiartra.

What symptoms accompany the proteinuria

  • Euchness .
  • Bad state of health - dizziness, weakness, headache, fever, poor appetite.
  • Bleeding, bias on the skin.

Sometimes the appearance of urine is changing, which becomes muddy and acquires a reddish tint caused by an admixture of blood.

In light cases, the appearance of a protein in Urin proceeds asymptomatic, manifested only with a laboratory examination of urine. But in this case, you need to consult a doctor and find out the reason for this phenomenon.

What is dangerous protein appearance in the urine

Since protein compounds are involved in a variety of metabolic processes and are used by the body as a building material, their elevated removal with urine may have unpleasant consequences:

  • The concentration of proteins regulating the water content in the body is reduced, which leads to swells . Selection with urine albumin, responsible for blood clotting causes bleeding and appearance on the skin of bruises, the origin of which the patient cannot explain.
  • Loss of proteins - immunoglobulins - leads to the decrease in immunity and frequent infection with infectious diseases.
  • Violation of metabolism caused by improper protein exchange leads to edema and hemorrhage in various organs.
  • The increased burden on the kidney associated with the need to filter a huge amount of protein leads To renal failure . Heavy renal disorders arise in poisoning and infectious diseases.

What surveys are carried out when protein is detected in the urine

Common and biochemical blood test. Studies diagnose disorders of the kidneys and other organs, and also identify anemia caused by the collapse of the red blood cells. In leukes, blast cells are found in the analyzes. In case of suspicion of myeloma disease, blood test is carried out on paraprotein.

General urine analysis, if necessary, the sample in the winter.

Three-footered sample, appointed with albuminuria caused by the defeat of the urogenital system. The patient urins first in the first glass, and then in the second and in the third:

  • Pathological changes in all three samples Indicate the kidney damage or tumor processes. When tumors in the urine can be detected blood.
  • Deviation from norm In the first glass - at urethritis.
  • If the strongest changes are detected in the second portion - The patient cystitis or prostatitis.
  • Deviation In the third sample indicate an isolated defeat of the prostate and inflammation of the bladder.

Ultrasound of the kidneys, prostate and bladder shows the localization of the pathological focus, it detects stones and tumors that cause a violation of the urinary system.

After finding out the reason for the appearance of a protein in the patient's urine, they are sent for treatment to a urologist or other specialist. With albuminuria, arising against the background of pregnancy, a woman needs consultation of the gynecologist and the ultrasound of the fetus. Treatment is prescribed depending on the identified pathology. After the treatment carried out, test surveys are carried out.

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Protein in urine

Protein in urine  - Serious violation in the body. A healthy person in the urine does not have an increased amount of protein. At a concentration of not more than 0.03 g / l, as well as in the presence of traces in the physiological fluid - the trouble is not worth the beat, but if after passing the tests, the numbers exceed this norm - should urgently consult with a specialist. Before passing tests, do not eat acetazolamide, clerical, aminoglycoside and other drugs.

Urologist  - This is a doctor who is treating the problems of the urogenital system. In the modern world, especially with the city lifestyle, many people suffer from such diseases. But urology stepped far ahead, timely recognizes the prerequisites for the disease, conduct a qualitative examination and prescribe adequate treatment, which quickly eliminates the person from discomfort and inconvenience, returning to healthy life.

Causes of protein appearance in urine

Often Protein in urine  Find women in position. It is not necessary to worry much, but it is better to consult with your doctor. Typically, the protein appears due to stress or hormonal failures, as well as due to the increase in the size of the uterus. In addition, the protein is noticed after taking into food of raw eggs or fresh dairy products.

Before passing tests, you should not eat such products. In all other cases, the cause is the cause of the functioning of the kidneys and organs, which accumulate and remove the urine:

  • pathology;
  • cancer education in the field of kidneys and urinary tract;
  • brain concussion;
  • epilepsy;
  • consequence of stress;
  • supercooling.

Also, an increased amount of protein is noticed in athletes due to the use of protein and heavy loads. Observe the recommendations of the doctors: you should go to an inspection to the urologist once a year at least, to pass the ultrasound kidneys, do not lead a sex life with random partners, balanced to feed, keep moving lifestyle and avoid stress.

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What is dangerous protein in the urine?

According to the physiological structure, the pathological deviation scheme indicating the appearance of a protein in the urine, signals the reaction of its increased disposal from cells and tissues. This phenomenon is found in disruption of the filtering ability of renal tissue membrane. Together with the protein from the bloodstream, red blood cells can be washed out, leading to the appearance of signs of anemia and changing the straw shade of urine on blood.

Since the participation of protein structures in the functional activity of almost all areas of the body is vital, including stabilization of protective parameters, allergenic and infectious confrontation, ensuring the hormonal balance, etc., their weighty loss has negative consequences.

The lack of a sufficient level of protein in the bloodstream has a negative impact, both on the functionality of the individual structures of the internal space and on the activities of the entire systems, leading to the violation of the homeostasis of the entire body. It threatens to slow down all recovery functions in organs and systems, significantly postponing the process of recovery.

Symptomatics of the disease

If a person is raised Protein in urine This indicates urological disease. With the following symptoms, contact a highly qualified technician:

  • fast fatiguability;
  • bone pain;
  • dizziness;
  • fatigue, scattering and drowsiness;
  • a change in urine color - it acquires a more whiten shade;
  • Chills and fever are symptoms appear in the presence of a high level of protein.

Newborns also have increased protein, but it should not be frightened here and should be. After all, his absence is not wrong. Therefore, protein should be controlled, both children and adults and at the very first symptoms to see the doctor.

Physiological limit of norm

With a healthy functional condition of the organism, in men and women, the quantitative content of the protein in the urine reaches 0.14 g in a liquid liter without pointing to the kidney dysfunction. In case of exceeding the boundaries of the value to the threshold of 0.33 g / dm 3, there is a development of pathological deviation in the form of a disease, the current indicator of which is proteinuria.

Pathology may have a light form of flow, mean and heavy. In the children's age group, the norm of proteins in the urine may have a border of 0.036 g in liter, its increase to 0.1 g / dm 3Diagnizes the moderate form of proteinuria. During the fetal period, the normalized protein threshold in the urine is shifted to a value of 0.03 g in liter. A more significant increase testifies to the development of a pathological disorder in the urinary system or urinary disposal.

An indicator of the shift of the boundary of the protein rate is largely different pathologies, or a temporarily manifested deviation that has a surrender character. Such a form of proteinuria is observed in a feverish state or significant loss of water, stressing voltage, burns or long-term supercooling. In men, the presence of a protein in the urine in the hard physical activity is observed.

Methods of laboratory detection of pathology

Proteinuria is diagnosed according to the results of laboratory confirmation of the quantitative exceeding the permissible threshold of the protein present in the urine. The technique is repelled on its molecular weight, according to which the filtering parameters of the renal membranes are evaluated. The overestimated value of the molecular weight of proteins signals a serious damage to the renal tissue with a violation of its functional ability.

According to the laboratory conclusion, the presence of protein and leukocytes in the urine diagnose the inflammatory process, and the combined increase in protein concentrations and the presence of red blood cells indicates the traumatic damage to the urinary tract tissues. There is a significant variety of techniques for quantitative and high-quality definition of protein in the urine, the use of a specific one is set by the doctor, depending on the individual parameters of the current pathology indicators.

Modern medicine allows to treat diseases of the urogenital system operational and very high quality. The clinics use many surveys methods. Among them is Bens-Jones method, and the method of determining protein cleavage products, and indicator paper, and a unified method of Brandberg-Roberts-Stolnikov, as well as a buret method and a photoelectrocolorimeter.

Can the protein in the urine in a child?

The kidney function in the child includes filtering the content of the bloodstream from toxic and unnecessary component organism, the molecular size of which is definitely small.

These substances include:

  • urinary acid;
  • urea;
  • Indican;
  • ammonium salts;
  • Creatine and others.

At the same time, the useful and necessary components of the blood components, namely glucose and amino acids, through the renal channel membrane are absorbed in the primary stage of urine filtration, which forms a plasma, in the absence of high molecular weight proteins in it. For the daily interval through the buds of the newborn, about 50 dm is transported 3The primary urine, but the secondary liquid is already standing out through the system, determining the components of the diuresis per day.

In an adult, the daily interval is disposed of about 180 dm 3Fluids at the primary filtering stage, while the total volume of diuresis per day is on average two liters. At child age, this figure depends on the overall state of the child's health, its weight and surface cover area. With the well-being of the state and the full health of the child in his urine, the protein is completely absent, but even minor traces within up to 0.03 g in Lytra are not an indicator of the development of pathology.

Treatment and prevention

The priority task of any person is timely supervision of the indicators of his own well-being and the signs that the body signals the existing pathological problems. When they are discovered, it is recommended to visit the urologist and go through the necessary types of diagnostic confirmation of the well-being of the body.

This approach will help to establish the root cause of protein detection in the urine and select the optimally effective method of rapid recovery, completely eliminating the current pathological problem. Against the background of diabetes mellitus during proteinuria, the doctor will recommend a diet adjustment, with an elevated level of vascular pressure, its constant control is necessary, the reception of stabilizing drugs, as well as the restriction of sugar, salt and rich food.

The conservative form of normalization of the protein threshold in the urine includes bed regime, a certain dietary table and corrective drug therapy, namely corticosteroids, antiperscript, ACE inhibitors, cytostatics and others.

When diagnosing a protein in the urine indicating the development of the inflammatory process, the formation of solid conglomerates, which has congenital defects in the development of the kidneys, must be systematically observed in the profile specialist.

Help specialists of our clinic

The main thing is that you need to do is follow the changes in your body and to detect problems in a timely manner. Then consult a doctor who will conduct a thorough objective examination, if necessary, appoints additional analyzes, will tell about the reasons to eliminate not only symptoms, but also the core of the disease.

Specialists of the Multidisciplinary Center "Doctor Plus" in Moscow are always happy to provide the required range of profile assistance for patients of any age category, including the consultation of the urologist and a laboratory study of urine. The clinic has several branches geographically scattered around the city, which allows you to choose to visit the most acceptable option of its location.

Prices for urologist in Moscow
Primary reception of the urologist 900. Publey
Repeating urologist 700. Publey
Call the urologist to the house 2 800. Publey
Ultrasound kidneys 1 000 Publey
Urine analysis for protein 600. Publey

The article is not a medical board and cannot serve as a substitute for advice with a doctor.

One of the deviations in the overall urine analysis is the presence of an increased level of protein.

A more accurate determination of the protein composition of Urin allows to obtain a biochemical study of urine. This condition is referred to as proteinuria or albuminuria.

In healthy people, the protein in the urine should be absent, or discovered in extremely minor quantities. Therefore, when a high level of protein is detected in the urine, immediate additional diagnosis is required.

Protein in the urine - what does this mean?

Most often, elevated protein in the urine appears with inflammatory processes in the urinary system. It usually means that the filtration function of the kidneys is broken as a result of partial destruction of the renal pelvis.

However, this does not always happen. Sometimes proteinuria appears with completely healthy kidneys. It can be enhanced sweating at elevated temperatures when a person is ill with influenza or ARVI, reinforced physical exertion, use on the eve of the analysis of a large amount of protein food.

Physiological and Functional Proteinuria

For physiological proteinuria, an increase in protein content in the morning urine is characterized to a level not exceeding 0.033 g / l.

And so why can the protein in the urine? This is facilitated by such factors:

  • severe physical exertion;
  • excess insolation;
  • supercooling;
  • increasing the level of norepinephrine and adrenaline in the blood;
  • excessive use of protein food;
  • stressful states;
  • Prolonged palpator examination of the kidney and abdomen.

The physiological increase in the content of protein in the urine in a child or in an adult is not a reason for excitement and does not require special treatment.

Causes of increased protein in the urine

The high amount of protein in the urine is one of the undoubted signs of violation of the normal operation of the kidneys caused by any disease. An increase in the amount of protein in the urine may be accompanied by various diseases - they are precisely the main cause of the increase in protein in the urine.

These diseases include:

  • Polycystic kidney;
  • pyelonephritis;
  • Glomerulonephritis;
  • amyloidosis and tread tuberculosis.

The kidneys can be affected again with certain pathologies of other organs and systems of the body. Most often, renal functions are broken at:

  • hypertensive disease;
  • diabetes;
  • pregnant woman (nephropathy);
  • Atherosclerosis of renal arteries.

Another group of reasons explaining why protein appeared in the urine - inflammatory diseases of the lower urinary tract and sexual sphere:

  • cystitis;
  • urethritis;
  • Prostatitis in men;
  • inflammation of ureters;
  • adnexitis, cervicitis, vulvovaginitis in women.

These are the most frequent causes of protein in the urine. Only by spending more in-depth diagnostics can be determined why a lot of protein appeared in the urine, and what it means in a particular case.

The norm of proteins in the urine

If the patient is preparing to pass the analysis of the protein content, it should not be taken on the eve of acetazolamide, clerical, aminoglycoside and other drugs. They directly affect the protein concentration in the urine.

In healthy people should not be. It happens that only a small amount appears. If the concentration in the body is not more than 0.03 g / l, then it is not scary. But with deviations from this rate it is necessary to worry.

Proteinuria is the detection of protein in concentrations in the urine in concentrations greater than the mark of 0.033 grams / liter. Taking into account the daily oscillations of the excretion (selection) of the protein with urine (the maximum number falls during the daytime), an analysis of daily urine is carried out to assess the scale of proteinuria, which makes it possible to determine the daily proteinuria.

Based on global medical standards, proteinuria is divided into several forms:

  • 30-300 mg / day protein - such a state is called microalbuminuria.
  • 300 mg - 1 g / day - Easy degree of proteinuria.
  • 1 g - 3 g / day - the middle shape.
  • Over 3000 mg / day - severe stage of the disease.

So that the analyzes are correct and unmistakable, you should collect urin correctly. As a rule, the collection is made in the morning when you just woke up.

Symptoms

A temporary increase in proteins in Urin does not give any clinical picture and very often flows without symptoms.

Pathological proteinuria is the manifestations of the disease, which contributed to the formation of protein molecules in the urine. With a prolonged course of such a condition in patients, regardless of their age (in children and adolescents, women, men), there are following symptoms:

  • soreness and lubrication in the joints and bones;
  • swelling, hypertension (signs of developing nephropathy);
  • clouding urine, detection of flakes and white plaque in the urine;
  • muscle soreness, convulsions (especially night);
  • pallor of skin, weakness, apathy (symptoms of anemia);
  • sleep disorders, consciousness;
  • Increase temperature, no appetite.

If the overall urine analysis showed an increased amount of protein, then it is necessary to re-study for one or two weeks.

Protein in the urine during pregnancy

The detection of protein in the urine in the early period of pregnancy can be a sign of a hidden pathology of the kidneys, which was in a woman even before the occurrence of pregnancy. In this case, the whole pregnancy must be observed from specialists.

The protein in the urine in the second half of pregnancy in small quantities may appear due to the mechanical squeezing of the kidney growing uterus. But it is necessary to eliminate the diseases of the kidneys and pregnant pregnant diseases.

What is dangerous high protein in the urine?

Proteinuria can manifest themselves the loss of various types of protein, therefore the symptoms of protein lack are also varied. With the loss of albumin decreases oncotic pressure plasma. This is manifested in edema, the occurrence of orthostatic hypotension and an increase in the concentration of lipids, which can be reduced only under the condition of the correction of protein composition in the body.

With excessive loss of proteins that are part of the complement system, resistance to infectious agents disappears. With a decrease in the concentration of procoagulant proteins, the coaguling ability of blood is disturbed. What does it mean? This significantly increases the risk of spontaneous bleeding, which is dangerous for life. If the proteinuria lies in the loss of thyroxincolive globulin, then the level of free thyroxine is increasing and functional hypothyroidism develops.

Since proteins perform many important functions (protective, structural, hormonal, etc.), their loss in proteinuria can have negative consequences on any organ or system of the body and lead to a violation of homeostasis.

Treatment

So, the possible causes of protein in the urine are already clarified and now the doctor must prescribe the appropriate treatment of the disease. It is incorrectly to say that it is necessary to conduct a protein treatment in the urine. After all, proteinuria is just a symptom of the disease, and the doctor should address the reasons that caused this symptom.

As soon as effective treatment of the disease begins, the protein in the urine will gradually disappear completely or its amount will decrease sharply. Physiological and orthostatic treatment proteinuria do not require at all.

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