Proteinuria: Difference between revisions
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==Causes/Differential Diagnosis== | ==Causes/Differential Diagnosis== | ||
===Functional=== | ===Functional=== | ||
*Benign: fever/acute illness, cold exposure, orthostatic proteinuria, strenuous exercise, [[hypertension]] | *Benign: [[fever]]/acute illness, cold exposure, orthostatic proteinuria, strenuous exercise, [[hypertension]] | ||
*[[CHF]], [[shock]] | *[[CHF]], [[shock]] | ||
*[[Preeclampsia]]/eclampsia | *[[Preeclampsia]]/[[eclampsia]]/[[HELLP]], [[acute fatty liver of pregnancy | ||
===Renal=== | ===Renal=== | ||
*Tubular dysfunction | *Tubular dysfunction | ||
*Glomerular disease (e.g. [[glomerulonephritis]], diabetes, HIV, SLE, | *Glomerular disease (e.g. [[glomerulonephritis]], [[diabetes]], [[HIV]], [[SLE]], [[amyloidosis]], [[IgA nephropathy]] or membranous nephropathy) | ||
*[[Nephrotic syndrome]] | *[[Nephrotic syndrome]] | ||
*[[Pyelonephritis]] | *[[Pyelonephritis]] | ||
*[[Malignant hypertension]] | *[[Malignant hypertension]] | ||
*[[Alport syndrome]] | |||
===Drugs=== | ===Drugs=== | ||
*[[Aminoglycosides]], [[penicillin]s, [[amphotericin]] | *[[Aminoglycosides]], [[penicillin]s, [[amphotericin]], [[penicillamine]], [[deferasirox]] | ||
*[[NSAIDs]], gold | *[[NSAIDs]], gold | ||
*[[Chloral hydrate toxicity]] | |||
*[[Lead toxicity]] | |||
===Protein overload=== | ===Protein overload=== | ||
''Note: bence-jones globulins NOT detected on dipstick'' | ''Note: bence-jones globulins NOT detected on dipstick'' | ||
| Line 25: | Line 28: | ||
===Other=== | ===Other=== | ||
*[[Gout]] | *[[Gout]] | ||
*[[Hypokalemia]], Cushing's syndrome | *[[Hypokalemia]], [[Cushing's syndrome]] | ||
*[[Electrocution]] | *[[Electrocution]] | ||
*Polycystic kidney disease | *[[Polycystic kidney disease]] | ||
*[[Hepatorenal syndrome]] | |||
*[[Leptospirosis]] | |||
*[[Polyarteritis nodosa]] | |||
*[[Serum sickness]] | |||
*[[Scleroderma]] | |||
===False Positives=== | ===False Positives=== | ||
*Menses or other vaginal bleeding | *Menses or other [[vaginal bleeding]] | ||
*Highly concentrated urine | *Highly concentrated urine | ||
*Alkaline urine | *Alkaline urine | ||
*Acetazolamide, cephalosporins, | *[[Acetazolamide]], [[cephalosporins]], [[bicarbonate]] | ||
==See Also== | ==See Also== | ||
| Line 38: | Line 46: | ||
[[Category:Renal]] | [[Category:Renal]] | ||
[[Category:Symptoms]] | |||
Latest revision as of 18:14, 16 October 2019
Background
- Normal protein excretion 150mg/24 hours or 10mg/100mL
- >3.5g/24h considered nephrotic range
- Dipstick: more sensitive to albumin, less sensitive to Bence-Jones protein and globulins
- "Trace" protein ≈ 10mg/100mL (i.e. upper limit of normal)
Causes/Differential Diagnosis
Functional
- Benign: fever/acute illness, cold exposure, orthostatic proteinuria, strenuous exercise, hypertension
- CHF, shock
- Preeclampsia/eclampsia/HELLP, [[acute fatty liver of pregnancy
Renal
- Tubular dysfunction
- Glomerular disease (e.g. glomerulonephritis, diabetes, HIV, SLE, amyloidosis, IgA nephropathy or membranous nephropathy)
- Nephrotic syndrome
- Pyelonephritis
- Malignant hypertension
- Alport syndrome
Drugs
- Aminoglycosides, [[penicillin]s, amphotericin, penicillamine, deferasirox
- NSAIDs, gold
- Chloral hydrate toxicity
- Lead toxicity
Protein overload
Note: bence-jones globulins NOT detected on dipstick
Other
- Gout
- Hypokalemia, Cushing's syndrome
- Electrocution
- Polycystic kidney disease
- Hepatorenal syndrome
- Leptospirosis
- Polyarteritis nodosa
- Serum sickness
- Scleroderma
False Positives
- Menses or other vaginal bleeding
- Highly concentrated urine
- Alkaline urine
- Acetazolamide, cephalosporins, bicarbonate