Proteinuria

Normal protein excretion in the urine is less than 100 mg / day. In a healthy patient, most of the secreted protein derived from tubular sekresjonsmekanismer (Tamm-Horsfall protein). Albumin is the predominant protein in glomeruli is filtered and is therefore an excellent marker for pathological protein secretion as a result of either increased filtration due glomerular diseases or reduced tubular reabsorption by tubulo-interstitial diseases. We therefore albuminuria measured by albumin / creatinine ratio (AKR) as a measure of the degree of proteinuria. When proteinuria is large, tubular sekresjonsmekanismer contribute little to proteinuria and one can just as easily use protein / creatinine ratio (PKR) as a measure of proteinuria.

Definition

AKR

Albumin per day

PKR

Proteinuria per day

Normal

0-3

0-30 mg / day

<200 mg / day

Microalbuminuria

3-30

30-300 mg / day

Proteinuria

30-300

300-3000 mg / day

50-300

500 mg-3 g / day

Nephrotic proteinuria

> 300

> 3 g / day

> 300

> 3 g / day

All kidney diseases may present with degrees of proteinuria. If proteinuria in nephrotic range (> 3 g / day) one can say with certainty that filtrasjonsbarrieren damaged and that there is a glomerular disease. If nephrotic proteinuria occurs with low see albumin (<30 g / l) and edema We denote the condition nephrotic syndrome which is a clear indication of renal biopsy.
If the patient presents with a kidney disease in which large proteinuria dominate the clinical picture, we say often that kidney disease presents itself nephrotic even if the patient does not fulfill all the criteria for nephrotic syndrome. The various glomerulonephritis tends clinically presenting itself either nephrotic or nephritic, which helps to substantiate the diagnosis before biopsy answer finally exists.
Proteinuria is an important diagnostic tool for finding patients with kidney disease. In addition, the degree of proteinuria an important prognostic marker for the progression of kidney disease. Regular monitoring of proteinuria is therefore essential when recruiting medical issues.