1. Proteinuria Hub A brief introduction of proteinuria, followed by links to overviews,research articles, case reports and clinical trials. proteinuria http://www.projectlinks.org/proteinuria/

Proteinuria is a condition in which urine contains an abnormal amount of protein. People with diabetes, hypertension, or certain family backgrounds are at risk for proteinuria. Proteinuria may be a sign that your kidneys are damaged and that you are at risk for end-stage renal disease. You may have proteinuria without noticing any signs or symptoms. Testing is the only way to find out how much protein you have in your urine. Groups at risk for proteinuria and kidney failure include African Americans, American Indians, Hispanic Americans, Pacific Islander Americans, people who are older or overweight, and people who have a family history of kidney disease. Acne Allergy Antibiotics Antioxidants ... Evaluating Proteinuria in Children - by Mahmoud Loghman-Adham, M.D., University of Utah School of Medicine, Salt Lake City, Utah. Evaluation of Asymptomatic Proteinuria - by Vanderbilt University Medical Center. Genitourinary and Renal Disease: Proteinuria, Nephrotic Syndrome, and Nephritic Urine Proteinuria from the Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University Proteinuria: Causes - by the College of Veterinary Medicine at Cornell University. Proteinuria and renal disease progression - by Giuseppe Remuzzi, MD., Mario Negri Institute for Pharmacological Research.

2. Proteinuria An introduction, a look at who is at risk, signs if this disease and kidney failure, testing, treatment, Category Health Conditions and Diseases proteinuria...... What Are the Signs of proteinuria and Kidney Failure? What Are the Tests for proteinuria?To test for proteinuria, you will need to give a urine sample. http://www.niddk.nih.gov/health/kidney/pubs/proteinuria/proteinuria.htm

Introduction Who Is at Risk? What Are the Signs of Proteinuria and Kidney Failure? What Are the Tests for Proteinuria? ... For More Information Introduction Proteinuria describes a condition in which urine contains an abnormal amount of protein. Proteins are the building blocks for all body parts, including muscles, bones, hair, and nails. Proteins in your blood also perform a number of important functions: protecting you from infection, helping your blood coagulate, and keeping the right amount of fluid circulating through your body. As blood passes through healthy kidneys, they filter the waste products out and leave in the things the body needs, like proteins. Most proteins are too big to pass through the kidneys' filters into the urine, unless the kidneys are damaged. The two proteins that are most likely to appear in urine are albumin and globulin. Albumin is smaller and therefore more likely to escape through the filters of the kidney, called glomeruli. Albumin's function in the body includes retention of fluid in the blood. It acts like a sponge, soaking up fluid from body tissues. Inflammation in the glomeruli is called glomerulonephritis

3. Asymptomatic Proteinuria Looks at what this disorder is, the causes, the protein, further investigation, treatment and where Category Health Conditions and Diseases proteinuria......Asymptomatic proteinuria. from EdREN, the website of the Renal Unit ofthe Royal Infirmary of Edinburgh. What is proteinuria? proteinuria http://renux.dmed.ed.ac.uk/EdREN/EdRenINFObits/ProteinuriaLong.html

Asymptomatic Proteinuria from EdREN , the website of the Renal Unit of the Royal Infirmary of Edinburgh What is proteinuria? What causes proteinuria What is the protein? Is the proteinuria always a bad thing? ... Where can I find further information? What is proteinuria? Proteinuria means the appearance of protein in the urine. It is usually detected by a simple dipstick test of the urine. In some circumstances it is detected on a routine check. Usually there are no symptoms from it. What causes proteinuria? Protein should not normally appear in the urine in detectable quantities. It is usually kept in the blood by the filtering units (glomeruli) within the kidney. Proteinuria is an indicator that the kidneys are damaged in some way. Diseases that affect the filtering units themselves are the most common cause of heavy proteinuria. Sometimes this is called glomerulonephritis, meaning inflammation of the glomeruli. Just as some examples, any of the causes of nephrotic syndrome could be causes of proteinuria. What is the protein?

4. Proteinuria In Children proteinuria in children A look at the role of protein in the body, what this disorder is, treatment and how to do a 24 hour urine collection. http://familydoctor.org/handouts/329.html

Information from Your Family Doctor Proteinuria in Children What's the role of proteins in the body? Proteins are essential in our bodies. Normally, proteins move around in our blood, carrying food, hormones and medicine to all parts of the body. They also help keep water inside tiny blood vessels. What is proteinuria? Proteinuria is the name of a medical condition. It means protein is in the urine. As blood moves through the kidneys, the kidneys filter out waste products, excess fluid and salts. The clean blood cycles back through the body. Most proteins are too big to go through the kidneys, so usually no protein is found in urine. If your doctor finds protein in your child's urine, that means your child's kidney may not be working as they shouldpossibly because of inflammation (swelling). Sometimes infection or toxic chemicals damage the kidneys, and this makes protein show up in the urine. Dipping a special strip of paper into a sample of urine tells your doctor if protein is in it. If only a little protein is in the urine, your child probably has a benign (harmless) condition such as orthostatic proteinuria (see below). Your doctor might do a few other tests to make sure. Your doctor may ask you to collect a 24-hour urine sample from your child. Directions for doing this are at the end of this handout. A 24-hour urine collection lets your doctor measure the protein in the urine. This test helps show how well your child's kidneys are working. Your doctor may also do some blood tests.

5. Proteinuria proteinuria. proteinuria. Urine protein (total), albumin. Renal biopsy , if indicated. http://www.rcpa.edu.au/pathman/proteinu.htm

Proteinuria Proteinuria Urine - protein (total), albumin. Renal biopsy , if indicated. Glomerular Pregnancy-induced hypertension See under Pregnancy Glomerulonephritis Nephrotic syndrome Diabetes mellitus ... Amyloidosis Hereditary nephropathies eg Alport syndrome Tubular Urine - alpha-1-microglobulin or beta-2-microglobulin. Renal tubular disorders Renal tubulo-interstitial disorders Bence Jones proteinuria See Multiple myeloma Urinary tract infection Physiological Orthostatic Post-exercise

6. Proteinuria And Microalbuminuria - Nephrologychannel An article about proteinuria detailing the types, causes and risk factors, symptoms, diagnoses, complicat Category Health Conditions and Diseases proteinuria......proteinuria is a kidney disorder resulting in an abnormally high amountof protein in the urine. Microalbuminuria is a type of proteinuria. http://www.nephrologychannel.com/proteinuria/

Home Search SiteMap Ask the Dr. ... Medical Store advertisement advertisement MICROALBUMINURIA Overview Types Cause Symptoms ... Treatment CONDITIONS Acute Glomerulonephritis (AGN) Acute Interstitial Nephritis (AIN) Acute Renal Failure (ARF) Acute Tubular Necrosis (ATN) Chronic Renal Failure Diabetic Nephropathy Hematuria Ischemic Nephropathy ... Nephrotic Syndrome (NS) Polycystic Kidney Disease Microalbuminuria Renal Artery Stenosis (RAS) Renal Vascular Hypertension (RVH) TREATMENT OPTIONS Hemodialysis Peritoneal Dialysis Kidney Transplant RELATED CONDITIONS Electrolyte Imbalance Hemolytic Uremic Syndrome (HUS) Thrombotic Thrombocytopenic Purpura (TTP) RESOURCES Anatomy Links Clinical Trials Videos ABOUT US Healthcommunities.com Pressroom Testimonial Bibliography Overview Proteinuria is an abnormally high amount of protein in the urine. Proteins in the blood, like albumin and immunoglobulin, help coagulation (clotting), balance bodily fluids, and fight infection. The kidneys remove wastes from protein-rich blood through millions of tiny filtering screens called glomeruli. Most proteins are too large to pass through the glomeruli into the urine. The glomeruli are negatively charged, so they repel the negatively charged proteins. Thus, a size and charge barrier keeps protein molecules from entering the urine. But when the glomeruli are damaged, proteins of various sizes pass through them and are excreted in the urine.

7. Proteinuria A look at the mechanisms of proteinuria, detection of protein in the urine, evaluation and nonpathological causes. http://pedclerk.bsd.uchicago.edu/proteinuria.html

Back to table of contents Proteinuria The child with protein in their urine is a common finding in pediatric practice. Protein may be found in the urine of healthy children. The incidence increases with age and the majority of protein is albumin. Mechanism of Proteinuria Increased glomerular filtration. The protein must pass through the glomerular capillary wall. Nephrotic Syndrome- minimal change disease and focal glomerulosclerosis Glomerulonephritis Drugs Decreased tubular reabsorption. Most filtered protein is reabsorbed proximally. With tubular damage, there will be increased protein in the urine Transport defects- Fanconi's Syndrome, Cystinosis Toxins- Penicillins, Heavy metals, Aminoglycosides, old tetracycline Ischemic injury- shock, ATN, Endotoxemia Obstructive uropathy, Polycystic disease Increased secretion - normally some protein is secreted but may increase with exercise, acute renal failure, transplant rejection, and stones. Detection of Protein in the Urine Dipsticks - Very sensitive and changes color secondary to reaction of tetrabromophenol with amino acids. Have false positives with ph >8, concentrated urine, long immersion time, or presence of wbcs or bacteria. Reading of 1+ needs to rechecked and if continues positive, timed collections should be done. Timed Collection - technically may be difficult. Doesn't allow for diurnal variations and effect of activity on proteinuria. In adults, >150 mg. 24 hours is positive. In children, > 4 mg./metered squared/hour is positive.

8. American Family Physician proteinuria in Adults A Diagnostic Approach by michael F. Carrol, M.D., and Jonathan L.Temte, M.D., PH.D. University of WisconsinMadison Medical School, Madison, Wisconsin. http://www.aafp.org/afp/20000915/1333.html

Advanced Search Proteinuria in Adults: A Diagnostic Approach MICHAEL F. CARROLL, M.D., and JONATHAN L. TEMTE, M.D., PH.D. University of Wisconsin-Madison Medical School, Madison, Wisconsin PROBLEM-ORIENTED DIAGNOSIS P roteinuria on initial dipstick urinalysis testing is found in as much as 17 percent of selected populations. Although a wide variety of conditions, ranging from benign to lethal, can cause proteinuria, fewer than 2 percent of patients whose urine dipstick test is positive for protein have serious and treatable urinary tract disorders. A knowledgeable approach to this common condition is required because the diagnosis has important ramifications for health, insurance eligibility and job qualifications. TABLE 1 Common Causes of Benign Proteinuria Dehydration Emotional stress Fever Heat injury Inflammatory process Intense activity Most acute illnesses Orthostatic (postural) disorder Definition of Proteinuria Twenty-four hundred years ago, Hippocrates noted the association between "bubbles on the surface of the urine" and kidney disease. Today, proteinuria is defined as urinary protein excretion of greater than 150 mg per day. Urinary protein excretion in healthy persons varies considerably and may reach proteinuric levels under several circumstances. Most dipstick tests (e.g., Albustin, Multistix) that are positive for protein are a result of benign proteinuria, which has no associated morbidity or mortality (

9. Proteinuria And Kidney Disease Fact Sheet A proteinuria and kidney disease fact sheet. http://www.kidney.org/general/news/proteinuria.cfm

Search Browse Please Select a Topic A to Z Health Guide Bed-Wetting NKF Brochures Online Dialysis Donor Families Health Information High Blood Pressure K/DOQI Kidney Disease Kidney Stones Message Boards and Chats Organ Donation Other Health Topics Transplant Athletics Transplant Recipients Transplantation Urinary Tract Disease Health Care Professionals K/DOQI Recipients Government Relations ... Show Your Support Important Facts About Proteinuria and Kidney Disease The kidneys normally act as filters and conserve protein, and very little or no protein appears in the urine. The appearance of protein in the urine may be the first sign of an otherwise silent kidney disease. Routine testing for urine protein as an early marker of kidney disease should be included in physical examinations in adults. Protein in the urine can be detected by a simple test that can often be done on the spot in your doctor’s office. While small amounts of protein loss in the urine have no associated symptoms, heavy losses may be associated with leg, eye and facial swelling. The most common cause of heavy protein losses in the urine is diabetes mellitus, which is the leading cause of chronic kidney failure in the U.S.

10. PROTEINURIA Welcome to . Advertisement. proteinuria The presence of protein in the urine. http://www.medhelp.org/glossary/new/gls_3506.htm

Welcome to .... Advertisement PROTEINURIA - The presence of protein in the urine. This is seen in some cases of kidney disease such as nephritis and nephrotic syndrome . Large amounts of protein in the urine can be quantified for diagnostic purposes. Med Help International Search Ask the Doctor Forums Patient Network The medical glossary has been made possible by a generous donation from: (revised: 1996) Advertisement

11. Proteinuria proteinuria. renal disease glomerulonephritis various causes; commonest is diabetes mellitus http://www.geocities.com/davidscerri/proteinuria.htm

PROTEINURIA renal disease: glomerulonephritis [various causes; commonest is diabetes mellitus] urinary tract infection obstructive nephropathy [orthostatic proteinuria; early morning urine normal] renal vein thrombosis (+ haematuria + loin pain) chronic interstitial nephritis eg. analgesic nephropathy nephrotic syndrome tubular disease [tubular proteinuria; very rare; proteinuria is mainly globulins]: Fanconi syndrome recovery phase of acute tubular necrosis heavy metal poisoning cystinosis extra-renal causes: congestive heart failure constrictive pericarditis postural (orthostatic) proteinuria transient in febrile illnesses following heavy exercise pregnancy multiple myeloma (Bence-Jones proteins; pass through normal glomeruli) click here to return to the main contents page of Differential Diagnoses in General Medicine

12. Case 2 A 9year-old girl presents with proteinuria. One year previously she had been treated for streptococcal pharyngitis http://www.mcl.tulane.edu/classware/pathology/medical_pathology/renal-lung_cases

Case presentation: A 9-year-old girl presents with proteinuria. One year previously she had been treated for streptococcal pharyngitis with a normal follow-up urinalysis. Four months previously she had an episode of fever followed by proteinuria and hematuria. At that time, her workup included the following: Urinalysis with 25 red cells per high-powered field 3+ proteinuria (2.8 grams/24 hr) Serum protein electrophoresis showed an increased alpha-2 band BUN and creatinine were normal BP 100/45 No edema Negative anti-streptolysin-O titres and throat cultures The current physical exam was unremarkable and the following labs were obtained: Urine Specific gravity 1.01, 1+ protein BUN 15 mg/dl Serum creatinine 0.4 mg/dl Questions: Was the girl's presentation 4 month's previously related to her streptococcal pharyngitis 1 year previously? How would assess her presentation 4 month's previously? What to you think of her current presentation?

13. How To Manage Asymptomatic Proteinuria How to manage asymptomatic proteinuria. Nephrotic level proteinuria usually requiresrenal biopsy to establish the cause, unless this is immediately evident. http://renux.dmed.ed.ac.uk/EdREN/Unitbits/ProtGuide.html

How to manage asymptomatic proteinuria A guideline for medical practitioners from EdREN , the website of the Renal Unit, Royal Infirmary of Edinburgh. Jump to summary of monitoring for low-risk patients Note that this guidance excludes pregnancy , and nephrotic level proteinuria Establish that the result is a true positive: Check separate samples including early morning. Persistent proteinuria on stick testing is abnormal and implies intrinsic renal disease. Exclude the following: fever urine infection exercise-induced haematuria 'orthostatic proteinuria' - absent in early morning sample Establish also that the finding is consistent Investigations Assess history blood pressure renal function , seek evidence for diabetes mellitus (random blood glucose and glycosylated Hb). The presence of the following increase the likelihood of significant renal disease, and indicate that further nephrological investigations are appropriate: Factors increasing likelihood of renal disease haematuria also present raised serum creatinine (if renal function is deteriorating, investigation is urgent)

14. Connecticut Children's Medical Center: Nephrology Provides primary and consultative services to patients with a variety of renal disorders including hematuria, proteinuria, nephrotic syndrome, acute renal failure, recurrent urinary tract infection, congenital renal anomalies including hydronephrosis and cystic diseases of the kidneys, kidney stones, chronic renal failure, end stage renal disease, hypertension, and a variety of fluid and electrolytes disorders. http://www.ccmckids.org/departments/neph.htm

Staff Office Locations The Division provides primary and consultative services to patients with a variety of renal disorders including hematuria, proteinuria, nephrotic syndrome, acute renal failure, recurrent urinary tract infection, congenital renal anomalies including hydronephrosis and cystic diseases of the kidneys, kidney stones, chronic renal failure, end stage renal disease, hypertension, and a variety of fluid and electrolytes disorders. In collaboration with Hartford Hospital's dialysis and transplant program, the Nephrology Division provides acute and chronic peritoneal and hemodialysis as well as renal transplantation. Staff Majid Rasoulpour, M.D. - Director mrasoul@ccmckids.org University of Tehran, 66 University of Tehran, 70, M.D. Internship/Residency: Lawrence General Hospital (MA), Rotating, 73-74; University of Connecticut, Pediatrics, 74-76; Fellowship: University of Connecticut, Pediatric Nephrology, 76-78 Board Certification: Pediatrics, 78; Pediatric Nephrology, 82

15. Proteinuria Evaluation of asymptomatic proteinuria. THE MERCK MANUAL NEPHROTIC SYNDROME (NS);Diagnosis http://www.orfeasnet.gr/nephroclin/proteinuria.htm

Evaluation of asymptomatic proteinuria THE MERCK MANUAL - NEPHROTIC SYNDROME (NS);Diagnosis Articles about diagnosis Articles about treatment Evaluation of asymptomatic proteinuria THE MERCK MANUAL - NEPHROTIC SYNDROME (NS);Diagnosis Articles about diagnosis Articles about treatment ... Effect of Angiotensin Converting Enzyme Inhibition by Perindopril on Proteinuria of Primary Renal Diseases

16. Proteinuria This results in a daily protein excretion of approximately 4080 mg. (1).Definition and Measurement of proteinuria. (1). Mechanisms of proteinuria. http://www.nursingceu.com/NCEU/courses/proteincc/

Proteinuria Author: Cheryl Curtis, MSN, RN, CNN 1 contact hour Course posted February 28, 2003 Course expires February 28, 2005 Course Objectives Upon completion of this course the learner will be able to: Define proteinuria. Explain protein handling mechanisms of normal kidneys. Describe the measurement of proteinuria. Identify four classifications of proteinuria. List the complications of proteinuria. Introduction Proteinuria is a condition in which urine contains an excess amount of protein. Proteinuria is often one of the first signs of renal disease and is often asymptomatic. Proteinuria is a finding in almost every form of glomerular disease. Protein Handling in Normal Kidneys In a healthy kidney, the glomerular capillary wall acts as a barrier to prevent proteins from entering the urine based on size and electrical charge of the proteins. This is dependent on the integrity of the capillary wall. The glomerular capillary wall consists of three layers: the fenestrated endothelium, the glomerular basement membrane, and the epithelial cells attached to the glomerular basement membrane. The primary barrier to the filtration of protein is the glomerular basement membrane. If the glomerulus is intact, only trace amounts of albumin escape in the glomerular filtrate. Proteins that are smaller than albumin (

17. PROTEINURIA Pediatric Database (PEDBASE); Discipline APP; Last Updated 5/04/94 proteinuria.DEFINITION DIFFERENTIAL DIAGNOSIS 1. Benign proteinuria. http://www.icondata.com/health/pedbase/files/PROTEINU.HTM

Pediatric Database (PEDBASE) Discipline: APP Last Updated: 5/04/94 PROTEINURIA DEFINITION: EPIDEMIOLOGY: incidence: 1 - 5% (depend upon age and number of samples) prevalence: 5 - 11% (1+ proteinuria) only 10% of kids with proteinuria will have abnormalities after 6-10 month of follow-up the incidence of proteinuria in patients with underlying renal disease is remarkably high DIFFERENTIAL DIAGNOSIS: 1. Benign Proteinuria 1. Benign Transient Proteinuria 2. Orthostatic Proteinuria* 3. Persistent Asymptomatic Proteinuria* 2. Pathologic Proteinuria 1. Glomerular 1. Hereditary Congenital Nephrotic Syndrome Alport Syndrome 2. Non-Hereditary 1. Acute Glomerulonephritis (GN) Poststreptococcal GN Hemolytic Uremic Syndrome Henoch-Schoenlein Purpura 2. Chronic Glomerulonephritis 1. Primary Glomerulonephritis Minimal Change Disease* Focal Segmental Glomerulosclerosis Mesangioproliferative GN Membranous GN Membranoproliferative GN 2. Secondary Glomerulonephritis Berger (IgA) Nephropathy Goodpastures Nephropathy SLE Nephropathy Wegeners Nephropathy Diabetic Nephropathy Renal Vein Thrombosis Sickle Cell Disease 2. Tubulointerstitial

18. Advanced Search Evaluating proteinuria in Children. MAHMOUD LOGHMANADHAM, MD, University ofUtah School of Medicine, Salt Lake City, Utah, Mechanisms of proteinuria. http://www.aafp.org/afp/981001ap/loghman.html

Advanced Search Articles Departments Patient Information Evaluating Proteinuria in Children MAHMOUD LOGHMAN-ADHAM, M.D., University of Utah School of Medicine, Salt Lake City, Utah A patient information handout on proteinuria, written by the author of this article , is provided on page 1158. Proteinuria is a common laboratory finding in children. It can be identified as either a transient or a persistent finding and can represent a benign condition or a serious disease. A rapid but qualitative assessment of proteinuria can be made using dipstick or sulfosalicylic acid methods. More precise quantitation is obtained by measuring protein excretion in 24-hour urine samples or by calculating the protein/creatinine ratio in random urine samples. Orthostatic proteinuria is a benign condition characterized by the presence of protein in urine samples collected in the upright position during the day and its absence in samples collected in the supine position. Persistent proteinuria and proteinuria associated with hematuria or other signs of renal disease carry a more severe prognosis. The latter conditions require referral to a pediatric nephrologist for further evaluation, which may include renal biopsy. M ost healthy children excrete small amounts of protein in their urine, representing so-called physiologic proteinuria.

19. Hypertension Online Slides - Proteinuria, Albuminuria, Hypertension Index of Slide Contents. SLIDE LIBRARY. Search proteinuria Results 45. The DualSignificance of proteinuria. Clinical Trials in Hypertension and Renal Diseases. http://www.hypertensiononline.org/slides2/slide01.cfm?q=proteinuria

20. Hypertension Online Slides - Proteinuria, Calcium Channel Blocker, Hypertension Comparison of Antihypertensive Regimens on proteinuria. Clinical Trialsin Hypertension and Renal Diseases. albuminuria antihypertensive http://www.hypertensiononline.org/slides2/slide01.cfm?tk=3&pg=4

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