Fixed Proteinuria

Chapter 520 Fixed Proteinuria



Priya Pais, Ellis D. Avner



Persons found to have significant proteinuria on a first morning urine sample on 3 consecutive days (>1+ on dipstick with urine specific gravity >1.015 or protein : creatinine ratio >0.2) have fixed proteinuria. Fixed proteinuria indicates renal disease and may be caused by either glomerular or tubular disorders.



520.1 Glomerular Proteinuria



Priya Pais, Ellis D. Avner



The glomerular capillary wall consists of 3 layers: the fenestrated capillary endothelium, the glomerular basement membrane, and the podocytes (with foot processes and intercalated slit diaphragms). Glomerular proteinuria results from alterations in the permeability of any of the layers of the glomerular capillary wall to normally filtered proteins and occurs in a variety of renal diseases (Table 520-1). Glomerular proteinuria can range from <1 g to >30 g/24 hr.



Table 520-1 CAUSES OF PROTEINURIA


TRANSIENT PROTEINURIA


Fever

Exercise

Dehydration

Cold exposure

Congestive heart failure

Seizure

Stress

ORTHOSTATIC (POSTURAL) PROTEINURIA


GLOMERULAR DISEASES CHARACTERIZED BY ISOLATED PROTEINURIA


Idiopatic (minimal change) nephrotic syndrome

Focal segmental glomerulosclerosis

Mesangial proliferative glomerulonephritis

Membranous nephropathy

Membranoproliferative glomerulonephritis

Amyloidosis

Diabetic nephropathy

Sickle cell nephropathy

GLOMERULAR DISEASES WITH PROTEINURIA AS A PROMINENT FEATURE


Acute postinfectious glomerulonephritis

Immunoglobulin A nephropathy

Henoch-Schönlein purpura nephritis

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Jun 18, 2016 | Posted by in PEDIATRICS | Comments Off on Fixed Proteinuria

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