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PROTEIN IN URINE _ PROTEINURIA
Normally, proteins move through the blood and only a very small amount is filtered by the kidneys in the urine as most protein molecules are larger than the glomerular filtration holes, so there is little or no urine in the urine of the protein.
However, sometimes due to a number of reasons such as overwork, excessive exercise, or illness, the amount of protein in the urine may temporarily increase. When the body stops tiring or recovers from illness, the aforementioned phenomenon of protein in the urine stops and the urine returns to normal, with no or very little protein.
So when protein levels are consistently high, it’s probably a sign of kidney disease and a condition known as proteinuria, also known as proteinuria. The presence of protein in the urine is an important sign of kidney damage as well as possible kidney problems.
How to recognize proteinuria?
Usually, people with proteinuria have no noticeable symptoms. Proteinuria is usually detected during routine urine tests.
And, as the cause of proteinuria worsens and the urine is elevated, the patient may notice signs and symptoms such as:
- Urinate several times
- Urinate with lots of foam
- Urine with blood
- Tired and shallow breathing
- Nausea and possibly vomiting
- Swelling of the face, abdomen, feet, ankles
- Pockets around the eyes, especially in the morning
- Anorexia
- Cramps at night
- etc …
If the protein level in the urine is too high, it can mean that the disease is serious, the patient may have nephrotic syndrome. At this time, water collects in the body causing swelling of the ankles, fingers, face, around the eyes … And if it is more serious, the patient may have symptoms such as swelling. legs and back, swelling of the abdomen and difficulty breathing.
In addition, the patient may also experience other symptoms which are not mentioned here. Therefore, if you have any symptoms that suggest that your kidneys are having problems, see your doctor immediately for a timely examination and treatment.
WHEN TO GET TESTED FOR PROTEINURIA?
You should have a proteinuria test when:
- Have kidney disease, decreased kidney function
- Have high blood pressure
- Have diabetes
- You suffer from cardiovascular diseases, such as coronary heart disease, heart failure, etc.
- Have systemic lupus erythematosus
- A member of your family has kidney disease
- There is blood in the urine
- Pregnant
DIAGNOSTIC TESTS FOR PROTEINURIA
The diagnosis of proteinuria can be based on qualitative and quantitative 24-hour urine tests for proteinuria. I would like to review so that you can imagine some of the most popular diagnostic testing methods today:
Qualitative method
Qualitative by “urine burn” method: Containing urine in a test tube and burning it on an alcohol lamp, the protein in the urine will coagulate at high temperature, making the urine cloudy and visible to the eye. naked eye.
Quantification by method of freezing with sulfosalicylic acid: In addition, because the protein has a property of coagulation in acidic medium, one can drop 3% of sulfosalicylic acid in the urine and observe the coagulation of the protein in the urine. this to detect the presence of proteinuria.
Semi-quantitative method
It is the method most commonly applied today, especially to meet the needs of screening for kidney disease in the community.
These test strips are impregnated with tetrabromophenol citrate (pH3), which changes color in the presence of protein in the urine. This reaction detects proteins in amounts as low as 150-200 mg / L.
Based on the degree of color change of the test strip from the standard color chart, it is possible to identify the level of protein in the urine.
Quantitative methods
This is the method that gives the most accurate results, of course not only qualitatively the presence or absence of protein in the urine, but also the quantification of the protein it contains with specific and precise numbers.
The medical staff will guide the patient to collect urine for 24 hours. After collecting the urine, the patient will take it to a medical facility for the medical staff to measure the urine protein. This method accurately quantifies the amount of protein in urine over 24 hours, helping physicians guide the diagnosis and treatment of patients.
Proteinuria electrophoresis method:
The above methods can only tell if and how much protein is in the urine to know if the proteinuria condition is severe or mild.
However, the proteinuria electrophoresis method can also help determine the components of protein in the urine, thus knowing the cause of the disease, the location of the damage, and the kidney’s function to help the doctor determine the cause, and for proper treatment.
Quantitative method of microalbuminuria by radioimmunoassay technique:
This is a method using the quantitative technique of radioimmunoassay – Micro Albumin, based on the principle of competitive binding, allowing the in vitro quantification of Micro Albumin in human urine.
Kidney biopsy method:
Sometimes a doctor needs to do a kidney biopsy, in which a very small part of the kidney tissue is taken under a microscope to look for the cause of proteinuria.
A kidney biopsy is done when there is insufficient clinical and other laboratory data to determine the nature of the disease. The results of a kidney biopsy are the standard for detecting kidney damage that helps doctors evaluate the results, make an accurate diagnosis, and optimize treatment.
WHAT CAUSES PROTEINURIA?
Proteinuria can be caused by a variety of factors, some of which do not cause kidney damage, and others that are caused by kidney damage by various diseases.
Causes of proteinuria but not kidney damage :
The causes include overwork, excessive exercise, posture (the level of protein in the urine increases with standing), exposure to extreme cold, fever, stressful mental states, etc. can cause mild proteinuria. At this time, the disease often appears on its own, without being accompanied by other symptoms such as high blood pressure, red blood cells, etc.
However, if this is the case, you should also monitor closely and return to the doctor immediately if there are any abnormal signs.
Possible causes of protein-related kidney disease:
- Kidney diseases, such as nephrotic syndrome, glomerulonephritis, kidney infection, etc.
- Hypertension, diabetes, heart failure, pericarditis.
- Goodpasture syndrome – an autoimmune syndrome of alveolar hemorrhage and glomerulonephritis caused by circulating anti-glomerular basement membrane (anti-GBM) antibodies.
- Amyloidosis – a rare disease that occurs due to the buildup of a substance called amyloid in the organs. Amyloid is an abnormal protein that is synthesized in the bone marrow and can be deposited in any tissue or organ.
- Granulomatosis (also known as sarcoidosis) is an overgrowth of inflammatory cells in various parts of the body, leading to inflammatory organ disease – most commonly in the lungs, lymph nodes, blood, eyes, and skin.
- Rheumatoid arthritis, lupus.
- Blood diseases such as multiple myeloma, cancerous diseases …
- Immune system disorders, etc.
RISK FACTORS FOR PROTEINURIA:
First, let’s say proteinuria can occur at any age, gender, or race.
However, the following factors can also increase your chances of developing proteinuria:
- The types of diseases mentioned in the section on causes above
- Age of the elderly. People over 65 are particularly at risk of proteinuria
- Family history of kidney disease
- Pregnancy, preeclampsia
- Injured
- Poisoned
- Infected
- Prolonged use of certain drugs such as NSAIDs (ibuprofen, naproxen, diclofenac, celecoxib, mefenamic acid, etoricoxib
- indomethacin, high-dose aspirin …)
TREATMENT OF PROTEINURIA
Proteinuria is not a specific disease. Treatment will therefore depend on identifying and treating the cause. Determining the right cause will help doctors direct and treat the right and most effective one.
- Mild proteinuria does not need to be treated, but it should still be examined and monitored periodically and regularly.
- Proteins caused by kidney disease require aggressive treatment to prevent chronic kidney disease.
- Cases of proteinuria caused by diseases such as hypertension, diabetes, etc. should be given appropriate treatment to prevent kidney damage that causes proteinuria.
There are two commonly used medicines for diabetes and high blood pressure that you can refer to, namely:
- Angiotensin converting enzyme inhibitors (‘angiotensin converting enzyme’), which work against constricted blood vessels and high blood pressure. Most drug names in this class end with the ending “pril”, such as captopril, enalapril, etc.
- Angiotensin receptor blockers – work against vasoconstriction, which narrows blood vessels in the body, causing high blood pressure. Commonly used angiotensin receptor blockers are losartan, telmisartan, irbesartan, valsartan, olmesartan, candesartan, azilsartan, …
CAN PROTEINURIA BE PREVENTED?
It is not simple and easy with just a few small steps or tips that can permanently prevent proteinuria.
However, we can also control this disease by minimizing the risk factors for the disease.
For example, some important metrics are:
- Reduce the amount of salt in the diet each day
- Always drink enough water for the body
- Control the diet appropriately, which is particularly low in fat and especially saturated fat, animal fat and trans fat.
- Exercise with assiduity and regularity with subjects adapted to the physical condition of each one
- And, it is necessary to have regular and regular check-ups to detect diseases and have the best treatment measures.
