Doctor, I have been urinating a lot of foam recently, is there something wrong with my kidneys......
Doctor, why is my urine yellow and thick, is there something wrong with my kidneys......
With the gradual improvement of social health awareness, the names of various kidney diseases such as acute glomerulonephritis, chronic glomerulonephritis, IgA nephritis, occult nephritis, lupus nephritis, diabetic nephropathy, purpura nephritis, etc., have gradually been recognized by the people, and proteinuria is one of the common symptoms of these diseases, which can be further diagnosed by combining the symptoms of patients and laboratory test results.
"Today, let's talk about proteinuria."
What is proteinuria?
Due to the glomerular filtration of the kidneys and the reabsorption of the renal tubules in the urine of normal people, the urine of healthy people contains only trace proteinuria, and the content of protein is very small, and the protein is negative in qualitative examination. When the amount of protein in the urine increases, the results of the general urine routine test can be seen + or ++, the urine protein qualitative test is positive, or the urine quantitative test exceeds 150 mg/24 hours, it is called proteinuria.
Classification of proteinuria
Proteinuria is divided into three categories: pseudoproteinuria, physiological proteinuria, and pathological proteinuria. That is, a positive proteinuria does not necessarily require treatment.
When proteinuria is detected during the examination, it is necessary to first distinguish between the authenticity of proteinuria, then determine whether it is physiologic proteinuria or pathological proteinuria, then evaluate the severity of proteinuria, and finally determine the cause of proteinuria. Based on the quantitative results of protein in the urine over a 24-hour period, proteinuria can be classified as mild, moderate, and severe. When the urine protein content ≥ 3.5 g/24 hours, it is called massive proteinuria.
Pseudoproteinuria is not true proteinuria. This condition can be due to the presence of blood, pus, inflammation, or tumor secretions in the urine, as well as menstrual blood, vaginal discharge, and other substances; or prolonged sitting; Or maybe certain drugs are excreted in the urine. These factors may cause cloudy urine to mimic proteinuria, which may be positive on routine proteinuria. However, after centrifugation or filtration of urine in the laboratory, the results are significantly reduced or even become negative, thus distinguishing pseudoproteinuria.
Physiological proteinuria includes a variety of types, such as functional proteinuria, which occurs in the case of strenuous exercise, fever, high temperature environment, etc., and can disappear once the cause is eliminated; The degree of proteinuria after exercise is affected by the intensity of exercise, and the maximum amount of protein in the urine generally reaches within half an hour after the exercise is stopped; Postural orthostatic proteinuria, which is common in elongated children and adolescents, is also known as the "nutcracker phenomenon."
Pathological proteinuria refers to proteinuria caused by various primary or secondary kidney diseases and hereditary diseases, characterized by persistent and unresolved urine proteinuria, or accompanied by hematuria, edema, hypertension and other manifestations; Simple proteinuria may also be present, without any clinical signs or symptoms, and specialist consultation is recommended.
Precautions for urine protein testing
Urine protein testing usually includes qualitative, quantitative, and special tests.
Qualitative testing is indicated by a "+" and is usually performed using morning urine, but this method is only used as a screening test and cannot be used as an accurate indicator of protein content in the urine.
For more accurate detection of urine protein content, a 24-hour quantitative urine protein test is required, which is more demanding and requires urine retention according to the specifications to obtain accurate results.
There are a few caveats when performing quantitative urine retention for proteinuria. Especially in hot climates, preservatives need to be added to the urine to prevent bacteria from multiplying and affecting the test results. In addition, the container for urine should be tightly capped and can be stored in cold water or in the refrigerator to maintain the freshness of the urine. These measures help ensure the accuracy of quantitative urine protein tests.
In addition to qualitative and quantitative examinations, there are also some special urine protein test methods, such as urine protein electrophoresis, immunofixation electrophoresis, urine protein discoid electrophoresis, etc., which can provide a deeper understanding of the nature and source of urine protein, which helps doctors diagnose and treat kidney diseases more accurately.
Nephrology experts remind
Proteinuria in pregnant women is one of the typical symptoms of "pregnancy-induced hypertension", which is often accompanied by symptoms such as high blood pressure and edema. Proteinuria during pregnancy is a fairly common symptom and usually indicates a serious condition that can lead to hypoxia and life-threatening conditions. Therefore, it is important to have regular check-ups during pregnancy, especially urine samples. If a protein is found to be "+" or the urine protein is more than 300 mg on urinalysis, you should seek medical attention promptly to identify and manage the underlying problem.
Proteinuria is one of the typical symptoms of kidney disease, but the amount of protein in the urine does not always reflect the severity of kidney disease. Even in people with mild chronic kidney disease, a low amount of protein in the urine does not mean that the kidneys are slightly damaged; Similarly, a large amount of proteinuria does not necessarily mean that the kidney disease is severe. The degree of proteinuria is not proportional to the severity of the disease. In patients with mild glomerular lesions, the amount of protein in the urine is not necessarily low.
In conclusion, proteinuria is a complex problem, and its causes and treatment options vary from individual to individual. If proteinuria or other kidney-related problems are suspected, it is advisable to consult a doctor for professional diagnosis and treatment recommendations. Early diagnosis and early treatment are essential to maintain kidney health.
Source: WeChat public account of Beijing Geriatric Hospital
Editor: Liu Jiyue
Review: Pan Huahong, Yan Yan