A common symptom for kidney disease-proteinuria

Proteinuria is a common symptoms for kidney disease patients,So today I want to tell you some basic knowledge about proteinuria
Any abnormal proteinuria is a significant risk factor for both renal disease and for cardiovascular morbidity and mortality. Unlike haematuria, proteinuria almost always has a renal origin. Management should include
Quantitate albumin/creatinine or protein/creatinine ratio (ACR or PCR)

Test for haematuria

Measure serum creatinine and eGFR
The risk of renal failure is greater in younger patients. The risk of dying from heart disease is greater in older patients. Risks may be altered by therapy.

How to measure it

Measurements should not be make during an acute illness or menstruation
ACR/PCR is more reproducible and generally useful than 24h collections
Units are mg/mmol (mg protein: mmol creatinine)
A PCR of 100, or ACR of 70, is approximately equal to 1g of protein per 24h. Below this level the conversion is non-linear.

In patients with diabetes

Microalbuminuria (ACR>2.5/3.5)* is an indication for
treatment with ACE inhibitors (or Angiotensin receptor blockers if those are not tolerated), with titration up to full dose irrespective of initial blood pressure: more information on treatment with ACEIs and ARBs
Plus control of hypertension to target (more info)

Good glycaemic control

ACR or PCR and serum creatinine should be measured annually

If you want to know more about proteinuria you can send me an e-mail:
kidney.hospital.china@gmail.com