Clinical significance of qualitative urine protein;
Urine protein positive is both physiological and pathological, and its positive degree varies with the degree of renal damage.
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Absolutely proportional. Patients with diabetes continue to have positive urinary protein. Besides urinary tract infection and primary nephropathy, the diagnosis of diabetic nephropathy should be considered. Some experts believe that proteinuria in the early stage of diabetic nephropathy is intermittent and positive only after labor or exercise. Therefore, the detection of urine protein after exercise has certain significance for the early detection of diabetic nephropathy.
Clinical significance of urinary protein quantification;
(1) The normal reference value of 24-hour urine protein quantification is 10 ~ 150 mg. If it is 150 ~ 500mg, it is microalbuminuria, and > 500mg is clinical proteinuria. Microalbuminuria suggests that it is necessary to control blood sugar for a long time in the early stage of diabetic nephropathy, which is of certain significance to reverse or delay the occurrence and development of nephropathy and retinopathy.
(2) The normal reference value of urinary albumin excretion rate (uAE) is less than 65438 0.5 μ g/min. In the early stage of diabetic nephropathy, the glomerular basement membrane was slightly damaged, so only a small amount of albumin leaked out. The uAE of early diabetic nephropathy is 15 ~ 200 μ g/min, and that of clinical diabetic nephropathy is > 200μ g/min. It is reported by experts that almost 100% of diabetic nephropathy patients with obvious proteinuria have diabetic retinopathy. When the uAE30 of diabetic patients is 30 μ g/min, it may be a critical moment to prevent and treat diabetic microvascular complications. After strict control of blood sugar, urinary albumin in early diabetic nephropathy can be reversed or partially reversed. At present, radioimmunoassay is commonly used to determine microalbuminuria.
What is urinary protein? Is there protein in the urine of normal people?
Urine protein is detected by the turbidity of urine after acidification and heating. Normal people usually excrete 40-80mg of protein from urine every day, and the upper limit is 150mg, which is called physiological proteinuria. Because the amount is small, the routine test is negative, and it is abnormal proteinuria if it exceeds 150mg/ day. Under the conditions of strenuous exercise, heavy physical labor, emotional excitement, supercooling, overheating and stress, the amount of urine protein can increase, which is called transient proteinuria and can return to normal within hours or days.
Common sense of urine test in patients with nephropathy
Problems needing attention in urine retention test;
Time of urine collection: Routine laboratory examination can be carried out at any time when urine is discharged. Generally, patients with kidney disease are required to get up in the morning for the first urine test, so as to observe the results before and after.
Urine volume for inspection: generally 5 ~ 10 ml, and if urine specific gravity is to be measured, it should be no less than 50ml.
Urine samples should be taken from the middle urine: that is, a part of urine should be discharged and discarded to wash away the bacteria left at the urethral orifice and anterior urethra, and then the middle urine should be taken for inspection.
Care should be taken not to bring non-urinary components into urine: for example, female patients should not mix leucorrhea with menstrual blood, and male patients should not mix prostatic fluid.
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Information:
Urinary albumin
Judging renal and urinary tract abnormalities by protein content.
Major diseases such as nephritis, nephrotic syndrome, nephrosclerosis and urinary tract infection. When the normal value [qualitative examination] is negative (-) and [quantitative examination] is lower than 100 mg per day.
What kind of inspection?
○ What is urinary protein
There is often a quantitative protein in the blood, which is indispensable for human life activities. Part of protein will be filtered into the urine in the renal fibroids, but it will be absorbed in the renal tubules and returned to the blood.
Therefore, if the function of the kidney is normal, there is only a small amount of protein in the urine, but when there is a problem with the kidney and catheter, a large amount of protein will leak out and become proteinuria. This urine protein test is called urine protein test.
○ Matters that can be understood in this inspection.
There are two methods to check urine protein: qualitative and quantitative. Qualitative examination is to put reagent or test paper into urine, and check whether there is proteinuria according to the degree of discoloration. Quantitative examination is to examine the amount of protein contained in urine in one day. From these tests, we can know whether there is any obstacle to renal function.
Normal value and its change
○ Healthy people also excrete some urine proteins.
Healthy people also have a very small amount of urine protein, but as long as the test paper does not change color, it is normal to be negative (1) in qualitative examination.
In addition, the amount of urine protein below 100 mg belongs to the normal range.
In addition, even if the body is barrier-free, as long as there is strenuous exercise, cold, high spirits and great pressure, urine protein will appear.
A suspected abnormal disease.
○ Suspected positive and positive are abnormal.
When the qualitative examination is suspected to be positive (+-) or positive (+), it is considered as an abnormal value.
In addition, in the quantitative inspection, the daily value exceeding 100 mg is an abnormal value.
Some diseases are caused by the kidney itself, and some are caused by reasons other than kidney diseases.
○ Proteinuria caused by reasons other than kidney disease.
Proteinuria caused by reasons other than kidney disease is mostly benign. When you get well, proteinuria disappears.
[Thermal proteinuria] When the fever caused by diseases such as colds reaches above 38 degrees Celsius, proteinuria will occur.
[Standing proteinuria] When young people bend forward in the spine and press the blood vessels in the kidneys, proteinuria will occur. If left untreated, it will disappear automatically around the age of 30.
[Congestion kidney] Urine protein will appear when renal vein is congested, such as heart failure, but after the congestion disappears, the protein will also disappear.
○ proteinuria caused by nephropathy
When protein appears every time you have a urine test, it is obvious that you have kidney disease.
[Nephritis] Acute nephritis or chronic nephritis, the amount of urine protein in a day ranges from a small amount to dozens of grams.
[Nephrotic syndrome] One day's urine will produce more than three grams of excessive urine protein. When the symptoms are severe, protein oozing from urine will reduce the concentration of protein in blood. In addition, there are cases caused by diabetic nephropathy, acne and collagen disease.
[Nephrotic sclerosis] With nephrosclerosis caused by essential hypertension, the amount of urine protein will decrease, mostly below 300 mg.
In addition, multiple myeloma, systemic lupus erythematosus, chronic rheumatoid arthritis, gout, edema and other mercury poisoning and lead poisoning diseases will also appear urine protein.
What should I do when there is an abnormal value?
○ A diagnosis cannot be made by one examination.
When urine protein appears in the first examination, it must be checked again. When there are still abnormalities in the re-examination, urine sediment, red blood cell count and white blood cell count are needed. And it is also necessary to accurately check the kidneys and urinary tract, and then combine the systemic symptoms to diagnose whether there is kidney disease or other diseases. When you have kidney disease, you should do other renal function tests and make a comprehensive diagnosis.
○ The basic treatment lies in diet therapy.
When you are diagnosed with urinary tract infection such as cystitis, pyelonephritis, nephritis and nephropathy, you must keep calm and take medicine according to the doctor's advice.
When it is diagnosed as nephritis or nephropathy, renal function examination must be accepted. When the test results are not good, it is necessary to limit exercise and implement diet therapy. The treatment of renal insufficiency is basically dietotherapy, which shows that dietotherapy is very important. We must follow the doctor's advice and control the intake of salt and protein within one day.