Is urinary protein leakage necessarily a kidney disease?

Urinary protein positive is a common clinical manifestation of kidney disease. Proteinuria is known as 24-hour urinary protein quantitation exceeding 150 mg or urinary protein/creatinine ratio (PCR) greater than 100 mg/g. 24-hour urinary albumin excretion was between 30 and 300 mg for microalbuminuria. However, is urinary protein leakage necessarily a kidney disease?

Is urinary protein leakage necessarily a kidney disease?

The leakage of urine protein is both pathological and physiological.

In addition to the pathological proteinuria, pathological proteinuria also has a dramatic increase in the pathological state of certain protein components of the human bloodstream, leading to the glomerular filtration of the protein to exceed the reabsorption capacity of the renal tubules and the overflow of the urinary protein.

The physiological proteinuria is a result of the body under stress, which is generally a transient, not a disease state, and less likely to be a kidney disease. Visible not all positive urine protein is necessarily kidney disease.

Pathological proteinuria includes renal proteinuria and spilled proteinuria.

Renal proteinuria is pided into glomerular proteinuria, renal tubular proteinuria, and renal tissue proteinuria. Glomerular proteinuria is mainly albumin leakage, renal tubular proteinuria is mainly small proteinuria, mostly β2 microglobulin, lysozyme, etc., renal tissue proteinuria is more common in kidney and after urinary tract infection, and renal tumors caused by the increase in protein secretion in the kidney tissue, leakage from the urine. The overflow of proteinuria is mainly due to multiple myeloma, crush injury, hemolysis and other urinary light chain protein, myoglobin, hemoglobin and other small and medium molecular weight proteins increased.

The physiological urinary protein leakage common in the human body heat, after strenuous exercise, the occurrence of a proteinuria. There is also a special type of proteinuria, orthostatic proteinuria, commonly seen in adolescents with developmental stages, proteinuria in erect or lordotic postures, disappearance of urinary protein in supine position, and urinary protein typically less than 1 g/day. .

In addition, although a few interstitial renal lesions and occult nephritis are also kidney diseases, there is no leakage of urine protein, and a small number of allergic purpura nephritis may cause kidney damage in the case of urinary protein negative.

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