Proteinuria

Proteinuria - allocation of protein in the urine. The healthy kidney protein in blood plasma is passed in the urine in small quantities and conventional methods not defined. Proteinuria occurs kidney disease (principally, jade), disorders of the circulation (congestive kidney)and with feverish infectious diseases, skull injuries, epileptic fits. In some cases, proteinuria may be caused by inflammation of the urinary tract. Proteinuria may occur in healthy people after considerable physical strain, cool, strong emotions and some children only in a vertical position (orthostatic proteinuria). The term "hypertensive" (the urine albumin) is not exact, because with urine excreted globulin and albumin.

Proteinuria (proteinuria; protein + GK. uron - urine) - allocation of protein in the urine. Urine protein generally contains no or very little. Albuminuria - allocation of urine albumin. More widely used the term proteinuria"as with urine usually identified not only albumin, and globulins.
There are kidney and vnepochechny proteinuria. When kidney proteinuria protein penetrates into the urine from the blood, the number varies in rather wide limits. When proteinuria, due to organic lesions of the kidneys, the protein content reaches sometimes (e.g. when nephrosis) 120 per thousand. Proteinuria in non-renal origin due to adulteration urine inflammatory exudate, products of cellular decay and secrets when passing through a modified urinary tract (zistopielit, urethritis, vulvovaginitis, decaying tumors and so on); the amount of protein rarely exceeds 1 PPT.
Kidney proteinuria is more often associated with organic lesions of the kidneys [nephritis, nephrosis, nephrosclerosis, acute renal failure, polycystic, infection (fever albuminuria), heart failure (congestive kidney)].
The onset of renal p. is the mechanism of the so-called clubockova-tubular circuit protein in the kidney. In norm the glomeruli miss protein particles with a molecular weight of up to 70 000. While glomerular filtrate in norm contains negligible amounts of protein, about 25-30 mg%, due to the very large volume of urine per day (170-180 l), in a cavity capsules glomeruli gets very significant amount of protein (42-55 g). Healthy kidney does not emit this protein in urine, and he absorbed back into the blood tubules. Increasing the concentration of protein in the blood plasma or increased penetration of protein through clubockova filter (in connection with increase its permeability) with a constant value clubockova filtering leads to an increase in the number of protein coming from makeshift urine to the bone. If this so-called filtration charge exceeds the maximum reabsorbtion ability tubular epithelium, protein excreted in the urine.
Urine with kidney proteinuria contains the same protein fraction, as the serum, but their value is volatile and is not always corresponds to the ratio them in the blood serum. Electrophoretic there are two groups renal proteinuria: ordinary and paraproteinemia. Among ordinary proteinurii there are three type - NS, serum and mixed. With nephrotic type in the urine lot of albumin and A1-globulins, little A2 - and especially ' -globulin, attitude A1-globulin to A2-globulin back available in serum, i.e. it increased in favor with A1-globulin. When serum type the ratio of protein fractions in the urine is almost the same as in the serum, the ratio A1-globulin to A2-globulin biased in favor A2-globulin. When mixed type attitude A1-globulin to A2-globulin in the urine is the same as with nephrotic type, in addition, there is an increase in ' -globulin.
If paraproteinemia occurring at different paraproteinemia (myeloma and other), in the urine is often only one fraction of the protein (the so-called M-fraction), which is located on europroteome between b - and V-globulins and occasionally in the field of a-globulin. This group consists of pathological proteins and belongs to the group of proteins Bence-Jones (see Bence-Jones protein).
The so-called functional kidney proteinuria benign, very quickly pass; on the mechanism of occurrence does not differ from organic renal proteinurii. They can occur when bathing in cold water, abundant protein diet, palpation of the kidneys, physical fatigue (March proteinuria), etc. To these proteinuria applies the so-called orthostatic (lordotic) proteinuria, more common in children.
The amount of proteinuria in various diseases of the kidney does not indicate the severity of suffering, but it should be borne in mind that significant losses of protein in urine cause Hypo - and dysproteinemia that was of primary importance in the development of edema.

Proteinuria in children. Proteinuria in children occurs for the same reasons as adults. Children age peculiar to the following types of proteinuria. The so-called physiological albuminuria is observed in the majority of newborns in the first weeks of life. The root cause is not clear. In the urine may contain up to 0.3 PPT protein without other changes. The forecast is favorable, the treatment of such proteinuria is not required.
Orthostatic proteinuria (lordotic, adolescence, youth) meets OU-7% of children aged 5-15 years; at the end of the growth of the child disappears. Usually detected by chance, mostly girls asthenic physique with instability of the nervous system, vasomotor lability and usually lordosis nizhnegnutov and lumbar spine.
Diagnosis by examining urine collected after a 15-minute standing with lodosianus spine (up to sample the child should urinate). When orthostatic proteinuria has scant sediment in the urine; the addition to urine acetic acid causes the precipitation in cold special protein that is missing when nephritis and nephrosis. Orthostatic proteinuria not require treatment; recommended for long stay on the air, a careful physical education, General gently.
More seriously need to orthostatic proteinuria in the presence of chronic infections (tonsillitis, adenoids, tinuity, carious teeth), when it may be the first manifestation of kidney damage; in these cases the necessary rehabilitation centers. In the period of recovery when nephrite can be observed orthostatic albuminuria. In such cases shows the treatment of nephritis and elimination of lordosis by assigning corrective exercises.