How should the diagnosis of proteinuria

Proteinuria (Proteinuria) are typical symptoms of chronic kidney disease , the causes of proteinuria and glomerular barrier function has a close relationship . Glomerular capillary structure composed of three layers , respectively from inside to outside the endothelial cell layer , the base layer and the epithelial cell layer. Because of this there are three cells are distributed filter pore sizes and a negative charge, so the glomerular capillary barrier function can be divided into two types , namely mechanical barrier - the filter holes and charge barrier - a negative charge.
( A ) physical
Note edema and effusion cases , bone joint inspection, the degree of anemia , heart, liver , kidney and signs checks. Fundus examination, fundus normal or mild acute nephritis vasospasm , arteriosclerosis, chronic nephritis, retinal hemorrhage , exudation , often occurs in diabetic retinal diabetic nephropathy .
(B ) history
According to the different causes of proteinuria should be focused questioning history , such as edema , hypertension occurrence , history of diabetes, history of allergic purpura , kidney damage drug use history , the history of heavy metal poisoning salts, as well as the history of connective tissue disease , metabolic disease and gout episode .
(C ) special examination of urinary protein from
Common urine protein electrophoresis tests, can distinguish between selective and non-selective proteinuria proteinuria . Multiple myeloma examination of urine protein electrophoresis typing help, can be divided into the following five types : chat. IgG, IgA, IgE, IgD type . Urinary protein radioimmunoassay is a qualitative method of urine , when urine negative, may show positive radioimmunoassay , the drawback of false positive rate. Radioimmunoassay determination of urinary β2-mg early diagnosis of renal tubular dysfunction more helpful .
(D ) laboratory tests
Urine protein checks can be divided into qualitative and quantitative inspection and special inspection.
A qualitative examination is best morning urine , morning urine most concentrated and may exclude orthostatic proteinuria. Qualitative examination only screening , daily urine output 2000ml qualitative ' +' urine than 400ml of urine protein characterized as " + ' by many, it is not an accurate indicator of urinary protein content . The diagnosis of kidney disease , observation of the disease, the efficacy of the judgment should be based on urinary protein excretion is appropriate.

2 more urine protein screening method , there are pasteurized , double reduction dolphin law , phosphotungstic acid method , a read acid , ferric chloride method to reduce dolphin double the most accurate method most commonly used . 24h urine protein 1g less fewer opportunities glomerular disease , a common cause of pyelonephritis and renal sclerosis, urinary tract obstruction , urinary tract tumors and calculi. The most common cause of urinary protein 1 ~ 3g is a primary or secondary glomerular diseases. 24h urinary protein found in 3.5g or more primary or secondary nephrotic syndrome.