Grauer Gregory F
Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
Top Companion Anim Med. 2011 Aug;26(3):121-7. doi: 10.1053/j.tcam.2011.04.002.
Proteinuria is a general term that describes the presence of any type of protein in the urine (e.g., albumin, globulins, mucoproteins, and Bence-Jones proteins); however, albumin is the predominate protein in urine in healthy dogs and cats as well as dogs and cats with renal disease. Proteinuria can arise from several different physiologic and pathologic causes, but persistent proteinuria associated with normal urine sediment is consistent with kidney disease. The urine dipstick colorimetric test is the usual first-line screening test for the detection of proteinuria, but false-positive reactions are common. When proteinuria of renal origin is suspected, the next diagnostic steps are quantitation and longitudinal monitoring via the urine protein/creatinine ratio. The recent availability of a species-specific albumin enzyme-linked immunosorbent assay technology that enables detection of low concentrations of canine and feline albuminuria has both increased diagnostic capability and stimulated discussion about what level of proteinuria/albuminuria is normal. Beyond being an important diagnostic marker, proteinuria is associated with kidney disease progression in both dogs and cats: the greater the magnitude of the proteinuria, the greater the risk of renal disease progression and mortality. Treatments that have attenuated proteinuria in dogs and cats have also been associated with slowed kidney disease progression and/or improved survival. For these reasons, screening for renal proteinuria and longitudinal assessment of renal proteinuria has recently received renewed interest.
蛋白尿是一个通用术语，描述尿液中存在任何类型的蛋白质（例如白蛋白、球蛋白、粘蛋白和本周氏蛋白）；然而，在健康的犬猫以及患有肾脏疾病的犬猫中，白蛋白是尿液中的主要蛋白质。蛋白尿可由多种不同的生理和病理原因引起，但与正常尿沉渣相关的持续性蛋白尿与肾脏疾病一致。尿试纸比色法检测是检测蛋白尿常用的一线筛查方法，但假阳性反应很常见。当怀疑是肾源性蛋白尿时，接下来的诊断步骤是通过尿蛋白/肌酐比值进行定量和纵向监测。最近出现的一种物种特异性白蛋白酶联免疫吸附测定技术，能够检测低浓度的犬猫白蛋白尿，这既提高了诊断能力，也引发了关于正常蛋白尿/白蛋白尿水平的讨论。除了作为一个重要的诊断标志物外，蛋白尿在犬猫中都与肾脏疾病进展相关：蛋白尿程度越高，肾脏疾病进展和死亡的风险就越大。在犬猫中减轻蛋白尿的治疗方法也与减缓肾脏疾病进展和/或提高生存率相关。由于这些原因，肾性蛋白尿的筛查和肾性蛋白尿的纵向评估最近重新受到关注。
