Nowak Albina, Serra Andreas L
Klinik und Poliklinik für Innere Medizin Universitätsspital Zürich.
Praxis (Bern 1994). 2013 Jun 19;102(13):797-802. doi: 10.1024/1661-8157/a001340.
Proteinuria is frequently found by general practitioners and is a possible sign of kidney disease. The insidious nature of many kidney diseases that develop without overt symptoms emphasize the clinical importance of urine analysis, both in screening and in monitoring of kidney pathology. Early detection of kidney disease plays a key role in preventing and progression of kidney disease. Thus, general practitioner can greatly contribute to early recognition and assessment of renal disease. Proteinuria may be benign or suggestive of glomerular disease. Patients with persistent proteinuria should be referred to a nephrologist for decisions regarding further management including renal biopsy. The standard urine dipstick detects only albumin and is not sensitive enough to detect non-albumins. Estimation of daily protein excretion using the total protein-to-creatinine ratio widely replaced the 24-hour urine measurement.
蛋白尿常被全科医生发现,可能是肾脏疾病的一个迹象。许多隐匿性肾病在没有明显症状的情况下发生,这凸显了尿液分析在筛查和监测肾脏病理方面的临床重要性。早期发现肾脏疾病在预防和控制肾脏疾病进展中起着关键作用。因此,全科医生对肾脏疾病的早期识别和评估可做出巨大贡献。蛋白尿可能是良性的,也可能提示肾小球疾病。持续性蛋白尿患者应转诊至肾病科医生处,以决定进一步的管理措施,包括肾活检。标准尿试纸仅能检测白蛋白,对检测非白蛋白不够敏感。使用总蛋白与肌酐比值估算每日蛋白质排泄量已广泛取代了24小时尿蛋白测定。