Résimont G, Gadisseur R, Lutteri L, Krzesinski J M, Cavalier E, Delanaye P
Service de Néphrologie, Dialyse, Transplantation rénale, Université de Liège, CHU de Liège, Belgique.
Département de Chimie clinique, Université de Liège. Chef de Service, CHU de Liège, Belgique.
Rev Med Liege. 2018 Oct;73(10):519-525.
The measurement of proteinuria is a very simple tool to screen and manage kidney diseases. Its predictive role is also relevant from a cardiovascular point of view. However, the interpretation of the results is not always easy. Indeed, there are several different methods to detect or measure proteinuria (or albuminuria), varying from the measurement on a 24-hour urine collection to the simplest detection with dipsticks or measurement on a random urine sample. Some methods are measuring total proteins, whereas others are measuring more specifically albuminuria. For all methods, pitfalls exist and will be discussed. A positive result must be confirmed by a quantitative measurement on 24-hour collection or on a first morning sample (this last one can only be interpreted as a ratio to urinary creatinine excretion). Lastly, we will briefly discuss the management of a patient with a new diagnosis of proteinuria (or albuminuria).
蛋白尿的检测是筛查和管理肾脏疾病的一种非常简单的工具。从心血管角度来看,其预测作用也很重要。然而,结果的解读并不总是那么容易。确实,有几种不同的方法来检测或测量蛋白尿(或白蛋白尿),从24小时尿液收集测量到用试纸条进行最简单的检测或随机尿样测量不等。一些方法测量的是总蛋白,而其他方法则更专门地测量白蛋白尿。对于所有方法,都存在陷阱并将进行讨论。阳性结果必须通过24小时收集或首次晨尿样本的定量测量来确认(最后一个只能解释为与尿肌酐排泄的比值)。最后,我们将简要讨论新诊断为蛋白尿(或白蛋白尿)患者的管理。