Papper S
Postgrad Med. 1977 Sep;62(3):125-30. doi: 10.1080/00325481.1977.11714612.
Patients with asymptomatic proteinuria have varied reasons for the proteinuria and travel diverse courses. In the individual with normal renal function and no systemic cause, ie, idiopathic asymptomatic proteinuria, the outlook is generally favorable. Microscopic hematuria probably raises some degree of question about prognosis. The kidney shows normal glomeruli, subtle changes, or an identifiable lesion. The initial approach includes a clinical and laboratory search for systemic disease, repeated urinalyses, quantitative measurements of proteinuria, determination of creatinine clearance, protein electrophoresis where indicated, and intravenous pyelography. The need for regularly scheduled follow-up evaluation is emphasized. Although the initial approach need not include renal biopsy, a decline in creatinine clearance, an increase in proteinuria, or both are indications for biopsy and consideration of drug therapy.
无症状蛋白尿患者出现蛋白尿的原因各不相同，病情发展也多种多样。对于肾功能正常且无全身性病因的个体，即特发性无症状蛋白尿，预后通常较好。镜下血尿可能会对预后产生一定程度的疑问。肾脏表现为肾小球正常、细微改变或可识别的病变。初始检查方法包括临床和实验室检查以寻找全身性疾病、多次尿液分析、蛋白尿定量测定、肌酐清除率测定、必要时进行蛋白电泳以及静脉肾盂造影。强调需要定期进行随访评估。虽然初始检查方法不一定包括肾活检，但肌酐清除率下降、蛋白尿增加或两者兼有都是进行活检和考虑药物治疗的指征。
