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Evaluation and Epidemiology of Proteinuria

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Proteinuria: Basic Mechanisms, Pathophysiology and Clinical Relevance

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Abstract

Proteinuria is a strong and independent predictor of increased risk of kidney disease progression and cardiovascular morbidity and mortality. Urinary excretion of protein >150 mg a day is considered to be a marker of kidney damage and to significantly increase the risk of progression to end stage renal disease. Epidemiological studies, however, suggest that excretion of as little as 10 mg/day of protein in the urine is associated with increased risk of kidney failure. There are several methods for measuring protein or albumin excretion in the urine including the spot urine protein-to-creatinine ratio (UPCR), the urine albumin-to-creatinine ratio (UACR), the urine dipstick and the 24 h urine collection. Of these, the 24 h urine collection is considered to be the gold standard. Proteinuria may be transient or persistent. While transient proteinuria is almost always benign, persistent proteinuria may be due to several different causes including primary glomerular diseases and systemic disorders that damage the kidneys.

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Abbreviations

AASK:

African-American Study of Kidney Disease and Hypertension

ACE-I:

Angiotensin converting enzyme inhibitor

AKI:

Acute kidney injury

ARB:

Angiotensin receptor blocker

CRIC:

Chronic Renal Insufficiency Cohort

eGFR:

Estimated glomerular filtration rate

ERAs:

Endothelin receptor antagonists

ESRD:

End stage renal disease

FSGS:

Focal segmental glomerulosclerosis

MDRD:

Modification of Diet in Renal Disease

NHANES:

National Health and Nutrition Examination Survey

RAA:

Renin angiotensin aldosterone system

RAS:

Renin angiotensin system

REIN:

Ramipril Efficacy in Nephropathy

UACR:

Urine albumin-to-creatinine ratio

UPCR:

Urine protein-to-creatinine ratio

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Authors and Affiliations

  1. Division of Renal Diseases and Hypertension, University of Colorado Denver, 12700 E 19th Ave., C281, Aurora, CO, 80045, USA

    Judith Blaine

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  1. Judith Blaine
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Correspondence to Judith Blaine .

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  1. Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado, USA

    Judith Blaine

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Blaine, J. (2016). Evaluation and Epidemiology of Proteinuria. In: Blaine, J. (eds) Proteinuria: Basic Mechanisms, Pathophysiology and Clinical Relevance. Springer, Cham. https://doi.org/10.1007/978-3-319-43359-2_1

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