Creatinine

acut-off rule

This Indicator Shows Proteinuria Exactly, But Most Kidney Patients Do not Know

2018-05-01 03:57

As one of the most important indicators in the early stage of chronic kidney disease (CKD), proteinuria is directly related to your treatment method. But there are still a lot of renal patients who are strange to it.

It is not that you do not know proteinuria, but not understand it, especially not know how to observe proteinuria. One of the most obvious feature is the use of + to determine the therapeutic effect.

 

This Indicator Shows Proteinuria Exactly, But Most Kidney Patients Do not Know

In the past two months, a renal failure patient was admitted to the hospital. After checkups, he had gone into uremia stage. But what surprised me was that no treatment was received before admission.

When asking him, he said:

“I had nephritis years ago, and proteinuria was 2+. After a period of treatment, proteinuria remained at 2+. I thought it was ineffective. Since chronic nephritis is incurable, I stopped the medications.”

I analyzed his lab report. After medicine, his urinary protein quantity decreased, which proved that his treatment took effect. But the patient did not know that, and stopped the medications without asking his doctor’s advice. Not until shortness of breath and weakness caused by uremia occurred did he realize that his disease got worse and he had to live on dialysis to maintain life.

This Indicator Shows Proteinuria Exactly, But Most Kidney Patients Do not Know

One month ago, another renal patient consulted me:

“half month ago, my urinary protein was 1+. Now it increases to 2+. What medicine can I take? What to do?”

Persistent proteinuria 2+ can cause kidney damage, so I asked him: “Have you checked your urinary protein quantity?”

He answered: “Last time my albumin quantity was over 600mg, now it is over 200.”

Such obvious improvements ignored. If this patient stopped the medicine due to the increased +, he may regret so much when his disease goes into uremia.

Afterwards I told him that his effect was very good and he should continue to use the medicine as planned. Last week, his albumin had dropped to less than 100mg, close to the standard of clinical cure.

 

This Indicator Shows Proteinuria Exactly, But Most Kidney Patients Do not Know

How to treat proteinuria correctly?

All the urinary protein indexes are prioritized. Higher-priority indicators are more accurate, more reliable and more meaningful than those with lower priority.

From KDIGO guidance, we can see that urinary albumin/creatinine ratio is the highest priority and the most reliable, while automatic reading test paper and manual reading test paper credibility is low. Therefore, if there is + in urine protein, it can only indicate that what state your kidneys are in. It can not be used as the basis for evaluating the proteinuria and your illness condition.

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