The most obvious symptom of proteinuria

The most obvious symptom of proteinuria is the abundance of foam. Of course, this is a more intuitive feeling for ordinary people. Proteinuria is divided into functional proteinuria, postural proteinuria and pathological proteinuria. For example, proteinuria may occur after strenuous exercise, when the body has a fever, or after eating some protein foods. This is a relatively normal phenomenon.

1. Functional proteinuria Functional proteinuria is a mild (24-hour urine protein quantity generally does not exceed 0.5-1 gram), temporary proteinuria. The proteinuria disappears rapidly after the cause is removed. It often occurs in young and middle-aged people, and can be seen after mental stress, severe cold or heat, long-distance marches, strenuous physical labor, congestive heart failure, and eating a high-protein diet.

2. Postural proteinuria: There is no protein in the urine in the morning, but proteinuria gradually appears after getting up and moving around. The protein content in the urine increases when standing, walking or strengthening the lordotic posture for a long time. The protein content in the urine decreases or disappears after lying down for 1 hour. It often occurs in young people or adults with a slender body shape. Recurrent postural proteinuria requires the exclusion of renal disease, such as the nutcracker phenomenon (also called left renal vein compression syndrome, which is caused by compression of the left renal vein by the aorta and superior mesenteric artery).

3. Pathological proteinuria : Proteinuria persists, the protein content in the urine is high, and routine urine examination often shows hematuria, leukocyturia and tubular urine. It may also be accompanied by other manifestations of kidney disease, such as hypertension, edema, etc. Pathological proteinuria is mainly seen in various glomerular and tubulointerstitial diseases, hereditary kidney diseases, renal vascular diseases and other kidney diseases. Common ones include: (1) Primary glomerular disease ① Nephritis can be latent, acute, rapidly progressive or chronic. It is often accompanied by hematuria, hypertension and edema. ② The 24-hour urine protein quantity of nephrotic syndrome is greater than or equal to 3.5 grams, accompanied by decreased blood albumin, edema, and hyperlipidemia. ③ Renal insufficiency is divided into acute and chronic renal insufficiency. Proteinuria is a sign of kidney damage.

(2) Secondary glomerular diseases ① Lupus nephritis is a manifestation of systemic lupus erythematosus involving the kidneys. It is more common in women of childbearing age. Depending on the severity of kidney involvement, the amount of protein in the urine can range from a small amount to a large amount.

(3) In patients with tubulointerstitial diseases such as pyelonephritis and interstitial nephritis, urine protein is usually + to ++, and the 24-hour urine protein quantity is usually < 2 grams. (4) Hereditary kidney diseases such as Alport syndrome, Fabry disease, thin basement membrane nephropathy, congenital nephrotic syndrome, etc., are caused by genetic abnormalities, leading to structural defects of the kidneys and causing varying degrees of proteinuria. (5) Others such as high altitude proteinuria can be seen in people who move from the plains to the plateau. The urine protein is positive, with a quantitative value of >400 mg/24 hours. There was no proteinuria before going to the plateau, but the disease occurs after entering the plateau. The condition improves with oxygen inhalation and returns to normal after returning to the plains.

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