Does proteinuria mean nephritis? A comprehensive inspection is still needed

Many people find proteinuria 1+ during routine checkups, and then they become very worried, fearing that they have nephritis. In fact, nephritis can cause proteinuria, but the presence of proteinuria does not mean it is nephritis. Relevant examinations should be done, and if nephritis is confirmed, it should be treated in time.

1. Does proteinuria mean nephritis?

In fact, there are many factors that lead to proteinuria 1+, so proteinuria 1+ does not necessarily mean nephritis. Let's listen to the experts' explanation! Experts said that as a common nephritis, one of the causes of proteinuria is nephritis. Proteinuria is also one of the important indicators for evaluating the treatment effect of nephritis. However, the amount of urine protein cannot explain the severity of nephritis, and it cannot be used as a criterion for judging the quality of renal function. A comprehensive analysis must be conducted in combination with clinical symptoms and other renal function tests to make a correct judgment. ① Clinically, some types of nephritis only have hematuria as the main manifestation without proteinuria. ② The amount of urine protein is not completely consistent with the severity of renal pathological changes. For example, in minimal change nephropathy, the clinical manifestation is massive proteinuria, but the pathological changes are normal under light microscopy and negative under immunofluorescence. Only electron microscopy shows fusion of the foot processes of glomerular epithelial cells. The patient responds well to corticosteroid treatment and has a good prognosis. ③ In the terminal stage of kidney disease, glomeruli are sclerotic, functional renal units are lost, and glomerular filtration rate decreases. At this time, proteinuria actually decreases. ④ When the plasma protein concentration decreases significantly, the 24-hour urine protein quantity may also decrease.

2. Nephritis examination method

(1) Routine urine examination.

(2) Routine blood examination.

Acute nephritis may cause mild anemia, the hemoglobin is generally not less than 10 grams/100 ml, and the white blood cell count is generally normal. However, in the early stages of streptococcal infection or combined bacterial infection, the white blood cell count may increase and the neutrophil count may rise. The erythrocyte sedimentation rate increases and can reach 30-60 mm/hour.

(3) Renal function test.

Most patients may experience a transient decrease in creatinine clearance and an increase in creatinine and urea nitrogen. After treatment, people can usually return to normal quickly.

(4) Ultrasound or CT examination.

In some patients, enlarged kidneys may be seen.

(5) Other special examinations.

Some patients with acute nephritis have increased antistreptolysin "o" titers, increased serum circulating immune complexes, and increased fibrin degradation products (PDP) in the blood or urine. Serum total complement (cH, o) and complement C, decreased.