How does albuminuria return a responsibility

summary

It can be seen in patients with multiple myeloma (Ben Zhou protein in urine), myoglobinuria with severe crush injury, lysozyme urine in myeloma and monocytic leukemia. As a more complex disease, how can urinary protein return a responsibility?

How does albuminuria return a responsibility

Reason 1: glomerular filtration of plasma protein, glomerular filtration membrane from inside to outside by capillary endothelial cells, glomerular basement membrane and renal vesicle visceral layer epithelial cells.

The second reason is that the capillary wall of normal glomerulus is negatively charged, so it is not easy for negatively charged proteins to leak out, which is called electrical barrier function. The function of basement membrane is very important. It has been suggested that the reduction of negative charge of glomerular wall fixation will not only lead to a large number of proteins entering the urinary cavity, but also make the larger molecular substances accumulate in the mesangium, and even affect the circulating immune complexes and make them deposit on the glomerular basement membrane.

The causes of low molecular weight of glomerular lysozyme, albumin, myoglobin, transferrin, etc. There may be less than 30 mg / min protein in urine, but it is almost completely reabsorbed by renal tubules; when the glomerular basement membrane is damaged, the basement membrane thickens, the pores increase, the protein leakage increases, or the renal tubule lesions, and the protein resorption capacity decreases, both of which can cause the increase of proteinuria.

matters needing attention

Warm reminder: according to the type of proteinuria and different conditions, different standard doses of protein diet should be used. For patients with nephritis, it can be supplied according to the normal demand, 0.8-1.0 g / kg per day for adults. It is recommended that patients choose proteins with high physiological value, such as eggs, milk, fish, lean meat, etc. For patients without nephrotic syndrome without renal function impairment, high protein diet can be provided, with protein of 1.5-2.0 g / kg per day for adults, and high quality protein can be provided. For patients with increased plasma urea nitrogen, low protein diet is generally appropriate.