What is pyuria + it’s significance?
Pyuria: WBCs in the urine - indicates inflammation (not just infection)
What are the regions of protein regulation in the nephron?
-Glomerulus: filtration barrier (size + charge selectivity)
-PCT: ~95% of filtered protein is reabsorbed
-Secretion: Tamm-Horsfall protein is secreted into the renal tubules, forms casts
What prevents albumin from being filtered at the glomerulus?
Albumin is (-) charge and podocyte foot processes have polyanions to repel it
What is considered abnormal proteinuria
> 150 mg/day
What are the 3 etiologies of protein in the urine
-Tubular interstitial: glomerulus is normal but the PCT can’t reabsorb proteins (primary htn, atherosclerosis)
-Glomerulus: due to damage to podocytes, basement membrane, or mesangium of the glomerulus
-Overflow: there is an excess of abnormal proteins - filtration exceeds reabsorption (myeloma)
Determining the etiology based on the quantity of proteinuria
<2 g/day: - tubular interstitial (htn, atherosclerosis)
>2 g/day: always glomerular
>3.5 g/day: nephrotic syndrome (low albumin + edema)
How to quantify proteinuria?
-Urine albumin:Cr
-Urine protein:Cr
-24hr urine collection
Gross hematuria is usually what colour in nephrologic vs urologic disease?
Nephrologic: brown (cause or urokinase)
Urologic: red/pink
Proliferative vs non-proliferative GN
Proliferative: hematuria + proteinuria, increased cells on biopsy
Non-proliferative: proteinuria w/o hematuria, abnormalities of the filtration barrier on biopsy (BM or podocytes)
