Question 2: What are the symptoms of proteinuria? Many patients with proteinuria are asymptomatic, and some people will have an increase in vesicular I in urine, which will last for a long time. Proteinuria is the most common clinical manifestation and one of the earliest detectable indexes of urinary system diseases. There is a small amount of protein in the urine of normal people, the content of which is less than 200mg/24h, which can not be detected by general urine protein qualitative methods. When the quantitative urine protein is more than 200mg/24h, the routine qualitative test of urine protein is positive, which is called proteinuria. Normal glomerular filtration membrane can selectively filter plasma proteins, which can effectively prevent most plasma proteins from filtering from glomerulus, and only a very small amount of plasma proteins enter glomerular filtrate. When the kidney is sick, the permeability of glomerular filtration membrane increases, which makes a lot of protein filtered into glomerular filtrate, far exceeding the reabsorption capacity of renal tubules, and protein enters the final urine and causes proteinuria. This reason is more common in primary or secondary glomerular diseases, renal circulatory disorders, hypoxia and so on. Urinary protein can be as small as 10g per day, and most of them are > 2g/24h urine, and albumin is the main one. Renal tubular reabsorption dysfunction, decreased protein reabsorption in glomerular filtrate, also causes proteinuria, which is common in glomerular interstitial diseases caused by various reasons, such as pyelonephritis, analgesic nephropathy, antibiotic nephropathy, heavy metal poisoning, congenital polycystic kidney disease and various congenital renal tubular diseases. The content of this kind of proteinuria is generally less than 2g/24h urine, mostly around 1g/24h urine, with small molecular weight protein as the main component and less albumin. There are also factors affecting protein filtration: ① protein molecular size: the three-layer structure of glomerular capillary wall has a mechanical barrier effect on plasma protein, and the greater the protein molecular weight, the less or no filtration; ② protein charged: Normal glomerular filtration membrane is negatively charged, which constitutes an electrostatic barrier. Based on the principle that like charges repel each other, protein with negative charge has the lowest clearance rate, while protein with positive charge has the highest clearance rate. When glomerular diseases occur, negatively charged sialic acid components in glomerular filtration membrane are obviously reduced, which makes negatively charged albumin easy to filter and form proteinuria. ③ The shape and variability of protein; ④ Hemodynamic changes.
Question 3: What are the manifestations of high urinary protein? Many people suffer from nephritis. Nephritis with proteinuria. Suffering from nephritis, the performance is not obvious, many patients do not know, and a few patients will have hematuria and proteinuria. Only when the patient changes from oliguria to polyuria and the blood pressure returns to normal can the intake of salt and water be appropriately increased. ? Let's ask the professor to explain it for us! ? In terms of hematuria and proteinuria, these nouns are more concise and easy to cause misunderstanding. Is hematuria just blood in the urine? Is proteinuria just protein in urine? Is this right or wrong? Yes, it is because this is the case in practice. Wrong, it is because we know very little about two abnormal situations in practice. Generally, we think hematuria refers to visible blood in stool, while proteinuria is even more vague. ? Combined salt intake is one of the methods to eliminate edema. Therefore, patients can't put salt (that is, salt-free diet) and soy sauce for three meals a day. Salty food such as pickles, salted eggs and bacon. Not edible, only flavored with sugar and vinegar. When oliguria occurs, patients often swallow hyperkalemia, so they can't eat foods with high potassium content such as bananas, oranges and oranges. Stem vegetables (such as celery, water bamboo, etc. ), high potassium content, should also be fasting. Patients with nephritis sometimes get worse unconsciously, which is caused by the patient's failure to do a good job in health care, but the patient himself did not pay attention to what caused it. In fact, most of this situation is caused by uncontrolled diet, such as salt intake and protein intake. These factors are all factors that can aggravate the disease. ? Therefore, it is necessary to plan the diet of patients with nephritis reasonably. When and how much salt, protein and water you need are strictly needed, rather than eating whatever you want. I hope that the majority of patients can pay attention to this. The incidence of cardiomyopathy in patients with chronic nephritis is also high. Hypertension and arteriosclerosis reduce pressure load, leading to centripetal hypertrophy of left ventricle. Anemia, fluid load and arteriovenous fistula increase the volume load, leading to left ventricular hypertrophy with dilatation. These abnormal changes in cardiac planning prevent ventricular shortening and diastolic function. ? The above is the professor's relevant analysis. In addition to timely medical treatment and bed rest, diet control is also very important. The professor suggests that you choose standard hospitals and experienced doctors for diagnosis and treatment. The diet of patients with acute nephritis should not only ensure the nutritional needs, but also try to reduce the burden on the kidneys and promote the remission of the disease. Therefore, the key to diet is to limit protein, salt and water. For more information, please click on the online professor to inquire!