Protein leakage in urine: importance of urinalysis

The possibility of chronic kidney failure, as dialysis and kidney transplant patients increase around us, makes many people worry, “How are my kidneys, may I have to undergo dialysis one day?” The most striking feature of the disease is its insidious course and the hospitalization of the person one day with the last drop. Suddenly, the fact of dialysis can fall like a bomb on a person’s life, or rather his entire family. However, in order to answer this question, physicians start by having a simple urinalysis before undertaking extensive research. Because only our kidneys, from our organs in our body, give us a report about their work by expelling a product we call urine. For this reason, the coincidental finding of any finding in the urine leads the person to the above-mentioned anxiety rightly. The most effective and reliable urinary finding in showing the presence of kidney damage is proteinuria, that is, the presence of protein in the urine.
WHAT IS PROTEINURIA?
Around 150mg of protein is excreted in the urine per day. This amount is not detected in simple urine examinations in routine use. At young ages, before the age of 30, proteinuria, which we call postural proteinuria, can be seen almost all during active times of the day (daytime), never exceeding 1 gm per day. This is a physiological state. However, such cases may sometimes have to be investigated and explained by a specialist doctor whether they are a symptom of another kidney disease (Military school examinations or similar situations) and even need to be followed up to the age of 30. Some proteinuria may also be seen transiently or intermittently in febrile conditions and heart failure. Usually, if there is a proteinuria above 300 mg per day, it can be detected in routine urinalysis.
The examination method, which we call complete urinalysis, is a cheap but very safe important research method. In this method, it is possible to detect urine findings with a semi-numeric expression between 1+ and 4+ by means of a test tool we call proteinuria, and the indicators working with the color index on it. The numerical value of the daily excretion of proteinuria, which is easily detected in a random urine sample, is very important. This amount can even be useful in estimating the type of disease. In addition, higher daily protein excretion suggests a more unfavorable course, except for one type of disease (minimal lesion disease). In general, proteinuria of 500mg or more in the daily urine is perceived as significant proteinuria, especially when it exceeds 1gm. Especially 3 gm and more daily protein excretion means more albumin loss due to its small molecule, which causes a decrease in the amount of albumin in the blood since it is an unmet loss. As a result, fluid accumulation in all parts of the body (legs, abdomen, pleural cavity), ie edema, is observed. We call this condition nephrotic syndrome. Nephrotic syndrome is always the disease of the functional organ of the kidney, which we call the nephron, the part of the kidney that we call the glomeruli, which consists of capillaries, we call such diseases glomerulonephritis.
These diseases, which have many types, cause other complaints besides edema. The most important thing is that a significant part of these diseases end with kidney failure (high urea) when treatment cannot be performed. If proteinuria is detected in a simple urinalysis, daily urine should be collected and a daily amount should be determined. Kidney biopsy should be performed in a nephrology clinic in the early and active period and before kidney failure develops, especially if it progresses with daily proteinuria of 1 gm or more. It is important to determine the type of glomerulonephritis by examining this part with special methods in a nephropathology laboratory. These diseases are the diseases that develop as a result of the inflammatory reaction initiated by the antibody-antigen complexes formed by the immune system that protects our body by developing a reaction against itself (auto-immune) by settling in the kidneys. For this reason, it will require the use of some immunosuppressive drugs for a while or continuously. These treatments may have successful, partially successful or unsuccessful results, which vary according to each type of glomerulonephritis and may differ from patient to patient. But it should be underlined that – many patients learn about their disease at the point they have to undergo dialysis – the only way to get a chance for an early treatment is to simply have a complete urinalysis and detect the presence of proteinuria, which is the most reliable indicator of kidney damage.