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단백뇨 / upc / post renal / pre renal / renal

태조산 2023. 10. 29. 02:05

'https://vetfocus.royalcanin.com/en/scientific/feline-renal-proteinuria

Table 1. Classification and causes of proteinuria and diagnostic testing to consider in the evaluation of cats with proteinuria.FeLV = Feline Leukemia Virus; FIV = Feline Immunodeficiency Virus; FIP = Feline Infectious Peritonitis; ICGN = Immune-complex glomerulonephritis; IRIS; International Renal Interest Society CausesDiagnostic tests

Pre-renal Proteinuria
  • Hemoglobinuria
  • Myoglobinuria
  • Immunoglobulin light chains
  • Complete blood count
  • Biochemistry panel
  • Visualization of the urine supernatant color
  • Urine protein electrophoresis
Functional proteinuria
  • Hypertension
  • Seizures
  • Fever
  • Strenuous exercise
  • Indirect blood pressure measurement
  • Body temperature
Renal proteinuria
ICGN:
 
  • Infectious (FeLV, FIV, FIP)
  • Idiopathic
Non-ICGN:


  • Chronic kidney disease (IRIS stages 1-4)
  • Acute kidney injury
  • Glomerular sclerosis or atrophy
  • Amyloidosis
  • Polycystic kidney disease
  • Renal dysplasia
  • Renal lymphoma or other neoplasia
  • Serum creatinine and/or symmetric dimethylarginine (SDMA) with urine specific gravity
  • Screening test for FeLV and FIV
  • Abdominal ultrasound
  • Renal histology with transmission electron microscopy and immunofluorescence
Post-renal proteinuria
  • Urolithiasis
  • Neoplasia
  • Sterile cystitis
  • Urinary tract infection
  • Urinalysis
  • Urine culture
  • Abdominal radiographs and/or ultrasound
  • Urolith analysis

 

https://todaysveterinarypractice.com/urology-renal-medicine/clinical-approach-to-proteinuria/

BOX 1 Classification and Causes of Proteinuria

Prerenal

  • Multiple myeloma (Bence Jones proteinuria)
  • Rhabdomyolysis (myoglobinuria)
  • Intravascular hemolysis (hemoglobinuria)
  • Drug reactions
  • Acute pancreatitis

Renal

  • Functional
    • Stress, strenuous exercise, fever, heatstroke, congestive heart failure
  • Pathologic
    • Tubular
      • Fanconi syndrome (basenjis, chlorambucil in cats)
      • Copper storage hepatopathy (Labrador retrievers)
      • Nephrotoxins (i.e., aminoglycosides)
      • Acute kidney injury
      • Chronic kidney disease
      • Leptospirosis
  • Glomerular
    • See BOX 2
  • Interstitial
    • Interstitial nephritis (i.e., pyelonephritis)

Postrenal

  • Urinary tract infection
  • Urolithiasis
  • Feline lower urinary tract disease
  • Transitional cell carcinoma
  • Vaginitis/prostatitis
BOX 2 Causes of Glomerular Proteinuria
Vascular
  • Hypertension

Infectious

  • Heartworm disease
  • Ehrlichiosis
  • Lyme disease
  • Leptospirosis
  • Leishmaniasis
  • Trypanosomiasis
  • Hepatozoonosis
  • Babesiosis
  • Anaplasmosis
  • Feline immunodeficiency virus
  • Feline infectious peritonitis
  • Coccidiodomycosis
  • Chronic pyoderma
  • Bacterial endocarditis
  • Schistosomiasis
  • Bartonellosis

Immune-mediated

  • Systemic lupus erythematosus
  • Immune-mediated polyarthritis
  • Inflammatory
  • Pancreatitis
  • Cholangiohepatitis
  • Pyoderma

Neoplastic

  • Lymphoma
  • Leukemia
  • Mast cell tumors
  • Primary erythrocytosis
  • Others

Endocrine/metabolic

  • Hyperadrenocorticism
  • Hyperthyroidism
  • Hyperlipidemia

Drugs

  • Glucocorticoids
  • Trimethoprim-sulfamethoxazole drugs
  • Tyrosine kinase inhibitors (masitinib, toceranib)

Breed-related

  • Renal dysplasia: Alaskan malamute, beagle, Chow Chow, golden retriever, Lhasa apso, miniature schnauzer, Shih Tzu, standard poodle
  • Amyloidosis: Chinese Shar-Pei, beagle, English foxhound, English bulldog, Abyssinian and Siamese cats
  • Membranous nephropathy: Doberman pinscher
  • Membranoproliferative glomerulonephritis: Bernese mountain dog
  • Immune-complex glomerulonephritis: Brittany spaniel, basenji
  • Type II collagen defect: Newfoundland
  • Type IV collagen defect: Bull terrier, English cocker spaniel, English springer spaniel, Samoyed