CHEMICAL

EXAMINATION
-
PROTEIN
Asane ladu
Bmlt21102
5th semester
Abnormal
constituent of
urine :
Glucose
Protein
Ketone bodies
Bile salt
Bilirubin
Urobilinogen
Blood
Protein :
- Normally ,kidneys excrete scant amount of protein in urine
- ( up to 150 mg/ 24hrs )

- These proteins include

 Protein from plasma (albumin )
 Protein derived from the urinary tract
 Tamm- Horsfall protein
 Secretory IgA
 Protein from tubular epithelial cells , leucocytes and other desquamated cells .

This amount of proteinuria cannot be detected by routine tests .

Proteinuria :
Pre – renal proteinuria
(overflow proteinuria )

Renal proteinuria

Post renal protenuria

Causes of proteinuria :

- Pre –renal proteinuria (overflow

proteinuria ) :

 Intravascular hemolysis
 Muscle injury
 Infections
 Inflammations
 Multiple myeloma .
Conts …..

Pre-renal proteinuria : increase in level of low molecular weight proteins in plasma

leads to their increased excretion in urine .

When concentration of a low molecular weight protein rises in plasma , it “overflow “

from plasma into the urine .

Such proteins include haemoglobin (intravascular hemolysis ) , myoglobin (skeletal

muscle trauma ) ,acute phase protein ,and bence jones protein .
Causes of renal
Glomerular : Glomerulonephritis , minimal
proteinuria: change disease , diabetes mellitus ,
preeclampsia , strenuous exercise ,
fever ,exposure to extreme cold , orthostatic
or postural proteinuria

Tubular proteinuria : pyelonephritis ,

interstitial nephritis , Fanconi syndrome.
Cont…

Glomerular proteinuria : proteinuria due to increased filtration of

proteins by glomeruli due to changes in glomeruli .

Tubular : proteinuria due to decreased reabsorption of filtered low

molecular weight proteins by renal tubules .
Causes of post renal proteinuria :

Post- renal proteinuria :

inflammation or
neoplasms of lower
urinary tract .
REFERENCES :

Essentials of clinical pathology ,second edition ; Shirish M

Kawthalkar .