Urine protein “+” number is much suddenly, how should kidney friend be good?These four cases should be solved separately
Zhou Xun kidney internal medicine director doctor urine protein “+” number is through urine analysis (urine routine) examination discovery, go to the hospital when checking or return visit, nephrotic patient will check urine routine.In patients with stable kidney disease, urine protein was generally negative (-) or maintained (± or +) at each urine routine examination, and the results of 24-hour quantitative urine protein assay were mostly less than 0.15g or less than 0.3-0.5g or less than 1.0 g.In general, the results of each examination showed that urinary protein levels were in the normal range or not too high.This is important because low levels of urinary protein can help stabilize kidney function in the long term and slow the progression of chronic kidney disease.On the other hand, if a patient’s urinary protein level is consistently high, it will accelerate the progression of chronic kidney disease and gradually deteriorate kidney function.So, urine protein “+” number suddenly much rise, how should kidney friend be good?As follows the occurrence of this situation, a lot of kidney disease friends may encounter.The first thing you need to know is what’s going on here.1. Higher urine protein of this kind of situation is very common, especially in patients with blood on an empty stomach, liver and kidney function and other laboratory tests in order to do, need patients don’t eat breakfast, at the same time, nor drink water or drink a little water, this time the patient’s urine in a condensed state, work out the urine is dark yellow, more in general more yellow thicker than usual.At this time for a routine urine test, the result must be much more urine protein “+”, which is originally “-“, “+” or “2 +”, was “+” into a “2 +” or “3 +”.However, the results of further 24 hour urine protein quantification did not change much.This is the false elevation of urinary protein.There is no need to adjust medication or change treatment regimen when there is false elevation of urinary protein.2. Transient elevation of urinary protein is also more common, especially in patients with fatigue, staying up late and high protein diet.After routine urine tests, the number of urine protein “+” increased, and the 24-hour urine protein level was also higher than before, but there were no significant changes in other indicators of the patient.There is no need to adjust medications or change treatment regimes. however, patients should correct unhealthy lifestyle and eating habits immediately.That is to say, those who are tired should rest well, those who stay up late should go to bed early and not stay up late, those who eat high protein diet should change to normal protein diet or low protein diet, and so on.Generally speaking, as long as the adjustment is good, the patient’s high urine protein will come down.You can’t just add drugs or change your treatment.3. Urine protein went up really high this kind of circumstance is not uncommon also, but be not kidney disease had a relapse truly, what meaning?IgA nephropathy, for example, or nephrotic syndrome (including small lesions and membranous nephropathy, etc.), after a cold or upper respiratory tract infection, check urine protein “+” in, more further assay 24 hours urinary protein quantitative is also rising, but, 24-hour urine protein increased not too much, IgA nephropathy patients has risen to 0.8 grams of urine protein,Patients with nephrotic syndrome whose urinary protein level is not elevated to 3.5 g, or patients with nephrotic syndrome whose urinary protein level is elevated to 3.5 g but whose plasma albumin is not below 30g/L or whose plasma albumin is not decreased, etc., are not considered recurrent nephropathy.At this time, as long as active anti-infection and symptomatic treatment, the increased urinary protein in most patients can be reduced, which may take 1-2 weeks.Generally speaking, also cannot add medicine casually or change treatment plan.4. Kidney disease is in the state of recurrence, this situation is certainly some, urine protein “+” number suddenly more up, further test 24 hours urine protein quantitative is also significantly increased.For example, the 24-hour urine protein level of IgA nephropathy patients increased from less than 0.3 g to more than 1.0 g.For example, in patients with nephrotic syndrome, the 24-hour urine protein level increased from the normal range to more than 3.5g and the plasma albumin was lower than 30g/L.Not only that, some patients also appear other accompanying symptoms, such as edema, little urine, nausea, vomiting and limb weakness.The occurrence of these situations, all suggest kidney disease really recrudesce.Kidney disease recrudescence, some and inducement related, some and no inducement, but with drug reduction related.Solution: those with inducement should first treat or correct the inducement, such as the infected person actively treat the infection, and then consider adding drugs or reformulating the treatment plan; those without inducement should directly add drugs or reformulate the treatment plan.Hormone dependence may be considered, as well as immunosuppressants (e.g., tacrolimus) or biologics (e.g., rituximab).Patients with kidney disease who have stopped taking drugs for a long time may consider using a previously unused treatment regimen, such as changing to a “hormone + cyclophosphamide” based treatment regimen, and so on.In conclusion, the administration of drugs as soon as possible can alter the treatment to allow the kidney disease to go into remission.In summary, it is found that urinary protein “+” number suddenly more up, kidney patients must further do the relevant examination and analysis of the disease, can not see “+” number more than that kidney disease has recurred.If the recurrence is true, must be in the treatment of the doctor under the guidance of a new treatment plan, but not their own medicine or change.With the same name “kidney first” wechat public number synchronous first, the article for Zhou Xun original.Shall not be reproduced without authorization.