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MN580 Unit 9 response 1 Haley

MN580 Unit 9 response 1 Haley

Question Description

I’m working on a nursing discussion question and need an explanation and answer to help me learn.

Please respond to discussion below and 1 interactive question.

Proteinuria is basically a broad term used to describe protein in the urine. The pathophysiology of this can relate to different principles such as glomerular, tubular, secretory, or overflow.  Glomerular proteinuria is due to increased filtration of macromolecules across the glomerular wall. Tubular proteinuria occurs when there is an increase excretion of filtered low molecular weight proteins due to impaired reabsorption by the proximal tubules. Secondary proteinuria is from over secretion of proteins in the tubules. Overflow proteinuria occurs when plasma concentrations of low molecular weight proteins exceed the capacity of the tubules to absorb the filtered protein and is the most common cause in children (Leung et al., 2017).  This finding causes a disturbance in the kidney function and can relate to early kidney disease. Across the population the prevalence of proteinuria is 8-33% (Haider & Aslam, 2022). Many patients do not present with symptoms, but some clinical features include recurrent urinary infection, family history, weight loss, polyuria, hematuria, fever, and abdominal pain. This is commonly found due to an incidental finding on a urine dipstick or urinalysis (Bökenkamp, 2020). Once detected further evaluation is necessary to rule out the cause and differential diagnosis to provide proper management. Treatment and management are focused on the underlying cause of proteinuria. The first line test is a 24-hour measurement of urine to evaluate protein excretion. The normal amount of protein in a child is less than 100mg per day (Leung et al., 2017). Laboratory test, imaging studies, and a renal biopsy mat be ordered if abnormal findings persist. A patient may require referrals to nephrologist, immunologist, endocrinology, cardiologist, neurologist, social workers, and case management for appropriate management. Differential diagnosis can include infection, malignancies, dehydration, recently physical exertion, emotional distress, drug-induced nephropathy, and cardiac failure (Haider & Aslam, 2022). 

Reference

Bökenkamp, A. (2020). Proteinuria—take a closer look!. Pediatric Nephrology, 35(4), 533-541.

Haider, M. Z., & Aslam, A. (2022). Proteinuria. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK564390/

Leung, A. K. C., Wong, A. H. C., & Barg, S. S. N. (2017). Proteinuria in children: Evaluation and differential diagnosis. American Family Physician, 95(4), 248–254.