Approach to the Patient with Non-nephrotic Proteinuria
2020
Abstract This chapter reviews the approach to the patient with non-nephrotic
proteinuria. The definition and prevalence of
proteinuriaare considered.
Proteinuriais important because it has implications for progression of chronic
kidney disease(CKD) and increased cardiovascular risk. The type of
proteinuriamay provide important diagnostic clues to the etiology of CKD. Evaluation includes review of the
urine sediment, serological evaluation, and
renal biopsyif appropriate. Lifestyle modification and antagonism of the renin–angiotensin–aldosterone system form the
cornerstoneof
conservative managementfor all patients with proteinuric
kidney disease. Immunosuppressive therapy may be indicated, depending on the etiology of the patient's renal disease. Additional specific therapies to reduce
proteinuriaand slow progression of CKD are eagerly awaited.
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