Core IM | Internal Medicine Podcast #10 Albuminuria: 5 Pearls segment
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Feb 28, 2018 Discover the ins and outs of albuminuria with five essential pearls! Learn about the effectiveness of dipstick tests versus more reliable urinalysis methods. Explore the conditions leading to transient proteinuria and the importance of timely rechecks. Uncover who should be screened for albuminuria and its link to cardiovascular mortality. Delve into how increased RAAS inhibition can enhance renal outcomes, and get tips on prescribing oral iron for better absorption. This episode is packed with vital insights for improving kidney health!
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Limitations of Dipstick and UA
- Dipsticks miss most moderately increased albuminuria (30-300 mg/day).
- Urinalysis has low sensitivity (43%) for moderate proteinuria.
Accurate Proteinuria Screening
- Use a urine albumin-creatinine ratio (UACR) for accurate proteinuria screening.
- Confirm positive random UACR with an early morning sample within three months.
Transient Proteinuria
- Orthostatic proteinuria, present when standing but absent when supine, is more common in younger individuals.
- Repeat proteinuria tests rule out transient causes like exercise, fever, or UTIs.