Implicancia de la Proteinuria en el Diagnóstico y Seguimiento de la Enfermedad Renal Crónica

摘要: Chronic kidney disease (CKD) is a clinical entity secondary to multiple etiologies, characterized for being still in early stages and, without an adequate treatment, it frequently follows progressive course that leads irreversible failure of the organ function and requires substitute treatment (dialysis or renal transplant). CKD risk factor cardiovascular (CV); this most frequent complication, including principal cause death these patients. The two prevalent causes are diabetes mellitus arterial hypertension. constitutes problem Public Health, not only because its potential need dialysis transplant long run, but also co-morbidity implicated from initial stages. Our Scientific Professional National Societies have recommended, previous document published 2010, evaluation be estimated by means glomerular filtrate index (GFI) formula, taking into account measure plasmatic creatinine. For our societies, recommended formula adults MDRD (Modification Diet Renal Disease). In one, parameter measured determination creatinine blood; although recient opinions highlight superiority CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration), particularly when slightly affected. Anyway, despite which best used, image functional condition at specific time, accumulated evidences offer little no possibility knowing evolution situation. persistent presence increased concentrations protein albumin urine signal injury constitutes, together with GFI, strategy on both diagnosis prediction rely on. order determine loss proteins urine, test strips samples taken ramdom first morning 24-hours were used depending It depends whether we performing population screening, specialized diagnostic confirmation, monitoring classic new antiproteinuric strategy. should highlighted use screening total has already been evaluated different means. These compared precision strip 24-hour populations high prevalence proteinuria. However, results show variable sensitivity specificity. That why majority practice guides suggest confirmation positive result quantitative measure. On other hand, semiquantitative based immunological nonimmunological procedures capable detecting small (the mean limit detection 20 mg/l). Moreover, negative predictive value concentration define albuminuria. Taking concepts mentioned above, those cases considered necessary evaluate amounts 4 Documento de Consenso: Implicancia la Proteinuria en el Diagnostico y Seguimiento ERC urinary ratio albumin/creatinine requested; preferably urine. Each situation preferential handlings methodologies, try perform existing Albumin/Creatinin Protein/Creatinin children, children control sphincters. referred minimize errors volume hydration status patient. will expressed mg/g, else mg/mmol, types units each laboratory. decimals (mg/g) one decimal (mg/mmol). If processed same day their obtainment, stored temperatures between 2 °C 8 7 days. advisable quit terms microalbuminuria macroalbuminuria, replace them instead albuminuria, as continuous risk. This provides general updated vision role proteinuria CKD.