Evaluation of proteinuria: which method is best?
Detection of proteinuria is always a significant clinical event; even small amounts of protein in the urine are usually associated with some form of renal disease. Furthermore, a persistently high level of proteinuria is a direct marker for the presence of severe underlying kidney pathology. It has also been shown that once detected, efforts to reduce the level of proteinuria may help to slow the rate of disease. Proteinuria may be caused by a variety of pathologies and once detected must be appropriately evaluated. Testing the urine for the presence of protein is easily undertaken in clinical practice and hence is amenable as a screening test in the general population and for those who are at particular risk of renal failure. Many different methods exist for the quantifying of protein in the urine and the question therefore to be answered is which screening test is the most appropriate for general use? This was the subject of a retrospective study undertaken by Methven and colleagues in Scotland. The case notes of over 5000 patients with chronic renal disease who attended a nephrology …