Proteinuria following Trauma

Abstract

Thirteen trauma patients admitted to a major injuries unit were classified according to their injury severity. Urinary excretion of total protein, albumin and gamma glutamyl transpeptidase (GGT) activity were assessed over the following 6 days. All patients showed an initial glomerular and tubular proteinuria during the first 24 h which subsided by the second post-trauma day. The excretion of total protein and albumin was positively correlated with injury severity. Those patients with the severest injuries showed a marked recurrent total proteinuria around days 3 to 4 post-trauma which exhibited features of a tubular lesion. The recurrent proteinuria peak coincided with peak levels of serum c-reactive protein (CRP).

Prognostic significance of microalbuminuria in non-diabetic patients with acute myocardial infarction

“…Previous studies have shown a pattern of urinary excretion after acute myocardial infarction similar to that found following trauma, surgery and acute pancreatitis [9][10][11]. After an initial high rate of excretion, urine albumin levels fall rapidly towards normal during the week after admission to the hospital [12].…”

Is low proteinuria an early predictor of severity of acute pancreatitis?

“…Urinary albumin and IgG were estimated by automated immuno-turbidimetry9 using rabbit anti-human antisera (Dako Ltd, High Wycombe, England, A001 and A090, respectively) and a Cobas Mira analyser (Hoffman-La Roche, Basle, Switzerland). Median (range) values for urinary albumin and IgG excretion rates in normal subjects were 3-4 (0-2-22-9) and 1-4 (0-2- [4][5] ug/minute, respectively. Polyacrylamide gel electrophoresis of selected urines was performed in sodium dodecyl sulphate buffer using a vertical slab discontinuous system (LKB Instruments Ltd, Croydon, England).'"…”

Monitoring Urinary Orosomucoid in Acute Inflammation: Observations on Urinary Excretion of Orosomucoid, Albumin, α1-Microglobulin, and IgG

“…Temporary proteinuria is present in many acute conditions (1)(2)(3)(4), can be induced by strenuous exercise (5 ), and involves many specific proteins, including albumin and orosomucoid (␣ 1 -acid glycoprotein) (1,5,6 ). Excess excretion of urinary proteins in the absence of renal disease, so-called functional proteinuria (7 ), is a common occurrence, but the pathophysiologic mechanisms responsible for this type of proteinuria are not known.…”

“…Gosling and coworkers (2,8 ) have presented findings indicating that proteinuria occurring 2-4 days after trauma coincides with an increase in plasma C-reactive protein (CRP), and that albuminuria present within 15 min of admission to the intensive care unit (ICU) shows promise as a predictor of outcome. These authors stated that microalbuminuria is a marker of systemic capillary permeability, a view that has been rejected by Molnar and coworkers (9,10 ), who argued that microalbuminuria in the critically ill is an acute marker of an inflammatory insult rather than a marker of generalized capillary leakage.…”