PROTEINURIJA: DIJAGNOSTIČKA STRATEGIJA BAZIRANA NA ODREĐIVANJU RAZLIČITIH PROTEINA MOKRAĆE

Abstract

Basal glomerular membrane represents mechanical and electrical barrier for passing of the plasma proteins. Mechanical barrier is composed of cylindrical pores and filtration fissure, and negative layer charge in exterior and interior side of basal glomerular membrane, made of heparan sulphate and sialoglicoproteine, provides certain electrical barrier. Diagnostic strategy based on different serum and urine proteins enables the differentiation of various types of proteinuria. Depending on etiology of proteinuria it can be prerenal, renal and postrenal. By analyzing albumin, α₁-microglobulin, immunoglobulin G and α₂-macroglobulin, together with total protein in urine, it is possible to detect and differentiate causes of prerenal, renal (glomerular, tubular, glomerulo-tubular) and postrenal proteinuria. The adequate and early differentiation of proteinuria type is of an immense diagnostic and therapeutic importance.

Keywords: proteinuria, α₁-microglobulin, albumin, immunoglobulin G, α₂-macroglobulin, cystatine C, diagnostic strategy