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Macroalbuminuria

Approach to Proteinuria in Adults and Elderly

Approach to Proteinuria in Adults and Elderly

Teaser: 

Fatemeh Akbarian, MD, Research Fellow, University of Toronto, Toronto, ON.
Hatim Al Lawati, MD, FRCPC, Cardiology Resident, Division of Cardiology, Faculty of Medicine, University of Toronto, Toronto, ON.
Mohammad Ali Shafiee, MD, FRCPC, General Internist, Nephrologist, Department of Medicine, Toronto General Hospital, University Health Network; Clinician Teacher, University of Toronto, Toronto, ON.

Abstract
Proteinuria can create one of the greatest challenges in primary practice, especially in the geriatric population. It is typically detected by dipstick urinalysis, an ordinary, non-invasive test. Proteinuria is frequently a marker of unsuspected kidney disease, progressive atherosclerosis or a systemic disease. There is a strong correlation between urinary protein excretion and progression of renal failure. Furthermore, Proteinuria is a strong and independent predictor of increased risk for cardiovascular disease and death, especially in people with diabetes, hypertension, chronic kidney disease, and the elderly. This article will review the clinical significance of proteinuria in adults, especially in the elderly population, and provide a practical diagnostic approach in addition to a summary of non-specific antiproteinuric therapy.
Keywords: Proteinuria, Microalbuminuria, Macroalbuminuria, elderly, Risk Factor.