| الوصف: |
Proteinurija predstavlja izlučivanje više od 150 mg proteina u 24 satnom urinu. Radi se o čestom simptomu mnogih primarnih bubrežnih bolesti, ali i mnogih sistemskih bolesti sa zahvaćanjem bubrega. Proteinurija se dalje opisuje kao blaga (manje od 1 g dnevno), umjerena (1-3,5 g dnevno) ili značajna (više od 3,5 g dnevno). Ovim radom je istražena učestalost i vrste proteinurije u odraslih pacijenata kojima je tijekom 2019. u KBC Zagreb učinjena biopsija bubrega. Rezultati su uspoređeni s histološkim promjenama nađenim biopsijom bubrega. U analiziranom razdoblju ukupno su u odraslih učinjene 152 biopsije bubrega; 87(57,24%) u muškaraca i 65(42,76%) u žena. Radilo se o 89(58,55%) biopsija nativnih i 63(41,44%) biopsije transplantiranih bubrega. Proteinurija je nađena u 126(83%) pacijenata, a vodeći simptom bila je u 45(29%) pacijenata. Razine proteinurije su bile više u pacijenata s biopsijom nativnih bubrega. Najčešće dijagnoze vezane za visoke vrijednosti proteinurije bile su fokalna segmentalna glomeruloskleroza, membranska nefropatija, bolest minimalnih promjena, dijabetička nefropatija i amiloidoza. Proteinurija u pacijenata s transplantiranim bubregom bila je nižih vrijednosti i povezana s kroničnim promjenama i kroničnim humoralnim odbacivanjem. S obzirom da se mnoge etiološki različite bolesti mogu klinički slično manifestirati i biti povezane sa proteinurijom, biopsija bubrega je od iznimne važnosti za postavljanje precizne dijagnoze i planiranje daljnjeg liječenja. Proteinuria is defined as an urinary protein excretion of more than 150 mg per day. It is a common sign of many kidney diseases, both primary, as well as systemic diseases. Based on the amount of excreted proteins, proteinuria is defined as mild (less than 1 gr per day), moderate (1-3,5 gr per day) or heavy (more than 3,5 gr per day) with typical signs of nephrotic syndrome. This study evaluated incidence and type of proteinuria in adult patients who underwent kidney biopsy in University Hospital Centre Zagreb during 2019. Results are correlated with histological changes found in kidney tissue. In period analysis, there were a total of 152 renal biopsies in adulta, including 87(57,24%) in males and 65(42,76%) in females. Biopsy of native kidney was performed in 89(58,55%) cases, and 63 (41,44%) were biopsies of transplanted kidneys (allograft biopsies). Proteinuria was found in 126(83%) patients and it was the leading symptom in 45(29%) cases. Levels of proteinuria were higher in patients with native kidney biopsy. The most common diagnoses wuith high levels of proteinuria were focal segmental glomerulosclerosis, membranous nephropathy, minimal change disease, diabetic nephropathy, and amyloidosis. Proteinuric patients with allograft biopsy tend to have lower levels of proteinuria, related to chronic changes, transplant glomerulopathy and chronic humoral rejection. Since many etiologicaly different diseases can have similar clinical manifestation and proteinuria, kidney biopsy is an essential tool to achieve precise diagnosis and assure adequate treatment. |
