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1/ When bubbles settle on the surface of the urine it indicates disease of the kidneys-Hippocrates

In the day, urinary exam was so crucial, the urine flask was as much a symbol of a physician as today's white🥼!

🧵Is proteinuria a worthy rival to GFR?
#Nephmadness #primarycare
2/
*⃣Normal urinary protein excretion is <150mg/d and comprises mainly Tamm-Horsfall proteins, with very little albumin (5-10mg/d)

*⃣ We don't understand what happens to albumin in the kidney 💯

*⃣ But overall the degree of albuminuria is a ⚖️of filtration + reabsorption 👇
3/Albuminuria is common in injury to the GBM (GLOMERULAR proteinuria)

But non-albumin proteins sometimes dominate the filtrate.
The classic case is OVERFLOW proteinuria in paraproteinemia
CLUE: Neg dipstick, with⬆️Urine PCR

💡Urine dip +=Albuminuria #renalrules
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