WordNet
- any of a large group of nitrogenous organic compounds that are essential constituents of living cells; consist of polymers of amino acids; essential in the diet of animals for growth and for repair of tissues; can be obtained from meat and eggs and milk and legumes; "a diet high in protein"
- liquid excretory product; "there was blood in his urine"; "the child had to make water" (同)piss, pee, piddle, weewee, water
PrepTutorEJDIC
- 蛋白(たんばく)質
- 尿,小便
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- 1. 成人における尿蛋白排泄量の評価および非ネフローゼ域蛋白尿のみの評価 assessment of urinary protein excretion and evaluation of isolated non nephrotic proteinuria in adults
- 2. 小児における蛋白尿の評価 evaluation of proteinuria in children
- 3. 重症蛋白尿およびネフローゼ症候群の概要 overview of heavy proteinuria and the nephrotic syndrome
- 4. 小児におけるネフローゼ症候群の病因、臨床症状、および診断 etiology clinical manifestations and diagnosis of nephrotic syndrome in children
- 5. 妊娠中の蛋白尿の評価 evaluation of proteinuria in pregnancy
English Journal
- A new screening method for proteinuria using Erythrosin B and an automated analyzer-Rapid, sensitive and inexpensive determination.
- Horikoshi S, Higurashi A, Kaneko E, Yoshimura H, Ohsawa I, Suzuki Y, Hamada C, Tomino Y.SourceDivision of Nephrology, Department of Internal Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
- Clinica chimica acta; international journal of clinical chemistry.Clin Chim Acta.2012 Jul 11;413(13-14):1087-91. Epub 2012 Mar 23.
- BACKGROUND: In spite of the urgent necessity for a screening test of urinary protein for the early diagnosis of kidney diseases, a rapid, accurate and cost-effective method for their detection has yet to be developed.METHODS: A solution containing a buffer agent (pH 2.3) and surfactants and a soluti
- PMID 22465201
- Inhibition of soluble epoxide hydrolase by cis-4-[4-(3-adamantan-1-ylureido)cyclohexyl-oxy]benzoic acid exhibits antihypertensive and cardioprotective actions in transgenic rats with angiotensin II-dependent hypertension.
- Neckář J, Kopkan L, Husková Z, Kolář F, Papoušek F, Kramer HJ, Hwang SH, Hammock BD, Imig JD, Malý J, Netuka I, Ošťádal B, Červenka L.SourceDepartment of Developmental Cardiology, Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic. neckar@biomed.cas.cz
- Clinical science (London, England : 1979).Clin Sci (Lond).2012 Jun;122(11):513-25.
- The present study was undertaken to evaluate the effects of chronic treatment with c-AUCB {cis-4-[4-(3-adamantan-1-ylureido)cyclohexyl-oxy]benzoic acid}, a novel inhibitor of sEH (soluble epoxide hydrolase), which is responsible for the conversion of biologically active EETs (epoxyeicosatrienoic aci
- PMID 22324471
Japanese Journal
- Enantioselective disposition of clenbuterol in rats
- Hirosawa Iori,Ishikawa Mai,Ogino Mio,Ito Hiroshi,Hirao Takuya,Yamada Harumi,Asahi Mariko,Kotaki Hajime,Sai Yoshimichi,Miyamoto Ken-ichi
- Biopharmaceutics and Drug Disposition 35(4), 207-217, 2014-05
- … Concentrations of clenbuterol enantiomers in plasma, urine and bile were determined by LC-MS/MS assay with a Chirobiotic T column. … The fractions of free (non-protein-bound) (-)-R- and (+)-S-clenbuterol in rat plasma were 48.8% and 33.1%, respectively. … These results indicated that there are differences in the distribution and excretion of the clenbuterol enantiomers, and these may be predominantly due to enantioselective protein binding. …
- NAID 120005373524
- Clinical features of isolated gestational proteinuria progressing to pre-eclampsia: retrospective observational study
- Akaishi Rina,Yamada Takahiro,Morikawa Mamoru,Nishida Ryutaro,Minakami Hisanori
- BMJ Open 4(4), e004870, 2014-04-19
- … Proteinuria was defined as a protein-to-creatinine ratio (mg/mg; … P/Cr) of 0.27 in the spot urine specimen. … Conclusions Women with P-PE were likely to exhibit greater proteinuria in the urine, greater water retention in the interstitial space and more enhanced coagulation-fibrinolysis, thus suggesting that they may constitute a more severe form of PE than women with O-PE do. …
- NAID 120005455887
- 腎生検を行った蛋白漏出性腎疾患の犬2例，猫1例における比較検討
- 小田切 時彦,三品 美夏,菅原 豪,代田 欣二,渡辺 俊文,Tokihiko Otagiri,Mika Mishina,Go Sugahara,Kinji Shirota,Toshifumi Watanabe
- 麻布大学雑誌 = Journal of Azabu University 25, 53-58, 2014-03-31
- … The urine protein-to-creatinine ratio and response to treatment were not consistent in these cases. … These results suggest that protein-losing nephropathy may present various pathological forms in small animalsand thus renal biopsy is essential for understanding the pathological process of the disease. …
- NAID 120005461973
Related Links
- urine protein. See urinary albumin. protein any large organic compound made from one or more polypeptides, which are chains of amino acids joined in a genetically determined order by peptide linkages between the carboxyl group of ...
- Describes how the urine protein test is used, when a urine protein test is ordered, and what the results of a urine protein test might mean ... Urine protein testing is used to detect protein in the urine, to help evaluate and monitor ...
Related Pictures
★リンクテーブル★
| リンク元 | 「尿蛋白」 |
| 拡張検索 | 「urine protein/creatinine ratio」 |
「尿蛋白」
- 英
- urine protein, urinary protein, protein in urine
- 同
- 尿中タンパク質、尿タンパク
- 関
- 蛋白尿、尿蛋白/クレアチニン比
尿蛋白の生化学
- 1/3は血清アルブミン
- 1/3はアルブミン以外の小分子蛋白質
- 1/3は尿細管上皮細胞中のタム-ホースフォール蛋白質（ムコ蛋白質）
基準値
24時間蓄尿
- 40-100 mg/day
- 運動、体位、精神的ストレスによって変動しうる
- 20-120 mg/day (臨床検査法提要第32版 p.1806)
- <150 mg/day (HIM.A-11)
生理的な尿蛋白
- 起立性蛋白尿：体位による。糸球体濾過圧が高まる？
- 機能性蛋白尿：運動、発熱、ストレス
診断
- 24時間蓄尿：150 mg/日以上で異常。1 g/day以上で糸球体疾患疑い。 ネフローゼ症候群の診断基準は3.5g/day以上
- 随時尿：30 mg/dl以上で異常
尿蛋白量と診断の目安
- 内科診断リファレンス.350
| 尿蛋白 | |
| 150mg/日未満 | 健常者の基準(15mg/dL 10dL) |
| 300mg/日 | 糖尿病性腎症の顕性タンパク尿の定義 |
| 1000mg/日 | 起立性タンパク尿や熱性タンパク尿などの良性タンパク尿の上限 (血尿があるときは500mg/日のタンパク尿で腎疾患を考慮) |
| 1500-3000mg/日 | 尿細管障害によるタンパク尿の限界で、これ以上は糸球体疾患と考える。 |
腎前性
- 低分子タンパク質の過剰産生
腎性(腎実質性)
- 糸球体毛細血管の障害、内圧亢進、尿細管障害
腎後性
- 下部尿路系の炎症、結石、腫瘍
- 下部尿路系の尿路結石
- 腎盂腫瘍
- 尿管腫瘍
- 膀胱腫瘍
尿蛋白による尿細管の障害
- 尿蛋白→尿細管での過剰吸収・蓄積→尿細管間質へのマクロファージ・T細胞の浸潤→(in vitroでは尿細管細胞をアルブミンと共存させるとMCP-1・炎症性サイトカイン(TNF, IL-1, LPS, 変性IgG)を分泌→間質炎症反応→間質線維化→腎瘢痕
臨床関連
異常値の出るメカニズム第5版 p.177改
| 分子量 (kDa) |
糖質 (%) |
機能 | |
| β2ミクログロブリン | 11 | 0 | 構造タンパク・HLAのL鎖 |
| リゾチーム | 15 | 0 | 消化殺菌酵素 |
| レチノール結合蛋白 | 20 | 0 | ビタミンA担体 |
| 免疫グロブリンL鎖 | 22 | 0 | 構造タンパク質 |
| α1ミクログロブリン | 30 | 20 | 輸送担体 |
| α1酸性糖タンパク | 44 | 38 | 急性相蛋白 |
| アルブミン | 67 | 0 | 膠質浸透圧維持、輸送担体 |
検査
試験紙法
- 随時尿で施行可能。感度が低い。
- 強アルカリ性で偽陽性 ← アルカリ性で青変する試薬を使用
- X線造影剤で偽陽性はでない。
- Bence Jones蛋白に対しては偽陰性
24時間蓄尿
- 尿の生化学的な分析を行う。
検査法の比較(QB E-134)
| 煮沸法 | スルフォサリチル酸法 | 試験紙法 | |
| 原理 | 蛋白質の熱変性による混濁 (特異性が高い) |
蛋白と酢酸の不溶性塩による混濁 | 指示薬の蛋白誤差を利用 |
| 感度 | 5mg/dl | 1.5-2mg/dl (鋭敏) |
5-20 mg/dl |
| 偽陽性 | ヨード造影剤 トルブタミド ペニシリン系抗菌薬 セフェム系抗菌薬 |
リン酸塩を含むアルカリ性尿 第4級アンモニウム化合物 (防腐剤、洗浄剤)EDTAのことか？ | |
| 偽陰性 | リン酸塩を含むアルカリ性尿 | 低分子タンパク尿(BJP等) | |
試験紙法による蛋白尿の評価
- 参考1
- 尿蛋白：± = 15 mg/dL。1+ = 30 mg/dL。2+ = 100 mg/dL。3+ = 300mg/dL ← 赤字はメーカー間で差が少ないらしい。
- 1+では蛋白尿が存在すると考えて良い水準。
参考
- 1. CKD診察ガイド2009