ASYMPTOMATIC URINARY ABNORMALITIES

Proteinuria in the nonnephrotic range and/or hematuria unaccompanied by edema, reduced GFR, or hypertension can be due to multiple causes (Table 145-5).
TABLE 145-5: Glomerular Causes of Asymptomatic Urinary Abnormalities
I. Hematuria with or without proteinuria
  1. Primary glomerular diseases
    1. Berger’s disease (IgA nephropathy)a
    2. Mesangiocapillary glomerulonephritis
    3. Other primary glomerular hematurias accompanied by “pure” mesangial proliferation, focal and segmental proliferative glomerulonephritis, or other lesions
    4. “Thin basement membrane” disease (? forme fruste of Alport’s syndrome)
  2. Associated with multisystem or hereditary diseases
    1. Alport’s syndrome and other “benign” familial hematurias
    2. Fabry’s disease
    3. Sickle cell disease
  3. Associated with infections
    1. Resolving poststreptococcal glomerulonephritis
    2. Other postinfectious glomerulonephritides
II. Isolated nonnephrotic proteinuria
  1. Primary glomerular diseases
    1. “Orthostatic” proteinuria
    2. Focal and segmental glomerulosclerosis
    3. Membranous glomerulonephritis
  2. Associated with multisystem or heredofamilial diseases
    1. Diabetes mellitus
    2. Amyloidosis
    3. Nail-patella syndrome
aMost common.
Source: Glassock RJ, Brenner BM: Harrison’s Principles of Internal Medicine, 13th ed, 1995.

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