Which physical findings indicate proteinuria?

Updated: Mar 25, 2020
  • Author: Beje Thomas, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The physical examination should include the following:

  • Assess intravascular volume status - Examine the jugular venous pulse (JVP), erect and supine pulse and blood pressure, and heart sounds

  • Assess extravascular volume status - Look for edema (eg, ankle, leg, scrotal, labial, pulmonary, periorbital), which may or may not be pitting, depending on the duration of edema; massive weight gain due to fluid is very common, especially in patients with nephrotic syndrome; patients may also have decreased breath sounds due to pleural effusions

  • Examine the patient for signs of systemic disease - Eg, retinopathy, rash, joint swelling or deformity, stigmata of chronic liver disease, organomegaly, lymphadenopathy, and cardiac murmurs

  • Examine the patient for complications such as venous thrombosis and peritonitis


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