Which lab studies are performed in the diagnosis of glomerular proteinuria?

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

To determine whether proteinuria may be glomerular in origin, perform the following:

  • Urine microscopy – To search for dysmorphic red blood cells and casts

  • Urine collection (24 h) for quantification of albumin (or protein) excretion and creatinine clearance – Especially if the patient is muscular or cachectic; spot protein/creatinine ratio can be used for subsequent assessments

  • Serum creatinine, albumin, cholesterol (see HDL cholesterol and LDL cholesterol), and blood glucose determinations

  • Autoantibody determinations - If indicated, including antistreptolysin O titers, antinuclear antibodies (ANAs), anti-DNA antibodies, complement levels (C3 and C4), anti-phospholipase A1 receptor autoantibody, and cryoglobulins

  • Hepatitis B, hepatitis C, and HIV serologies - If indicated

  • Urine and plasma protein electrophoresis for light chains - If indicated

  • Anti–glomerular basement membrane (anti-GBM) antibodies and antineutrophil cytoplasmic antibodies (ANCA) – If there is a suspicion of pulmonary renal syndrome.

  • Hemoglobin A1C


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