Proteinuria and microalbuminuria: what's all the fuss about?

Proteinuria – an excessive amount of protein in urine–has lately come under increased scrutiny because of emerging insights into its role as a marker for, and perhaps direct mediator of, progressive renal disease in dogs and cats. Proteinuria may be detected as an incidental finding during routine laboratory screening of pre-operative, geriatric and ill patients or an astute clinician may suspect its presence and test specifically for it. Proteinuria is often an important clinical finding and should prompt a sequence of diagnostic and sometimes therapeutic steps that have been well described in recent textbooks and articles. In dogs with chronic renal failure (CRF) it has recently been shown that proteinuria at the time of initial CRF diagnosis is associated with a greater risk of progression of renal failure, development of uraemic crises and death. Last year, the American College of Veterinary Internal Medicine published a consensus statement on assessment and management of proteinuria in dogs and cats