Proteinuria typing

To determine the type of proteinuria, it is necessary to know the spectrum of proteins excreted in the urine. ;Electrophoretic methods' are used for this. Electrophoretic distribution of urinary proteins according to their molecular weight enables semi-quantitative evaluation of individual diagnostically significant proteins and classification of proteinuria. Agarose or polyacrylamide gel electrophoresis gradually became the method of choice for urine protein analysis.

In order to separate proteins according to size (and not according to charge), a polyacrylamide gel can be used, the density of which increases from the cathode to the anode (i.e. the "eyes" or "pores" in the gel gradually decrease). Small molecules in such a gel travel further than large molecules. Another, more frequently used option is to treat the sample with the detergent sodium lauryl sulfate (dodecylsíranem sodným – SDS), which "surrounds" the protein and replaces its own charge with its negative charge. The resulting complexes have approximately the same charge (more precisely: they have the same surface charge density). If electrophoresis is then carried out in a relatively dense gel, it is divided depending on the relative molecular weight : smaller molecules travel through the gel faster than large ones (molecular sieve technique). β2--microglobulin moves the fastest, albumin lies about in the middle of the dividing path; between start and albumin, proteins with Mr higher than 70,000 are located 70 000.

Urine protein electrophoresis evaluation
thumb|Typizace proteinurie pomocí elektroforézy na agarózovém gelu v přítomnosti SDS In glomerular proteinuria, we find proteins in the electrophorogram between the start and albumin inclusive (i.e. Mr > 70 000).


 * {| Class=wikitable

Proteins seen in glomerular proteinurias ! !! Mr !! !!
 * Albumin || 68 000 || selective || non-selective
 * Transferin || 77 000 || selective || non-selective
 * IgG || 150 000 || || non-selective
 * IgA || 160 000 || || non-selective
 * Haptoglobiny || 85 000–1 000 000 || || non-selective
 * }
 * IgA || 160 000 || || non-selective
 * Haptoglobiny || 85 000–1 000 000 || || non-selective
 * }
 * Haptoglobiny || 85 000–1 000 000 || || non-selective
 * }

Tubular proteinuria is characterized by the presence of protein between albumin and the anodic end of the electrophorogram (ie, Mr < 70 000).


 * {| class=wikitable

! !! Mr
 * + Protein seen in tubular proteinurias
 * β2-mikroglobulin || 11 800
 * Lysozym || 15 000
 * Retinol vázající protein (RBP) || 21 000
 * Free Ig light chains || 25 000
 * α1-mikroglobulin || 33 000
 * Dimer of free Ig light chains || 50 000
 * Albumin || 68 000
 * }
 * α1-mikroglobulin || 33 000
 * Dimer of free Ig light chains || 50 000
 * Albumin || 68 000
 * }
 * Albumin || 68 000
 * }
 * }

Mixed proteinurias are characterized by the presence of proteins demonstrated in both glomerular and tubular proteinurias, located both cathodically and anodically from the albumin strip.

The presence of α2-makroglobulinu (Mr = 800 000) with other findings similar to mixed proteinuria is suggestive of postrenal proteinuria.

Související články

 * Proteinurie
 * Bílkoviny v séru a moči

Externí odkazy

 * Video o elektroforetických metodách používaných v klinické biochemii pro vyšetření bílkovin v séru a moči