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severeadjective Referring to the intensity (severity) of a specific event, as in mild, moderate or severe.
The term “severe” is not synonymous with serious, as an event may be of acute distress but relatively minor medical significance (e.g., a severe headache). Seriousness serves as a guide for defining regulatory reporting obligations.
proteinuriaNephrology The excretion of excessive (> 5 mg/dL) protein in the urine; normally, about 150 mg/day of protein is lost in the urine,1⁄3 is albumin,1⁄3 is Tamm-Horsfall glycoprotein; the rest is divided among actively secreted proteins–eg, retinol binding proteins, β2-microglobulin, Ig light chains and lysozyme; in absence of disease, large proteins are retained due to their size, while the smaller proteins are actively resorbed; proteinuria is most often caused by kidney disease, due to glomerular defects, and defective renal tubular resorption, and most often detected by screening with reagent strip–dipstick. See Functional proteinuria, Overflow proteinuria.
Severe ≥ 1.0 g/dL, due to glomerulonephritis, nephrotic syndrome, lupus nephritis, amyloidosis
Moderate ≥ 0.2 g/dL, ≤ 1.0 g/dL, due to CHF, drugs, acute infections, myeloma, chemical toxins
Mild 0.05-0.2 g/dL, due to polycystic kidneys, pyelonephritis, renal tubular defects
Glomerular pattern Due to a loss of fixed negative charge on the glomerular capillary wall, allowing albumin and other large (≥ 68 kD) molecules to leak into Bowman's space–eg, in glomerulonephritis and nephrotic syndrome Lab ↓ albumin, antithrombin, transferrin, prealbumin, α1-acid glycoprotein, α1-antitrypsin
Hemodynamic pattern Due to rheostatic changes in the body, causing a loss of 20 to 68 kD molecules, seen in transient proteinuria, CHF, fever, seizures, excess exercise.
Overflow pattern Due to tissue/cell destruction that overwhelms renal capacity to excrete certain proteins–eg, Bence-Jones proteinuria and myoglobinuria
Tubular pattern Due to renal tubular dysfunction with loss of normally filtered low molecular weight (≤ 40 kD) molecules Lab ↓ β2-microglobulin and lysozyme–eg, Fanconi syndrome, Wilson's disease, interstitial nephritis, antibiotic-induced injury and heavy metal intoxication