Urinary protein excretion in evaluation of renal impairment progression in hypertension

Renal impairment due to arterial hypertension is a well-known clinical phenomenon. Initiation and course of some progressive renal diseases in hypertension may depend both on mechanical factors, and on cellular and inflammatory mechanisms. Increase in urinary excretion of protein is an independent marker of glomerular damage and at the same time a pathogenic factor - a mediator of progressive damage to renal tubules and parenchyma. Measurement of total urinary protein seems to be of lesser diagnostic and prognostic significance than the evaluation of individual proteins. Characteristic features of these proteins (size and charge of a particle), their origin (plasma or nephrons), and functions (involvement in inflammatory reaction) may be specific for an anatomical localization, stage and activity of renal impairment in course of arterial hypertension.