Has anybody seen this?

I have two patients who routinely have significantly lower spot protein to creatinine ratios as compared to 24-hour urine for protein.

The urine electropheresis shows non-specific proteinuria.

  • The first patient is an obese young African American woman with WHO type V lupus nephritis.
  • The other patient is a thin young Caucasian woman with secondary FSGS due to chronic reflux. Her most recent PCR is 1.7, and her 24-hour urine from one week prior is 4.9 g.

Any ideas? What am I missing?

Teaching on 2 Ell, the second week

On Monday one of our interns gave a lecture on the range of renal pathology possible found with lupus nephritis.

Lupus Nephritis

View SlideShare presentation or Upload your own. (tags: sle pathology)

This was a follow up on her lecture on the renal manifestations of lupus nephritis by WHO criteria. After her lecture we went down to bowels of the hospital to look at the kidney biopsy we had done on Friday on one of our patients with lupus.

On Thursday we began interpretation of Acid-Base disorders.
Also on Thursday I lectured the house staff on Nephrogenic Fibrosing Dermopathy, Acute Phosphate Nephropathy and Contrast Nephropathy. Renal adventures in imaging.

On Friday the 13th we completed Acid-Base disorders. As part of acid-base we talked about the anion gap. This article in CJASN on the anion gap was wonderful.