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#Néphrologie #Protéinurie #UpToDate
Total urinary protein excretion in the normal adult should be less than 150 mg/day.
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opics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Oct 2020. | This topic last updated: Jan 22, 2020. INTRODUCTION — <span>Total urinary protein excretion in the normal adult should be less than 150 mg/day. Higher rates of protein excretion that persist beyond a single measurement should be evaluated, as they often imply an increase in glomerular permeability that allows the filtration of




#Néphrologie #Protéinurie #UpToDate
In this study of 1011 patients, of whom 68 had a kidney biopsy, the ratio of the urine albumin to total protein concentration was generally less than 0.4 in patients with tubular or overflow proteinuria and greater than 0.4 in patients with predominantly glomerular proteinuria
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se. Measuring the urine concentrations of both albumin and total protein (with either two separate tests or with a urine protein electrophoresis) can help determine the type of proteinuria [2]. <span>In this study of 1011 patients, of whom 68 had a kidney biopsy, the ratio of the urine albumin to total protein concentration was generally less than 0.4 in patients with tubular or overflow proteinuria and greater than 0.4 in patients with predominantly glomerular proteinuria. Glomerular proteinuria — Glomerular proteinuria is due to increased filtration of macromolecules (such as albumin) across the glomerular capillary wall. This is a sensitive marker for




#Néphrologie #Protéinurie #UpToDate
In one study of more than 2000 patients, for example, a urine dipstick for proteinuria of 2+ or higher was predictive of significant proteinuria (urine protein-to-creatinine ratio (UPCR) greater than or equal to 500 mg/g) regardless of the specific gravity; however, a urine dipstick for proteinuria of trace or 1+ was only predictive of significant proteinuria if the specific gravity was 1.025 or less [9]
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n urine concentration. Limited data suggest that using the urine-specific gravity to judge urine concentration may improve the ability to identify abnormal proteinuria with the dipstick [9,10]. <span>In one study of more than 2000 patients, for example, a urine dipstick for proteinuria of 2+ or higher was predictive of significant proteinuria (urine protein-to-creatinine ratio (UPCR) greater than or equal to 500 mg/g) regardless of the specific gravity; however, a urine dipstick for proteinuria of trace or 1+ was only predictive of significant proteinuria if the specific gravity was 1.025 or less [9]. False positive urine dipstick results may occur in the following settings: ●After the use of iodinated radiocontrast agents [11]. Thus, the urine should not be tested for protein with




#Néphrologie #Protéinurie #UpToDate

False positive urine dipstick results may occur in the following settings:

● After the use of iodinated radiocontrast agents [11]. Thus, the urine should not be tested for protein with the standard dipstick for at least 24 hours after a contrast study.

● With a highly alkaline urine (pH greater than 8) [12,13].

● In the presence of gross hematuria and a urocrit (the percent of urine volume comprised of red blood cells) greater than 1 percent [14].

● When specific antiseptics (eg, chlorhexidine, benzalkonium) are used for clean-catch urine samples [15]

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mg/g) regardless of the specific gravity; however, a urine dipstick for proteinuria of trace or 1+ was only predictive of significant proteinuria if the specific gravity was 1.025 or less [9]. <span>False positive urine dipstick results may occur in the following settings: ●After the use of iodinated radiocontrast agents [11]. Thus, the urine should not be tested for protein with the standard dipstick for at least 24 hours after a contrast study. ●With a highly alkaline urine (pH greater than 8) [12,13]. ●In the presence of gross hematuria and a urocrit (the percent of urine volume comprised of red blood cells) greater than 1 percent [14]. ●When specific antiseptics (eg, chlorhexidine, benzalkonium) are used for clean-catch urine samples [15]. Sulfosalicylic acid test — In contrast to the urine dipstick, which primarily detects albumin, SSA detects all proteins in the urine at a sensitivity of 5 to 10 mg/dL [1]. Use of SSA i




#Néphrologie #Protéinurie #UpToDate
As a general rule in adults under the age of 50 years, daily creatinine excretion should be 20 to 25 mg/kg (177 to 221 micromol/kg) of lean body weight in men and 15 to 20 mg/kg (133 to 177 micromol/kg) of lean body weight in women. From the ages of 50 to 90 years, there is a progressive 50 percent decline in creatinine excretion (to approximately 10 mg/kg in men, lower in women) due primarily to a fall in muscle mass. Formulas that incorporate race and weight with or without serum phosphorous in addition to age and sex may improve the estimation of creatinine excretion
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(Over- and under-collections are common.) The adequacy of the collection can be estimated by quantifying the 24-hour urine creatinine and comparing this value to the expected urine creatinine. <span>As a general rule in adults under the age of 50 years, daily creatinine excretion should be 20 to 25 mg/kg (177 to 221 micromol/kg) of lean body weight in men and 15 to 20 mg/kg (133 to 177 micromol/kg) of lean body weight in women. From the ages of 50 to 90 years, there is a progressive 50 percent decline in creatinine excretion (to approximately 10 mg/kg in men, lower in women) due primarily to a fall in muscle mass. Formulas that incorporate race and weight with or without serum phosphorous in addition to age and sex may improve the estimation of creatinine excretion. This is discussed elsewhere in more detail. (See "Assessment of kidney function", section on 'Limitations of using creatinine clearance' and "Patient education: Collection of a 24-hour




#Néphrologie #Protéinurie #UpToDate
However, the UPCR may produce errors when applied to the individual patient, especially in those who consistently excrete much more (or less) than 1 g/day of creatinine (which is typical for younger men and many younger women) or in those who are losing or gaining muscle mass
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ine is equivalent to 3.4 mg/mmol creatinine. The UPCR is easy for patients and providers, and the correlation with daily protein excretion is reasonably good on the population level (figure 1). <span>However, the UPCR may produce errors when applied to the individual patient, especially in those who consistently excrete much more (or less) than 1 g/day of creatinine (which is typical for younger men and many younger women) or in those who are losing or gaining muscle mass. (See 'Limitations of the UPCR and UACR' below.) The UPCR and the UACR in spot urine samples are both supported by Kidney Disease: Improving Global Outcomes (KDIGO) as appropriate metho




#Néphrologie #Protéinurie #UpToDate
The UPCR is useful on the population level because the average 24-hour urine creatinine excretion for the population is assumed to be approximately 1000 mg/day (8.84 mmol/day) per 1.73 m2.
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daily creatinine production. ●Urine protein excretion can vary throughout the day (especially resulting from exercise and posture) and from day to day [27]. Influence of the urine creatinine — <span>The UPCR is useful on the population level because the average 24-hour urine creatinine excretion for the population is assumed to be approximately 1000 mg/day (8.84 mmol/day) per 1.73 m2. Since the denominator of the UPCR is in grams of creatinine (ie, grams of protein per 1 gram of creatinine), the UPCR is an accurate estimate of 24-hour proteinuria only in someone who




#Néphrologie #Protéinurie #UpToDate

● In individuals with large muscle mass, in whom creatinine excretion may be much higher than 1000 mg/day, the UPCR (or UACR) will underestimate proteinuria.

● In a cachectic patient or a patient with small muscle mass, in whom creatinine excretion may be much lower than 1000 mg/day, the UPCR (or UACR) will overestimate proteinuria

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1170 mg/day [30]. In addition, the accuracy of the ratio is diminished if creatinine excretion is either markedly higher or lower than the average population value of 1000 mg/day. Specifically: <span>●In individuals with large muscle mass, in whom creatinine excretion may be much higher than 1000 mg/day, the UPCR (or UACR) will underestimate proteinuria. ●In a cachectic patient or a patient with small muscle mass, in whom creatinine excretion may be much lower than 1000 mg/day, the UPCR (or UACR) will overestimate proteinuria. The following studies illustrate how variability in the urine creatinine among individuals can create erroneous estimates of 24-hour proteinuria: ●In a study of 16,000 men and women re




#Néphrologie #Protéinurie #UpToDate
In addition, all patients with persistent proteinuria that is greater than 500 mg/day for total protein (or an estimated protein excretion rate [ePER] greater than 0.5 g/day) or greater than 300 mg/day for albumin (or an estimated albumin excretion rate [eAER] greater than 300 mg/day) should be referred to a nephrologist for decisions regarding further evaluation and management (eg, kidney biopsy, discussed below)
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tiple myeloma: Clinical features, laboratory manifestations, and diagnosis".) ●A kidney ultrasound examination to rule out structural causes (eg, reflux nephropathy, polycystic kidney disease). <span>In addition, all patients with persistent proteinuria that is greater than 500 mg/day for total protein (or an estimated protein excretion rate [ePER] greater than 0.5 g/day) or greater than 300 mg/day for albumin (or an estimated albumin excretion rate [eAER] greater than 300 mg/day) should be referred to a nephrologist for decisions regarding further evaluation and management (eg, kidney biopsy, discussed below). Role of kidney biopsy — A kidney biopsy should generally be done in all patients with proteinuria of more than 3.5 g/day (ie, nephrotic range) or if non-nephrotic proteinuria is associ




Flashcard 6248227802380

Question
someone in charge of a particular branch of a bank, shop in a chain of shops, etc.
Answer
branch manager n. [C]

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Flashcard 6248229637388

Question
a local office of a company, usually in a different town or city to the company’s main office
Answer
branch office n. [C]

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Flashcard 6248231472396

Question
a name given to a product by a company so that the product can easily be recognised by its name or its design
Answer
brand n. [C]

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Flashcard 6248233307404

Question
the collection of ideas and beliefs that people have about a brand
Answer
brand image n.

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Flashcard 6248235142412

Question
goods or products have brand names and so can easily be recognised by their name or design
Answer
branded adj.

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Flashcard 6248236977420

Question
dishonestly giving money to someone to persuade them to do something to help you
Answer
bribery n. [C]

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Flashcard 6248238812428

Question
a detailed plan made by an organisation or a government of how much it will receive as income over a particular period of time, and how much it will spend, what it will spend the money on, etc.
Answer
budget n. [C]

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Flashcard 6248240647436

Question
an organisation’s spending plan for advertising during a particular period of time
Answer
advertising budget

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Flashcard 6248242482444

Question
involving or having a lot of complicated and unnecessary official rules
Answer
bureaucratic adj.

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Flashcard 6248244317452

Question
a word or phrase from one special area of knowledge that people suddenly think is important and use a lot
Answer
buzzword n. [C]

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Flashcard 6248246152460

Question
to arrange that a planned activity or event will not now happen
Answer
cancel v. (cancelled, cancelling BrE ; canceled, canceling AmE ) [T]

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Flashcard 6248247987468

Question
a decision or statement that a planned activity will not happen or that an agreement will be ended
Answer
cancellation n. [C, U]

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Flashcard 6248249822476

Question
a person or company whose job is to transport goods from one place to another
Answer
carrier n. [C]

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Flashcard 6248252968204

Question
the amounts of money coming into and going out of a company, and the timing of these
Answer
cashflow ( also cash flow) n. 1 [U]

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Flashcard 6248254803212

Question
profit for a particular period, defined in different ways by different businesses
Answer
cashflow 2 [C, U]

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Flashcard 6248256638220

Question
an organisation that collects money to help people, for example those who are sick or poor, or to help certain types of activity, such as artistic activity
Answer
charity n. ( plural charities) [C] (= not-for-profit organization; non-profit organization AmE )

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Flashcard 6248258473228

Question
a mathematical drawing or list, showing information arranged in a way that is clear and easy to understand
Answer
chart n. [C]

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Flashcard 6248260308236

Question
to find out whether something is correct, true or safe
Answer
check v. [T]

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Flashcard 6248262143244

Question
to go to the desk at a hotel or airport and say that you have arrived
Answer
check in phr.v. [I, T]

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Flashcard 6248263978252

Question
the manager with the most authority in the normal, everyday management of a company. The job of .......... is sometimes combined with other jobs, such as that of president.
Answer
Chief Executive Officer (CEO) n.

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Flashcard 6248265813260

Question
a request or demand for money, or the amount of money asked for expenses claim money that an employee spends on things such as food and travel while they are doing their job, which their employer then pays back to them
Answer
claim n. [C]

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Flashcard 6248267648268

Question
to state that something is true, even though it has not been proved
Answer
claim v. [T]

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Flashcard 6248270269708

Question
an amount of money paid to someone according to the value of goods, shares, bonds, etc. they have sold
Answer
commission n. 1 [C, U]

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Flashcard 6248272104716

Question
an official organisation that ensures that the law is obeyed in a particular activity
Answer
commission n. 2 [C]

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Flashcard 6248273939724

Question
a temporary official organisation looking at problems in a particular area and suggesting changes
Answer
commission n. 3 [C]

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Flashcard 6248275774732

Question
a promise to do something or to behave in a particular way
Answer
commitment n. 1 [C, U]

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Flashcard 6248277609740

Question
the hard work and loyalty that someone gives to an organisation or activity
Answer
commitment n. 2 [U]

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Flashcard 6248279444748

Question
a product that can be sold to make a profit, especially one in its basic form before it has been used or changed in an industrial process. Examples of .....ies are farm products and metals.
Answer
commodity n. ( plural commodities) [C]

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Flashcard 6248281279756

Question
an amount paid to someone because they have been hurt or harmed
Answer
compensation n. [U] 1

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Flashcard 6248283114764

Question
the total amount of money and other advantages that someone receives as an employee
Answer
compensation n. [U] 2

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Flashcard 6248284949772

Question
an idea for a product
Answer
concept n. [C] 1

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Flashcard 6248286784780

Question
a rule or idea saying how something should be done
Answer
concept n. [C] 2

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Flashcard 6248288619788

Question
a state of disagreement between people, groups, countries, etc.
Answer
conflict n. [C, U] 1

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Flashcard 6248290454796

Question
a situation in which you have to choose between two or more different needs
Answer
conflict n. [C, U] 2

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Flashcard 6248292289804

Question
a quantity of goods delivered at the same time
Answer
consignment n. [C]

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Flashcard 6248294124812

Question
a formal, written agreement between two or more people or groups which says what each must do for the other, or must not do
Answer
contract n. [C]

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Flashcard 6248295959820

Question
If a group of people convenes , or if someone convenes them, they come together for a formal meeting.
Answer
convene v. [I, T]

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Flashcard 6248297794828

Question
relating to a company, usually a large one, or business in general
Answer
corporate adj. [only before a noun]

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Flashcard 6248299629836

Question
the crime of giving or receiving money, gifts, a better job, etc. in exchange for doing something dishonest or illegal
Answer
corruption n. [U] 1

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Flashcard 6248302251276

Question
when someone who has power or authority uses it in a dishonest or illegal way to get money or an advantage
Answer
corruption n. [U] 2

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Flashcard 6248304086284

Question
the place where you are served in a shop, bank, etc.
Answer
counter n. [C]

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Flashcard 6248310377740

Question
Princípios
Answer
[default - edit me]

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Ênfase - Portal
1:21 04:28 1 x Resumo16 minutos E-book28 minutos Questões6 questões Legislação9 minutos Princípios DIREITO PROCESSUAL DO TRABALHO DIREITO PROCESSUAL DO TRABALHO Princípios 1. Noção introdutória <span>Princípios são normas jurídicas que conferem unidade e coerência ao ordenamento jurídico, sinalizando finalidades que devem ser buscadas pelo intérprete e que, em razão de seu conteúdo aberto, pod