Glycosuria - is the identification of glucose in urine. In the urine of healthy human glucose in very low concentrations (0,06-0,083 mmol / l). Therefore, and due to the low sensitivity of the method, it is not detected in the urine in clinical diagnostic laboratories.
Detection of glucose in urine indicates pathology. Glucosuria depends on three factors:
- blood glucose concentration
- of glomerular filtrate kidney in 1 minute
- amount reabsorbed in the tubules of glucose in 1 ml
Glycosuria frequently precedes hyperglycemia. Filtered in the glomeruli of the glucose is reabsorbed in the proximal renal tubules.
With normally functioning kidneys glucosuria appears only when blood glucose levels exceed 8,8-9,9 mmol / l, the so-called "renal threshold" or the glomerular clearance of glucose. The notion of a relative as "renal threshold" determined by an enzyme system of the renal epithelium and, therefore, largely individual. The child "renal threshold" above (10,45-12,65 mmol / l).
Volume of glomerular filtration rate also affects the level of glycosuria. Its decline even at high levels of blood glucose may not cause glycosuria. Therefore, for some chronic kidney disease threshold of glucose rises. In the case of nephropathy accompanied by impairments of resorption of glucose (diabetes, renal) may glycosuria and normal or low blood glucose.
Causes of glycosuria may be:
- insulin deficiency
- decline of renal function and / or liver
- impairment of the hormonal regulation of carbohydrate metabolism, eating large amounts of carbohydrates
Glycosuria types include:
- pancreatic (insular) - due to insufficient insular apparatus,
- extrapankreatic (extrainsulyar), resulting from a impairment of one of the links in the regulation of carbohydrate metabolism
There are kinds of glycosuria:
- diabetic glycosuria
- glucosuria, which is observed in acute pancreatitis
- Glycosuria during prolonged starvation
- alimentary glycosuria appearing 30-60 minutes after meals rich in carbohydrates
- glycosuria of nervous origin in cases of cranial trauma, brain tumors, meningitis, toxicosis, encephalitis, seizures, intracranial hemorrhages, anesthesia
- emotional glycosuria - during mourning, fear, hysteria
- glycosuria for poisoning (toxic)
- endocrine glycosuria, resulting from a impairment of secretion of adrenaline, thyroxine, glucocorticoids, with acromegaly, Cushing's syndrome-Itsenko, pheochromocytoma, hypernephroma, an overdose of ACTH, cortisol, drugs, or their long-term treatment
- kidney (renal) glycosuria developed in consequence of pathological resorption of glucose in the tubules
Distinguish between primary and secondary renal glucosuria:
primary glucosuria, the so-called renal diabetes - is an anomaly mechanism of resorption of glucose in the proximal renal tubule. Renal threshold for glucose decreased to 6,32-0,82 mmol / l without violating the intermediate metabolism of carbohydrates.
Secondary renal glycosuria can occur at different organic lesions of the kidney (chronic nephritis, nephrosis, acute renal failure, glycogen disease).
Variants of hyperglycemia and glucosuria:
- impairment of the resorption of glucose in the tubules is characterized by glucosuria with normal blood glucose
- hyperglycemia is not accompanied by glucosuria, is observed in cases where the concentration of glucose in the urine does not exceed the threshold for glucose reabsorption in the tubules, when exceeding the renal threshold for hyperglycemia is accompanied by glucosuria
- increase in blood glucose and its absence in the urine indicates a impairment of renal filtration
- in old age, due to the reduction of enzyme activity of renal epithelium may be a slight glycosuria, which is easily compensated for by diet
If you have any questions about the diagnosis or treatment of glycosuria, you can specify them with our urologist or a nephrologist on the phone: +7 (926) 988-14-23
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