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Commentary

Unravelling the enigma of proteinuria in burn patients

Filippo Mariano and Giovanni Camussi*

Author Affiliations

Dipartimento di Scienze Mediche, Università di Torino and Città della Salute e Scienza di Torino, 10126 Torino, Italy

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Critical Care 2012, 16:184  doi:10.1186/cc11684


See related research by Hu et al., http://ccforum.com/content/16/5/R172

Published: 5 December 2012

Abstract

Hu and coworkers in the previous issue of Critical Care provide evidence for the clinical relevance of proteinuria in the outcome of burn patients. Proteinuria is a common finding after severe burns, appears within a short period and is detectable for several weeks. Proteinuria ranging from 0.5 to 3 to 4 g/day is initially of mixed type, then, after a week, gradually changes to tubular proteinuria. The clinical role of proteinuria is still unclear, mainly due to a lack of data on its pathogenesis. Recent studies have demonstrated an association between proteinuria and incidence of inhalation injury, sepsis, acute kidney injury and mortality rate. Proteinuria is considered the mirror of increased systemic capillary permeability, and possibly a direct marker of glomerular and tubular injury. Circulating plasma inflammatory mediators and pro-apoptotic factors reflecting burn injury, sepsis and acute kidney injury can affect the viability and function of tubular cells and podocytes. These studies highlight that proteinuria in burn patients should receive due consideration.