6.What causes glycosuria?

Increased excretion of glucose in the urine is due to various causes. In healthy individuals the glycosuria is not expressed, it can not be determined by routine laboratory methods, and increase the severity of glycosuria, for example, during the glucose tolerance test is transient.

Renal glycosuria is often a separate disease, it is usually detected incidentally, polyuria and polydipsia is extremely rare. Sometimes accompanied by other renal glycosuria tubulopathy including Fanconi syndrome in the.

Among the possible causes of renal glucosuria type 1 and 2 discuss the mutation of one of the tubular carrier proteins, glucose is reabsorbed along with two sodium ions. However, the distinction of these options at the genetic level is difficult, because one family diagnosed cases of renal glycosuria as the 1st and 2nd type.

Three types of isolated renal glucosuria.

In renal glucosuria type 1 showed a significant reduction of glucose reabsorption in the proximal tubule with a relatively intact values ​​of glomerular filtration. The ratio of the maximum to the reabsorption of glucose in GFR in patients with renal glucosuria type 1 decreased.

Renal glucosuria type 2 is characterized by a significant increase in the threshold for glucose reabsorption of proximal tubular epithelial cells. The ratio of the maximum to the reabsorption of glucose close to normal GFR.

Very rarely observed renal glucosuria type 0, in which the ability of epithelial cells of proximal tubules reabsorb glucose-Vat is completely absent. Glycosuria development associated with the mutation, causing a lack of or a significant defect, accompanied by a complete loss of function is reabsorbed, tubular proteins that transport glucose. In these patients, the value of glycosuria reach particularly high numbers.

There are more rare variants of renal glycosuria. Described the combination of renal glucosuria type 1 and glitsinuriey giperfosfaturiey , with other signs of Fanconi syndrome, including acidaminuria absent.

When combined with renal glycosuria glitsinuriey patients often suffer from cystic fibrosis. It is believed that this option tubulopathy inherited in an autosomal dominant pattern.

Identified mutation, which determines a significant reduction in the activity of intestinal trasportera for glucose and galactose. Simultaneously, these patients show a violation of glucose reabsorption in the tubules, more similar to renal glucosuria type 2.

Renal glycosuria observed in pregnant women. Its development is due to a significant increase in GFR in physiological relatively stable, the maximum re-absorption of glucose. Glycosuria pregnant is transient.

Laboratory diagnosis of glycosuria

Renal glycosuria diagnosed by the presence of glucose in urine with normal fasting glucose levels. Renal origin confirm detection of glucose at least three urine samples and no change in curve during OGTT.

In renal excretion of glucose amount of urine varies from 500 mg / day to 100 mg / day or more, in most patients it is 1-30 g / day.

Differential diagnosis of glycosuria

Pregnant differential diagnosis with diabetes during pregnancy.

Treatment glycosuria

Kidney provides selection of a balanced diet containing adequate amounts of carbohydrates. When polyuria to prevent loss of potassium is recommended to use dried fruits.