Glycosuria
| Glycosuria | |
|---|---|
| Classification and external resources | |
| Specialty | Lua error in Module:Wikidata at line 446: attempt to index field 'wikibase' (a nil value). |
| ICD-10 | R81 |
| ICD-9-CM | 791.5 |
| DiseasesDB | 5323 |
| Patient UK | Glycosuria |
| MeSH | D006029 |
Glycosuria or glucosuria is the excretion of glucose into the urine. Ordinarily, urine contains no glucose because the kidneys are able to reclaim all of the filtered glucose back into the bloodstream. Glycosuria is nearly always caused by elevated blood glucose levels, most commonly due to untreated diabetes mellitus. Rarely, glycosuria is due to an intrinsic problem with glucose reabsorption within the kidneys themselves, a condition termed renal glycosuria.[1] Glycosuria leads to excessive water loss into the urine with resultant dehydration, a process called osmotic diuresis.
Pathophysiology
Blood is filtered by millions of nephrons, the functional units that comprise the kidneys. In each nephron, blood flows from the arteriole into the glomerulus, a tuft of leaky capillaries. The Bowman's capsule surrounds each glomerulus, and collects the filtrate that the glomerulus forms. The filtrate contains waste products (e.g. urea), electrolytes (e.g. sodium, potassium, chloride), amino acids, and glucose. The filtrate passes into the renal tubules of the kidney. In the first part of the renal tubule, the proximal tubule, glucose is reabsorbed from the filtrate, across the tubular epithelium and into the bloodstream. The proximal tubule can only reabsorb a limited amount of glucose. When the blood glucose level exceeds about 160 – 180 mg/dl, the proximal tubule becomes overwhelmed and begins to excrete glucose in the urine.
| Urine dipstick designation |
Approximate plasma concentration |
|---|---|
| trace | 100 mg/dL [2] |
| 1+ | 250 mg/dL[2] df |
| 2+ | 500 mg/dL[2] |
| 3+ | 1000 mg/dL[2] |
| 4+ | 2000 mg/dL[2] |
This point is called the renal threshold of glucose (RTG).[3] Some people, especially children and pregnant women, may have a low RTG (less than ~7 mmol/L[3] glucose in blood to have glucosuria).
If the RTG is so low that even normal blood glucose levels produce the condition, it is referred to as renal glycosuria.
Glucose in urine can be identified by Benedict's qualitative test.
Medical induction
Glycosuria can be induced therapeutically for treatment of diabetes mellitus type 2 using SGLT2 inhibitors canagliflozin, dapagliflozin, and empagliflozin (collectively known as gliflozins).
References
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