Damage to the glomerular capillary wall causes which of the following to appear in urine?

INI-CET EXAM -2026

Applied Physiology

Medium

Appeared in: INI-CET EXAM -2026

Explanation

The primary function of the glomerulus is to act as a filtration barrier, preventing large molecules from entering the urine.
Proteins, particularly albumin, are large molecules that are normally retained in the blood by the healthy glomerular filter.
Damage to the glomerular capillary wall increases its permeability, allowing proteins to leak from the blood into the urine.
The presence of a significant amount of protein in the urine (proteinuria) is a hallmark sign of glomerular damage and kidney disease.

Option A: Uric acid is a normal waste product of metabolism that is regularly filtered by the kidneys and excreted in the urine in small amounts. Its presence is not a specific indicator of glomerular damage.
Option B: Glucose in the urine (glucosuria) typically occurs when blood glucose levels are so high (above 180 mg/dL) that they overwhelm the reabsorptive capacity of the renal tubules. It is a sign of hyperglycemia, not a direct result of a damaged glomerular filter.
Option C: Ketones appear in the urine (ketonuria) when the body breaks down fat for energy instead of glucose. This is common in conditions like diabetic ketoacidosis (DKA), starvation, or very low-carbohydrate diets, and is not caused by glomerular wall damage.

Clinical Relevance

Nursing practice connection: Knowing Glomerular filtration and the pathophysiology of proteinuria helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Proteinuria is a critical and often early indicator of kidney disease. Nurses play a key role in collecting urine samples for urinalysis and educating patients about the significance of the results.
Monitoring for proteinuria is essential in patients with risk factors for kidney disease, such as diabetes and hypertension, as early intervention can slow disease progression.
What if? If a patient's urinalysis showed both significant protein and glucose, it would strongly suggest diabetic nephropathy, where long-term high blood sugar has damaged the glomeruli.

How to Approach the Question

First, identify the core concept in the question stem: 'damage to the glomerular capillary wall'.
Recall the primary function of the glomerulus. It acts as a size-selective and charge-selective filter for blood.
Consider what substances are normally kept out of the urine by this filter. The largest molecules are proteins and blood cells.
Evaluate each option. Uric acid, glucose (when reabsorbed), and ketones are small molecules that are either normally excreted or appear for reasons unrelated to the filter's integrity.
Conclude that damage to the filter would cause the substances it normally blocks—proteins—to leak through into the urine.

Concept Tested & Keywords

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