Definition

What is proteinuria?

Proteinuria which was also known as Protein in Urine, is a condition whereby the urine containing an abnormal amount of protein. The condition is often a sign of kidney disease.

Healthy kidneys do not allow a significant amount of protein to pass through their filters. However filters damaged by kidney disease may let proteins such as albumin leak from the blood into the urine.

How common is proteinuria?

Proteinuria can affect patients at any age. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of proteinuria?

Normally there are no symptoms, but protein is detected by a routine urine test. A positive test may not mean there is any serious problem with the kidneys.

If the amount of protein in the urine is very high, a condition called nephrotic syndrome may develop. Nephrotic syndrome causes water to build up in the body. The extra water can cause ankle swelling, or swelling in the hand (rings go tight on fingers) or around the eyes. Severe swelling can develop all the way up the legs and around the back. There may be swelling of the tummy or breathlessness due to water around the lungs.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes proteinuria?

Your kidneys filter waste products from your blood while retaining components your body needs — including proteins. However, some diseases and conditions can allow proteins to pass through the filters of your kidneys, causing protein in urine.

Conditions that can cause a temporary rise in the levels of protein in urine, but it does not necessarily indicate kidney damage, include:

  • Cold exposure;
  • Emotional stress;
  • Fever;
  • Heat exposure;
  • Strenuous exercise.

A small amount of protein in the urine is normally not a problem. However, larger levels of protein in the urine is not a good sign. Diseases and conditions that can cause persistently elevated levels of protein in urine, which may indicate kidney disease, include:

  • Amyloidosis (buildup of abnormal proteins in your organs);
  • Certain drugs;
  • Chronic kidney disease;
  • Diabetes;
  • Glomerulonephritis (inflammation in the kidney cells that filter waste from the blood);
  • Goodpasture’s syndrome (disease involving the kidneys and lungs);
  • Heart disease;
  • Heart failure;
  • High blood pressure (hypertension);
  • Hodgkin’s lymphoma (Hodgkin’s disease);
  • IgA nephropathy (Berger’s disease) (kidney inflammation resulting from a buildup of the antibody immunoglobulin A);
  • Kidney infection;
  • Leukemia;
  • Lupus;
  • Malaria;
  • Multiple myeloma;
  • Orthostatic proteinuria (urine protein level rises when in an upright position);
  • Pericarditis (inflammation of the sac that surrounds the heart);
  • Preeclampsia;
  • Pregnancy;
  • Rheumatoid arthritis;
  • Sarcoidosis (development and growth of clumps of inflammatory cells in your organs);
  • Sickle cell anemia.

Risk factors

What increases my risk for proteinuria?

There are many risk factors for Proteinuria, such as:

  • Diabetes;
  • High blood pressure (hypertension): Both diabetes and high blood pressure can cause damage to the kidneys, which leads to proteinuria.

Other types of kidney disease unrelated to diabetes or high blood pressure can also cause protein to leak into the urine. Examples of other causes include:

  • Medications;
  • Trauma;
  • Toxins;
  • Infections;
  • Immune system disorders;
  • Increased production of proteins in the body can lead to proteinuria. Examples include multiple myeloma and amyloidosis.

Other risk factors include:

  • Obesity;
  • Age over 65;
  • Family history of kidney disease;
  • Preeclampsia (high blood pressure and proteinuria in pregnancy);
  • Race and ethnicity: African-Americans, Native Americans, Hispanics, and Pacific Islanders are more likely than whites to have high blood pressure and develop kidney disease and proteinuria.

Some people get more protein into urine while standing than while lying down. That is known as orthostatic proteinuria.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is proteinuria diagnosed?

Protein in the urine can be detected by a routine urine test. The simple test with a dipstick (small plastic strip with an indicator paper attached) can detect very small amounts of protein, so that a positive test may not mean there is any serious problem with the kidneys.

Further tests may be necessary after protein has been detected by a simple ‘dipstick’ test on a small urine sample. This dipstick test is very sensitive, but cannot measure exactly how much protein is in the urine. To get an exact measurement, some urine needs to go to the laboratory. This can be done with a single small urine specimen, in which the laboratory measures the levels of protein and creatinine (‘protein-creatinine ratio’ or PCR for short). It is becoming more usual to measure the amount of protein in the urine by testing for albumin, and the result is an albumin-creatinine ratio (ACR). Albumin is a large part of the protein in the body, and anyone with a raised PCR will have a raised ACR, though the level will be slightly lower.

  • An ACR of less than 3 mg/mmol does not require further action.
  • An ACR of 3-30 does not usually require action, though would be checked annually.
  • An ACR of greater than 30 suggests significant leakage of protein through the kidneys, and the higher the level the more concern, especially if it is over 100.

If the ACR is high, the doctor will also take a full history, and check there is no-one else in the family with kidney disease. Several blood tests will be done, and your blood pressure will be measured. The size and shape of the kidneys may be measured in the X-ray department with an ultrasound (sound wave) scan.

Sometimes, to make a firm diagnosis of the cause of proteinuria, it is necessary to perform a kidney biopsy. This is the removal of a small fragment of kidney using a needle, so that the kidney can be examined under a microscope.

How is proteinuria treated?

Proteinuria is not a specific disease. So its treatment depends on identifying and managing its underlying cause. If that cause is kidney disease, appropriate medical management is essential. Untreated chronic kidney disease can lead to kidney failure. However, in mild or temporary proteinuria, no treatment may be necessary.

Drugs are sometimes prescribed, especially in people with diabetes and/or high blood pressure. These may come from two classes of drugs:

  • ACE inhibitors (angiotensin-converting enzyme inhibitors);
  • ARBs (angiotensin receptor blockers).

Proper treatment — especially in patients with chronic disease such as diabetes and high blood pressure — is essential to prevent the progressive kidney damage that is causing the proteinuria.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage proteinuria?

The following lifestyles and home remedies might help you cope with Proteinuria:

  • If you have the underlying condition of water retention that leads to Proteinuria, reduce the amount of salt and water taken in your diet each day.
  • If you have high blood pressure, also reduce salt in your diet, and have proper dietary control (eating less fat) with more exercise.If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 4, 2017 | Last Modified: January 4, 2017

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