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Protein in urine (Proteinuria): Meaning, symptoms, causes, and other details

Team AckoSept 21, 2023

Protein in urine, also known as Proteinuria, is a medical condition related to excessive amounts of protein present in the urine. It can be a sign of an underlying health issue such as kidney disease, diabetes, or high blood pressure. This article will provide you with an overview of this condition.

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Contents

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What is Proteinuria?

Proteinuria refers to the presence of excess protein in the urine, which is often an indicator of kidney damage or dysfunction. When protein leaks into the urine, it can mean that the kidneys are not functioning properly and are unable to filter the protein adequately. Monitoring protein levels in urine is important for assessing kidney function and detecting potential kidney-related issues.

Protein in urine symptoms

Protein in the urine may be a sign of an underlying health condition. Some symptoms that may indicate the presence of protein in the urine include the following.

  • Foamy urine

  • Swelling in the hands, feet, or face

  • Fatigue or weakness

  • Frequent urination

  • Abdominal pain or discomfort

  • High blood pressure

  • Unexplained weight loss

  • Changes in urine colour or appearance

What causes protein in the urine?

Some common causes include the following.

  • Kidney damage

  • Low blood pressure

  • Kidney disorders such as polycystic kidney disease or nephrotic syndrome

  • Diabetes

  • Infections in the urinary tract or kidneys

  • Autoimmune diseases 

  • High stress

  • Strenuous exercise

  • Fever

  • Inflammation

  • Dehydration

  • Exposure to extreme cold

Types of Proteinuria

There are mainly four types of Proteinuria, which are as follows.

  • Glomerular Proteinuria: Glomerular Proteinuria occurs when there is damage to the glomeruli in the kidneys, resulting in the leakage of protein into the urine. It is commonly seen in conditions such as glomerulonephritis and diabetic kidney disease.

  • Overflow Proteinuria: It occurs when there is an excess of protein in the blood that cannot be properly filtered by the kidneys, causing it to spill into the urine. This can occur in conditions such as multiple myeloma and amyloidosis.

  • Tubular Proteinuria: It is caused by dysfunction of the renal tubules, which leads to improper reabsorption of proteins back into the bloodstream. It can be associated with conditions like Fanconi syndrome and certain genetic disorders.

  • Post renal Proteinuria: It occurs if there is a blockage in the urinary tract, preventing the normal flow of urine. This can lead to the presence of protein in the urine.

Categories of Proteinuria

The categories of Proteinuria based on the amount passed in urine, are as follows.

  • Normal: In this category, the amount of protein in the urine is within the normal range (<150 mg/day), indicating a healthy kidney function.

  • Moderately increased: This category refers to an elevated level (150-500 mg/day) of protein in the urine, but not to a severe extent. It may indicate some kidney damage or an underlying condition.

  • Severely increased: This category represents a significantly high amount (150-500 mg/day) of protein in the urine.

  • Nephrotic range Proteinuria: This is the most severe category, where the amount of protein in the urine is greater than 3.5 grams per day. It is usually a result of kidney disease or damage, such as glomerulonephritis or diabetes.

Diagnosis of Proteinuria

When it comes to diagnosing Proteinuria, healthcare professionals rely on several tests to accurately evaluate the condition. These tests are important in determining the presence and extent of protein in the urine.

The Diagnostic procedure of Proteinuria includes the following.

  • History and physical examination: A thorough medical history will be taken. 

  • Urinalysis: This initial screening test examines a urine sample for the presence of protein. Doctors check for elevated levels of protein, which may indicate Proteinuria.

  • 24-hour urine collection: In this test, individuals are required to collect all their urine over a 24-hour period. The collected urine is then analysed to measure the amount of protein excreted over a day. This test provides a more accurate measurement of Proteinuria compared to a single urine sample.

  • Dipstick test: A dipstick is a narrow strip of paper or plastic that is dipped into a urine sample. It contains reagents that react with proteins, indicating the presence of Proteinuria. While this test is convenient and easy to perform, it may not provide specific information about the exact amount of protein present.

Additional tests to determine the cause and severity of Proteinuria

In addition to the initial diagnostic tests mentioned above, healthcare professionals may order additional tests to further evaluate the cause and severity of Proteinuria.

  • Blood tests: Some common blood tests include serum creatinine, blood urea nitrogen (BUN), and albumin levels.

  • Imaging studies: Imaging studies may be recommended to visualise the kidneys and identify any structural abnormalities or blockages that could be causing Proteinuria.

  • Kidney biopsy: This test can help determine the underlying cause of Proteinuria, such as kidney disease or inflammation.

  • Glomerular filtration rate (GFR): GFR is a measure of the kidney's ability to filter waste products from the blood. It is an important indicator of kidney function and can help determine the severity of Proteinuria. 

  • Renal ultrasound: This can help identify any structural abnormalities or blockages that may be causing Proteinuria. This test is non-invasive and does not involve radiation.

  • Kidney function tests: To measure how well the kidneys are functioning. Examples include blood urea nitrogen (BUN) and creatinine clearance tests.

  • Immunological tests: If Proteinuria is suspected to be caused by an autoimmune or inflammatory condition, immunological tests may be ordered. These tests can help identify specific antibodies or immune system abnormalities that may be contributing to Proteinuria. Examples of immunological tests include antinuclear antibody (ANA) testing and complement level testing.

  • Genetic testing: It may be recommended to determine if Proteinuria is due to an inherited genetic condition. This can help identify specific gene mutations associated with Proteinuria and guide further management and treatment options.

Treatment of Proteinuria

The best treatment approach for Proteinuria depends on the underlying cause of the condition. Mentioned below are some medications that are commonly used to treat Proteinuria.

  • Angiotensin-converting enzyme (ACE) inhibitors: These medications work by dilating blood vessels, reducing blood pressure, and decreasing protein leakage in urine.

  • Angiotensin II receptor blockers (ARBs): They help lower blood pressure and reduce Proteinuria.

  • Diuretics: Diuretics help increase urine production, which can reduce fluid buildup and alleviate Proteinuria.

  • Corticosteroids: These anti-inflammatory medications can help reduce inflammation in the kidneys and decrease Proteinuria.

  • Immunosuppressants: These medications suppress the immune system to prevent it from attacking the kidneys and reduce Proteinuria.

  • Anticoagulants: Sometimes anticoagulants are used to prevent blood clots and improve blood flow in the kidneys, which can help reduce Proteinuria.

  • Statins: Statins are commonly used to lower cholesterol levels, but they may also have a beneficial effect on Proteinuria by reducing inflammation and improving kidney function.

  • Antiplatelet agents: These medications can help decrease Proteinuria.

Lifestyle modifications to manage Proteinuria

In some cases, a combination of lifestyle modifications and medications may be recommended to effectively manage this condition.

  • Diet changes: A balanced and low-sodium diet can help manage Proteinuria. It is recommended to limit the intake of processed foods, saturated fats, and added sugars. Instead, focus on consuming a variety of fruits, vegetables, lean proteins, and whole grains. Additionally, reducing salt intake can help control blood pressure and reduce protein leakage.

  • Regular exercise: Exercise helps maintain a healthy weight, promotes cardiovascular health, and improves kidney function.

  • Maintaining a healthy weight: Excess weight can put additional strain on the kidneys and worsen Proteinuria. 

Frequently Asked Questions

Here are some FAQs related to Proteinuria.

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How much protein in urine is normal?

A protein level of less than 150 milligrams per day is considered normal.

How will I know if I have protein in my urine?

To determine if you have protein in your urine, you can undergo a urine test called a urinalysis.

What happens during a protein in urine test?

During a protein in urine test, a sample of urine is collected and analysed for the presence of protein. 

What does 2 plus protein mean in a 24 hr urinalysis?

2 plus protein in a 24 hr urinalysis refers to the prevalence of protein in the urine.

Is protein in urine temporary?

Yes, protein in urine can be temporary or transient. There are several reasons why protein may appear in urine temporarily. For example, intense exercise can lead to temporary Proteinuria.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.

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