Proteinuria refers to excess protein in the urine. While some amount of protein in the urine is normal, excessive amounts are a sign that the kidneys are not working properly due to a number of different reasons.
- The main protein in the blood is albumin, which is also the main protein in the urine. For this reason, proteinuria is sometimes referred to as albuminuria.
- Diabetes and hypertension (high blood pressure) are two chronic conditions that can cause kidney damage over time, leading to excess protein in the urine.
- Acute (sudden onset) problems with the kidneys, like acute renal failure, also cause proteinuria.
- Some conditions can transiently increase the amount of protein in the urine, including emotional stress, vigorous exercise, fever, or exposure to heat or cold extreme temperatures.
Other causes of proteinuria (protein in the urine)
- Bacterial Infections
- Chronic Renal Failure
- Fanconi Syndrome
- Focal Segmental Glomerulonephritis
- Goodpasture Syndrome
- Idiopathic Membranous Glomerulonephritis
- IgA Nephropathy
- Interstitial Nephritis
- Membranoproliferative Glomerulonephritis
- Minimal Change Disease
- Nephrotic Syndrome
- Renal Transplant Rejection
- Uric Acid Nephropathy
- Viral Infections
- Wilson Disease
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Causes of Proteinuria (Protein in the Urine)
Amyloidosis is a group of diseases resulting from abnormal deposition of certain proteins (amyloids) in various bodily areas. The amyloid proteins may either be deposited in one particular area of the body (localized amyloidosis) or they may be deposited throughout the body (systemic amyloidosis). There are three types of systemic amyloidosis: primary (AL), secondary (AA), and familial (ATTR). Primary amyloidosis is not associated with any other diseases and is considered a disease entity of its own. Secondary amyloidosis occurs as a result of another illness. Familial Mediterranean Fever is a form of familial (inherited) amyloidosis. Amyloidosis treatment involves treating the underlying illness and correcting organ failure.
Blood in Urine
Blood in the urine is termed hematuria. Hematuria, whether it be gross or microscopic, is abnormal and should be further investigated.
Congestive Heart Failure (CHF)
Congestive heart failure (CHF) refers to a condition in which the heart loses the ability to function properly. Heart disease, high blood pressure, diabetes, myocarditis, and cardiomyopathies are just a few potential causes of congestive heart failure. Signs and symptoms of congestive heart failure may include fatigue, breathlessness, palpitations, angina, and edema. Physical examination, patient history, blood tests, and imaging tests are used to diagnose congestive heart failure. Treatment of heart failure consists of lifestyle modification and taking medications to decrease fluid in the body and ease the strain on the heart. The prognosis of a patient with congestive heart failure depends on the stage of the heart failure and the overall condition of the individual.
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Endocarditis, a serious infection of one of the four heart valves is caused by growth of bacteria on one of the heart valves; leading to an infected massed called a "vegetation." The infection can be caused by having bacteria in the bloodstream after dental work, colonoscopy, or other similar procedures. Endocarditis symptoms include fever, fatigue, weakness, chills, aching muscles and joints, night sweats, edema in the legs, feet, or abdomen, malaise, shortness of breath and small skin lesions. Treatment for endocarditis is generally aggressive antibiotic treatment.
Heart disease (coronary artery disease) occurs when plaque builds up in the coronary arteries, the vessels that supply blood to the heart. Heart disease can lead to heart attack. Risk factors for heart disease include: Smoking High blood pressure High cholesterol Diabetes Family history Obesity Angina, shortness of breath, and sweating are just a few symptoms that may indicate a heart attack. Treatment of heart disease involves control of heart disease risk factors through lifestyle changes, medications, and/or stenting or bypass surgery. Heart disease can be prevented by controlling heart disease risk factors.
Heart failure (congestive) is caused by many conditions including coronary artery disease, heart attack, cardiomyopathy, and conditions that overwork the heart. Symptoms of heart failure include congested lungs, fluid and water retention, dizziness, fatigue and weakness, and rapid or irregular heartbeats. There are two types of congestive heart failure, systolic or left-sided heart failure; and diastolic or right-sided heart failure. Treatment, prognosis, and life-expectancy for a person with congestive heart failure depends upon the stage of the disease.
Hepatitis (Viral Hepatitis A, B, C, D, E, G)
Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, E, F (not confirmed), and G) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease). The main nonviral causes of hepatitis are alcohol and drugs. Many patients infected with hepatitis A, B, and C have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu-like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, and aching in the abdomen. Treatment of viral hepatitis is dependent on the type of hepatitis.
High Blood Pressure (Hypertension)
High blood pressure (hypertension) is a disease in which pressure within the arteries of the body is elevated. About 75 million people in the US have hypertension (1 in 3 adults), and only half of them are able to manage it. Many people do not know that they have high blood pressure because it often has no has no warning signs or symptoms. Systolic and diastolic are the two readings in which blood pressure is measured. The American College of Cardiology released new guidelines for high blood pressure in 2017. The guidelines now state that blood normal blood pressure is 120/80 mmHg. If either one of those numbers is higher, you have high blood pressure. The American Academy of Cardiology defines high blood pressure slightly differently. The AAC considers 130/80 mm Hg. or greater (either number) stage 1 hypertension. Stage 2 hypertension is considered 140/90 mm Hg. or greater. If you have high blood pressure you are at risk of developing life threatening diseases like stroke and heart attack.REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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Human Immunodeficiency Virus (HIV)
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Kidney Infection (Pyelonephritis)
Kidney infection (pyelonephritis) usually is caused by E. coli and other bacteria that have spread from the bladder from a UTI (urinary tract infection), poor hygiene, sexual intercourse, pregnancy, catheter, cystoscope exam, surgery, kidney stones, or prostate enlargement. Symptoms of kidney infection include back pain, frequent urination, pain during urination, fever, and or pus or blood in the urine. Kidney infection can be cured with antibiotic treatment. Cranberry juice may prevent UTIs, but that hasn’t been proven in all research studies.
Leukemia is a type of cancer of the blood cells in which the growth and development of the blood cells are abnormal. Strictly speaking, leukemia should refer only to cancer of the white blood cells (the leukocytes) but in practice, it can apply to malignancy of any cellular element in the blood or bone marrow, as in red cell leukemia (erythroleukemia).
Lupus (Systemic Lupus Erythematosus or SLE)
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous system. When only the skin is involved, the condition is called discoid lupus. When internal organs are involved, the condition is called systemic lupus erythematosus (SLE).
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Preeclampsia and Eclampsia
Preeclampsia is a condition in pregnant women marked by high blood pressure and a high level of protein in the urine. Eclampsia occurs when preeclampsia goes untreated. Eclampsia can cause coma and death of the mother and baby. Preeclampsia symptoms include rapid weight gain, abdominal pain, headaches, blood in the urine, dizziness, and excessive vomiting and nausea. The only real cure for preeclampsia and eclampsia is the birth of the baby.
Rheumatoid Arthritis (RA)
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Sickle Cell Disease (Anemia)
Sickle cell anemia (sickle cell disease), a blood disease that shortens life expectancy, is caused by inherited abnormal hemoglobin. Symptoms of sickle cell anemia may include bacterial infections, painful swelling of the hands and feet, fever, leg ulcers, fatigue, anemia, eye damage, and lung and heart injury. Treatment for sickle cell anemia aims to manage and prevent the worst manifestations of the disease and focuses on therapies that block red blood cells from stacking together, which can lead to tissue and organ damage and pain.
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Examples of Medications for Proteinuria (Protein in the Urine)
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McPherson, Richard A., and Matthew R. Pincus. Henry's Clinical Diagnosis and Laboratory Medicine, 23rd Ed. China: Elsevier Saunders, 2016.