Protein in urine (proteinuria)

Dr. Rajalakshmi VK (AIIMS)MBBS

August 19, 2020

January 29, 2024

Protein in urine
Protein in urine

Our body requires a lot of elements for proper functioning. Apart from fats and sugars, our body requires proteins to build up muscle and bone, to regulate the amount of fluid in the blood, to deal with infection and to repair damaged tissues. Protein usually stays in the bloodstream, but if it is found in the urine, the condition is called proteinuria.

In healthy individuals, the glomeruli (tiny loops of blood vessels present in the kidneys) filter the blood to remove waste products and excess water which are turned into urine. The glomeruli are unable to pass larger proteins and blood cells. Even if some of the proteins try to sneak past the glomeruli, the tubules (long thin, hollow tubes in the kidneys) reabsorb the proteins and send them back to the blood. In case of any damage to these structures of the kidneys, there would be a problem in the absorption of protein, and the proteins could flow into the urine. 

The symptoms of proteinuria are usually seen in the advanced stages. They include frequent urination, foam in the urine, fatigue, swelling of body parts and loss of appetite. 

There can be various causes of proteinuria but the most common is kidney damage. Kidney damage mostly occurs due to diabetes and hypertension. Other known causes of proteinuria are preeclampsia, autoimmune diseases, cancer and heart disease. Usually, proteinuria is temporary and resolves on its own but the treatment of chronic cases of proteinuria involves the treatment of its underlying cause.

Protein in urine (proteinuria) symptoms

In most cases, people with proteinuria would not present with any symptoms until the kidneys start getting damaged. In advanced stages, the person may present with the following symptoms: 

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Protein in urine (proteinuria) causes

Usually, proteinuria is caused due to non-cancerous diseases or temporary medical conditions. The conditions that can lead to temporary proteinuria include dehydration, inflammation in the body, low blood pressure, intense exercise, emotional stress, continuous intake of aspirin and exposure to a cold environment. 

Sometimes, proteinuria could be an early indication of chronic kidney disease which if gets worse can require dialysis or even a kidney transplant. Kidney damage mostly occurs due to diabetes and high blood pressure

Other causes of proteinuria include:  

  • Autoimmune disorders such as lupus, Goodpasture’s syndrome and rheumatoid arthritis
  • Nephrotic syndrome (damage to the filtering vessels of the kidney)
  • Glomerulonephritis (inflammation of the kidney)
  • Multiple myeloma (cancer of plasma cells)
  • Kidney cancer
  • Intravascular hemolysis (destruction of red blood cells, followed by the release of haemoglobin in the blood)
  • Cardiovascular diseases such as heart failure, heart attack or arrhythmias
  • Preeclampsia (high blood pressure and proteinuria in a pregnant woman)
  • Trauma to the kidney
  • Sickle cell anaemia
  • Use of certain drugs such as NSAIDs (nonsteroidal anti-inflammatory drugs)
  • Amyloidosis (buildup of abnormal proteins in the organs)
  • Endocarditis (infection of the inner lining of the heart)
  • Berger's disease (inflammation of the kidney due to buildup of the antibody immunoglobulin A)
  • Sarcoidosis (deposition of inflammatory cells in the body)

Protein in urine (proteinuria) prevention

Proteinuria cannot be prevented as it does not present any symptoms until the situation is advanced. However, it can be controlled by treating the underlying causes of proteinuria such as diabetes, high blood pressure, preeclampsia and kidney disease.

Protein in urine (proteinuria) diagnosis

Proteinuria is diagnosed through a routine urine test. Usually, the lab technician uses a dipstick, a thin plastic stick with a chemical coating on the tip, to test the presence of protein in the urine. In the presence of too much protein in the urine, the chemical tip of the stick changes colour.

Other tests that are done to diagnose proteinuria include:

  • Urine culture: Urine culture is done to check for the presence of microorganisms in the urine.
  • Urine microscopy: Urine microscopy helps in examining abnormal red and white blood cells, bacteria and hard crystals in the urine. These crystals can grow and develop into kidney stones.
  • Blood tests: A creatinine test (creatinine is a chemical waste product) helps to estimate the glomerular filtration rate (GFR) and to assess the level of proteins in the serum. 
  • CT scans and ultrasounds: The doctor may prescribe CT scans and ultrasounds to check for any kidney stones, tumours or urinary tract obstruction.
  • Kidney biopsy: Kidney biopsy would be done to determine the cause and extent of kidney disease.
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Protein in urine (proteinuria) treatment

For mild or temporary proteinuria, treatment may not be necessary. The treatment of proteinuria depends on the underlying condition.

If you have uncontrolled diabetes, your doctor will prescribe anti-diabetic medications. Diabetics must also get a glomerular filtration rate (GFR) blood test done every year to know if the kidneys are working fine.

Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin receptor blockers (ARBs) are given to patients with high blood pressure and proteinuria. These drugs prevent the kidneys from getting further damaged. 

If the tests show confirmed kidney disease, the treatment would not only include medications but a change in diet, weight loss and regular exercising. A pregnant woman with proteinuria would require constant monitoring as the condition could be preeclampsia. Preeclampsia usually resolves on its own once the baby is born. In some cases, the doctor may need to deliver the baby prematurely to save the woman and the baby.

If proteinuria isn’t accompanied by diabetes, high blood pressure or any other medical condition, the doctor would still prescribe blood pressure medications to prevent kidney damage. 

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Medicines for Protein in urine (proteinuria)

Medicines listed below are available for Protein in urine (proteinuria). Please note that you should not take any medicines without doctor consultation. Taking any medicine without doctor's consultation can cause serious problems.