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Proteinuria: Essential Facts, Answers, and Treatment

Understand the facts, answers, and treatment for proteinuria as discussed by Dr. Prince Singh, a nephrologist .

A female doctor holding a tube of a urine sample.

What is proteinuria?

Proteinuria (pro-tee-nyur-ee-uh) is the presence of protein (albumin predominantly) in urine.

Is it normal to have proteinuria?

Yes - average daily proteinuria can be up to 30 mg.

Are there physiological (non-disease) conditions that may cause proteinuria?

Yes. There are normal day to day activities that may result in proteinuria such as:

  • Exercise

  • Prolonged standing

  • Lifting heavy weights

  • Sexual intercourse

  • Conditions such as a fever

See the table below for other factors:

A table showcasing factors that increase proteinuria.

What is pathological proteinuria?

Proteinuria in excess of the usual limit is generally more than 100 mg/24-hour. Its classification (Figure) is based on the area of kidney which seem to be affected to be causing it:

1. Glomerular proteinuria- most common 2. Tubular proteinuria- least common 3. Overflow proteinuria- multiple myeloma or light chain disease

What are signs and symptoms of proteinuria?

This is a painless condition. Most of the clinical findings appear to be benign at least early in the course of disease. But persistent proteinuria tends to manifest as:

  • Swelling in legs, arms, and face

  • Abdominal cavity swelling (ascites)

  • Weight gain

  • Cloudiness in urine

  • Increased frothiness or bubbles in urine

A diagram of proteinuria,
Heyman et al Cells 2022

What does having proteinuria imply?

Having proteinuria implies increased risk of kidney dysfunction or kidney failure which may subsequently lead to kidney failure requiring dialysis. It also portrays a higher risk of dying of cardiovascular causes.

What are the common causes that result in (pathological) proteinuria?

  • Uncontrolled and long-standing diabetes

  • Severely elevated blood pressure

  • Autoimmune kidney diseases such as membranous nephropathy, minimal chain disease, focal segmental glomerulosclerosis (FSGS), lupus kidney, infectious glomerulonephritis

  • Cancer or treatment of cancer affecting kidney function

  • Lead or heavy metal toxicity

  • Chronic use of painkillers such as NSAIDs (Ibuprofen, Aleve, Motrin or Celecoxib, etc.)

What is the treatment for proteinuria?

Treatment of proteinuria rests on treating the cause of proteinuria which in most cases end up needing a kidney biopsy. Once the results of kidney biopsy are available, treatment can be specifica

lly directed towards the cause.

What are some of the more common things to do when you suffer from proteinuria?

Some changes you can make in your daily life include:

  • Better control of diabetes or blood pressure

  • Losing 5-10% of your body weight

  • Limiting dietary salt intake - aim for less than 2.5 grams of sodium in your diet

  • Avoiding possible culprit medications such as NSAIDs

When do you need to see a kidney disease specialist?

Contact your healthcare provider if you notice signs and symptoms as described. Referral to a kidney specialist will be needed for proper diagnosis and treatment of proteinuria.

Dr. Prince Singh is a kidney disease specialist who specializes in treatment of kidney diseases and related conditions such as proteinuria. Book a consultation with Dr. Singh or call 507-316-3907.

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