Introduction

Proteinuria is increased levels of protein in the urine. This condition can be a sign of kidney damage.

Proteins – which help build muscle and bone, regulate the amount of fluid in blood, combat infection and repair tissue – should remain in the blood. If proteins enter the urine they ultimately leave the body, which isn’t healthy.

How does protein get into urine?

Protein gets into the urine if the kidneys aren’t working properly. Normally, glomeruli, which are tiny loops of capillaries (blood vessels) in the kidneys, filter waste products and excess water from the blood.

Glomeruli pass these substances, but not larger proteins and blood cells, into the urine. If smaller proteins sneak through the glomeruli, tubules (long, thin, hollow tubes in the kidneys) recapture those proteins and keep them in the body.

However, if the glomeruli or tubules are damaged, if there is a problem with the reabsorption process of the proteins, or if there is an excessive protein load, the proteins will flow into the urine.

Causes

• Immune disorders like lupus and goodpasture’s syndrome
• Acute inflammation of the kidney (glomerulonephritis)
• Cancer of plasma cells (multiple myeloma)
• Intravascular hemolysis, which is the destruction of red blood cells and release of hemoglobin in the bloodstream
• Cardiovascular disease
• Preeclampsia, the simultaneous development of hypertension and proteinuria in a pregnant woman
• Poisoning
• Trauma
• Kidney cancer
• Congestive heart failure

Symptoms

• More frequent urination
• Shortness of breath
• Tiredness
• Nausea and vomiting
• Swelling in the face, belly, feet or ankles
• Lack of appetite
• Muscle cramping at night
• Puffiness around the eyes, especially in the morning
• Foamy or bubbly urine

Diagnosis

• Blood test to measure the levels of creatinine (chemical waste products). Healthy kidneys move these substances from the blood to the urine. If the kidneys are not working properly, creatinine will remain in the blood.
• Blood test to estimate the glomerular filtration rate (GFR). The GFR compares a patient’s size, age, sex and race to levels of creatinine and albumin in the blood. The GFR tells a doctor how well the kidneys are working and how far the kidney disease has advanced. It also helps the doctor plan treatment.
• Blood test to measure all proteins in the serum. The serum is part of the blood filled with proteins.
• Imaging tests like CT scans and ultrasounds. These tests show images of the kidneys, helping doctors spot problems like kidney stones, tumors or obstruction of the urinary tract.
• Urine protein electrophoresis. Doctors search for specific types of proteins in a urine sample. For example, the presence of a protein called Bence-Jones might indicate multiple myeloma (cancer of plasma cells).
• Immunofixation blood test. This test finds proteins called immunoglobulins – which are antibodies that fight infection – in the blood. Too many of the same immunoglobulins can indicate blood cancer.
• A kidney biopsy. This is a procedure involving removal of a tiny piece of kidney. Doctors examine the sample under a microscope to determine what caused the kidney disease and the extent of damage.

Conclusion

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Journal of Kidney Treatment and Diagnosis