One of the ways that your provider assesses your kidney function is to check for protein in the urine. Chances are you’ve given a urine sample many times for this very reason. Proteinuria is a term that means that there is an increased amount of protein in the urine. There are many causes of proteinuria, but what you need to know is that it could mean that your kidneys may not be working as they should. Here’s what to know about proteinuria.
Kidney function 101
Your kidneys play a remarkable role in keeping you healthy. One of their jobs is to keep the blood clean by filtering out toxins, waste products and excess fluid into the urine. The kidneys’ filtering ability is thanks to tiny blood vessels called glomeruli. There are about one million glomeruli in each kidney — that’s pretty mind boggling! Glomeruli filter out the things that don’t belong but retain the things that do, including protein. However, if the glomeruli are damaged for any reason, they don’t do their job so well, and that’s when some protein can squeeze by and enter the urine. Now, sometimes small amounts of protein may get by the glomeruli but the tubules in the kidney (long, thin tubes) recapture that protein and return it to the body. But if the tubules are damaged, they can’t trap protein and that means protein is excreted in the urine.
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How much protein in the urine is too much?
How do you know if you have too much protein in your urine? A urine test can check for protein. Your provider may do a random test using a dipstick. The dipstick changes color if there is protein in the urine. Dipstick testing isn’t highly accurate, though, so your provider may send your urine sample to the lab for a urine albumin-to-creatinine ratio (UACR) test. You may be asked to provide a 24-hour urine collection for this test. A normal result is less than 30 mg/g. A result of 30–300 mg/g is called microalbuminuria, and a result above 300 mg/g is called proteinuria (sometimes called albuminuria).
Causes of proteinuria
There are many causes of proteinuria; some are more serious than others. These include:
Chronic kidney disease
Chronic kidney disease occurs when a disease or condition damages the kidneys, including high blood pressure, diabetes, glomerulonephritis and polycystic kidney disease.
Infection, certain diseases and immune disorders can cause damage to and inflammation of the glomeruli, which, in turn, can cause proteinuria.
Heart disease/heart failure
Proteinuria is a marker of heart disease and congestive heart failure.
Lupus, an autoimmune disorder that affects joints and can cause organ damage, and Goodpasture syndrome, which affects the lungs and kidneys, can cause proteinuria.
A complication of pregnancy, preeclampsia is characterized by high blood pressure and protein in the urine.
Other causes of proteinuria include dehydration, intense exercise, kidney stone, stress and aspirin. In these cases, proteinuria is often temporary.
Proteinuria risk factors
Also, some people have a higher risk of developing proteinuria. Risk factors are:
- African American, American Indian, Hispanic or Pacific Islander ethnicity
- Older age
- Congestive heart failure
- High blood pressure
- Overweight or obesity
Symptoms of proteinuria
You may not have any symptoms with proteinuria, but typical symptoms include:
- Frequent urination
- Urine that looks foamy
- Feeling tired
- Nausea and vomiting
- Lack of appetite
- Swelling in your face, stomach, ankles or feet
- Muscle cramping
Treatment for proteinuria
Proteinuria is not a disease; rather, it’s sign of a disease or condition. This means, then, that the underlying cause of proteinuria is what need to be treated.
If you have diabetes and have proteinuria, your provider will likely recommend a number of steps to take. These may include:
- Changing or increasing your diabetes medication.
- Encouraging a healthy eating plan that is lower in sodium and protein.
- Regular physical activity.
- Losing weight.
- Stopping smoking.
- Taking certain medicines such as ACE inhibitors or ARBs. These medicines are used to treat high blood pressure and they protect kidney function, as well.
Be sure to keep all of your healthcare appointments. Talk with your provider about the tests and exams that you need to help you manage your diabetes and avoid or delay complications. Always ask for your results and if they are not within target, ask your provider what steps you can take to improve them.
Want to learn more about keeping your kidneys healthy with diabetes? Read “How to Keep Your Kidneys Healthy,” “Kidney Disease: Your Seven-Step Plan for Prevention” and “Ten Things to Know About Kidney Disease.”