16428 Proteinuria

Overview

Proteinuria means there is extra protein in your urine. Healthy kidneys filter blood and keep most protein in your body. When kidneys leak protein into urine, it can be a sign of kidney strain or another health problem. Sometimes it is temporary and harmless.

It is common to find a little protein in urine, especially during illness, after hard exercise, or when you are low on fluids. This often settles. Protein that stays in the urine is less common and needs medical review.

Anyone can have protein in their urine. It is more likely in people with diabetes, high blood pressure, heart failure, lupus (a condition where the immune system attacks the body), or a family history of kidney disease. It can also happen during pregnancy and in children.

Symptoms

Common symptoms

• Most people have no symptoms at all.
• Foamy or bubbly urine that does not clear quickly.
• Swelling in the face, eyelids, hands, feet, or belly.
• Weight gain from extra fluid.
• Feeling more tired than usual.
• Poor appetite or feeling sick.

Symptoms in children

• Puffiness around the eyes, especially in the morning.
• Foamy urine.
• Swelling in the legs or belly.
• Poor appetite or slow growth.
• More infections than usual in some children.

Symptoms in older adults

• Swelling in the legs or feet that may be mistaken for normal aging.
• Tiredness or low energy.
• Shortness of breath if fluid builds up.
• Protein found during routine tests for diabetes or high blood pressure.

Causes

Main causes

• Temporary causes: fever, hard exercise, dehydration, stress, or a urinary tract infection.
• Diabetes and high blood pressure are common long-term causes.
• Kidney filter inflammation (glomerulonephritis).
• Heart failure or other heart problems.
• Lupus and other immune system conditions.
• Pregnancy-related high blood pressure problems, such as preeclampsia.
• Some medicines can harm the kidneys.
• Less common causes include some cancers and blood conditions.
• In young people, protein can appear only when standing and go away when lying down.

Risk factors

• Diabetes.
• High blood pressure.
• Family history of kidney disease.
• Heart disease or heart failure.
• Lupus or other immune conditions.
• Obesity.
• Smoking.
• Being pregnant.
• Taking medicines that can harm the kidneys without checks.
• Older age.

When to see a doctor

See a doctor urgently if:

• You notice new or worsening swelling.
• You have foamy urine that does not go away.
• You see blood in your urine.
• You are passing much less urine than usual.
• You have fever with back or side pain.
• You are pregnant and have headache, vision changes, or sudden swelling.

Book a routine appointment if:

• A urine test shows protein and you have not had it checked before.
• You have diabetes, high blood pressure, or a family history of kidney disease.
• You have repeated urine tests showing protein.
• You feel very tired or have swelling that worries you.

Diagnosis

Your doctor will ask about your health, medicines, and symptoms. They will check your blood pressure and usually test your urine. If protein is found, the test may be repeated. Your doctor may do blood tests and sometimes scans to look at kidney function and find the cause.

Tests that may be done

• Urine dipstick test: a quick strip test that checks for protein.
• Repeat urine test to see if protein is temporary.
• Urine protein-to-creatinine ratio: a urine test that estimates how much protein is leaking.
• 24-hour urine collection: collecting all urine for one day to measure protein.
• Blood tests for kidney function, blood sugar, cholesterol, and protein levels.
• Blood pressure checks.
• Kidney ultrasound scan to look at the shape and size of the kidneys.
• Kidney biopsy: a small tissue sample is taken from the kidney in some cases.

What to expect at your appointment

You may need to give a urine sample, and sometimes collect urine at home for 24 hours. Results can take a few days. Your doctor may repeat tests over weeks or months. Not all protein in urine means serious kidney disease.

Treatment

Treatment depends on the cause. If protein is temporary, you may not need any treatment. If it is caused by diabetes, high blood pressure, or kidney disease, the goal is to protect your kidneys and lower the risk of long-term problems.

Self-care at home

• Take any prescribed medicines as directed.
• Keep your blood pressure and blood sugar in the target range your doctor sets.
• Limit salt in your food.
• Eat balanced meals and stay at a healthy weight.
• Stay active in a way that suits you.
• Do not smoke, and get help to quit if needed.
• Avoid becoming dehydrated.
• Ask your pharmacist or doctor before using common painkillers, as some can harm kidneys.
• Keep follow-up appointments and urine tests.

Medical treatments

Doctors may use medicines to lower blood pressure, control blood sugar, reduce protein leaking, remove extra fluid, or treat infection or immune problems. Some people need a dietitian for advice on salt and protein. Your doctor will choose treatment based on the cause and your overall health.

When is surgery considered?

Surgery is not a usual treatment for proteinuria. It may be needed if tests find a blockage, stone, or structural problem causing kidney trouble.

Living with this condition

Most people can live a normal life while being monitored. Keep your appointments, take medicines as prescribed, and track swelling or weight changes if your doctor asks. Tell your care team about any new symptoms.

Lifestyle tips

• Keep a healthy daily routine with regular meals and sleep.
• Check your blood pressure at home if your doctor advises.
• Stay physically active within your limits.
• Quit smoking and avoid secondhand smoke.
• Limit alcohol to the amount your doctor advises.
• Ask your pharmacist before taking any new medicine, supplement, or herbal product.

Diet and exercise

A balanced diet with less salt can help control blood pressure and fluid. Your doctor or dietitian may advise on protein intake. Regular activity, such as walking or swimming, is helpful for most people. Ask your care team what is safe for you.

Mental health and emotional wellbeing

Waiting for test results or living with a kidney concern can feel worrying. Talk to your doctor about your fears. If you feel very anxious or low, ask for support. If you ever have thoughts of harming yourself, call your local emergency number or a local crisis service right away.

Prevention

Not all proteinuria can be prevented. You can lower your risk by managing diabetes and high blood pressure, staying at a healthy weight, not smoking, limiting salt, and avoiding medicines that can harm the kidneys without advice.

Vaccines

There is no vaccine for proteinuria. Keep up with routine vaccines your doctor recommends, especially if you have kidney disease.

Screening programmes

Urine and blood pressure checks are important if you have diabetes, high blood pressure, heart disease, or a family history of kidney disease. Pregnant women are usually checked for protein in urine. Ask your doctor if you need screening.

Complications

If left untreated

• Slow loss of kidney function.
• Chronic kidney disease or kidney failure over time.
• Higher risk of heart and blood vessel problems.
• Blood clots in some people with heavy protein loss.
• More infections.
• Poor nutrition or muscle loss in severe cases.

Long-term outlook

Many people with proteinuria have a temporary or mild cause and do well. When a cause is found, early care can protect the kidneys and lower the risk of problems. Most people can be supported with monitoring and treatment.

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