Fluctuations In Protein Excretion
The following conditions can cause transient increase in protein excretion:
- Urinary tract infection
- Upright posture
Proteinuria can be seen in otherwise healthy young adults because of upright posture. This is called postural proteinuria, which is usually less than 1 gram/day. In this condition, random sample of urine shows protein but first morning sample of urine does not show any protein. This condition is benign and does not denote a kidney disease. Normal people and those with chronic kidney disease have diurnal variation in excretion of protein. At night, protein excretion is lower and less variable than in daytime. Samples taken at first void in the morning are more likely to accurately predict 24-hour protein and albumin excretion.
What Is The Normal Range For Protein In Urine
Urine testing is the most common way to monitor the progress of the disease and your response to treatment. Urine testing will show if you are losing protein in your urine.
Normal protein levels in urine range between 0 to 8 mg/dL. The average protein value in your urine is usually less than 150 mg for a 24-hour urine collection. This level may vary slightly from one lab to another. You can consult your doctor to know the results correctly.
What is a dangerous level of protein in urine? A dangerous level of protein in urine is one that is significantly higher than the normal range. This can be indicative of a number of serious medical conditions, such as kidney disease, and should be evaluated by a medical professional as soon as possible.
How Is A Urine Test Done
A simple urine test can be done in your doctor’s office. You will be asked to pee into a clean cup called a specimen cup. Only a small amount of your urine is needed to do the test. Some of the urine is tested right away with a dipstick a thin, plastic strip that is placed in the urine. The rest is examined under a microscope.
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Protein In Urine Symptoms
Most people who have proteinuria wonât notice any signs, especially in early or mild cases. Over time, as it gets worse, you might have symptoms including:
- Foamy or bubbly pee
- A family history of kidney disease
- African American, Native American, Hispanic, or Pacific Islander descent
Some people get more protein into their urine while standing than while lying down. This condition is called orthostatic proteinuria.
When To See A Doctor
If a urine test reveals protein in your urine, your health care provider may ask you to have more testing done. Because protein in urine can be temporary, you may need to repeat a urine test first thing in the morning or a few days later. You also may need to do a 24-hour urine collection for lab testing.
If you have diabetes, your doctor may check for small amounts of protein in urine also known as microalbuminuria once or twice each year. Newly developing or increasing amounts of protein in your urine may be the earliest sign of diabetic kidney damage.
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Is There Anything Else I Need To Know About A Protein In Urine Test
At-home test kits that check for protein in urine test are available without a prescription. The kits usually include dipsticks and instructions for how to collect and test your urine sample. At-home urine tests are easy to do and provide accurate results as long as you carefully follow all instructions. Ask your provider which protein in urine test is best for you.
Diagnosis / Testing Of Proteinuria
Routine complete urine examination test uses a multireagent dipstick for screening of protein in the urine. It is low cost, widely available and provides rapid point of care information. These dipstick reagents have a pH-sensitive colorimetric indicator which changes color when proteins bind to it. Based on the color, amount of proteinuria is estimated in a semiquantitative way . These dipsticks predominantly detect albumin and likely to miss non albumin and small LMW proteins. Very dilute urine can give false negative result and very concentrated urine can give false positive result. Blood in the urine can also give a false positive result, which is generally seen in menstruating women if the urine sample is collected during days of menstrual bleeding.
Proteinuria repeatedly positive on dipstick needs to be quantified which can be done by 24-hour urine total protein or albumin quantification for which urine is to be collected over 24 hours.
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Protein In Urine Causes
Protein in the urine is not always an emergency. A number of daily activities and normal conditions can temporarily cause this condition, also called proteinuria, including exposure to intense heat or cold, emotional stress, fever, and strenuous exercise
Because proteinuria can also be a sign of kidney disease, elevated levels of protein in the urine should not be ignored.
Is Protein Normally Found In Urine
If we take a normal kidney, around 180 liters of filtrate in produced from plasma in a whole day. The amount of plasma filtered to produce 180 Liters of filtrate has around 10 kg of protein. However, only 0.01% or 1 gram of protein passes into the filtrate at the glomerulus. This is because of the filtration barrier inside the glomerulus, which restricts passage of large molecules like albumin in the urine and allows the passage of water and small solvents. Because of the filtration barrier, only small amounts of albumin is passed in the urine. Small molecules called low molecular weight proteins easily pass the filtration barrier into the filtrate. The filtered load of these small molecules is less and ultimately are excreted in even lesser amounts because the LMW proteins are again reabsorbed by kidney tubules. There are also small amounts of proteins in the urine which are not filtered but directly secreted into the urine in the kidney .
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How Do I Take Care Of Myself
The best way to take care of yourself is to take your medications as prescribed by your healthcare provider.
Other ways to help take care of yourself include:
- Eating less protein.
- Limiting your salt intake, which can lower your blood pressure.
- Eating more fiber, which can help reduce cholesterol and control blood sugar.
- Exercising or moving regularly. Aim for at least two hours of activity every week.
- Regularly checking your blood sugar.
- Quitting smoking and tobacco use.
- Avoiding nonsteroidal anti-inflammatory drugs unless recommended by your healthcare provider. The most common NSAIDs include aspirin , ibuprofen and naproxen .
What Happens If You Have Proteinuria
Protein gets into your pee if your kidneys arent working correctly.
Glomeruli are groups of tiny blood vessels in your kidneys. They perform the first stage of filtering waste products and excess water from your blood. The waste products and excess water leave your body through your pee. Glomeruli dont allow passage of larger proteins or blood cells into your pee. If smaller proteins sneak through your glomeruli, then long, thin tubes in your kidneys recover the proteins and keep them in your body.
Proteins may flow into your pee if theres:
- Damage to your glomeruli or tubules.
- A problem with the reabsorption process of the proteins.
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What Is Pediatric Proteinuria
Proteinuria is an excess if protein in your child’s urine. If your child has proteinuria, its often not serious. But sometimes, it can indicate a more serious problem with the kidneys. You should watch for any signs that your childs fluids seem out of balance and check with a doctor.
If proteinuria indicates a kidney disease, your doctor will refer your child to a nephrologist, a doctor who specializes in treating kidney diseases.
What Are The Symptoms Of Protein In Urine
When a person first begins to have kidney problems, they may not notice any symptoms. This is why a urine test can be essential to detect protein in the urine, which may indicate early signs of kidney disease.
In addition to proteinuria, symptoms of kidney disease can include:
- Foamy or frothy urine
- Trouble concentrating
If you are pregnant, protein in urine can also be a sign of preeclampsia, a very dangerous condition that can cause high blood pressure and lead to hospitalization. Additional signs of preeclampsia can include headaches, vision changes, abdominal pain, nausea, decreased urine output, and shortness of breath.
What Do The Results Mean
If a large amount of protein is found in your urine sample, it doesnât always mean that you have a medical problem that needs treatment. Strenuous exercise, dehydration, diet, stress, pregnancy, and other conditions can cause a temporary rise in urine protein levels.
Your provider may recommend other urinalysis tests to see whether you continue to have a high level of protein in your urine over time. If your urine protein remains high, it is likely a sign of kidney disease or kidney damage from other conditions.
The amount of protein in your urine is linked to the amount of kidney damage you may have. But you will need more tests to diagnose what is causing the damage. To learn what your results mean, talk with your provider.
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What Are The Causes
- Diseases of the glomeruli , for example glomerulonephritis or diabetes.
- Urine infection can cause proteinuria, but usually there are other signs of this such as a urinary tract infections.
- Proteinuria can be a symptom of some other conditions and diseases: for example: congestive heart failure, a first warning of eclampsia in pregnancy.
- Sometimes a positive dipstick for protein isnt abnormal, for example concentrated samples first thing in the morning, or if you have become dehydrated or havent drunk much.
- Temporary proteinuria may occur after vigorous exercise or if you have a high fever.
- Sometimes, almost always in children, proteinuria can be detected later in the day, but not in the morning. This is known as orthostatic proteinuria and it is usually harmless.
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What Are The Signs And Symptoms Of Pediatric Proteinuria
Your child may have no symptoms while in the earliest stages of proteinuria. As large amounts of protein move from the blood to the urine and out of the body, the following signs and symptoms may occur and may indicate progression of kidney disease.
- Difficulty breathing
- Swelling , especially around the eyes and in the hands, feet, and belly
- Urine that appears to be foamy or bubbly because of large amounts of protein
Asymptomatic Proteinuria And Hematuria Syndrome
, MD, Washington University in St. Louis
Small amounts of protein excreted in the urine or blood excreted in the urine can make urine appear pink, red, or brown, depending on the amount of blood, how long it has been in the urine, and how acidic the urine is. An amount of blood… read more ) are sometimes discovered in people without symptoms when urine tests are done for some routine purpose. The presence of clumps of red blood cells or abnormally shaped red blood cells is a clue for doctors that the blood in the urine came from glomeruli. Casts and proteinuria may be present because the person is recovering from a recent undiagnosed episode of kidney inflammation . It is characterized by body tissue swelling… read more ). If this situation seems likely, a doctor needs only to recheck the person over the next weeks or months to make sure that the abnormalities resolve.
If red blood cells and proteinuria persist, the cause is usually one of three disorders:
Alport syndrome Alport Syndrome Alport syndrome is a hereditary disorder that results in glomerulonephritis in which kidney function is poor, blood is present in the urine, and deafness and eye abnormalities sometimes… read more , a progressive hereditary disorder that can be severe and lead to kidney failure and decreased hearing and vision.
Thin basement membrane disease , a hereditary disorder caused by thinning of a part of the glomerulus called the basement membrane.
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How Can I Know If I Have Protein In My Urine
When your kidneys start having problems and you do not have a lot of protein in your urine, you will not feel symptoms. The only way to know if you have protein in your urine, it is to have a urine analysis. The urine protein test measures the amount of albumin in your urine, compared to the amount of creatinine in your urine.
When renal damage is worsening and large amounts of protein through the urine, the following symptoms may be observed:
- Foaming or sparkling urine when using the bathroom
- Swelling in the hands, feet, abdomen or face
If you have any of these symptoms, the damage caused to your kidneys can be serious. Talk to your doctor immediately on what can cause your symptoms and what treatment is the best for your situation.
Treatment Of Nutcracker Syndrome
If a person experiences mild symptoms, simply observing the symptoms is recommended by the doctor to see if they resolve. If the symptoms are observed to be not improving, low-dose aspirin and angiotensin-converting enzyme ACE inhibitors are recommended.
Surgical options for nutcracker syndrome include the following:
- Venous Stenting: It involves inserting a small tube or stent into the left renal vein to keep it open.
- Blood Vessel Surgery: It involves rerouting the blood vessels with the help of grafts or moving compressed vessels.
- Nephrectomy: In this, the affected kidney is removed. This is an appropriate option when other treatment options fail.
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What Are The Causes Of Blood And Protein In Urine
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Recovering From Nutcracker Syndrome
People undergoing surgery would need several weeks to recover. Recovery time for each individual depends on the health condition of an individual and the type of surgery. Those undergoing venous stenting recover quicker than those undergoing complex procedures such as nephrectomy.
Even after surgery, a kidney function test may be ordered to look for the glomerular filtration rate. If a person undergoes nephrectomy, the eGFR may take months to recover
A person if undergone surgery for treatment may need to take a blood thinner or undergo more surgeries.
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What Is Orthostatic Proteinuria
Orthostatic proteinuria occurs in some older children and teenagers. The word orthostatic means upright. The condition is called orthostatic proteinuria because protein goes into the urine only when the child is in the upright position .
Children with this condition have no kidney damage but, for some unknown reason, they lose protein into the urine during the day when they are active. At night, while they sleep, their kidneys don’t let any protein into the urine. Your doctor diagnoses this harmless condition by checking two urine samples. The first one is collected in the morning, right after your child gets up, and it’s kept in one container. The second sample is collected during the day . If your child has orthostatic proteinuria, the morning sample won’t have protein in it. The urine collected during the day will have protein in it.
Protein In Urine Diagnosis
A urine test called a urinalysis can tell whether you have too much protein in your pee. First, youâll pee into a cup. A lab technician will dip in a stick with chemicals on the end. If the stick changes color, itâs a sign of too much protein. You might need to have this test more than once to find out how long the protein is there.
The technician will also look at the pee under a microscope. Theyâre checking for things that shouldnât be there, which might mean kidney problems. These include red and white blood cells, crystals, and bacteria.
If your doctor suspects kidney disease, you might need to have other urine tests. Your doctor might also order:
- Blood tests. These measure certain chemicals to check how well your kidneys are working.
- Imaging tests. CT scans and ultrasounds can spot kidney stones, tumors, or other blockages.
- A kidney biopsy. Your doctor might need to take a small sample of kidney tissue so a lab technician can look at it under a microscope.
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How To Treat Proteinuria
Proteinuria is not a disease but rather a condition caused by another illness. As such, the treatment is mainly focused on resolving or managing the underlying cause.
For instance, the symptoms of acute kidney injuryâformerly known as acute kidney failureâwill usually clear once the underlying condition is treated. In most cases, the kidney function will return to normal with no permanent damage to the kidneys.
With chronic kidney disease , the focus is placed on improving the function of the kidneys to slow the progression of the disease. With respect to proteinuria, lifestyle measures will help control diabetes and high blood pressure as ways to slow progression of the disease.
In addition, medications like ACE inhibitors and angiotensin II receptor blockers help reduce urine protein levels.Statin drugs, used to reduce cholesterol, appear to have similar benefits in people with CKD.