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Concept
Proteinuria
Summary
Proteinuria is the presence of excess proteins in the urine. In healthy persons, urine contains very little protein; an excess is suggestive of illness. Excess protein in the urine often causes the urine to become foamy (although this symptom may also be caused by other conditions). Severe proteinuria can cause nephrotic syndrome in which there is worsening swelling of the body.
Proteinuria often causes no symptoms and it may only be discovered incidentally.
Foamy urine is considered a cardinal sign of proteinuria, but only a third of people with foamy urine have proteinuria as the underlying cause. It may also be caused by bilirubin in the urine (bilirubinuria), retrograde ejaculation, pneumaturia (air bubbles in the urine) due to a fistula, or drugs such as pyridium.
There are three main mechanisms to cause proteinuria:
Due to disease in the glomerulus
Because of increased quantity of proteins in serum (overflow proteinuria)
Due to low reabsorption at proximal tubule (Fanconi syndrome)
Proteinuria can also be caused by certain biological agents, such as bevacizumab (Avastin) used in cancer treatment. Excessive fluid intake (drinking in excess of 4 litres of water per day) is another cause.
Proteinuria may be a sign of renal (kidney) damage. Since serum proteins are readily reabsorbed from urine, the presence of excess protein indicates either an insufficiency of absorption or impaired filtration. People with diabetes may have damaged nephrons and develop proteinuria. The most common cause of proteinuria is diabetes, and in any person with proteinuria and diabetes, the cause of the underlying proteinuria should be separated into two categories: diabetic proteinuria versus the field.
With severe proteinuria, general hypoproteinemia can develop which results in
diminished oncotic pressure. Symptoms of diminished oncotic pressure may include ascites, edema and hydrothorax.
Proteinuria may be a feature of the following conditions:
Nephrotic syndromes (i.e. intrinsic kidney failure)
Pre-eclampsia
Eclampsia
Toxic lesions of kidneys
Amyloidosis
Collagen vascular diseases (e.
Official source
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