Proteinuria Resource Center Proteinuria (pro-teen-yur-EE-uh) is an early warning sign of chronic kidney disease (CKD). In some cases, there are no signs or symptoms to warn about early kidney disease. It can take months or years for symptoms to become obvious, and many of the symptoms are non-specific and even temporary. Because of this, many people are unaware they may be at risk for serious health problems. This is not a diagnostic site, but rather an informational one that is designed to encourage people to have better discussions with their doctors. What is proteinuria? Proteinuria is the name used by medical professionals when a large amount of protein, or albumin, that should remain circulating in a person’s blood is “spilled” into their urine and eliminated from the body. Proteins are large molecules that our bodies need to function properly. Proteinuria can also be referred to as albuminuria. Proteinuria indicates the kidneys filtering units are not functioning properly. Some pregnant women have higher than normal levels of protein in their urine, and taking certain medications can also trigger higher than normal protein loss. It is not always serious, but it should NOT be ignored. Proteinuria has been also known to occur in people with cancer, diabetes, heart disease, or excessive weight gain, as well as those with a chronic kidney problem. However, much high levels of protein in the urine is serious. A cause of the proteinuria must be found and the goal of treatment should be to stop or lower the amount of protein as soon as possible to prevent permanent kidney damage. What are the risk factors for proteinuria? The two most common health conditions associated with proteinuria are diabetes and high blood pressure. Both diabetes and high blood pressure can cause damage to the kidneys, which can lead to proteinuria. Kidneys can also become damaged in other ways, such as from: Medications Injury Poisons Infections Immune system disorders Rare kidney diseases such as: Nephrotic Syndrome Minimal Change Disease Focal Segmental Glomerulosclerosis Membranous Nephropathy MPGN C3G C1q Nephropathy IgA Nephropathy IgM Nephropathy Alport Syndrome Other risk factors include: Obesity Being over 65 years of age Family history of kidney disease Preeclampsia (high blood pressure and proteinuria during pregnancy) Race and ethnicity What are the signs and symptoms of proteinuria? Signs and symptoms include: Edema: Swelling of the body, especially around the face, hands, and feet Rapid weight gain Foamy or bubbly urine High blood pressure Feeling tired Sometimes there are no signs or symptoms at all Blood with normal amounts of protein keeps your body’s fluids in balance. Kidneys that are not working properly by spilling protein will cause fluid to leak into your body’s tissue and cause swelling. This is usually seen around the eyes, in hands and feet and in your belly (abdomen). This swelling is called edema and is a common symptom associated with proteinuria. Edema is not the same as normal weight gain. People with proteinuria may gain a lot of weight, but it is as a result of the untreated kidney problem and fluid retention. A large amount of protein in your urine may make it look frothy, foamy, have lots of bubbles, or have a funny color. People with proteinuria may have trouble breathing or feel fatigued due to the strain on the body caused by underlying kidney problems and fluid retention. These signs of large protein loss indicate the possibility of a kidney problem. Proteinuria can be discovered during a routine doctor’s visit through a simple urine sample. Further laboratory testing is the only way to find out whether the protein in a person’s urine is significant. What can proteinuria lead to? If the underlying problem that causes proteinuria is left untreated, a person is at risk for developing more serious kidney problems. The kidneys can loose some of their function or even stop working. End-stage renal disease (ESRD) is the last step in the disease process. Long term dialysis or a kidney transplant are the only treatment options to replace lost kidney function. What is Nephrotic Syndrome, and how does it relate to proteinuria? Nephrotic Syndrome is the name medical professionals give to a group of symptoms that suggest a serious kidney problem. Nephrotic Syndrome is not a disease, but a collection of symptoms that can be caused by any one of several diseases. Proteinuria is one of the most important signs (or laboratory findings) that suggest a person could have Nephrotic Syndrome. What can your test results mean? It is important that you talk with your doctor if you have symptoms or a laboratory test result that may suggest you have proteinuria. Testing can help a doctor make a correct diagnosis, but you need to manage your own health care actively. You can determine your level of proteinuria using our Proteinuria Calculator. Urine Protein to Creatinine Ratio (UPCR) or Albumin to Creatinine Ratio (ACR) Tests A UPCR test, also known as an ACR test, is performed through a urine sample and is used to quickly and simply estimate the amount of protein being spilled into the urine. While small amounts of protein in the urine is normal, large amounts can indicate the risk for kidney disease. A normal UPCR/ACR test result is less than 30 mg/g. Levels between 30 – 300 mg/g are considered moderate levels of proteinuria. UPCR/ACR levels of protein greater than 300 mg/g are considered severe proteinuria, and a patient should consult with a kidney specialist called a nephrologist. It is important to understand that patients with severe levels of protein being spilled into their urine should seek treatment immediately. Your top priority should be to: Ask your kidney specialist to help figure out what is causing the protein in your urine. Make sure your specialist is aggressively treating your condition in order to stop or slow the amount of protein spilling into your urine. Monitoring your condition is not aggressively treating. Please assume that while you have severe levels of proteinuria, your kidneys are actively being damaged. If you don’t feel you are being treated aggressively, consider seeking a second opinion. Visit our NephCure Specialists page to see if there are any NephCure-approved kidney care experts near you. NephCure Kidney International is a patient advocacy organization and is not licensed to practice medicine. The information on this site is intended to be educational and not diagnostic or recommended treatment. Consult with your doctor if you learn anything that might alarm you or if you have any questions. NephCure thanks Questcor Pharmaceuticals for its support of the Proteinuria Resource Center.