Understanding what it means to have protein in urine

When kidneys cannot work properly, proteins leak out and get collected in urine. Proteinuria is a condition having high levels of proteins in the urine. Proteins play important functions in the body such as muscle and bone building, regulating the amount of fluid in the body, repairing damaged cells, and fight with infections. To perform their functions proteins should remain in the blood but having excess proteins in urine may indicate kidney damage which can affect overall health. Proteinuria is an early warning or sign of Chronic Kidney Disease (CKD) which denotes the gradual deterioration of kidney functions.

Causes of Proteinuria
There are several reasons and health conditions that can cause proteinuria-

1. Causes of short-term proteinuria- These includes a high level of stress, cold temperatures, dehydration, fever, and physical activity with high intensity.
2. Causes of long-term proteinuria- The long-term conditions leading to proteinuria include kidney diseases, diabetes, hypertension, pregnancy, nephritic syndrome, preeclampsia, immune disorders like lupus and Good pasture’s syndrome, plasma cell cancer, destruction of red blood cells, cardiovascular disease (congestive heart failure), poisoning, and trauma.

Symptoms of Proteinuria
When kidney damage is in the initial stage no signs will be seen but in severe kidney damage following symptoms will be noticed- frequent urination, muscle cramps at night, stomach feeling upset, swelling (in hands, belly, face, and feet), bubbly foamy urine, shortness of breath, tiredness, nausea, vomiting, loss of appetite, puffiness around eyes in the morning, etc.

Risk Factors for Proteinuria
Proteinuria can affect anyone but most frequently it occurs if –
•    Age ≥65 years
•    Patient has diabetes or other kidney-affecting condition.
•    Patient is from Native American, Hispanic, or black ethnicity.
•    Patient has a family member suffering from kidney disease.
•    Patient with body weight and high blood pressure.

Diagnosis of Proteinuria
Urine tests- These examines urine’s chemical, visual, and microscopic aspects to look for substances which do not belong to urine such as red blood cells, proteins, salts, bacteria, stones, etc.
Dipstick test- In the urine sample a chemically coated dipstick is placed which changes the color if the urine sample contains excess proteins.

Treatment of Proteinuria
Doctors treat proteinuria according to the cause of the disease.

• In the case of diabetes, lifestyle medication and treatment therapy to reduce blood glucose levels are suggested such as remaining active, checking blood sugar, etc.
• In the case of high blood pressure, the doctor suggests antihypertensive drugs including ACE inhibitors, ARBs, etc.
• Drinking excess water doe not benefit the treatment it can only dilute urine.
• Dietary changes will be suggested by the doctor if the patient is suffering from diabetes and high blood pressure.
• Maintain body weight.
• Avoid NSAIDs unless it is recommended by the physician.
• In case of glomerulonephritis or acute kidney failure, dialysis is the last resort to maintain fluid imbalance and blood pressure.

Summary
Proteinuria is a condition having excess proteins in urine. It occurs mainly due to pre-existing diseases and affects the kidneys which may lead to chronic kidney diseases. Proteinuria can be temporary so it may resolve without treatment. Doctors treat proteinuria based on its causes. So, the treatment aims to resolve underlying conditions.

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