-It’s natural and healthy to have protein in your blood. Protein is necessary for life; it helps to build bone and muscle, prevent infection, and regulate the amount of fluid in your bloodstream. While trace amounts of protein may escape from your bloodstream into your urine, significant amounts of protein in your urine (>150mg/day) are abnormal and can indicate either a temporary health issue or a chronic, life-threatening one. 

The condition of having too much protein (usually albumin) in your urine is called proteinuria.* Here’s what you need to know about this condition, what causes it, and how to treat it.

Why is proteinuria a problem?

When your kidneys are healthy, they flush wastes and extra fluids from your body, returning proteins, vitamins, and minerals in their proper amounts to your bloodstream. Protein in your urine is an indication that your kidneys are not functioning properly. 

Improper kidney function negatively affects all your other body systems and organs, including your heart. It’s critical to determine whether the cause of improper kidney function is:

• From something temporary
• From irreversible and/or progressive damage, due to injury or disease

What causes proteinuria?

Proteinuria can be caused by intense exercise, exposure to cold, or certain temporary medical conditions that are easily treated, such as:

• Dehydration 
• Inflammation 
• Low blood pressure
• Emotional stress
• Kidney stones

However, it can also indicate a variety of serious illnesses and conditions, too, including:

• Lupus and other autoimmune disorders
• Cardiovascular disease
• Poisoning
• Kidney cancer
• Congestive heart failure
• Chronic kidney disease 

What are the risk factors?

The most common risk factors for proteinuria are the same as those for chronic kidney disease, which are:

• Diabetes 
• High blood pressure (hypertension)
• Family history of kidney disease

What are some symptoms of proteinuria?

The symptoms of proteinuria are also the same as those of kidney disease. In the beginning, symptoms may be mild or nonexistent. By the time symptoms appear, the proteinuria is likely advanced, and you should contact your doctor immediately. 

Common symptoms include:

• Foamy or bubbly urine
• More frequent urination
• Shortness of breath
• Lack of appetite
• Fatigue
• Nausea and vomiting
• Muscle cramping at night
• Puffiness around the eyes, especially upon waking
• Swelling (edema) in the face, feet, ankles, hands, or abdomen

How is proteinuria diagnosed?

Proteinuria is detected via urinalysis, a test that measures the amount of the protein albumin in your urine compared to the amount of creatinine (product of muscle metabolism). This measurement is known as the urine albumin-to-creatinine ratio (UACR). If your kidneys are functioning well, your UACR won’t be more than 30 mg/g.

What treatments are available?

Treatments for proteinuria are geared toward relieving the burden on your kidneys and supporting any remaining function. This often means treating and controlling underlying health issues, such as diabetes, high blood pressure, and heart disease, with:

• Medications, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)
• Kidney-friendly diet, which is high in fresh produce and low in sugar, sodium, potassium, and red meat
• Lifestyle changes, including increased exercise and quitting smoking

If you have proteinuria, you can work with your primary care physician, nephrologist, and dietician to craft a personalized treatment program to best fit your unique needs.

*American Kidney Fund. (2020, Aug. 12). What is Proteinuria? https://www.kidneyfund.org/kidney-disease/kidney-problems/protein-in-urine.html