Protein in the urine always comes from the kidney and in general it implies significant kidney disease.\u00a0 Any renal disease may cause proteinuria.\u00a0 Glomerular disease may cause heavy proteinuria, but in many patients it is initially detected at lower levels. The level of proteinuria is a prognostic factor for most diseases – the higher, the poorer the renal prognosis.<\/p>\n
Proteinuria may be caused by almost any renal lesion, but higher levels (>2g\/d) are always caused by glomerular disease; some key causes are listed at\u00a0nephrotic syndrome<\/a>.<\/p>\n Usually asymptomatic, identified on dipstick test of urine Quantification:<\/span><\/strong>Ratios of protein or albumin to Creatinine (PCR, ACR)\u00a0have largely replaced 24h collections for quantitating proteinuria.\u00a0 Albumin is about 70% of glomerular proteinuria at levels >1g\/d.\u00a0 So\u00a0very approximately<\/em>:<\/p>\n Proteinuria 1g<\/span><\/strong>\/day\u00a0<\/strong>=PCR 100<\/span><\/strong>mg\/mmol\u00a0<\/strong>=\u00a0ACR 70<\/span><\/strong>mg\/mmol<\/p>\n Is there:<\/span><\/strong><\/p>\n If so:\u00a0\u00a0 \u00a0<\/span><\/strong><\/p>\n Even low levels of proteinuria (including microalbuminuria) are associated with increased mortality, mainly from cardoiovascular causes. The risk increases with the amount of proteinuria. The explanation for this is not known.<\/p>\n In the absence of haematuria, hypertension or impaired renal function, or other symptoms, history or abnormalities, it is usually reasonable to monitor urine tests, blood pressure and renal function at 6 months, extending the interval to annually, indefinitely.<\/p>\n Protein in the urine always comes from the kidney and in general it implies significant kidney disease.\u00a0 Any renal disease may cause proteinuria.\u00a0 Glomerular disease may cause heavy proteinuria, but in many patients it is initially detected at lower levels. The level of proteinuria is a prognostic factor for most\u2026<\/p>\n
\nDiagnosis<\/span><\/strong><\/h3>\n
\nProtein\/creatinine ratio, or 24h urine collection, to quantitate.
\nProteinuria is probably not important if it:<\/p>\n\n
\nFurther investigation<\/span><\/strong><\/h3>\n
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\nProteinuria and cardiovascular risk<\/span><\/strong><\/h3>\n
\nManagement of low level proteinuria<\/span><\/strong><\/h3>\n
\nFurther info<\/span><\/strong><\/h3>\n
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