Protein in Urine (Proteinuria)

People with proteinuria have unusually high amounts of protein in their urine. The condition is often a sign of kidney disease.

Your kidneys are filters that don’t usually let a lot of protein pass through. When kidney disease damages them, proteins such as albumin may leak from your blood into your pee. You can also have proteinuria when your body makes too much protein.

Kidney disease often has no early symptoms. Protein in your pee might be one of the first signs. Your doctor may spot proteinuria on a urine test during a routine physical.

Protein in Urine Symptoms

Most people who have proteinuria won’t notice any signs, especially in early or mild cases. Over time, as it gets worse, you might have symptoms including:

  • Foamy or bubbly pee
  • Swelling (edema) in your hands, feet, belly, and face
  • Peeing more often
  • Shortness of breath
  • Fatigue
  • Loss of appetite
  • Upset stomach and vomiting
  • Muscle cramps at night

Protein in Urine Causes

Some common things can cause proteinuria. These include:

  • Dehydration
  • Inflammation
  • Low blood pressure
  • Fever
  • Intense activity
  • High stress
  • Kidney stones
  • Taking aspirin every day
  • Very low temperatures

Conditions that damage your kidneys can also make you have too much protein in your urine. The two most common are diabetes and high blood pressure.

Other serious conditions that can cause proteinuria include:

  • Immune disorders such as lupus
  • Kidney inflammation (glomerulonephritis)
  • A blood cancer called multiple myeloma
  • Preeclampsia, which affects pregnant women
  • A buildup of protein in your organs (amyloidosis)
  • Cardiovascular disease
  • Intravascular hemolysis, a condition in which red blood cells are destroyed
  • Kidney cancer
  • Heart failure

Protein in Urine Risk Factors

Things that might make you more likely to have protein in your urine include:

  • Obesity
  • Age over 65
  • A family history of kidney disease
  • African American, Native American, Hispanic, or Pacific Islander descent

Some people get more protein into their urine while standing than while lying down. This condition is called orthostatic proteinuria.

Protein in Urine Diagnosis

A urine test called a urinalysis can tell whether you have too much protein in your pee. First, you’ll pee into a cup. A lab technician will dip in a stick with chemicals on the end. If the stick changes color, it’s a sign of too much protein. You might need to have this test more than once to find out how long the protein is there.

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The technician will also look at the pee under a microscope. They’re checking for things that shouldn’t be there, which might mean kidney problems. These include red and white blood cells, crystals, and bacteria.

If your doctor suspects kidney disease, you might need to have other urine tests. Your doctor might also order:

  • Blood tests. These measure certain chemicals to check how well your kidneys are working.
  • Imaging tests. CT scans and ultrasounds can spot kidney stones, tumors, or other blockages.
  • A kidney biopsy. Your doctor might need to take a small sample of kidney tissue so a lab technician can look at it under a microscope.

Protein in Urine Treatment

Proteinuria a sign of another illness. So treatment depends on figuring out what caused it. You might not need treatment if proteinuria is mild or lasts only a short time. But it’s crucial to treat kidney disease before it leads to kidney failure.

Your doctor might prescribe medication, especially if you have diabetes and/or high blood pressure. Most people will take one of two types of blood pressure medicine:

  • ACE inhibitors (angiotensin-converting enzyme inhibitors)
  • ARBs (angiotensin receptor blockers)
WebMD Medical Reference Reviewed by Jennifer Robinson, MD on March 30, 2020

Sources

SOURCES:

Journal of the American Medical Association, JAMA Patient Page: "Proteinuria."

National Kidney and Urologic Diseases Information Clearinghouse: "Proteinuria."

Labtestsonline: "Urine Protein and Urine Protein to Creatinine Ratio" and "Proteinura."

Cleveland Clinic: “Proteinuria.”

Mayo Clinic: “Protein in urine.”

UpToDate: “Patient Education: Protein in the urine (proteinuria) (Beyond the Basics).”

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