Proteins are responsible for a wide range of activities. These include shifting molecules within your system, rendering structure to cells, making replica of your DNA, enabling activities needed for metabolism, etc. Going by the work they do, you can understand how important these molecules truly are. But, what if they get out of your body through urine? Protein is too precious a nutrient to be lost. With needful treatment, such losses can be averted.
Proteins form the basis for enzymes and help catalysing many chemical activities in your body. Protein-enriched enzymes trigger metabolic activity as well as most of your DNA-related processes. Also, antibodies which enable your immunity levels are based on proteins. These antibodies help to bundle harmful, invading bodies (also called as antigens) and mark them for elimination from your system. Not stopping with these, proteins render mechanical properties to cells. For example, motility (or movement) of sperm cells depend to a greater extent on proteins. In sum, proteins do a multifaceted role including cell-level repairs, building of bones and muscles, eliminate risks of infections and regulate fluid levels in your blood.
Presence of proteins in your urine
Loss of proteins through urine is not a healthy sign. If your urine has a larger proportion of proteins, it can be due to a renal disorder. Your kidneys are endowed with very tiny tubes called glomeruli – known as renal capillaries. The prime function of these finer capillaries is to filter water and waste from your blood. In general, glomeruli exert needful control to never let proteins – however small they are – to pass into urine. Even when very tiny protein molecules pass through glomeruli, the finer tubular ends are vigilant enough to reabsorb them and help your body to retain them.
But, when these capillary tubules are injured or damaged, they lose their ability to retain protein molecules. This condition is referred as proteinuria. It is characterised by high proportion of proteins in urine. Normal amount of protein in urine is either lesser or upto 150 milligrams per day. Presence of proteins beyond this normal level is attributed to problems in the filtering function of the kidneys. Such problems are relatively more pronounced in people living with chronic ailments such as renal disorders as well as among elderly people.
Factors causing protein in urine
Proteinuria is generally considered as a short term anomaly or as a condition caused by non-malignant triggers. It can occur due to chronic kidney disorders, abnormal blood pressure, loss of water or dehydration, intense workout sessions, excessive anxiety levels or stress, diabetes mellitus and also due to a regular intake of aspirin. Presence of stones in your kidneys can also be another cause.
Chronic kidney disorder and related diseases
In some cases, abnormal levels of proteins in urine may serve as an early warning sign of a chronic kidney disorder or disease (CKD). In such instances, excessive protein content over a period of time may indicate a steady decline of renal health. If the condition if left untreated, it can lead to a severe kidney dysfunction – needing either a transplant or continued dialysis sittings.
Renal diseases or disorders do not show up through any major symptoms. The most significant sign however is observation of a high level of proteins in your urine. After many clinical studies, nephrologists often consider it as an indicator of a likely problem in your kidneys. In most cases, proteinuria is accidentally discovered while doing a regular test on your urine sample. Also, all other symptoms show up only at an advanced stage of kidney dysfunction. As the kidney condition worsens further, you may observe other signs such as urge to pee often, muscular cramps in your abdomen – especially during bedtime, respiratory problems such as gasping for breath, edema (accumulation of water and swelling) of feet, hands, face and stomach. Your pee may assume a bubbly form, and at times it can become foamy in nature.
Increase of blood pressure weakens vessels carrying blood to kidneys. Once vessels are weakened, it minimizes your kidneys’ capability to recapture proteins. Hypertension is a condition which develops very slowly, over many years. Hence, in the initial stages – it is very difficult to detect this medical condition. But, once the condition takes an acute form, you may experience signs such as nasal bleeding, gasping for breath, dizziness, and headache, increased sweating and blurring of vision.
Your treating doctor will aim to understand if increased traces of proteins in urine is a short term occurrence and if the quantum if not very abnormal. For example, if dehydration is a cause for losing a lot of fluids from your body, it may result in a short term spell of proteinuria. Water is an essential source to transport proteins to vital organs such as kidneys. In the absence of needful water, kidneys may find it difficult to reabsorb proteins; this means, more proteins may get discharged through your urine. The signs associated with dehydration are thirstiness, feeling dizzy, headache, tiredness, dryness of skin as well as mouth, decreased output of urine, etc. Your urine may also assume a very dark color. You may need to consume more glasses of water as well as avoid intense workouts or exercise sessions. At times, vomiting or diarrhea can also lead to spells of dehydration. In all such instances, it is a good practice to consume more water to stabilize the fluid balance of your body.
A high level of blood sugar pushes kidneys to overdo the filtering action. Such over-filtering eventually leads to injuring your kidneys. The damages caused may result in excessive proteins in urine. The significant signs of diabetes mellitus are persistent feeling of hunger and thirst, blurring of vision, excessive tiredness and frequent urges to urinate.
Proteinuria can also show up as a result of other conditions that can injure or damage your kidneys. These are categorised as inflammation of your kidneys, conditions impairing your immune system (conditions such as goodpasture’s syndrome, lupus, etc.), preeclampsia, cancers, cardiac disorders, angina or congestive heart ailments.
Inflammation of kidneys
This may be due to pyelonephritis which occurs if infectious bacteria enter from your urinary bladder. Another likely cause for inflammation is glomerulonephritis. This can occur when capillary tubules cease to work. This condition may also result in discharge of white cells while you urinate. The key signs of glomerulonephritis include inflammation of ankles and feet. This condition occurs when your kidney is under attack by your own immunity. It can also be an outcome of a medical condition like hepatitis (B or C), HIV AIDS, diabetes mellitus, etc.
This is an autoimmune medical condition. It shows up as an accumulation of proteins (of autoimmune genre) in your lungs and kidneys. Such build-up eventually leads to damaging various vital parts of your body. If left untreated, it can result in inflammation of kidneys as well as renal failure. Timely treatment is necessary for this medical condition, or else it can turn into a near-fatal or fatal situation.
Lupus is an autoimmune medical condition. It can show up as an inflammation along with other signs such as dehydration, excessive tiredness, fever, skin conditions such as itchiness or rashes, etc.
This condition occurs among pregnant women – especially those in the 20th week of their pregnancy. When such women develop hypertension, it can directly impact the functioning of their kidneys. The common signs of preeclampsia are increase in body weight, swelling of face and arms, blurring of eyesight as well as headache. In general, you may experience an acute pain in the right side of your abdomen. It is likely to go away soon after your delivery; needful caution however is required as it can lead to premature births.
These can also be a cause for high levels of protein in urine. The various types of cancers that can trigger this outcome include cancer in cells of kidneys, colorectal cancers, breast cancer, lung cancer, multiple myeloma, non-Hodgkin’s lymphoma and Hodgkin’s lymphoma. The main cause is the inflammation cancers cause and the resultant changes to how your kidneys function. As mentioned, once kidneys cease to function normally, they lose an essential property to reabsorb proteins.
Renal cell cancers are often known to spread on the linings and walls of tubules – i.e., very tiny capillaries – of kidneys. It is known for its quick progression; it can reach your lungs and also to other vital organs in a very short span of time.
Multiple myeloma is not as common as renal cell cancers. These can impact your marrow and can thus change the cells of your blood plasma.
Non-Hodgkin’s lymphoma develops from your lymphocytes. Cancers that originate from tissues of lymph are referred as lymphoma; on the other hand, cancers spreading to lymphocytes are not called as lymphomas.
Hodgkin’s lymphoma – this condition also starts from lymphocytes; the main difference is the involvement of unique cells called as Reed-Sternberg. These cells make Hodgkin’s lymphoma a very unique medical condition.
How to diagnose the causes for protein in urine?
The real causes for the higher proportion of protein in urine can help understand the underlying medical condition. A test known as urinalysis is done to assess quantum of proteins. This is a color change test; change of color of a chemical-coated dipstick is an indicator for presence of excessive amount of protein in urine. The same test also includes examination of urine sample through a microscope. Presence of white cells, bacteria, crystals, etc. indicates likely kidney disorders.
Based on the findings of urinalysis, your doctor may recommend a few other diagnostic tests. These include scans (ultrasound or CT scan to detect cancerous growth, internal blocks or formation of stones), testing of blood samples (to assess presence of a few chemicals) and a biopsy of kidney (samples of renal tissues are observed under closer scrutiny). Of these, a test called as glomerular rate of filtration helps check the efficiency of renal function. Your doctor may also advise a 24-hour urine sampling test; in this test, your urine is collected over a period of one full day. Samples collected at various points in time are tested for their protein content. If the samples show only a mild deviation from the normal range of 150 milligrams per day, it may not necessitate a treatment or medication plan.
Who may be at risk?
If you are aged 65 years or more, you are generally more vulnerable to dehydration as well as renal problems. Also, those with chronic spells of hypertension may be prone to this medical condition. Those who are obese and those with a family history of proteinuria are at added risk.
Treatment of protein in urine
If it is a short-term medical condition you may not need a treatment plan. However, if you have a chronic condition of proteinuria, you will need a customized treatment plan. The approaches to treat include medications to reduce your blood pressure, changes to your diet – especially to reduce your body weight, case management of diabetes if you have a high level of blood sugar, etc. In case your condition is severe, you may need to opt for dialysis sittings; these are aimed to bring your electrolytes as well as blood pressure under control.
In sum, protein in urine is an indicator for a likely kidney problem. It may indicate that your renal function is not effectively filtering your blood. If it is short-term or a temporary condition, you may not need an elaborate treatment plan for it. But, if your condition is diagnosed as acute or severe, then the root cause is diagnosed and needful treatment plan is started soon.
As mentioned, proteinuria can either be a temporary anomaly or a condition caused by non-malignant causes. In most cases, it occurs due to high blood pressure, chronic kidney disorder, dehydration, anxiety or stress and diabetes. You also need to be aware that it can be triggered by inflammation of kidneys, impairment of immune system (autoimmune conditions such as goodpasture’s syndrome or lupus), preeclampsia, cancers, etc. A test known as urinalysis is performed to understand the level of protein in urine. This is a test done based on color-change of reagents. Urine samples are also examined to check for the presence of white cells, bacteria, etc.
Approaches to treat proteinuria – when protein levels are very high in urine – include drugs to reduce hypertension, dietary changes to reduce obesity, etc. You are advised to talk to a qualified medical practitioner for needful treatment and medication plan.