Protein in Urine (Isolated Proteinuria): Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Alport syndrome (also called progressive hereditary nephritis) – genetic disorder with both autosomal dominant and autosomal recessive inheritance with malformed collagen fibers that can lead to nephritis (inflammation of the kidneys) with progressive renal insufficiency (kidney weakness), sensorineural hearing loss, and various ocular disorders such as a cataract
  • Cystic kidney disease – kidney disease characterized by the presence of many cysts (fluid-filled cavities).

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Amyloidosis – extracellular (“outside the cell”) deposits of amyloids (degradation-resistant proteins) that can lead to cardiomyopathy (heart muscle disease), neuropathy (peripheral nervous system disease), and hepatomegaly (liver enlargement), among other conditions
  • Diabetes mellitus
  • Diabetic nephropathykidney disease that occurs as a result of diabetes mellitus (diabetes).
  • Wilson’s disease (copper storage disease) – autosomal recessive inherited disease in which copper metabolism in the liver is disturbed by one or more gene mutations.

Cardiovascular system (I00-I99).

  • Hypertension (high blood pressure)
  • Cardiomegaly (enlargement of the heart)
  • Nephrosclerosis (synonym: hypertensive nephropathy) – noninflammatory nephropathy (kidney disease) resulting from arterial hypertension (high blood pressure), which is associated with proteinuria (increased excretion of protein in the urine) and can lead to renal failure (renal function impairment)

Musculoskeletal system and connective tissue (M00-M99).

Neoplasms – tumor diseases (C00-D48)

  • Monoclonal gammopathy with pathological production of immunoglobulins characterized by malignant (malignant) proliferation of antibody-producing cells, plasma cells.
  • Plasmocytoma – malignant (malignant) systemic disease. It belongs to the non-Hodgkin’s lymphomas of B lymphocytes. Multiple myeloma is associated with malignant neoplasia (new formation) of plasma cells and the formation of paraproteins.

Pregnancy, childbirth, and puerperium (O00-O99).

  • Pregnancy (physiological proteinuria)
  • Gestational edema (water retention during pregnancy) and gestational proteinuria [pregnancy-induced] without hypertension/hypertension (ICD-10 O12.-)

Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99)

  • Fever (eg, due to febrile infections) [transient proteinuria].
  • Myoglobinuria – excretion of myoglobin (muscle protein) in the urine (e.g., rhabdomyolysis due to muscle trauma).

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Analgesic nephropathy (kidney disease caused by chronic abuse of pain medications (analgesics); 75% of cases involve middle-aged women)
  • Chronic glomerulonephritis (inflammation of the renal corpuscles):
  • Gouty kidney
  • Glomerulopathies – clinical pictures caused by dysfunction of the glomeruli (kidney tangles).
  • Hemoglobinuria – excretion of hemoglobin (red blood pigment) through the kidneys.
  • Nephropathies (kidney disease), toxic.
  • Nephrotic syndrome – collective term for symptoms that occur in various diseases of the glomerulus (renal corpuscles); proteinuria (excretion of protein (protein) with urine) with a protein loss of more than 1 g/m² KOF/d; hypoproteinemia, peripheral edema (water retention) due to hypalbuminemia of < 2.5 g/dl in serum; hyperlipoproteinemia (lipid metabolism disorder).
  • Nephritic syndrome (inflammation of the glomeruli/renal corpuscles; characterized by the so-called Volhard triad: hematuria; edema/water retention (emphasized on eyelids) due to water retention; hypertension (high blood pressure)).
    • Idiopathic: e.g., IgA nephritis (associated with deposition of immunoglobulin A (Ig A) in the mesangium (intermediate tissue) of the glomeruli)
    • Autoimmune diseases: Lupus nephritis, lupus erythematosus, vasculitides (vascular inflammation).
    • Postinfectious nephritis: for example, after an infection with the bacterium Streptococcus pyogenes after tonsillitis (tonsillitis); bacterial endocarditis (endocarditis)).
  • Pyelonephritis (inflammation of the renal pelvis), bacterial.
  • Prostatitis (inflammation of the prostate)
  • Tubulopathies, unspecified – clinical pictures caused by dysfunction of the tubules (renal tubules).
  • Urolithiasis (urinary stone disease).
  • Cystitis (inflammation of the bladder), hemorrhagic

Further

  • Physical stress (“march proteinuria”) [transient proteinuria].
  • Orthostatic proteinuria (esp. in upright posture, i.e., during the day; no increased protein excretion is measurable at night when the person is lying down)
  • Phenacetinniere
  • Stress proteinuria [transient proteinuria].
  • Transplant kidney
  • Heavy metal poisoning (e.g., cadmium)