An excessive amount of protein in the urine is not uncommon and occurs very frequently. However, the possible consequences and, to an even greater extent, the possible triggers should not be underestimated in any way.
What is protein in urine?
Proteinuria refers to an abnormally increased excretion of protein through the urine, where the limit of 150 milligrams of protein excreted daily is significantly exceeded. If the excretion exceeds 20 times the normal value, this is known as major proteinuria and can have serious consequences. If, however, this excessive excretion does not occur regularly, but only at irregular intervals, it is referred to, on the other hand, as benign reversible proteinuria, which in most cases disappears again without any adverse effects on health.
Causes
The causes of proteinuria are very diverse and varied. Thus, on the one hand, it can occur as a consequence of a whole range of diseases or exposure to substances. On the other hand, it often arises as an independent condition that can slowly and permanently damage the kidneys and, subsequently, other organs of the body. Any toxins, drugs or allergens can be just as causative for the development of proteinuria as chronic graft rejection after a kidney transplant. A metabolic disease, such as diabetes mellitus, or a disease of the blood can also result in the occurrence of an increased amount of protein in the urine. Since all of the above-mentioned diseases or foreign substances result in damage to the kidney‘s sensitive system, it can no longer properly perform its primary task – cleansing the blood of toxins – and simply lets through the proteins that it would normally keep large portions of from passing through the glomerulus filter as well as the renal tubules from entering the bladder.
Symptoms, complaints, and signs
In this condition, sufferers suffer from an appearance of protein in the urine. Usually, this complaint indicates another underlying disease, and in this case, it should be treated without fail. In most cases, those affected by protein in the urine also suffer from discomfort during urination. This results in burning or stabbing pain. This pain can also lead to irritability or further psychological complaints or depression. In severe cases, patients are dependent on a kidney transplant or dialysis to prevent death. Furthermore, protein in the urine also indicates diabetes, which also negatively affects the patient’s health. Furthermore, thrombosis and edema occur. In severe cases, complete kidney failure or even a heart attack occurs. The disease can lead to a general feeling of illness and to a permanent tiredness and fatigue of the patient. If treatment is not received, the patient’s life expectancy will be significantly reduced by the disease. In many cases, the disease can be resolved by changing the diet, although patients suffer from some limitations in their daily life.
Diagnosis and course
Detection of an elevated concentration of protein in the urine can nowadays be made very easily and quickly. Complications only arise when it comes to narrowing down the possible causes and finding out whether permanent proteinuria is present at all, as only then is there an acute need for action. In recent years, testing with the aid of a test strip, which responds to albumin, the globular protein that is increasingly found in the urine in cases of proteinuria, has become established. To do this, the test strip is briefly dipped into the urine sample to be tested and then checked for discoloration. If the strip has turned blue-green, there is an increased excretion of protein. However, only a laboratory test can reliably determine whether there is a permanent increase in protein in the urine and whether there may already be damage to the kidneys. If proteinuria remains undetected or untreated, it leads to albumin deficiency, which can lead to edema, thrombosis and infections. It also increases the risk of kidney failure as well as myocardial infarction.
Complications
Protein in the urine does not necessarily cause complications or discomfort directly.In many cases, the symptom also does not need to be treated directly. The complications occur mainly during the diagnosis, because it is relatively difficult for the doctor to find out the right cause of the protein in the urine. As a rule, the patient may have kidney or heart disease. Thus, renal insufficiency or a heart attack can occur, and both consequences can be life-threatening for the affected person. If the kidneys have been irreversibly damaged, the patient may be dependent on dialysis for the rest of his life. In any case, the treatment of the disease is causal and always depends on the underlying disease. If certain medications or foods are responsible, they must be discontinued or changed. Likewise, the affected person must pay attention to a low-protein diet so that the symptom does not intensify. Complications can occur if there is no treatment at all. Whether there will be a decreased life expectancy cannot be generally predicted.
When should you see a doctor?
If the urine is foamy and may also have an unusual odor, there is an increased amount of protein in the urine. A visit to the doctor is recommended if the proteinuria occurs for no apparent reason – that is, outside of the flu and independent of physical exertion or stress. This applies in particular if the above-mentioned signs have not disappeared after one week at the latest. If accompanying symptoms occur, medical advice must be sought immediately. For example, anyone experiencing urinary retention and other serious kidney problems should have this clarified immediately. If kidney failure or signs of a heart attack occur, emergency medical attention must be sought immediately. People with existing kidney disease should have protein in the urine clarified quickly by a doctor in any case. The same applies to patients who suffer from type 2 diabetes mellitus or have another condition for which an elevated protein level in the body could be problematic. Alone, in order to resolve the uncertainty and thus also prevent possible psychological consequences in the long term, a medical clarification is necessary in the case of protein in the urine.
Treatment and therapy
Although proteinuria cannot be completely cured in most cases, its course can be slowed to the extent that the likelihood of kidney failure and other serious sequelae are minimized. Thus, in many cases, a low-protein diet is recommended in conjunction with the intake of medication. If, on the other hand, other diseases or various foreign substances are responsible for the increased concentration of protein in the urine, these must be combated or the intake stopped in order to stop proteinuria.
Outlook and prognosis
Proteinuria is still not considered curable with current medical options. However, with good medical care, symptoms can be significantly reduced and disease progression is slowed. If no treatment is sought, in many cases there is a gradual deterioration in health. In severe cases, the disease can lead to premature death of the affected person. Most patients with protein in the urine suffer causally from functional or metabolic disorders. The heart or kidneys are not fully functional or chronic diseases are present. In the case of proteinuria, the patient is therefore at increased risk of organ failure and thus a life-threatening condition. In addition to drug treatment, a change in diet improves the prognosis for the patient. In the long term, attention should be paid to a balanced and low-protein food intake. If, in addition, harmful substances such as alcohol, nicotine or drugs are avoided, this has a positive influence on the general state of health. If the affected person suffers from foreign substances in the organism, these must be treated so that the symptoms can be alleviated. Without therapy of the underlying disease, the value of protein in the urine will be permanently present and lead to further health problems.
Prevention
Prevention of proteinuria is possible only to the extent that a healthy lifestyle can protect against the occurrence of various diseases that can trigger it. On the other hand, since the exact triggers of independent proteinuria have not yet been fully elucidated, no preventive measures can yet be advised.Although proteinuria can be observed in almost everyone from time to time, it usually disappears again after a short time and rarely indicates a serious disease. Nevertheless, any triggers should be checked and permanently increased excretion of protein should be ruled out to avoid serious long-term damage.
Follow-up
In most cases, protein in the urine indicates another underlying disease, so the underlying disease must be treated first and foremost to relieve symptoms. The first priority is also to identify this complaint at an early stage so that it does not lead to further complications and also to a worsening of the condition. Whether or not the disease limits life expectancy depends very much on the underlying disease, so that no general prediction can be made in this regard. In most cases, however, this disease cannot be treated completely, so that the affected person will always suffer from renal insufficiency in the further course. However, this should be delayed as long as possible. The protein in the urine is treated with the help of medication. These should always be taken according to a doctor’s instructions and, above all, in the correct dosage to provide lasting relief from the symptoms. Furthermore, many people affected by protein in the urine are also dependent on psychological support. This can be provided by one’s own family or friends, although in some cases professional support may also be necessary.
What you can do yourself
If affected individuals notice that their urine smells strange or that their kidneys hurt, urine should be given to a doctor. The diagnosis is made quickly. With proteinuria, it is important, especially if it is not chronic and diagnosed for the first time, to check the urine regularly. This can be done by yourself, as the urine smells strange when there is too much protein. If this smell does not disappear, a visit to the doctor is necessary. This can prevent kidney failure. In everyday life, the affected person must make sure to eat a low-protein diet. This means that the diet must be changed so that protein levels can be reduced. Foods containing protein are primarily meat, fish and dairy products. Eggs, soy products and cereals also contain protein. A diet plan can be worked out in cooperation with the doctor, since protein must be taken in as a matter of principle. It is the task of the affected person to adhere to the guidelines and to take the combined medication regularly. Regular monitoring in conjunction with a diary is useful in order to be able to rule out other causes. In this way, long-term damage can be effectively avoided.