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Glomeruli are tiny blood vessels in the kidneys that normally filter salt, water and waste products from the blood. They keep protein in the blood, which helps them absorb water from tissues. When these filters are damaged, protein can leak from the blood into the urine, resulting in proteinuria—an excess of protein in the urine. Proteinuria is also called albuminuria or urine albumin.
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What isPediatric Proteinuria (Excess Protein in Urine)?
Proteinuria is an excess if protein in your child's urine. If your child has proteinuria, it’s often not serious. But sometimes, it can indicate a more serious problem with the kidneys. You should watch for any signs that your child’s fluids seem out of balance and check with a doctor.
If proteinuria indicates a kidney disease, your doctor will refer your child to a nephrologist, a doctor who specializes in treating kidney diseases.
What are the signs and symptoms of Pediatric Proteinuria (Excess Protein in Urine)?
Your child may have no symptoms while in the earliest stages of proteinuria. As large amounts of protein move from the blood to the urine and out of the body, the following signs and symptoms may occur and may indicate progression of kidney disease.
- Difficulty breathing
- High blood pressure
- Swelling (edema), especially around the eyes and in the hands, feet, and belly
- Urine that appears to be foamy or bubbly because of large amounts of protein
How is Pediatric Proteinuria (Excess Protein in Urine) diagnosed?
If you or your child’s pediatrician suspect that your child has proteinuria, a condition in which protein leaks from the blood into the urine, the doctor will recommend a urine test.
In the past, a 24-hour urine collection was required to diagnose proteinuria. The patient would collect urine in a single container from the first visit to the bathroom in the morning through the first visit on the next day. This test may still be used, but most of the time, a simple urine test can be done in a doctor’s office to test how much protein is in your child’s urine. A chemically-treated paper dipped into the urine sample will change color if protein levels are high.
If your child has no symptoms and a urine sample collected first thing in the morning indicates no protein or only trace amounts, the doctor may suggest that your child be tested again in a year. If protein is discovered in the urine, another first morning sample should be tested and also examined under a microscope, and further urinalysis— the physical, chemical, and microscopic testing of a sample of urine—will be necessary. If the urine tests reveal excess protein and urinalysis results are abnormal, your child may need further evaluation because if the proteinuria persists, it can mean that your child’s kidney function is declining.
To check your child’s overall and kidney health, the doctor will ask about your child’s complete medical history, perform a physical examination and take blood samples to measure levels of creatinine and urea nitrogen—waste materials that are filtered by the kidneys in healthy people. Excess amounts may indicate poor kidney function.
In some cases, the doctor may recommend an ultrasound of the kidneys to detect structural damage or abnormalities. This test provides the doctor with information about the size and shape of the kidney and helps detect cysts, kidney stones, obstructions, masses in the kidney and other problems. The test is painless and noninvasive. A technologist moves a probe over the kidney from outside the body, which creates sound waves that bounce back from the kidney, forming an image on a video screen.
In rare case, your child may need a kidney biopsy. The doctor may want to look at a piece of kidney tissue under a microscope to try to pinpoint the precise kidney disease. For a biopsy, which involves an overnight hospital stay, your child will receive a light sedative and local anesthesia. The doctor will direct a biopsy needle into the kidney guided either by images from an ultrasound or a computed tomography (CT) scan, a test that uses multiple X-ray images to provide a detailed picture of the body structures. The kidney tissue will be examined to diagnose the kidney disease that is causing protein in the urine.
What are the causes of Pediatric Proteinuria (Excess Protein in Urine)?
One of the functions of protein in the blood is to help balance the body’s fluid levels. When protein spills into the urine, it causes fluid to leak into the body’s tissues, which results in swelling.
Although proteinuria is often harmless and may result from stress, fever or exercise, it also can be a sign of a serious underlying kidney disease (also called renal disease) or a disease that started in another part of your child’s body. Proteinuria also may be a sign of another condition, nephrotic syndrome, which may indicate an underlying kidney disease. The most common risk factors for proteinuria are
The most common risk factors for proteinuria arediabetes and hypertension, or high blood pressure. Both of these diseases can cause kidney damage and proteinuria.
Risk factors include:
- Family history of kidney disease
- Kidney damage or disease
- Race and ethnicity: African-Americans, Hispanics, Native Americans, and Pacific Islanders are more likely than Caucasians to develop proteinuria.
Untreated, proteinuria can result in serious kidney problems. It is the most common cause of chronic kidney disease.
How is Pediatric Proteinuria (Excess Protein in Urine) treated?
If your child has proteinuria, the leaking of protein from blood into the urine, it can signal a more serious problem with the kidneys. In other cases, the problem has no known cause and can be treated easily. Regardless, you should seek treatment for your child right away.
Your child’s pediatrician or a nephrologist, a kidney disease specialist, will treat proteinuria with no known cause, called idiopathic proteinuria, by stopping the flow of protein into the urine. The doctor also will recommend treatment to ease your child’s symptoms, such as swelling and fatigue. Usually, the doctor prescribes medications such as prednisone, which is a corticosteroid. If prednisone fails or causes unwanted side effects, the doctor can recommend other drugs, such as cyclophosphamide, chlorambucil or cyclosporine. In patients with kidney disease who do not respond to these drugs, another type of medication called an ACE inhibitor may be used.
When your child’s doctor determines the cause for proteinuria, your child will receive treatment to correct the problem that is causing protein to leak into the urine and guard against kidney damage. For example, children who have diabetes will need to keep their blood sugar under control. Your child’s doctor may suggest making some changes to your child’s diet to restrict how much salt and protein your child eats.
If proteinuria causes damage to your child’s kidneys, a kidney disease specialist will evaluate the damage and manage the problem, trying to preserve as much of your child’s normal kidney function as possible. Proteinuria is a leading cause of chronic kidney disease, so it is important to keep the condition under control.
Pediatric Proteinuria (Excess Protein in Urine) Doctors and Providers
Michel Baum, MD Pediatric Nephrologist
Elizabeth Brown, MD Pediatric Nephrologist
Keri Drake, MD Pediatric Nephrologist(Video) Nephrotic Syndrome/Protein leak in urine/swelling of body in kids- Dr Saumil Gaur
Jyothsna Gattineni, MD Pediatric Nephrologist
Halima Janjua, MD Pediatric Nephrologist
Raymond Quigley, MD Pediatric Nephrologist
Smitha Vidi, MD Pediatric Nephrologist
Matthias Wolf, MD Pediatric Nephrologist(Video) Proteinuria - Protein in Urine - Dr. Gaytri Manek (formerly Gandotra)
Robin Landgraf, APRN, PNP-PC Nurse Practitioner - Nephrology
Frequently Asked Questions
What is proteinuria?
Proteinuria is excess protein in the urine.
What causes proteinuria?
Proteinuria occurs when protein leaks from the blood into the urine and into the body’s tissues. It happens when there’s been damage to the glomeruli, structures in the kidney that filter blood.
Who is at risk for proteinuria?
People with diabetes and hypertension have a higher risk for proteinuria. Other risk factors include obesity, kidney disease, and a family history of kidney disease.
Are certain groups of people more likely to have proteinuria?
Some groups of people are more likely than Caucasians to be at risk for proteinuria, including African-Americans, Hispanics, Native Americans, and Pacific Islanders.
Is proteinuria always dangerous?
While proteinuria can be a sign of kidney disease, it may also be harmless and occur in response to stress, fever, or exercise.
What symptoms should I look for in my child?
Among the symptoms you might notice in your child is edema (swelling), especially around the eyes, or in the hands, feet, or belly. Your child may also complain of fatigue, have difficulty breathing, or have urine that is foamy or bubbly.
What are the consequences of proteinuria?
If proteinuria is untreated, it can lead to serious kidney problems.
What tests will the doctor do to determine if my child has proteinuria?
Your child’s doctor can diagnose proteinuria through a simple urine test. Further tests may be necessary to determine the cause of proteinuria.
How is proteinuria treated?
The symptoms of proteinuria are generally treated with a steroid medication, such as prednisone. If an underlying cause for proteinuria is determined, further treatment will be targeted to the cause.
If a lot of protein is found in your child's urine, a more serious kidney disease might be the problem. Proteinuria doesn't cause pain. But when a lot of protein is in the urine, the level of protein in the blood may go down. This can cause swelling in your child's eyelids, ankles and legs.What does it mean if a child has protein in their urine? ›
Protein in the urine — known medically as proteinuria or albuminuria — occurs when the kidneys improperly spill protein in the urine. This can be normal if it occurs with exercise or fever, or it can be a sign of kidney disease.Is proteinuria curable in kids? ›
Your child's pediatrician or a nephrologist, a kidney disease specialist, will treat proteinuria with no known cause, called idiopathic proteinuria, by stopping the flow of protein into the urine. The doctor also will recommend treatment to ease your child's symptoms, such as swelling and fatigue.How much protein in urine is normal for kids? ›
In adults and children over two years of age, a UPr/Cr of less than 0.2 on a random urine specimen obtained during the day is considered normal. In children aged six months to two years, the upper limit of normal should be extended to 0.5. A UPr/Cr above 3.0 is consistent with nephrotic-range proteinuria.Can proteinuria be harmless? ›
Sometimes, almost always in children, proteinuria can be detected later in the day, but not in the morning. This is known as orthostatic Proteinuria and it is usually harmless.What happens if kids have too much protein? ›
Excess protein means excess calories. If a child can't burn the calories off, the body stores them as fat. Organ damage. High protein levels can cause kidney stones and make the kidneys work harder to filter out waste products.What is the most common cause of persistent proteinuria in children? ›
Orthostatic proteinuria is the most common cause of pro- teinuria in children, especially in adolescent males. 1,14,15 It is a benign condition without clinical significance.How serious is protein in urine? ›
Is protein in urine serious? Yes, protein in your urine is serious. Proteinuria may increase your risk of death from heart disease and cardiovascular disease. Occasionally, proteinuria is an early sign of chronic kidney disease (CKD), although you can have CKD and have normal levels of protein in your urine.What is the treatment for protein in urine? ›
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)How do you stop protein in urine in children? ›
In some cases, your doctor may recommend surgery to remove 1 or both of your child's kidneys. This will stop proteins being lost in your child's urine and reduce their risk of potentially serious problems, such as blood clots. If both kidneys do need to be removed, your child will need dialysis.
Multiple trials have reported that ACE inhibitors are effective at reducing proteinuria in both diabetic and non-diabetic populations. ACE inhibitors also reduce the rate of progression of kidney disease, and the risk of dialysis or transplantation by up to 50% in patients with proteinuria.How long do proteinuria patients live? ›
Life expectancy for men with mild and heavy albuminuria was 7.3 (95% CI: 6.9-7.8) and 11.3 (95% CI: 10.5-12.2) years shorter than men with normal proteinuria, respectively.How much protein is too much protein for a child? ›
The good news is that the recommended intakes of protein established by the Institute of Medicine and followed by the American Academy of Pediatrics are well below this limit: only 11 grams per day for babies from 7 to 12 months and 13 grams per day for toddlers.Can healthy people have proteinuria? ›
Anyone can have protein in their urine. You may be more likely to have protein in your urine if you have one or more of the risk factors for kidney disease. There are health problems that can cause long-lasting protein in the urine, and some that can cause short-term protein in the urine.Can proteinuria go away? ›
Proteinuria can be temporary, so some people with proteinuria won't require treatment. However, proteinuria often means that your kidneys aren't properly filtering blood. Therefore, the goal of treatment is to manage any underlying conditions you may have.Is protein in urine always kidney disease? ›
If your urine protein remains high, it is likely a sign of kidney disease or kidney damage from other conditions. The amount of protein in your urine is linked to the amount of kidney damage you may have. But you will need more tests to diagnose what is causing the damage.Why do children have a high protein requirement? ›
Protein is essential for your child's growth, maintenance and repair for the body. It contains key nutrients that are needed for your child's health. Key nutrients that we also get from protein foods include iron, omega 3s, zinc, B vitamins, vitamin D, calcium and selenium.What are symptoms of excess protein? ›
- intestinal discomfort and indigestion.
- unexplained exhaustion.
- mood changes.
- low blood pressure.
- hunger and food cravings.
- Chronic kidney disease.
- Diabetic nephropathy (kidney disease)
- Focal segmental glomerulosclerosis (FSGS)
- Glomerulonephritis (inflammation in the kidney cells that filter waste from the blood)
- High blood pressure (hypertension)
If the underlying problem that causes proteinuria is left untreated, a person is at risk for developing more serious kidney problems. The kidneys can loose some of their function or even stop working. End-stage renal disease (ESRD) is the last step in the disease process.What can cause sudden proteinuria? ›
Proteinuria is high levels of protein in the urine. It shows that the kidneys are not filtering blood as they should. Causes of proteinuria can be temporary, such as dehydration, or chronic, such as an autoimmune disease. People with diabetes or high blood pressure have the highest risk of proteinuria.Can you live with proteinuria? ›
Overall survival is differentially affected by proteinuria according to clinical setting. The six-year overall survival rate of patients with A1 proteinuria group on UA was 93.3% for OP, 90.5% for ED, and 67.0% for IP (Table 2).What stage of kidney disease is protein in urine? ›
Stage 1 CKD means you have a normal estimated glomerular filtration rate (eGFR) of 90 or greater, but there is protein in your urine (i.e., your pee). The presence of protein alone means you are in Stage 1 CKD.What foods to avoid if you have proteinuria? ›
Some specific examples include:
- Oranges and orange juice.
- Leafy green vegetables, such as spinach and greens (collard and kale)
There are three types of proteinuria: transient (temporary), orthostatic (related to sitting/standing or lying down), and persistent (always present). Certain types of urine testing are needed to determine the type of proteinuria.Can proteinuria be cured naturally? ›
Reduce proteinuria naturally with home remedies
Eat plenty of fruits and vegetables, grains, and legumes. Lean meats are better than red meat, as the latter is harder to break down. Consume more fish. Restrict salt intake.
- Don't take supplements containing creatine. ...
- Reduce your protein intake. ...
- Eat more fiber. ...
- Talk with your healthcare provider about how much fluid you should drink. ...
- Lower your salt intake. ...
- Avoid overusing NSAIDs. ...
- Avoid smoking. ...
- Limit your alcohol intake.
|Age||Grams of protein per day|
|Toddlers 1 to 3 years||13g (or 0.5g per pound of body weight)|
|Children 4 to 8 years||19g|
|Children 9 to 13 years||34g|
|Teens 14 to 18 years Boys||52g|
Protein requirements for older adults ages 65+
Age becomes more important to protein intake as you hit 65+. Once you reach your 60s, you might want to begin upping the amount of protein you consume per day in an effort to maintain muscle mass and strength, bone health and other essential physiological functions.
Is protein in urine serious? Yes, protein in your urine is serious. Proteinuria may increase your risk of death from heart disease and cardiovascular disease. Occasionally, proteinuria is an early sign of chronic kidney disease (CKD), although you can have CKD and have normal levels of protein in your urine.What level of protein in urine is alarming? ›
The amount of protein present in the urine sample excreted over 24-hours is used to diagnose the condition. More than 2 g of protein is considered to be severe and is likely to be caused by a glomerular malfunction.Should I worry about 1+ protein in urine? ›
Normally, you should have less than 150 milligrams (about 3 percent of a teaspoon) of protein in the urine per day. Having more than 150 milligrams per day is called proteinuria. DOES PROTEINURIA CAUSE SYMPTOMS? People with a small amount of proteinuria generally have no signs or symptoms.Can protein in urine be OK? ›
A small amount of protein in your urine is normal, but too much can be a sign of kidney disease.How do you remove protein from urine? ›
- Changes to your diet. If high levels of protein are caused by kidney disease, diabetes, or high blood pressure, your doctor will give you specific diet changes.
- Weight loss. ...
- Blood pressure medication. ...
- Diabetes medication. ...
Proteinuria can be temporary, so some people with proteinuria won't require treatment. However, proteinuria often means that your kidneys aren't properly filtering blood. Therefore, the goal of treatment is to manage any underlying conditions you may have.How much proteinuria is normal? ›
Normally, you should have less than 150 milligrams (about 3 percent of a teaspoon) of protein in the urine per day. Having more than 150 milligrams per day is called proteinuria. DOES PROTEINURIA CAUSE SYMPTOMS? People with a small amount of proteinuria generally have no signs or symptoms.How long does proteinuria last? ›
The proteinuria is not indicative of significant underlying kidney disease; it may be precipitated by high fever or heavy exercise, and it disappears upon repeat testing. Exercise-induced proteinuria usually resolves within 24 hours.Can proteinuria be reversed? ›
Proteinuria is also a strong predictor of cardiovascular events. Convincing preclinical and clinical evidence exists that proteinuria and the underlying glomerulosclerosis are reversible processes.
Protein in urine may be an early sign of kidney disease before you even have symptoms. So your provider may order a protein in urine test if you have a high risk for kidney disease. You're more likely to develop kidney disease if you have: A family history of kidney disease. Diabetes.Does protein in urine mean kidney damage? ›
They also remove things your body doesn't need, like waste products and extra water. If your kidneys are damaged, protein can “leak” out of the kidneys into your urine. Having protein in your urine is called “albuminuria” or “proteinuria.”What are the major causes of proteinuria? ›
- Amyloidosis (buildup of abnormal proteins in your organs)
- Certain drugs, such as nonsteroidal anti-inflammatory drugs.
- Heart disease.
- Heart failure.
- Hodgkin's lymphoma (Hodgkin's disease)
- Kidney infection (pyelonephritis)
- Loss of appetite.
- Fatigue and weakness.
- Sleep problems.
- Urinating more or less.
- Decreased mental sharpness.
- Muscle cramps.