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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
- Fatigue
- 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
Risk factors include:
- Family history of kidney disease
- Kidney damage or disease
- Obesity
- 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
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Mouin Seikaly, MD Pediatric Nephrologist
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Michel Baum, MD Pediatric Nephrologist
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Elizabeth Brown, MD Pediatric Nephrologist
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Keri Drake, MD Pediatric Nephrologist
(Video) Proteinuria in pediatrics -
Jyothsna Gattineni, MD Pediatric Nephrologist
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Halima Janjua, MD Pediatric Nephrologist
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Raymond Quigley, MD Pediatric Nephrologist
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Smitha Vidi, MD Pediatric Nephrologist
- (Video) Proteinuria - Protein in Urine - Dr. Gaytri Manek (formerly Gandotra)
Matthias Wolf, MD Pediatric Nephrologist
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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.
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FAQs
Is it normal for kids to have protein in urine? ›
Most proteins are too big to go through the kidneys, so usually no protein is found in urine. If your doctor finds protein in your child's urine, that means your child's kidney filters may not be working as they should—possibly because of inflammation (swelling).
Is proteinuria in kids curable? ›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.
What are the causes of proteinuria in children? ›| Cause of proteinuria | Laboratory findings* |
|---|---|
| Glomerular | |
| Adaptation (hyperfiltration) due to nephron loss | Elevated serum creatinine or blood urea nitrogen level |
| Alport syndrome | RBCs on urinalysis |
| Collagen vascular disease or vasculitis | |
Orthostatic proteinuria is common in older children and adolescents with a prevalence of 2–5% [7]. Orthostatic proteinuria is the most common cause of proteinuria in adolescents (75%) [2].
Is protein in urine always serious? ›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.
Can proteinuria be cured? ›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 long can you live with proteinuria? ›Across the board, results showed that mild or heavy amounts of proteinuria was tied to shorter life spans in men and women between 30 and 85 years of age. For example, the life expectancies of 40-year-old men and women with no proteinuria were 15.2 and 17.4 years longer, respectively, than those with heavy proteinuria.
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)
- Potatoes.
- 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. ...
- Dialysis.
Transient proteinuria can occur with a medical condi- tion (e.g., fever, seizure) or another trigger, such as exer- cise, stress, dehydration, or cold exposure. It can also be idiopathic. Orthostatic proteinuria is the most common cause of pro- teinuria in children, especially in adolescent males.
Is nephrotic syndrome curable in child? ›
Nephrotic syndrome is almost always treatable, but the treatment depends on the cause. Kids with nephrotic syndrome usually are treated by a nephrologist (a doctor who specializes in kidney problems). To treat minimal change disease, the doctor will prescribe: Prednisone.
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.
How do I know if my child has kidney problems? ›Symptoms of Kidney Problems
swelling around the eyes, face, feet, and ankles (called edema) burning or pain during peeing. significant increase in the frequency of urination. difficulty in controlling urination in kids who are mature enough to use the toilet.
Although nephrotic syndrome can be a serious condition most people respond well to treatment and can live essentially a normal life particular if the condition goes into remission. Depending on the cause patients may respond to treatment within a few days but may take several weeks or even months.
What medication is used 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)
Can protein in urine be temporary? ›Temporarily high levels of protein in urine aren't unusual either, particularly in younger people after exercise or during an illness. Persistently high levels of protein in urine may be a sign of kidney disease.
What stage of kidney disease is protein in urine? ›In Stage 1 CKD, the damage to your kidneys is mild. Your kidneys are still working well, but you may have signs of kidney damage or physical damage to your kidneys. 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).
Does protein in urine always mean kidney disease? ›A small amount of protein in your urine is normal, but too much can be a sign of kidney disease.
How do you stop proteinuria naturally? ›- 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.
- Drink plenty of water and avoid soda.
- Exercise regularly.
- Minimize alcohol intake.
Results: Among the 212 patients studied, 52% recovered from proteinuria within 2 years and an additional 22% recovered within 5 years, for a total of 74%. The level of proteinuria at baseline visit predicted the time to improvement.
How can I reduce protein in my urine naturally? ›
- Changes in your diet.
- Medication to control kidney disease symptoms that include swelling and high blood pressure.
- Cessation of smoking and alcohol consumption.
- Regular exercise.
- Weight loss.
Left untreated, conditions that cause proteinuria can lead to a severe condition, end-stage renal (kidney) disease. Some people with proteinuria do not have symptoms. However, if you have proteinuria, you may notice urine that appears frothy, or you may experience swelling in the body (edema).
What happens if you leave proteinuria untreated? ›What can proteinuria lead to? 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.
How does the body get rid of excess protein? ›On the other hand, according to the National Kidney Foundation, if high protein levels are the result of dehydration, you may be able to flush out excess protein (or dilute the concentration) by drinking more water and making sure that you're getting enough electrolytes.
What fruit is good for kidneys? ›- Cranberries keep the urinary tract free from infection (UTI)
- Red grapes reduce inflammation and help protect against diabetes.
- Apples help to prevent constipation and reduce cholesterol.
Yet people with chronic kidney disease (CKD) have to limit dairy products in their kidney diet. High levels of phosphorus, potassium and calcium in something like low-fat milk are not good for someone on a kidney diet.
What disease causes protein in urine? ›Other conditions and factors affecting the kidneys that may result in protein in urine include: Amyloidosis (buildup of abnormal proteins in your organs) Certain drugs, such as nonsteroidal anti-inflammatory drugs. Heart disease.
Why do doctors test for protein in urine? ›This test is most often done when your provider suspects you have kidney disease. It may also be used as a screening test for kidney disease, for example in people with diabetes. Although small amounts of protein are normally in urine, a routine dipstick test may not detect them.
What are the first signs of kidney disease? ›- Nausea.
- Vomiting.
- Loss of appetite.
- Fatigue and weakness.
- Sleep problems.
- Urinating more or less.
- Decreased mental sharpness.
- Muscle cramps.
Nearly one fifth of all initial nonresponders with minimal change nephrotic syndrome died. Thus the pattern of response to initial steroid therapy in patients with minimal change nephrotic syndrome may have prognostic significance.
What is the most common cause of nephrotic syndrome in children? ›
Diabetes can lead to kidney damage (diabetic nephropathy) that affects the glomeruli. Minimal change disease. This is the most common cause of nephrotic syndrome in children.
Why is nephrotic syndrome common in children? ›Congenital nephrotic syndrome is usually caused by an inherited faulty gene. For the condition to be passed on to a child, both parents must have a healthy copy of the gene and a faulty one.
Does proteinuria cause kidney damage? ›The possibility that proteinuria may accelerate kidney disease progression to end-stage renal failure has received support from the results of increasing numbers of experimental and clinical studies.
Is 3+ protein in urine high? ›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.
When is proteinuria diagnosed? ›Proteinuria is usually diagnosed by measuring the quantity of protein in urinary excretion in a 24-hour period. This test involves the collection of all urine excreted over a complete day, which is then analyzed for the quantity of protein.
What is the first indication of nephrotic syndrome in children? ›You may see swelling around your child's eyes in the morning. Often, that's the first sign. As time passes, the swelling may last all day, and you may see swelling in your child's ankles, feet or belly.
How long can a child live with kidney disease? ›About 70% of children with chronic kidney disease develop ESRD by age 20 years. Children with ESRD have a 10-year survival rate of about 80% and an age-specific mortality rate of about 30 times that seen in children without ESRD.
How can I improve my child's kidney function? ›Water is important for good kidney health and helps the kidneys remove wastes from the blood in the form of urine. Water also helps the blood travel freely through the kidneys and the rest of the body. Making sure kids drink enough water is important, especially when they are active when the weather is warm and humid.
What is the best treatment for nephrotic syndrome? ›- Blood pressure medications. Drugs called angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure and the amount of protein released in urine. ...
- Water pills (diuretics). ...
- Cholesterol-reducing medications. ...
- Blood thinners (anticoagulants). ...
- Immune system-suppressing medications.
What is nephrotic syndrome in children? Nephrotic syndrome is a problem where too much protein called albumin is released from the body into the urine. It means that one or both kidneys are damaged. The kidneys contain many coils of tiny blood vessels.
What food should be avoided during nephrotic syndrome? ›
A low salt diet is recommended in nephrotic syndrome to help reduce fluid retention. Avoid using salt in cooking and do not add it to food at the table. Choose foods that are low in salt.
Is protein in urine always serious? ›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.
Can UTI cause protein in urine in children? ›During a fever or urinary tract infection
The kidneys may also leak some protein during a fever or a urinary tract infection (UTI), when germs get into the urine and travel up the urinary system. The proteinuria usually disappears after the child gets better, and does not cause any long-term problems.
- fever.
- swelling around the eyes, face, feet, and ankles (called edema)
- burning or pain during peeing.
- significant increase in the frequency of urination.
- difficulty in controlling urination in kids who are mature enough to use the toilet.
Foamy urine is a sign of protein in the urine, which is not normal. “Kidneys filter the protein, but should keep it in the body,” explains Dr. Ghossein. If kidneys are releasing protein into the urine, they are not working properly.
Can dehydration cause protein in urine? ›Strenuous exercise, dehydration, diet, stress, pregnancy, and other conditions can cause a temporary rise in urine protein levels. Your provider may recommend other urinalysis tests to see whether you continue to have a high level of protein in your urine over time.
How long can you live with proteinuria? ›Across the board, results showed that mild or heavy amounts of proteinuria was tied to shorter life spans in men and women between 30 and 85 years of age. For example, the life expectancies of 40-year-old men and women with no proteinuria were 15.2 and 17.4 years longer, respectively, than those with heavy proteinuria.
What foods reduce protein in urine? ›Focus on fiber-rich carbohydrates, such as whole grains, whole fruits and vegetables. While rich in nutrients, starchy vegetables such as potatoes and corn can also raise blood sugar when eaten in excess.
What are the major causes of proteinuria? ›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)
Is kidney disease curable in children? ›PKD cannot be cured, so children with the condition receive treatment to slow the progression of kidney disease and treat the complications of PKD.
What is the first indication of nephrotic syndrome in children? ›
You may see swelling around your child's eyes in the morning. Often, that's the first sign. As time passes, the swelling may last all day, and you may see swelling in your child's ankles, feet or belly.
How long can a child live with kidney disease? ›About 70% of children with chronic kidney disease develop ESRD by age 20 years. Children with ESRD have a 10-year survival rate of about 80% and an age-specific mortality rate of about 30 times that seen in children without ESRD.
Is nephrotic syndrome curable in child? ›Nephrotic syndrome is almost always treatable, but the treatment depends on the cause. Kids with nephrotic syndrome usually are treated by a nephrologist (a doctor who specializes in kidney problems). To treat minimal change disease, the doctor will prescribe: Prednisone.
What happens if proteinuria is left untreated? ›Left untreated, conditions that cause proteinuria can lead to a severe condition, end-stage renal (kidney) disease. Some people with proteinuria do not have symptoms. However, if you have proteinuria, you may notice urine that appears frothy, or you may experience swelling in the body (edema).
What stage of kidney disease is foamy urine? ›This is called proteinuria. It's a sign of chronic kidney disease or the late stage of kidney damage, called end-stage renal disease.
Does protein in urine always mean kidney disease? ›A small amount of protein in your urine is normal, but too much can be a sign of kidney disease.
What stage of kidney disease is protein in urine? ›In Stage 1 CKD, the damage to your kidneys is mild. Your kidneys are still working well, but you may have signs of kidney damage or physical damage to your kidneys. 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).
Can protein in urine be temporary? ›Temporarily high levels of protein in urine aren't unusual either, particularly in younger people after exercise or during an illness. Persistently high levels of protein in urine may be a sign of kidney disease.