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Proteinuria

Marvin Sineath Jr and Algimantas Simpson, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

Urinary protein excretion of >150 mg/day 
  • Nephrotic-range proteinuria: urinary protein excretion of >3.5 g/day; also called heavy proteinuria

  • Three pathologic types:

    • Glomerular pr...

DIAGNOSIS

HISTORY

  • Frothy/foamy urine

  • Change in urine output

  • Blood- or cola-colored urine

  • Recent weight change

  • Swelling

  • Rule out systemic illness: diabetes, heart failure, autoimmune, poststreptococcal infec...

TREATMENT

  • BP goal for both diabetic and nondiabetic adults is ≤140/90 mm Hg (5)[C].

  • Proteinuria goal is <0.5 g/day (6)[A].

  • BP goal of 130/80 mm Hg for patients with normal urinary albumin concentra...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

All patients with persistent proteinuria should be followed with serial BP checks, UA, and renal function tests in the outpatient setting. Inter...

REFERENCES

1
Gaitonde DY, Cook DL, Rivera IM. Chronic Kidney Disease: Detection and Evaluation. Am Fam Physician. 2017 Dec 15;96(12):776-783.
2
Hull RP, Goldsmith DJ. Nephrotic syndrome in adults. BMJ. 2...

CODES

ICD10

  • R80.9 Proteinuria, unspecified

  • R80.2 Orthostatic proteinuria, unspecified

  • R80.1 Persistent proteinuria, unspecified

  • R80.8 Other proteinuria

SNOMED

  • 29738008 Proteinuria (finding)

  • 32482005 Orthosta...

CLINICAL PEARLS

  • Transient and orthostatic proteinuria are benign conditions that do not convey a poor prognosis.

  • Proteinuria >2 g/day likely represents glomerular malfunction and warrants a nephrolo...

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