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Proteinuria

Lovella Duru Kanu, MD Reviewed 06/2019
 


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 (3)[C].

  • Proteinuria goal is <0.5 g/day (4)[A].

GENERAL MEASURES

  • Limit protein intake to 0.8 g/kg/day in adults with DM or wi...

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
National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation classification, and stratification: guideline 5. Assessment of proteinuria. http://ww...

CODES

ICD10

  • R80.9 Proteinuria, unspecified

  • R80.2 Orthostatic proteinuria, unspecified

  • R80.1 Persistent proteinuria, unspecified

  • R80.8 Other proteinuria

ICD9

  • 791.0 Proteinuria

  • 593.6 Postural proteinuria

SNOMED

  • ...

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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