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Proteinuria

Lovella Duru Kanu, MD Reviewed 06/2018
 


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 ...

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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