Albuminuria (proteinuria): symptoms, causes and treatment

Definition

What is albuminuria (proteinuria)?

Albuminuria (proteinuria) is a condition where urine or urine contains an abnormal amount of albumin. Albumin is a type of protein in the blood. This condition is not a disease, but is a symptom that can indicate a certain disease.

Healthy kidneys do not allow too much protein to pass through the kidney filters. However, filters that are damaged by kidney disease can allow proteins such as albumin to leak from the blood into the urine.

This condition, also known as proteinuria, is often a symptom of kidney disease, especially if you have severe proteinuria where your urine contains 2-3 grams of protein per day.

How common is this condition?

This condition can occur in patients of any age. Albuminuria can be treated by reducing risk factors. Talk to your doctor for more information.

Signs & symptoms

What are the signs and symptoms of albuminuria?

Usually patients who have this condition show no symptoms, especially when a new disease appears. However, albuminuria can cause symptoms after the disease has become more severe, some of which are:

• more frequent urination (overactive bladder),
• hard to breathe,
• nausea and vomiting,
• fatigue,
• loss of appetite,
• swelling in the area of ​​the face, stomach, or legs and around the ankles,
• muscle cramps at night,
• swollen eyes, and
• foamy urine.

This symptom is also a sign of chronic kidney disease. In addition, high amounts of protein in the urine will also cause a condition called nephrotic syndrome.

Nephrotic syndrome causes water accumulation in the body. This excess water will make your body swell in several parts.

There may be signs and symptoms not listed above. If you have concerns about a particular symptom, consult your doctor.

When should I see a doctor?

You should immediately see a doctor when you have experienced one or more of the various symptoms. Especially if you start to experience swelling and foamy urine, visit your doctor immediately so you can get treatment as soon as possible.

Cause

What causes this condition?

Protein can enter the urine if the kidneys are not working properly. The blood vessels in the kidneys, called the glomerulus, work by filtering waste products from the blood and maintaining the components the body needs, including protein.

The glomerulus will ensure that protein and larger blood cells do not pass into the urine. If anything enters the tubule, the kidneys will recapture the protein and store it in the body.

But when both of them are disturbed or if there is an excessive protein load, this protein will also flow in the urine.

In addition, the presence of urinary tract stones can also cause proteinuria.

Not only kidney-related diseases, this disease can be caused by temporary health conditions such as dehydration, inflammation, and low blood pressure.

Too intense exercise, stress, use of aspirin drugs, and exposure to cold are other causes that may cause proteinuria.

Risk factors

What increases my risk for albuminuria?

There are several factors that can put you at increased risk of albuminuria. The two diseases that most often trigger are diabetes and high blood pressure.

Other types of kidney disease that are not related to diabetes or high blood pressure can also cause protein to leak into the urine.

Other risk factors include:

• obesity,
• age over 65, and
• family history of kidney disease.

Some people have more protein in the urine when standing up than when lying down. This condition is called orthostatic proteinuria.

There are also various conditions that contribute to an increase in protein levels in the urine, including:

• autoimmune disease,
• plasma cell cancer (multiple myeloma),
• heart disease,
• acute kidney inflammation,
• preeclampsia, a complication in the form of high blood pressure in pregnant women,
• intravascular hemolysis or the destruction of red blood cells and the release of hemoglobin in the bloodstream,
• kidney cancer, and
• congestive kidney failure.

Diagnosis

How to diagnose this condition?

Proteinuria can be detected by a urine test. You don't need special preparation to do it. You can even do this test at home, following the instructions given by your doctor.

Test dipstick

A simple test is a urine test using dipstick (a small plastic strip with indicator paper) which can detect very small amounts of protein.

Later, if there is too much substance in the urine, the ends will change color. Because protein in the urine can last only temporarily, this test should be done regularly to determine if you really have kidney problems.

Test dipstick This is very sensitive, but can't measure exactly how much protein albumin is in the urine. To get a precise measurement, your urine must be checked in a laboratory.

When the results are inconclusive, the remaining urine is examined under a microscope. From these observations the doctor will find out substances that should not be in the urine, such as red and white blood cells, bacteria, or crystals that can grow into kidney stones.

One positive urine test result for protein cannot determine whether you have kidney disease. However, if the result is still positive every time you take the test, then it is likely that your kidneys are having problems.

Albumin and creatinine levels test

This test is done to show how much protein albumin and creatinine levels have been excreted within 24 hours in the urine. Creatinine is a waste product that has been filtered in the kidneys and then excreted by passing urine.

ACR is said to be high if the result is above 30, this indicates a significant protein leakage. The higher the level, the more dangerous the impact will be.

ACRs ranging from 3-30 usually do not require action, but patients need to be screened annually. Meanwhile, ACR less than 3 mg / mmol does not require further action.

Further examination

If the ACR is high, the doctor will look at the patient's and family's medical history, then perform further kidney examinations. These examinations can include:

• Blood test. Blood tests are performed to measure creatinine levels, protein, and estimate the glomerular filtration rate. This test can also be a picture of how well your kidneys are working.
• Scan test. Tests like CT scan or ultrasounds can show you a picture of the kidney that will help the doctor find any problems in it.
• Urine protein electrophoresis. The doctor will look for certain types of protein in the urine sample that can indicate a disease.
• Immunotherapy blood test. The test aims to find a protein called immunoglobulin, which is an infection-fighting antibody in the blood.
• Kidney biopsy. This procedure involves removing a small portion of the kidney organ. Later this sample will be examined under a microscope.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the treatments for albuminuria?

Albuminuria is not a specific disease, so treatment depends on identifying and treating the cause. Generally, if your proteinuria tends to be normal, you don't need treatment.

It is different if the condition is caused by kidney disease, proper medical care is very important. Untreated chronic kidney disease can lead to kidney failure.

Medicines are sometimes given, especially to people with diabetes and / or high blood pressure. Drugs can come from two classes of drugs, namely ACE (angiotensin-converting enzyme) inhibitors and ARB (angiotensin receptor blockers).

The two types of drugs are actually more widely used to help lower blood pressure. However, in patients with albuminuria, this drug can help protect the kidneys from damage.

Appropriate treatment - especially in patients with chronic diseases such as diabetes and high blood pressure - is important to prevent progressive kidney damage that causes albuminuria.

In patients with diabetes and high blood pressure, patients experiencing albuminuria should also control blood sugar levels.

In addition, diabetic patients should have an annual glomerular filtration rate (GFR) test. If there are kidney problems, the patient will be referred to a nephrologist, a doctor who specializes in kidney disease.

Meanwhile, if albuminuria occurs in pregnant women who have preeclampsia, their condition must be monitored more. Fortunately, most albuminuria will go away on its own after the baby is born.

Even if the patient does not have other diseases such as diabetes, blood pressure problems, or other conditions, blood pressure medications may still be prescribed to prevent kidney damage.

Home remedies

What are some lifestyle changes or home remedies that can be used to treat albuminuria?

Because this condition can be caused by a disease that you are suffering from, then you must take care that aims to stay away from things that trigger the symptoms.

However, generally you have to make various changes, especially in your diet. Here are ways that can help you deal with albuminuria.

• If you have a water retention condition that causes albuminuria, reduce the amount of salt and water intake in your daily diet. Sodium in salt also increases the glomerular capillary pressure which interferes with its work.
  
• If you have high blood pressure, also reduce salt in your diet, and adjust your diet well.
  
• Maintain a healthy weight. Obesity has often been a trigger for various health problems, including the health of your kidneys and urinary system. Apart from eating healthy foods, also make your body more active by exercising or other physical activities.

If you have any questions, consult your doctor for the best solution to your problem.