Proteinuria (from protein and urine) means the presence of an excess of serum proteins in the urine.^[1] The protein in the urine often causes the urine to become foamy, although foamy urine may also be caused by bilirubin in the urine (bilirubinuria),^[2] retrograde ejaculation,^[3] pneumaturia (air bubbles in the urine) due to a fistula,^[4] or drugs such as pyridium.^[5] The term symptom (from the Greek meaning chance, mishap or casualty, itself derived from συμπιπτω meaning to fall upon or to happen to) has two similar meanings in the context of physical and mental health: Strictly, a symptom is a sensation or change in health function experienced by a patient. ... In medicine, a sign is a feature of disease as detected by the doctor during physical examination of a patient. ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // R00-R99 - Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R09) Symptoms and signs involving the circulatory and respiratory systems (R00) Abnormalities of heart beat (R000) Tachycardia, unspecified (R001) Bradycardia, unspecified (R002) Palpitations (R008) Other and unspecified abnormalities of heart beat (R01) Cardiac murmurs and other... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... A representation of the 3D structure of myoglobin, showing coloured alpha helices. ... This article or section is in need of attention from an expert on the subject. ... Bilirubin is a yellow breakdown product of normal heme catabolism. ... In medicine, bilirubinuria is an abnormality where bilirubin is detected in the urine. ... In males, retrograde ejaculation occurs when the fluid to be ejaculated, which would normally exit via the urethra, is redirected towards the urinary bladder. ... Phenazopyridine is a chemical which, when secreted into the urine, has a specifical local analgesic effect. ...

Measurement

Proteinuria is often diagnosed by a simple dipstick test although it is possible for the test to give a false negative even nephrotic range proteinuria if the urine is dilute. False negatives may also occur if the protein in the urine is composed mainly globulins or Bence-Jones Proteins because the reagent on the test strips, Bromphenol blue, is highly specific for albumin. ^[6][7] Traditionally dipstick protein tests would be quantified by measuring the total quantity of protein in a 24-hour urine collection test, and abnormal globulins by specific requests for Protein electrophoresis.^[8][9] A globular protein is a protein that is globe-like, or rounded in shape, often soluble in aqueous solution. ... A Bence Jones protein is a monoclonal globulin protein found in the blood or urine. ... This article does not cite any references or sources. ... Schematic representation of a protein electrophoresis gel In chemistry and medicine, protein electrophoresis is a method of analysing a mixture of proteins by means of gel electrophoresis, mainly in blood serum (blood plasma is not suitable). ...

Alternatively the concentration of protein in the urine may be compared to the creatinine level in a spot urine sample. This is termed Protein/Creatinine Ratio (PCR). The 2005 UK Chronic Kidney Disease guidelines states that PCR is a better test than 24 hour urinary protein measurement. Proteinuria is defined as a Protein:creatinine ratio >45 mg/mmol (which is equivalent to Albumin:creatinine ratio of >30 mg/mmol) with very high levels of nephrotic syndrome being for PCR > 100 mg/mmol.^[10] Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass). ... Microalbuminuria - the measurement of small amounts of albumin in the urine that cannot be detected by urine dipstick methods. ...

Associated conditions

Proteinuria may be a sign of renal (kidney) damage. Since serum proteins are readily reabsorbed from urine, the presence of excess protein indicates either an insufficiency of absorption or impaired filtration. Diabetics may suffer from damaged nephrons and develop proteinuria. The kidneys are organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... This article is about the disease that features high blood sugar. ... Nephron of the kidney A nephron is the basic structural and functional unit of the kidney. ...

With severe proteinuria, general hypoproteinemia can develop which results in diminished oncotic pressure. Symptoms of diminished oncotic pressure may include ascites, edema, and hydrothorax. Hypoproteinemia (or Hypoproteinaemia) is a condition where there is an abnormally low level of protein in the blood. ... In blood plasma, the dissolved compounds have an osmotic pressure. ... This page is about the condition called edema. ...

Conditions with proteinuria as a sign

Proteinuria may be a feature of the following conditions:^[7]

• Nephrotic syndromes (i.e. intrinsic renal failure)
• Pre-eclampsia
• Eclampsia
• toxic lesions of kidneys
• Collagen vascular diseases(e.g., systemic lupus erythematosus)
• Dehydration
• Glomerular diseases, such as membranous glomerulonephritis, focal segmental glomerulonephritis, minimal change disease (lipoid nephrosis)
• Strenuous exercise
• Stress
• Benign Orthostatic (postural) proteinuria
• Focal segmental glomerulosclerosis (FSGS)
• IgA nephropathy (i.e., Berger's disease)
• IgM nephropathy
• Membranoproliferative glomerulonephritis
• Membranous nephropathy
• Minimal change disease
• Sarcoidosis
• Alport's syndrome
• Diabetes mellitus
• Drugs (e.g., NSAIDs, nicotine, penicillamine,gold, ACE inhibitors, antibiotics, opiates especially heroin.^[11]
• Fabry's disease
• Infections (e.g., HIV, syphilis, hepatitis,post-streptococcal infection)
• Aminoaciduria
• Fanconi syndrome
• Heavy metal ingestion
• Hypertensive nephrosclerosis
• Interstitial nephritis
• Sickle cell disease
• Hemoglobinuria
• Multiple myeloma
• Myoglobinuria
• Organ rejection- kidney tansplant patients may have gamma-globumins in their urine if the kidneys start to reject.^[12]
• Ebola hemorrhagic fever
• Nail Patella Syndrome

Pre-eclampsia (US: preeclampsia) is a medical condition where hypertension arises in pregnancy (pregnancy-induced hypertension) in association with significant protein in the urine. ... The kidneys are organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... Glomerulus refers to two unrelated structures in the body, both named for their globular form. ... Membranous glomerulonephritis (MGN), also known as membranous nephropathy is a slowly progressive disease affecting mostly patients between ages of 30 and 50 years. ... Glomerulonephritis is a primary or secondary autoimmune renal disease featuring inflammation of the glomeruli. ... Minimal change disease or nil disease (lipoid nephrosis) is a disease of the kidney which causes nephrotic syndrome and usually affects children (peak incidence at 2-3 years of age). ... Focal segmental glomerulosclerosis (FSGS) is a cause of nephrotic syndrome in children and adolescents, as well as an important cause of kidney failure in adults. ... Focal segmental glomerulosclerosis (FSGS) - a kidney disorder where the glomerulus is dysfunctional, leaks protein and has focal scarring. ... IgA nephropathy (also known as IgA nephritis, IgAN, Bergers disease and synpharyngitic glomerulonephritis) is a form of glomerulonephritis (inflammation of the glomeruli of the kidney). ... Membranoproliferative Glomerulonephritis or MPGN is a type of glomerulonephritis caused by immune complexes depositing in the kidney glomerular mesangium and basement membrane (GBM), activating complement and damaging the glomeruli. ... Membranous nephropathy (or membranous nephritis, or membranous glomerulonephritis) is an immunologic renal disorder characterized by subepithelial immune deposits in the glomerular capillary wall. ... Minimal change disease or nil disease (lipoid nephrosis) is a disease of the kidney which causes nephrotic syndrome and usually affects children (peak incidence at 2-3 years of age). ... Alport syndrome is a genetic condition characterized by the progressive loss of kidney function and hearing. ... For the disease characterized by excretion of large amounts of very dilute urine, see diabetes insipidus. ... Wikipedia does not yet have an article with this exact name. ... Nicotine is an alkaloid found in the nightshade family of plants (Solanaceae), predominantly in tobacco, and in lower quantities in tomato, potato, eggplant (aubergine), and green pepper. ... Penicillamine is a pharmaceutical of the chelator class. ... ACE inhibitors, or inhibitors of Angiotensin_Converting Enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in most cases as the drugs of first choice. ... An antibiotic is a drug that kills or slows the growth of bacteria. ... An opioid is any agent that binds to opioid receptors found principally in the central nervous system and gastrointestinal tract. ... For other uses, see Heroin (disambiguation). ... Fabry disease (also known as Anderson-Fabry disease, Angiokeratoma corporis diffusum, Ceramide trihexosidosis, and Sweeley-Klionsky disease) is an X-linked recessive inherited lysosomal storage disease. ... Species Human immunodeficiency virus 1 Human immunodeficiency virus 2 Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS, a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections). ... Syphilis is a sexually transmitted disease caused by Treponema pallidum. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... Aminoaciduria is the presence of amino acids in the urine. ... Fanconi syndrome (also known as Fanconis syndrome) is a disorder in which the proximal tubular function of the kidney is impaired, resulting in improper reabsorption of electrolytes and nutrients back into the bloodstream. ... Hypertensive nephropathy (or hypertensive nephrosclerosis, or Hypertensive renal disease) is a medical condition referring to damage to the kidney due to chronic high blood pressure. ... Interstitial nephritis (or Tubulo-interstitial nephritis) is a form of nephritis affecting the interstititum of the kidneys surrounding the tubules. ... ... In medicine, haemoglobinuria is a condition in which the oxygen transport protein haemoglobin is found in abnormally high concentrations in the urine. ... Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahlers disease after Otto Kahler) is a type of cancer of plasma cells which are immune system cells in bone marrow that produce antibodies. ... Myoglobinuria is the presence of myoglobin in the urine, usually associated to rhabdomyolysis or muscle destruction. ... Organ rejection is a process by which the immune system of the recipient of a transplant attacks the transplanted organ. ... Species Ivory Coast ebolavirus Reston ebolavirus Sudan ebolavirus Zaire virus Ebola hæmorrhagic fever (EHF — alternatively Ebola hemorrhagic fever; commonly referred to as simply Ebola) is a recently identified, severe, often fatal infectious disease occurring in humans and some primates caused by the Ebola virus. ...

Conditions with proteinuria consisting mainly of Bence-Jones proteins as a sign

• Waldenstrom's macroglobulinemia
• Chronic lymphocytic leukemia
• Amyloidosis
• Malignancies (e.g., lymphoma, other cancers)
• multiple myeloma

Waldenström macroglobulinemia (WM) is a hematological malignancy involving lymphocytes. ... Chronic lymphocytic leukemia (also known as chronic lymphoid leukemia or CLL), is a type of leukemia, or cancer of the white blood cells (lymphocytes). ...

See also

• Albuminuria
• Microalbuminuria
• List of terms associated with diabetes

Albuminuria is a pathological condition where albumin is present in the urine. ... Microalbuminuria - the measurement of small amounts of albumin in the urine that cannot be detected by urine dipstick methods. ... This page lists and explains terms connected with diabetes. ...

Footnotes

1. ^ The American Heritage Stedman's Medical Dictionary. KMLE Medical Dictionary Definition of proteinuria. Retrieved 2007-01-20
2. ^ http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20
3. ^ http://www.medhelp.org/forums/urology/archive/195.html Retrieved 2007-01-20
4. ^ Pneumaturia at GPnotebook Retrieved 2007-01-20
5. ^ http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20
6. ^ http://medlib.med.utah.edu/WebPath/TUTORIAL/URINE/URINE.html Retrieved 2007-01-20
7. ^ ^{a b} Simerville JA, Maxted WC, Pahira JJ (2005). "Urinalysis: a comprehensive review". American family physician 71 (6): 1153-62. PMID 15791892. 
8. ^ http://www.pathguy.com/lectures/urine.htm Retrieved 2007-01-20
9. ^ http://www.answers.com/topic/protein-electrophoresis Retrieved 2007-01-20
10. ^ Identification, management and referral of adults with chronic kidney disease: concise guidelines (PDF). UK Renal Association (27/9/05). - see Guideline 4 Confirmation of proteinuria, on page 9
11. ^ Dettmeyer RB, Preuss J, Wollersen H, Madea B (2005). "Heroin-associated nephropathy". Expert opinion on drug safety 4 (1): 19-28. PMID 15709895. 
12. ^ Hermann G, Zühlke V, Faul P (1970). "Gamma globulin fragments in urine of kidney transplant patients in relation to rejection crisis". European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes 2 (1): 55-63. PMID 4131420.