The third blog post of our series about proteinuria covers pathologic proteinuria, a condition that signifies that you have excess protein in your urine and is indicative of an underlying medical issue. This blog post will cover pathologic proteinuria in detail, explaining:
The definition of pathologic proteinuria
- Causes of pathologic proteinuria
- Consequences of pathologic proteinuria
- Medical conditions related to pathologic proteinuria
- Diseases related to pathologic proteinuria
- Guidance and empowerment
By reading this detailed information about pathologic proteinuria on the FKP Kidney Health blog, you will come to better understand this serious condition. Pathologic proteinuria should be addressed immediately so an underlying medical condition is not left untreated.
Introduction
Many medical conditions are classified into different types in order to provide the most appropriate framework as it relates to diagnosis, prognosis, and treatment.
In the case of proteinuria—a condition marked by the appearance of high levels of protein in the urine—there are three main classifications: transient, orthostatic, and persistent. Transient and orthostatic are generally harmless because they’re known to resolve on their own over time. Persistent proteinuria, however, is always present.
This blog post will focus solely on persistent proteinuria—the most concerning and dangerous of the three.
Understanding Pathologic Proteinuria
In this blog post, we will refer to persistent proteinuria as pathologic proteinuria. This classification denotes that this type of proteinuria is caused by an underlying pathologic condition that requires a prompt diagnosis and immediate intervention so further damage to your kidneys can be prevented.
Unlike the other two types of proteinuria mentioned above, pathologic proteinuria is associated with structural or functional abnormalities within the kidneys.
Causes of Pathologic Proteinuria
Once you’re diagnosed with pathologic proteinuria, your doctor must determine what’s causing high levels of protein to leak into your urine. What underlying condition is causing damage to your kidneys? Chronic kidney disease, glomerulonephritis, diabetes, and hypertension are among the most common underlying conditions related to pathologic proteinuria. Let’s take a closer look at each of these causes of pathologic proteinuria.
- Kidney diseases: Glomerulonephritis, diabetic nephropathy, and polycystic kidney disease can compromise your kidney’s ability to filter blood, eliminate metabolic waste, and regulate the balance of fluids in your body. When these and other kidney diseases threaten the functionality of the kidneys by destroying certain structures or impairing essential processes, protein in your urine reveals that your kidney health is being jeopardized by your underlying condition.
- Hypertension: According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIH), high blood pressure weakens and narrows your blood vessels. You have many delicate blood vessels in your kidneys, and they’re bound to become vulnerable to damage if you have hypertension. This can lead to pathologic proteinuria, especially if your blood pressure is left untreated.
- Autoimmune Diseases: Autoimmune diseases can also damage your kidneys, which is why they are listed among the causes of pathologic proteinuria. Lupus is an example of an autoimmune disease that causes your immune system to attack your kidneys, specifically its filtering units (glomeruli). Protein leakage will be more likely to occur when your kidneys become damaged or inflamed due to the presence of an autoimmune disease.
- Medications and Toxins: Certain medications can harm your kidneys. Cleveland Clinic notes that nonsteroidal anti-inflammatory drugs should be avoided whenever possible. It’s also advisable to limit your exposure to toxins, as medications and toxins can both have detrimental effects on renal function and lead to proteinuria.
- Infections: Your kidneys excel at fluid balance, electrolyte regulation, and blood pressure control. When you develop an infection—especially one that targets your kidneys—your kidneys’ stable internal environment gets disrupted as part of your immune system’s response. Pathologic proteinuria can result.
If you have pathologic proteinuria or suspect that you do, medical attention is required to diagnose and treat the underlying cause. Further diagnostic testing will be conducted so your doctor or nephrologist can provide an accurate diagnosis and give you the answers and information you need as you move forward with a customized care plan designed to prioritize your kidney health.
Consequences of Pathologic Proteinuria
A diagnosis of pathologic proteinuria should not be taken lightly. The potential consequences of pathologic proteinuria can include the following:
- Kidney Damage: If a urinalysis reveals that you have protein in your urine and the type of proteinuria is classified as pathologic, you should consult with your healthcare provider or nephrologist so you can understand the next steps you must take to protect your kidneys. A proactive approach will help ensure your pathologic proteinuria is not left untreated. If you do not undergo further testing to determine the underlying cause of your pathologic proteinuria, you risk developing chronic kidney disease (CKD). Chronic kidney disease—also known as chronic kidney failure—will progress over time, causing you to gradually lose kidney function. You may also experience complications of decreased renal function; these symptoms can include electrolyte imbalances, increased potassium levels, and weakened bones, just to name a few. If your pathologic proteinuria is indeed caused by CKD, you’ll need to regularly monitor your kidney function, maintain a healthy diet, and work closely with your doctors to establish a customized treatment plan designed to slow the progression of this disease.
- Complications: Your care team will label pathologic proteinuria as a cause for concern not just due to the underlying condition that’s causing it but also the complications that are commonly associated with pathologic proteinuria. These complications include, but are not limited to: swelling, anemia, high blood pressure, and an increased risk of cardiovascular problems. Many of these potential complications can be avoided if you seek timely medical treatment and closely follow your doctor’s care plan.
- Reduced Kidney Function: Another consequence of pathologic proteinuria is the implication that it is a marker of reduced kidney function. Your kidneys are powerful organs that filter waste, maintain fluid balance, and purify your blood. They are part of the body’s endocrine system, and they work in concert with other bodily systems to keep you healthy. Proteinuria is not merely a standalone condition; it’s a warning sign that you are experiencing reduced kidney function. Please heed that warning sign!
Medical Conditions and Diseases Linked to Pathologic Proteinuria
Several medical conditions and diseases are commonly linked to pathologic proteinuria. These medical conditions and diseases include:
- Diabetic Nephropathy: Diabetic nephropathy signifies a consistent elevation in blood glucose levels. This medical condition damages the small blood vessels in your kidneys, jeopardizing their functionality and causing protein leakage.
- Glomerulonephritis: The delicate filtration units within your kidneys are called glomeruli. When they’re functioning normally, they are constantly filtering waste, purifying your blood, and retaining essential proteins—proteins that should not be excreted into your urine. Regarded as a group of diseases that target and damage the glomeruli, glomerulonephritis inflames and undermines the normal function of the glomeruli, which is why there’s a connection between these diseases and pathologic proteinuria.
- Hypertension: High blood pressure is a medical condition that puts excess strain on your cardiovascular system. When the force of your blood against your artery walls is too high, your doctor will want to treat this condition. It’s a serious one because untreated hypertension can lead to heart disease, stroke, and other health problems. Hypertension is linked to pathologic proteinuria because it puts increased pressure on the glomeruli, which, in turn, allows proteins to leak into your urine.
- Autoimmune Diseases: Inflammation within the kidneys can diminish their overall efficiency. Lupus, vasculitis, and Goodpasture’s Syndrome are examples of autoimmune diseases that trigger kidney inflammation. When your immune system mistakenly attacks your kidneys, they become less capable of retaining essential proteins, which will result in pathologic proteinuria.
Empowering Patients with Knowledge
We trust that this blog post gave you helpful information about pathologic proteinuria. To recap, we defined pathologic proteinuria, discussed its causes and consequences, and examined some specific medical conditions and diseases related to this condition.
If you have been diagnosed with pathologic proteinuria, or if you are having symptoms of pathologic proteinuria—such as foamy urine, increased urination, and swelling—it’s imperative that you schedule an appointment with your doctor or nephrologist so you can receive support, guidance, and answers.
No matter what underlying condition you have, early intervention and appropriate management can help prevent your kidneys from sustaining further damage. As always, thank you for reading the FKP Kidney Health blog and learning about proteinuria. Please stay tuned for our next post.