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  • Proteinuria is the presence of an excess of serum proteins in the urine (>300 mg/24h). Isolated proteinuria is urinary protein without other symptoms or urinary abnormalities. In many renal disorders, proteinuria occurs with other urinary abnormalities (e.g., hematuria). The presence of protein in the urine is toxic to the kidneys and causes renal damage. Proteinuria caused by renal disorders usually is persistent (i.e., present on serial testing). The upper limit of normal urinary protein excretion is considered to be 150 mg/day, which can be measured in a 24-h urine collection or estimated by random urine protein/creatinine ratio (values > 45 mg/mmol are abnormal); for albumin it is about 30 mg/day. Albumin excretion between 30 and 300 mg/day (20 to 200 mcg/min) is considered microalbuminuria, and higher levels are considered macroalbuminuria. When in the nephrotic range, proteinuria can cause significant protein wasting. May be associated with foamy urine. Classification of proteinuria: Glomerular proteinuria; Tubular proteinuria; Overflow proteinuria; Functional proteinuria; Orthostatic proteinuria.
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