Proteinuric chronic kidney disease: what to know

Healthy kidney filters retain most protein in the bloodstream. When filtering tissue is damaged, albumin and other proteins can pass into urine. A urine result can vary with exercise, illness, hydration and the timing of collection, so clinicians often repeat it and compare it with kidney blood tests. Proteinuria may occur with hypertension or type 2 diabetes, and chronic kidney disease can also affect fluid balance and the removal of waste. Early disease may cause no obvious symptoms; fatigue, excessive thirst, swelling or changes in urination deserve discussion rather than self-diagnosis.

Keep scheduled urine and blood tests so your clinician can track protein loss and kidney function over time. Take prescribed blood-pressure or kidney medicines as directed, and ask before using anti-inflammatory pain medicines, supplements or high-protein products. Follow an eating and fluid plan tailored to your kidney function; salt, potassium and protein needs are not identical for everyone. Control diabetes if it applies to you, avoid smoking, and maintain activity within your advice. Kidney disease may also be linked with anaemia, gout or restless legs syndrome, which can need separate assessment.

Contact your kidney team promptly if swelling increases, urine becomes markedly reduced, breathlessness develops, or you cannot keep fluids or medicines down. Seek urgent help for severe breathlessness, chest pain, confusion, fainting, or sudden weakness. New severe headache or very high blood-pressure readings also need prompt assessment. Do not change fluid intake or prescribed treatment based only on a home urine result.

How much protein is in my urine, and will it be repeated? What are my kidney function and blood-pressure targets? Which pain medicines, supplements and foods should I avoid?