Proteinuria (albuminuria) is a condition of having too much protein in the urine which results from damage within the kidneys.
Proteinuria in diabetes will usually be the result of either long term hyperglycemia (high blood sugar levels) or hypertension (high blood pressure).
What is proteinuria?
When the kidneys are working correctly they filter waste products out of the blood but keep in important elements including albumin. Albumin is a protein which helps to prevent water from leaking out of the blood into other tissues.
If high blood sugar levels over a number of years damage the kidneys, they may allow too much albumin to be lost from the blood.
Proteinuria is a sign therefore that the kidneys have become damaged.
Symptoms of proteinuria
The signs of proteinuria will only become noticeable once the kidneys have become very damaged and levels of protein in the urine are high. If this happens, the symptoms may present as swelling of the ankles, hands, tummy or the face.
Diagnosing and screening for albuminuria
Because the symptoms only occur at a later stage of kidney damage, it is important that as someone with diabetes you are screened for signs of kidney disease at least once a year.
The screening involves providing a sample of urine which will be tested by your health team for any abnormal levels of protein. To do this, they compare the ratio of albumin to creatinine.
A healthy albumin to creatinine ration is defined as:
- Men : less than or equal to 2.5 mg/mmol
- Women : less than or equal to 3.5 mg/mmol
- Read more on screening for kidney damage
What causes proteinuria
In diabetes, the main causes of proteinuria are high blood glucose levels over a period of years. High blood pressure can also lead to the development of kidney damage.
Pre-eclampsia, a condition which can affect pregnant women, includes very high blood pressure and is another potential cause of protein in the urine.
Treatment for proteinuria
The primary treatment for proteinuria will be to control both blood pressure and blood glucose levels, which may be achieved through lifestyle changes and could include taking additional medication.
If fluid is accumulating in your ankles or around the lungs, you may be given water tablets, a diuretic medication that helps to remove water from the body.
If the level of kidney damage is severe, you may need to undergo kidney dialysis or a kidney transplant
