TYPEDEFINITIONCAUSES
FunctionalProtein <2 g/24 hrNot associated with renal diseaseFever, exercise, congestive heart failureOrthostatic (postural): occurs with standing and is absent in the recumbent state. Urine protein is absent in the first morning void. No progression to renal disease.
Overflow  Protein loss is variableLMW proteinuriaAmount filtered > tubular reabsorptionMultiple myeloma with BJ proteinuriaHemoglobinuria: e.g., intravascular hemolysis (e.g., paroxysmal nocturnal hemoglobinuria)Myoglobinuria: crush injuries, McArdle glycogenosis (deficient muscle phosphorylase). Increase in serum creatinine kinase.
GlomerularNephritic syndrome: protein >150 mg/24 hr but <3.5 g/24 hrNephrotic syndrome: protein >3.5 g/24 hrDamage of GBM: nonselective proteinuria with loss of albumin and globulins. Example: poststreptococcal glomerulonephritisLoss of negative charge on GBM: selective proteinuria with loss of albumin and not globulins. Example: minimal change disease (lipoid nephrosis)
TubularProtein <2 g/24 hrDefect in proximal tubule reabsorption of LMW proteins (e.g., aminacids at normal filtered loads)Heavy metal poisoning: e.g., lead and mercury poisoning Fanconi syndrome: inability treabsorb glucose, aminacids, uric acid, phosphate, and bicarbonateHartnup disease: defect in reabsorption of neutral aminacids (e.g., tryptophan) in the GI tract and kidneys
Types of Proteinuria