Protein in Urine: Pictures, Causes, Testing, Treatment

What Does Protein in Your Urine Look Like?

Protein in your urine, known medically as proteinuria, is an abnormal condition that can be an early sign of kidney disease. Protein in the urine often causes the urine to become foamy, although sometimes you may not notice any visible symptoms.

Learning to recognize what abnormal proteinuria looks like can help you identify potential issues early and get the right treatment. Heres a look at what protein in urine typically looks like, what causes it, symptoms, and how its diagnosed and treated.

Causes of Protein in Urine

Healthy kidneys should only filter tiny amounts of protein into the urine, usually less than 150 mg per day. Higher amounts could point to an underlying condition. Common causes of proteinuria include:

Kidney Disease

Chronic kidney disease and kidney damage from conditions like glomerulonephritis can allow large amounts of protein to leak into the urine. The more damaged the kidneys become, the more protein that is able to pass through the filters.

Diabetes

Uncontrolled blood sugar levels in diabetes can cause damage to the blood vessels in the kidneys leading to proteinuria. This diabetic kidney disease is the leading cause of kidney failure.

High Blood Pressure

Untreated high blood pressure puts extra strain on the small blood vessels of the kidneys, which can become scarred and start letting proteins pass into the urine.

Urinary Tract Infection (UTI)

A UTI can cause temporary proteinuria, which usually goes away once the infection is treated.

Heavy Exercise

Strenuous exercise can temporarily cause protein to leak into the urine, especially in someone with underlying kidney damage. The proteinuria tends to resolve with rest.

Symptoms of Protein in Urine

Many people with proteinuria dont experience any noticeable symptoms. But some possible signs can include:

• Foamy urine - due to the protein causing more bubbles
• Tea-colored urine - from blood in the urine (hematuria)
• Swelling in hands and feet - from fluid retention related to kidney damage
• Fatigue and weakness - from anemia and buildup of waste products that healthy kidneys would remove

What Does Protein in Urine Look Like?

The amount and type of protein in the urine affects its visible appearance. Heres what to look out for:

Foamy Urine

One of the most common visible signs of protein in the urine is foam or bubbles. The protein causes the urine to become more frothy and form bubbles more easily, even without vigorous shaking.

Cloudy Urine

Proteinuria can cause the urine to look slightly cloudy or hazy rather than clear. The cloudiness is more pronounced in acidic urine.

Pink, Red or Cola-Colored Urine

Blood in the urine from conditions like kidney disease or UTI can mix with the protein to cause pink, red or brown urine. This is known as hematuria.

Flakes or Particles

With high protein levels, the urine may contain visible flecks, particles or flakes. These are clumps of protein floating in the urine.

Protein in Urine Test

A urine test is needed to confirm if protein is actually present and measure the levels. This involves collecting a urine sample over 24 hours or sometimes just getting a one-time sample.

The sample can be visually inspected for signs of proteinuria like foam. Then it is sent to a lab for quantitative testing to determine the exact protein levels.

Elevated protein levels on a urine protein test can indicate:

• 150-300 mg/day - moderately increased
• 300-3500 mg/day - markedly increased
• > 3500 mg/day - nephrotic range proteinuria

Protein in Urine Under Microscope

Examining the urine sample under a microscope provides additional information about the type of protein present. The urine sediment is spun in a centrifuge. Then a drop is placed on a slide and visualized.

Different types of protein appear differently, for example:

• Lipid droplets - fats
• RBC casts - blood cells stuck together
• WBC casts - clumps of white blood cells
• Granular casts - indicate kidney damage

Identifying the composition of the proteinuria gives clues as to its origin and can help guide treatment.

Proteinuria Treatment

Treatment focuses on addressing the underlying cause of the excess protein in the urine. This may include:

• Controlling blood sugar in diabetes
• Lowering blood pressure
• Treating kidney infections
• Medications to reduce proteinuria
• Dialysis in severe kidney failure

Limiting protein intake may also be recommended to help reduce the protein load on the kidneys.

Can Kidneys Heal from Proteinuria?

If treated early, the kidneys have a good ability to heal and regain function. However, significant or long-standing proteinuria can lead to irreversible kidney scarring and further deterioration.

Close monitoring and follow up testing is important to ensure protein levels normalize with treatment. Urine testing will be required periodically to check if the proteinuria resolves.

Protein in Urine Prognosis

The outlook depends on the cause and severity of the proteinuria. Transient or mild proteinuria generally has an excellent prognosis. But persistent heavy proteinuria that leads to kidney damage has a poorer prognosis and can progress to end stage kidney failure.

Protein in Urine Pictures

Here is a collection of photos showing what abnormal protein in urine looks like and how it compares to healthy urine:

Normal Urine

Normal urine is clear and pale yellow in color with no visible particles or sediment.

Foamy Proteinuria

The hallmark sign of protein in urine is increased foam and bubbles, even without agitation.

Proteinuria With Hematuria

Blood mixed in the urine with protein can cause a pink, red or cola color.

Cloudy Urine With Protein

Proteinuria can cause the urine to take on a slightly cloudy or hazy appearance.

Protein Flakes and Particles

High levels of protein in the urine may cause visible flakes, globs or particles.

Lipid Droplets in Urine

Under the microscope, lipid droplets as seen here indicate protein in the form of fats.

RBC Casts in Urine

Blood cell casts like these suggest kidney damage causing

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.