Albumin in Urine - Symptoms, Causes and Prevention

Albumin is the most abundant protein in the blood. Its primary roles are to maintain fluid balance within the bloodstream and to transport various substances like hormones, fatty acids, and medications.

The presence and disorders of the albumin level in the urine or blood indicate underlying issues in the liver and kidneys.

What is albuminuria?

Albuminuria refers specifically to increased albumin in the urine, while proteinuria is a broader term that includes the presence of various proteins in urine. Albuminuria is a subset of proteinuria.

The reasons for having higher protein in the urine could be harmless, like intensive exercise and dehydration. Furthermore, serious conditions like immune disorders and kidney disease could also lead to albuminuria.

How Serious is Albuminuria?

Persistent albuminuria is an early marker of chronic kidney disease (CKD) and is used, along with estimated glomerular filtration rate (eGFR), to diagnose and stage CKD. It interrupts normal kidney functions, which eventually requires the patient to opt for dialysis or a kidney transplant.

Older adults are at higher risk primarily due to the increased prevalence of diabetes, hypertension, and vascular disease rather than age alone. In addition to that, individuals who have a family history of kidney disease also run the risk of albuminuria.

What are the symptoms of albuminuria?

It is normal to have protein in the urine if it is within 150 milligrams per day. Increasing this limit leads to albuminuria. Early stages of albuminuria do not have any significant symptoms, but the following are some significant symptoms of advanced albuminuria:

1. Puffiness around the eyes
2. Frequent urination
3. Foamy urine
4. Fatigue
5. Muscle Cramps
6. Loss of Appetite
7. Swelling in the belly, ankles, feet or face
    

What is the Most Common Cause of Albuminuria?

The most common causes of albuminuria are:

1. Diabetes mellitus (diabetic nephropathy)
2. High blood pressure (hypertensive nephrosclerosis)
3. Inflammation in the body
4. Kidney stones
5. Dehydration
6. Immune disorders like lupus and Goodpasture’s syndrome
7. Plasma cell cancer or multiple myeloma
8. Cardiovascular disease
9. Trauma
10. Kidney Cancer
     

How is Albuminuria Diagnosed?

There are multiple ways to diagnose albuminuria. Such as:

1. Dipstick Test: Medical experts do a dipstick test to diagnose albuminuria. They place a thin plastic stick coated with special chemicals into a urine container. If the stick changes colour, it indicates that there is an excess level of protein in the urine.
2. Urine Analysis: Another way to diagnose albuminuria is to do a urine analysis or urine albumin-creatinine ratio to identify substances like white blood cells, bacteria, protein crystals, and red blood cells in urine. It helps to determine whether an individual has potential kidney disease.

What are the risks of albuminuria?

Albuminuria is a significant marker that the patient is suffering from kidney and cardiovascular diseases. The following are noteworthy risks of albuminuria:

1. Progression of Kidney Disease

Albuminuria is the most significant indicator that the patient's kidneys are not functioning at an optimal level. It confirms that the kidney's filtration system, consisting of tiny blood vessels called glomeruli, is damaged, which is why albumin is leaking into the urine.

Normal total protein excretion is <150 mg/day, while normal urine albumin‑to‑creatinine ratio (ACR) is <30 mg/g. However, if this amount is crossed, it means that the individual has albuminuria, which is the first sign of chronic kidney disease (CKD).

2. End-Stage Renal Disease (ESRD)

Chronic Kidney Disease (CKD) is a broad term for conditions that damage the kidneys. The persistent presence of elevated albumin in the urine (albuminuria) is both a sign of kidney damage and a key criterion for diagnosing and staging CKD. 

Having 3 to 3.5 grams of protein in the urine indicates that the patient has nephrotic syndrome. It is a rare health condition. Regularly tracking albumin levels in the urine can show how quickly the disease is progressing.

3. Cardiovascular Disease

Besides kidney disorders, albuminuria is a marker of systemic endothelial dysfunction and is strongly associated with increased cardiovascular risk. Endothelial dysfunction is a condition where the endothelium, the inner lining of blood vessels, fails to function and increases the risk of heart failure and stroke.

Furthermore, albuminuria can significantly exacerbate microvascular disease that affects small blood vessels by triggering inflammation within vessel walls.

How is Albuminuria Treated?

Depending on its cause, the treatment of albuminuria varies. The following are some treatment methods:

1. If kidney disease causes albuminuria, medical experts will prescribe diet changes, medication and exercise.
2. Patients with diabetes suffering from albuminuria need to control blood sugar levels.
3. If patients with blood pressure issues have albuminuria, they need to have medications to keep it in check.
    

How to Prevent Albuminuria?

Albuminuria can often be prevented or delayed through evidence‑based measures such as blood pressure control, glycaemic control, use of ACE inhibitors or ARBs (where indicated), and lifestyle modification. The preventative measures are as follows:

1. Maintaining a healthy diet consisting of fruits and vegetables.
2. Controlling chronic conditions like high blood pressure and diabetes.
3. Exercising, brisk walking for a minimum of 30 minutes.
4. Managing stress levels and having sufficient sleep for at least 7 to 8 hours.
5. Reducing alcohol intake.
6. Quitting all forms of tobacco consumption.
    

What Infections Cause Low Albumin?

Infections such as community-acquired pneumonia and sepsis cause inflammation and lead to protein or albumin leakage in the tissues. A low albumin level in the body is known as hypoalbuminemia. Medical experts have also found that healthcare-associated infections and COVID-19 can drastically reduce albumin levels.

Hypoalbuminemia is extremely common among patients suffering from critical conditions like kidney disease, heart failure and malnutrition. When children suffer from hypoalbuminemia, it limits their growth since a lack of albumin interrupts the transportation of growth hormones. People who are over 70 years of age and suffering from the disease usually feel excessive weakness and are prone to recurring injury and infection.

The presence of albumin in the blood is significant since it contributes to the transmission of chemical compounds in the body. However, excessive levels of it in the urine are a matter of concern. Therefore, it is necessary to monitor and track albumin levels. Talk to a medical professional regarding the symptoms, underlying causes and how to maintain an accurate albumin level, as it could help to lead a happy and healthy life.

Reader Information: The information provided in this article is intended for general educational purposes only. Albumin levels in urine and blood can vary based on individual health conditions, laboratory methods, and clinical context. Always consult a qualified healthcare professional for personalized medical advice, appropriate testing, and treatment options related to kidney health, albuminuria, or any associated conditions.

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