Causes of Proteinuria - Differential Diagnosis Algorithm

Persistent Proteinuria >150mg/d protein present on repeat testing including overnight testing

Transient Proteinuria

 • Exercise

 • Fever

 • UTI

Orthostatic Proteinuria

 • Tall adolescents

Tubular Proteinuria (Negative urine dip = no albuminuria)

 - Overflow

     • Multiple Myeloma

     • MGUS

 - Poor reabsorption

     • RTA

     • Fanconi's syndrome

     • Drugs

Glomerular Proteinuria (Positive urine dip = albuminuria)

 - Active urine sediment - WBC/RBC casts

     • IgA nephropathy

     • Membranoproliferative GN

     • Mesangial proliferative

     • Anti-GBM antibodies

     • Granulomatosis with polyangiitis (GPA) / microscopic polyangiitis (MPA)

     • SLE

     • HSP

     • Post-infectious GN

 - Bland urine sediment

     • FSGS

     • Minimal change disease

     • Membranous nephropathy

     • HTN

     • Diabetes

     • Protein deposition (eg. Amyloidosis)



#Proteinuria #Nephrology #Differential #Diagnosis #Algorithm #Causes