There are three main mechanisms to cause proteinuria: * Due to disease in the glomerulus * Because of increased quantity of proteins in serum (overflow proteinuria) * Due to low reabsorption at proximal tubule (Fanconi syndrome) Proteinuria can also be caused by certain biological agents, such as bevacizumab (Avastin) used in cancer treatment. Excessive fluid intake (drinking in excess of 4 litres of water per day) is another cause. Proteinuria may be a sign of renal (kidney) damage. Since serum proteins are readily reabsorbed from urine, the presence of excess protein indicates either an insufficiency of absorption or impaired filtration. People with diabetes may have damaged nephrons and develop proteinuria. The most common cause of proteinuria is diabetes, and in any person with proteinuria and diabetes, the cause of the underlying proteinuria should be separated into two categories: diabetic proteinuria versus the field. With severe proteinuria, general hypoproteinemia can develop which results in diminished oncotic pressure. Symptoms of diminished oncotic pressure may include ascites, edema and hydrothorax. Conditions with proteinuria Proteinuria may be a feature of the following conditions: * Nephrotic syndromes (i.e. intrinsic kidney failure) * Pre-eclampsia * Eclampsia * Toxic lesions of kidneys * Amyloidosis * Collagen vascular diseases (e.g. systemic lupus erythematosus) * Dehydration * Glomerular diseases, such as membranous glomerulonephritis, focal segmental glomerulonephritis, minimal change disease (lipoid nephrosis) * Strenuous exercise * Stress * Benign orthostatic (postural) proteinuria * Focal segmental glomerulosclerosis (FSGS) * IgA nephropathy (i.e. Berger's disease) * IgM nephropathy * Membranoproliferative glomerulonephritis * Membranous nephropathy * Minimal change disease * Sarcoidosis * Alport syndrome * Diabetes mellitus (diabetic nephropathy) * Drugs (e.g. NSAIDs, nicotine, penicillamine, lithium carbonate, gold and other heavy metals, ACE inhibitors, antibiotics, or opiates (especially heroin) * Fabry disease * Infections (e.g. HIV, syphilis, hepatitis, poststreptococcal infection, urinary schistosomiasis) * Aminoaciduria * Fanconi syndrome in association with Wilson disease * Hypertensive nephrosclerosis * Interstitial nephritis * Sickle cell disease * Hemoglobinuria * Multiple myeloma * Myoglobinuria * Organ rejection: * Ebola virus disease * Nail–patella syndrome * Familial Mediterranean fever * HELLP syndrome * Systemic lupus erythematosus * Granulomatosis with polyangiitis * Rheumatoid arthritis * Glycogen storage disease type 1 * Goodpasture syndrome * Henoch–Schönlein purpura * A urinary tract infection which has spread to the kidney(s) * Sjögren syndrome * Post-infectious glomerulonephritis * Living kidney donor * Polycystic kidney disease Bence–Jones proteinuria * Amyloidosis * Pre-malignant plasma cell dyscrasias: * Monoclonal gammopathy of undetermined significance * Smoldering multiple myeloma * Malignant plasma cell dyscrasias * Multiple myeloma * Waldenström's macroglobulinemia * Other malignancies * Chronic lymphocytic leukemia * Rare cases of other Lymphoid leukemias * Rare cases of Lymphomas
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