What should I do if proteinuria is elevated in the third trimester of pregnancy?
Mar 05, 2022
Source: Cainiu Health
Dr. Yu Wenjing
Introduction
It is recommended to perform a 24-hour urinary protein quantification test to assess the amount of protein excretion and thereby determine whether kidney damage is present. In healthy pregnant women, mild proteinuria may occur, which is associated with body position, increased renal blood flow, and elevated glomerular filtration rate. During pregnancy, physiological changes normally occur in the kidneys—even in the absence of underlying disease—including increases in kidney length and weight.
After becoming pregnant, every expectant mother hopes her baby will be born healthy. Therefore, in daily life, pregnant women typically consume abundant nutrients—some even eat multiple meals per day. As nutritional intake increases, some women are found to have proteinuria during routine prenatal checkups. So, what should be done if proteinuria is elevated in late pregnancy? Below, we address this question.
What to do if proteinuria is elevated in late pregnancy
It is recommended to undergo a 24-hour urinary protein quantification test to determine the exact amount of protein excreted, thereby assessing whether kidney damage has occurred.
Dietary management should emphasize low-salt, low-protein, and high-quality protein intake. Specifically, avoid seafood, tofu, and animal offal. Daily consumption of a moderate amount of milk is acceptable. Adequate rest is also essential.
Mildly increased urinary protein excretion may occur in healthy pregnant women. This is associated with changes in body position, increased renal blood flow, and an elevated glomerular filtration rate (GFR). During pregnancy, physiological adaptations occur in the kidneys—including increased length and weight—and GFR rises significantly. Consequently, protein filtration increases, resulting in a 24-hour urinary protein excretion of up to 300–500 mg, observed in approximately 20% of pregnancies. Additionally, lumbar lordosis during pregnancy compresses the inferior vena cava via the liver, while the enlarging uterus compresses the renal veins—both contributing to physiological proteinuria. Urinary protein levels often decrease when the woman assumes a lateral decubitus position.
Therefore, if a woman had no pre-existing kidney disease prior to pregnancy, the appearance of proteinuria is generally considered a normal physiological phenomenon and does not warrant concern.
The above outlines appropriate management strategies for elevated proteinuria in late pregnancy. We hope this information is helpful to you.
