What are non- glomerular causes of proteinuria?

Updated: Mar 25, 2020
  • Author: Beje Thomas, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Other causes of proteinuria include the following:

  • Neoplasms: Carcinoma (eg, bronchus, breast, colon, stomach, kidney), leukemia, lymphomas, melanomas
  • Medications/drugs: Heroin, interferon alfa, lithium, nonsteroidal anti-inflammatory drugs, pamidronate, sirolimus
  • Viral Infections: Epstein-Barr virus, hepatitis B and C, herpes zoster, human immunodeficiency virus
  • Allergic: Antitoxins, insect stings, poison ivy
  • Genetic: Hereditary nephritis ( Alport syndrome)
  • Other causes: Castleman disease, malignant hypertension, pre-eclampsia, transplant glomerulopathy

In patients with cancer, treatment with vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs) has been associated with an increased risk of developing proteinuria. A meta-analysis of randomized controlled trials of five newly approved VEGFR-TKIs (regorafenib, vandetanib, cabozantinib, lenvatinib, axitinib)  found an increased risk of episodes of all-grade proteinuria (relative risk [RR] 2.35, 95% confidence index [CI] 1.69-3.27, P < 0.001) and high-grade proteinuria (RR 3.70, 95% CI 2.09-6.54, P < 0.001). [13]

On subgroup analysis, risk of all-grade proteinuria was significantly increased with lenvatinib, axitinib, and vandetanib, while risk of high-grade proteinuria was increased with lenvatinib. In addition, the risk of experiencing high-grade proteinuria was significant for patients with hepatocellular carcinoma and renal cell carcinoma, but not for patients with colorectal cancer and thyroid cancer. [13]


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