What are the common causes of protein in urine. How is proteinuria diagnosed and treated. What are the potential complications of untreated proteinuria. When should you see a doctor about protein in your urine.

Understanding Proteinuria: What Is Protein in Urine?

Proteinuria, the medical term for protein in urine, occurs when your kidneys allow protein molecules to pass through their filtration system and enter your urine. Normally, healthy kidneys prevent most proteins from leaving the bloodstream. However, certain conditions can cause this filtering mechanism to malfunction, resulting in protein leakage into the urine.

The presence of protein in urine is often an early indicator of kidney disease or other underlying health issues. While small amounts of protein in urine may be harmless, persistently high levels can signal a more serious problem that requires medical attention.

Types of Proteinuria

• Transient proteinuria: Temporary and usually harmless
• Orthostatic proteinuria: Occurs when standing upright
• Persistent proteinuria: Constant protein excretion, often indicating kidney disease
• Nephrotic syndrome: Severe proteinuria accompanied by other symptoms

Common Causes of Protein in Urine

Protein in urine can result from various factors, ranging from benign temporary conditions to serious underlying health problems. Understanding these causes is crucial for proper diagnosis and treatment.

Temporary Causes of Proteinuria

Several factors can lead to a temporary increase in urine protein levels without indicating kidney damage:

• Dehydration
• Emotional stress
• Exposure to extreme cold
• Fever
• Strenuous exercise

These conditions typically resolve on their own, and protein levels return to normal once the underlying cause is addressed.

Chronic Conditions Associated with Proteinuria

Persistent proteinuria often signals an underlying health issue, particularly kidney disease. Common chronic conditions that can cause elevated protein levels in urine include:

• Diabetes
• High blood pressure (hypertension)
• Chronic kidney disease
• Glomerulonephritis
• Lupus
• Amyloidosis
• Multiple myeloma

These conditions require ongoing medical management to prevent further kidney damage and other complications.

Recognizing the Symptoms of Proteinuria

In its early stages, proteinuria often presents no noticeable symptoms. As the condition progresses, however, individuals may experience various signs that indicate the presence of protein in their urine.

Early Signs of Proteinuria

The initial symptoms of proteinuria can be subtle and easily overlooked:

• Foamy or bubbly urine
• Swelling in hands, feet, or face (edema)
• Increased frequency of urination

Advanced Symptoms of Proteinuria

As proteinuria worsens, more pronounced symptoms may develop:

• Shortness of breath
• Fatigue
• Loss of appetite
• Nausea and vomiting
• Muscle cramps, especially at night

If you experience any of these symptoms, particularly in combination with foamy urine or swelling, it’s important to consult a healthcare professional for proper evaluation.

Diagnosing Protein in Urine: Tests and Procedures

Detecting and measuring protein in urine is crucial for diagnosing kidney problems and other health issues. Healthcare providers use several tests to assess proteinuria accurately.

Urine Dipstick Test

This simple, quick test involves dipping a chemically treated strip into a urine sample. The strip changes color based on the protein concentration in the urine, providing a rough estimate of protein levels.

24-Hour Urine Collection

For a more accurate measurement, doctors may request a 24-hour urine collection. This test involves collecting all urine produced over a full day, allowing for a comprehensive analysis of protein excretion.

Urine Protein-to-Creatinine Ratio

This test compares the amount of protein in the urine to the level of creatinine, a waste product filtered by the kidneys. The ratio provides a reliable indicator of kidney function and protein excretion.

Additional Diagnostic Tests

Depending on the initial findings, healthcare providers may recommend further tests to identify the underlying cause of proteinuria:

• Blood tests to assess kidney function and overall health
• Imaging studies such as ultrasound or CT scans of the kidneys
• Kidney biopsy in cases where the cause remains unclear

Treatment Options for Proteinuria

The treatment of proteinuria primarily focuses on addressing the underlying cause and preventing further kidney damage. The approach varies depending on the severity and origin of the condition.

Lifestyle Modifications

For mild cases of proteinuria, especially those related to temporary factors, lifestyle changes may be sufficient:

• Maintaining proper hydration
• Reducing salt intake
• Adopting a healthy diet rich in fruits and vegetables
• Regular exercise (as advised by a healthcare provider)
• Stress management techniques

Medication-Based Treatments

When proteinuria is caused by an underlying health condition, medications may be prescribed to manage the root cause and reduce protein excretion:

• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for hypertension and kidney protection
• Blood sugar-lowering medications for diabetes management
• Immunosuppressants for autoimmune-related kidney diseases
• Diuretics to reduce swelling and lower blood pressure

Treatment of Specific Underlying Conditions

Addressing the primary cause of proteinuria is crucial for effective management:

• Diabetes: Strict blood sugar control through medication, diet, and lifestyle changes
• Hypertension: Blood pressure management with medications and lifestyle modifications
• Glomerulonephritis: Treatment may include corticosteroids or other immunosuppressive drugs
• Lupus: Management with immunosuppressants and anti-inflammatory medications

Complications and Long-Term Outlook of Untreated Proteinuria

When left untreated, persistent proteinuria can lead to various complications and have a significant impact on long-term health.

Potential Complications

Untreated proteinuria may result in:

• Progressive kidney damage and chronic kidney disease
• Increased risk of cardiovascular disease
• Nephrotic syndrome, characterized by severe protein loss, swelling, and other symptoms
• Increased susceptibility to infections
• Malnutrition due to protein loss

Long-Term Prognosis

The outlook for individuals with proteinuria varies depending on the underlying cause and how quickly treatment is initiated:

• Early detection and treatment can often prevent or slow the progression of kidney damage
• Management of underlying conditions like diabetes and hypertension can significantly improve outcomes
• Some cases of proteinuria, particularly those related to temporary factors, may resolve completely with appropriate interventions
• Severe or prolonged proteinuria may lead to end-stage renal disease, requiring dialysis or kidney transplantation

Prevention Strategies for Reducing the Risk of Proteinuria

While not all cases of proteinuria can be prevented, several strategies can help reduce the risk of developing this condition or minimize its severity.

Lifestyle Modifications for Proteinuria Prevention

Adopting healthy habits can play a crucial role in maintaining kidney health and preventing proteinuria:

• Maintain a healthy weight through balanced diet and regular exercise
• Limit sodium intake to help control blood pressure
• Stay well-hydrated by drinking adequate amounts of water daily
• Avoid smoking and excessive alcohol consumption
• Manage stress through relaxation techniques or mindfulness practices

Managing Underlying Health Conditions

Proper control of chronic health conditions can significantly reduce the risk of developing proteinuria:

• Diabetes: Maintain target blood sugar levels through medication, diet, and lifestyle changes
• Hypertension: Keep blood pressure within recommended ranges
• Obesity: Achieve and maintain a healthy body weight
• Heart disease: Follow prescribed treatment plans and adopt heart-healthy habits

Regular Health Check-ups and Screening

Routine medical examinations can help detect proteinuria early, allowing for prompt intervention:

• Annual physical exams that include urinalysis
• Regular kidney function tests for those at higher risk (e.g., individuals with diabetes or hypertension)
• Follow-up testing as recommended by healthcare providers

By implementing these preventive strategies and maintaining open communication with healthcare providers, individuals can significantly reduce their risk of developing proteinuria and protect their overall kidney health.

Protein in urine Causes – Mayo Clinic

Your kidneys filter waste products from your blood while retaining what your body needs — including proteins. However, some diseases and conditions allow proteins to pass through the filters of your kidneys, causing protein in urine.

Conditions that can cause a temporary rise in the levels of protein in urine, but don’t necessarily indicate kidney damage, include:

1. Dehydration
2. Emotional stress
3. Exposure to extreme cold
4. Fever
5. Strenuous exercise

Diseases and conditions that can cause persistently elevated levels of protein in urine, which might indicate kidney disease, include:

1. Amyloidosis (buildup of abnormal proteins in your organs)
2. Certain drugs, such as nonsteroidal anti-inflammatory drugs
3. Chronic kidney disease
4. Diabetes
5. Endocarditis (an infection of the inner lining of the heart)
6. Focal segmental glomerulosclerosis (FSGS)
7. Glomerulonephritis (inflammation in the kidney cells that filter waste from the blood)
8. Heart disease
9. Heart failure
10. High blood pressure (hypertension)
11. Hodgkin’s lymphoma (Hodgkin’s disease)
12. IgA nephropathy (Berger’s disease) (kidney inflammation resulting from a buildup of the antibody immunoglobulin A)
13. Kidney infection (pyelonephritis)
14. Lupus
15. Malaria
16. Multiple myeloma
17. Nephrotic syndrome (damage to small filtering blood vessels in the kidneys)
18. Orthostatic proteinuria (urine protein level rises when in an upright position)
19. Preeclampsia
20. Pregnancy
21. Rheumatoid arthritis (inflammatory joint disease)
22. Sarcoidosis (collections of inflammatory cells in the body)
23. Sickle cell anemia

Causes shown here are commonly associated with this symptom. Work with your doctor or other health care professional for an accurate diagnosis.

• Definition
• When to see a doctor

April 21, 2020

Show references

1. What you should know about albuminuria (proteinuria). National Kidney Foundation. https://www.kidney.org/atoz/content/proteinuriawyska. Accessed Jan. 19, 2017.
2. Protein in urine. American Kidney Fund. http://www.kidneyfund.org/kidney-disease/kidney-problems/protein-in-urine.html. Accessed Jan. 19, 2017.
3. Proteinuria. Merck Manual Professional Version. http://www.merckmanuals.com/professional/genitourinary-disorders/symptoms-of-genitourinary-disorders/proteinuria. Accessed Jan. 19, 2017.
4. Rovin BH. Assessment of urinary protein excretion and evaluation of isolated non-nephrotic proteinuria in adults. https://www.uptodate.com/contents/search. Accessed April 14, 2020.
5. Albuminuria: Albumin in the urine. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis/albuminuria-albumin-urine. Accessed Jan. 19, 2017.
6. Somers MJ. Orthostatic (postural) proteinuria. https://www.uptodate.com/contents/search. Accessed April 14, 2020.
7. Kelepouris E, et al. Overview of heavy proteinuria and the nephrotic syndrome. https://www.uptodate.com/contents/search. Accessed April 14, 2020.
8. O’Connell TX. Proteinuria. In: Instant Work-Ups: A Clinical Guide to Medicine. 2nd ed. Philadelphia, Pa.: Elsevier; 2017. http://www.clinicalkey.com. Accessed Jan. 20, 2017.

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Protein in Urine (Proteinuria): Causes, Symptoms, and Treatment

People with proteinuria have unusually high amounts of protein in their urine. The condition is often a sign of kidney disease.

Your kidneys are filters that don’t usually let a lot of protein pass through. When kidney disease damages them, proteins such as albumin may leak from your blood into your pee. You can also have proteinuria when your body makes too much protein.

Kidney disease often has no early symptoms. Protein in your pee might be one of the first signs. Your doctor may spot proteinuria on a urine test during a routine physical.

Protein in Urine Symptoms

Most people who have proteinuria won’t notice any signs, especially in early or mild cases. Over time, as it gets worse, you might have symptoms including:

• Foamy or bubbly pee
• Swelling (edema) in your hands, feet, belly, and face
• Peeing more often
• Shortness of breath
• Fatigue
• Loss of appetite
• Upset stomach and vomiting
• Muscle cramps at night

Protein in Urine Causes

Some common things can cause proteinuria. These include:

• Dehydration
• Inflammation
• Low blood pressure
• Fever
• Intense activity
• High stress
• Kidney stones
• Taking aspirin every day
• Very low temperatures

Conditions that damage your kidneys can also make you have too much protein in your urine. The two most common are diabetes and high blood pressure.

Other serious conditions that can cause proteinuria include:

• Immune disorders such as lupus
• Kidney inflammation (glomerulonephritis)
• A blood cancer called multiple myeloma
• Preeclampsia, which affects pregnant women
• A buildup of protein in your organs (amyloidosis)
• Cardiovascular disease
• Intravascular hemolysis, a condition in which red blood cells are destroyed
• Kidney cancer
• Heart failure

Protein in Urine Risk Factors

Things that might make you more likely to have protein in your urine include:

• Obesity
• Age over 65
• A family history of kidney disease
• African American, Native American, Hispanic, or Pacific Islander descent

Some people get more protein into their urine while standing than while lying down. This condition is called orthostatic proteinuria.

Protein in Urine Diagnosis

A urine test called a urinalysis can tell whether you have too much protein in your pee. First, you’ll pee into a cup. A lab technician will dip in a stick with chemicals on the end. If the stick changes color, it’s a sign of too much protein. You might need to have this test more than once to find out how long the protein is there.

The technician will also look at the pee under a microscope. They’re checking for things that shouldn’t be there, which might mean kidney problems. These include red and white blood cells, crystals, and bacteria.

If your doctor suspects kidney disease, you might need to have other urine tests. Your doctor might also order:

• Blood tests. These measure certain chemicals to check how well your kidneys are working.
• Imaging tests. CT scans and ultrasounds can spot kidney stones, tumors, or other blockages.
• A kidney biopsy. Your doctor might need to take a small sample of kidney tissue so a lab technician can look at it under a microscope.

Protein in Urine Treatment

Proteinuria a sign of another illness. So treatment depends on figuring out what caused it. You might not need treatment if proteinuria is mild or lasts only a short time. But it’s crucial to treat kidney disease before it leads to kidney failure.

Your doctor might prescribe medication, especially if you have diabetes and/or high blood pressure. Most people will take one of two types of blood pressure medicine:

• ACE inhibitors (angiotensin-converting enzyme inhibitors)
• ARBs (angiotensin receptor blockers)

Test for Protein in Urine

Overview

What is a urine protein (albumin) test?

A urine protein test is a screening test to look for the presence of proteins in the urine. One of these proteins is called albumin.

Why might this test be ordered?

Proteins are the “building blocks” of the body that also perform other vital functions such as:

• Nourishing tissues.
• Transporting hormones, vitamins and other essential nutrients.
• Keeping the proper amount of fluids circulating through the body.

When the kidneys are healthy, virtually no proteins pass out of the kidneys and into the urine (only waste products circulating in the blood are removed). However, if a person’s kidneys become diseased or damaged, they are less able to leave the proteins behind, and some proteins begin to filter through and appear in the urine.

What is the difference between micro-albuminuria and proteinuria?

Albumin is a type of protein found in large amounts in the blood. Because it is a small molecule in size, it is one of the first proteins able to pass through the kidneys into the urine when there are kidney problems. This presence of small amounts of albumin in the urine is the condition called micro-albuminuria. It is important to note that some physiologic conditions may cause micro-albuminuria, such as an episode of exercising. If your urine micro-albumin is elevated, it would be worth repeating after a day or two of no exercising.

As kidney damage progresses and the amount of albumin in the urine increases, the name of the condition changes from micro-albuminuria to macro-albuminuria (macro meaning large) or proteinuria.

What are the signs of micro-albuminuria/proteinuria?

In its early stages, there may be no noticeable signs or symptoms. As kidney function declines and large amounts of proteins are passing into the urine, swelling of the hands, feet, abdomen and face may occur. If albuminuria progresses, it may result in permanent kidney damage. In some patients, it might result in the need for dialysis or a kidney transplant. With or without symptoms, the only way to find out how much protein is passing into the urine is to test it.

Micro-albuminuria is linked with cardiovascular disease. Damaged blood vessels can lead to stroke and heart failure in addition to kidney disease.

Who is at risk for the development of micro-albuminuria/proteinuria?

People with certain chronic diseases – including diabetes, hypertension, obesity and other forms of kidney diseases – are at risk for developing micro-albuminuria/proteinuria. Other at-risk groups include:

• African Americans.
• American Indians.
• Hispanic-Americans.
• Pacific Islander Americans.
• Older people.
• Overweight people.
• People with a family history of kidney disease.

Test Details

How is the urine protein test used for determining micro-albuminuria/proteinuria?

You will be asked to give a urine sample. Your doctor will decide if the sample can be a random sample provided at your doctor’s office or needs to be a sample collected over a certain time frame (such as over four hours, overnight or for 24 hours). In either case, you will be given a container and instructions for properly collecting a urine sample. The sample will then be tested to determine the amounts of protein or albumin in it. Your doctor may also order a blood test to check for other signs of kidney damage (to look for the presence of waste products that would normally be removed from the blood if the kidneys are functioning properly).

Results and Follow-Up

What do the urine protein test results mean?

There’s a range of test results that can indicate normal kidney function. Your healthcare provider will discuss the ranges with you and tell you about your specific results. High values might mean that there’s kidney disease or damage. If your test result shows a high level of protein or albumin, it’s likely that your provider will repeat the test.

If your second test is also high, your healthcare provider may order additional tests to further check your kidney function. When either diabetes or high blood pressure is the cause of the albuminuria, treatment of these problems may reduce albuminuria or its progression to kidney disease. Certain blood pressure medications (angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers) are especially helpful at limiting kidney damage after micro-albuminuria or albuminuria has been found.

Causes, Symptoms, Tests & Treatment

Overview

What is proteinuria?

Proteinuria is increased levels of protein in the urine. This condition can be a sign of kidney damage.

Proteins – which help build muscle and bone, regulate the amount of fluid in blood, combat infection and repair tissue – should remain in the blood. If proteins enter the urine they ultimately leave the body, which isn’t healthy.

How does protein get into urine?

Protein gets into the urine if the kidneys aren’t working properly. Normally, glomeruli, which are tiny loops of capillaries (blood vessels) in the kidneys, filter waste products and excess water from the blood.

Glomeruli pass these substances, but not larger proteins and blood cells, into the urine. If smaller proteins sneak through the glomeruli, tubules (long, thin, hollow tubes in the kidneys) recapture those proteins and keep them in the body.

However, if the glomeruli or tubules are damaged, if there is a problem with the reabsorption process of the proteins, or if there is an excessive protein load, the proteins will flow into the urine.

How common is proteinuria?

Normal amount of protein in the urine are less than 150mg/day. High levels of protein in the urine are associated with rapid decline in kidney function. It affects about 6.7 percent of the United States population. It is seen more in elderly and people with other chronic illnesses.

Symptoms and Causes

What causes proteinuria?

In many cases, proteinuria is caused by relatively benign (non-cancerous) or temporary medical conditions.

These include dehydration, inflammation and low blood pressure. Intense exercise or activity, emotional stress, aspirin therapy and exposure to cold can also trigger proteinuria. In addition, a kidney stone in the urinary tract can cause proteinuria.

Occasionally, proteinuria is an early indication of chronic kidney disease, a gradual loss of kidney function that may eventually require dialysis or a kidney transplant. Diabetes and high-blood pressure can damage kidneys and are the number-one and number-two causes of kidney disease.

Other potentially kidney-harming diseases and medical conditions, which can lead to proteinuria, include:

• Immune disorders like lupus and Goodpasture’s syndrome
• Acute inflammation of the kidney (glomerulonephritis)
• Cancer of plasma cells (multiple myeloma)
• Intravascular hemolysis, which is the destruction of red blood cells and release of hemoglobin in the bloodstream
• Cardiovascular disease
• Preeclampsia, the simultaneous development of hypertension and proteinuria in a pregnant woman
• Poisoning
• Trauma
• Kidney cancer
• Congestive heart failure

Also, most serious illnesses can result in proteinuria.

What are the symptoms of proteinuria?

Often, someone with proteinuria doesn’t experience symptoms, especially if kidneys are just beginning to have problems. However, if proteinuria is advanced, symptoms can include:

These are also symptoms of chronic kidney disease. Anyone experiencing these symptoms, especially foamy urine and swelling, should see a doctor immediately.

Diagnosis and Tests

How is proteinuria diagnosed?

Proteinuria is diagnosed through a urine test. The patient provides a urine sample, which is examined in a lab. Doctors use a “dipstick” – a thin plastic stick with chemicals on the tip – to test part of the sample right away. If too much of any substance is in the urine, the chemical tip changes color.

The remainder of the urine is then examined under a microscope. Doctors look for substances that don’t belong in urine. These substances include red and white blood cells, bacteria and crystals that can grow and develop into kidney stones.

What happens when chronic kidney disease or another serious condition is diagnosed or suspected?

A doctor who suspects kidney disease would repeat the urine test three times over three months. If the samples test positive for proteins each time, the patient likely has kidney disease. The earlier the diagnosis, the more chance doctors have to slow the disease and stop it from progressing.

Additional tests might include:

• Blood test to measure the levels of creatinine (chemical waste products). Healthy kidneys move these substances from the blood to the urine. If the kidneys are not working properly, creatinine will remain in the blood.
• Blood test to estimate the glomerular filtration rate (GFR). The GFR compares a patient’s size, age, sex and race to levels of creatinine and albumin in the blood. The GFR tells a doctor how well the kidneys are working and how far the kidney disease has advanced. It also helps the doctor plan treatment.
• Blood test to measure all proteins in the serum. The serum is part of the blood filled with proteins.
• Imaging tests like CT scans and ultrasounds. These tests show images of the kidneys, helping doctors spot problems like kidney stones, tumors or obstruction of the urinary tract.
• Urine protein electrophoresis. Doctors search for specific types of proteins in a urine sample. For example, the presence of a protein called Bence-Jones might indicate multiple myeloma (cancer of plasma cells).
• Immunofixation blood test. This test finds proteins called immunoglobulins – which are antibodies that fight infection – in the blood. Too many of the same immunoglobulins can indicate blood cancer.
• A kidney biopsy. This is a procedure involving removal of a tiny piece of kidney. Doctors examine the sample under a microscope to determine what caused the kidney disease and the extent of damage.

Management and Treatment

How is proteinuria treated?

Treatment depends on the underlying condition that caused proteinuria. Each condition requires different treatments.

If kidney disease is confirmed, a treatment plan might include medication, diet changes, weight loss and exercise. Diabetes and hypertension patients with proteinuria might need blood pressure medication, and those with diabetes will have to control their blood sugar. Diabetes patients should receive glomerular filtration rate (GFR) blood tests every year and may be referred to a nephrologist, a doctor who specializes in the kidneys.

Pregnant women with preeclampsia should be watched carefully. The condition, although serious during pregnancy, usually resolves itself once the baby is born. Proteinuria patients with low blood pressure should schedule annual urine tests and blood pressure checks.

If proteinuria isn’t accompanied by diabetes, high blood pressure or any other medical condition, blood pressure medication still might be prescribed to prevent kidney damage. Blood pressure and urine should be checked every six months to make sure kidney disease isn’t present. As for those with mild or temporary proteinuria, treatment may not be necessary.

Prevention

Can proteinuria be prevented?

Proteinuria cannot be prevented, but it can be controlled. Many of the causes of proteinuria can be treated (diabetes, high blood pressure, preeclampsia and kidney disease), allowing your healthcare provider to improve the condition.

Proteinuria in Children – American Family Physician

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor. org, the AAFP patient education website.

Information from Your Family Doctor

Am Fam Physician. 1998 Oct 1;58(5):1158-1159.

 
See related article on proteinuria.

Proteins are essential in our bodies. Normally, proteins move around in our blood, carrying food, hormones and medicine to all parts of the body. They also help keep water inside tiny blood vessels.

What is proteinuria?

Proteinuria is the name of a medical condition. It means protein is in the urine. As blood moves through the kidneys, the kidneys filter out waste products, excess fluid and salts. The clean blood cycles back through the body. Most proteins are too big to go through the kidneys, so usually no protein is found in urine. If your doctor finds protein in your child’s urine, that means your child’s kidney filters may not be working as they should—possibly because of inflammation (swelling). Sometimes infection or toxic chemicals damage the kidneys, and this makes protein show up in the urine.

Dipping a special strip of paper into a sample of urine tells your doctor if protein is in it. If only a little protein is in the urine, your child probably has a benign (harmless) condition (such as orthostatic proteinuria—see below). Your doctor might do a few other tests to make sure.

Your doctor will ask you to collect a 24-hour urine sample from your child. Directions for doing this are at the end of this handout. A 24-hour urine collection lets your doctor measure the protein in the urine. This test helps show how well your child’s kidneys are working. Your doctor may also do some blood tests.

If a lot of protein is found in your child’s urine, a more serious kidney disease might be the problem. Proteinuria doesn’t cause pain. But when a lot of protein is in the urine, the level of protein in the blood may go down. This can cause swelling in your child’s eyelids, ankles and legs. High blood pressure is another sign of this problem.

What is orthostatic proteinuria?

Orthostatic proteinuria occurs in some older children and teenagers. The word orthostatic means “upright.” The condition is called “orthostatic proteinuria” because protein goes into the urine only when the child is in the upright position (standing up).

Children with this condition have no kidney damage but, for some unknown reason, they lose protein into the urine during the day when they are active. At night, while they sleep, their kidneys don’t let any protein into the urine. Your doctor diagnoses this harmless condition by checking two urine samples. The first one is collected in the morning, right after your child gets up, and it’s kept in one container. The second sample is collected during the day (all the urine collected during the day is put in the second container). If your child has orthostatic proteinuria, the morning sample won’t have protein in it. The urine collected during the day will have protein in it.

How is proteinuria treated?

If your child has orthostatic proteinuria or only small amounts of protein in the urine, no treatment is needed. Sometimes your doctor will check your child’s urine again after a few months. Your doctor wants to see if the amount of protein in the urine goes down. If the amount of protein in the urine doesn’t change or if there is more protein, your doctor will send you and your child to a kidney specialist (called a nephrologist—say: neff-rollo-gist). The nephrologist may perform a kidney biopsy. (A small piece of kidney tissue is taken out, using a needle. The kidney tissue is looked at under a microscope.) When your doctor finds out what causes the protein in your child’s urine, he or she can find the best way to treat the problem.

No matter what caused the kidney problem, a few simple things can help your child. Eating less salt can reduce the swelling. Medicine can control the inflammation (swelling) of the kidneys that may be causing protein to get into the urine. The medicine is usually given in a high dose at first, and in a lower dose later on. Some children take a low dose of medicine for months, or even years. It’s important to follow your doctor’s instructions about taking the medicine. It’s also important to visit the doctor for regular checkups.

Do I need to restrict my child’s activities?

No. Although protein in the urine can increase during exercise, this won’t hurt your child’s kidneys. So you don’t need to restrict your child’s activities.

How do I do a 24-hour urine collection?

In children who are potty-trained, you should start the collection on a day when your child doesn’t go to school, usually on a Sunday. As soon as your child gets out of bed in the morning, have him or her urinate into the toilet. This urine is not saved; just flush it down the toilet. Write down the exact time your child urinates. (Children who aren’t potty-trained usually go in the hospital for this test.)

After this, whenever your child needs to urinate, have your child urinate in the special container the doctor or the laboratory gives you. For girls, collect the urine first in a urine “hat,” then pour it into the special container. You don’t need to mark the times when these urine samples are collected.

It’s important to collect all the urine your child produces all day and in the night. The next morning, wake your child up at about the same time as you did the day before. Have your child urinate into the container one last time. This ends the 24-hour collection. Now write the date and the time on the container label. Bring the container to the laboratory on this day. Since bacteria can grow in urine at room temperature, it’s important to keep the urine container in a refrigerator during the collection and before you deliver it to the laboratory. Be sure to wash your hands after handling the container.

Albuminuria: Albumin in the Urine

On this page:

What is albuminuria?

Albuminuria is a sign of kidney disease and means that you have too much albumin in your urine. Albumin is a protein found in the blood. A healthy kidney doesn’t let albumin pass from the blood into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin in your urine, the better.

Sometimes albuminuria is also called proteinuria.

A healthy kidney doesn’t let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.

More information is provided in the NIDDK health topics, Diabetic Kidney Disease and High Blood Pressure and Kidney Disease.

Why is urine albumin important?

Measurement of urine albumin is an important tool for

• diagnosing kidney disease
• monitoring the progression of kidney disease

Health care providers regularly test people for albuminuria as part of a routine medical exam and will closely monitor urine albumin in people with kidney disease.

A urine albumin level that stays the same or goes down may mean that treatments are working. Treatment that lowers the urine albumin level may lower the chances that kidney disease will progress to kidney failure.

People who have diabetes, high blood pressure, heart disease, or a family history of kidney failure are at risk for kidney disease. Talk with your health care provider about how often you should get a urine test for albumin.

How is albuminuria detected?

A health care provider often tests for albuminuria using a urine dipstick test followed by a urine albumin and creatinine measurement.

You will be asked to collect a urine sample in a special container in your health care provider’s office or a commercial facility. The office or facility tests the sample onsite or sends it to a lab for analysis.

Dipstick test for albumin. A dipstick test performed on a urine sample can detect the presence of albumin in the urine. For the test, a nurse or technician places a dipstick, a strip of chemically treated paper, into the urine. The dipstick changes color if albumin is present in the urine.

Albumin and creatinine measurement. A health care provider uses this measurement to determine the ratio between the albumin and creatinine in the urine and to estimate the amount of albumin excreted in 24 hours. Creatinine is a waste product that is filtered in the kidneys and excreted in the urine. Health care providers consider a urine albumin-to-creatinine ratio above 30 mg/g higher than normal.

If you have kidney disease or are at risk for kidney disease, talk with your health care provider about how often you should get a urine test for albumin.

How can albuminuria be reduced?

You may be able to reduce the amount of albumin in your urine by taking medicines that lower blood pressure called ACE inhibitors or ARBs. The names of these medicines end in -pril or -sartan.

You may also be able to protect your kidneys and reduce albuminuria by working with a registered dietitian who can help you plan meals and change your eating habits. The meal plan may help you

Meet with a dietitian who can help you plan meals and change your eating habits.

Clinical Trials

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.

What are clinical trials, and are they right for you?

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Pediatric Proteinuria (Excess Protein in Urine)

Glomeruli are tiny blood vessels in the kidneys that normally filter salt, water and waste products from the blood. They keep protein in the blood, which helps them absorb water from tissues. When these filters are damaged, protein can leak from the blood into the urine, resulting in proteinuria—an excess of protein in the urine. Proteinuria is also called albuminuria or urine albumin.

What is Pediatric Proteinuria (Excess Protein in Urine)?

Proteinuria is an excess if protein in your child’s urine. If your child has proteinuria, it’s often not serious. But sometimes, it can indicate a more serious problem with the kidneys. You should watch for any signs that your child’s fluids seem out of balance and check with a doctor.

If proteinuria indicates a kidney disease, your doctor will refer your child to a nephrologist, a doctor who specializes in treating kidney diseases.

What are the signs and symptoms of Pediatric Proteinuria (Excess Protein in Urine)?

Your child may have no symptoms while in the earliest stages of proteinuria. As large amounts of protein move from the blood to the urine and out of the body, the following signs and symptoms may occur and may indicate progression of kidney disease.

• Difficulty breathing
• High blood pressure
• Fatigue
• Swelling (edema), especially around the eyes and in the hands, feet, and belly
• Urine that appears to be foamy or bubbly because of large amounts of protein

How is Pediatric Proteinuria (Excess Protein in Urine) diagnosed?

If you or your child’s pediatrician suspect that your child has proteinuria, a condition in which protein leaks from the blood into the urine, the doctor will recommend a urine test.

In the past, a 24-hour urine collection was required to diagnose proteinuria. The patient would collect urine in a single container from the first visit to the bathroom in the morning through the first visit on the next day. This test may still be used, but most of the time, a simple urine test can be done in a doctor’s office to test how much protein is in your child’s urine. A chemically-treated paper dipped into the urine sample will change color if protein levels are high.

If your child has no symptoms and a urine sample collected first thing in the morning indicates no protein or only trace amounts, the doctor may suggest that your child be tested again in a year. If protein is discovered in the urine, another first morning sample should be tested and also examined under a microscope, and further urinalysis— the physical, chemical, and microscopic testing of a sample of urine—will be necessary. If the urine tests reveal excess protein and urinalysis results are abnormal, your child may need further evaluation because if the proteinuria persists, it can mean that your child’s kidney function is declining.

To check your child’s overall and kidney health, the doctor will ask about your child’s complete medical history, perform a physical examination and take blood samples to measure levels of creatinine and urea nitrogen—waste materials that are filtered by the kidneys in healthy people. Excess amounts may indicate poor kidney function.

In some cases, the doctor may recommend an ultrasound of the kidneys to detect structural damage or abnormalities. This test provides the doctor with information about the size and shape of the kidney and helps detect cysts, kidney stones, obstructions, masses in the kidney and other problems. The test is painless and noninvasive. A technologist moves a probe over the kidney from outside the body, which creates sound waves that bounce back from the kidney, forming an image on a video screen.

In rare case, your child may need a kidney biopsy. The doctor may want to look at a piece of kidney tissue under a microscope to try to pinpoint the precise kidney disease. For a biopsy, which involves an overnight hospital stay, your child will receive a light sedative and local anesthesia. The doctor will direct a biopsy needle into the kidney guided either by images from an ultrasound or a computed tomography (CT) scan, a test that uses multiple X-ray images to provide a detailed picture of the body structures. The kidney tissue will be examined to diagnose the kidney disease that is causing protein in the urine.

What are the causes of Pediatric Proteinuria (Excess Protein in Urine)?

One of the functions of protein in the blood is to help balance the body’s fluid levels. When protein spills into the urine, it causes fluid to leak into the body’s tissues, which results in swelling.

Although proteinuria is often harmless and may result from stress, fever or exercise, it also can be a sign of a serious underlying kidney disease (also called renal disease) or a disease that started in another part of your child’s body. Proteinuria also may be a sign of another condition, nephrotic syndrome, which may indicate an underlying kidney disease.

The most common risk factors for proteinuria are diabetes and hypertension, or high blood pressure. Both of these diseases can cause kidney damage and proteinuria.

Risk factors include:

• Family history of kidney disease
• Kidney damage or disease
• Obesity
• Race and ethnicity: African-Americans, Hispanics, Native Americans, and Pacific Islanders are more likely than Caucasians to develop proteinuria.

Untreated, proteinuria can result in serious kidney problems. It is the most common cause of chronic kidney disease.

How is Pediatric Proteinuria (Excess Protein in Urine) treated?

If your child has proteinuria, the leaking of protein from blood into the urine, it can signal a more serious problem with the kidneys. In other cases, the problem has no known cause and can be treated easily. Regardless, you should seek treatment for your child right away.

Your child’s pediatrician or a nephrologist, a kidney disease specialist, will treat proteinuria with no known cause, called idiopathic proteinuria, by stopping the flow of protein into the urine. The doctor also will recommend treatment to ease your child’s symptoms, such as swelling and fatigue. Usually, the doctor prescribes medications such as prednisone, which is a corticosteroid. If prednisone fails or causes unwanted side effects, the doctor can recommend other drugs, such as cyclophosphamide, chlorambucil or cyclosporine. In patients with kidney disease who do not respond to these drugs, another type of medication called an ACE inhibitor may be used.

When your child’s doctor determines the cause for proteinuria, your child will receive treatment to correct the problem that is causing protein to leak into the urine and guard against kidney damage. For example, children who have diabetes will need to keep their blood sugar under control. Your child’s doctor may suggest making some changes to your child’s diet to restrict how much salt and protein your child eats.

If proteinuria causes damage to your child’s kidneys, a kidney disease specialist will evaluate the damage and manage the problem, trying to preserve as much of your child’s normal kidney function as possible. Proteinuria is a leading cause of chronic kidney disease, so it is important to keep the condition under control.

90,000 Urinalysis for total protein

Total protein in urine (or proteinuria) is a pathological condition of the body that signals kidney disease and increased excretion of protein in the urine.

In a healthy person, protein in the urine is absent in principle or is contained in insignificant quantities. The membrane is a kind of barrier, it also traps proteins, the molecules of which are large enough to pass through this filter. If the membrane is damaged, blood plasma proteins pass through the “filter” and enter the urine.Protein in the urine is a clear sign of primary kidney disease. Inflammation or swelling of the urethra and bladder can also be the cause of total protein in the urine.

Total protein in urine can also mean the presence of pathologies such as impaired renal blood flow, multiple myeloma, nephrosclerosis, infections and malignant tumors of the genitourinary system, heavy metal poisoning and other diseases.

When and to whom is the analysis assigned?

• All patients who first see a doctor
• For diabetes mellitus, amyloidosis and any disease or suspicion of kidney disease
• Patients with coronary heart disease
• Suffering from edema of the lower extremities
• With arterial hypertension
• People with obesity or with an unreasonable change in weight
• With increased fatigue
• Patients who are prescribed nephrotoxic drugs: cisplatin, non-steroidal anti-inflammatory drugs, furosemide.

An indication for analysis may be over fifty years of age.

Decoding of the analysis for total protein

Only the absence of protein in the urine is normal, but the minimum amount (0.3 g per day) is allowed. This may be due to a person’s prolonged exposure to the sun, diet, eating a large amount of protein foods, or severe physical overstrain of the patient.

• The following quantitative intervals of the presence of protein in urine can be distinguished:
• A mild degree of proteinuria is diagnosed when there is protein in the urine in an amount of up to 1 g per day.Most likely, this indicates a urinary tract infection
• Moderate assumes up to 3 g of protein per day and can diagnose necrosis or glomerunephritis
• For severe or acute degree (more than 3 g per day). we can talk about a suspicion of nephrotic syndrome.

Preparation for analysis for total protein in urine

• The day before the study, it is forbidden to drink alcohol
• It is recommended to refrain from taking diuretics, as well as aspirin, penicillin or acetazolamide for 48 hours.

You can have a urine test for total protein at one of the centers of the Medical Commission No. 1 network. Our branches are open in 7 districts of St. Petersburg and are equipped with their own high-tech laboratories and equipment. Analysis results will be ready as soon as possible. We work seven days a week!

Laboratory diagnostics of urine in SZDCM

One of the routine medical examinations is laboratory urinalysis .This technique is widely used due to the ease of collection of biomaterial and information content. A urine test can confirm or exclude a range of conditions and diseases. Thanks to the study of the analysis, it is possible not only to assess the functioning of the kidneys, but also the activity of the whole organism, since urine is a waste product and bears the imprint of most of the processes in the body.

All substances, the level of which in the body is increased, are excreted along with the urine, on which laboratory diagnostics are based. A general urine test is prescribed for almost every patient and is included in the number of mandatory studies. There are other methods for studying biomaterial, which are prescribed, most often, for pathology of the kidneys and excretory system. The peculiarity of urine analysis is that the technique is sensitive to changes in the body when there are no symptoms yet, which is important for making a diagnosis in the early stages.

Types of laboratory diagnostics of urine

There are the following types of urine analysis :

Go to analyzes

Depending on the pathology, one or another type of study is assigned.A general urine test is indicated for any disease, since this is a common clinical research method that is routine. Urine analyzes must be assessed comprehensively, based on blood test data, instrumental research methods, and the general condition of the patient. If necessary, the analysis is prescribed over time. this is especially true for patients of urological, nephrological profile. Urine analysis is of great importance for those who have undergone surgery, are detoxified.Regular checking of urinalysis data is relevant when evaluating treatment, for its correction, if necessary.

Let’s look at each technique in more detail.

General urinalysis

One of the main research methods used in medical practice. Based on the fact that urine is a complex solution of minerals, salts and organic matter. Thousands of substances are dissolved in water, which makes up the majority of urine.To a greater extent, urea and sodium chloride are excreted in the urine. Otherwise, even in healthy people, the composition of urine is constantly changing. The general analysis includes an assessment of transparency, acidity, density. The amount of basic elements of the sediment is studied – the level of protein, glucose, ketone bodies, blood corpuscles, pigments.

The general analysis of urine allows you to control and adjust the treatment, provides comprehensive information about what processes occur in the body. It is fast to execute and does not require complex equipment, therefore it is widespread and often used.

The general analysis of urine does not require special preparation. In urgent cases, a collection is carried out, regardless of the preparation of the patient.

Urine analysis according to Nechiporenko

The technique was proposed by a specialist urologist, A.Z. Nechiporenko. The peculiarity of the technique – the calculation of the studied parameters is carried out not in the field of view, as in the general analysis, but in the unit of urine. The technique is highly informative, does not require significant costs and time, is possible with a small amount of urine and does not require special preparation.

It is used as a refinement of the general analysis if it showed deviations. Some indicators are not thoroughly covered by the general analysis and more detailed research is required. It does not replace the general analysis, but complements it. It is widely used in urology, therapy, surgery and nephrology.

Urine analysis according to Nechiporenko is prescribed if traces of blood, leukocytes, traces of protein are found in the general analysis. The technique is informative in the diagnosis and treatment of various diseases of the kidneys and urinary system.With the help of the analysis, the number of erythrocytes, leukocytes, and cylinders changes. The composition of the cylinders and their structure are assessed.

Measurement of urine protein

The protein that is excreted from the body in the urine is only traces of the total amount of protein that is filtered and reabsorbed back into the kidney structures every day. Sometimes, protein is elevated based on functional changes, even in healthy people. This is observed with changes in blood circulation indicators, acute diseases, changes in temperature. Functional proteinuria disappears simultaneously with the cause that caused it.

Proteinuria – the content of protein in the urine, indicates a decrease in the normal function of the kidneys to retain protein in the body. This can be increased filtration or decreased reabsorption. Also, protein can be initially increased in the body, and its excess is excreted in the urine.

Microscopic analysis of urine

This method allows you to study the organized and unorganized urine sediment, to assess the number and quality of cylinders.We are talking about more than ten indicators. We take into account epithelial cells and casts, blood cells. From the unorganized sediment, the level of salts, ions, minerals is measured. Most often, the level of urates, phosphates and oxalates is studied. An increase in these indicators may indicate serious metabolic disorders and diseases.

The casts mean casts of the urinary tract, which are formed from various substances – hyaline, erythrocytes, epithelium. They are formed in the renal tubules and speak of impaired renal function, as well as general changes in the body.

Assessment of urine glucose

Normally, urine contains a low concentration of glucose. It is not detected with the standard research method, because the norms of the indicators correspond to the absence of glucose in the urine. If glucose is detected in urine, it is called glucosuria. Most often, this is associated with an increase in glucose in the body (hyperglycemia).It is not scary if glucose rises with a high intake of carbohydrates, taking certain medications. It happens that glucose in the blood is at a normal level, but its concentration in the urine is increased – this happens in some pathologies, during gestation. Be sure to take into account the consumption of carbohydrates and the volume of urine that was excreted from the body per day, this makes the analysis more objective.

Basic properties of urine and pathology in which they change

The main indicators of urine include:

Let’s consider these indicators in more detail.

Volume

Normally, the volume of a portion of urine is 100-300 ml. A low amount of urine volume indicates kidney failure, dehydration. Polyuria is an increase in the volume of urine, which may indicate the presence of diabetes, pyelonephritis and other conditions. Distinguish oliguria – the daily amount of urine up to 500 ml. It occurs with pathologies of the heart, kidneys. There is also anuria – a daily amount of urine up to 200 ml. This is a serious condition that occurs in cancer, meningitis, and acute kidney failure.

In addition to the volume of urine, the nature of urination is assessed. This may be the predominance of nocturnal diuresis over daytime, although normally it should be the other way around. Abnormalities include small and frequent urine, painful urination, involuntary acts, and false urge. It is necessary to assess these indicators in a comprehensive manner, because they form a complete clinical picture.

Color

Normal urine is straw yellow in color. A lot can be said about the color change. For example, bile pigments, which increase in urine with hepatitis, cirrhosis, disorders of bile outflow, give an orange hue. Red color is observed with an increase in red blood cells in the urine. It accompanies pyelonephritis, passage of kidney stones, cancer, tuberculosis. A greenish-white color is observed with blotches of pus. Black urine occurs in case of poisoning. intoxications. Urine can be brown, it is also compared to the color of beer – this happens when there are disorders in the metabolism of bile pigments, dehydration, the use of certain foods and chemicals.

The color of urine can vary depending on food, medication. A normal color does not exclude changes and pathology, but a violation of this indicator clearly speaks of the problem.

Smell

In some conditions, urine changes its smell. For example, when it is inflamed, it smells like ammonia. Diabetic patients have a slight acetone odor. Normal urine odor is specific, but not harsh, without additional shades.This indicator is not specific and is not widely used. Rather, it is an indicator that can alert the patient and serve as a reason to see a doctor.

Foam

There should be no foam in the urine. It can appear with jaundice, increased protein, diabetes and other metabolic disorders.

Transparency

Normally, the urine should be clear. It becomes cloudy if it has impurities of pus, salts, a large amount of mucus or corpuscles.This is observed in infectious diseases. In the laboratory, different reagents are used and they study which one will make the urine clear. For this, acids, alcohol, heating are used. The effectiveness of a particular method indicates what caused the clouding of urine.

Density

An increase in the indicator indicates a decrease in water in the body, and a decrease in kidney pathology. The norm is 1018-1025 units. The density level is influenced by the amount of protein, glucose, sediment, and the presence of bacteria.Low density is observed with diabetes, renal failure, hypertension, and the use of diuretics. High density is observed with various intoxications, edema.

Acidity of urine

The norm of urine pH is 5-7, that is, slightly acidic or neutral. A more acidic environment is observed with tuberculosis, nephritis, gout, acidotic changes in the body. Also, acidic urine is observed with an increased use of animal proteins, some medicines.

An alkaline reaction accompanies a high amount of vegetables in the diet, the use of alkaline mineral waters, hyperkalemia, alkalosis, and inflammatory diseases.

Standards and interpretation of research results

Protein

Norm – up to 0.033 g / l

Reasons for the increase: diabetes, pathology of the cardiovascular system, amyloidosis, metabolic disorders.

Glucose

Norm – absent

Increased in diabetes, urinary tract disorders, inflammatory processes in the kidneys.

Bilirubin

Normal – absent

Increased in pathology of the liver, biliary tract.

Ketone bodies

Normal – absent. Appear with diabetes.

Erythrocytes

Norm – no more than 2 in the field of view

They appear with urolithiasis, pyelonephritis, infectious diseases, systemic pathologies and poisoning.

Leukocytes

Normally, 3-5 cells may be present in the field of view.

An increase in the indicator occurs with cystitis, prostatitis, urethritis and other inflammatory processes.

Hyaline cylinders

Normally should not be detected.

They appear in renal pathology, cardiovascular diseases, hyperthermia.

Granular cylinders

Normally absent.

Appear with pyelonephritis, glomerulonephritis, nephropathy with diabetes, some infections and poisoning.

Salt

Normally, they shouldn’t be.

Appear with changes in diet, severe physical exertion, gout, kidney failure.

How to Prepare for Diagnostics

For the study, the morning urine portion is used. It is necessary to conduct a thorough toilet of the external genital organs, as this makes the diagnosis more accurate.There is no collection of urine during menstruation. On the eve, it is necessary to limit the consumption of vegetables and fruits that have a bright color. In the evening, you cannot eat spicy marinades, sauces, smoked meats, honey. Also, it is worth limiting the use of certain medications. Check with your doctor in advance. It is advisable to avoid strenuous physical activity before collecting urine. Limit consumption of alcohol, strong tea, coffee.

How to properly collect material for research?

After appropriate preparation, the urine is collected in a dry sterile container. To do this, you need to use a special container designed for single use. It is better not to collect the first portion of urine, as it may contain traces of flushing from the external genital organs. It is best to start collecting with a clean, second portion of urine. The container should not touch the body during the collection of material. It is better to stop collecting until the end of the act of urination. After collecting the required portion, the container is tightly closed with a lid.

Please note that urine collection should be done shortly before the test.Do not store the container for more than 2 hours and keep it in a cool place.

Collection of daily urine

If you are scheduled to collect your urine for 24 hours, follow your normal lifestyle and drinking routine. The first portion of the morning is poured out, and all the rest of the urine is collected throughout the day. It is necessary to collect in a dish with a wide mouth and sufficient volume. All the time during the day, the dishes should be in a cool place, but it should not be allowed to freeze.The start time of the collection and its end must be the same.

Analysis according to Nechiporenko

For analysis, it is necessary to collect the average portion of the first morning urine. During urination, a man should pull the skin fold over the penis and release the opening of the urethra. Women need to move their labia apart.

The beginning of urination occurs in the first channel, the next portion is collected in the second, and the last in the third.The second portion should prevail in volume.

Analysis for bacteriological research

The collection is carried out in the morning, after a thorough toilet of the genitals. The second, middle portion is collected.

The general rules for any analysis are clean, dry dishes, proper storage conditions and fast delivery to the laboratory.

Terms of results readiness

Urinalysis results can be ready the next day.It may take time for the chemicals to work, but in general, urinalysis is not time consuming.

It is advisable to take tests in the same laboratory, especially if there is a chronic pathology and it is necessary to monitor the condition.

General urine analysis – Medical Center in Tomsk “Multi Clinic”

Dictionary of Medical Terms

General urinalysis

Probably, the first thing that a doctor asks a patient who turns to him is to pass two of the simplest tests – blood and urine.The general analysis of urine, despite its simplicity, gives at least a general idea of ​​the state of the organs, but tells the doctor a lot. Normally, urine analysis has the following indicators: the amount of urine submitted, its density, color, the number of leukocytes, erythrocytes, protein, salts and bacteria. Let us briefly dwell on each of these indicators.

Density of urine. This indicator tells the doctor about kidney function. Normally, this value ranges from 1015 to 1025. However, it is worth noting that this indicator, when performing a general analysis of urine, does not always accurately reflect renal function, since the density of urine largely depends on the patient’s drinking regimen.If the day before the analysis, the patient drank a lot of water, juice or other liquid, or ate watermelons, then the density of urine will be low. Conversely, with low fluid intake in the patient, the urine density will be high. In addition, this indicator also depends on the content of protein, sugar, salts, etc. in urine.

Leukocytes. Normally, the permissible leukocyte count in urine ranges from 0 to 3-4 per field of view. In women, these numbers may be slightly higher (which is due to the specifics of the structure of the genitourinary organs).The appearance in the urine of a significant number of leukocytes speaks of only one thing – an infectious inflammation in the genitourinary system. To clarify the location of this inflammation, various tests have been invented: two-glass, tehstakannaya and others. They allow the doctor to know if the inflammation is in the kidneys, or in the bladder, or in the urethra.

Erythrocytes. Red blood cells are red blood cells that contain hemoglobin. As you already know, blood is filtered in the kidneys.At the same time, its liquid part, plasma, is preliminarily filtered into the glomeruli. But sometimes in some diseases (for example, glomerulonephritis), this function of the glomeruli of the kidneys is impaired, and erythrocytes also enter the urine along with plasma. Another most common reason for the detection of red blood cells in the urine may be urolithiasis. This is due to the fact that during an attack of renal colic, the edges of the stone injure the wall of the cups, renal pelvis, ureters or bladder, as a result of which blood appears in the urine (hematuria).Finally, hematuria can be a sign of another serious kidney or bladder disorder – cancer.

Protein. There is no normal protein in urine, or it is present in a very small amount – 0.0330 / 00 (read ppm). Protein in urine is mainly a signal of certain kidney diseases, in particular glomerulonephritis. But sometimes it can be urolithiasis, which is again associated with scratching the edges of the stone of the walls of the urinary tract. It should be noted that with the loss of protein in the urine, there is a corresponding decrease in it in the blood.And this, in turn, is manifested by edema.

Finally, another indicator of urine analysis is salts. Moreover, first of all, the doctor is interested not even in their quantity, but in the chemical composition, since, knowing it, the doctor selects the appropriate treatment for the patient and, of course, the diet.

Bacteria. Bacteria in urine appear in inflammatory diseases of the kidneys or urinary tract.

90,000 Why does protein appear in urine and what to do about it

What is the norm of protein in urine

A healthy person excretes ^{to 150 mg of protein per day in the urine. This is so small that it is impossible to detect the substance there in a general analysis of urine. The test is simply insensitive to that amount.}

Protein enters the urine from the blood, which is continuously filtered through the kidneys ^{. It passes through the glomeruli, a plexus of small vessels – capillaries. They let water, ions and some toxic substances pass through their walls, but do not allow large proteins and cells to pass. But small proteins seep, so they can be in the urine in small amounts.}

If the kidneys are impaired, they stop retaining large protein molecules, so there is more than 150 mg of it in the urine. This condition is called proteinuria.

How to find out that there is protein in urine

A person cannot determine by the appearance of urine that there is a lot of protein in it. Although doctors point out ^{that in this case it foams a lot. The only reliable way to confirm your guesses is to get tested. The therapist may prescribe the following options for :}

• General urinalysis. Collected at any time of the day. Laboratory technicians determine the protein using a special test strip. It changes color if its level exceeds the norm.
• Daily urinalysis ^{. A person after waking up and within 24 hours is emptied into a special container. Then the laboratory determines the total amount of isolated protein.}

Usually, if the proteinuria is mild, then the state of health does not change. Symptoms appear in those who suffer from kidney or other systemic diseases that cause a lot of protein to be lost in the urine.The most common signs are swelling on the face, abdomen, and feet. Sometimes other symptoms of ^{come to the fore:}

• shortness of breath;
• fatigue;
• nausea and vomiting;
• Frequent urination;
• Cramps at night.

Why does proteinuria appear

Sometimes protein molecules leak into the urine due to temporary deterioration in health ^{. For example, with severe dehydration, high body temperature, due to stress, exercise or hypothermia. This is not dangerous and will go away by itself.}

But there are various diseases that are accompanied by kidney damage, disruption of their work and the development of renal failure. Scientists believe that proteinuria can be a sign of such diseases ^:

• Kidney amyloidosis is a pathology in which harmful proteins accumulate in the organs.
• Glomerulonephritis is a chronic inflammatory disease.
• Pyelonephritis – kidney infection.
• Autoimmune diseases.For example, systemic lupus erythematosus, rheumatoid arthritis.
• Cardiovascular diseases, including arterial hypertension.
• Diabetes mellitus.
• Tumor processes. For example, sarcoidosis, Hodgkin’s lymphoma, myeloma, kidney cancer.
• Preeclampsia is a disease of pregnant women in which blood pressure rises, protein in the urine is detected and edema occurs.
• Poisoning, drug action. This is often a side effect of NSAIDs.
• Serious injuries suffered.

Proteinuria ^{can occur after a person has stood for a long time. This happens rarely and usually in adolescents or people over the age of 30. Why this happens, no one knows. But there is no need to treat this condition, there is no threat to health.}

What to do if protein is found in urine

If protein is found in one urine test, the therapist will send ^{for a study every 30 days. Only in case of repeated deviations is in-depth diagnostics necessary.To do this, use the following methods:}

• Blood test for creatinine. It is a metabolic product that must be excreted by the kidneys. But if their function is impaired, it remains in the bloodstream.
• Glomerular filtration rate. A special study that helps to determine the rate of creatinine excretion and the level of albumin in the blood depending on the sex, age, weight and race of the patient.
• Study of the concentration of all serum proteins.
• Kidney ultrasound or MRI. You need to consider the structure of the organ.
• Urine protein electrophoresis. With its help, it is determined which proteins are excreted. This helps to make a more accurate diagnosis.
• Kidney biopsy. A piece of tissue from this organ is taken from the patient under anesthesia. It is used as a last resort when cancer is suspected.

The doctor will prescribe treatment ^{depending on what caused the increased protein in the urine. In some cases, therapy is not needed; in others, medications are prescribed.If proteinuria is due to chronic kidney failure, sometimes the only way to improve the condition is with hemodialysis . This is the name of the method of treatment when the blood is filtered by a special apparatus.}

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Determination of protein in daily urine

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Intermedical | Daily proteinuria

Proteinuria (protein in daily urine) – an indicator of excretion of proteins in the urine per day, reflecting the functional state of the kidneys.

Main indications for prescription: preventive examinations, kidney pathology, diabetes mellitus, cardiovascular diseases, infections and many other diseases.

A small amount of protein in the urine is found in completely healthy individuals. However, these protein concentrations are not determined in single portions of urine when it is determined by widely used conventional methods (on test strips). Most researchers indicate that the content in a single urine is normally up to 140 mg / l (up to 0.140 g / l.In order to more accurately identify the loss of protein in the urine, it is advisable to conduct a study of the concentration of protein in daily urine.
Traces of protein are found in normal urine, including albumin and globulins, as well as glycoproteins and mucoproteins from the mucous membranes of the urogenital tract. When proteinuria actually occurs, the main components of the total urine protein are serum albumin (and partially globulins). Therefore, it is advisable to determine the albumin in the urine.
The main cause of increased urinary protein is increased permeability of the glomerular membrane.Diseases that increase the permeability of the membrane contribute to the development of nephrotic syndrome, characterized by significant loss of protein in the urine. Such diseases include: acute glomerulonephritis, chronic glomerulonephritis associated with primary damage to the glomeruli and subsequent increase in membrane permeability, amyloidosis, when a pathological protein is deposited in the walls of blood vessels, leading to damage to the glomerular membrane, toxicosis of pregnant women.

It is advisable to distinguish the variability of proteinuria: with a daily loss of protein up to 1 g – moderate, from 1 to 3 g – average and more than 3 g – pronounced.

Distinguish between physiological proteinuria associated with high protein intake with food, exercise and pathological. Pathological, more often associated with renal diseases: glomerulonephritis, pyelonephritis. Proteinuria develops due to damage to the membrane of the renal glomeruli and impaired tubular reabsorption. Extrarenal diseases: cystitis, urethritis, prostatitis.

Normally, only proteins with a low molecular weight are filtered through the membrane of the renal glomeruli.Then most of them are reabsorbed in the kidney tubules. Thus, such a small amount of protein is excreted in the urine that during a screening study (for example, on strips), the protein in the urine is not detected.

As a rule, a qualitative analysis is carried out first, allowing to reveal the fact of proteinuria itself. If the analysis is positive, quantitative research methods are used. For quantitative analysis, it is necessary to collect daily urine. For unexplained proteinuria and ongoing proteinuria, urine electrophoresis is advisable.Electrophoresis of organic urine sediment makes it possible to isolate the following fractions in it: Bence-Jones protein, hemoglobin, myoglobin and albumin.

• Explain to the patient that the test can detect protein in urine.
• No dietary or dietary restrictions are required.
• The patient is informed that to perform the test, a study of daily urine or an arbitrary portion of it is necessary.
• It is necessary to know if the patient is taking medications that may affect the test result (in some cases, it is necessary to refrain from using them).

PROCEDURES

• Urine is collected in a special container with a volume of 3 liters for 24 hours, while the first (morning at the initial moment of collection) portion of urine is drained. Further, urine is collected exactly one day.
• Record the total volume of urine excreted per day.
• Part of the urine is poured into a 100 ml container and sent to the laboratory.
• After collecting urine, the patient may resume medication.

• Normally, urinary protein excretion at rest per day averages 50-80 mg / day, not more than 150 mg / day.With physical activity, it should not exceed 250 mg / day.

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Total protein in urine can be considered an early and rather informative marker of kidney pathology of primary or secondary genesis. In the physiological state, a minimal amount of protein structures is found in urine. Protein loss is prevented by the glomerular filter. The analysis for total protein in urine, which can be taken at the Doctor Ryadom clinic, allows diagnosing diseases accompanied by a decrease in the functional ability of the kidney glomeruli.

However, it should be noted that protein in urine (proteinuria) does not always indicate a pathological condition. In some cases, proteinuria can be temporary or benign.

It occurs after stressful conditions, dehydration, severe fever, excessive physical activity, and so on. Also, protein structures in urine can be detected with their increased consumption with food. This is due to the fact that a large amount of proteins exceeds the reabsorption capacity in the renal tubules and they are excreted from the body.

In most cases, high urine protein levels are common in many kidney diseases. Most often, proteinuria is observed in diabetic nephropathy and glomerulonephritis.

With the progression of these diseases, the intensity of the loss of protein in the urine increases. In addition, an increased protein in the general analysis of urine can be observed in diseases of the urinary system of an infectious nature, such as urethritis and cystitis.Proteinuria is also a persistent symptom of malignant neoplasms of the urinary system, such as kidney and bladder cancer.

Urinary protein loss is of clinical importance. If this indicator exceeds 3.5 g / l, then hypoalbuminemia develops in the body. This, in turn, causes a decrease in oncotic blood pressure, against the background of which edema or ascites develop.

Significant proteinuria is indicative of severe renal dysfunction.Even a small loss of protein (microalbuminuria) is considered a serious problem because it indicates an increased risk of coronary heart disease.

Preparation for analysis for total protein in urine

Before passing the total protein in the urine, it is necessary to clarify the preparation rules with the staff of the Doctor Ryadom clinic. First, a container with an airtight lid and vial must be obtained from the medical office. On the day before taking the test, you should not eat food, in particular fruits and vegetables, which can cause a change in the color of urine.

Also, to improve the accuracy of the study, diuretics should not be taken. Before collecting urine for analysis for total protein, it is recommended to conduct a full-fledged toilet of the genitals. For women, there is a rule according to which protein content should not be determined in the general analysis of urine (OAM) during the period of menstruation.

For research, 50 ml of urine collected in the morning is collected in a container. In this case, the first portion goes down into the toilet (within the first seconds).After this, without interruption in urination, a container is placed to collect urine. Immediately after the urine has been collected, the container is closed with an airtight lid. It must be delivered to the branch of the Doctor Ryadom clinic during the day. If it is impossible to bring urine immediately, it should be stored at a temperature of 2 to 8 degrees.

Indications for testing for total protein in urine

Doctors of the clinic “Doctor Ryadom” advise you to take this test in the following situations:

• Detection of glomerulonephritis, lipoid necrosis, glomerular sclerosis and various primary glomerular lesions;
• Diagnosis of nephropathy in autoimmune connective tissue diseases, diabetes mellitus, multi-organ renal pathology, amyloidosis;
• Identification of renal pathology in people at high risk of developing chronic renal dysfunction;
• Assessment of the likelihood of developing chronic renal failure in patients with renal pathology;
• Control of renal function with the use of nephrotoxic drugs.

Interpretation of the results of the general analysis of urine for protein

In the laboratory of the Doctor Ryadom clinic, the protein norm in the general urine analysis is up to 0.15 g / l. In a physiological state, in some cases, the level of protein in urine can reach 0.3 g / l. For example, traces of protein in a general urinalysis can be noted after intense physical activity or after excessive consumption of protein with food.

A pathological excess of the protein norm in the general analysis of urine is observed in the following diseases:

• Primary kidney diseases, for example, primary glomerulonephritis, pyelonephritis, lipoid nephrosis, tubulointerstitial nephritis, etc.;
• Secondary damage to the renal tissue in systemic diseases – diabetes mellitus, hypertension, systemic connective tissue pathology, amyloidosis, and so on;
• Renal dysfunction due to the use of nephrotoxic drugs;
• Damage to kidney tissue associated with mercury and lead poisoning;
• Renal cell carcinoma;
• Multiple myeloma;
• Injury to muscle tissue;
• Malignant neoplasm of the bladder;
• Chronic congestive heart failure;

A negative urinalysis protein is normal and not diagnostic.