If there is a lot of protein in the urine, how to treat it. Protein in urine - what does it mean in women and men; norms and reasons for increase

From the article you will learn about protein in the urine, what it means in women, is it normal, and how to treat it. Proteins (proteins) are a necessary component of all living structures. They provide structural function, metabolic processes, are catalysts for many biochemical reactions, and also carry out the transport of other molecules.

Determining the level of protein in urine is the first step in diagnosing kidney pathologies. In addition, analysis is necessary to determine the effectiveness of the chosen treatment tactics.

Total protein in urine is a laboratory analysis that allows one to identify kidney pathologies at an early stage with a high degree of reliability, as well as diagnose secondary damage to the glomerular apparatus in chronic diseases.

In a healthy person, a small amount of protein molecules is excreted in the urine due to the presence of a filtration mechanism in the glomeruli of the kidneys. The filter is capable of preventing the reverse diffusion of large charged molecules into the primary filtrate. It is known that small molecules of peptides (molecular weight up to 20 kDa) are able to freely penetrate through the filtration mechanism, and high molecular weight albumin (65 kDa) is retained by them.

The presence of protein in the urine is a signal to prescribe an additional extended examination of the patient. This fact is due to the fact that normally the overwhelming concentration of peptide molecules is reabsorbed into the bloodstream in the convoluted tubules of the kidneys. In this case, only a small amount is excreted along with urine. About 20% of the total number of released peptides are low molecular weight antibodies (immunoglobulins), while 40% are albumins and mucoproteins.

Why is the analysis prescribed?

A referral for analysis to determine total protein in the urine can be prescribed by a general practitioner, nephrologist, endocrinologist or cardiologist. It is used for the following purposes:

early diagnosis of pathological conditions of the kidneys (focal sclerosing glomerulonephritis, membranous glomerulonephritis or degenerative kidney disease);
diagnosis of cardiovascular pathologies;
differential diagnosis of the causes of edema;
identifying disturbances in the normal functioning of the kidneys due to diabetes mellitus, Libman-Sachs disease, as well as amyloid dystrophy;
determining the likelihood of developing chronic kidney failure;
assessing the effectiveness of the selected drug treatment tactics and preventing the development of recurrent pathologies.

Who can get the test?

The study is prescribed for patients with diabetes mellitus, as well as for symptoms of kidney failure:

excessive swelling of the lower extremities or face;
accumulation of free fluid in the peritoneal cavity;
unexplained weight gain;
persistently high blood pressure for a long time;
blood when urinating;
a sharp decrease in the amount of urine excreted per day;
increased drowsiness and decreased performance.

In addition, the normal level of protein in urine in men and women should be determined during a routine annual examination. The analysis is of particular importance for patients at risk: age over 50 years, smoking and alcohol abuse, as well as the presence of aggravating factors in the family history.

Table of norms for protein in urine in women by age

Important: the data presented is for informational purposes only and is not sufficient to make a final diagnosis.

Only the attending physician has the right to decipher the results of the study, who determines the diagnosis and prescribes appropriate treatment based on the patient’s general medical history, as well as data from other laboratory tests and instrumental studies.

The standard units of measurement are mg/day; however, some laboratories use g/day. Units of measurement are converted using the formula: g/day*1000= mg/day.

It should be noted that when selecting reference (normal) values, the gender and age of the patient should be taken into account.

The table shows acceptable protein concentrations in urine in healthy women, selected according to age.

It has been established that after intense strength training, an increased protein content in the urine is recorded, the value of which reaches 250 mg/day. However, the concentration of the parameter under consideration should return to the reference values within 1 day.

Normal level of protein in urine in men

Normally, protein in the urine of men, as well as women, should be either completely absent or present in trace amounts. The maximum permissible values are 150 mg/day.

Proteinuria – pathology or normal?

Proteinuria is a condition in which a patient has increased protein in the urine. In the vast majority of cases, this condition does not relate to pathologies, but is a variant of the norm or the result of improper preparation of the patient for the donation of biomaterial (physical or emotional fatigue, acute stage of an infectious process, or dehydration).

Elevated protein is diagnosed in approximately 20% of the healthy population. In this case, proteinuria is considered normal. In only 2% this condition is the cause of serious pathology. With benign proteinuria, protein in the urine in men and women is recorded at a concentration of 200 mg per day or less.

Orthostatic proteinuria

Separately, there is orthostatic proteinuria - a condition characterized by an increased concentration of total protein only after prolonged walking or being in a horizontal static position. This fact explains the discrepancy in results in the presence of orthostatic proteinuria: positive when examining daily urine and negative when diagnosing a single portion. According to statistics, this condition occurs in 5% of the population under 30 years of age.

Increased protein in the urine can also be found as a result of its active synthesis in the human body, which leads to the need to enhance filtration processes by the kidneys. In this case, there is an excess of the possibility of reabsorption of protein molecules in the renal tubules and their diffusion into the urine. This condition is also a variant of the norm.

The exception is situations when not low-molecular-weight organic peptides are detected, but specific molecules, for example, Bence-Jones protein. It is known that the sensitivity of the method is not enough to determine the concentration of this protein. If there is a suspicion of a malignant lesion of epithelial tissue (myeloma), it is necessary to undergo a urine screening test for Bence Jones protein.

When is proteinuria a pathology?

A condition characterized by an increase in protein in the urine over a long period of time accompanies various pathologies of the urinary organs. Depending on the mechanism of occurrence, it is customary to divide proteinuria into:

glomerular, which occurs against the background of a violation of the integrity of the basement membrane of the renal glomeruli. It is known that the basement membrane acts as a natural barrier that prevents the diffusion of large molecules with a charge, and when it is damaged, there is a free flow of proteins into the urine. This condition can be an independent pathology or occur as a consequence of an underlying disease, for example, diabetes mellitus (from 30 to 500 mg of protein per day). Another cause of glomerular proteinuria is the use of medications;
tubular - the result of a disorder in the process of reabsorption of substances in the renal tubules. In this case, a lower protein level is recorded in urine analysis (no more than 200 mg per day) compared to the glomerular type. The most common cause of this condition is a complication of hypertension.

Other reasons for exceeding the norm

The reasons for increased protein in the urine in men and women are also:

infection of the urinary system by pathogenic microorganisms, for example, cystitis or urethritis;
bladder oncology;
vulvitis, vaginitis, etc.
chronic heart failure;
inflammation of the inner lining of the heart;
extensive injuries;
intestinal obstruction.

Preparing for analysis

The reliability of the results obtained by the patient primarily depends on his preparation for the test. The material for the study is a single portion of morning urine. Or all the urine collected by the patient himself during the day.

Before collecting biomaterial, you should avoid drinking alcohol 24 hours before. As well as fatty and smoked dishes. You must stop using diuretics within 48 hours. And for women, collect biomaterial 2 days after or before menstruation.

How to reduce protein in urine?

In order for increased protein in the urine in men, women and children to return to normal values, it is necessary to first establish the reason for its deviation from the norm. False-positive results indicating proteinuria are often detected in the morning portion of biomaterial in the analysis for the criterion in question. That is why, if an abnormality in protein in the urine is detected, a repeat test is prescribed.

Depending on the initial cause, appropriate treatment for protein in the urine is prescribed. In the case of an infectious disease, it is necessary to determine the type of pathogenic microorganism that provoked it. After this, a test is carried out to determine the sensitivity of the isolated species of bacteria to various groups of antibiotics. The most effective antibacterial drugs are prescribed to the patient.

In the case of arterial hypertension, medications that lower blood pressure are selected, and in the case of cancer pathologies, a course of chemotherapy is determined.

Diet for high protein in urine

One of the key points in treatment is quitting smoking and alcohol. And also diet. Patients are recommended:

limit the amount of salt consumed to 2 g per day;
exclude meat and fish in order to reduce protein intake;
drink no more than 1 liter of liquid per day (including juices, soups, tea);
consume rice dishes and fermented milk products with a low percentage of fat, as well as raw and steamed vegetables;
give preference to rosehip tea and currant fruit drinks.

Protein in urine - treatment with folk remedies

Important: traditional medicine methods cannot act as the main treatment for high levels of proteins in the urine.

The priority treatment should remain the one prescribed by the attending physician from the methods of official medicine. This fact is argued by the fact that herbal decoctions and infusions are not effective enough to completely cure the underlying disease. They can only have an auxiliary effect and enhance the effect of certain medications.

Bee products have a positive effect on the immune system due to their pronounced antimicrobial and anti-inflammatory properties. In addition, they are able to strengthen the wall of blood vessels and serve as a source of vitamins. In consultation with a doctor, it is permissible to use alcohol and water decoctions based on propolis. The limitation for use is individual intolerance to bee waste products. You should also consume a large amount of fresh berries and fruit drinks based on them.

It is important to understand that when treated with folk remedies, the level of protein in the urine of men and women is not immediately restored. The minimum duration of the course should be 3-4 weeks.

conclusions

Thus, to summarize, it is necessary to highlight the important points:

Normally, protein in the urine of men, women and children is completely absent. Or its concentration does not exceed 150 mg per day;
the presence of proteins in the analysis is not always a signal of pathology. However, it is necessary to undergo a comprehensive examination in order to determine the cause;
if protein and leukocytes are detected in the urine, then additional laboratory and instrumental diagnostic methods are prescribed. The cause may be an infectious disease or cancer;
The sensitivity of the method is not enough to diagnose Bence Jones protein, which is a marker of oncology of the urinary organs.

In this article we will look at what can cause protein to appear in urine.

Passing through the kidneys, the blood is filtered, as a result only those substances that the body needs remain in it, and the rest is excreted in the urine.

Protein molecules are large, and the filtering system of the renal corpuscles does not allow them to pass through. However, due to inflammation or other pathological reasons, the integrity of the tissues in the nephrons is disrupted, and the protein passes freely through their filters.

Protein is one of the possible deviations in the general analysis. The most accurate determination of the composition of urine can be obtained from biochemical studies. What does protein in urine mean? A condition in which its level is elevated is medically called “albuminuria” or “proteinuria.”

Protein is the main building material in the human body. It is present in all its organs, tissues and environments. Normally, protein in urine is detected in very small quantities, since the kidneys carefully filter it out during reabsorption processes. An increase in values may be the result of physiological (stress, diet, etc.) or pathological (oncology, pathologies of the genitourinary system, etc.) reasons.

What does protein in the urine of a man and a woman mean is interesting to many.

It performs important functions in the body:

promote the construction of new cells and the formation of intercellular connections;
provides an immune response to external or internal stimuli;
forms colloid-osmotic (oncotic) blood pressure;
takes part in the creation of enzymes that play a special role in biochemical reactions.

Increased protein in urine: causes

The presence of small levels of protein is due to diet, physical activity and minor health problems.

If an infectious, inflammatory or other pathological process occurs in the filtration system of the kidneys, then various inclusions are detected in the urine, including globulins - large protein compounds.

It is important to find out what protein in urine means.

The excretion of large amounts of it in the urine is called proteinuria. If more than 3 g of protein is excreted from the body per day, then this is a reason to suspect dysfunction of the glomerular renal system. Proteinuria that lasts more than three months indicates chronic kidney disease. Losing more than 3.5 g of protein per day can lead to nephrotic syndrome (mass swelling and increased cholesterol levels).

What else causes protein in urine?

In addition, the loss of proteins may be due to a violation of their reabsorption (reabsorption into the blood) in the proximal renal tubule. There are several reasons for this condition:

infectious or inflammatory processes;
side effects from certain medications;
nephrological diseases in the chronic stage, etc.

People at risk for high levels of protein in urine include:

people over 65 years of age;
patients with diabetes;
children with weak immune systems;
patients with obesity of various types;
women during pregnancy;
athletes.

It should be noted that in men and women, the reasons for the increase in protein concentration in the urine are almost the same, with the exception of cases when such a condition is provoked by pathologies of the reproductive system.

Indications for analysis

Why protein appeared in the urine should be determined by a doctor. The analysis is prescribed if the following clinical symptoms are present:

pain, discomfort, itching or burning when urinating;
feeling of insufficient emptying of the bladder;
pain in joints and bones, bone fragility (due to loss of protein);
constant weakness and drowsiness, increased fatigue;
frequent attacks of dizziness, fainting (may indicate accumulation of calcium in the blood);
pathological swelling;
numbness or tingling of fingers;
attacks of fever or chills, hyperthermia without an established cause;
chronic anemia (low hemoglobin);
cramps, muscle spasms;
digestive disorders (dyspeptic symptoms, appetite disturbances) without an established cause.

In addition, testing for protein in urine is prescribed for the following diseases:

systemic pathologies of any form;
diagnosis of diseases of the genitourinary system: cystitis, pyelonephritis, urolithiasis, renal failure, prostatitis, glomerulonephritis;
diabetes mellitus;
childhood infections and diseases;
in the diagnosis of myeloma (oncological tumor of plasma cells);
monitoring the effectiveness of intoxication therapy (poisoning with snake venom, heavy metals, drug overdose);
oncological diseases of the genitourinary system;
injuries or massive burns;
congestive heart failure;
prolonged hypothermia of the body;
recent surgery.

Physiological proteinuria

In cases of slight or one-time excess of protein norms in the urine, functional (physiological) causes should first be excluded. Among them are the following:

hyperthermia not associated with a disease of the genitourinary system;
long-term physical activity, sports activities, heavy lifting;
prolonged hypothermia;
a sharp change in position immediately before delivery of the biomaterial;
emotional stress;
long-term stay “on your feet”;
dehydration, insufficient fluid intake;
taking medications that can increase the concentration of protein in the urine;
allergic reactions;
pregnancy period (the increasing size of the uterus puts pressure on the kidneys, which affects their filtration function).

Increased by nutrition

So, we continue to understand why protein appears in the urine. This may occur due to the consumption of such products:

protein without heat treatment (raw eggs, dairy products, fish and meat);
confectionery, sweets;
too hot, salty or spicy dishes;
alcoholic drinks, including beer;
vinegar-based sauces;
large volume of mineral water.

Pathological proteinuria

If, when deciphering a general urine test in adults, an increase in indicators is detected again, it is advisable to exclude the following pathologies: infectious disease in the genitourinary system, inflammation of the kidneys, bladder, renal failure, cystitis, nephrotic syndrome, nephritis, disruption of the renal tubules, diseases of the reproductive system in women and men, oncological pathologies of the kidneys, leukemia (blood cancer), cysts of the genitourinary system, myeloma. Pathologies affecting the transmission of impulses (concussion, epilepsy, stroke), sickle cell anemia, heart and vascular diseases are also excluded.

Renal and extrarenal proteinuria

The reasons for increased protein in the urine are not always easy to determine.

Renal proteinuria is of two types - tubular and tubular.

Tubular proteinuria is observed with:

immunosuppressive therapy;
acute interstitial nephritis;
Sjögren's syndrome;
long-term use of NSAIDs;
cryoglobulinemia (presence of cryoglobulin proteins in the blood that cause systemic vasculitis).

Glomerular proteinuria, which occurs due to damage to the glomeruli, which is observed in various forms of glomerulonephritis.

Extrarenal proteinuria can be prerenal or postrenal. Overflow proteinuria develops as a result of increased production of atypical low molecular weight proteins, causing acute kidney damage. It occurs in diseases such as rhabdomyolysis (the process of destruction of muscle cells) and multiple myeloma.

The causes of postrenal proteinuria are infections, urolithiasis, and various tumor processes in the kidneys. What does protein in urine mean in women?

Proteinuria while expecting a baby

Reference values during this period are 0-0.3 g/l 2. What causes protein in the urine of pregnant women?

If these indicators exceed acceptable standards, then the patient’s risk of developing gestational pyelonephritis increases. An increased level in the later stages (3rd trimester) is a reason to suspect gestosis, which is a serious complication manifested by increased pressure, massive swelling and muscle cramps. With pathological proteinuria, a pregnant woman experiences a general deterioration in health, chronic drowsiness and weakness, and high blood pressure. At the same time, the likelihood of developing oxygen starvation of the fetus, developmental disorders, miscarriage and premature birth increases. In addition, in the case of severe proteinuria, the likelihood of intrauterine fetal death increases 5 times.

Interpretation of a general urine test in adults

Deciphering requires the necessary medical qualifications, so experts do not recommend interpreting the results independently. This laboratory test is highly informative, easy to carry out and is considered fundamental in the diagnosis of any disease.

Parameters included in the general urine test:

organoleptic indicators (smell, color, volume, foaminess, transparency);
physicochemical values (acidity, density);
biochemical indicators (sugar, protein, ketone bodies, urobilin);
microscopic examination of sediment (leukocytes, erythrocytes, epithelial cells, casts, bacteria, salt crystals, fungi).

Only a doctor can evaluate the results obtained during the study and take into account the characteristics of the patient’s condition.

Why might it be necessary to determine protein in urine?

Diagnostics when the indicator deviates from the norm

As already mentioned, there is a daily norm for protein excreted in the urine, so any deviations from it should be the basis for a thorough medical examination. In order to accurately determine whether there is a particular pathology in the body, you should contact a nephrologist or urologist. If protein is detected in the urine in late pregnancy, then not only a doctor in the field of nephrology or urology, but also a therapist or gynecologist can solve this problem. Diagnostic measures include the following mandatory procedures:

Ultrasound of the bladder and kidneys;
MRI of the kidneys;
radioisotope diagnostics for the presence of various urological diseases;
urodynamic diagnostics;
uroflowmetry.

In addition to instrumental diagnostic techniques, the patient must undergo a urine test for traces of albumin and protein.

How to lower the level?

The treatment course to eliminate this problem depends on the factors that provoked it. If an increased protein content in the urine is detected, specialized therapy is prescribed aimed at eliminating the underlying disease. Due to the fact that this condition has many causes, a comprehensive diagnosis is necessary. First of all, the urinary system is examined.

Most often, when there is a high protein content in the urine, experts prescribe the following medications:

antibiotics, the action of which should be aimed at eliminating a specific pathogen, previously determined using laboratory tests;
anti-inflammatory drugs;
medications that can lower blood pressure;
antihistamines;
cytostatics (if necessary);
glucocorticosteroids;
painkillers, if the patient experiences severe pain.

As a rule, after eliminating the underlying pathology that provoked the change in protein levels in the urine, this value is normalized.

Preparing for analysis

In order for the analysis to give the most accurate result, the patient needs to know how to collect urine to detect daily proteinuria.

For urine, you need to purchase a special container. 24 hours before urine collection, you should avoid spicy, fatty, rich and salty foods, as well as vegetables, citrus fruits, and fatty foods. In addition, you should postpone taking medications for some time. Women of reproductive age should wait for urine tests if they are menstruating during this period.

When collecting urine, the genitals must be clean, otherwise the result will be unreliable. After collecting the liquid, cover the jar tightly with a lid and place it in a cool, dark place. The biomaterial can be stored for a maximum of two hours before testing.

We looked at what increased protein in the urine means.

An examination of the human body begins with general tests. Identified deviations from accepted norms during diagnostics allow specialists to assume or diagnose the patient.

Increased protein in the urine indicates a violation of certain functions of organs and systems. Why does this happen and when is this indicator a cause for concern?

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Classmates

The kidneys are responsible for normalizing the concentration of beneficial and harmful components in the plasma. That is, they remove substances that are in excess: water, salts, urea, creatinine, indican, uric acid, ammonium salts and others. If the protein in the urine is increased, this means that the functioning of the kidneys or the functionality of certain organs is impaired. In medicine, this phenomenon is called proteinuria.

A reliable picture of deviations from the norm can be obtained by repeating the test or collecting urine within 24 hours. In the latter case, experts take into account the concentration of protein molecules in the amount of urine produced per day. Depending on the result obtained, pathological proteinuria is divided into 3 degrees of severity in g/l:

Weak – 0.3-1.
Moderate – 1-3.
Significant – more than 3.

Based on the cause of the increase in protein in the urine, the phenomenon is classified into renal and extrarenal. Accepted standards depend on certain factors and are defined differently for children and adults.

Initially, specialists rely on data from a general urine test. To obtain expanded information, daily urine collection is prescribed.

Protein standards in various laboratories are measured in g/l or mg/l. That is, in one institution the tests indicate 0.021 g/l, in another – 21 mg/l. Units of measurement do not affect acceptable standards.

Vacuum urine collection system

The severity of proteinuria is calculated in its morning portion. The norms for increasing total protein in urine differ in children and adults; they should not exceed g/l in:

men and women – 0.033;
pregnant women – 0.14;
premature babies in the first month of life – 0088-0.845;
full-term infants in the first month of life – 0.094-0.455;
children from 2 months to one year – 0.070-0.315;
children 2-4 years old – 0.045-0.217;
children 4-10 years old – 0.050-0.223;
teenagers – 0.045-0.391.

As the body ages, the renal system works less smoothly, as evidenced by increased protein in the urine. Therefore, for the age category over 50 years, minor deviations from the norm are allowed. Increased protein in the urine of a teenager is explained by puberty and growth. However, its value should not exceed 0.3 g/l.

Increased protein in the urine is often a consequence of chronic diseases of the body. This fact is important to take into account when interpreting analysis indicators.

In daily urine

For daily analysis, there are different standards for increasing the concentration of protein in the urine. The permissible enzyme level in g/l, as in the general analysis, depends on age, for:

men and women – up to 0.15;
pregnant women – up to 0.2;
premature babies in the first month of life – 0.014-0.060;
full-term infants in the first month of life – 0.032-0.068;
children from 2 months to one year – 0.017-0.087;
children 2-4 years old – 0.020-0.121;
children 4-10 years old – 0.026-0.194;
teenagers – 0.029-0.238.

The daily volume of urine is collected in a clean container with an easy-to-empty neck. This container is sold in pharmacies. In case of increased protein in daily urine, the patient is referred for additional examination.

Causes

All causes of high protein in urine are renal and extrarenal in nature.

Why does it increase?

Temporary proteinuria can be provoked by:

excessive physical activity;
depression, nervous breakdown, stressful situations;
previous infectious and cold diseases;
hypothermia of the body;
use of certain medications;
collection of analysis with a concomitant increase in temperature;
allergic reactions;
a diet oversaturated with protein products: dairy foods, eggs, undercooked meat, etc.

Minor changes in kidney function go away on their own after eliminating the provoking factor.

In what diseases does the concentration of protein structures increase?

If all of the above reasons for increased protein in the urine are excluded, and repeated analysis confirms proteinuria, a thorough examination is performed. During diagnostics, specialists can detect the following kidney diseases, in which there is increased protein in the urine:

Pyelonephritis is an inflammation of the kidneys, in most cases of a bacterial nature.
Glomerulonephritis is a disease of the renal glomeruli.
Nephritis is a group of inflammatory kidney diseases, each of which is characterized by an individual etiology.
Oncological formations in the renal system.
Amyloidosis is a disorder of protein metabolism, as a result of which a protein-polysaccharide complex such as amyloid can be deposited in organs.
Kidney failure.
Polycystic kidney disease.
Cystitis is inflammation of the bladder.

Pathological changes in the kidneys can also occur against the background of diabetes mellitus and diabetes insipidus, hypertension, and heart failure.

In severe blood diseases (myeloma, leukemia, severe hemolysis), the amount of protein increases significantly, and the kidneys do not have time to reabsorb it. As a result, proteinuria develops. Other extrarenal causes that cause increased protein in the urine include inflammatory processes in the female and male reproductive systems, epilepsy, stroke, and concussion.

What to do if the protein content is high?

All therapeutic methods for proteinuria come down to a single goal - reducing the loss of useful substances. If the analysis shows “unhealthy” values, specialists first study why the protein in the urine is increased. They collect the patient’s medical history, find out hereditary connections, the presence of chronic diseases, and then prescribe a diagnosis. Often proteinuria is accompanied by certain symptoms, which enable the doctor to decide in what direction to act.

Proteinuria has been latent for a long time. It is discovered at the next preventive examination or when the disease clearly makes itself felt.

How to reduce?

Before deciding what to do if the protein in the urine is elevated, you should make sure that there is proteinuria. It is impossible to reduce the concentration of the substance in urine with any special drugs. The attending physician’s task is to find the original source of the problem and prescribe appropriate therapy.

If the increase in protein is caused by bacterial damage to the kidneys, you cannot do without taking antibiotics. In case of secondary proteinuria occurring against the background of an extrarenal disease, therapy for the underlying pathology is required. For example, for diabetes mellitus, treatment will consist of taking insulin or other drugs to restore the functionality of the pancreas.

All drugs prescribed for renal and extrarenal proteinuria can be classified into the following groups:

drugs that suppress the reaction of the body's immune system - immunosuppressants;
antibiotics of various groups;
diuretics – diuretics;
corticosteroids – artificial substitutes for corticosteroid hormone;
medications that lower blood pressure in hypertensive patients;
cytostatic agents;
drugs that reduce blood clotting;

Additional therapy methods aimed at reducing protein loss are selected individually for each patient. At the time of treatment, it is important to eliminate the above factors that provoke temporary proteinuria.

Do I need to stick to a diet?

A special diet for increased protein in the urine due to kidney disease is table No. 7 according to Pevzner. Adhering to an appropriate diet is especially recommended for acute and chronic kidney diseases. The diet is based on the following rules:

Consuming only vegetarian soups. You cannot prepare first courses based on fish and meat broths, as well as beans. You can add sour cream, butter, citric or acetic acid, various cereals and vegetables to soups.
No alcohol or carbonated drinks. They retain fluid in the body and negatively affect the functioning of many internal organs. The use of non-strong vegetable and fruit juices is allowed. During the treatment period, it is a good idea to give preference to blackcurrant juice, rosehip decoctions and herbs that are beneficial for the functioning of the kidneys.
Use of fish and meat. Low-fat varieties of poultry, beef, trimmed pork and boiled or baked seafood up to 150 g per day are allowed. It is strictly forbidden to consume smoked or salted fish and meat. Among the taboos are sausages, sausages, canned food, caviar, and stews without prior boiling.
Sauces, seasonings, spices. Dietary food with increased protein in the urine should consist of non-spicy dishes. It is forbidden to include pepper, mustard, horseradish in the diet. You should also avoid eating fish and meat sauces. Vegetable sour and sweet gravies will be useful.
Compliance with drinking regime. You should drink no more than 1 liter of free liquid per day.

It is not prohibited to add salt to dishes, but its amount should be limited. Despite some restrictions on protein foods, the consumption of dairy products is allowed, with the only exception being cheeses.

Dietary table according to Pevzner

Men are less likely to experience pathological proteinuria. This is due to the anatomical features of the structure of the urinary system. Increased protein content in the urine in men is more often provoked by a number of physiological factors listed above and improper collection of analysis.

Pathological disorders in the male body that lead to negative test results often occur against the background of the development of urological diseases. Dysfunction of the renal system and malfunctions of other internal organs occur with corresponding symptoms.

The cause-and-effect relationship of urine analysis with elevated protein in women is not much different from that in men. The clinical picture of pathological proteinuria is also similar. Only the symptoms of infectious and inflammatory processes in the reproductive system can be exceptional. A false positive test is also observed at the end of menstruation.

An increase in protein in the urine is often accompanied by and, which should not normally be present in urine. In this case, mandatory additional examination is required.

The development of the fetus in a woman’s body puts additional stress on the kidneys. For this reason, acceptable standards for pregnant women have been expanded. It is recommended to submit urine for general analysis throughout the entire period of pregnancy.

An increased level of protein in the urine and the presence of hypertension, toxicosis, and swelling if not treated in a timely manner are fraught with pathologies and abnormalities in the development of the fetus and the health of the expectant mother.

Normally, protein should be completely absent in a child’s urine. However, there are still acceptable standards for general and daily analysis, which do not indicate the development of diseases. Poor nutrition, excessive physical activity caused by the modern rhythm of life, hormonal changes do not go unnoticed in a growing body. But obtaining negative diagnostic results must be refuted by repeating the test. You should also not ignore additional alarming symptoms: drowsiness, fatigue, headaches, etc.

Conclusion

Proteinuria is an increase in protein in the urine, more than 0.3 g/l, caused by physiological or pathological factors. If in the first case, the phenomenon can go away after eliminating the source of the problem, then in the second, appropriate treatment is required.
Taking medications that eliminate bacterial and inflammatory processes in the renal system, as well as following a diet, give a favorable outcome. Especially if the pathology was diagnosed in a timely manner.
In order not to encounter severe proteinuria, experts recommend monitoring the health of the body and taking a general urine test at least once every six months. If alarming symptoms appear, you should immediately seek help from a doctor.

In contact with

Proteinuria is a condition in which protein is present in the urine. The phenomenon refers to the symptoms of a wide range of diseases. It is impossible to detect such an impurity in urine at home. To remove the compound from urine, it is necessary to act on the underlying pathology. The localization of the lesion can only be determined using laboratory, hardware and instrumental diagnostic methods. Without undergoing an examination, it is impossible to determine the cause of the deterioration. In 99% of cases, treatment is indicated for patients with a protein compound in their urine.

Proteinuria indicates the development of a serious pathological process in the body. It can be destructive, infectious-inflammatory or tumor in origin. The physiological function of the kidneys is disrupted - filtration, excretory (excretory). Toxic substances that should normally be eliminated from the body through urination accumulate in the blood, causing harmful effects.

What is the norm

When the body is in good condition, the protein compound is not contained in the urine at all. But taking into account the patient’s possible intake of Aminoglycoside, Colistin or Acetazolamide, the acceptable concentration is considered to be up to 0.033 g/l per day. In pregnant women, this value is 0.14 g/l, as hormonal and other physiological changes occur in the body. Depending on the concentration of the protein compound in the urine, proteinuria is classified into 4 degrees.

Occurs:

Microalbuminuria. Protein concentration – 30-300 mg/day
Mild degree. The condition can be quickly corrected. Protein content varies from 300 mg to 1 g/day
Average degree. The patient requires hospitalization. Protein concentration – 1-3 g/day
Severe degree. The patient is being treated in the intensive care unit. The presence of protein compounds exceeds 3000 mg/day

To correctly determine protein levels, you need to correctly submit your urine for testing. Morning urine is suitable for analysis, which should be collected in a clean, dry container immediately after hygiene measures. To compare protein levels, the doctor may order an analysis of the daily volume of urine - in this case, it will have to be collected over a 24-hour period.

Symptoms

As proteinuria increases, the patient experiences the following symptoms:

Twisting sensations in the joints of the arms and legs
Increased blood pressure, difficult to correct
Swelling in the arms, legs, face, and in severe pathologies, fluid accumulates inside the abdominal cavity
Pale skin, dizziness, feeling of general weakness
Cramps mainly at night
Lack of appetite
Chills, nausea
Increased fatigue
Unpleasant sensations in the lumbosacral back

Depending on the underlying cause that caused the urine to become saturated with protein, the patient may have an increase in body temperature. Additional symptoms are disturbances in sleep and brain activity, changes in the shade of urine - it becomes cloudy, containing characteristic flakes.

Causes

Factors that cause proteinuria are previous poisonings, burns, progressive or recently resolved infectious and inflammatory processes in the body. Other reasons are allergies, hypothermia, exposure to stress, and a genetic predisposition to the development of diseases that cause urine to become saturated with protein. The phenomenon also occurs due to taking certain medications and compression of the kidneys by the growing uterus (during pregnancy). Rarely, saturation of urine with protein is a consequence of poor nutrition: if it is dominated by the consumption of raw eggs and dairy products.

Polycystic kidney disease

Multiple cysts inside a paired organ are a consequence of genetic predisposition, previous lower back injuries, and the negative influence of endogenous and exogenous factors. The patient’s health condition does not bother him for a long time. He learns about polycystic disease during an examination for another reason or when tumors are suppurating. Proteinuria is a consequence of inflammation of cysts, which is dangerous due to organ abscess. If the neoplasms fester (for example, when bacteria transfer to the parenchyma from another pathogenic focus), in addition to the saturation of urine with a protein compound:

Body temperature rises significantly
There is severe pain in the lower back
Blood pressure levels decrease, which causes weakness, dizziness, and loss of appetite
Increased sweat production

When cysts suppurate, the patient is indicated for surgical treatment, followed by antibiotic therapy.

Pyelonephritis

Damage to the renal pelvis, which occurs due to exposure to pathogenic microflora, often bacteria. Men and women are equally susceptible to the disease. The reasons for the development of pathology are hypothermia, the transfer of pathogens from neighboring foci of inflammation, and the use of potent medications.

Symptoms of pyelonephritis:

Lower back pain
Increased body temperature
Weakness, lack of appetite, dizziness
Increased urge to urinate
Reduced blood pressure levels
Pallor, sleep disturbance

When the patient voices the listed complaints, he is examined and prescribed a diagnostic test. It is on the basis of the results of the study that the presence of a high volume of protein is determined, which serves as an indication for immediate hospitalization. Treatment is antibiotic therapy, administration of vitamins and non-steroidal anti-inflammatory drugs, hormones. Also, for pyelonephritis, nutritional correction is indicated: exclusion of salty, spicy, sour, and alcoholic foods.

Glomerulonephritis

Inflammation of the glomerular apparatus of the kidneys is a consequence of exposure to conditions of high air humidity, genetic predisposition, and poisoning.

Signs of glomerulonephritis:

Pain in the lower back when urinating, changing body position, or performing even a small amount of physical activity
Light pink coloration of urine
Increased body temperature
Weakness, lethargy, dizziness, lack of appetite and other signs associated with intoxication of the body

The presence of protein in urine is an indicator of the progression of a severe inflammatory process inside the kidneys.

Glomerulonephritis is eliminated through antibiotic therapy, the use of hemostatic drugs, hormones, and vitamins. The disease also requires adherence to a diet, reduced consumption of salt and water. Glomerulonephritis is dangerous due to renal failure, in which the only treatment option is hemodialysis, and then organ transplantation.

Amyloidosis and renal tuberculosis

Amyloidosis is a pathological condition in which toxic compounds – amyloids – accumulate in the body. The exact reasons for the development of the disease have not been established, but according to the observations of doctors, the main factor is hereditary predisposition. Those at risk for pathology include malignant tumors and autoimmune processes (systemic lupus erythematosus, scleroderma, rheumatoid arthritis).

Symptoms of amyloidosis:

Frequent urination
Decreased sensation in the arms and legs
Reduced blood pressure readings
Swelling of the arms and legs
Pale pink hue of urine
Weight gain (including due to edema)
Shortness of breath, chest pain
Dizziness

In severe forms of amyloidosis, total intoxication of the body occurs, accumulation of large amounts of fluid inside the tissues. Kidney tuberculosis is a pathological process in which the structure of the organ is destroyed. The cause of the development of pathology is infection with mycobacteria entering the blood through the hematogenous route.

The main manifestations of renal tuberculosis are dull pain in the lower back, an increase in body temperature to low levels, the presence of blood in the urine, and discomfort when urinating. Protein in urine is not the only symptom detected during analysis in patients with the disease in question. In tuberculosis, urine additionally contains mycobacteria and red blood cells.

Hypertonic disease

A pathological condition in which the patient’s blood pressure often increases, which is facilitated by:

Hereditary predisposition
Abuse of alcohol, junk food, chaotic medication use
Constant exposure to stress
Frequent exposure to high temperatures
Presence of obesity of 2 or more degrees

Hypertension is dangerous because of a crisis - a condition in which the level of blood pressure reaches unacceptably high limits. This leads to the development of a stroke. Protein in urine with hypertension indicates problems with blood clotting - the risk of clots increases. Blood clots can block the lumen of veins and arteries, block blood flow to organs, cause hypoxia, or break off.

Diabetes

One of the most severe endocrine diseases. The cause of development is hereditary predisposition, stress, alcoholism. Main manifestations of the disease:

Long-term healing of even small wounds
Thirst
Increased sweating
Increased daily diuresis

Proteinuria in diabetes mellitus indicates a significant imbalance of hormones in the blood and confirms the presence of pancreatic dysfunction. To maintain insulin levels in the body at normal levels and avoid the development of coma, you need to visit an endocrinologist.

Preeclampsia in pregnant women

Consequence of stress factors, hereditary predisposition, age over 40 years, taking medications. The presence of proteinuria during gestation is a sign that the child’s growth and development may be impaired. The reason is insufficient blood flow to the fetus, intoxication with compounds that accumulate in the blood due to the failure of the kidneys to filter.

A woman’s blood pressure levels rise to critical levels, a severe headache occurs, and convulsions appear. If there is a massive loss of protein during urination, albumin transfusion is indicated for all pregnant women. This action relates to replacement therapy, reduces the likelihood of fetal death, placental abruption, and premature birth.

Atherosclerosis of the renal arteries

A serious disease of the cardiovascular system, in which the arteries supplying the paired organ with blood are clogged with fatty deposits. Atherosclerotic plaques form gradually, this is accompanied by poor nutrition, staying near foci of toxic effects, and the heredity factor. Proteinuria indicates impaired renal function, which leads to necrosis of organ tissue due to insufficient blood supply. In case of aggravated atherosclerosis of the renal arteries, organ-preserving surgery is performed.

Cystitis

Inflammation of the bladder develops for several reasons, the main of which are:

Hypothermia
Introducing bacteria from other foci of inflammation (with vaginal candidiasis, colitis, pyelonephritis)
Failure to comply with personal hygiene rules
Recent medical and diagnostic procedures using non-sterile instruments
Excessive activity during intimacy
Allergy to latex condoms; intolerance to the fabric from which pads and tampons are made
Unprotected sexual intercourse with a partner who does not maintain personal hygiene
Suffered severe poisoning - food, drug or other type

In women, cystitis occurs more often than in men, which is associated with the anatomical features of the urinary canal. Proteinuria during inflammation of the bladder is a sign of extensive damage to the organ, an indicator of the risk of a possible transition of the pathological process to the kidneys. Symptoms of cystitis are pain and burning during urine discharge, a feeling of incomplete emptying of the bladder, spasms above the pubis, increased body temperature. Cystitis is eliminated with antibiotics, uroseptics, and non-steroidal anti-inflammatory drugs. Additionally, it is recommended to apply a heating pad to the suprapubic area, but provided there is no hematuria (when the urine is saturated with blood).

Urethritis

Inflammation of the urethra is a consequence of insufficient personal hygiene, hypothermia, wearing too tight underwear, allergies. Urethritis is manifested by proteinuria in a chronic course and a high probability of spread of the lesion to neighboring organs. Manifestations of the pathology are irritation during urination, a slight increase in body temperature, swelling of the urethra, redness of the tissues of the vulva. Treatment does not differ from the therapy used for the development of cystitis.

Prostatitis in men

Inflammation of the prostate gland is a consequence of factors such as hypothermia, physical inactivity, lack of constant sexual activity, and the presence of a sexually transmitted disease. Prostatitis also occurs with a genetic predisposition to the disease. Signs of prostate inflammation:

Pain when urinating, pain inside the urethra
Increased body temperature
Urine discharge in a sluggish, intermittent stream
Discomfort in the perineum when a man is in a sitting position
The appearance of an unpleasant odor from urine, a change in color
The need to tense the abdominal muscles to completely empty the bladder

Protein in urine in men suffering from prostatitis indicates extensive damage to organ tissue and the development of hormonal imbalance. If acute prostatitis is not eliminated in a timely manner, it becomes chronic. The disease can lead to the development of impotence and cause infertility. The inflammatory and infectious process of the prostate gland is treated with antibiotics, non-steroidal drugs, hormonal drugs, and vitamins. Additionally, prostate massage and a number of physiotherapeutic procedures are prescribed.

Inflammation of the ureters

The disease is promoted by hypothermia, the movement of pathogenic microflora from neighboring lesions, and prolonged inhibition of the urge to urinate. Also, inflammation of the ureters occurs due to poor personal hygiene, abuse of salty, sour and spicy foods.

The pathology is eliminated by using antibiotics, uroseptics (Furazolidone and its analogues), and multivitamin complexes. Additionally, adherence to a diet is indicated - refusal to eat salty, sour, spicy, smoked foods; exclusion of alcohol, fruit drinks, caffeine. Proteinuria during inflammation of the ureters is an indicator of the lack of proper treatment, a signal of the imminent transition of the pathological process to the kidneys and bladder.

Possible complications

Proteins perform a wide range of functions in the body:

adjust hormone levels
balance the degree of blood clotting
protect the body from attacks by pathogens of all types
support tissue structure, preventing the degeneration of cells from physiological to malignant

Complications associated with increased protein compounds in the blood include hormonal imbalance, reduced immunity and predisposition to diseases, including cancer. Depending on the underlying cause of proteinuria, the patient may experience a kidney abscess, failure of this organ; in pregnant women – premature birth, placental abruption. If urine is oversaturated with protein compounds, fetal death may occur - the kidneys cannot cope with the filtration function and toxins accumulate in the blood.

Which doctor should I contact?

Initially, if your health worsens, you should visit a therapist: he will prescribe a basic examination. Taking into account the diagnostic results, the underlying pathology is established. This is how the profile of the doctor is determined, who will subsequently prescribe, monitor and adjust therapy. If protein is detected in the urine of pregnant women, a treatment plan is drawn up by the observing gynecologist. Proteinuria caused by diabetes mellitus is treated by an endocrinologist. If protein saturates the urine due to inflammation of the urogenital tract, you will need to consult a urologist. If there is a relationship between increased protein in urine and hypertension, contact a cardiologist.

Diagnostics

To establish the root cause of urine saturation with protein, extensive diagnostics are prescribed. Basic methods:

Clinical, biochemical blood test.
Urinalysis - general, bacteriological, according to Zimnitsky, according to Nechiporenko.
Ultrasound of the kidneys, bladder, ureters (depending on the organ whose usefulness the doctor has doubts about).
MRI or CT. Complex radiation imaging methods provide information about the state of health when other types of diagnostics are less informative.
X-ray examination (a general overview image allows you to assess the condition and location of the kidneys).
Urethral smear to determine microflora.
Urine examination for mycobacteria (if kidney tuberculosis is suspected).

Additional types of diagnostics depend on the characteristics of the clinical case. It is possible to prescribe a Doppler ultrasound, a blood test to determine its sugar level, and excretory urography.

Treatment

To eliminate protein from urine and stop the underlying disease that caused proteinuria, patients are prescribed:

Corticosteroids. Hydrocortisone, Prednisolone or Dexamethasone prevent the development of inflammation and restore renal activity. Hormonal drugs are administered taking into account the patient’s weight and age.
Antibacterial drugs. A specific type of antibiotic is prescribed only taking into account the identified causative agent of the underlying pathology that caused proteinuria.
Non-steroidal drugs (NSAIDs). Drugs in this group relieve pain and eliminate the process of inflammation. General contraindications for the use of NSAIDs are the presence of gastritis, colitis, gastric or duodenal ulcers.
Vitamins. Synthetic substitutes for biologically active substances help restore immunity and normalize blood circulation.
Antihypertensive drugs. Allows you to normalize blood pressure, avoid the development of crisis and hemorrhagic stroke.

For kidney tuberculosis, medications are prescribed to prevent the organ tissue from shrinking. Copious bleeding during urination (for example, with glomerulonephritis) is an indication for the use of Dicinone, Calcium chloride, Sodium ethamsylate, Aminocaproic acid. In case of hypertensive crisis, the patient is prescribed the administration of Dibazol, Papaverine, Magnesium sulfate. These drugs help quickly normalize blood pressure levels.

Prevention

To prevent the development of diseases that are characterized by saturation of urine with protein, it is necessary:

Avoid hypothermia.
During sports or professional activities, protect the body from possible injuries.
Keep your distance from sources of toxic or radiation radiation.
Do not use medications without a doctor's prescription.
Control your diet and avoid the presence of unnatural products in it.
Carry out hygiene measures carefully and regularly.
Stop drinking alcohol and other bad habits.

Protein in the urine is a signal of a serious disorder in the body. It is possible that it has a hidden form, but this does not make the degree of negative impact on health less. To get rid of proteinuria, the underlying condition that caused this symptom is eliminated. Depending on the identified disease, the use of antibiotics, anti-tuberculosis drugs, and hormones is prescribed.

A slight increase in protein in the urine is acceptable during pregnancy. But, given the frequent development of preeclampsia in pregnant women, women with proteinuria are under increased control by gynecologists.

Video: Decoding urine test

[06-038 ] Total protein in urine

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This is a clinical and laboratory sign of kidney damage, used to diagnose kidney diseases and monitor treatment.

SynonymsEnglish

Urine total protein, urine protein, 24-Hour Urine Protein.

Research method

Colorimetric photometric method.

Units

G/l (grams per liter), g/day. (grams per day).

What biomaterial can be used for research?

The average portion of morning urine, daily urine.

How to properly prepare for research?

Do not drink alcohol for 24 hours before the test.
Avoid taking diuretics for 48 hours before donating urine (in consultation with your doctor).

General information about the study

Total protein in urine is an early and sensitive sign of primary kidney diseases and secondary nephropathies in systemic diseases. Normally, only a small amount of protein is lost in the urine due to the filtration mechanism of the renal glomerulus - a filter that prevents the penetration of large charged proteins into the primary filtrate. While low molecular weight proteins (less than 20,000 daltons) freely pass through the glomerular filter, the supply of high molecular weight albumin (65,000 daltons) is limited. Most of the protein is reabsorbed into the bloodstream in the proximal tubules of the kidney, with the result that only a small amount is ultimately excreted in the urine. About 20% of the protein secreted normally is low molecular weight immunoglobulins, and 40% each is albumin and mucoproteins secreted in the distal renal tubules. Normal protein loss is 40-80 mg per day, the release of more than 150 mg per day is called proteinuria. In this case, the main amount of protein is albumin.

It should be noted that in most cases, proteinuria is not a pathological sign. Protein in the urine is detected in 17% of the population and only 2% of them cause serious illness. In other cases, proteinuria is considered functional (or benign); it is observed in many conditions, such as fever, increased physical activity, stress, acute infectious disease, and dehydration. Such proteinuria is not associated with kidney disease, and protein loss is insignificant (less than 2 g/day). One of the types of functional proteinuria is orthostatic (postural) proteinuria, when protein in the urine is detected only after prolonged standing or walking and is absent in a horizontal position. Therefore, with orthostatic proteinuria, an analysis of total protein in the morning urine will be negative, and an analysis of 24-hour urine will reveal the presence of protein. Orthostatic proteinuria occurs in 3-5% of people under 30 years of age.

Protein in the urine also appears as a result of its excess production in the body and increased filtration in the kidneys. In this case, the amount of protein entering the filtrate exceeds the possibilities of reabsorption in the renal tubules and is ultimately excreted in the urine. This “overflow” proteinuria is also not associated with kidney disease. It can accompany hemoglobinuria with intravascular hemolysis, myoglobinuria with muscle tissue damage, multiple myeloma and other plasma cell diseases. With this type of proteinuria, it is not albumin that is present in the urine, but some specific protein (hemoglobin in hemolysis, Bence Jones protein in myeloma). In order to identify specific proteins in urine, a 24-hour urine test is used.

For many kidney diseases, proteinuria is a characteristic and constant symptom. According to the mechanism of occurrence, renal proteinuria is divided into glomerular and tubular. Proteinuria, in which protein in the urine appears as a result of damage to the basement membrane, is called glomerular. The glomerular basement membrane is the main anatomical and functional barrier to large and charged molecules; therefore, when it is damaged, proteins freely enter the primary filtrate and are excreted in the urine. Damage to the basement membrane can occur primarily (in idiopathic membranous glomerulonephritis) or secondary, as a complication of a disease (in diabetic nephropathy due to diabetes mellitus). The most common is glomerular proteinuria. Diseases accompanied by damage to the basement membrane and glomerular proteinuria include lipoid nephrosis, idiopathic membranous glomerulonephritis, focal segmental glomerular sclerosis and other primary glomerulopathies, as well as diabetes mellitus, connective tissue diseases, post-streptococcal glomerulonephritis and other secondary glomerulopathies. Glomerular proteinuria is also characteristic of kidney damage associated with certain medications (non-steroidal anti-inflammatory drugs, penicillamine, lithium, opiates). The most common cause of glomerular proteinuria is diabetes mellitus and its complication – diabetic nephropathy. The early stage of diabetic nephropathy is characterized by the secretion of a small amount of protein (30-300 mg/day), the so-called microalbuminuria. As diabetic nephropathy progresses, protein loss increases (macroalbuminemia). The degree of glomerular proteinuria varies, often exceeding 2 g per day and can reach more than 5 g of protein per day.

When protein reabsorption function in the renal tubules is impaired, tubular proteinuria occurs. As a rule, protein loss with this option does not reach such high values as with glomerular proteinuria, and amounts to up to 2 g per day. Impaired protein reabsorption and tubular proteinuria are accompanied by hypertensive nephroangiosclerosis, urate nephropathy, intoxication with lead and mercury salts, Fanconi syndrome, as well as drug-induced nephropathy when using non-steroidal anti-inflammatory drugs and some antibiotics. The most common cause of tubular proteinuria is hypertension and its complication – hypertensive nephroangiosclerosis.

An increase in protein in the urine is observed in infectious diseases of the urinary system (cystitis, urethritis), as well as in renal cell carcinoma and bladder cancer.

The loss of a significant amount of protein in the urine (more than 3-3.5 g/l) leads to hypoalbuminemia, a decrease in blood oncotic pressure and both external and internal edema (edema of the lower extremities, ascites). Significant proteinuria provides an unfavorable prognosis for chronic renal failure. Persistent loss of small amounts of albumin does not cause any symptoms. The danger of microalbuminuria is the increased risk of coronary heart disease (especially myocardial infarction).

Quite often, as a result of a variety of reasons, the analysis of morning urine for total protein is false positive. Therefore, proteinuria is diagnosed only after repeated analysis. If two or more tests of the morning urine sample are positive for total protein, proteinuria is considered persistent, and the examination is supplemented by an analysis of 24-hour urine for total protein.

Testing morning urine for total protein is a screening method for detecting proteinuria. It does not allow assessment of the degree of proteinuria. In addition, the method is sensitive to albumin, but does not detect low molecular weight proteins (for example, Bence Jones protein in myeloma). In order to determine the degree of proteinuria in a patient with a positive morning urine sample for total protein, 24-hour urine is also tested for total protein. If multiple myeloma is suspected, 24-hour urine is also analyzed, and it is necessary to conduct additional research for specific proteins - electrophoresis. It should be noted that analysis of 24-hour urine for total protein does not differentiate the variants of proteinuria and does not reveal the exact cause of the disease, so it must be supplemented with some other laboratory and instrumental methods.

What is the research used for?

For the diagnosis of lipoid nephrosis, idiopathic membranous glomerulonephritis, focal segmental glomerular sclerosis and other primary glomerulopathies.
For the diagnosis of kidney damage in diabetes mellitus, systemic connective tissue diseases (systemic lupus erythematosus), amyloidosis and other multiorgan diseases with possible kidney involvement.
For the diagnosis of kidney damage in patients at increased risk of chronic renal failure.
To assess the risk of developing chronic renal failure and coronary heart disease in patients with kidney disease.
To assess renal function during treatment with nephrotoxic drugs: aminoglycosides (gentamicin), amphotericin B, cisplatin, cyclosporine, non-steroidal anti-inflammatory drugs (aspirin, diclofenac), ACE inhibitors (enalapril, ramipril), sulfonamides, penicillin, thiazide, furosemide and some others.

When is the study scheduled?

For symptoms of nephropathy: edema of the lower extremities and periorbital region, ascites, weight gain, arterial hypertension, micro- and gross hematuria, oliguria, increased fatigue.
For diabetes mellitus, systemic connective tissue diseases, amyloidosis and other multi-organ diseases with possible kidney involvement.
With existing risk factors for chronic renal failure: arterial hypertension, smoking, heredity, age over 50 years, obesity.
When assessing the risk of developing chronic renal failure and coronary heart disease in patients with kidney disease.
When prescribing nephrotoxic drugs: aminoglycosides, amphotericin B, cisplatin, cyclosporine, non-steroidal anti-inflammatory drugs, ACE inhibitors, sulfonamides, penicillins, thiazide diuretics, furosemide and some others.

What do the results mean?

Reference values (average morning urine sample)

Concentration:

Reference values (daily urine)

Highlight:

after heavy physical activity

Reasons for increased levels of total protein in urine:

1. Kidney diseases:

primary kidney diseases: lipoid nephrosis, idiopathic membranous glomerulonephritis, focal segmental glomerular sclerosis, IgA glomerulonephritis, membranoproliferative glomerulonephritis, pyelonephritis, Fanconi syndrome, acute tubulointerstitial nephritis;
kidney damage in systemic diseases: diabetes mellitus, arterial hypertension, systemic connective tissue diseases, amyloidosis, post-streptococcal glomerulonephritis, preeclampsia, urate nephropathy, malignant neoplasms (lungs, gastrointestinal tract, blood), sickle cell anemia, etc.;
kidney damage during treatment with nephrotoxic drugs: aminoglycosides, amphotericin B, cisplatin, cyclosporine, non-steroidal anti-inflammatory drugs, ACE inhibitors, sulfonamides, penicillins, thiazides, furosemide and some others;
kidney damage due to poisoning with lead and mercury salts;
renal cell carcinoma.

2. Increased protein production and filtration in the body (overflow proteinuria):

multiple myeloma, Waldenström's macroglobulinemia;
hemoglobinuria with intravascular hemolysis;
myoglobinuria due to damage to muscle tissue.

3. Transient (benign) proteinuria.