Proteinuria: Key Questions and Considerations

Q: Proteinuria: Key Questions and Considerations

Hello： Albumin is just one component of proteinuria. <br>In other words, if the urine protein level is 0.15 g/L, then the absolute amount of albumin in the urine is less than 0.15 g/d (at most, all protein could be albumin). <br>Testing for microalbuminuria is more ideal, especia

Proteinuria - Supplementary Questions

Therefore, when urine protein is greater than 0.15 g/d, several issues need to be considered: 1.
Is the urine protein primarily albumin? 2.
Was the urine sample collected during a time when the daily urine volume was close to 1-1.5 liters? Otherwise, there may be a possibility of overestimation.
Thank you very much, Dr.
Wu, for your response.
Today, I would like to add a few questions.
When I went for a follow-up on proteinuria in the nephrology department, the doctor indicated that the second urine test did not show any proteinuria reaction.
The report indeed showed -/<25 for the proteinuria test.
The random urine sample was collected after noon, and the report did not mention whether it was primarily albumin.
Dr.
Wu mentioned a calculation formula; is it derived from the microalbumin results divided by urine creatinine? However, I did not arrange for the microalbumin test at that time, so does my test result of 0.15 g/L (reference value is 0.12 g/L) not apply to the calculation formula mentioned by Dr.
Wu? As it stands, could you please tell me if my proteinuria test is considered normal? I would appreciate Dr.
Wu's help in answering these questions.
Thank you.

JJ, 30~39 year old female. Ask Date: 2016/10/04

Dr. Wu Hongjie reply Internal Medicine

Hello: Albumin is just one component of proteinuria.
In other words, if the urine protein level is 0.15 g/L, then the absolute amount of albumin in the urine is less than 0.15 g/d (at most, all protein could be albumin).
Testing for microalbuminuria is more ideal, especially for patients with diabetes, as a level of 30 mg (0.03 g) is already significant.
For non-diabetic patients or other specific renal disease populations, proteinuria can be used as a substitute (U protein) with a threshold of <0.15 g/L considered normal.
Proteinuria is often detected through a single urine sample, so if a positive result occurs, it should be confirmed again to increase accuracy.
Based on your situation, the hospital considers you a non-diabetic patient, so using U PROTEIN instead of MICROALBUMIN is appropriate; the first test was positive, and the second test was negative (normal).
It is recommended that you ask your physician to test for microalbuminuria to alleviate your concerns.
Generally, to confirm the presence of urine protein, at least 2-3 positive results from single urine tests are needed to diagnose proteinuria.
Wishing you all the best.

Reply Date: 2016/10/04

More Info

Understanding proteinuria is crucial for assessing kidney health and overall well-being. Proteinuria refers to the presence of excess protein in the urine, which can be an indicator of various underlying health issues, particularly kidney disease. When urine protein levels exceed 0.15 g/d, it is essential to consider several factors to understand the implications fully.

Key Considerations for Proteinuria
1. Type of Protein: The primary concern is whether the protein present in the urine is predominantly albumin. Albumin is a type of protein that is typically found in the blood, and its presence in urine can indicate kidney damage or dysfunction. Other proteins may also appear in urine, but albumin is the most clinically significant marker for kidney health. If your urine test does not specify the type of protein, it may be beneficial to request a microalbumin test, which can provide more detailed information about albumin levels.

2. Sample Collection Timing: The timing of urine sample collection can significantly affect the results. Ideally, urine samples should be collected when the total daily urine output is approximately 1-1.5 liters. If the sample is collected at a time when urine concentration is unusually high or low, it may lead to inaccurate results. For instance, a random sample taken at a time of dehydration may show elevated protein levels, while a well-hydrated state may yield more accurate readings.

3. Follow-Up Testing: In your case, the follow-up test showing no proteinuria is a positive sign. It suggests that the initial reading may have been an anomaly, possibly due to transient factors such as dehydration, exercise, or stress. It is not uncommon for protein levels to fluctuate, and a single abnormal result does not necessarily indicate chronic kidney disease.

4. Understanding Your Results: The reported value of 0.15 g/L, which is slightly above the reference value of 0.12 g/L, indicates mild proteinuria. However, without a microalbumin test, it is challenging to determine the significance of this finding fully. The calculation you mentioned (microalbumin result divided by urine creatinine) is typically used to assess the degree of albuminuria and is particularly useful in diabetic patients or those at risk for kidney disease.

5. Clinical Context: It is essential to interpret proteinuria in the context of your overall health, medical history, and any existing conditions. For example, if you have risk factors for kidney disease (such as diabetes, hypertension, or a family history of kidney issues), your healthcare provider may recommend more frequent monitoring or additional tests.

Conclusion
In summary, while your recent test showing no proteinuria is encouraging, it is essential to continue monitoring your kidney health, especially if you have risk factors or symptoms that warrant further investigation. If you have concerns about your protein levels or kidney function, discussing these with your healthcare provider is crucial. They can provide tailored advice based on your specific situation, including whether additional tests like microalbuminuria are necessary. Regular follow-ups and a comprehensive approach to managing your health will help ensure that any potential issues are addressed promptly.

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