Urine Tests: What High Protein Levels Mean for Kidney Health

Urinalysis for renal function assessment?

Doctor, I visited the clinic due to anxiety-related hypertension and underwent a urinalysis, which revealed proteinuria at 20.51 mg/dL (normal range 0-20 mg/dL) and creatinine at 26.60 mg/dL (normal range 0-250 mg/dL).
However, the ratio of urine protein to creatinine was significantly elevated at 771.05 (normal range 0-150).
The doctor mentioned that there is an issue with glomerular filtration.
Since I was seen at a general practice clinic, do I need to follow up at a larger hospital for this value? Thank you.

Mǐnī, 40~49 year old female. Ask Date: 2021/01/16

Dr. Wu Jiyu reply Internal Medicine

In the past, testing for proteinuria required a 24-hour urine collection, but this is no longer necessary.
Now, a single urine sample can be tested for protein and creatinine to provide a rough estimate.
For example, (20.51/26.6)*1000=771, which is greater than the normal value of 150.
This preliminary assessment indicates a potential issue, and it is recommended to consult a nephrologist for further evaluation.
Thank you for your inquiry.
Changhua Hospital, Nephrology Department cares about you.

Reply Date: 2021/01/16

More Info

High levels of protein in urine, known as proteinuria, can be a significant indicator of kidney health and function. When evaluating kidney health, urine tests are essential tools that help in diagnosing potential kidney issues. In your case, the urine protein level of 20.51 mg/dL is slightly above the normal range, and the urine protein to creatinine ratio (U-PCR) of 771.05 is notably elevated, indicating a significant amount of protein being excreted in your urine.

Proteinuria can arise from various causes, including kidney damage, systemic diseases such as diabetes or hypertension, or even transient conditions like dehydration or stress. The kidneys filter waste and excess substances from the blood, and when they are damaged or diseased, they may allow protein to leak into the urine. The presence of protein in urine is often one of the first signs of kidney dysfunction.

The U-PCR is a crucial metric because it provides a more accurate assessment of proteinuria by accounting for variations in urine concentration. A U-PCR greater than 150 mg/g is generally considered abnormal and warrants further investigation. Your U-PCR of 771.05 suggests a significant protein loss, which could indicate conditions such as glomerulonephritis, diabetic nephropathy, or nephrotic syndrome.

Given your elevated protein levels and U-PCR, it is advisable to follow up with a nephrologist (kidney specialist) at a larger medical facility. They can perform more comprehensive tests, including blood tests to assess kidney function (such as serum creatinine and estimated glomerular filtration rate, eGFR), and possibly imaging studies or a kidney biopsy if necessary. A kidney biopsy can provide definitive information about the underlying cause of the proteinuria, especially if the protein levels remain elevated or if there are other concerning symptoms.

In addition to seeking further medical evaluation, it is essential to monitor your blood pressure closely, as hypertension can exacerbate kidney damage. Lifestyle modifications, including a balanced diet low in sodium and protein, regular exercise, and maintaining a healthy weight, can also help manage both blood pressure and kidney health.

In summary, your elevated protein levels and U-PCR are concerning and should not be ignored. It is crucial to seek further evaluation from a nephrologist to determine the underlying cause and appropriate management of your kidney health. Early intervention can help prevent further kidney damage and improve your overall health outcomes.

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