What Does It Mean If Protein In Urine – The main protein in blood is albumin. Protein has many important functions in the body, including helping to build bones and muscles, preventing infection, and regulating the amount of fluid in the blood.
Each normal kidney contains about one million functional units called nephrons. Each nephron has a filtering unit called glomerulus that filters blood and produces filtrate. Nephrons also have tubular parts called tubules that absorb and excrete the urinary component of the filtrate and eventually produce urine for excretion. Protein in the urine, known as proteinuria, is one of the main symptoms of kidney disease.
What Does It Mean If Protein In Urine
Healthy kidneys remove excess water and waste from food, but also transport proteins and other important nutrients back into the blood. When the kidneys are functioning normally, some protein (albumin) can pass through the filter in the urine. If there is protein in the urine, it is called proteinuria (or albuminuria). Protein in the urine can be an early sign of nephrotic syndrome or kidney disease.
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Anyone can develop proteinuria. Your risk may be higher if you have one or more of the following risk factors for kidney disease:
A normal kidney produces about 180 liters of plasma filtrate (a component of blood) per day. A volume of plasma filtered to obtain 180 liters of filtrate contains approximately 10 kg of protein. However, only 0.01% or 1 g of protein enters the filtrate from the glomerulus. This is due to a “filtration barrier” within the glomeruli that prevents the passage of larger molecules such as albumin into the urine and allows water and smaller solvents to pass through. Only a small amount of albumin is excreted in the urine due to the filtration barrier. Small molecules called low molecular weight (LMW) proteins can easily pass through the filtration barrier and enter the filtrate. As LMW proteins are reabsorbed by the renal tubules, these small molecules have a reduced filtration load and are ultimately excreted in smaller amounts. Urine also contains small amounts of proteins (such as Tamm-Horsfall protein) that are excreted directly by the kidneys into the urine without being filtered.
Proteins found in urine fall into two main categories: plasma proteins (mainly albumin, although in small amounts) and proteins secreted by the renal tubules. Taken together, less than 150 mg of protein is excreted in the urine per day, with less than 30 mg of albumin per day.
Proteinuria is common in healthy young people because of their upright posture. This is called positional proteinuria and is usually less than 1 gram per day. In this case, random urine samples showed protein, but the first morning urine sample (after going to bed each night) did not. This condition is benign and does not indicate kidney disease. There are diurnal fluctuations in protein excretion in normal individuals and in patients with chronic kidney disease (CKD). At night, protein excretion is lower than during the day, and turnover is lower. Samples taken on the first morning void were more likely to more accurately predict 24-hour protein and albumin excretion.
Urine And Urination
If your kidneys start to have problems and your urine doesn’t have a lot of protein, you may not have any symptoms. The only way to know if you have protein in your urine is through a urinalysis. A urine protein test measures the amount of albumin in the urine compared to the amount of creatinine in the urine.
As kidney damage occurs and large amounts of protein are excreted in the urine, symptoms may include:
If you have these symptoms, you may have serious kidney damage. Talk to your doctor right away about what your symptoms might be and what the best treatment is for your situation.
Routine complete urinalysis tests use multi-reagent dipsticks to screen for protein in the urine. It provides low cost, widely available and rapid maintenance information. These dipstick reagents feature a pH-sensitive colorimetric indicator that changes color upon protein binding. Proteinuria was estimated semiquantitatively based on color (reported as trace/+/++/+++). These strips primarily detect albumin and are likely to miss non-albumin and small LMW proteins. Urine that is too dilute can give false negative results, and urine that is too concentrated can give false positive results. Blood in the urine can also give false positive results, which is common in menstruating women if the urine sample is taken during menstruation.
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Proteinuria that is repeatedly positive on dipsticks requires quantification, which can be done with a 24-hour urine total protein or albumin quantification (gold standard), i.e., a 24-hour urine collection. Urine.
A 24-hour urine collection is the gold standard for measuring protein excretion. The main problem with this method is that urine collection is not accurate, as it can be cumbersome. A random or spot urine protein sample is usually inaccurate due to variation in urine concentration due to the patient’s hydration status and diurnal variations in protein excretion.
For urine concentration and fluctuation of protein excretion, protein-to-creatinine ratio (PCR) and albumin-to-creatinine ratio (ACR) are used. They are calculated by dividing the urine protein concentration by the urine creatinine concentration in the same sample. This solves the problem of urine concentration and diurnal variation in protein excretion by taking the first urine sample early in the morning. Overall, PCR and ACR values can provide reliable information for physicians and are easy to perform for patients.
If protein is found on a complete urine test (using the dipstick method), it should be confirmed by repeat testing. If a complete urinalysis reveals persistent proteinuria and temporary causes of proteinuria are ruled out, the protein in the urine should be measured and an ophthalmologist should be consulted for further evaluation and treatment. Should.
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Next steps in management include assessment of renal function (measurement of blood urea and serum creatinine), as well as urinalysis and microscopy to check for red blood cells in the urine, and to look at kidney and bladder size and evidence. Ultrasonography is included. stone. Based on the information obtained after the above examination and clinical examination, a renal biopsy may be required to further clarify the specific cause of proteinuria, to further guide treatment.
If you have diabetes or high blood pressure (a major cause of kidney disease), it’s important to keep these conditions well under control.
If you have diabetes, manage your blood sugar by checking your blood sugar levels, taking medications as directed by your doctor, and maintaining a healthy diet and exercise plan. If you have high blood pressure, your doctor may prescribe medication to lower your blood pressure and protect your kidneys from further damage.
If you have protein in your urine but don’t have diabetes or high blood pressure, talk to your doctor about the best treatment for your situation.
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