Increased protein in urinalysis is proteinuria. Proteins enter the urine from the blood plasma. Albumins make up the majority, and tissue proteins are represented mainly by complex glycoproteins. They are synthesized by the mucous organs of the genitourinary system and the renal tubules. In apparently he althy individuals, the protein should not be present or it may be in minimal amounts. If the urine test showed protein, this is a reason for additional examination.
General information
Protein, or, it is also called protein, is the main material that is present in all structures of the body, including biofluids. Due to the good filtration capacity of the kidneys, it is detected in the primary urine in minimal quantities. Further, the process of reverse absorption of the protein in the renal tubules is carried out. If an individual has he althy kidneys and there is no excess protein in the blood plasma, then in the biofluid that leaves the body, it is present in small volumes or absent. The provocateurs of increasing its level are both physiological and pathological reasons.
Proteins perform the following functions in the body of an individual:
- Form colloid osmotic blood pressure.
- Provides a response to an internal or external stimulus.
- Participate in the construction of intercellular connections and new cells, as well as in the creation of enzyme substances that promote the flow of biochemical reactions.
If the protein in the urine as a result of the analysis was found in excess of the allowable values, then this phenomenon is called proteinuria. In this case, an additional examination is recommended to the individual, the purpose of which is to find the cause of the failure.
Types of pathological proteinuria
Depending on the source of the appearance of protein in the urine, there are such types of abnormal disorders as:
- Prerenal - is formed as a result of the presence of a significant amount of various protein compounds in the blood plasma. As a result, the renal tubules cannot cope, as they cannot absorb proteins in a large volume. In addition, a violation can also occur with the introduction of albumin from the outside, i.e. artificially, against the background of the course of nephrotic syndrome.
- Renal or renal - formed against the background of kidney disease. It occurs when the normal process of protein reuptake is disrupted, in which case it is called tubular or it is also called tubular. If the provocative factor is a failure at the level of the cleansing ability of the renal glomeruli, then this is glomerular (tubular) proteinuria.
- Postrenal - appears as a result of pathogenicprocesses occurring in the urinary tract. The protein enters the urine that has exited the kidney filter.
- Secretory - against the background of some diseases, specific proteins and antigens are secreted.
Types of functional proteinuria
They are temporary and are not accompanied by diseases of the genitourinary system and kidneys. Among them, proteinuria is distinguished:
- Lordotic, or postural - protein appears in urine after a long stay in a mobile vertical position, as well as walking in children, adolescents and young individuals with an asthenic physique.
- Emotional - is the result of severe stress.
- Stress (otherwise it is called working(- most often found in military personnel and athletes, i.e. with high physical activity.
- Feverish - detected in case of damage to the kidney filter against a background of very high temperature.
- Palpation - occurs with prolonged and intense palpation in the abdomen.
- Alimentary - after eating protein-rich foods.
- Centrogenic - epilepsy or concussion is considered to be the cause of its occurrence.
- Congestive - occurs as a result of oxygen starvation in heart failure or very slow blood flow in the kidneys.
Often the last two functional proteinuria are combined and included in the list of pathological disorders called extrarenal.
Factors affecting the pathological and physiological increase in protein
Pathological causesexcess protein in urine analysis:
- glomerulonephritis;
- diabetic nephropathy;
- sclerosis of the kidney;
- nephrotic syndrome;
- cystitis;
- poisoning with heavy compounds;
- urethritis;
- autoimmune diseases;
- neoplasms of malignant and benign nature;
- kidney tuberculosis;
- impaired renal circulation.
Physiological causes:
- hypothermia;
- stress;
- cold;
- excessive exercise;
- protein intake;
- allergic manifestations;
- predominance of protein foods in the diet.
Degrees of proteinuria
Proteinuria comes in varying degrees:
- Mild - characteristic of a kidney tumor, cystitis, urolithiasis, urethritis. At the same time, from 0.3 to 1.0 g of protein is excreted from an individual per day.
- Moderate - occurs at the initial stage of amyloidosis, glomerulonephritis, acute necrosis of the tubular filter. In the daily analysis of urine, the protein norm is significantly exceeded, its loss is from one to three grams.
- Severe - observed in multiple myeloma, renal failure in the chronic phase, as well as nephrotic syndrome. More than three grams of protein is excreted from the body.
Indications for protein testing
The doctor will recommend this study when the following clinic appears in the individual:
- abnormal swelling;
- chronic anemia;
- bone and joint pain due to protein loss;
- sudden bouts of loss of consciousness and dizziness;
- drowsiness, lethargy, constant weakness;
- convulsions, muscle spasms;
- numb fingers, tingling;
- nausea, diarrhea, vomiting, loss or vice versa increased appetite for no reason;
- bouts of chills or fever;
- feeling of incomplete bladder emptying;
- pain, discomfort, itching, burning during urination.
In addition, a urinalysis for protein is indicated for:
- Diabetes mellitus (diagnosis and treatment monitoring).
- When registering for a dispensary, including pregnancy.
- Diagnosis of the genitourinary system, multiple myeloma.
- Prolonged hypothermia of the body.
- Oncology of the genitourinary system.
- Systemic diseases of acute and chronic nature.
- Extensive burns and injuries.
Changes in characteristics such as sediment, daily urine volume, density, odor, sediment, transparency, the appearance of blood blotches are also an indication for this study.
How much protein should be in a urine test: norm (g / l)
Protein is one of the most important indicators that the doctor first of all pays attention to when studying the results of the study. It is not possible to visually detect the presence of protein in the urine.
When it is detected, a reanalysis is shown after two weeks,while examining the morning and daily portion of the biomaterial. Protein in urine:
| Morning Analysis | Daily analysis | |
| Men | 0, 033 | 0, 06 |
| Women | 0, 033 | 0, 06 |
| Pregnant women | 0, 033 | 0, 3 |
| Children | 0, 037 | 0, 07 |
Methods for diagnosing diseases
After detecting a single increase in protein in the general urine test, it is necessary to differentiate pathological and functional forms. For this, an anamnesis is collected, an orthostatic test is performed in children and adolescents. In case of suspected concomitant illness, the individual is recommended to consult such specialist doctors as a urologist or gynecologist. Ultrasound of the bladder, kidneys and organs of the genital area is shown. As well as tests: general and biochemical blood, urine culture, according to Nechiporenko, for daily and specific proteins.
In addition, other types of examinations may be prescribed.
Signs indicating protein in urine
Let's consider the symptoms that an individual may have with an elevated protein in the urine test:
- pale and dry skin, peeling;
- general weakness;
- puffiness;
- expressed shortness of breath;
- brittle hair and nails;
- increasepressure;
- headache;
- due to excess fluid weight gain.
It is important to know what to look for in the presence of protein in the urine, as confirmed proteinuria indicates the presence of serious kidney disease, as well as other systemic disorders.
Preparatory activities for the analysis. Urine Collection Rules
For the reliability of the results, the following conditions must be met:
- get a good night's sleep the night before the test;
- exclude any overloads;
- warn the doctor about taking medication;
- do not change the diet and drinking regimen before and during the collection of biomaterial;
- eliminate all alcoholic beverages.
To conduct a daily protein analysis, urine should be collected correctly. To do this correctly, you will need:
- prepare a sterile container;
- the first portion of urine is not collected, starting from the second and then during the day - it is added to the prepared container and the time of each urination is recorded;
- store the collected biomaterial in the refrigerator;
- after collecting urine, you need to write down its volume;
- mix and pour about 200 ml into a separate sterile container;
- take the container with the biomaterial, the urination schedule, the recorded daily volume of urine, information about your height and weight to the laboratory.
Before collecting each portion of urine, hygiene procedures are carried out.
Increased protein in pregnant women
The cause of such a phenomenon is a consequence:
- Nephropathy - this condition develops most often at a later date, i.e. when premature delivery can end in the death of the baby, and it is impossible to terminate the pregnancy.
- Gestosis is a pregnancy that occurs with complications (increased pressure, swelling, convulsions).
- Toxicosis is a failure of the water-s alt balance against the background of dehydration.
Women expecting a baby are regularly examined, the results of which are carefully analyzed by the attending physician. It is very important not to miss gestosis. If a urine test for protein during pregnancy showed an excess of the norm, then hospitalization is recommended. A woman is prescribed therapy aimed at reducing its concentration, and measures are taken to help bring the baby to the due date. For example, the following clinic is typical for nephropathy:
- nausea;
- thirst;
- hidden and obvious edema;
- dizziness;
- weakness;
- pressure increase;
- pain in the right hypochondrium, liver enlargement;
- appearance of hyaline casts in urine.
In addition, with nephropathy, the expectant mother has a failure of protein and water-s alt metabolism, oxygen starvation of all internal organs and the fetus, and an increase in the permeability of the vascular wall. High risk of developing late gestosis. At risk are women with chronic kidney disease, Rh conflict, as well as problems with blood vessels andhormonal disorders. Untimely assistance and lack of treatment leads to eclampsia and preeclampsia. These states are accompanied by:
- hemorrhagic stroke;
- pulmonary edema;
- convulsions;
- loss of consciousness;
- renal and liver failure;
- intrauterine fetal death;
- premature placental abruption.
Diseases in which protein in the urine test is elevated
Prerenal form of proteinuria is characteristic of the following pathological conditions:
- malignant changes in lymphatic and hematopoietic tissue;
- diseases of the connective tissue of an allergic nature, in which two or more organs are affected;
- rhabdomyolysis;
- epileptic seizure;
- hemolytic anemia;
- poisoning;
- macroglobulinemia;
- incompatible blood transfusions;
- traumatic brain injury.
Postrenal proteinuria is a sign of ailments such as:
- kidney tuberculosis;
- inflammatory processes in the genitals, urethra, bladder;
- benign bladder tumors;
- bleeding from the urethra.
The renal form is formed in the following renal pathologies:
- amyloidosis;
- urolithiasis;
- jade interstitial;
- diabetic nephropathy;
- hypertensive nephrosclerosis;
- glomerulonephritis.
If urine is foundwhite blood cells and protein, what to do?
The detection of protein and leukocytes in the urine test indicates inflammatory processes occurring in the urinary system. White blood cells, performing a protective function, do not allow pathogenic microflora to multiply. As a result of the fight against infection, they die and leave the body of the individual along with urine. The presence of these cells in the biomaterial in excess of the allowable values is called leukocyturia. Its main causes are diseases:
- urinary system;
- genitals;
- venereal.
In addition, a long course of antibiotic treatment and poorly performed hygienic manipulations before donating the biofluid provoke the appearance of leukocytes in urine. It should be noted that in children the norm is higher than in adults. This phenomenon is connected with the fact that the kidneys are still being formed and are not able to fully perform some functions.
Diseases that are most common in medical practice
- Glomerulonephritis is a common cause of proteinuria. According to the results of urine analysis, the protein significantly exceeds the norm, and there is also gemma-, leukocyturia, an increase in specific gravity and a large number of epithelial cells. The disease can be both primary and develop against the background of other pathological conditions. Lack of treatment leads to chronic glomerulonephritis. The disease is accompanied by: severe swelling of the face, persistent increase in pressure, enlargement of the liver, damage to the glomeruli and failure of the filtersystem. If the nephrotic syndrome is mild, then high blood pressure and edema are absent.
- Protein in the urine test is also exceeded in cystitis, the acute form of this disease can occur at any age. Most often it is diagnosed in women. In the urine, both the content of protein and leukocytes is increased. In addition, it acquires a sharp specific smell. The individual has a general malaise, painful urination. Treatment is antibiotics and diet therapy. Foods rich in vitamin C and proteins are prohibited.
- Pyelonephritis - this pathology is characterized by: a pale shade of urine, cloudy in the presence of pus; exceeding the allowable values of leukocytes and protein; acidity and density within normal limits. The patient has a high temperature, weakness, pain in the lumbar region when urinating.
- Diabetes diabetes - disrupted kidney function. Protein control in such patients is indicated once every six months
Instead of a conclusion
If the protein is elevated in the urine test, then most often this indicates a malfunction in the kidneys. When it is detected, the doctor sends the individual for a second study, since one of the reasons may be poor-quality preparation for the delivery of the biomaterial, i.e. the protein is able to enter the urine from the external genitalia. If repeated tests show protein in the urine, the condition is called proteinuria.
