Proteinuria

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In medicine, proteinuria is "the presence of proteins in the urine, an indicator of kidney diseases."[1] Proteinuria may occur in acute kidney injury or chronic kidney disease.

Diagnosis

The standard dipstick test only measures albumin. "A dipstick test result <1+ or less than trace has a high negative predictive value in the general community setting, with minimal risk of a missed diagnosis of macroalbuminuria". Sensitivity for any any abluminuria was 58%.[2] In this study any abluminuria was defined as albumin-creatinine ratio >/=30 mg/g and macroalbuminuria was defined as albumin-creatinine ratio >/=300 mg/g.

The sulfosalicylic acid (SSA) test measures all protein.

Spot protein/creatinine ratio

One study found that in the presence of stable renal function, a protein/creatinine ratio:[3]

Spot urine albumin/creatinine ratio

In adults, albuminuria is a more sensitive than total protein in detecting chronic kidney disease from many glomerular diseases.[4]

  • <30 mg/g is a normal albumin-creatinine ratio
  • 30-300 mg/g is microalbuminuria

References

  1. Anonymous (2023), Proteinuria (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. White SL, Yu R, Craig JC, Polkinghorne KR, Atkins RC, Chadban SJ (2011). "Diagnostic accuracy of urine dipsticks for detection of albuminuria in the general community.". Am J Kidney Dis 58 (1): 19-28. DOI:10.1053/j.ajkd.2010.12.026. PMID 21411199. Research Blogging.
  3. Ginsberg JM, Chang BS, Matarese RA, Garella S (1983). "Use of single voided urine samples to estimate quantitative proteinuria.". N Engl J Med 309 (25): 1543-6. PMID 6656849.
  4. National Kidney Foundation (2002). "K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification.". Am J Kidney Dis 39 (2 Suppl 1): S1-266. PMID 11904577.