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Proteinuria ≥ 0.3 grams (300 mg) or more of protein in a 24-hour urine sample or a SPOT urinary protein to creatinine ratio ≥0.3 or a urine dipstick reading of 1+ or greater (dipstick reading should only be used if other quantitative methods are not available). [3]
Alternatively, the concentration of protein in the urine may be compared to the creatinine level in a spot urine sample. This is termed the protein/creatinine ratio. The 2005 UK Chronic Kidney Disease guidelines state that protein/creatinine ratio is a better test than 24-hour urinary protein measurement.
Urine protein/creatinine ratio is a widely used initial method to estimate daily protein excretion in urine. [1] [2] [3] Since the diagnosis and management of proteinuric renal diseases and the staging of chronic kidney disease depend on accurate identification and quantitation of proteinuria, [4] [1] the implementation of the 24-hour urine collection is the most accurate procedure in practice ...
If proteinuria is persistently detected by dipstick testing, a 24-hour urine collection can be performed to obtain an accurate measurement of protein levels; alternatively, protein excretion can be estimated from the urine protein/creatinine ratio of a single specimen. Measuring the amount of protein in the urine helps to distinguish between ...
Urine cytology — cytopathological examination of cells in the urine, used to screen for cancer [21] Urine protein electrophoresis — classification and measurement of different proteins in the urine; used to help diagnose monoclonal gammopathies [22] Urine organic acids, urine amino acids — used to test for some inborn errors of metabolism [8]
Normal urine contains very little protein, usually less than 100–300 mg/L or 100 mg per 24 hours is excreted. This protein consists primarily of low-molecular-weight serum proteins that have been filtered by the glomerulus and proteins produced in the genitourinary tract.
Urine analysis, urine cytology, complement activity, urine culture, and serological studies can help differentiate orthostatic albuminuria from other causes of proteinuria. Recumbent and upright urine protein to creatinine ratio is often used as a screening test. 24-hour split urine testing is often tested. [10]
Preeclampsia superimposed on chronic hypertension occurs when a pregnant woman with chronic hypertension develops signs of pre-eclampsia, typically defined as new onset of proteinuria ≥30 mg/dL (1+ in the dipstick) in at least 2 random urine specimens that were collected ≥4 h apart (but within a 7-day interval) or 0.3 g in a 24-h period. [19]