An increase in protein in a urinalysis is proteinuria. Proteins enter urine from blood plasma. Albumins account for the majority, and tissue proteins are represented mainly by complex glycoproteins. They are synthesized by the mucous membranes of the genitourinary system and renal tubules. In healthy individuals, protein should not be present, or it may be in minimal amounts. If a urinalysis showed protein, this is an occasion 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 ability of the kidneys, it is detected in minimal amounts in primary urine. Further, the process of reverse absorption of the protein in the renal tubules is carried out. If an individual has healthy kidneys and there is no excess protein in the blood plasma, then in the biofluid that leaves the body, it is present in small amounts or absent. Both physiological and pathological causes are provocateurs of increasing its level.
Proteins perform the following functions in the body of an individual:
- Form colloid osmotic blood pressure.
- Provide a response to an internal or external stimulus.
- They participate in the construction of intercellular connections and new cells, as well as in the creation of enzyme substances that contribute to the flow of biochemical reactions.
If the protein in the urine as a result of the analysis was detected in excess of the permissible values, then this phenomenon is called proteinuria. The individual in this case recommend an additional examination, 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, types of abnormal disorders are distinguished, such 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, since they cannot absorb proteins in large volumes. In addition, a violation can occur with the introduction of albumin from the outside, that is, artificially, against the background of the course of nephrotic syndrome.
- Renal or renal - is formed against a background of kidney disease. It occurs when the normal process of protein reuptake is disturbed, in this case it is called tubular or it is also called tubular. If a malfunction at the level of the cleansing ability of the renal glomeruli is a provocative factor, then this is glomerular (tubular) proteinuria.
- Postrenal - appears, as a result of pathogenic processes occurring in the urinary canal. Protein enters urine that has come out of the kidney filter.
- Secretory - against the background of some diseases specific proteins and antigens are released.
Types of functional proteinuria
They are temporary and are not accompanied by diseases of the genitourinary system and kidneys. Among them, proteinuria is distinguished:
- The lordotic or postural protein appears in urine after a long stay in a mobile upright position, as well as walking in children, adolescents and young individuals with an asthenic physique.
- Emotional - is a consequence of severe stress.
- Stresses (it is called working in another way) - most often occurs in military personnel and athletes, i.e., with high physical activity.
- Feverish - identify in case of damage to the renal filter against a background of very high temperature.
- Palpation - occurs with prolonged and intense palpation in the abdomen.
- Alimentary - after eating protein-rich foods.
- Centrifugal - the cause of its appearance is considered to be epilepsy or concussion.
- Stagnant - occurs as a result of oxygen starvation with 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 causes of an increase in excess of protein in a urinalysis:
- glomerulonephritis;
- diabetic nephropathy;
- kidney sclerosis;
- nephrotic syndrome;
- cystitis;
- heavy compound poisoning;
- urethritis;
- autoimmune ailments;
- neoplasms of a malignant and benign nature;
- kidney tuberculosis;
- impaired renal circulation.
Physiological reasons:
- hypothermia;
- stress
- cold;
- excessive physical activity;
- protein intake;
- allergic manifestations;
- the predominance of protein foods in the diet.
Degrees of proteinuria
Proteinuria is of varying degrees:
- Light - characteristic of a kidney tumor, cystitis, urolithiasis, urethritis. At the same time, a protein from 0.3 to 1.0 g is excreted per day in an individual
- Moderate - occurs at the initial stage of amyloidosis, glomerulonephritis, acute tubular filter necrosis. In the daily urine analysis, the protein norm is significantly exceeded, its loss is from one to three grams.
- Severe - observed in 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 research
The doctor will recommend this study when the following clinic appears in an individual:
- abnormal swelling;
- chronic anemia;
- bone and joint pain due to protein loss;
- sudden attacks of loss of consciousness and dizziness;
- drowsiness, lethargy, constant weakness;
- cramps, muscle cramps;
- numbness of the fingers, tingling;
- nausea, diarrhea, vomiting, loss, or vice versa increased appetite for no reason;
- bouts of chills or fever;
- a feeling of incomplete emptying of the bladder;
- pain, discomfort, itching, burning during urination.
In addition, a general urine test for protein is indicated for:
- Diabetes mellitus (diagnosis and monitoring of treatment).
- When registering for a dispensary, including pregnancy.
- Diagnosis of the genitourinary system, myeloma.
- Prolonged hypothermia of the body.
- Oncology of the genitourinary system.
- Systemic diseases of an acute and chronic nature.
- Extensive burns and injuries.
Changes in characteristics such as sediment, daily urine volume, density, odor, precipitate, transparency, and the appearance of blood spots are also indications for this study.
How much protein should be in the analysis of urine: normal (g / l)
Protein is one of the most important indicators that a doctor first of all pays attention to when studying the results of a study. It is not possible to detect the presence of protein visually in urine.
When it is detected, a second analysis is shown after two weeks, while the morning and daily portion of the biomaterial is examined. The protein norm 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 identifying a single increase in protein in the general analysis of urine, 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 suspicion of a concomitant ailment, an individual is recommended to consult specialist doctors such as a urologist or gynecologist. Ultrasound of the bladder, kidneys and genitals is indicated. As well as analyzes: total and biochemical blood, urine culture, according to Nechiporenko, for daily and specific proteins.
In addition, other types of examinations may be prescribed.
Signs of protein in urine
Consider the symptoms that an individual may have with an elevated protein in a urine test:
- pale and dry skin, peeling;
- general weakness;
- swelling;
- severe shortness of breath;
- brittle hair and nails;
- increase in pressure;
- headache;
- due to excess fluid weight gain.
It is important to know by what signs the presence of protein in the urine can be suspected, since confirmed proteinuria indicates the presence of serious renal diseases, 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:
- sleep well on the eve of the analysis;
- exclude any overload;
- warn doctors about taking medication;
- Do not change the diet and drinking regime before and during the collection of biomaterial;
- exclude any alcohol-containing drinks.
To conduct a daily protein test, urine should be collected correctly. To competently do this, 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, it is necessary to record its volume;
- mix and pour about 200 ml into a separate sterile container;
- take to the laboratory containers with biomaterial, a schedule of urination, a fixed daily volume of urine, information about their height and weight.
Before collecting each serving of urine, hygiene procedures are carried out.
Protein Increase in Pregnant Women
The reason for this phenomenon is a consequence:
- Nephropathy - this condition develops most often in the late term, that is, when premature delivery can result in the death of the baby, and it is impossible to terminate the pregnancy.
- Gestosis - a pregnancy proceeding with complications (increased pressure, swelling, convulsions).
- Toxicosis is a failure of the water-salt balance against the background of dehydration.
Women awaiting the appearance of the baby regularly undergo examinations, the results of which are carefully analyzed by the attending physician. It is very important not to miss gestosis. If urinalysis for protein during pregnancy showed an excess of the norm, then hospitalization is recommended. A woman is prescribed a therapy aimed at reducing his concentration, as well as measures are being taken to help bring the baby to the due date. For example, the following clinic is characteristic of nephropathy:
- nausea;
- thirst;
- swelling hidden and overt;
- dizziness;
- weakness;
- increase in pressure;
- pain in the right hypochondrium, enlarged liver;
- the appearance in the urine of hyaline cylinders.
In addition, with nephropathy, the expectant mother has a failure of protein and water-salt metabolism, oxygen starvation of all internal organs and the fetus, 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 and hormonal disorders. Untimely assistance and lack of treatment leads to eclampsia and preeclampsia. These conditions are accompanied by:
- hemorrhagic stroke;
- pulmonary edema;
- cramps
- loss of consciousness;
- renal and liver failure;
- fetal death of the fetus;
- premature placental abruption.
Diseases in which an increased protein in the analysis of urine
The 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;
- transfusion of incompatible blood;
- traumatic brain injury.
Postrenal proteinuria is a sign of ailments such as:
- kidney tuberculosis;
- inflammatory processes in the genitals, urethra, bladder;
- benign tumors of the bladder;
- bleeding from the urethra.
The renal form is formed with the following renal pathologies:
- amyloidosis;
- urolithiasis disease;
- interstitial nephritis;
- diabetic nephropathy;
- hypertensive nephrosclerosis;
- glomerulonephritis.
If white blood cells and protein are found in urine, what should I do?
The identification of protein and leukocytes in urine analysis indicates inflammatory processes 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 together with urine. The presence of these cells in the biomaterial in excess of the permissible values is called leukocyturia. The main causes of it are diseases:
- urinary system;
- genitals;
- sexually transmitted.
In addition, a long course of antibacterial treatment and poorly performed hygienic manipulations before delivery of 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 associated with the fact that the kidneys are still forming and are not able to fully perform some functions.
The diseases that are most often found in medical practice
- Glomerulonephritis is a common cause of proteinuria. According to the results of the analysis of urine, the protein significantly exceeds the norm, and hema, leukocyturia, an increase in the specific gravity and a large number of epithelial cells are also observed. The disease can be both primary and develop against the background of other pathological conditions. Lack of treatment leads to chronic glomerulonephritis. The ailment is accompanied by: severe swelling of the face, persistent increase in pressure, enlargement of the liver, damage to the glomeruli and a malfunction in the filter system. If nephrotic syndrome is mild, then high pressure and swelling are absent.
- The protein in the analysis of urine is exceeded and with cystitis, the acute form of this disease can occur at any age. Most often it is diagnosed in a female. In the urine, both protein and white blood cells are elevated. In addition, it acquires a sharp specific smell. The individual has a general malaise, painful urination. Treatment - antibiotics and diet therapy. It is forbidden to take foods rich in vitamin C and proteins.
- Pyelonephritis is characteristic of this pathology: a pale shade of urine, cloudy in the presence of pus; excess of acceptable values of leukocytes and protein; acidity and density are within normal limits. The patient has a high fever, weakness, and urination pain in the lumbar region.
- Diabetes mellitus - kidney function is impaired. Protein control in such patients is indicated every six months.
Instead of a conclusion
If the protein in the urine analysis is elevated, then most often this indicates a malfunction in the kidneys. When it is detected, the doctor directs the individual for re-examination, since one of the reasons may be poor preparation for the delivery of biomaterial, that is, the protein is able to get into urine from the external genital organs. If repeated tests showed protein in urine, then this condition is called proteinuria.