Urine Protein

Aka: Urine Protein, Urine Albumin, Urine Dipstick Protein

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II. Interpretation: Normal

  1. Dipstick with trace Protein or less
  2. Protein 1+ or greater is considered abnormal, suggesting glomerular injury

III. Technique

  1. First morning void collected
    1. Orthostatic Proteinuria (benign, common cause in male teens) may be seen with later samples in the day
  2. Detection Method
    1. Initial: Dipstick Urine Protein
      1. High Test Sensitivity and Test Specificity (>99%) for albumin, but not for other Proteins
    2. Confirmation
      1. Urine Protein to Creatinine Ratio
      2. Sulfosalicylic Acid Test (older test)
  3. Dipstick turns from yellow to green for Protein present (Tetrabromophenol blue colorimetric method)
    1. Negative: <10 mg/dl
    2. Trace: 10-20 mg/dl
    3. Protein 1+: 30 mg/dl (abnormal)
    4. Protein 2+: 100 mg/dl
    5. Protein 3+: 300 mg/dl
    6. Protein 4+: 1000 mg/dl

IV. Causes: Increased Urine Protein

  1. See Proteinuria in Adults
  2. See Proteinuria in Children

V. Causes: False Positive Urine Protein

  1. Alkaline urine (Urine pH >8)
  2. Increased Urine Specific Gravity (concentrated, Urine Specific Gravity >1.030)
  3. Dipstick immersed too long in urine (or placed directly in urine stream)
  4. Non-albumin Proteins
  5. Medications
    1. Penicillin
    2. Sulfonamide
    3. Tolbutamide
    4. Phenazopyridine (Pyridium)
    5. Chlorhexidine contamination (Hibiclens, Peridex)
    6. Iodinated radiocontrast in urine
    7. Benzalkonium
    8. Quaternary Ammonium Compounds (QAC, Quaternary Amines) found in disinfectants (Quats)
  6. Body fluid contamination
    1. Gross Hematuria present
    2. Bacteriuria
    3. Pus
    4. Semen
    5. Vaginal secretions

VI. Causes: False Negative Urine Protein

  1. Albumin is not the primary Protein
    1. Light chain Protein (detected by Sulfosalicylic acid)
  2. Dilute urine (Urine Specific Gravity <1.010)
  3. Urine Protein concentration <10 mg per deciliter
  4. Urine pH decreased (pH <4.5)

VII. References

  1. Hitzeman (2022) Am Fam Physician 106(1): 27-35 [PubMed]
  2. Leung (2017) Am Fam Physician 95(4): 248-54 [PubMed]
  3. Simerville (2005) Am Fam Physician 71(6): 1153-62 [PubMed]

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Related Studies

Ontology: Urine albumin tests (C0042038)

Concepts Laboratory Procedure (T059)
SnomedCT 167453009
Italian Albumina nelle urine
Japanese 尿中アルブミン, ﾆｮｳﾁｭｳｱﾙﾌﾞﾐﾝ
English Urine albumin tests, Albumin urine, albumin urine test, urine test albumin, albumin urine, Urine albumin, Albumin - urine, urine albumin (lab test), urine albumin, Urine Albumin Test, urine albumin test, Test;urine;albumin
Czech Albumin v moči
Hungarian Albumin vizeletben
Portuguese Albumina na urina
Spanish Albúmina en orina
Dutch albumine urine
French Albumine urinaire
German Albumin im Urin
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Urine protein test (C0262923)

Definition (NCI) The determination of the amount of protein present in a urine sample.
Concepts Laboratory Procedure (T059)
SnomedCT 167284009, 144520004, 148462000, 144674004, 167449007, 167456001, 144681006, 144507002, 57378007, 167271000, 171247004
English Urine protein NOS, Urine protein test NOS, Urine screen for protein, Protein urine, Urine Protein Measurement, protein urine test, urine protein level test, Urine protein test NOS (procedure), Urine protein (& level), Protein - urine, Urine protein (& level) (procedure), Urine protein NOS (procedure), urine protein, urine protein test (lab test), urine protein test, Urine Protein Test, Protein measurement, urine, Urine protein, Urine protein level, Protein measurement, urine (procedure), Urine protein test (procedure), Urine screening for protein (procedure), Urine screening for protein, Urine protein test
Italian Proteine nelle urine
Japanese 尿蛋白, ﾆｮｳﾀﾝﾊﾟｸ
Spanish rastreo mediante la detección de proteinuria, pesquisa de proteinuria, detección selectiva de proteinuria (procedimiento), cribado mediante la detección de proteinuria, detección selectiva de proteinuria, cribado de proteinuria, cribado mediante la detección de proteinuria (procedimiento), screening mediante la detección de proteinuria, screening de proteinuria, tamizaje mediante la detección de proteinuria, cribaje mediante la detección de proteinuria, tamizaje de proteinuria, pesquisa mediante la detección de proteinuria, cribado mediante la detección de proteinas en orina, cribado mediante la detección de proteínas en orina, determinación de proteinuria, SAI, prueba de proteinuria, SAI, prueba de proteinuria, SAI (procedimiento), Urine protein NOS, Urine protein test NOS, determinación de proteinuria, SAI (procedimiento), medición de proteína en orina (procedimiento), medición de proteína en orina, prueba de proteinuria (procedimiento), prueba de proteinuria, Proteínas en orina
Czech Bílkovina v moči
Hungarian Fehérje vizeletben
Portuguese Proteína na urina
Dutch eiwit urine
French Protéine urinaire
German Protein im Urin
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Urine dipstick for protein (C0430371)

Concepts Laboratory Procedure (T059)
SnomedCT 167280000, 144516003, 271346009
English Urine dipstick for protein (situation), Urine dipstick for protein, Urine dipstick for protein (procedure)
Spanish determinación de proteinuria con tira reactiva (procedimiento), determinación de proteinuria con tira reactiva
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Pathology and Laboratory Medicine

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