Protein in Urine and its Relationship to Kidney Health

Chris A. Stoll
Chris A. Stoll
December 9, 2022
min read
Technically reviewed by: 
H. Ali, Ph.D.
Protein in Urine and its Relationship to Kidney Health

Protein in urine is called proteinuria and is not considered normal. While many diseases can trigger protein leakage in urine, it usually indicates a kidney problem. Test strips for protein in urine can help diagnose kidney infections, manage kidney disease as well as in early detection of risks to kidney health. A urine protein test allows you to take preemptive actions to protect the health of your kidneys.

Kidney function

The kidney filters extra water and wastes from your blood to produce urine. Proteins are large molecules that your body requires to function correctly. Protein can be found in all body parts, including the blood. When your kidneys remove waste from your blood, tiny filters prevent large protein molecules from exiting your body via urine. In ideal circumstances and with healthy kidneys, the body should utilize protein, e.g., to build and maintain muscles and fight infections. The protein may leak into the urine if these filters are not working properly.

What is the purpose of checking protein in urine?

Urine protein testing is a vital part of a routine urinalysis, which measures various cells, chemicals, and substances in your urine. Urinalysis is used to evaluate your overall health and helps in the diagnosis of several diseases, such as nephrotic syndrome, preeclampsia, proteinuria in diabetes, gestational diabetes, and lupus disease, among others. Protein in urine during pregnancy requires timely treatment for the health of the mother and fetus; therefore, monitoring proteinuria in pregnancy is essential. Since kidney function involves the filtration of the bloodstream to excrete unnecessary substances from the body, urine testing greatly helps with the diagnosis of kidney disease and various other health issues. A urine protein test is thus essential to evaluate the health of your kidneys and assess any potential risks.

Testing protein levels in the urine for kidney disease

The presence of protein in urine is considered an early sign of kidney disease. Protein in urine is usually one of the first observable symptoms of kidney disease (before other physical symptoms appear). If you have a high risk of kidney disease or are going through kidney-related health issues, your provider may suggest routine monitoring of urine protein levels. You are more likely to develop kidney disease if you have a family history of kidney disease, high blood pressure, diabetes, or heart disease. These tests may include a 24-hour urine protein test, tests to measure protein concentration in urine, and rapid testing with an at home urine test using protein urine test strips.

Symptoms of Kidney Disease

Kidney diseases, such as chronic kidney disease or CKD, may not always cause noticeable symptoms in the early stages of the disease. As the disease progresses, the typical symptoms of kidney disease include:

  • Increased or decreased urination
  • Hand and foot swelling or puffy eyelids
  • Dry skin and itching
  • Fatigue and Muscle cramps
  • Bloody or foamy urine
  • Loss of appetite and weight loss
  • Nausea and vomiting
  • Shortness of breath
  • Sleep issues
  • Difficulty thinking clearly

Causes of Kidney Disease

Kidney function can be impaired due to diseases such as

  • Lupus disease
  • Nephrotic syndrome
  • Preeclampsia
  • Diabetes that can lead to proteinuria in diabetes
  • Gestational diabetes
  • Hypertension or high blood pressure and
  • Obesity

An impaired kidney function can lead to chronic kidney disease (CKD). Other causes of CKD include, but are not limited to:

  • Inflammation of the kidney's filtration units (glomeruli) or tubules (nephritis)
  • Genetic or hereditary kidney diseases
  • Urinary Tract Infections or obstructions in the urinary tract
  • Bacteria in the urinary tract
  • Kidney stones
  • Frequent recurring episodes of kidney infections
  • Autoimmune diseases (when the body's own immune system attacks the healthy cells/organs)

Covid-19 infections have also resulted in an increase in acute kidney injury (also known as acute renal failure) Causes of kidney disease due to Covid-19 infections include:

  • Coronavirus infecting kidney cells
  • Abnormally low levels of oxygen levels in the bloodstream of covid patients
  • Body's own (hyper-active) immune response
  • Clogged blood vessels in the kidneys
  • Acute kidney injury, if left untreated, develops into chronic kidney disease.

Testing urine protein levels is a valuable diagnostic tool for kidney diseases that various conditions, including the Covid-19 infection, can cause.

How is a urine protein test performed?

A urine protein test can be performed at a provider's office, a laboratory, or home using urine test strips. You will need your urine sample for the test.

Urine protein testing in professional settings:

A healthcare professional may give you a cleansing wipe, a small container, and instructions for collecting your urine sample using the "clean catch" method. It's critical to follow these steps to avoid introducing germs/impurities from your skin into the sample:

1. Wash your hand with soap and water.

2. You should open the sterile container without touching it inside.

3. Use the cleansing wipe to clean your genital area:

  • If you have biologically male anatomy, clean your penis by wiping the entire head (end) of the penis. Pull your foreskin back first if you have one.
  • If you have biologically female anatomy, clean your vagina by separating the labia (the skin folds around the vagina) and gently wipe the inner sides from front to back.

4. Urinate for seconds before stopping the flow. Begin urinating once more, this time into the container. Don't let the container come into contact with your skin.

5. You should collect at least an ounce of urine into the container. The container will probably have markings to show how much urine is needed.

6. After you finish urinating, put the cap on the container and return it to your provider as instructed.

Tell your provider before your test if you have hemorrhoids that bleed or have your menstrual period.

Home urine testing for protein in urine:

At-home urine test strips that check the presence of protein in the urine (1-parameter urine protein dipstick tests) are available off-the-shelf and do not require a prescription. These reagent-based dipstick tests are simple to perform and provide reasonably accurate results. Dipsticks and instructions for collecting and testing your urine sample are usually included in the kits.

Begin by getting a clean, disposable, preferably sterile urine container for the test. You can easily buy an affordable one online.

Follow the instructions provided in the previous section to collect the urine sample.

Remove the dipstick from the container or pouch. Immerse the strip briefly in the urine sample and remove it. The reagent pad on the dipstick will start reacting with the urine sample. Compare the color of the reagent pad with the color chart provided by the manufacturer to interpret the results.

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What do the findings imply?

Protein in the urine is typically reported in g/L or mg/dL or semi-quantitatively as negative, trace, and positive from level 1 to level 4.

Low level of protein in the urine

Level 1 protein in urine is equated to 0.3 g protein per liter (30mg/dL or 300mg/L), whereas level 4 protein in urine is considered greater than or equal to 20 g per liter (2,000 mg/dL or 20,000mg/L).

High level of protein in the urine

A high protein level in your urine sample does not always indicate that you have a medical problem that requires treatment. Urine protein levels can temporarily rise due to strenuous exercise, diet, dehydration, stress, pregnancy, and other factors. A professional healthcare provider can diagnose the real cause of protein in urine and explain if it requires clinical intervention, such as medications.

If protein levels in urine are consistently elevated, it is most likely a sign of kidney disease or kidney damage caused by other conditions. Your healthcare provider or doctor may recommend other urinalysis tests to determine whether you continue to have high protein levels in urine over time.

The concentration of protein in your urine is related to the severity of your kidney damage or kidney disease. However, more tests will be required to determine what is causing the damage.
Urine Protein Color Chart
Color Chart for Urinox Urine Protein Test Strips

24-hour urine protein sample

Sometimes, your provider may ask you to collect the urine sample during a 24 hours window. A "24-hour urine sample test" provides better and more complete results as the amount of protein in urine can change throughout the day.

Talk to your healthcare provider or doctor to inquire what your results tell about your kidney health. You can learn more about reference ranges, laboratory tests, and results from the interpretation chart printed on the packaging of urine test strips.

Why is it Necessary to Regularly Test Protein in Urine?

To summarize, regular screening for protein in urine can help to keep track of urinary tract health and keep a check on your kidney health. Routine testing for protein in the urine may be helpful to you if you are at risk of kidney disease or are going through a kidney issue, such as taking prescriptions/supplements that can impact kidney or renal function or have recently had surgery, such as a kidney transplant. Testing protein in urine on a regular basis may also be helpful if you are a professional athlete or sportsperson to precisely monitor metabolic function and kidney health. Checking urine protein levels is also an excellent screening exercise for general health awareness and staying proactive with your health.

About the Author
Chris A. Stoll

Chris Stoll is a medical content writer with a passion for science and understanding how the human body functions. He has spent the last several months working with Diagnox, a leading provider of health and wellness products, to educate consumers about a variety of topics related to health and wellness. In addition to his work in the medical field, Chris is also a dedicated Star Wars fan and enjoys spending his free time exploring the vast universe created by George Lucas. With a strong understanding of science and a desire to share that knowledge with others, Chris is dedicated to helping people understand the intricacies of the human body and how to maintain optimal health and wellness.

About the Reviewer
This blog was
Technically reviewed by: 
H. Ali, Ph.D.

Hussnain Ali received his Ph.D. degree in EE in 2015 from the University of Texas at Dallas, USA. He is the co-founder and the Chief Executive Officer (CEO) at Diagnox Health, Plano, TX 75024, USA, and a visiting research scientist at the University of Texas at Dallas. His academic and industry experience spans over 15 years in organizations like the Center for Advanced Research in Engineering, The University of Texas at Dallas, and Harman/Samsung. He has served as a co-PI on an RO1 grant from the National Institutes of Health (NIH). His research interests include biomedical devices, auditory rehabilitation, and cochlear implants. He has authored and co-authored over 70 international publications and has been awarded multiple US patents. His latest work at Diagnox encompasses the development of innovative healthcare and wellness products/solutions that provide convenient and affordable at-home screening/diagnosis. He aims to bridge conventional clinical diagnostic products with Artificial Intelligence (AI) and contemporary data-centric technologies to modernize the healthcare and wellness industry.

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