Determining the presence of protein in urine is an important method for diagnosing the condition of the body. Such tests may also be ordered during preventive examination, and in connection with patient complaints. A general urine test includes, among other things, qualitative and quantitative determination of protein.

Normal protein in urine

Let's say right away: normal There should be no protein in the urine. In such cases, abs is often written on test forms.

How can protein get into urine?

To better understand why protein should not appear in the urine and in what cases it may be present there, we need to say a few words about the work of the kidneys.

Filtration in the kidneys

These paired organs of the excretory system are responsible for the formation of urine - everyone knows this. But how is it formed? – Blood, flowing through the smallest capillaries in the kidney tissue (consists of nephrons), is filtered and formed primary urine.

This liquid contains not only “harmful”, “waste” substances, but also those compounds that the body needs, including some low-molecular protein fractions. The membrane filter of the glomerular capillaries is responsible for this.

Further, primary urine passes through a system of tubules, where a significant part of the liquid and some valuable substances, including proteins, are reabsorbed from it. This is how it appears secondary urine- the one that collects along the ureters in bladder and is brought out.

We see that if health is not impaired, protein from the blood simply does not enter the urine.

Collection and excretion of urine

Urine enters the bladder through the ureters and is discharged through the urethra. On this path, mucus may enter it, leukocytes, exfoliated epithelium. Such fractions also “saturate” the urine with protein. Its presence will reflect urinary tract involvement not related to the kidneys.

Causes of protein in urine

Kidney diseases

If any of the stages of urine formation or its removal from the body is disrupted, this can lead to the appearance of protein in the urine. This symptom called proteinuria.

Firstly, we may be talking about filtration disorders in the kidneys. Glomerulonephritis, pyelonephritis, renal failure various kinds(decrease in the number of normally functioning nephrons), tumors, autoimmune diseases - can lead to the loss of protein from the blood and its excretion in the urine.

To more accurately determine what pathology is present in a person, you need to look at other indicators. For example, the presence of blood in the urine, the presence of leukocytes, the presence and types of renal epithelium, and so on.

Urinary tract diseases

We have already noted that protein can enter the urine even after it is formed in the kidneys. For example, if there is inflammation of the bladder, the lining epithelium in it will actively exfoliate. Urine is filled with leukocytes and mucus.

Physical activity, fever

But even in people whose kidney health does not suffer, it is possible temporary proteinuria.

High physical activity increases metabolism and may cause some protein to be filtered into the urine. There is also a known condition called orthostatic proteinuria, which is observed during prolonged walking or standing and disappears as soon as a person takes a horizontal position.

As a rule, these cases of the appearance of protein in the urine are simply not recorded. After all, a general analysis is taken in the morning, after a night's rest.

Protein in the urine sometimes appears during hypothermia or prolonged exposure to the sun. Some medications impair kidney function, causing temporary proteinuria.

With an illness that causes fever - chills, low-grade fever - proteinuria is possible. Most often, this symptom is observed in children, adolescents, and the elderly.

The difference between these types of proteinuria and those that mark kidney pathologies is that they are short-term. With the disappearance of the cause that caused such proteinuria ( physical activity, fever) – it disappears.

Quantity and quality of protein in urine

Before we start talking about proteinuria in different groups patients, we need to clarify what indicators we can find in urine protein tests.

First, its quantity is estimated. The values ​​could be:

• Complete absence;
• Traces - up to 0.033 g / l - may be a variant of the norm and are associated with the high sensitivity of devices that analyze the composition of urine;
• Anything that exceeds this amount is a symptom of certain pathologies;

Secondly, the time at which protein appears in the urine can be assessed. In some conditions, proteinuria is constantly present, in others it appears and disappears. And it is very important to understand what causes such changes.

Thirdly, the types of protein themselves may differ. As a rule, this is albumin, a blood plasma protein. But proteins-antibodies, proteins of deteriorating tissues (muscles, blood cells), Tamm-Horsfall protein, which indicates the formation of kidney stones and so on.

For a more accurate understanding of the cause of proteinuria, it is necessary to evaluate all existing symptoms together, the number and high-quality composition proteins, carry out additional research, for example, blood biochemistry, Ultrasound kidneys and so on.

Protein in urine in children

Only in newborns in the first days of life is the presence of protein in the urine normal. Such proteinuria is associated with the “tuning” of the excretory system. If the child is more than one week old and protein is detected in the urine, this is a reason to start examining his kidneys.

We have already said that in case of a cold or ARVI, a general urine test can show proteinuria. In this case, it is important to repeat the studies to track the dynamics of changes. If, as you recover and the temperature normalizes, the amount of protein in the urine decreases to zero - good. If proteinuria remains, you should look for the cause in the condition of the kidneys and other body systems.

Protein in urine in pregnant women

Since pregnancy is a noticeable burden on the mother’s body, a small amount of protein may be detected in the urine. This is quite physiological.

But, at the same time, such a load can lead to kidney pathologies or manifest diseases that were hidden before conception. Therefore, any detection of protein in the urine of a pregnant woman (and women must undergo a general analysis at least once every two weeks) is a reason for detailed investigation.

Unfortunately, many doctors immediately interpret proteinuria during pregnancy as a pathology. And this is very frightening and upsetting for a woman. You need to understand that if your kidneys are not working well, other symptoms should appear:

• Edema;
• Increased pressure;
• Lower back pain;

The combination of three symptoms: edema, hypertension and proteinuria is a sign of gestosis ( dangerous condition, which usually develops in the last trimester).

If there are only traces of protein in the urine, do an ultrasound of your kidneys, confirm their health, and then change those doctors who are scaring you in vain.

Treatment

From all that has been said, it is clear that it is first necessary to establish the disease that led to the excretion of protein in the urine. He should be treated.

Unfortunately, if kidney pathology is present, treatment will only help maintain normal kidney function and reduce the severity of symptoms. It is practically impossible to completely restore health.

However, in many cases, for example, with acute cystitis, urethritis– there is hope for complete healing.

Protein in the urine is not an independent disease. This is a sign that helps diagnose various deviations of the body’s condition from the norm.

A general urine test can give the doctor a lot of information about a person's health. To understand this a little yourself, it’s worth reading this article.

A general urine test is a procedure whose importance is difficult to overestimate. A general urine test is a procedure by which a specialist can identify various pathologies in the human body, make a correct diagnosis, prescribe medications and start treatment on time. Also using general analysis the doctor can determine the quantity and rate of certain components in the material.

But here it is worth noting that the norm for the number of elements that can be detected during a urine test can be deciphered by doctors in English or Latin. To understand what this or that indicator means, it will be described further in the material. It is also worth noting that the interpretation of a urine test may differ in men or women, since they different norm in urine of certain elements.

Before decoding standard indicators, the doctor initially determines physical indicators, which includes the color, density of urine, its smell and others. This method of decoding may mean that the doctor will receive only general data about the condition of the patient’s body based on a urine test.

The first parameter is the normal color of urine. U healthy person The color of urine should be light and yellowish. Also, this parameter can be influenced not only by pathology in the body, but also by what products the person consumed before collecting the material. This will help you decipher and understand only general state patient.

Smell. The norm means that the smell of urine should not be strong. Those who suffer from diabetes may experience a sweetish odor. Acute - this indicator means that a person suffers from kidney disease or that inflammatory processes are occurring in the body.

Transparency. The norm for a healthy person means that urine should be clear. If there are any impurities in it, then this may indicate that there is an infection in the body. Also, the presence of a reddish tint indicates that this is a violation of the urine color norm, and therefore additional examinations should be carried out.

There are also other indicators that can be determined by chemical testing of urine in the laboratory. They will be described in more detail in the table.

Interpretation of a general urine test

Knowing these points, you will also be able to control urine tests when taking them.

The results of a urine test performed on modern medical analyzers are impossible to understand without special knowledge: just English letters without explanation. Below is a breakdown of those very “incomprehensible letters”, as well as the norms of one or another indicator.

BLd - red blood cells,
Bil - bilirubin,
Uro - urea,
KET ketones,
PRO protein,
NIT - nitrites (in the usual meaning - bacteriuria),
GLU - glucose,
pH - acidity,
S.G - density,
LEU - leukocytes,
UBG - urobilinogen.

Red blood cells
- There should be no red blood cells in the urine. If present, repeat analysis and observation are required. Women's urine may contain blood that got there during the menstrual period, which gives the presence of red blood cells in the urine. No more than 1-2 red blood cells per field of view are allowed. An increase in the number of red blood cells in the urine is called hematuria. Its causes are as follows: bleeding into the urinary tract, tumors, kidney and ureteral stones, inflammatory

Bilirubin
-Bilirubin is normally practically absent in urine. Identified in parenchymal liver lesions ( viral hepatitis), mechanical (subhepatic) jaundice, cirrhosis, cholestasis. In hemolytic jaundice, the urine usually does not contain bilirubin. It should be noted that only direct (bound) bilirubin is excreted in the urine.

Ketones
-presence of ketone bodies in urine (acetone) - normally absent; if ketone bodies are detected, diabetes mellitus, fasting, lack of carbohydrates, hyperinsulism can be assumed. Occurs when the body’s fat reserves are intensively consumed. Attention to those who are losing weight and hungry! - can lead to hyperglycemic coma. In fact, 20-50 mg of ketone bodies (acetone, acetoacetic acid, beta-hydroxybutyric acid) are excreted in the urine per day, but they are not detected in single portions. Therefore, it is believed that normally there should be no ketone bodies in a general urine test.

Protein
-the presence of protein in the urine (normally there is no protein) is a sign of kidney pathology; protein enters the urine during pyelonephritis, nephrotic syndrome, and renal amyloidosis. Protein in the urine can appear from the urinary tract and genital organs during inflammation, cystitis, vulvovaginitis, prostate adenoma - in these cases it is usually no more than 1 g/l. If a woman's urine during pregnancy contains protein, this may be a sign of pregnancy nephropathy. Normally, the protein content in urine is so low that it can only be determined by ultrasensitive methods. Sometimes traces of protein are detected, however, this is a borderline condition and requires detailed study. The fact is that traces of protein are acceptable, but only in single analyses.

Nitrites (bacteriuria)
- bacteria in urine are normally absent or detected in small quantity. In a healthy person, the urine in the kidneys and bladder is sterile. When urinating, microbes from the lower part of the urethra enter it, but their number is not more than 10,000 per ml. Therefore, it is believed that bacteria are normally absent in a general urine test. A large number of bacteria may indicate infection urinary tract. The presence of bacteria indicates infection genitourinary system, cystitis, nephritis.

Glucose
-normally should be absent; if glucose is present in the urine, manifestations can be suspected diabetes mellitus, receiving large quantity carbohydrates from food, acute pancreatitis.

Acidity
- the kidneys maintain a blood pH of 5.0-6.0 - a slightly acidic reaction. At a pH greater than 7, hyperkalemia and functional deviation can be assumed thyroid gland, infection of the urinary system, with a pH less than 5 - hypokalemia, diabetes mellitus, urolithiasis, kidney failure.

Density
- with a density of more than 1030, one can assume the presence of glucose (diabetes mellitus), protein (glomerulonephritis), with a density of less than 1010 - renal failure, damage to the renal tubules. Since the density of urine depends on the amount of water drunk, this indicator has no significant value in diagnosis.

Leukocytes
-an increased content of leukocytes in the urine is called leukocyturia, also an indicator of nephritis and urethritis. This condition is observed in various inflammatory diseases urinary system. Too pronounced leukocyturia, when the number of these cells exceeds 60 in the field of view, is called pyuria. Almost all kidney diseases and urinary system increase the content of leukocytes in the urine.

Urobilinogen
-normal urine contains traces of urobilinogen. Its level increases sharply with hemolytic jaundice (intravascular destruction of red blood cells), as well as with toxic and inflammatory lesions of the liver, intestinal diseases(enteritis, constipation). With subhepatic (obstructive) jaundice, when there is complete blockage of the bile duct, there is no urobilinogen in the urine. Urobilinogen is formed from direct bilirubin excreted in bile in small intestine. Therefore, the complete absence of urobilinogen serves reliable sign stopping the flow of bile into the intestines.

Below is also a table of normal urine test values:

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If you have diabetes, the most important thing you can do to stay healthy is control it. "ABC"

• "A" stands for “A1C”() - A1C is a blood test that shows your average blood sugar levels over the past few months.
• "B" stands for blood pressure - If you have diabetes, your blood pressure is just as important as controlling your blood sugar. High blood pressure increases the risk of heart disease and kidney disease.
• "C" stands for cholesterol - High cholesterol is another risk factor for heart attack, stroke and other serious problems.

Compared to people who don't have diabetes, people with diabetes are 2 to 3 times more likely to have a heart attack or stroke. Patients with diabetes also have more high risk heart attack in at a young age. In addition, people with diabetes are more likely to suffer from kidney disease. By controlling ABC, you can greatly reduce the risk of concomitant diseases and their severity.

Isn't controlling my blood sugar the most important thing?

But at the same time, blood sugar just one of many factors, which you should pay attention to.

High blood pressure and high level Cholesterol levels are themselves significant risk factors for cardiovascular accidents, and in the presence of diabetes mellitus, their harmful effects are greatly enhanced.

What should my ABC level be?

The level you should aim for will depend on how severe your diabetes is, how old you are, and what other health problems you have. Ask your doctor what level you should reach.

Most people with diabetes should try to achieve the following goals:

• A1C level below 7%
• Blood pressure below 130/85, or even lower in some cases
• LDL cholesterol below 1.8 mmol/L (LDL is a type of cholesterol, often called “bad cholesterol”)

How can I control ABC?

• Medicines. Most people with diabetes should take medications every day to control blood sugar. Also, many people with diabetes need medications to treat high blood pressure and/or high cholesterol for the prevention of cardiovascular diseases.
• Lifestyle changes. what and how much you eat, what your level of physical activity is, whether you are overweight, all this affects your health right now and in the future. There are several things that can help you keep your ABCs under control or reduce your health risks:
• Eat healthy foods. You need to eat plenty of fruits, vegetables, unprocessed grains, and low-fat foods. Limit the amount of meat, fried and fatty foods in your diet.
• Be active. Walking, gardening or other physical activity at least 30 minutes a day.
• Stop smoking. Smoking increases the risk of heart attack, stroke, and cancer.
• Lose weight. Being overweight increases your risk of developing many health problems.
• Avoid drinking alcohol. Alcohol can increase blood sugar and blood pressure.