High urine protein is called proteinuria. While transitory proteinuria is common, persistent proteinuria is a red flag for kidney disease. This symptom often lurks under the radar until it's revealed by a urine test, often performed in conjunction with a routine physical or insurance exam. If the proteinuria is still present after a second test, the doctor often refers the patient to a nephrologist to determine the cause.
Causes
Stress, intense exercise, fever, inflammation or illnesses such as colds may cause transitory proteinuria. Such instances of proteinuria resolve by themselves. The proteinuria associated with chronic kidney disease is more serious. It can be caused by diabetes, diseases of the glomeruli, or kidney filters, or diseases of the renal tubules. The higher the urine protein value, the more likely the cause is related to glomerular disease.
Measurement
Nephrologists use several different techniques to measure urine protein. The 24-hour test involves saving all your urine in a big jug that is provided by the laboratory. While this is the gold standard for protein measurement, it requires complete patient compliance.
A dipstick test is a cheap, but less accurate, way of measuring urine protein. Many other measurements, such as pH, specific gravity, are included in the dipstick.
Measuring the protein and creatinine in a single urine specimen and using the results to calculate a protein-to-creatinine ratio is a popular technique that is more accurate than the dipstick and less onerous for the patient than the 24-hour test.
Treatment
Nephrologists often treat mild-to-moderate urine protein with angiotensin-converting enzyme inhibtors -- better known as ACE inhibitors -- and a low-protein diet. If urine protein levels exceed more than 3 g per day, nephrologists commonly recommend prednisone or some other immunsuppressant. Getting urine protein under control is important because it accellerates the rate of renal decline independently from the underlying disease.
Warning
High urine protein is not something to take lightly. This is not the time to self-diagnose. Many patients drink large amounts of water before undergoing exams in the hope that they can lower their urine protein values. Drinking an excessive amount of water may slightly decrease your urine protein level, but it will also shift the specific gravity of your urine. A better approach is to eat and drink normally.
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