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      The Significance of Trace Proteinuria

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          Abstract

          Background: The clinical significance of a trace protein reading on urinalysis is unclear, and such a result is often ignored by the clinician. Methods: We examined 185 samples of urine with trace proteinuria by both Chemstrips and sulfosalicylic acid testing, and compared the results with those of urinary albumin and total protein concentrations. Results: Taking for the purposes of this study an arbitrary upper limit of normal of 20 mg/l for albumin and 100 mg/l for total protein concentration, we found abnormal albumin excretion in 87% and abnormal total protein excretion in 88% of trace samples. In this study, a negative urinalysis for protein excluded microalbuminuria in 87% and proteinuria in 78% of cases. Conclusion: Qualitative testing for protein by urinalysis has a high sensitivity and specificity for diagnosing or ruling out microalbuminuria. Trace proteinuria usually means microalbuminuria; negative proteinuria tends to rule it out.

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          Microalbuminuria and all-cause mortality in 2,089 apparently healthy individuals: a 4.4-year follow-up study. The Nord-Trøndelag Health Study (HUNT), Norway

          Solfrid Romundstad, Jostein Holmen, Kurt Kvenild … (2003)
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            Urinary protein and albumin excretion corrected by creatinine and specific gravity

            David J Newman, Michael Pugia, John Lott. … (2000)
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              Screening for Microalbuminuria Simplified by Urine Specific Gravity

              Chirag Parikh, Geeta G Gyamlani, Christos Carvounis (2002)
              Background: The albumin-to-creatinine ratio and the 24-hour urine collection to measure microalbuminuria are inconvenient and expensive. The newer rapid and less expensive dipstick methods for screening of microalbuminuria estimate only albumin and are subject to errors caused by variation in volume. We determined the relation between urine-specific gravity (Usg) and urine creatinine (Ucr) so that Ucr can be derived from Usg to correct for albumin concentration in the urine which is influenced by urine volume. Methods: We randomly included 42 consecutive patients from the primary care clinic, and 34 patients from the diabetic clinic. Results: We found that a very good correlation existed between Usg and Ucr in the 42 patients from the primary care clinic (Ucr = 11.4 × Usg –11,509, r = 0.83, p < 0.001). Patients from the diabetic clinic who had well-controlled blood sugar (n = 21) showed a similar trend (Ucr = 10.82 × Usg –10,882, r = 0.87, p < 0.001). However, this was not the case with uncontrolled diabetics (Ucr = 2.53 × Usg –2,513, r = 0.26, NS). Using simple arithmetic, we derived a simplified formula where Ucr can be predicted from Usg. Using multiple regression to incorporate the urinary glucose level by dipstick, a more generic formula was obtained for estimating urinary creatinine. Conclusion: Usg can be used instead of Ucr to normalize for the varied urine concentration while screening for microalbuminuria. Poorly controlled diabetics should be screened after their blood sugars are well controlled or use the more generic formula that incorporates urinary glucose. Thus, by measuring spot urine albumin and specific gravity by dipsticks one gets an easy, immediate and accurate estimation of microalbuminuria in an office setting.
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                Author and article information

                Journal
                Journal ID (publisher-id): AJN
                Journal ID (nlm-ta): Am J Nephrol
                Journal ID (doi): 10.1159/issn.0250-8095
                Title: American Journal of Nephrology
                Publisher: S. Karger AG
                ISSN (Print): 0250-8095
                ISSN (Electronic): 1421-9670
                Publication date Subscription-year: 2003
                Publication date (Print): December 2003
                Publication date (Electronic): 21 November 2003
                Volume: 23
                Issue: 6
                Pages: 438-441
                Affiliations
                aDivision of Nephrology, Cook County Hospital, bSection of Nephrology, University of Illinois at Chicago and VAMC, West Side Division, cHektoen Institute for Medical Research, Chicago, Ill., USA
                Article
                Publisher ID: 74535 Other ID: Am J Nephrol 2003;23:438–441
                DOI: 10.1159/000074535
                PubMed ID: 14583662
                SO-VID: f86f2951-7a0b-4a95-8e17-1707aced228f
                Copyright © © 2003 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date accepted : 14 July 2003
                Page count
                Figures: 2, Tables: 2, References: 33, Pages: 4
                Categories
                Subject: Original Report: Laboratory Investigation

                ScienceOpen disciplines: Cardiovascular Medicine,Nephrology
                Keywords: Microalbuminuria,Proteinuria,Trace proteinuria,Urinalysis
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine, Nephrology
                Keywords: Microalbuminuria, Proteinuria, Trace proteinuria, Urinalysis

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