Urine Protein and Urine Protein to Creatinine Ratio
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- Also Known As:
- 24-Hour Urine Protein
- Urine Total Protein
- Urine Protein to Creatinine Ratio
- UPCR

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At a Glance
Why Get Tested?
To screen for excess protein in the urine, to help evaluate and monitor kidney function, and to detect kidney damage
When To Get Tested?
As part of a routine physical, often as part of a urinalysis; urine total protein and urine protein to creatinine ratio (UPCR) have traditionally been used as important indicators of kidney disease and as a follow-up testing for monitoring the disease. However, albumin to creatinine ratio (ACR) is now the preferred testing for these purposes.
UPCR should still be requested to identify preeclampsia in pregnant women and where the excess urine total protein is suspected to be other than albumin.
Sample Required?
A single urine sample is collected in a clean container at any time (random/spot). For a 24-hour urine collection, the collection process generally begins first thing in the morning by discarding the first morning void and then collecting all of the urine for the remaining 24-hour period. The sample must be refrigerated during this period. There should be no preservatives in the container. Occasionally, a split 24-hour sample, with the night collection (11 pm to 7 am) separated from the day collection (7 am to 11 pm), may be used. Often, a blood sample may also be taken to measure your creatinine and serum protein levels, especially when 24-hour urine has been ordered.
Since the results from both types of sample collection methods are highly correlated, the spot urine collection may be used as a rapid and reliable alternative for UPCR measurement.
Test Preparation Needed?
None
What is being tested?
Urine protein tests detect and/or measure protein being released into the urine. Normal urine protein elimination is less than 150 mg/day and less than 30 mg of albumin/day. Elevated levels may be seen temporarily with conditions such as infections, stress, pregnancy, diet, cold exposure, or heavy exercise. Persistent protein in the urine suggests possible kidney damage or some other condition that requires additional testing to determine the cause.
There are several different kinds of urine protein tests, including:
- A semi-quantitative protein “dipstick” may be performed as part of a urinalysis, generally on a random urine sample.
- The quantity of protein in a 24-hour urine sample may be measured and reported as the amount of protein released per 24 hours.
- The amount of protein in a random urine sample may be measured along with urine creatinine and reported as the ratio of urine protein to creatinine (UPCR).
Creatinine, a byproduct of muscle metabolism, is normally released into the urine at a constant rate. When both a urine creatinine and a random urine protein test are performed, the resulting protein/creatinine ratio approaches the accuracy of the 24-hour urine protein test. Since saving all of the urine for 24 hours can be cumbersome for adults and difficult for infants and children, a random urine protein to creatinine ratio is sometimes substituted for a 24-hour urine protein sample.
Plasma proteins are essential for all living beings. The kidneys, two organs found in the back at the bottom of the rib cage, recapture these proteins by filtering the blood by removing wastes and eliminating them from the body in the urine. When the kidneys are functioning normally, they retain or reabsorb the filtered proteins and return them to the blood.
However, if the kidneys are damaged or compromised due to other conditions, they become less effective at filtering, causing detectible amounts of protein to spill over into the urine. Routine dipstick testing of urine measures the presence of albumin. Albumin, a protein produced by the liver, makes up about 50%-60% of the protein in the blood. The rest is a mixture of globulins, including immunoglobulins. As kidney damage progresses, the amount of albumin in the urine increases, a key factor in the early detection of a potential kidney disorder.
Protein in the urine, also called proteinuria, is frequently seen in chronic diseases, such as diabetes and/or hypertension, with increasing amounts of protein in the urine reflecting increasing kidney damage. There are often no signs and symptoms with early kidney damage. As kidney damage progresses, or if protein loss is severe, you may develop symptoms such as fluid build-up (edema), shortness of breath, nausea, and fatigue. The production of too much protein, as seen with multiple myeloma, lymphoma, and amyloidosis, can also lead to proteinuria.
The presence of albumin in the urine (albuminuria) is a sensitive indicator of kidney disease in people with diabetes and/or hypertension. Therefore, it is recommended that people with these conditions be regularly screened for albumin in the urine, as opposed to total urine protein.
Common Questions
Health Professionals – LOINC
LOINC Observation Identifiers Names and Codes (LOINC®) is the international standard for identifying health measurements, observations, and documents. It provides a common language to unambiguously identify things you can measure or observe that enables the exchange and aggregation of clinical results for care delivery, outcomes management, and research. Learn More.
Listed in the table below are the LOINC with links to the LOINC detail pages. Please note when you click on the hyperlinked code, you are leaving Testing.com and accessing Loinc.org.
LOINC | LOINC Display Name |
---|---|
13801-6 | Protein/Creatinine (24H U) [Mass ratio] |
2890-2 | Protein/Creatinine (U) [Mass ratio] |
40486-3 | Protein/Creatinine (24H U) [Ratio] |
34366-5 | Protein/Creatinine (U) [Ratio] |
27298-9 | Protein Qn (U) |
21028-6 | Protein (24H U) [Interp] |
50749-1 | Protein (U) [Interp] |
21482-5 | Protein (24H U) [Mass/Vol] |
2888-6 | Protein (U) [Mass/Vol] |
50561-0 | Protein Auto test strip (U) [Mass/Vol] |
5804-0 | Protein Test strip (U) [Mass/Vol] |
35663-4 | Protein Unsp time (U) [Mass/Vol] |
2889-4 | Protein (24H U) [Mass/Time] |
32209-9 | Protein Test strip Ql (24H U) |
2887-8 | Protein Ql (U) |
53525-2 | Protein SSA method Ql (U) |
57735-3 | Protein Auto test strip Ql (U) |
20454-5 | Protein Test strip Ql (U) |
View Sources
Sources Used for Current Review
2020 review performed by Li-Sheng Chen, PhD, DABCC, FACB.
(©2020) National Kidney Foundation. What You Should Know About Proteinuria. Available online at https://www.kidney.org/atoz/content/proteinuriawyska. Accessed on 4/23/2020.
(©2020) National Kidney Foundation. Kidney Disease. Available online at https://www.kidney.org/kidneydisease. Accessed on 4/23/2020.
Inker LA, Astor BC, Fox CH, et al. KDOQI US commentary on the 2012 KDIGO clinical practice guideline for the evaluation and management of CKD. Am J Kidney Dis. 2014;63(5):713–735. doi:10.1053/j.ajkd.2014.01.416.
Carroll MF, Temte JL. Proteinuria in adults: a diagnostic approach. Am Fam Physician. 2000;62(6):1333–1340.
Henderson JT, Thompson JH, Burda BU, Cantor A, Beil T, Whitlock EP. Screening for Preeclampsia: A Systematic Evidence Review for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2017.
Sources Used for Previous Reviews
Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].
Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.
(2004 March 17, Updated) A.D.A.M. editorial, Agha, I., previously reviewed. Protein-urine. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003580.htm.
Brose, M, Updated (2003 May 8). Protein electrophoresis – urine. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003589.htm.
Carroll, M. and Temte, J. (2000 September 15). Proteinuria in Adults: A Diagnostic Approach. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/20000915/1333.html.
Loghman-Adham, M. (1998 October 1). Evaluating Proteinuria in Children. American Family Physician [On-line journal]. Available online at http://www.aafp.org/afp/981001ap/loghman.html.
(2003 June) Proteinuria. Kidney and Urologic Diseases Information Clearinghouse, NIH Publication No. 03-4732 [On-line information]. Available online at http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/.
Pagana, Kathleen D. & Pagana, Timothy J. (© 2007). Mosby’s Diagnostic and Laboratory Test Reference. 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 971-978.
Clarke, W. and Dufour, D. R., Editors (2006). Contemporary Practice in Clinical Chemistry. AACC Press. Washington, DC. Pp 312-317.
Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests. Fourth Edition. Saunders Elsevier. St. Louis, Missouri. Pp 916-919.
Mushnick, R. (2007 October 22, Updated). Protein – urine. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003580.htm. Accessed on 9/30/08.
Mushnick, R. (2007 October 22, Updated). 24-hour urine protein. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003622.htm. Accessed on 9/30/08.
Aggarwal, N. et. al. (2008 April 22). A Prospective Comparison of Random Urine Protein-Creatinine Ratio vs 24-hour Urine Protein in Women With Preeclampsia. Medscape J Med. 2008;10(4):98 [On-line information]. Available online at http://www.medscape.com/viewarticle/571729. Accessed on 9/30/08.
(2005 November). Proteinuria: Approach to the Genitourinary Patient. Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec17/ch226/ch226j.html?qt=urine%20protein&alt=sh. Accessed on 9/30/08.
Lerma, E. and McLaughlin, K. (2007 February 5, Updated). Proteinuria. EMedicine [On-line information]. Available online at http://www.emedicine.com/med/TOPIC94.HTM. Accessed on 9/30/08.
Dugdale, D. (Updated 2011 August 20). Protein – urine. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003580.htm. Accessed October 2012.
Dugdale, D. (Updated 2011 August 21). 24-hour urine protein. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003622.htm. Accessed October 2012.
Pagana, K. D. & Pagana, T. J. (© 2011). Mosby’s Diagnostic and Laboratory Test Reference 10th Edition: Mosby, Inc., Saint Louis, MO. Pp 1003-1004.
Clarke, W., Editor (© 2011). Contemporary Practice in Clinical Chemistry 2nd Edition: AACC Press, Washington, DC. Pp 366-368.
(© 1995-2012). Protein, Total, Urine. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/8261. Accessed October 2012.
Barclay, L. (2011 August 4). Urine Dipstick Protein Test Detects Silent Kidney Disease. Medscape Medical News [On-line information]. Available online at http://www.medscape.com/viewarticle/747567. Accessed October 2012.
Lerma, E. et. al. (2015 December 10 Updated). Proteinuria. Medscape Drugs and Diseases [On-line information]. Available online at http://emedicine.medscape.com/article/238158-overview. Accessed 4/17/16.
(2014 April). Proteinuria. National Institute of Diabetes and Digestive and Kidney Diseases [On-line information]. Available online at http://www.niddk.nih.gov/health-information/health-topics/kidney-disease/proteinuria/Pages/facts.aspx. Accessed 4/17/16.
Martin, L. (2014 November 2 Updated). Protein urine test. MedlinePlus Medical Encyclopedia [On-line information]. Available online at https://www.nlm.nih.gov/medlineplus/ency/article/003580.htm. Accessed 4/17/16.
(© 1995–2016). Protein, Total, 24 Hour, Urine. Mayo Clinic Mayo Medical Laboratories. [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8261. Accessed 4/17/16.
Mayo Clinic Staff (2014 May 8). Protein in Urine. Mayo Clinic [On-line information]. Available online at http://www.mayoclinic.org/symptoms/protein-in-urine/basics/definition/SYM-20050656. Accessed 4/17/16.
Cohen, E. and Lippold, C. (2016 March 8 Updated). Nephrotic Syndrome. Medscape Drugs and Diseases [On-line information]. Available online at http://emedicine.medscape.com/article/244631-overview. Accessed 4/17/16.
Lin J, Denker BM. Azotemia and Urinary Abnormalities. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Harrison’s Principles of Internal Medicine, 19e. New York, NY: McGraw-Hill; 2015. Available online at http://accessmedicine.mhmedical.com.libproxy1.upstate.edu/content.aspx?bookid=1130&Sectionid=79726507. Accessed April 17, 2016.
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