Urine
Urine screening
Laboratory screening of ten urine parameters, including protein, glucose, blood cells, nitrite, pH and specific gravity. You collect the sample at home.
€ 35,00
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Urine tests · Urine
Protein
Protein in the urine; a possible sign of kidney damage, but often temporary due to exercise, fever or an infection.
At a glance
- Measured in urine
- In 1 test panel
- Check the preparation
Explanation
Protein: what is measured?
Healthy kidneys keep proteins in the blood; only a very small amount ends up in the urine. The pad on the dipstick mainly reacts to albumin, the most important protein in the blood. With damage to the kidney filters, albumin appears in the urine first, and with greater damage other proteins as well. The dipstick only detects a considerable amount; it misses the small amounts of albumin that occur with early kidney damage.
What can it detect?
- Kidney damage, for example due to diabetes or high blood pressure
- Inflammation of the kidney filters (glomerulonephritis)
- Temporary protein loss due to exercise, fever or a urinary tract infection
Result
What does the result mean?
Positive result
Protein in the urine is often temporary and harmless: after heavy exercise, with fever, dehydration or a urinary tract infection, or in some young people only after standing for a long time (orthostatic proteinuria). Menstrual blood, discharge and very concentrated or alkaline urine can also give a positive result. If the protein is still present on repeat testing, this may point to kidney damage, usually due to diabetes or high blood pressure, and sometimes to a kidney disease. Kidney damage causes no symptoms for a long time; with a lot of protein loss, swollen ankles and foamy urine can develop.
Negative result
A negative result is normal. It does not rule out early kidney damage, because the dipstick does not detect small amounts of albumin; in diabetes or high blood pressure, the albumin-creatinine ratio is needed for this. The dipstick can also miss protein in very diluted urine and with proteins other than albumin.
After an abnormal result
With a positive result, the GP first rules out a urinary tract infection. Then, according to the Dutch GP guideline (NHG) on chronic kidney damage, the albumin-creatinine ratio in morning urine and the eGFR in blood follow, repeated to see whether the abnormality persists. With a lot of protein, rapidly declining kidney function or protein together with blood in the urine, the GP refers you to an internist-nephrologist.
Reliability
How reliable is the test?
A urine dipstick is a quick screening and not a diagnosis. According to the Dutch GP guideline (NHG) on urinary tract infections, the dipstick is a first step with symptoms that fit a bladder infection; if in doubt, a culture or sediment test follows. For detecting kidney damage, the dipstick is less sensitive than the albumin-creatinine ratio in urine and the eGFR in blood; the NHG guideline on chronic kidney damage is based on those. In people without symptoms, most abnormal dipstick results are temporary or harmless; a single abnormal result therefore says little.
What can affect the result?
- Sample collection: preferably use first morning urine or urine that has been in the bladder for at least 4 hours, and after washing, catch the middle part of the stream (midstream), so that no discharge or skin bacteria get into it.
- Menstruation, and the days before and after it, often gives a positive result for blood and sometimes for leukocytes and protein; it is better to collect at another time.
- Vitamin C (supplements or a lot of fruit juice) can suppress the reaction for blood, glucose, nitrite and bilirubin and give a false negative result.
- Heavy exercise, fever and dehydration in the day before sample collection can temporarily cause protein, blood or ketones. Urine that has been standing for a long time or has become warm gives less reliable results, especially for nitrite, bilirubin, urobilinogen and pH.
Preparation
- Preferably use the first morning urine, or urine that has been in your bladder for at least 4 hours.
- Collect the middle part of the stream.
- Do not collect urine during your period.
Who it is for
Who is the test useful for?
Useful for
Useful with symptoms that may fit a bladder infection, such as frequent and painful urination, or as a simple addition to blood tests for the kidneys, sugar or liver. For detecting kidney damage in diabetes or high blood pressure, the albumin-creatinine ratio in urine says more than the dipstick. In people without symptoms and without risk factors, the chance of a harmless abnormality is greater than the chance of a real condition.
How common is it?
Bladder infection is one of the most common infections in women; in men it is much less common. Chronic kidney damage occurs in about 1 in 10 adults, usually without symptoms. In people without symptoms, an abnormality on the dipstick is found in some, usually without a serious cause.
NHG guideline on urinary tract infections; NHG guideline on chronic kidney damage
Get tested
Protein: test panels
Protein is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and resultsMore explanations
Other tests: Urine tests
- Bilirubin
- Erythrocytes and free hemoglobin
- Glucose
- Ketones
- Leukocytes
- Nitrite
- pH
- Specific gravity
- Urobilinogen