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A urine protein test is a simple but important way to check how well your kidneys are working. This is important for people with several conditions, including IgA nephropathy (IgAN), a form of chronic kidney disease (CKD). A urine protein test looks for proteinuria (protein in your urine). Having protein in your urine is often one of the first signs of kidney damage from IgA nephropathy or other kidney conditions.
Understanding your results can help you see how your kidneys are doing over time. It also helps your healthcare team know whether your current treatment is protecting your kidneys or if changes are necessary.
In this article, we’ll explain what a urine protein test measures, what counts as a normal or high protein level, and what you can expect when you give a urine sample.
When the kidneys are healthy, they act like filters. They keep proteins, which are important building blocks in the body, in your bloodstream. At the same time, they get rid of extra water and waste products. When kidneys become damaged — as happens when you have IgA nephropathy — protein can leak from the bloodstream into the urine. The urine test results give doctors an idea of how much protein is being lost in your urine.
Dipsticks are quick tests that can estimate protein levels almost immediately using a color scale. A test strip is dipped into a urine sample to reveal how much protein is present on the following scale:
Although a dipstick test is less accurate than a lab test, it’s a low-cost and quick way to monitor major changes in the amount of protein in your urine.
Total protein is one of the common indicators found in a urinalysis, or a basic urine test. This number is the total amount of protein in a urine sample. It tests for the overall amount of protein, but it doesn’t tell the difference between different types of protein.
This test is often used for an initial screening. If your total urine protein is elevated, your healthcare provider will likely order more specific tests to gather additional information.
Albumin is the most common protein found in the blood. If the kidneys’ filters are damaged, albumin is often one of the first proteins to leak into the urine because there is so much of it and it’s relatively small in size.
In IgAN, albumin levels in urine often rise during flare-ups or when the disease is getting worse.
Your doctor may ask you to collect your urine for 24 hours to measure albumin (or total protein) over a full day. This helps smooth out normal changes that happen throughout the day and gives a more accurate picture of how much protein is leaking from your kidneys.
Creatinine is a waste product that your body makes at a steady rate. A test of your urine protein/creatinine ratio (UPCR) compares the amount of protein with the amount of creatinine in a single urine sample and gives more accurate results than a total protein test. Comparing protein to creatinine helps doctors understand how much protein you’re losing throughout the day.
This test is helpful because it avoids the need for a full 24-hour urine collection test.
Similar to the protein/creatinine ratio, a test of your urine albumin/creatinine ratio (ACR or uACR) specifically measures albumin loss compared to creatinine. It’s one of the most important tests for detecting early kidney damage, as albumin is usually the first protein to be seen in the urine in IgA nephropathy. This test is also critical for tracking kidney health over time.
IgA nephropathy damages the kidney’s filtering units, which are called glomeruli. When immunoglobulin A (IgA) builds up in these filters, it causes inflammation and makes them “leaky.” As a result, protein that should stay in the bloodstream can spill into the urine.
Tracking protein over time helps your care team:
Lowering your urine protein levels is one of the most important goals in IgAN management.
Understanding the healthy ranges for urine protein values can make your own chart results easier to follow.
On a dipstick, it’s normal to have negative or trace protein. Any result of 1 or higher is abnormal. Total urine protein over 24 hours should be less than 150 milligrams per day.
The urine albumin/creatinine ratio should be less than 30 milligrams of albumin per gram of creatinine. A moderately elevated level would be between 30 and 300 milligrams per gram. Greater than 300 milligrams per gram is considered severely elevated.
These numbers help your care team understand how much protein your kidneys are losing and whether damage may be getting better or worse over time.
Normal or low levels of protein in the urine usually mean that your kidneys are filtering well. If your urine protein is normal or low, it may be a sign that your treatment is helping, and your IgA nephropathy is more stable.
Moderately elevated protein levels can mean early kidney damage or mild disease activity. Severely elevated protein levels are associated with worse kidney damage.
You may take a urine test at home, in your doctor’s office, at the hospital, or in the lab. Different types of tests provide different information.
One general rule is that you should avoid intense exercise the day before a protein test. Exercise may falsely elevate urine protein levels. Let your doctor know if you have a fever, menstrual bleeding, or a urinary tract infection at the time of your test, as these can also alter your test results.
Some people with IgAN use home testing to monitor their protein level between checkups. During a dipstick test, you dip a test strip into your urine. Based on the levels of protein in your urine, the test strip changes color. By comparing the color to the scale on the bottle, you can estimate how elevated your urine protein is.
This test is fast and easy. It helps you track patterns and detect early flares from home. However, dipsticks are less precise than lab tests, and can’t measure exact amounts.
You may give a sample during your visit or bring it to a lab. Lab testing provides exact numbers, like uACR or UPCR. With a 24-hour urine collection, you can see exactly how much protein you lose in a 24-hour period. These lab tests are used when dipstick tests don’t match your symptoms or when you have very high levels of protein.
A clean urine sample helps to make sure the results are accurate, as contact with skin can contaminate the levels of protein in your sample. In order to collect a clean-catch sample, follow these steps:
Deliver the sample to the lab or clinic within the requested amount of time.
If you’re collecting from home, follow your doctor’s or lab’s instructions. They may ask you to refrigerate your sample or bring it back within a certain period of time.
The frequency of urine tests to monitor your IgA nephropathy depends on specific advice from your nephrologist. How often you need a urine test is usually based on how active your IgAN is and what treatments you’re on. If your condition is stable, you may only require urine testing every few months. If you have a newer diagnosis, are experiencing a flare, or have recently changed your medications, you may need these tests more often.
Many doctors use a combination of a urine test and a blood test at the same visit to get a more complete picture of how your kidney is functioning.
Some changes may mean it’s time to call your doctor. If you notice a sudden jump in your home dipstick results (such as trace to 2+ or higher), or notice a rising uACR or UPCR on your lab tests, talk to your doctor about how your IgAN is being managed.
Symptoms to look out for that could signify protein being lost in the urine include:
When you’re sick, dehydrated, or stressed, your protein levels may worsen. By communicating well with your healthcare team, you can ensure that you’re taking good care of your kidneys and overall health.
On myIgANteam, people share their experiences with IgAN, get advice, and find support from others who understand.
What has been your experience with protein in the urine after your IgA nephropathy diagnosis? Let others know in the comments below.
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