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Microalbumin Random Urine with Creatinine

Also known as

24-Hour Urine Protein, Urine Total Protein, Urine Protein to Creatinine Ratio, UPCR

This test is ordered by the doctor to screen for excess protein in the urine. It is also used to monitor kidney function and identify kidney damage.
The test is ordered in a variety of situations. It is often part of the urinalysis. The Urine Protein and the Urine Protein to Creatinine ratio values are used by doctors as indicators of kidney disease. They are also used as follow-up testing for monitoring the disease. The test is also used by the doctor to identify preeclampsia in a pregnant woman. Moreover, it is ordered when excess urine total protein is thought to be other than albumin.
The test has two different types of urine collections. A single urine collection is supposed to be collected at any given time during the day. On the other hand, the 24-hour urine collection is a drawn-out process. The collection begins first thing in the morning by discarding the first void and is followed by the collection of all of the urine afterward for the remainder of the day. Moreover, the sample should be kept in the fridge during this period. The container should be clean, and there should be no preservatives in it. Sometimes the sample is a split 24-hour sample, with a night collection from 11 pm to 7 am. And a day collection is from 7 am to 11 pm. Sometimes a blood sample is also taken by the doctor to measure the serum protein and creatinine levels, particularly when a 24-hour urine test has been ordered. A spot urine collection is a quicker and reliable alternative.
There is no special preparation needed for the test.
The tests measure the amount of protein that is being released into the blood. On average, urine protein elimination is less than 150 mg per day and less than 30 mg of albumin per day. Temporary higher levels are linked to infections, stress, pregnancy, diet, exposure to cold or heavy exercise. On the other hand, if levels are persistent, they are linked to kidney damage or some other condition that must be investigated. Creatinine is produced as a by-product by muscle metabolism and is released in the urine at a constant rate. Both single spot urine tests and 24-hour urine tests are conducted; the single spot test has an accuracy rate of a 24-hour one. Plasma proteins are important for all living beings. Kidneys capture these proteins through the process of filtration and eliminate them from the body via urine. When the kidneys are functioning healthily, they reabsorb the filtered proteins and return them to the blood. If they are damaged or not functioning properly, they become less effective at the process of filtering, leading to detectable amounts of protein spilling over into the urine. The presence of protein in the urine is also called proteinuria and occurs commonly in chronic diseases like diabetes and hypertension. The higher the amount of protein in the blood, the more the kidney damage Kidney damage has no signs and symptoms in the early stage. It progresses with time, with symptoms like fluid build-up, shortness of breath, nausea, and fatigue – this occurs when protein loss is high. When too much protein is produced, it can be indicative of lymphoma, amyloidosis, multiple myeloma and may also lead to protein in the urea. The presence of albumin in the protein also indicates kidney disease in people with diabetes or hypertension
There are three different urine tests:
  1. A semi-quantitative protein "dipstick" is performed as part of a urinalysis, typically on a single urine sample.
  2. The quantity of protein in a 24-hour urine sample may be measured and reported as the amount of protein released per 24 hours.
  3. The amount of protein in a random urine sample can also be measured alongside the amount of urine creatinine and reported as the ratio of urine protein to creatinine (UPCR).
  4. The routine dipstick test measures the amount of albumin in the urine. Albumin is a protein that composes nearly 60% of the protein in the blood. If the kidneys are damaged, the amount of albumin in the urine rises. If slight to moderate amounts of protein are found, then a repeat of the urinalysis and dipstick may be ordered at a later time to see if it has subsided. High levels of protein warrant repeat testing. If the same levels or increased levels are found, then other blood tests and a 24-hour test will be ordered. UP/CR can be ordered on a single sample if there is a high level of protein in the blood. 24-hour or random sample tests are used for monitoring people with kidney conditions, and dipstick urine or protein to creatinine ratio is used for people that are on medication that impacts kidney function.
Dipstick urine is ordered as a screening test as part of urinalysis. It can be routine, part of pregnancy work-up, or when a urinary tract infection is suspected. It can also be done when someone is admitted to the hospital or to evaluate function. It may also be ordered in other situations, such as when a pregnant woman is at risk of preeclampsia or someone is on a medication that may impact kidney function.
If the test result is negative, it means there was no detectable protein when the test was carried out. Protein can also be temporary in a single spot test due to an infection, diet, cold exposure, etc. Protein in the urine is an indicator of a serious condition and requires further investigation. Three positive urine tests over a period of time are often followed up with additional tests. Persistent or high protein indicates kidney disease. The higher the amount, the more damage caused or severe the condition is. The most common causes of protein in urine are diabetes and hypertension. Proteinuria may also be seen with many other diseases and conditions. A healthcare practitioner may order other tests and take into account those results to help determine the cause. Some examples of these causes include:
  1. Urinary tract infection
  2. Preeclampsia
  3. Lupus
  4. Multiple myeloma
  5. Amyloidosis
  6. Bladder cancer
  7. Congestive heart failure
  8. Drug therapies that are potentially toxic to the kidneys
  9. Goodpasture syndrome
  10. Heavy metal poisoning
Related Tests

Microalbumin Urine, Random Urine with creatinine, Urinalysis, Albumin, Urine Albumin, and Albumin to Creatinine Ratio, Total Protein, Albumin-Globulin (A/G) Ratio, Protein Electrophoresis, Immunofixation Electrophoresis, Blood Urea Nitrogen (BUN), Creatinine, Urine, Creatinine Clearance, Estimated Glomerular Filtration Rate (eGFR)