In clinical work, we often ask patients to keep urine for 24 hours and measure the total amount of urine protein in it, which is called 24-hour urine protein quantification. Patients are very concerned about the results of their urine protein quantification, and sometimes the errors after the clinical measurement are large, causing unnecessary panic to patients. In fact, there are many clinical factors that can affect the 24-hour urine protein quantification results.
1, whether the urine retention is accurate
24-hour urine protein quantification, as the name implies, is to retain 24 hours of urine, that is, all 24 hours of urine collection. Clinical generally collect the urine from 7:00 a.m. of the first day to 7:00 a.m. of the next day.
The specific methods are as follows.
(1) Active urination at 7:00 a.m. on the day of urine retention, this time the urine is produced before 7:00 a.m. and should be discarded.
(2) After 7:00 a.m. until 7:00 a.m. the next day, each urine discharge should be kept in a clean container.
(3) You should also initiate urination at 7:00 a.m. the next morning, and all urine produced before 7:00 a.m. this time must be kept.
(4) Collect and stir the urine for 24 hours and record the total amount.
(5) Remove 10 ml of the mixed 24-hour urine and send it to the laboratory to test the concentration of it as much as possible at 1 hour, multiplying it by the total amount of 24-hour urine to get the 24-hour urine protein quantification. It can be seen that the urine volume method is very accurate, while the total amount of measurement is accurate (try to use a measuring cylinder accurate to 10ml is best), and whether the urine is mixed before sending the test are affected by the experimental results.
2, whether there is fever and other factors.
Fever and hyperthyroidism, increased cardiac output, accelerated metabolism, will cause increased urinary protein excretion. When right heart insufficiency, the body circulation stasis, will also increase protein loss.
3. High protein diet.
High-protein diet will increase the burden on the kidneys and also increase urinary protein excretion, which will have an impact on the experimental results.
4, urine contamination.
Such as adnexal inflammation, prostatitis, urine collected during menstruation, etc. can be affected, thus causing a false increase in urine protein.
5, after the infusion of albumin.
Clinically, proteinuric patients, especially those with nephrotic syndrome, are routinely not infused with albumin, except to initiate diuresis after increasing colloid osmotic pressure, which is compelling, but only occasionally. The more albumin is infused, the more it is excreted. Therefore, the excretion of urinary protein is increased for several days after clinical infusion of albumin.
6. Increased blood pressure.
Increased blood pressure will increase the pressure in the glomerulus, increase perfusion, increase filtration, and thus increase proteinuria.
7.Due to changes in the disease itself.
8, other.
Such as test errors, specimens wrong, etc. will also affect the experimental results.
In summary, encounter proteinuria fluctuations, the first factor to affect the increase in urinary protein excretion is the disease itself factors, no doubt, to actively treat the disease. If it is caused by other reasons, it should be avoided as much as possible. What is more, the 24-hour urine protein quantification should be tested several times in a row (generally 3 times) to take the average value which is relatively accurate and its closer to the real level.