Urine Protein Creatinine Ratio

What is a urine protein creatinine ratio test?

A urine protein creatinine ratio (UPCR) test measures the levels of protein and creatinine in your pee. Creatinine is a waste product that your muscle cells make when they use energy. Protein in the urine can mean you have kidney damage.

Healthy kidneys filter waste products out of your blood. The waste products leave your body in your pee. Creatinine is one of these waste products. Creatinine is only a marker that providers use to adjust for the protein measure.

A UPCR test gives healthcare providers important information about how your kidneys are working. The results can help them diagnose conditions that cause kidney damage. UPCR can also tell providers how well treatments are working. Depending on the results, they may recommend more tests or treatments.

When is it performed?

Your healthcare provider may recommend a urine protein creatine ratio test to look for high protein levels in your pee (proteinuria). Proteinuria is a symptom of kidney disease.

Providers may also recommend a UPCR:

• At a routine physical exam
• If you’re pregnant and have signs of high blood pressure (preeclampsia)
• To monitor kidney damage
• If you have signs or symptoms of chronic kidney disease (CKD)
• If you have diabetes or high blood pressure

How does a urine protein creatinine ratio test work?

A urine protein creatinine ratio test is a type of kidney function test. It measures protein and creatinine in only one sample. Measuring both substances helps make a UPCR accurate.

When your kidneys function normally, they filter chemical wastes like creatinine from your blood. They also filter some proteins. Proteins are essential building blocks of your body. Your body systems need them to function normally. In healthy kidneys, almost all the protein that filters into the pee goes back to the blood. When your kidneys don’t work as expected, more protein than normal can leak into your pee. Your kidneys can’t send all the protein back to your blood. These proteins leak into your pee.

How do I prepare for the test?

It’s a good idea to drink a glass of water about 30 minutes before the test so you can give about 2 ounces of pee. But otherwise, you don’t need to do anything to prepare for a urine protein creatinine ratio test.

Sometimes, healthcare providers measure protein in your pee over a 24-hour period. A 24-hour UPCR can give a more accurate look at your levels throughout the day.

What to expect during the test

You’ll pee into a clean container at your healthcare provider’s office. You’ll do this in a private bathroom with a toilet and sink.

During the test, you’ll do the following:

1. Wash your hands with soap and water.
2. Take the lid off the container.
3. Clean your genitals — especially around your urethra — with antimicrobial wipes.
4. Pee into the toilet for several seconds.
5. Stop peeing and place the collection cup under your genitals.
6. Pee into the collection cup.
7. Stop peeing once you fill it to a line on the cup. Move the cup away when you’re done.
8. Finish peeing in the toilet.
9. Place the lid back onto the collection cup.
10. Return the collection cup to your provider.

You may be able to collect a pee sample at home. If you do, follow the steps above. When you’re finished, store the collection cup in your refrigerator until you can take it to your provider.

What to expect after the test

After collecting your pee sample, your healthcare provider either tests your pee in their office or sends it to a lab for testing. They’ll contact you with your results.

What are the benefits and risks of a UPCR test?

The main benefit of a urine protein creatinine ratio test is that it can check for kidney disease and monitor conditions that cause kidney damage.

Unlike other types of pee tests, a UPCR measures creatinine and protein levels. You only need to provide one sample. But your healthcare provider may want to repeat the test several times over a few weeks. This allows them to get a more accurate measure of protein in your pee. It’s a convenient, reliable alternative to other types of tests that may need multiple samples.

A UPCR test doesn’t have any risks. It’s noninvasive, quick and painless. In rare cases, your results may be unclear or inconclusive. If this happens, you may need to give another sample.

What type of results do you get and what do the results mean?

Healthcare providers interpret your UPCR results according to the ratio between protein and creatinine in your pee. A lower number means your kidneys are working as they should. A higher number means you may have kidney damage.

For adults, if your kidneys are working as they should, they get rid of less than 150 milligrams of protein per day in your pee. A moderate increase is between 150 milligrams and 500 milligrams. A severe increase is greater than 500 milligrams.

When should I know the results of the test?

It depends. Your results may be ready in a few minutes, or it may take up to a few days. Your healthcare provider will let you know when to expect your results.

What causes a high urine protein creatinine ratio?

Temporary causes of high protein levels in your pee include:

• Infection
• Inflammation
• Intense physical activity
• Pregnancy
• Stress
• Taking aspirin every day

Unmanaged diabetes and high blood pressure are the most common causes of severe kidney damage and kidney failure.

What does it mean if it’s high?

If your UPCR is high, it means you may have kidney damage. Your healthcare provider may recommend additional tests to confirm kidney disease. These may include:

• Albumin blood tests
• Creatinine clearance test
• CT scans
• Estimated glomerular filtration rate (eGFR)
• Globulin blood tests
• Kidney biopsy
• Ultrasounds

When should I worry about urine protein creatinine ratio?

A UPCR that’s higher than expected over several months can indicate kidney disease. Your healthcare provider may refer you to a nephrologist. Nephrologists are medical doctors who specialize in diagnosing and treating kidney conditions.

What is the protein creatinine ratio in pregnancy?

Your urine protein creatinine ratio increases during pregnancy. During pregnancy, 300 milligrams of protein or higher is common. It doesn’t indicate any kidney problems in you or complications with your pregnancy.

When should I call my doctor?

Call your healthcare provider if you have any questions about your UPCR results. They can explain next steps, including any necessary follow-up tests or treatments.