PROTEIN TOTAL , URINE

Reference values Modification

Test code: 319

Mnemonic code: PO24

Effective update from 23/09/2024

The presence of persistently elevated levels of protein or albumin in the urine is a sign of kidney damage and, along with the estimation of glomerular filtration rate, forms the basis for diagnosing chronic kidney disease (CKD). Its presence identifies a group of patients at higher risk for disease progression and greater cardiovascular morbidity. The treatment aimed at reducing proteinuria levels is considered a therapeutic goal.

In our commitment to continuous improvement in the service and quality of results provided by Synlab and to offer recommendations to clinical and laboratory professionals for the detection and monitoring of proteinuria as a marker for the presence of CKD in adults and children, we have conducted a literature review on the normal values for protein concentration.

This review indicates that despite the importance of detecting and monitoring proteinuria in the diagnosis and follow-up of CKD, there is no absolute consensus among clinical practice guidelines published by different scientific societies or in the reference values adopted by different laboratories. Although reference limits for 24-hour urine protein concentrations range from 150, 230, to 300 mg/24h, we will update the reference values to align with the current trends recommended by clinical guidelines from societies such as K/DOQI, NICE, SIGN, CARI, and UK, which establish <150 mg/24h.

Consequently, starting from September 23, 2024, the following update will be made to the reference value for 24-hour urine protein and improvement of the information provided: 

              Current value: <300 mg/24h                                   Updated value: <150 mg/24h

Additionally, please remember that:

• Aside from a known diagnosis of kidney disease already under follow-up, an initial finding of proteinuria exceeding 500 mg/24 hours should be evaluated by immunofixation to determine if there is a monoclonal immunoglobulin light chain and, if so, to identify it as either kappa or lambda type.
• In healthy individuals, urine protein concentrations of up to 300 mg/24 hours may appear after intense physical exercise.

PREVIOUS	NEW
Reference values:               Less than 300 mg/24 h             Version of Test: 12	Reference values:                   Less than 150 mg/24 h                Version of Test: 13

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