What Is Urine Protein Creatinine Ratio Test? Meaning, Normal Range & Results Explained

The urine protein creatine ratio is a test that helps doctors understand the functioning of your kidneys. It tests the levels of protein and creatine in your urine, allowing your doctors to assess kidney diseases and monitor conditions that could cause kidney damage.

So, what causes a high protein/creatinine ratio? Read on to understand this and other details about this vital test.

What is the Urine Protein Creatinine Ratio Test?

The urine protein creatinine ratio is a test conducted to measure the protein and creatinine levels in your urine. Your muscle cells use creatine to produce energy and, in the process, release a waste product called creatinine. The creatinine then passes through your kidneys and is excreted from the body in your urine. It is your kidney's job to filter the creatinine from your blood to eliminate it from the body.

As filtering creatinine from the blood is an essential function of the kidneys, a urine protein creatinine ratio test helps determine the functioning of your kidney and its efficiency in eliminating creatinine from the body. This test allows doctors to diagnose kidney diseases and choose the best treatment options for your condition.  

When is a UPCR Test Performed?

A urine protein creatinine ratio (UPCR) test is usually prescribed if your doctor thinks you may be showing signs of kidney damage. This test looks for high levels of proteins in your blood, also known as proteinuria. The UPCR test is one of the best options for diagnosing kidney diseases.

You might need a UPCR test:

• As a routine checkup for kidney functioning or proteinuria
• In pregnancy, if you display symptoms of preeclampsia.
• To monitor or diagnose kidney diseases if you show symptoms such as abnormal lab test results for serum creatinine

A normal urine protein creatinine ratio level is typically considered to be 0.3 mg/mg or higher. This means that the amount of protein in the urine is relatively low compared to the concentration of creatinine. A higher UPCR level indicates a lower risk of kidney damage, as it suggests that the kidneys are effectively filtering out waste products and preventing excessive protein leakage into the urine.

How Does a Urine Protein Creatinine Ratio Test Work?

As an essential part of your urinary system, your kidneys filter waste products from the blood to be excreted in the form of urine. It also helps filter out some proteins needed for the body and sends them back to the blood to carry out functions like fighting infections and controlling the amount of fluid in your blood.

A damaged kidney will not be able to filter proteins from the blood the first time, resulting in higher amounts of proteins in your urine.

The urine protein creatinine ratio test helps assess kidney damage by measuring the amounts of proteins present in your urine. As it tests protein and creatinine levels in a single urine sample, it is considered more accurate than other liver function tests.  

How do I Prepare for a Urine Protein Creatinine Ratio Test?

A urine protein creatinine ratio test does not require any specific preparations. The laboratory technician will give you a clean, sterilised container where you must collect a urine sample that is then tested at the lab.

You may be asked for a sample over 24 hours to reduce the impact of protein creatinine variation throughout the day.

What Should I Expect After a UPCR Test?

After you have collected a urine sample, the technician will send it to the laboratory for further testing. Here, the levels of proteins and creatinine in the urine will be assessed before the final results are created.

Once your results are ready, you must contact your doctor to understand the next steps.

If the urine protein creatinine ratio levels are normal, you will not require any medication. 

If your urine protein creatinine ratio levels are not within the normal range, you may have to undergo further testing to check microalbumin creatinine ratios and urine albumin creatinine ratios.

What are the Benefits of the Urine Protein Creatinine Ratio Test?

The benefits of the urine protein creatinine ratio test are as follows.

1. Noninvasive and painless: As a urine protein creatinine ratio test only needs a urine sample, it is a relatively quick and painless process while being noninvasive, unlike most blood tests.
2. Multiple uses: Here, small amounts of urine are used to check for different diseases and disorders that affect the working of your kidneys.
3. Monitor treatment: This test also helps doctors understand how effectively your treatment plan works and whether you need to make any changes. It also helps monitor the side effects of treatment using medicines known to affect the kidneys.
4. Dual value: Most commonly used kidney function tests only test for whether creatinine or protein levels in the urine over a specific period. Protein and creatinine levels are measured in this test, making it a convenient and reliable solution to other tests.

What Affects the Urine Protein Creatinine Ratio?

Several factors can influence your urine protein creatinine ratio (UPCR):

• Kidney function: Damaged kidney filters allow protein to leak into urine, raising UPCR.
• Muscle mass: Creatinine is a byproduct of muscle metabolism. Individuals with greater muscle mass tend to have higher creatinine levels, which can influence the UPCR.
• Urine concentration: A more concentrated urine sample (e.g., first-morning sample) may alter the ratio slightly but is generally preferred for consistency.
• Medications: Certain medications, including NSAIDs, some antibiotics, and ACE inhibitors, can affect kidney function or protein excretion, potentially impacting UPCR results.
• Physical activity: Intense exercise may temporarily increase protein in urine.
• Medical conditions: Infections, high blood pressure, diabetes, and autoimmune diseases can elevate UPCR.

For example, if you have diabetes and your blood sugar is poorly controlled, this can damage your kidneys over time, causing more protein loss and a higher urine protein creatinine ratio.

What Are The Uses of the Urine Protein Creatinine Ratio?

The urine protein creatinine ratio test or UPCR test uses are many, especially with important clinical applications:

• Screening for early kidney disease before symptoms appear
• Diagnosing kidney disorders like chronic kidney disease (CKD), glomerulonephritis, and diabetic nephropathy
• Monitoring kidney disease progression and treatment response
• Providing a convenient alternative to 24-hour urine protein collection
• Stratifying risk of kidney failure and heart problems in kidney or diabetes patients

What are the Risks?

This is a noninvasive test, so there are no prominent risks while taking the urine protein creatinine ratio test. Sometimes, the test may not give you conclusive results or be unclear, requiring you to provide another urine sample for retesting.

When Should I Know the Results of the Urine Protein Creatinine Ratio Test?

Your urine protein creatinine ratio test results can take a few minutes, days or weeks to arrive. Contact the laboratory to know when to expect your UPCR test results and to understand the results further.

You can also use the urine protein creatinine ratio calculator to check the protein level in your urine.

What do High Levels of Protein in Urine Mean?

When the protein level in urine is found to be high, it can be indicative of an underlying kidney disease. The presence of protein in urine, also known as proteinuria, is not a normal occurrence as healthy kidneys filter waste products, toxins, and excess fluids from the bloodstream while preventing the loss of important proteins. Therefore, the detection of elevated protein levels in urine warrants further investigation to identify any potential kidney-related issues.

Your UPCR may also show higher-than-normal levels if you have:  

• Diabetes
• Heart diseases
• High blood pressure
• Kidney stones
• Kidney cancer or multiple myeloma
• Autoimmune diseases
• Condition of polycystic kidney disease 

Other various factors that can result in proteinuria condition are:

• Constant dehydration
• Excess physical activity
• Stress
• Some illnesses or infection

You may also have to check other parameters such as:

• Normal range of microalbumin creatinine ratio: Less than 30 mg/gm
• Microalbumin creatinine ratio: 30-299 mg/gm shows a condition of microalbuminuria. A value higher than 300 mg/gm shows a state of clinical albuminuria.

The values of urine protein creatinine ratio and its treatments vary depending on the disease.

Conclusion

The kidneys play a vital role in maintaining the body's overall health by filtering waste products, excess water, and toxins from the blood. When kidney problems are neglected, they can progressively worsen, leading to more severe health issues. Prompt diagnosis, treatment, and regular monitoring are crucial to prevent the progression of kidney problems and mitigate the risk of severe complications.

Be sure to contact your doctor immediately if you experience any symptoms of kidney disease and get a test from a renowned diagnostic centre like Metropolis Labs. We provide all kinds of tests, from blood and stool to urine. With our home sample collection services, you can get all the tests you need from the comfort of your home. Check out all our available services and tests, or contact our experts to book your appointment today.  

FAQs

What does it mean when your UPCR is high?

An elevated UPCR indicates proteinuria – too much protein in your urine. This usually points to kidney damage or disease, as healthy kidneys prevent significant protein loss. Persistently high urine protein creatinine ratio test results need further evaluation and treatment.

How accurate is the Urine Protein Creatinine Ratio?

The urine protein creatinine ratio is a reliable estimate of 24-hour urine protein excretion in most cases. While convenient, its accuracy can be affected by large variations in muscle mass or hydration status.

Can a Urine Protein Creatinine Ratio test diagnose kidney disease?

A UPCR test alone cannot definitively diagnose all kidney diseases but is an important screening and monitoring tool. Consistently high protein levels on a UPCR test suggest kidney dysfunction, triggering additional diagnostic workup.

What should I do if my Urine Protein Creatinine Ratio is high?

See your doctor for a thorough evaluation, which may include blood tests, imaging, or kidney biopsy based on your UPCR test report and symptoms.

Is fasting required for Urine Protein Creatinine Ratio test?

No, fasting is not needed for a urine protein creatinine ratio test. A first-morning urine sample is preferred, as it is more concentrated.

Can the Urine Protein Creatinine Ratio be used to monitor kidney function over time?

Yes, serial urine protein creatinine ratio measurements help track kidney disease progression and treatment response, guiding management decisions.

What lifestyle changes can help lower the Urine Protein Creatinine Ratio?

To protect your kidneys and reduce proteinuria, you must control blood pressure and sugar, limit salt intake, eat a balanced, low-protein diet, exercise regularly, avoid smoking and excess NSAIDs, and maintain a healthy weight and cholesterol levels.

Does the Urine Protein Creatinine Ratio differ by age or gender?

Urine protein creatinine ratio can vary somewhat by age and sex due to differences in muscle mass and creatinine excretion. However, the normal range is generally similar for adults.

Can medications affect the Urine Protein Creatinine Ratio?

Certain drugs like NSAIDs, ACE inhibitors, and some antibiotics can impact kidney function and protein excretion, affecting the urine protein creatinine ratio. Always inform your doctor about all medications you take.

What are the long-term consequences of untreated proteinuria?

Persistent proteinuria is associated with increased risks of kidney function decline and kidney failure, cardiovascular events like heart attack and stroke, complications like anaemia and bone disease, and overall reduced life expectancy.