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Related Experiment Videos

Urinary total protein estimation--fact or fiction?

R E Chambers1, D G Bullock, J T Whicher

  • 1Department of Chemical Pathology, Bristol Royal Infirmary, UK.

Nephron
|January 1, 1989
PubMed
Summary

Urinary total protein assays show significant variability in laboratory results. Many labs incorrectly identified protein levels, suggesting a need to discontinue this test in favor of urinary albumin measurement.

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Area of Science:

  • Clinical Chemistry
  • Laboratory Medicine
  • Urine Analysis

Background:

  • Urinary total protein estimation is a common diagnostic test.
  • Variability in assay performance can lead to misinterpretation of results.
  • Current methods may not accurately reflect the physiological state of urine protein.

Purpose of the Study:

  • To assess the accuracy and consistency of urinary total protein assays across UK laboratories.
  • To evaluate the performance of routine methods and calibrants in detecting low protein levels.
  • To propose alternative diagnostic strategies for assessing renal health.

Main Methods:

  • Two simulated urine specimens (salt solution and normal urine) were distributed to 370 UK laboratories.
  • Laboratories used their routine methods and calibrants without knowing the specimen's nature.
  • Quantitative and non-quantitative results were collected and analyzed.

Main Results:

  • Significant variability in quantitative results was observed for both specimens.
  • A substantial percentage of laboratories failed to correctly exclude proteinuria in the salt solution (29%) and normal urine (41%).
  • Non-quantitative results and 'nil' or 'not detected' reports further highlighted assay limitations.

Conclusions:

  • Urinary total protein estimation exhibits considerable analytical challenges and clinical ambiguity.
  • The study recommends discontinuing urinary total protein estimation due to its unreliability.
  • Urinary albumin measurement, potentially supplemented by other specific protein or enzyme tests, is proposed as a more accurate alternative.

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