Urine tests give important information about how your kidneys are working. They can also help spot early problems with your kidneys. For people with PKD, these tests can help with nutrition changes that may slow cyst growth, protect kidney function, and reduce kidney stones.

This blog will explain the common urine tests used to monitor PKD and what the results might mean. While this post shares general information and reference ranges, it’s always important to talk to your healthcare team for advice that’s right for you.

Types of Urine Tests

1. Urinalysis

This is the most common urine test. It looks at what’s in your urine, including protein, blood, sugar, and signs of infection.

What to watch for with PKD:

• Protein: Normally, urine should not contain protein. Protein in the urine (proteinuria) can be a sign of kidney damage or disease progression.
• Blood: Blood in the urine (hematuria), even if you can’t see it, can happen with PKD due to cysts breaking, kidney stones, or infection. If your urine looks red or brown, get it checked.
• Infection: White blood cells or bacteria may show a urinary tract infection (UTI). It's important to see a doctor.

2. Microalbuminuria Test (Albumin-to-Creatinine Ratio)

This test checks for small amounts of albumin (a type of protein) in your urine that might not show up on a regular urinalysis. Protein in your urine can be an early sign of kidney damage or disease progression.

Why it matters:

• Helps find early signs of kidney stress before you lose a lot of protein.
• Especially useful if you also have diabetes or high blood pressure.
• Helps track kidney function and plan treatment (like using medications such as ACE inhibitors or ARBs).

3. Urine Culture

If you get frequent kidney infections, this test finds out which bacteria are causing the infection so the right antibiotic can be prescribed.

Why it matters with PKD:

• Infected cysts or frequent UTIs are common. It’s important to talk to your doctor if you have pain or changes when you pee.

4. 24-Hour Urine Collection

Some kidney doctors may ask for a full-day urine test to check:

• Total protein loss
• Creatinine clearance
• Electrolyte balance (like sodium and potassium)
• Uric acid levels (PKD can raise the risk of gout)

Why you might need this:

• Gives a full picture of kidney health, beyond blood tests.
• Helps guide diet changes, especially for salt and fluid intake.

How to Do a 24-Hour Urine Collection

• Collect every drop of urine for 24 hours.
• You might need more than one bottle—ask the lab how much each holds.
• Eat and drink like you normally do so your results match your usual habits.
• Start in the morning after your first pee. Don’t collect that first one. Then collect all urine for the rest of the day and night.
• End the test by collecting your first morning pee the next day.
• Keep the bottles cool or refrigerated until you return them to the lab.

What’s Measured in a 24-Hour Urine Test:

• Volume: How much urine you make in a day. People with PKD or kidney stones should aim for about 2.5 litres of urine per day.
• pH: This measures how acidic your urine is. A pH between 5.8 and 6.2 can help prevent kidney stones. Low fruit and veggie intake and high animal protein can lower your pH.
• Osmolarity: This shows how concentrated your urine is. With PKD, it’s best to keep morning urine osmolarity under 280 mOsm/kg by following a 2000 mg sodium diet.
• Sodium: Shows how much salt you're eating. People with PKD should aim for less than 90 mmol of sodium in 24 hours (about 2000 mg in the diet).
• Oxalate: A natural substance in food and made by the body. Too much in urine can lead to kidney stones, especially calcium oxalate stones. Aim for less than 440 μmol/day. Managing oxalate and eating enough calcium can help.
• Urea: Shows how much protein your body is breaking down. It helps your dietitian or kidney doctor know if you’re eating too much protein.
• Citrate: Citrate helps prevent kidney stones. Low citrate levels increase the risk. Aim for more than 1.6 mmol/24 hours. Veggies, fruit, and lemon juice are good sources of citrate.

A 24-hour urine test gives helpful information about kidney health. A dietitian who understands PKD can help you use these results to adjust your diet and better manage the disease. Talk to your healthcare team about how often you should do this test and whether more tests could help guide your nutrition plan.

Why Urine Tests Matter with PKD

Just like blood tests, regular urine testing can help:

• Catch kidney damage early
• Track how the disease is changing
• Guide treatment plans
• Prevent problems like kidney stones, UTIs, or infected cysts

At your next appointment, ask your kidney doctor:

• How often you should get urine tests
• What your results mean
• Which tests are best for your stage of PKD
• How your results affect your treatment plan

Next time you have a urine test, use this blog post to help guide your conversation with your healthcare team.

About the Author

Emily Campbell, RD CDE MScFN is a Registered Dietitian and Certified Diabetes Educator with a Master’s Degree in Foods and Nutrition. Emily specializes in helping those with kidney disease overcome the confusing world of nutrition to promote health. Emily can be found at kidneynutrition.ca.

More

• Learn about blood tests for PKD here.
• Looking for more information about what to eat with PKD? Check out Love Your Kidneys, a PKD cookbook and nutrition guide written especially for people with PKD.
• Watch one of Emily's webinar or PKD Summit recordings on the topic of Nutrition and PKD here, or 
• Browse through Emily's Kidney Nutrition blogs on our website.