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Protein In Urine

Kidney Cancer Discussions

Protein In Urine

Postby Allin » Tue Apr 26, 2016 4:48 pm

In March I failed a life insurance screen test for a protein result of 486(NOT KIDDING) for the single dipstick urine test.  I was told to seek medical evaluation.  A subsequent single dipstick urine test result was 290ish.  This doctor ordered a 24 hour urine test and that result was 280ish so I was referred to a kidney specialist.  He was somewhat concerned but believed the high results were due to my intake(not very recent but he didn't seem to care) of Aleve/Motrin.  I was told to stay off the Aleve/Motrin and conduct another 24 hour urine test 3 months later.  I just got the results of this second test and it was 360ish.  The doctor was not happy to see the results go up.  I have low/normal blood pressure, no swelling or shortness of breath.  All the blood tests(renal panel, lupus screen, etc.) were normal and the kidney sonogram he ordered was normal.  I am a little underweight(5'9" and about 120) and do not exercise much or eat that healthy but otherwise do not have any serious health problems.  I eat a high carb diet as compared to a high protein diet.  The doctor said we have two options, either wait and do another 24 hour test in 3-4 months to see if this is really chronic or a kidney biopsy.  He has recommend waiting as he feels the biopsy is a bit invasive since I have no other symptoms beyond the high protein urine results.  I am only in my early 30s so this is a bit scary and my mother is very concerned.  I am going to seek a second opinion but would appreciate your thoughts on how serious this could be and if I should be overly concerned or just keep an eye on the situation.  I will also add that to my knowledge there is no history of kidney disease in my family.  High cholesterol and some cancer but no kidney disease.  I appreciate your thoughts.
Allin
 
Posts: 46
Joined: Wed Jan 15, 2014 1:30 pm

Protein In Urine

Postby Arnatt » Tue Apr 26, 2016 5:24 pm

In March I failed a life insurance screen test for a protein result of 486(NOT KIDDING) for the single dipstick urine test.  I was told to seek medical evaluation.  A subsequent single dipstick urine test result was 290ish.  This doctor ordered a 24 hour urine test and that result was 280ish so I was referred to a kidney specialist.  He was somewhat concerned but believed the high results were due to my intake(not very recent but he didn't seem to care) of Aleve/Motrin.  I was told to stay off the Aleve/Motrin and conduct another 24 hour urine test 3 months later.  I just got the results of this second test and it was 360ish.  The doctor was not happy to see the results go up.  I have low/normal blood pressure, no swelling or shortness of breath.  All the blood tests(renal panel, lupus screen, etc.) were normal and the kidney sonogram he ordered was normal.  I am a little underweight(5'9" and about 120) and do not exercise much or eat that healthy but otherwise do not have any serious health problems.  I eat a high carb diet as compared to a high protein diet.  The doctor said we have two options, either wait and do another 24 hour test in 3-4 months to see if this is really chronic or a kidney biopsy.  He has recommend waiting as he feels the biopsy is a bit invasive since I have no other symptoms beyond the high protein urine results.  I am only in my early 30s so this is a bit scary and my mother is very concerned.  I am going to seek a second opinion but would appreciate your thoughts on how serious this could be and if I should be overly concerned or just keep an eye on the situation.  I will also add that to my knowledge there is no history of kidney disease in my family.  High cholesterol and some cancer but no kidney disease.  I appreciate your thoughts.
Arnatt
 
Posts: 68
Joined: Sun Jan 19, 2014 3:07 am

Protein In Urine

Postby Floinn » Tue Apr 26, 2016 8:29 pm

Dear Angela:

Protein in the urine(proteinuria) is abnormal and is usually an indicator of kidney disease. However, there is a condition called orthostatic proteinuria in which almost all of the protein is spilled into the urine when the patient is upright and ambulating.  This is a normal variant and  no cause for concern.  You need to have this ruled out.  Although is is usually described in males, being female doesn't exclude it.  It is diagnosed and/or excluded by doing a split 24 hour urine collections(2 twelve hour collections) and measuring the protein excretion is each.  If all of the protein is found in the upright specimen(that is, the specimen collected during the 12 hour period that you were up, around and active) you have orthostatic proteinuria and are normal.  If the proteinuria is essentially equally divided between the two 12 hour specimens you have kidney disease.  You need to have this done.

I agree with your nephrologist that watchful waiting rather than a kidney biopsy is the best course for now as long as your creatinine is normal.  If the 24 hour protein excretion is less than 2 grams(2000 milligrams)(your's is 200-300 milligrams)a biopsy rarely results is a diagnosis because it is usually too early is the disease process to give definitive changes or because the disease was/is trivial and is resolving. So, the wisest plan is watchful waiting(I call it therapeutic neglect)and regroup if the creatinine rises or the protein excretion increases above the 2 gram per day threshold.  It has the fewest side effects and complications.

Having said the above, there is a group of kidney diseases called interstitial nephropathies that may occur with exposure to certain toxins, especially heavy metals(lead, murcury, etc) and drugs(that is why your Doctor stopped the aleeve & motrin).  It would be prudent to exclude occult heavy metal exposure by checking a 24 hour urine for heavy metals and try not to use any medication at all unless absolutely necessary.

A second opinion is always smart and if your Doctor is offended by that idea then it's time for a new Doctor with fewer ego issues.

Complicated, I know, but I hope this is of some use to you.  Please feel free to follow up if you wish.

Good luck.

Sincerely,

Dr. Falkinburg  
Floinn
 
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Joined: Fri Apr 04, 2014 5:54 pm


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