Category Archives: Proteinuria

Hello, I am a 30 yo female with a history of Turner syndrome, common variable Immunodeficiency, and undifferentiated connective tissue disease (leaning towards lupus). I have had high blood pressure since I was about 21. I take Celexa, Plaquenil, and IVIG infusions. Since January 6 I have been on 10 mg of prednisone. I have been on my higher doses for longer periods of time previously though with no issues. Last year it was stable on just 10 mg of lisinopril (I had lost 30 lbs with diet and got off of 25 mg of metoprolol). My heart rate had been running in the 90s-100s and was but after losing weight was in the 80s at resting. 5 weeks ago my blood pressure started spiking to the 140s/90s. I had also noticed then even though my resting heart rate was 80s it would go up into the 110s within minutes when I would get up and move around. Cardiology placed me back on 25 mg of metoprolol. My blood pressure responded then 2 days later started spiking again and went to 158/100. The metoprolol was doubled to 50 mg. I did have a CMP at this time that showed GFR and creatinine were normal. My blood pressure started responding and then started going back up again and was 140s over 90s in the cardiologist office. I was also having episodes of dizziness, lightheadedness and palpitations. I also noticed my ankles looked swollen even though it was not pitting edema. The metoprolol was doubled again and now 100 mg. The echo was not concerning although I was showing quite a few PVCs though which I have never done before. Aldosterone, renin, and magnesium labs were done. My aldosterone and magnesium where normal but my renin was very high (33.4 with a range of 0.5-4). With my history of systemic autoimmune disorder I have been referred to nephrology to take a look. I also started have right kidney pain (full throbbing not sharp) and noticed the edema became stage 1-2 pitting when I would wake up, and I had one day where I did not have to urinate for 10 hours even though I drank almost 64 oz during that time. I have kept track of my diet for the past 5 weeks and have kept my sodium at about 1000-1500 mg/day and I only drink water and drink about 64 to 80 oz a day. The multiple UAs I had done since last summer had all show 1+ protein, one also showed 1+ ketones, and another one also showed hyaline casts. The UA I had done last week had a specific gravity of less than 1.005 and did not show any protein but did show amorphous crystals. I have not had a 24 hour urine done. If I have read literature correctly the urine being so dilute could give a false negative on the protein and could be caused by kidney disease. The soonest I can get into nephrology is May and in the meantime I am very concerned with all that my kidneys are having trouble. I have a kidney ultrasound scheduled next week but nothing else to look further at my kidneys. Am I correct that my kidneys could be trouble with all of this information? I am not sure what else to do if they are in trouble in the meantime while I wait to see nephrology.

The situation that you describe is very complex and difficult to establish an underlying diagnosis.  I am unable to make a specific diagnosis based on the information that you present.  If your blood testing for kidney disease is normal and … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hypertension/High Blood Pressure, Kidney-Related Health Questions, Lupus, Nephrologist, Proteinuria

Dear Dr. Spry, I’m a male, 68 years old, diagnosed with IgAN in 2008, with heavy proteinuria, and my nephrologist has reported my annual lab results have been excellent in the last several years, with an increased kidney function as well, above normal. My IgAN has been in remission for many years. That said, for the last 10 years, I’ve had 3 “high potassium” test scores in the “caution” zone, whereby my doctor and nutritionist discussed with me the need for a low-potassium diet, which I’ve been adhering to since last year, and it seems to working out, though a bit challenging when cooking and shopping for groceries. I’m managing. Here’s my question. In addition to my annual renal-based blood and urine lab work, is there an over the counter or mail-order potassium test that I could take regularly at home to monitor my potassium level and one that’s inexpensive? I suppose I could ask my nephrologist if he could write a lab order for it, say quarterly, if my insurance will cover it. I feel that I need more regular testing to ensure I manage my potassium intake to safe levels. Thoughts? Thanks.

There is not a “home potassium test” that I am aware.  Testing for potassium should be done by a reliable lab that continuously calibrates the equipment and makes sure of accuracy and reliability.  You may need to discuss your concerns … Continue reading

Posted in Ask the Doctor, Diet/Nutrition, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Proteinuria

Can sperm cause high protein in urine tests? Urinalysis, ACR?

No. Sperm in a urine sample should not be associated with an elevated albumin or protein level in the sample.

Posted in Ask the Doctor, Kidney-Related Health Questions, Proteinuria

Is there a significant health risk to a 71 year old man if he donates a kidney to his sister? What precisely are the risks? I live in France and wonder if you have any contacts here I could talk to and discuss the potential risks to my brother if he decides to donate a kidney to me.

The risks of donating a kidney include the risks of having major surgery, the risk of anesthesia and the risk of infection complications after the surgery.  The risks of kidney failure after donating a kidney has recently been reviewed and … Continue reading

Posted in Ask the Doctor, Dialysis, Hypertension/High Blood Pressure, Kidney Failure, Kidney-Related Health Questions, Proteinuria, Urinary Tract Infection/Pyelonephritis

In 1996, I was found to have hematuria. In 2000, I started experiencing ulcers on my legs diagnosed as the result of leukocytoclastic vasculitis. I should I just go with this? In 2005, I had proteinuria. A few years later I allowed a biopsy of my kidney. Results showed a damaged kidney. Some unidentified autoimmune cause. Only treatment my nephrologist could give me is blood pressure control. Now, I am told peritoneal dialysis is next.

I am not able to establish a specific diagnosis based on the information that you present.  It is possible to have leukocytoclastic vasculitis of the kidney.  It is commonly called Henoch Shonlein vasculitis or purpura (HSP).  It can be an … Continue reading

Posted in Ask the Doctor, Dialysis, Kidney Biopsy, Kidney-Related Health Questions, Nephrologist, Proteinuria

I had protein leak in the urine for sometime. In 2017, it became more than 5gm per day. It got controlled with administration of steroids and came down to about 2gm per day. After stopping steroids, it started increasing. Biopsy interpretation is initial stage of primary membranous nephropathy. Have undergone 4 cycles of IV Cyclophosphamide and it has increased to 14gm a day. Any advise for next step is welcome.

There are a number of tests that are commonly performed on patients with Membraneous Glomerulonephritis. These tests should include an Anti-PLAR2 antibody,  Anti-THSD7A antibody, Anti-NEP antibody and others that help to determine if Membraneous disease is primary or secondary and … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Proteinuria

Hi I am from INDIA. Age: 60 Years My creatinine level is 1.5 mg/dl. But BUN, URIC ACID, UREA, URINE CREATININE, URINE PROTEIN, URINE ALBUMIN ARE ALL IN NORMAL RANGE. PLEASE TELL ME WHETHER 1.5 mg/dl is normal at the age 60 years. And also tell me to decrease/control the creatinine level to avoid the increase in creatinine level further.

I suggest that you visit our web site and use your serum creatinine and other vital information to calculate your estimated glomerular filtration rate (eGFR).  This will help with establishing your kidney function. You can use our calculating equation at: https://www.kidney.org/professionals/KDOQI/gfr_calculator … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Proteinuria, Serum Creatinine, Urinary Tract Infection/Pyelonephritis

In 2016, proteinuria and neutropenia was found during routine lab work in my African American teen. Orthostatic was ruled out with multiple urine and 24 hrs test. Hem/onc work negative and ANCA and complements negative. Biopsy 3 years later states acute tubular injury. What are we missing?

Protein in the urine (proteinuria) is not usually a component of acute tubular injury.  The kidney biopsy provides the diagnosis but does not necessarily explain the protein in the urine. In some cases, further observation and time will provide clarification … Continue reading

Posted in Acute Kidney Injury, Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney Biopsy, Kidney-Related Health Questions, Laboratory Testing, Proteinuria, Urinary Tract Infection/Pyelonephritis

Should I be considered that I’ve tests positive for protein ++/3 times, +/ one time, 2+ one time and a trace one time?

The tests that you report are qualitative tests that suggests you may have protein in your urine. These are generally done with a dipstick in the urine. The best test to do is a urine protein to creatinine ratio (P/C … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Proteinuria

Hello Doc, Our normally very healthy 12 year old, who recently had a growth spurt and is strong and tall for his age, was given a urine check which showed protein. He has no other symptoms and we have been going back and forth the past month or two to get tests and more tests. He clearly has 100 to 300 though after getting up it’s 3 and as the day goes by and he drinks water it keeps going down..as much as a trace or 30. They have not said much except to wait for the time being. Are they waiting for swelling or other symptoms? We are devastated and need some advice.Would greatly appreciate your opinion. If you need any information please let me know and I will send the blood test or give you the numbers you might need to help you get an idea of what’s going on.Thank you and God bless you.

Young and otherwise healthy young boys can develop “exercise induced” or so called “orthostatic” proteinuria (protein in the urine). This is a benign condition and he will commonly “grow out of this” by the time he hits his 20’s. It … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Proteinuria