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  #1  
Old 04-21-2010, 08:34 PM
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Protein in the urine

Hey everyone, just wondering if anyone has had this problem from a medical visit. I first found out with a urine sample done when I did blood work for blood pressure issues. After finding protein in the urine, I had to a 24 hr urinalysis which also showed protein in the urine. My doctor sent me to a kidney specialist which ordered more blood work. All my tests come back fine other than I had over 4 grams of protein in my urine which he then scheduled me for a kidney biopsy. With the higher blood pressure and the protein present, he was concerned I guess or just looking for a little more money. Don't know but I am not happy due to the fact I have to hold off any cycles for the time being to make sure it is nothing serious and that the cycle will worsen. Anyone else dealt with or know someone with any similar situation?
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Old 04-21-2010, 09:44 PM
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This should answer some of your questions:
Urine Protein: The Test

Urine Protein and
Urine Protein to Creatinine Ratio
Also known as: 24-Hour Urine Protein; Urine Total Protein; Urine Protein to Creatinine Ratio; UPCR
Formal name: Urine Protein
Related tests: Urinalysis; Albumin; Microalbumin; Protein Electrophoresis; Total Protein

* At a Glance
* Test Sample
* The Test
* Common Questions
* Ask Us
* Links

The Test

1. How is it used?
2. When is it ordered?
3. What does the test result mean?
4. Is there anything else I should know?

How is it used?
Urine protein testing is used to detect protein in the urine, to help evaluate and monitor kidney function, and to help detect and diagnose early kidney damage and disease. A semi-quanititative test such as a dipstick urine protein is used to screen the general population for the presence of protein in the urine as part of a routine urinalysis. If slight to moderate amounts of protein are detected, then a repeat urinalysis and dipstick protein may be performed at a later time to see if there is still protein in the urine or if it has dropped back to undetectable levels. If there is a large amount of protein in the first sample and/or the protein persists in the second sample, then a 24-hour urine protein may be used as a follow-up test. Since the dipstick primarily measures albumin, the 24-hour urine protein test also may be ordered if a doctor suspects that proteins other than albumin are being released.

The urine protein test tells the doctor that protein is present in the urine, but it does not indicate which types are present or the cause of the proteinuria. When a doctor is investigating the reason, he also may order a serum and urine protein electrophoresis test to determine which proteins are being excreted and in what quantities. This is especially true if he suspects abnormal protein production, such as with multiple myeloma. He may order a Comprehensive Metabolic Panel (CMP) to look at albumin and total protein levels in the blood and to help evaluate kidney and liver function. If kidney disease or damage is suspected, he may also may imaging scans to evaluate the appearance of the organ.

A protein to creatinine ratio may be ordered on a random urine sample if a child shows evidence of significant and persistent protein in their urine with the dipstick urine test. Children, and sometimes adults, occasionally have some degree of transient proteinuria without apparent kidney dysfunction and may have a higher excretion of protein into their urine during the day than at night. The doctor may monitor their urine at intervals to see if the amount of proteinuria changes over time.

Either a 24-hour urine protein or a random protein to creatinine ratio may be used to monitor a patient with known kidney disease or damage. A dipstick urine protein and/or a protein to creatinine ratio may be used to screen patients on a regular basis when they are taking a medication that may affect their kidney function.

When is it ordered?
A dipstick urine protein is measured frequently as a screening test, whenever a urinalysis is performed. This may be done as part of a routine physical, a pregnancy workup, when a urinary tract infection is suspected, as part of a hospital admission, or whenever the doctor wants to evaluate kidney function. It may also be done when a previous dipstick has been positive for protein to see if the protein excretion persists.

A 24-hour urine protein may be ordered as a follow-up test when the dipstick test shows that there is a large quantity of protein present in the urine or when protein is shown to be persistently present. Since the dipstick primarily measures albumin, the doctor may order a 24-hour urine protein test even when there is little protein detected on the dipstick if he suspects that there may be proteins other than albumin being released.

When a doctor is diagnosing the cause of proteinuria, he also may order a urine protein electrophoresis test to determine exactly which proteins are being excreted and in what quantities. A serum protein electrophoresis may also be ordered to look at the proteins in the blood, especially when abnormal protein production is suspected. Other blood tests, such as a Blood Urea Nitrogen (BUN) and creatinine, may be ordered to evaluate kidney function and an albumin and/or total protein test may be performed to look at the proteins in the blood.

A protein to creatinine ratio may be ordered on a random urine sample when a child shows evidence of significant and persistent protein in their urine with the dipstick urine test. It may also be ordered when a patient has known kidney disease or damage and the doctor wants to monitor kidney function over time. A dipstick urine protein and/or a protein to creatinine ratio on a random urine sample may be used as a screen for kidney involvement when a patient is taking a medication that may potentially affect kidney function.

What does the test result mean?

Looking for reference ranges?
Protein in the urine is a warning sign. It may indicate kidney damage or disease or it may be a transient elevation due to an infection, medication, vigorous exercise, or emotional or physical stress. In some people, it may be present during the day and absent at night when the patient is lying down (orthostatic proteinuria). In pregnant women, elevated urine protein levels can be associated with pre-eclampsia.

When kidney damage is present, the amount of protein present is generally associated with the severity of damage, and increasing amounts of protein over time indicate increasing damage and decreasing kidney function. Proteinuria is associated with many diseases and conditions, including:
# Amyloidosis
# Bladder cancer
# Congestive heart failure
# Diabetes
# Drug therapies that are potentially toxic to the kidneys
# Glomerulonephritis
# Goodpasture’s syndrome
# Heavy metal poisoning
# Hypertension
# Kidney infection
# Multiple myeloma
# Polycystic kidney disease
# Systemic lupus erythematosus
# Urinary tract infection

Is there anything else I should know?
The different methods of detecting protein in the urine vary in performance. For example, a positive dipstick protein may be elevated due to other sources of protein, such as blood, semen, or vaginal secretions in the urine. Since it measures primarily albumin, the dipstick may occasionally be normal when significant quantities of other proteins are present in the urine. A 24-hour urine sample gives the protein excretion rate over 24 hours. It will be accurate only if all of the urine is collected. The protein to creatinine ratio is more of a snapshot of how much protein is in the urine at the time the sample is collected. If it is elevated, then protein is present; if it is negative, it is possible that the patient was just not excreting measurable amounts of protein at that time.
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Old 04-22-2010, 06:19 AM
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The doctor correctly ordered the biopsy due to your history. The doctor could care less about the money (which might get him $5 after the insurance reimbursement) but he does care about being sued for malpractice if he ignored your proteinuria and you died. High blood pressure and protein in the urine is a serious red flag. Negative effects of injectable steroids on the kidneys are very rare unless they are compounds that build water. Orals are another story they beat the crap out of the kidneys. What are your Creatinine levels? The level of this chemical waste molecule generated from muscle metabolism is key to the health of your kidneys. The biopsy concerns me, did you have a CT,MRI, or any other diagnostic imaging modalities before they ordered the biopsy?
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Old 04-22-2010, 07:12 AM
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Thanks for the info posted, my creatinine levels came back ok, on the high end of ok but ok. The kidney doctor all together before deciding for the biopsy had me do a 24hr urine test, give 11vials of blood for whatever test he ordered and had to do a kidney ultrasound. He said all the test were good, just had 4grams of protein in urine. He said the biopsy would tell him 99.9% what was causing this if anything is wrong with the kidneys. I personal think it has something to do with my blood pressure which was detected back in 2008 and been taking blood pressure pill enalapril since. Just recently started getting high again with pill so was prescribed second pill twice a day as well as uping enalapril to twice a day.
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Old 04-22-2010, 07:16 AM
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Also I have been drinking monster lo carb energy drink before workouts for about 3yrs and just wondering if anyone has heard of any negative outcomes from this drink. I dont drink it everyday, about 3-5 days a week before workouts or sometimes after work if coming off night shift and not going to bed immediately.
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Old 04-22-2010, 11:10 AM
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A couple years ago, my count was high on my bloodwork and my doc sent me to a nephrologist also. When I went in the guy looked at me and said...you a bodybuilder? I said yes if you use that term loosely, (lol). He said the typical "bodybuilder" sill be higher than normal by .2 or .3 simply due to the amount of protein we take in. My nephrologist wasn't concerned. But brother, it is better safe than sorry in this game. Do what he says! You don't want to be a Flex Wheeler and on a transplant list.
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Old 04-23-2010, 07:24 AM
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Im also wondering if it could be your adrenal glands. It could be an increased output in renin (angiotensinogenase) which is an enzyme that controls blood pressure. The adrenals are located on the top of the kidneys. Im still puzzled as to why a dynamic kidney/adrenal MRI with gadolinium was not performed. The biopsy seems a little invasive but he is the treating physician so I have to respect that. If the biopsy is negative, try to convince him to get the adrenal MRI. The monster before workout should be ok as long as it doesnt pin your bp high for the day. If you have the monster everyday and this had been happening since, take a break and see if this corrects the problem because there are metabolites in that that can stay active for hours/days. Some people can drink 4 or 5 a day with no problems others retain the ingredience in there tissues i.e. kidneys and cause fluctuating bp's
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Old 05-10-2010, 10:25 AM
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Well the biopsy was completed on the 5th and know I am just waiting on the results. I have to say the worst part was the 6 sticks it took to get my IV started. I think the IV team needs a little more training. Just kidding though, I think my veins were not cooperating very much. I guess I can just hope for the best outcome.
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