Losing Protein, but Why?

Hello,

Something doesn’t seem right with the labs as reported above. Can you please scan or take a screen shot and upload the reports you reference? Please ensure you remove any personal identifying information from what you attach.

Dr. Jordan Weinstein

Sure..

Hello,

The amount of protein in your urine is only very minimally elevated. I don't think this explains the edema you re experiencing. What is your level of kidney function?

Dr. Jordan Weinstein

I've been told they are normal. Here they are.

Is there anything else to look at? Do you think it can be reversed with no kidney damage?

It is a level of proteinuria that might never deteriorate further but without more information, it's hard to comment.

• How old are you?
  
• What medications do you take
  
• What medical conditions do you have?
  

Dr. Jordan Weinstein

I do not know if that is a good thing or a bad thing.

I am 38 years old.
I am currently taking humalog, synthroid and furosemide daily. I take claritin as needed for my allergies.
I have type 1 diabetes, hypothyroidism and primary Sjogren's syndrome.

Vanessa

I do not know if that is a good thing or a bad thing.

I am 38 years old.
I am currently taking humalog, synthroid and furosemide daily. I take claritin as needed for my allergies.
I have type 1 diabetes, hypothyroidism and primary Sjogren's syndrome.

Vanessa

The presence of diabetes changes things substantially. In that case, I would ensure:

• blood pressure is treated to less than 130/80
  
• strong consideration is given to using an ACE inhibitor or angiotensin receptor antagonist
  
• treatment of HbA1C to less than 6.5-7%
  
• assessment and treatment of LDL cholesterol
  
• assessment of Sjogren's to decide whether it is playing a role in your proteinuria
  

I can only base my opinion on the information provided and your health-care provider might arrive at different conclusions once you have provided an entire history and had a physical examination performed. As always, this forum provides general medical information only and is limited to educational use only. Please discuss the above remarks with your health-care provider.

Dr. Jordan Weinstein

I have. I get a physical every year. They've checked everything, and it all comes back normal. A1C was 5.8 last time, cholesterol normal limits, blood pressure normal like 118/74 just this week. My rheumatologist and the GI I saw say its not Sjogrens related.
Every doctor I go to is dumbfounded. I am too.
I was just worried about my kidneys.

Hello,

Roughly 50% of patients with diabetes will develop some form of kidney disease. Even if your A1C is normal now, it very likely was not at some point and therefore, it would be entirely possible a small amount of proteinuria would be present as a result.

Dr. Jordan Weinstein

Ok...
I saw another nephrologist who said this is a normal amount of protein lost in urine. Should I really consider this normal? Of so, should I do anything about this? What do I do so my kidneys will not be damaged? I keep tight control. This would be my fear.
No one can explain the edema.

The total amount of protein in the urine is normal however if it was all albumin, this would represent an abnormality that likely relates to having diabetes. This could be clarified by performing an albumin [not protein] to creatinine ratio. Even still, it represents only a small amount of proteinuria that could be reversible or at least halted by taking an angiotensin receptor blocker or ACE inhibitor if it were present. That, in addition to tight glycemic and blood pressure control will definitely minimize the risk of kidney deterioration moving forward.

Dr. Jordan Weinstein

Thank you for that explanation.
I'll request that test and I will take that thought to my doctor.