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Urology (Expert Forum)
nocturia,protein 10 yr old
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
nocturia,protein 10 yr old
by Barb R., Sep 11, 1999 12:00AM
Thank you for the Forum. My ten yr old son was diagnosed with grade 1-2 reflux 4 yrs ago. He has had 5-15 trips to bathroom nightly within the last several weeks. No frequency in the day until this last week. No burning or pain. He had urine checked yesterday and had small amount of protein. ( 1) No infection present or blood. The nurse said to watch for swelling. My peditrician told me (through a nurse) that it was such a small amount of protien and nothing to worry about.
Is that accurate? I had reconstruction/reimplantation of double ureters at age ten and 3/4 of one kidney removed due to silent Pylo. My twin and I have partitions in kidneys. My son had some enlagement of one kidney four years ago (VCG) and we were told the reflux would fix itself. If no infection- no worry.
Should we? His eyeslids swell out to his eye brow -upon examing him this A.M.
I requested a culture on the urine.
Barb R.
Is that accurate? I had reconstruction/reimplantation of double ureters at age ten and 3/4 of one kidney removed due to silent Pylo. My twin and I have partitions in kidneys. My son had some enlagement of one kidney four years ago (VCG) and we were told the reflux would fix itself. If no infection- no worry.
Should we? His eyeslids swell out to his eye brow -upon examing him this A.M.
I requested a culture on the urine.
Barb R.
Doctor's Answer
by HFHS M.D.-BE, Sep 17, 1999 12:00AM
=============================================
Dear Barb R.,
Urinary frequency could be due to different causes, such as infection, inflammation, too much fluid intake, diabetes, unstable bladder, bladder stones, and bladder tumors to name a few. In a child infection or an unstable/overactive bladder is more likely than other causes. In your son's case infection has been ruled out. The possibility of an overactive bladder should be looked at. Urinary frequency may resolve and disappear just as fast as it came on, especially in children.
All healthy individuals excrete small amounts of protein in their urine (proteinuria) on a daily basis. When it has exceeded certain levels and is detectable by a dipstick or by a more direct method of measurement , then it may be indicative of underlying kidney disease or other diseases, and may need to be further evaluated. When using a dipstick there are incidences of false positive readings (i.e., when the dipstick shows protein being present while there is no protein). This could happen when a urine sample tested is too dilute (specific gravity is less than 1.018), or if the urine is too alkaline (as opposed to be acidic).
Proteinuria may be transient, intermittent, or persistent. Most of the proteinuria seen in the pediatric population is transient, and usually resolves spontaneously within a few days and would not require any evaluation, except for several urine checks a few days apart. It could be as a result of fever, emotional stress, or exercise. In adults it may be due to heart failure. Obviously if the protein in the urine does not resolve, it should be investigated further.
Intermittent proteinuria may be due to low blood pressure as a result of standing for long periods of time. In case of a normal kidney function, this may not require any work up.
Persistent proteinuria is often a sign of kidney disease or other diseases, such as multiple myeloma, which is not common in children. One of the possible signs of kidney problem is unexplained swelling of the face and extremities. Since your son has swelling as you described , you should let your doctor know.
As far as reflux, if it is present ( I am not certain from your letter , if your son has reflux or not), the patient must be kept on prophylaxtic (preventive) doses of antibiotics to prevent infection. Urinary reflux does tend to run in families, and with your history, your son and other children must be re-evaluated and watched closely by a urologist.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword: proteinuria and urinary frequency
Dear Barb R.,
Urinary frequency could be due to different causes, such as infection, inflammation, too much fluid intake, diabetes, unstable bladder, bladder stones, and bladder tumors to name a few. In a child infection or an unstable/overactive bladder is more likely than other causes. In your son's case infection has been ruled out. The possibility of an overactive bladder should be looked at. Urinary frequency may resolve and disappear just as fast as it came on, especially in children.
All healthy individuals excrete small amounts of protein in their urine (proteinuria) on a daily basis. When it has exceeded certain levels and is detectable by a dipstick or by a more direct method of measurement , then it may be indicative of underlying kidney disease or other diseases, and may need to be further evaluated. When using a dipstick there are incidences of false positive readings (i.e., when the dipstick shows protein being present while there is no protein). This could happen when a urine sample tested is too dilute (specific gravity is less than 1.018), or if the urine is too alkaline (as opposed to be acidic).
Proteinuria may be transient, intermittent, or persistent. Most of the proteinuria seen in the pediatric population is transient, and usually resolves spontaneously within a few days and would not require any evaluation, except for several urine checks a few days apart. It could be as a result of fever, emotional stress, or exercise. In adults it may be due to heart failure. Obviously if the protein in the urine does not resolve, it should be investigated further.
Intermittent proteinuria may be due to low blood pressure as a result of standing for long periods of time. In case of a normal kidney function, this may not require any work up.
Persistent proteinuria is often a sign of kidney disease or other diseases, such as multiple myeloma, which is not common in children. One of the possible signs of kidney problem is unexplained swelling of the face and extremities. Since your son has swelling as you described , you should let your doctor know.
As far as reflux, if it is present ( I am not certain from your letter , if your son has reflux or not), the patient must be kept on prophylaxtic (preventive) doses of antibiotics to prevent infection. Urinary reflux does tend to run in families, and with your history, your son and other children must be re-evaluated and watched closely by a urologist.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-BE
*keyword: proteinuria and urinary frequency
