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Urology (Expert Forum)
9 year old with Protein/Blood in Urine
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.
9 year old with Protein/Blood in Urine
by Cindi__0, Feb 04, 1999 12:00AM
I took my son into the doctor today because he has had terrible headaches
, sore throat, and today he started running a fever of 102.5 He saw a nurse practioner
She took a throat culture, which was also done 3 weeks ago for a sore throat. She doesn't believe he has strep, but
I did tell her he has lost 2 lbs in three weeks, plus he has started to go to the bathroom much more frequently(urinating) She stated
she was looking for possible signs of diabetes or UTI. She called me later in the afternoon to tell me they found protein and blood in his urine, but stated
that it could be just because he was sick and that they would repeat the test in a week. She also said the betadine that they gave him to clean himself with could have been confused by the lab as blood?! This doesn't sound right to me, does it to you?
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, sore throat, and today he started running a fever of 102.5 He saw a nurse practioner
She took a throat culture, which was also done 3 weeks ago for a sore throat. She doesn't believe he has strep, but
I did tell her he has lost 2 lbs in three weeks, plus he has started to go to the bathroom much more frequently(urinating) She stated
she was looking for possible signs of diabetes or UTI. She called me later in the afternoon to tell me they found protein and blood in his urine, but stated
that it could be just because he was sick and that they would repeat the test in a week. She also said the betadine that they gave him to clean himself with could have been confused by the lab as blood?! This doesn't sound right to me, does it to you?
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Doctor's Answer
by hfhs M.D.-AK, Feb 04, 1999 12:00AM
_
Dear Cindi,
There are different types of doctors in medicine, those that deal with primarily medical issues and those that deal with surgical issues. At this point in time your son may need to be evaluated for a possible diagnosis of his proteinuria and hematuria. This would first be handled by a nephrologist and a urologist would only get involved if consulted. Even before a Nephrologists get involved, your son’s urine tests should be repeated as you indicated. If they remain positive, a nephrologist deals specifically with kidney disease and would do a better job of answering your specific questions and helping you arrive at a diagnosis. They deal with proteinuria on a daily basis. An initial consultation with a nephrologist may help determine if certain urine tests need to be obtained(24hr urine).
There are different levels of proteinuria and if he is being evaluated by a nephrologist, he or she can tell you to worry or not about protein excretion. A normal range of protein excreted in a 24 hr. period is less than 150mg/d. Of this 150, 5-15 mg is albumin and the rest is composed of over thirty different types of renal proteins. He should probably have the protein fractionated, if elevated, to determined what is causing the proteinuria. Excretion of mainly albumin signifies a glomerular lesion, the glomerulus being the filtering apparatus of the kidney.
By definition, greater than 3.5g in a 24 hr. urine signifies a nephrotic syndrome, a protein losing syndrome. This usually happens when the glomeruli are damaged enough to allow plasma proteins to enter the urine. I don’t know much history here, but if your son has a persistence of protein in the urine he needs to be seen by a nephrologist.
In regards to the other part of your questions, I think your child may need a full work-up for childhood UTI’s, if not already done. Initially, a urinalysis and culture should be sent. If this is positive for infection, and if there is persistent hematuria, an ultrasound of the kidneys and bladder, with a VCUG would be indicated. If negative, a repeat urine culture should be done if any another unexplained febrile episode occurs, the more invasive tests would be held. Any Urologist could manage your son, but if he did have a UTI or has persistent hematuria, a Pediatric Urologist, if available, handles these patients all the time.
First see the medical doctor to repeat the urine tests to see if there is any indication to see the nephrologist or urologist. Your family doctor can help you with these decisions.
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.-AK
*keyword:Proteinuria
Dear Cindi,
There are different types of doctors in medicine, those that deal with primarily medical issues and those that deal with surgical issues. At this point in time your son may need to be evaluated for a possible diagnosis of his proteinuria and hematuria. This would first be handled by a nephrologist and a urologist would only get involved if consulted. Even before a Nephrologists get involved, your son’s urine tests should be repeated as you indicated. If they remain positive, a nephrologist deals specifically with kidney disease and would do a better job of answering your specific questions and helping you arrive at a diagnosis. They deal with proteinuria on a daily basis. An initial consultation with a nephrologist may help determine if certain urine tests need to be obtained(24hr urine).
There are different levels of proteinuria and if he is being evaluated by a nephrologist, he or she can tell you to worry or not about protein excretion. A normal range of protein excreted in a 24 hr. period is less than 150mg/d. Of this 150, 5-15 mg is albumin and the rest is composed of over thirty different types of renal proteins. He should probably have the protein fractionated, if elevated, to determined what is causing the proteinuria. Excretion of mainly albumin signifies a glomerular lesion, the glomerulus being the filtering apparatus of the kidney.
By definition, greater than 3.5g in a 24 hr. urine signifies a nephrotic syndrome, a protein losing syndrome. This usually happens when the glomeruli are damaged enough to allow plasma proteins to enter the urine. I don’t know much history here, but if your son has a persistence of protein in the urine he needs to be seen by a nephrologist.
In regards to the other part of your questions, I think your child may need a full work-up for childhood UTI’s, if not already done. Initially, a urinalysis and culture should be sent. If this is positive for infection, and if there is persistent hematuria, an ultrasound of the kidneys and bladder, with a VCUG would be indicated. If negative, a repeat urine culture should be done if any another unexplained febrile episode occurs, the more invasive tests would be held. Any Urologist could manage your son, but if he did have a UTI or has persistent hematuria, a Pediatric Urologist, if available, handles these patients all the time.
First see the medical doctor to repeat the urine tests to see if there is any indication to see the nephrologist or urologist. Your family doctor can help you with these decisions.
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.-AK
*keyword:Proteinuria
