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Urology (Expert Forum)
Blood & protein 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.
Blood & protein in urine.
by Jenifer-Cleary, Jan 20, 1999 12:00AM
Hello,
I am a 26 year old female, and about 2 years ago my doctor discovered blood and protein in my urine. I was ordered and IVP, which turned out to be inconclusive. The doctor deduced that I had a "leaky kidney", and shrugged it off by saying that we will just keep an eye on it. Last year's physical showed the same levels of blood and protein, and since I had no other symptoms no additional testing was ordered.
Yesterday I had a physical again, and the doctor said that my blood and protein levels have increased (my urine was very dark, and usually is darker in the morning). I have an appointment in one month with a kidney specialist.
I am very worried about this and have been provided limited information and advise from my regular doctor regarding this. I have been reading up on it on the internet, and found an article about Hematuria. I hate to self-diagnose myself, but this is sounding dead on. This article goes on to say that the blood and, and particularly protein, may be a sign of cancer, and that has got me even more worried. I know very little about kidney cancer, but I don't like the sounds of it!!
I guess I really have 2 questions for you that I am hoping that you can answer:
1. How worried should I be? What other symptom are there for kidney cancer?
2. What steps should I be taking now to take better care of my kidneys?
Any information that you could provide me with would be most appreciated.
Thanks,
Jennifer Cleary
-------------------------------------------------------------------------------------------------------------------------------
Dear Jennifer,
Blood in the urine is referred to as hematuria. It may be visible to the naked eye (gross hematuria) or only detected by a dipstick urine test or microscope (microscopic hematuria). In any case, there are a variety of causes for blood in the urine (such as stones, infection, cancer/tumor, filtration problem/kidney disease, etc.), the source of which may be anywhere in the urinary tract; kidneys, ureters, bladder, or urethra. However, since the list of differential diagnoses is long, I will limit this reply to your specific questions. The only thing that I would like to indicate is that the work-up of hematuria is a IVP and cystoscopy (one of which you have had) to evaluate both the upper and lower urinary tracts respectively. Usually the results are negative, and the hematuria is attributed to benign causes such as “exercise induced hematuria”. However, at least after undergoing the work-up, one can usually conclude that nothing really bad is going on. The major part of the situation that you describe that leads one to believe that the problem may be related to your kidneys is the protein found in the urine. Under normal circumstances the kidneys are able to filter the blood in a manner that prevents large proteins and blood cells from passing through into the urine (which is the filtrate plus and minus other things that are secreted or removed) and any small proteins such as immunoglobulins are reabsorbed in the tubules. If protein is detected in the urine it is referred to as proteinuria. There are three types of proteinuria which may or may not be associated with hematuria. If there is a filtration problem it is called Glomerular Proteinuria (there are a variety of such disorders with different medical terms). If the defect is in the reabsorption of small proteins that are filtered, it is called Tubular Proteinuria. In the absence of kidney disease, one may have Overflow Proteinuria which is referred to the overflow of small proteins (such as immunoglobulins) that are abnormally present in large quantities in the blood and surpass the normal absorptive capacity of the tubules. In order to differentiate the above a referral to a nephrologist is probably the best next step. Especially since this has not resolved and possibly become worse over the past couple of years.
You seem to be worried about kidney cancer. Although the hematuria may be one sign of kidney cancer, proteinuria is usually not part of the disease process. Kidney cancer usually has a classical triad of symptoms of hematuria, flank pain, and palpable mass. However, since it is a slow growing tumor, it is frequently not detected as a mass or large enough to cause pain before it is detected incidentally by an ultrasound, CT scan, or MRI that may have been ordered to evaluate another problem. Therefore, I don’t think you need to worry yourself about kidney cancer at this time, but would recommend you see a nephrologist and urologist who can evaluate your specific situation and make the appropriate recommendations. As far as what you “can do to take better care of your kidneys”, the list would depend on what disease process you are worried about. In regards to renal cell carcinoma, it would be advisable not to smoke (or to quit if you are currently smoking) since it is considered a risk factor in the development of this type of cancer. I hope this information is useful and wish you the best.
This information is provided for general medical education 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.-JJ
*Keyword: hematuria, proteinuria, kidney cancer
I am a 26 year old female, and about 2 years ago my doctor discovered blood and protein in my urine. I was ordered and IVP, which turned out to be inconclusive. The doctor deduced that I had a "leaky kidney", and shrugged it off by saying that we will just keep an eye on it. Last year's physical showed the same levels of blood and protein, and since I had no other symptoms no additional testing was ordered.
Yesterday I had a physical again, and the doctor said that my blood and protein levels have increased (my urine was very dark, and usually is darker in the morning). I have an appointment in one month with a kidney specialist.
I am very worried about this and have been provided limited information and advise from my regular doctor regarding this. I have been reading up on it on the internet, and found an article about Hematuria. I hate to self-diagnose myself, but this is sounding dead on. This article goes on to say that the blood and, and particularly protein, may be a sign of cancer, and that has got me even more worried. I know very little about kidney cancer, but I don't like the sounds of it!!
I guess I really have 2 questions for you that I am hoping that you can answer:
1. How worried should I be? What other symptom are there for kidney cancer?
2. What steps should I be taking now to take better care of my kidneys?
Any information that you could provide me with would be most appreciated.
Thanks,
Jennifer Cleary
-------------------------------------------------------------------------------------------------------------------------------
Dear Jennifer,
Blood in the urine is referred to as hematuria. It may be visible to the naked eye (gross hematuria) or only detected by a dipstick urine test or microscope (microscopic hematuria). In any case, there are a variety of causes for blood in the urine (such as stones, infection, cancer/tumor, filtration problem/kidney disease, etc.), the source of which may be anywhere in the urinary tract; kidneys, ureters, bladder, or urethra. However, since the list of differential diagnoses is long, I will limit this reply to your specific questions. The only thing that I would like to indicate is that the work-up of hematuria is a IVP and cystoscopy (one of which you have had) to evaluate both the upper and lower urinary tracts respectively. Usually the results are negative, and the hematuria is attributed to benign causes such as “exercise induced hematuria”. However, at least after undergoing the work-up, one can usually conclude that nothing really bad is going on. The major part of the situation that you describe that leads one to believe that the problem may be related to your kidneys is the protein found in the urine. Under normal circumstances the kidneys are able to filter the blood in a manner that prevents large proteins and blood cells from passing through into the urine (which is the filtrate plus and minus other things that are secreted or removed) and any small proteins such as immunoglobulins are reabsorbed in the tubules. If protein is detected in the urine it is referred to as proteinuria. There are three types of proteinuria which may or may not be associated with hematuria. If there is a filtration problem it is called Glomerular Proteinuria (there are a variety of such disorders with different medical terms). If the defect is in the reabsorption of small proteins that are filtered, it is called Tubular Proteinuria. In the absence of kidney disease, one may have Overflow Proteinuria which is referred to the overflow of small proteins (such as immunoglobulins) that are abnormally present in large quantities in the blood and surpass the normal absorptive capacity of the tubules. In order to differentiate the above a referral to a nephrologist is probably the best next step. Especially since this has not resolved and possibly become worse over the past couple of years.
You seem to be worried about kidney cancer. Although the hematuria may be one sign of kidney cancer, proteinuria is usually not part of the disease process. Kidney cancer usually has a classical triad of symptoms of hematuria, flank pain, and palpable mass. However, since it is a slow growing tumor, it is frequently not detected as a mass or large enough to cause pain before it is detected incidentally by an ultrasound, CT scan, or MRI that may have been ordered to evaluate another problem. Therefore, I don’t think you need to worry yourself about kidney cancer at this time, but would recommend you see a nephrologist and urologist who can evaluate your specific situation and make the appropriate recommendations. As far as what you “can do to take better care of your kidneys”, the list would depend on what disease process you are worried about. In regards to renal cell carcinoma, it would be advisable not to smoke (or to quit if you are currently smoking) since it is considered a risk factor in the development of this type of cancer. I hope this information is useful and wish you the best.
This information is provided for general medical education 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.-JJ
*Keyword: hematuria, proteinuria, kidney cancer
Member Comments
by debideb, Oct 16, 2009 02:36PM
A related discussion, about my son was started.
