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Urology (Expert Forum)
Protein in Urine after Reflux disorder
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Protein in Urine after Reflux disorder
by MammaStringbean, Dec 09, 2004 12:00AM
I am a 35 year old female with a history of urinary reflux disorders. At age 25 I was diagnosed with a double ureter system with a Type 4 reflux on my right kidney. Outside of an occasional UTI, I had never experienced any symptoms of kidney infection though I had developed severe scarring. The end result - a partial nephrectomy of my right kidney. For ten years I had been 100% free of any UTI's.
In January of this year, I once again began to experience recurring UTIs - though this time they had an extremely fast on-set of blood in urine and back pain. I was referred back to my urologist and put through a myriad of tests. Resulting diagnosis was that I had now developed a reflux on my left kidney system - this time type 2. I went through two treatments with Cipro to get rid of the infection and am using Macrodantin daily as a deterrent for infection.
This year at my annual physical, my urine test came up positive for the presence of protein in my urine. My primary care was not overly concerned - she recommended I reschedule another urine test with the lab but did not make a recommendation to see my urologiest again. I admit that I am overly paranoid when it comes to these kidneys, but given my history, I am terified that the presence of protein might be an indicator of potential kidney failure.
So my questions are as follows: Is my concern warranted? Is there such a thing as "acceptable" levels of protein in urine that do not warrant follow-up? Could the protein be caused by something outside of poor kidney function? Worst of all, Is it common in patients with VUR to experience eventual kidney failure? What questions should I be asking - what signs should I be watching out for?
In January of this year, I once again began to experience recurring UTIs - though this time they had an extremely fast on-set of blood in urine and back pain. I was referred back to my urologist and put through a myriad of tests. Resulting diagnosis was that I had now developed a reflux on my left kidney system - this time type 2. I went through two treatments with Cipro to get rid of the infection and am using Macrodantin daily as a deterrent for infection.
This year at my annual physical, my urine test came up positive for the presence of protein in my urine. My primary care was not overly concerned - she recommended I reschedule another urine test with the lab but did not make a recommendation to see my urologiest again. I admit that I am overly paranoid when it comes to these kidneys, but given my history, I am terified that the presence of protein might be an indicator of potential kidney failure.
So my questions are as follows: Is my concern warranted? Is there such a thing as "acceptable" levels of protein in urine that do not warrant follow-up? Could the protein be caused by something outside of poor kidney function? Worst of all, Is it common in patients with VUR to experience eventual kidney failure? What questions should I be asking - what signs should I be watching out for?
Doctor's Answer
by Kevin Pho, MD, Dec 11, 2004 12:00AM
, Dec 11, 2004 12:00AM
Protein in the urine isn't normal. There can be a myriad of causes - including infection as well as various disorders of the kidney.
Up to 1/3 of untreated VUR can lead to renal insufficiency and failure. So, given your history I would certainly pursue further evaluation.
I would consider a referral to a nephrologist (a kidney specialist) in addition to the urology referral. Things like a 24-hr urine collection (to quantify the amount of protein) as well as kidney imaging and possible kidney biopsy can all be considered for further evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Up to 1/3 of untreated VUR can lead to renal insufficiency and failure. So, given your history I would certainly pursue further evaluation.
I would consider a referral to a nephrologist (a kidney specialist) in addition to the urology referral. Things like a 24-hr urine collection (to quantify the amount of protein) as well as kidney imaging and possible kidney biopsy can all be considered for further evaluation.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
