protien in unrine?

[liz32]

Hi, the doc says that my last blood and urine workup came back ok except that it was showing protien in my urine. She said she wasn't worried as it's common for diabetics. What does this mean, anything? Or is it truly something not to worry about. Thanks
Liz

[amccrazgrl]

I know when my dr said i had some protein in my urnie they put me on 10mg lisinipril/zestril (same thing)

If it wasn't much and she didn't seem worried then, you should be fine. If it bothers you ask her about it.

[Ritehsedad]

Get a copy of the report and do some research.

My understanding is that protein in urine is one of the early signs of nephropathy, something you don't want.

Is your new med an ACE inhibitor (BP med)? ACE inhibitors are good to your kidneys.

[liz32]

No it's not and ace inhibitor. This first med is for weight loss. Now that we've realized that i can't take it, she'll be starting me on two new meds. I have a feeling it will be something like that. Right now I'm just working on getting into a more in depth carb counting class. I go back to the doc in three weeks and that's when I'll probably start the new meds. I just hope this protien thing is going to be taken care of. I will do some research on the web about it.
Liz

[greendavid]

My kidneys were spilling protein ("microalbumin") at a rate of 292 -- normal is below 50. This is a very early indicator of the beginning of kidney disease (because your kidneys are supposed to filter all the protein from your urine).

I'm now on Lisinopril which is both a drug for high blood pressure and to protect the kidneys from diabetes-caused disease. After 1 month, my lab test was 2 (that's "two"), i.e. back to normal.

You need to get your blood pressure under control, as well as your blood glucose, because high blood pressure can affect the kidneys (and the heart).

Here are the "ABC's" of diabetes, the recommended long-term goals:

A1c (a measure of average blood glucose): under 7% (check 2-4 times per year).
Blood pressure: 130/80 or below (check at every doctor visit, and maybe at home).
Cholesterol: LDL (bad cholesterol) under 100 (check at least annualy).

[sheish]

When my urine tests came back with protein, my doctor said it was an early sign of kidney damage ( nephropathy ) , in my case microalbuminuria. He said not to worry about it and he prescribed captopril ( an ACE inhibitor ). My lab results are really better with it; last test came with only traces of protein, almost normal. He also said 28 mg of protein in a 24 hour urine collection was really ok ( I used to have more than 150 ) and now we are working on keeping my blood pressure within normal range, because high BP also affects the kidneys.

sheish.

[liz32]

I was reading this morning about it on the web and it all said that it indicates the beginnings of kidney disease. Needless to say this freaks me out....like I don't already have enough to deal with! My last A1C was 6.0 and my blood pressure was 130/80. The 80 is a little high for me as I'm usually 130/73, but I did have to run to my appointment so I don't know it that has any effect or not. When I go back in three weeks I'm making sure I have all my answers and if that means starting more meds, so be it. I don't want kidney disease. the thing that bothers me is that I've only had diabetes for a year. My A1c' were like this: 1)16 somthing, 2)9.7, 3) 5.7, 4)5.8 and this last one 6.0. Are these terrible enough to bring on nuropathy already? I was under the impression that these were ok although I need to aim a little lower. I don't want to over react but I don't want to under react either. What do I do?
Liz

[sheish]

First of all, my dear, don't blame yourself if your kidneys are affected already. Some patients have excellent A1c, diet and BP and they develop some complications anyway. It's not fair, but it happens anyway. What you can do is relax ( stress is also bad for us ), don't panic and keep the good work with your blood glucose, BP,diet, exercise and meds. You can keep neurophathy under control in the early stages if you take good care of yourself. I was also freaked out when I developed microalbuminuria, but my doctor and I talked about it and now I feel more confident about it.

sheish.

[vvti-le]

I myself take Lisinnopril but when I developed high BP my doctor told me he prescribed me an ACE Inhibitor since I was a diabetic. I take my father to the hemodialysis center 3 times a week and it's a very depressing site seeing all these patients on dialysis that has nephropathy due to high BP, diabetes or some sort of kidney disease. I had a friend who lost his kidneys due to Strep throat. If Strep throat is not treated properly it can infect the kidneys.

[liz32]

The big question is I guess, is, is it reversable? If I start on all this medication will it go away? Or am I stuck with this?
Liz

[sheish]

Dear Liz : I found this on the web; the source is very trustworthy in Diabetes matters; It says type 1 diabetes, but my doc says it is also true for type 2 BOSTON — June 3, 2003 — A new study by Joslin Diabetes Center researchers published in this week's New England Journal of Medicine (NEJM) is good news for the thousands of Americans with type 1 diabetes who have microalbuminuria, the earliest sign of kidney disease.

One in three patients with type 1 diabetes develop end-stage kidney disease, which eventually requires either a kidney transplant or every-other-day dialysis treatment for life. The earliest sign of kidney disease is the leakage of small amounts of proteins from the blood into the urine, called microalbuminuria. When it appears in the urine, it was once believed that one could only hope to postpone — but not prevent — kidney disease by intensified efforts to control blood sugar, treatment with certain blood pressure drugs, and a low protein diet.

However, the prognosis for patients with microalbuminuria turns out to be not so dire, according to the results from the Joslin Kidney Study being reported in the NEJM. Andrzej Krolewski, M.D., Ph.D., head of the Section on Genetics and Epidemiology at Joslin, and his colleagues found in this study of people with type 1 diabetes that early signs of microalbuminuria can be reversed with proper medical screening and diabetes control. Dr. Krolewski is Associate Professor of Medicine at Harvard Medical School (HMS) and Associate Professor of Epidemiology at Harvard School of Public Health.

"In this early stage, we found kidney injury is still a dynamic process that can either get worse or get better — even revert back to normal," said Bruce Perkins, M.D., M.P.H., F.R.C.P., and a lead author of the paper. Dr. Perkins is a Clinical Fellow in Endocrinology at HMS.

In this study, 400 patients with microalbuminuria persisting over a two-year period were followed for six additional years. "Surprisingly, the leakage of protein subsided in 58 percent of them, even among those who were not taking ACE inhibitors, a type of drug known to be helpful in people with microalbuminuria," Dr. Perkins said.

"It stands to reason that these landmark studies will heighten physicians' awareness of the importance of screening for microalbuminuria to permit aggressive early intervention, particularly intervention that leads to tight glycemic control," Eberhard Ritz, M.D., of the University of Heidelberg in Germany, writes in an accompanying editorial in the NEJM on the Joslin study and another study appearing in the journal.

Early diagnosis and low blood cholesterol are key
Among the factors associated with a return to normal kidney function were an early diagnosis of microalbuminuria by frequent screening and very good levels of blood sugar, blood pressure and cholesterol. Although high cholesterol was known to be bad for patients with advanced kidney disease, it was not known just how important it is to keep cholesterol levels low in the earliest stages of the disease. "In view of this finding, perhaps cholesterol-lowering drugs should be given a trial," Dr. Perkins said.

"Since microalbuminuria can go away and certain factors are associated with its remission, we infer that specific mechanisms of repair exist in the kidney that enable the kidney to repair itself in the early stages. When we understand these mechanisms better, we can develop more effective treatments for preventing serious kidney disease," Dr. Perkins said. "In the meantime, the study highlights the need for frequent screening and early intervention for microalbuminuria in patients with type 1 diabetes. Once it is identified, the treatment plan should be directed toward improving multiple factors — blood sugar control, blood pressure control, and cholesterol lowering — rather than relying on ACE-inhibitor treatment alone."

p.s. DON'T LISTEN TO HORROR STORIES ! ! ! Each patient is different, so if your doctor said not to worry, maybe your case is like the article describes.

sheish.

[liz32]

Thanks for the information. It definately gives me hope! I will definately talk to my doc in three weeks. I want definitive answers. Thank you all for all your help. I must admit that I rely on you guys almost as much as the docs because unless you're living with this you really don't understand. thanks guys!
Liz

[sheish]

" Been there, done that ". I know just how you feel because I have protein in the urine too and sometimes it's frustrating when you need info and nobody seems to know squat, but we can beat this, Liz, I hope so. Talk to your doctor and ask ALL the questions you want. After all, that's what doctors are for, aren't they ? to take careof us ! Good luck !

sheish.

[beckyc]

I was glad to see your post Liz as I'm in the same situation. My doctor found protein in my urine this week during my routine diabetes check up. I was at the top number of their normal range and had been running negative numbers. We're going to check again in 3 months. I have been "freaked" out since learning this information so it was helpful to read all the replies in this thread. I'll keep watching. I'm Type 2 - take Prandin before meals - BS under control - BP under control with a low dose of an ace inhibitor and cholesterol is good. I've been Type 2 for two and a half years. My doc told me if the protein is still present at higher levels she would increase the dosage of my ace inhibitor. As usual, it's very nice to have others who have experienced the same thing and to have a place where one can go for help, information and support.

[Grant]

Hi, the doc says that my last blood and urine workup came back ok except that it was showing protien in my urine. She said she wasn't worried as it's common for diabetics. What does this mean, anything? Or is it truly something not to worry about. Thanks
Liz

Liz, I had exactly the same results come back after a urine test. Infact the doctors pestered me for 3 more samples within 2 days. The doctor never actually told me if it was serious or not but when you hear something like that, you do start to worry. I posted this problem here on the forums not so long ago. I found out on the Internet that leaking protein into the urine is a sign that the kidneys are not doing their job correctly and are passing protein into the urine and then passing out waste into the blood stream. I've stopped looking at the Internet for questions as it only scares me now! :(
Here is the link of a very similar topic regarding protein-in-urine, if you would like to have a look. :)

http://www.diabetesforums.com/type-two-diabetes/7848-leaking-protein-into-my-urine.html