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protein in urine

Discussion in 'Parents of Children with Type 1' started by Java, Aug 29, 2012.

  1. Java

    Java Approved members

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    We went to our usual endo appointment they and did blood wk. the dr. sent a letter in the mail saying, protein in urine " potential kidney problems" and wants to start him on a pill.:mad: Has anyone ever had this come up in blood work?
     
  2. TheFormerLantusFiend

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    Many of us have had microalbuminuria, which is teeny amounts of protein.
    If he has large amounts of protein (proteinurea or macroalbuminuria) then press for other answers.

    ACE inhibitors (which are pills) are the first treatment for microalbuminuria in type 1 diabetics and many docs will want to put all adult type 1s on ACE inhibitors even without microalbuminuria.

    I have had one microalbuminuric reading; this is not enough to diagnose microalbuminuria (that takes two out of three in a row). We discussed an ACE inhibitor at the time and decided against it because it lowers blood pressure (that may, in fact, be all it really does to protect kidneys) and my blood pressure's already low.

    I later had a proteinuric reading, and that turned out to be related to something else and the proteinurea went away when that other thing (gallstones) got removed.
     
  3. Amy C.

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    The knee jerk reaction is not to start on a pill -- what doesn't hurt to take anyway for the protective elements it has for the kidneys -- but to do a couple of 24 hour urine collections to see if the result is the same.
     
  4. MommaKat

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    While this is understandably something to watch for and be proactive about when T1D is already in the picture, one lab value isn't typically enough to immediately start a pill. Think of it this way, a lab value is like a photo - a snap shot of one moment in time. It might help to ask your endo and family doc / pedi to consult with each other and you. Like Amy C. said, the next reasonable step is usually a 24 hour urine which will give more of a panoramic view. You could say that the 24 hour urine is to the lab result you received the same way a hemoglobin A1C is to one blood glucose check. They give a broader picture of what's happening over a wider range of time.

    Every clinic and doc is different. I learned with our center that they're so busy some docs prefer to take a proactive approach and immediately jump to pharmaceuticals, others will refer this to the family doc / pedi, and still others will follow up by phoning in a 24 hour urine and have families pic up what they need from a local lab. Don't worry about asking questions with your doc. A good one should be open to discussion.
     
  5. kiwikid

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    Rachel is 11 and has been on Lisinopril for 4 years now.
    We had to do several early morning (overnight) urine collections (which were positive) to rule out Postural Hypertension after her first random urine showed Microalbumin. Being on Lisinopril has helped her Microalbumin levels return to normal and they haven't caused any problems.

    Rachel saw a paediatric nephrologist and had a kidney scan before starting the tablets. :cwds:
     
    Last edited: Aug 29, 2012
  6. Jeff

    Jeff Founder, CWD

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    Was the test a spot urine or a 24-hour urine?

    If spot, do nothing until you get a 24-hour urine.
     
  7. colebenmom

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    That happened to us last year. They had us do the lab over and it came back okay. I would push for a re-test
     
  8. 3kidlets

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    I would not jump on a pill for one test.
    Many people have protein in the urine randomly. I had it several times when I was an adolescent and a teenager and I don't have D. I was always told it is common in athletes (which I was at the time). No one was ever overly concerned about it.
    I would ask for a retest.
    My non - D 8 year old niece also had this last year during her physical. They retested and it wasn't present on the second test.
     
  9. Annie4cure

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    What dosage is she on? How long did it take for the Microalbumin to fall back to the normal range?
     
  10. tom_ethansdad

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    Our DS had protein show up during one of the normal yearly full lab screenings. The referred us to a pediatric nephrologist who asked for multiple urine samples over time including a 24 hour sample plus did an ultra-sound of the kidneys to rule other things out. Protein continued to show in slightly elevated amounts in the urine so he was started on 2.5 mg of lisinopril (the smallest dose available I believe). He takes the pill once daily. Since then, and that has been almost two years ago there have been no more signs of elevated protein in the urine. We submit a sample once every six months (which we drop off during regular appointments with endo) as a way for them to continue to monitor.

    The endo said that they put most of their T1 patients on some type of ACE inhibitor as they get into their teen years to help protect the kidneys.
     
  11. Annie4cure

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    Tom,
    My son is also on Lisinopril 2.5mg he is 14. After starting on Lisinopril , when was your sons next urine? 3 months or 6 months? My son has been on Lisinopril for almost 3 months and is due for a urine but I don't want to have the urine done if it is too soon and have it come back with positive results and have the Dr. Increase the dose!

    Thanks!
     
  12. kiwikid

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    Rachel is on 7.5 mg per day and we do 3 monthly urines just as a check. It took about 9 months and an increase from 5mg to 7.5 mg to get microalbumin levels back to normal.
     
  13. Annie4cure

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    Lisinopril

    Does She ever get light headed being on 7.5mg? How is her blood pressure? Has Lisinopril affected it?
     
  14. kiwikid

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    She hasn't said anything about light headed or dizzy, and her blood pressure is fine when checked each 3 monthly visit. She does feel sick quite often, but did before lisinopril as well. Shes very active and energetic though anxious type.
     
  15. Megnyc

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    I take 2.5 mg of enalapril daily for kidney protection. I have never had protein in my urine or any signs of kidney disease related to diabetes but there is decent evidence for the use of ACE inhibitors in diabetics even without detectable kidney disease. I was put on it at my request. My blood pressure has always been very low but I have had no issues since starting it or any side effects.
     
  16. tom_ethansdad

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    We did urine samples every 3 months after he started. At the first 3 month sample it was still a little elevated by the nephro left him at 2.5mg. I think it was by about six months that levels had returned to normal and they have stayed normal since. Now we just drop off a sample every six months and only see the nephro once a year since his levels are now normal.
     
  17. Annie4cure

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    Thank you so much!
     

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