24 hr urine test

[Gotroot]

Hi,

I am a 53 year old female. Just had a 24hr urine test that came up with some out of range results. Phosphate concentration came up low: result 9.8 mmol/L, normal range 11-44 mmol/L, but the total phosphate per day was normal at 22.5 mmol/day within the range of 11-45 mmol/day. Is the low concentration something I should be worried about if the total is normal? Not sure how to interpret this.

The Calcium concentration came up normal at 3.75 within range of 0.23-6.30, but the total per day is high at 8.63, normal range 2.5-7.5.

Creatinine, urea, protein, albumin, magnesium, potassium came up normal.

The reason for the test is that at the end of February i had an untreated uti that got to the kidneys and since then i have been dealing with bilateral kidney pain, deep, dull, diffuse that lasts for hours and hours, really debilitating, lost weight quickly, hands shaking, nausea, worst pain i have ever had. The pain alternates between bad days with bad pain, and better days with vague to mild pain and at times no pain at all. It is better now overall but not a lot better. The family doctor and urologist have no explanation, waiting for appointment with nephrologist. Ultrasound done in April showed reduction of cortical thickness from 1 cm in both kidneys (from previous US before this started) to 0.6 and 0.7. CT scan showed nothing abnormal. Albumin to creatinine ratio normal but eGFR in April was 85 versus 96 in September last year (always had gfr over 90). I also have some patches of foam/small bubbles in my urine that don't go away that also started after the infection.

Has anyone else experienced this? Family doctor said all is good and i am hypochondriac. Very frustrating!! I had to ask for the 24 hr urine test and now i cannot get a hold of him to comment on the results and the nephrologist could take a month or two.

Any feedback is appreciated and i apologize for the long post.

[KidneyCoach NKF Ambassador]

Kidney infections can be tough to treat for some. Firstly some small minor changes are expected. I would find a new doc to replace any who disregarded my health concerns as being hypochondriac. Personally I would try to give it a few months to heal before returning for more testing.

In the meantime stay away from NSAIDS, prevent or treat new infections asap, stay hydrated, avoid dark colas, keep active, keep blood pressures and sugars well controlled, control stress.

JMHO.

BLESSINGS

[Gotroot in reply to KidneyCoach]

Thank you KidneyCoach. I am trying to stay positive but it is not easy especially when I have pain; it's already been over three months... And now with the high calcium and questionable phosphate I am getting more concerned. Also started to feel pain in my neck and there is something swollen under my jaw so I am fearing hyperparathyroidism. Afraid to mention this to doc after his comments, but since the parathyroid regulates calcium and phosphate I intend to ask for blood tests for these and PTH. Thanks again for your reply.

[KidneyCoach NKF Ambassador in reply to Gotroot]

Concerning bloodwork would be high phosphorus and high calcium, high creatinine, low albumin. Your average egfr is still likely to be over 90 which is great. That's just my experience not advice. Were you well hydrated prior to tests?

The real concern imho is your rapid weight loss.

Consider a new doctor and be open and honest about your issues.

This could be something completely unrelated to kidneys. Women who are sexually active are prone to UTI's. Be sure to get up post sex and empty bladder. This can help.

Wishing you the best.

[Gotroot in reply to KidneyCoach]

The creatinine was good in April, we'll see what it is on the next blood test. The other ones you mentioned I did not have yet, intend to ask for them plus PTH since I have discovered swollen node in neck after feeling pain under the jaw. For the last few days started feeling pain in other areas of neck but cannot feel any lumps. But this, together with the high urine calcium makes me worried about hyperparathyroidism. Not something I need when I am already dealing with the on and off pain from kidneys.Maybe not very well hydrated when I had the April blood test, since I did the test early morning (it required fasting glucose as well) so maybe that was a reason of lower GFR, but I did drink some water when I woke up and before the test. Besides, I always had the test in the morning and the GFR was ok. So I think the reason was the fact that something/the infection affected the kidneys and they were not working as they should have.

Weight loss also worries me and the fact that I don't seem to gain any although I eat. Don't have much of an appetite since I am not feeling well but I force myself to eat anyway.

I live in Canada and changing the doctor is not easy here, and even more complicated especially now with covid. No doctor has seen me yet, everything was over the phone; another frustrating thing.

Sorry for all the complaints, I really appreciate you taking the time to answer.

[Bet117 NKF Ambassador]

Gotroot,

Kidney Coach has covered a lot of good ground. Ask your doctor to review labs and set an action plan for you; including a healthy diet.

You are never a bother and complaining - that's what we are here for; to listen and support each other.

Please reach back and let us know the outcome of a good discussion and lab review with your doctor.

Waiting to hear.

Bet