Update and first time referral to a neph... - Kidney Disease

Kidney Disease

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Update and first time referral to a neph...

Bananas2007 profile image
14 Replies

Hi everyone,

This is my second post. My first post, my husband had been leaking protein and was told it would go away. A year later, he still has it. Now he's being referred to a Nephrologist for the first time. Does anyone have any suggestions or tips on what to ask?

He's not diabetic and his blood pressure is great but now he's leaking Glucose in his urine as well. His protein went from a +2 down to a +1 but I'm not sure if that matters? I will post his updated test results below...nephew...

Urinalysis:

UA PH 7.5

UA Spec Grav 1.012

UA color light yellow

UA appear cloudy

UA Glucose 1+

UA ketones Negative

UA blood 2+

UA Protein 1+

UA urobilinogen Normal

UA bili Negative

UA nitrite Negative

UA leuk test Negative

UA WBC <1

UA RBC 3

UA mucus Trace

UA amorph 1+

CMP

Sodium 142

Potassium 4.0

Chloride 106

Total C02 28

Anion Gap 8

Calcium 9.5

Glucose level 81

BUN 12

Creatitine 1.26

Albumin 5.2

Total protein 7.3

Bili total 0.9

Alk Phos 115

ALT 34

AST 31

GFR 74 (this was 96 back in 2018)

He's had a cat scan of his kidneys that came back normal. Kidneys are identical in size and nothing found.

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Bananas2007 profile image
Bananas2007
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14 Replies
S_dillow profile image
S_dillow

Did you have him checked for Ckd early stages?

Bananas2007 profile image
Bananas2007 in reply to S_dillow

What do you mean? He's going to a Nephrologist on the 22nd. He's never had an official diagnosis but he has protein in his urine.

Bangginjal profile image
Bangginjal

The doctor might ask to do Hepatitis B, C and other tests including ANA to see the cause of protein in Urine. I hope everything will come back normal.

Bananas2007 profile image
Bananas2007 in reply to Bangginjal

His doctor has already ran over 17 blood test. He has been tested for hepatitis and it came back negative. I'm not sure what a ANA test is. I will research that. Thank you.

Bangginjal profile image
Bangginjal

ANA is for autoimmune test. This can be the caused of protein in urine.

Bananas2007 profile image
Bananas2007 in reply to Bangginjal

Okay thanks. I just checked his MyChart and he was tested for that. It's Negative. We are scratching our heads because he's otherwise healthy.

jodaer profile image
jodaer

HI, if i remember right you hubby had his neph apt yesterday. If you don't mind sharing how did it go?

Bananas2007 profile image
Bananas2007

You have a good memory. His appointment went well. Still no answers but the neph promises that we will get to the bottom of this. He can't say for sure but he doesn't think he has CKD. He's making my husband go off his baby asprin for 7 days then take another urinalysis. He will be doing a 24 hour urine test too. He's more concerned with the microhematuria than the protein. He explained that the previous test my husband had could be inaccurate since it was a dipstick test. We will see. The Nephrologist also said the statin could explain it too but wants to see what going off the asprin does. He also will be getting a ultrasound. Last year he had a renal ct scan but the neph said the ultrasound will tell more. I will keep you updated.

Bananas2007 profile image
Bananas2007 in reply to Bananas2007

Oh and they will be running a genetic test on him too. His mom has unexplained microhematuria so the neph said it could be something genetic. We just hope it's not Alport syndrome.

jodaer profile image
jodaer

Confession time,,, the 22nd is also my daughter's birthday so it was easy to remember. It sounds to me that things are moving along now and you will get some answers soon so yo can start dealing with what you will have to do. Hopefully it's the baby aspirin and not Alport. (i had to look that up) Sounds like your neph is a winner. He's in NE KY isn't he?

Bananas2007 profile image
Bananas2007 in reply to jodaer

Happy Belated Birthday to your daughter. We are crossing out fingers it's the medicine. If so, my husband wants to see a lipid specialist and maybe explore other options other than the statin and asprin. I was on my lunch break in my reply above and forgot to mention, the Nephrologist is leaning towards a medication issues due to the small amount of blood that's showing up along with his other tests. I also forgot he's going to re-run my husband's gfr using a urine test. He said he doesn't like to use the blood test for someone who is on the younger side and in someone who doesn't have diabetes or high blood pressure.

His Nephrologist is located in Northern Kentucky. He is very nice, a fantastic listener and explains things well. His name is Dr. Ai Tran.

jodaer profile image
jodaer

I checked your doctor out and he does look good. I'm moving to Cincinnati area next week but I will be on the north end in Maineville so that's too far to go. I do have a couple of leads on other nephs. I think it's probably the meds too, they can do a lot of damage in other areas. Best of luck. Let us know how it's going.

Thanks for the BD wishes.

Bananas2007 profile image
Bananas2007

So his Nephrologist had him stop his baby asprin to see if the microhematuria will go away. He just ordered a bunch of test:

1. CBC with differential

2. Urine creatitine level

3. Parathyroid level

4. Protein level urine

5. Renal function panel

6. Vitamin D 25 hydroxy

7. Urinalysis

8. Uric acid

9. Sodium level urine

10. Creatitine Kinase

11. PT/INR

12. Ultrasound renal and bladder

Anyone have a clue what he's looking for? Are these your standard tests?

Blackknight1989 profile image
Blackknight1989

My normal labs at my nephrologist visit and results.

﴾ABNORMAL﴿ PARATHYROID HORMONE ‐ Final result ﴾07/21/2021 3:09 PM CDT﴿Component

PTH

Ref Value Range

349.6 ﴾H﴿ 10 ‐ 65 pg/mL

Anatomical Location / Laterality

﴾ABNORMAL﴿ PROTEIN URINE RANDOM ‐ Final result ﴾07/21/2021 3:09 PM CDT﴿

Component

Protein Urine

Specimen ﴾Source﴿

Urine

Ref Value Range

120 ﴾H﴿ <10 mg/dL

Anatomical Location / Laterality

Result Type

URINE

CREATININE URINE RANDOM ‐ Final result ﴾07/21/2021 3:09 PM CDT﴿

Component

Creatinine urine

Specimen ﴾Source﴿

Urine

Ref Value Range

57.90 10.00 ‐ 300.00 mg/dL

Anatomical Location / Laterality

Result Type

URINE

ABNORMAL﴿ VITAMIN D 25 HYDROXY ‐ Final result ﴾07/21/2021 3:09 PM CDT﴿

Component

Vitamin D 25‐OH

Comment:

Value

19 ﴾L﴿

Test Method

Specimen ﴾Source﴿

Blood

Ref Range

30 ‐ 100 ng/mL

ng/mL

Analysis Performed

Comment for VITAMIN D 25 HYDROXY

Pediatric (< 17 Years):

20 - 100

07/24/2021 AEL 8:07 AM

CDT

﴾ABNORMAL﴿ URINALYSIS WITH MICROSCOPIC IF INDICATED ‐ Final result ﴾07/21/2021 3:09 PM CDT﴿

Component

Color, UA

pH, UA

Value

Yellow

5.5

Ref Range

Yellow

5.0 ‐ 8.0

Glucose, UA

Negative

Negative

Negative

Trace‐intact ﴾A﴿

None Seen

0‐1

Negative mg/dL

Negative

Negative

Negative

0 ‐ 2 /hpf

0 ‐ 1 /hpf

07/21/2021 3:27 PM CDT

Bilirubin, UA

Leukocytes, UA

Blood, UA

Squamous epithelial, UA

RBC, UA

Specimen ﴾Source﴿

Urine

Specific gravity, UA 1.025 1.005 ‐ 07/21/2021 NEAM LAB 1.030 3:27 PM

CDT

Ketones, UA Negative Negative 07/21/2021 NEAM LAB mg/dL 3:27 PM

CDT

Protein, UA 2+ ﴾A﴿ Negative 07/21/2021 NEAM LAB mg/dL 3:27 PM

CDT

Nitrite, UA Negative Negative 07/21/2021 NEAM LAB 3:27 PM

CDT

Urobilinogen, UA 0.2 0.0 ‐ 1.0 07/21/2021 NEAM LAB E.U./dL 3:27 PM

CDT

WBC, UA 0‐1 0 ‐ 1 /hpf 07/21/2021 NEAM LAB 3:27 PM

CDT

Bacteria, UA None Seen None 07/21/2021 NEAM LAB Seen /hpf

ABNORMAL﴿ CBC WITHOUT DIFF ﴾CBC WITHOUT DIFFERENTIAL﴿ ‐ Final result ﴾07/21/2021 3:09 PM CDT﴿

Ref Component Value Range

WBC 9.1 5.0 ‐ 10.0 K/uL

Test Method

Analysis Performed

Time At Pathologist Signature

Hemoglobin

13.7 ﴾L﴿

88.4

34.5

7

14.0 ‐ 18.0 g/dL

80.0 ‐ 97.0 fL

32.0 ‐ 36.0 g/dL

7.4 ‐ 10.4 fL

07/21/2021 3:19 PM CDT

Hematocrit 39.7 ﴾L﴿ 40.0‐ 07/21/2021 NEAM LAB <54.0 % 3:19 PM

CDT

MCH 30.5 27.0 ‐ 07/21/2021 NEAM LAB 32.0 pg 3:19 PM

CDT

Platelet 274 150 ‐ 500 07/21/2021 NEAM LAB K/uL 3:19 PM

CDT

RDW CV 14.1 11.5 ‐ 07/21/2021 NEAM LAB 14.5 % 3:19 PM

CDT

﴾ABNORMAL﴿ RENAL FUNCTION PANEL ‐ Final result ﴾07/21/2021 3:09 PM CDT﴿

Component

Sodium

Chloride

Anion gap

BUN

Value

137

107

12

41 ﴾H﴿

Ref Range

135 ‐ 145 mmol/L

98 ‐ 107 mmol/L

6 ‐ 16 mmol/L

7 ‐ 18 mg/dL

Test Method

Potassium 5.2 ﴾H﴿ 3.5 ‐ 5.0 07/21/2021 NEAM LAB mmol/L 3:36 PM

CDT

Carbon dioxide 18 ﴾L﴿ 21 ‐ 32 mmol/L 07/21/2021 NEAM LAB 3:36 PM

CDT

Glucose 87 70 ‐ 110 mg/dL 07/21/2021 NEAM LAB 3:36 PM

CDT

Creatinine 2.80 ﴾H﴿ 0.60 ‐ 1.30 07/21/2021 NEAM LAB

BUN/Creatinine Ratio

14.6

11.7 ‐ 13.9

2.5 ‐ 4.9 mg/dL

3.4

EGFR 23.7 ﴾L﴿

Specimen ﴾Source﴿

Blood

You nephrologist is just checking all to ensure there is nothing else causing the issues. Don’t stress the results until an in-depth discussion occurs with said nephrologist and a proper explanation is given and only then if there is a real concern allow yourself to stress. (I know easier said than done). My best of luck to you and your husband!

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