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Kidney Diseases

Confusing results- protein, kidneys

07/06/2009

Question:

I had a slightly low (56 mL/min) creatinine clearance and a slightly high (41) microalbumin/creatine ratio in my routine urinalysis. In a subsequent test, I had an even higher microalbumin/creatinine ratio (114) and a low (52) eGFR but normal protein. The doctor then ordered a 24 hour urine test- creatinine was 23 mg/24 hours (normal range is 8-170) but again creatinine clearance was 53, and total protein was 184 (normal is less than 150). Then, the doctor ordered an other 24 hour test, and now total protein is only 75, but eGFR is still low, 57. My doctor ordered an ultrasound, on the basis of "kidney pain", but I had never had any pain. The report refers to "medical kidney disease". I am going to see a specialist but I am very confused. Did the doctor saying "kidney pain" possibly influence the way the ultrasound was read? Why would a doctor say that? I never had this kind of result before. I am 50 years old, female.

Answer:

It sounds like you do indeed have chronic kidney disease, stage 3 -- please see the links below for more information about the stages of kidney disease and the tests that we use to diagnose kidney disease and monitor kidney function.

It is not uncommon for the amount of protein and microalbumin in the urine to vary, depending on things like a person's recent dietary intake.  In any case, having protein in your urine indicates that there is some damage to the kidneys, as does your lower-than-normal eGFR.

As for your ultrasound results, the fact that your doctor wrote "kidney pain" as the reason for ordering the ultrasound should not affect the way it was read by the radiologist.  The reading of "medical kidney disease" indicates that the radiologist detected that your kidneys are more dense than normal, indicating replacement of normal kidney tissue with scar tissue. 

You should definitely be under the care of a kidney specialist (nephrologist), who can help to determine the cause of your kidney disease (diabetes and hypertension being the most common causes) and do what is needed to preserve your remaining kidney function for as long as possible.  So your doctor has done the appropriate thing in making the referral.  Good luck to you, and please write back if you have more questions.

Related Resources:

Basic Information About the Kidneys
Kidney Tests

For more information:

Go to the Kidney Diseases health topic, where you can:

Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University