Proteinuria: Key Insights for Kidney Health Management

Q: Proteinuria: Key Insights for Kidney Health Management

Hello： 1. <br>It is recommended to conduct tests outside of the menstrual period. <br>2. <br>Microalbuminuria and urinary protein levels are both higher than normal; if this is confirmed again after three months, it is classified as stage one chronic kidney disease. <br>"Chronic"

Urinary protein issue?

Hello, doctor.
I was born with one kidney, and recently I noticed bubbles in my urine, so I went to a nearby clinic for blood and urine tests.
A few days later, when I reviewed the results, the doctor informed me that I had mild proteinuria (+30 mg/dL), while other urine and blood parameters were normal (my serum creatinine clearance was 102.3).
The doctor advised me to undergo further urine tests.
At that time, I informed the doctor that I was on my menstrual period and asked if it would affect the tests.
The doctor said they would call the lab to check if the previous urine sample could be used for further testing, and then the consultation ended.
Later, the receptionist informed me that the lab said the previous urine sample could not be used for further testing, and I needed to provide a new sample.
I again mentioned to the receptionist that I was on my menstrual period, but she said that the tests were specifically for proteinuria and that menstruation would not affect the results.
So, I provided a new urine sample for testing.
After a few days, I returned for the results, which showed a urine creatinine level of 26 mg/dL, microalbumin of 122.19 mg/L, and a microalbumin/creatinine ratio of 470 mg/g.
The doctor advised me to take medication and return for testing in three months.
They prescribed me a medication called Xunxue Min.
I have a few questions, and I would appreciate your guidance.
Thank you!
1.
I found information online stating that women often have proteinuria during their menstrual period.
Would my test results be accurate if conducted during this time?
2.
Does this indicate chronic kidney disease, or do I need to wait for the results in three months to determine that? Is there a chance for improvement back to normal?
3.
The doctor advised me to limit my protein intake, but I noticed that even without eating meat, many foods like eggs and legumes still contain protein.
It is challenging to keep my protein intake very low.
What is the maximum amount of protein I can consume given my current kidney condition?

MM, 30~39 year old female. Ask Date: 2020/02/10

Dr. Wu Hongjie reply Internal Medicine

Hello: 1.
It is recommended to conduct tests outside of the menstrual period.
2.
Microalbuminuria and urinary protein levels are both higher than normal; if this is confirmed again after three months, it is classified as stage one chronic kidney disease.
"Chronic" indicates that abnormalities have been present for more than three months.
Chronic diseases are mostly manageable; even if medication controls the condition to normal levels, there is a possibility of relapse after discontinuation of the medication.
Once there is urinary protein present for more than three months, it is quite difficult to achieve normal levels without any intervention.
3.
Some small studies indicate that animal protein is more likely to cause higher levels of proteinuria compared to plant protein.
It is generally recommended to reduce total protein intake to 0.6 to 0.8 grams per kilogram of body weight per day, particularly from animal sources.
However, these low-protein studies primarily focus on whether low protein intake can reduce the deterioration of kidney function, and they mostly involve patients with stage three or higher kidney disease (glomerular filtration rate <60 ml/min).
Implementing a low-protein diet too early may reduce proteinuria, but its effectiveness in preventing the deterioration of kidney function remains uncertain.
Wishing you good health.

Reply Date: 2020/02/10

More Info

Understanding proteinuria and its implications for kidney health is crucial, especially for individuals with pre-existing kidney conditions or those who have experienced changes in their urinary patterns. Based on your situation, let’s address your questions and provide some insights into managing your kidney health effectively.

1. Impact of Menstrual Cycle on Urine Tests: It is true that during menstruation, women may experience transient proteinuria due to various physiological changes. However, the presence of protein in urine during this time does not necessarily indicate a chronic issue. While some studies suggest that menstrual blood can introduce protein into urine samples, many healthcare providers still consider the results valid, especially if the protein levels are not significantly elevated. It is always best to discuss with your healthcare provider whether to repeat the test outside of your menstrual cycle for a more accurate assessment.

2. Chronic Kidney Disease (CKD) Assessment: The presence of protein in urine, especially in the form of microalbuminuria (like your result of 122.19 mg/L), can be an early indicator of kidney damage. However, a single test result is not sufficient to diagnose chronic kidney disease. CKD is typically diagnosed based on a combination of factors, including persistent proteinuria, elevated serum creatinine levels, and reduced glomerular filtration rate (GFR) over time. Your GFR of 102.3 mL/min is within the normal range, which is reassuring. It is essential to follow up with your doctor after three months to see if the protein levels have normalized or if further investigation is needed. There is a possibility of improvement, especially if the underlying cause of proteinuria can be addressed.

3. Protein Intake Recommendations: Regarding dietary protein intake, it is important to balance your nutritional needs with your kidney health. While it is advisable to limit protein intake in cases of kidney disease, the exact amount can vary based on individual circumstances. Generally, for someone with mild proteinuria and normal kidney function, a protein intake of about 0.8 grams per kilogram of body weight is recommended. However, if your kidney function begins to decline or if you develop more significant proteinuria, your healthcare provider may recommend a lower intake. Foods like eggs and legumes do contain protein, but they also provide essential nutrients. It is crucial to focus on a balanced diet that includes a variety of foods while monitoring your total protein intake.

Additional Considerations for Kidney Health Management:
- Regular Monitoring: Regular follow-ups with your healthcare provider are essential. This includes routine blood and urine tests to monitor kidney function and protein levels.

- Dietary Adjustments: In addition to monitoring protein intake, consider reducing sodium intake and avoiding excessive consumption of processed foods, which can exacerbate kidney issues. Incorporating more fruits and vegetables can provide necessary nutrients without overloading your kidneys.

- Hydration: Staying well-hydrated is important for kidney health. However, if you have any restrictions on fluid intake due to kidney function, be sure to follow your doctor’s advice.

- Lifestyle Modifications: Maintaining a healthy weight, engaging in regular physical activity, and avoiding smoking and excessive alcohol consumption can significantly benefit your overall health and kidney function.

- Medication Compliance: If prescribed medications, such as the one you mentioned (循血敏), it is crucial to take them as directed and discuss any concerns with your healthcare provider.

In conclusion, managing proteinuria and maintaining kidney health involves a comprehensive approach that includes regular monitoring, dietary adjustments, and lifestyle changes. Always consult with your healthcare provider for personalized advice tailored to your specific health needs.

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