Abnormal Urine Test Results: Albumin Concerns and Kidney Health

Q: Abnormal Urine Test Results: Albumin Concerns and Kidney Health

Hello： Based on the urine test results you provided, along with the normal albumin/creatinine ratio and protein/creatinine ratio, it is highly likely that the abnormal test data is influenced by gynecological issues. <br>It is recommended that you return to the nephrology clinic

Urinalysis shows elevated levels of urinary albumin?

Hello Doctor,
I had a health check-up this month, and there were several abnormal results in my urinalysis.
The findings included red blood cells at 10-19, bacteria at 1+, and trace amounts of hemoglobin.
I also had a history of hematuria during my middle school years, but my urine tests and ultrasounds at Chang Gung Memorial Hospital have been normal for many years, although one of my kidneys is naturally smaller.
My last check-up at Chang Gung was two years ago, and now I am concerned about the abnormal urine albumin levels.
I read on a website that abnormal urine albumin for more than three months could indicate the onset of kidney disease.
Could my test results be a warning sign of kidney disease?
Additionally, during the testing period, I had a bit of increased vaginal discharge, so I wiped the area before urinating.
Could this discharge potentially affect the urinalysis results?
For your reference, here are some related data: blood pressure and blood sugar levels are normal, glomerular filtration rate is 147%, fasting blood sugar is 91, total cholesterol is 185, triglycerides are 60.2, urine specific gravity is 1.022, protein qualitative test is normal, creatinine (urine) is 200, albumin/creatinine ratio is normal, glucose qualitative test is normal, and protein/creatinine ratio is normal.
Thank you very much for taking the time to respond amidst your busy schedule.

Wu, 20~29 year old female. Ask Date: 2020/06/23

Dr. Lin Wuxuan reply Internal Medicine

Hello: Based on the urine test results you provided, along with the normal albumin/creatinine ratio and protein/creatinine ratio, it is highly likely that the abnormal test data is influenced by gynecological issues.
It is recommended that you return to the nephrology clinic for follow-up urine tests in 1-3 months.
Additionally, before the nephrology follow-up, it is advisable to address the issue of vaginal discharge with a gynecologist.
Please also remember to avoid your menstrual period when collecting urine samples, as this will improve the accuracy of subsequent urine tests for better interpretation by the physician.

Reply Date: 2020/06/23

More Info

Understanding abnormal urine test results, particularly concerning albumin levels, is crucial for assessing kidney health. In your recent urine analysis, you reported several concerning findings, including the presence of red blood cells, bacteria, and elevated albumin levels. Let's break down these results and their implications for your kidney health.

Urine Test Results Overview
1. Red Blood Cells (RBCs): The presence of RBCs in urine (hematuria) can indicate various conditions, ranging from benign issues like urinary tract infections (UTIs) to more serious conditions such as kidney stones or glomerular disease. Given your history of hematuria, it is essential to monitor this closely, especially since you have a smaller kidney on one side.

2. Bacteria: The presence of bacteria (1+) suggests a possible urinary tract infection. UTIs can cause inflammation and irritation in the urinary tract, leading to hematuria and discomfort.

3. Albumin Levels: The detection of albumin in urine is significant. Albuminuria (the presence of albumin in urine) can be an early sign of kidney damage, particularly in the context of diabetes or hypertension. The threshold for concern is often set at 30 mg/dL or higher. Since you mentioned an albumin level of 30 mg/dL, this is indeed a point of concern and warrants further investigation.

Kidney Health Implications
The presence of albumin in urine, especially if it persists over three months, can indicate the onset of kidney disease. Chronic kidney disease (CKD) can develop silently, and early detection is crucial for management and prevention of progression. Given your history of hematuria and the recent findings, it would be prudent to follow up with a nephrologist for a comprehensive evaluation.

Impact of External Factors on Urine Test Results
You also mentioned that you had increased vaginal discharge during the testing period and that you wiped before urination. While this may not significantly affect the urine test results, it is always best practice to ensure that the sample is as uncontaminated as possible. Any residual discharge could potentially introduce bacteria or other substances into the urine sample, which might affect the results, particularly in terms of bacterial counts.

Recommendations
1. Follow-Up Testing: Given the findings, it is advisable to repeat the urine test after a few weeks to monitor the albumin levels and the presence of RBCs and bacteria. A 24-hour urine collection for protein might also be beneficial to quantify proteinuria more accurately.

2. Consult a Specialist: A referral to a nephrologist is recommended for a thorough evaluation of your kidney function, especially considering your history and the current findings. They may suggest additional tests, such as imaging studies or blood tests, to assess kidney function and structure.

3. Lifestyle Modifications: Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and proper hydration, can support kidney health. Monitoring blood pressure and blood sugar levels is also crucial, as these factors can significantly impact kidney function.

4. Monitoring Symptoms: Keep an eye on any new symptoms, such as changes in urination patterns, swelling, or fatigue, and report these to your healthcare provider promptly.

In conclusion, while your current urine test results raise some concerns, especially regarding albumin levels, further evaluation and monitoring are essential. Early intervention can significantly impact kidney health outcomes, so staying proactive about your health is vital.

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