Proteinuria: When to Worry About Kidney Health

Response: Second diagnosis of kidney issues (proteinuria)?

Hello, Doctor.
I previously asked about the issue of suspected proteinuria, and your response was that vaccination and infections can trigger the production of antibodies to protect against foreign viral invasion.
Antibodies are a type of protein, and we need to wait for the effects of the vaccine (which produces a large amount of antibodies) to return to normal before the proteinuria caused by the antibodies can resolve.
You suggested that if proteinuria persists 3-6 months after diagnosis or vaccination, I should return for follow-up to rule out kidney issues.
I have already gone to a clinic for a urinalysis, and the results were normal, except for a slight increase in crystals (A.urate ↑).
However, the doctor I consulted said this was not significant.
I also had a kidney ultrasound, which was normal.
Should I conclude that this is just related to the antibodies as you mentioned, or is there still a risk of undetected issues? Thank you.

Niming, 30~39 year old female. Ask Date: 2023/07/07

Dr. Wu Hongjie reply Internal Medicine

Yes, wishing you health and safety.

Reply Date: 2023/07/07

More Info

Understanding proteinuria and its implications for kidney health is crucial, especially when considering the various factors that can influence kidney function. Proteinuria, or the presence of excess protein in the urine, can be a sign of kidney damage or disease. However, it can also occur due to transient conditions such as infections, stress, or vigorous exercise.
In your case, you mentioned that you had previously experienced proteinuria, which may have been linked to vaccinations or infections that can temporarily elevate antibody levels, resulting in protein leakage into the urine. This is a common phenomenon and is often referred to as "functional proteinuria." The body produces antibodies in response to vaccines or infections, and these antibodies are proteins that can sometimes be detected in the urine.
You also noted that subsequent urine tests showed normal results, except for a slight elevation in uric acid crystals. The presence of crystals can be related to dietary factors, dehydration, or metabolic conditions, but they do not necessarily indicate kidney damage. The fact that your kidney ultrasound was normal is a positive sign, suggesting that there is no significant structural damage to your kidneys.

Given these findings, it is reasonable to consider that your previous proteinuria may have been a temporary response to an external factor, such as vaccination or infection. However, it is essential to continue monitoring your kidney health, especially if you have risk factors for kidney disease, such as hypertension, diabetes, or a family history of kidney problems.

Here are some key points to consider regarding proteinuria and kidney health:
1. Monitoring: Regular follow-up with your healthcare provider is essential. If proteinuria persists beyond three to six months after the initial episode, further investigation may be warranted to rule out underlying kidney disease.

2. Lifestyle Factors: Maintaining a healthy lifestyle can significantly impact kidney health. This includes staying hydrated, following a balanced diet low in sodium and protein (if advised), and managing blood pressure and blood sugar levels.

3. Further Testing: If you experience any new symptoms, such as swelling, changes in urination patterns, or persistent proteinuria, additional tests may be necessary. These could include blood tests to assess kidney function (e.g., serum creatinine, estimated glomerular filtration rate) and possibly a 24-hour urine collection to quantify protein excretion.

4. Understanding Risks: While your current tests are reassuring, it is essential to remain vigilant. Certain conditions, such as glomerulonephritis or diabetic nephropathy, can develop silently. Therefore, understanding your risk factors and discussing them with your healthcare provider is crucial.

5. Consultation with Specialists: If there are ongoing concerns about kidney health or if proteinuria recurs, consulting a nephrologist (kidney specialist) may provide more tailored insights and management options.

In summary, while your current situation appears stable, ongoing monitoring and a proactive approach to kidney health are essential. If you have any further concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for advice and potential further evaluation.

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