Abnormal Urine Protein Levels: Kidney Health Insights

Abnormal urine protein test?

Hello, doctor.
Three months ago, an ultrasound examination revealed that I have kidney stones, all measuring less than 0.5 cm.
At that time, the doctor prescribed potassium citrate (K citrate), with a dosage of two tablets in the morning and two in the evening.
After three months, I had a blood test, and the results were abnormal as follows: Albumin—4.6, Spot Urine Protein—0.4 g, Creatinine—0.9, eGFR—99.8, Uric Acid—5.9, Magnesium—2, Potassium—3.8, Inorganic Phosphorus—3.2, Total Calcium—9.4, Fasting Blood Glucose—92, Hemoglobin A1c—5.7.
This time, BUN was not tested, but kidney function appears normal; however, proteinuria is elevated.
Am I in the first stage of chronic kidney disease? I consciously drink 250 cc of water every half hour in the morning, and I did the same on the day of the blood and urine tests.
Despite drinking so much water, I still have proteinuria.
Does this indicate that my usual proteinuria is more severe? Additionally, I noticed that since taking potassium citrate, my first morning urine is clear, whereas before, it would have persistent bubbles.

Xiao Zhang, 30~39 year old female. Ask Date: 2024/07/30

Dr. Lin Wuxuan reply Internal Medicine

Chronic kidney disease (CKD) is defined as kidney damage lasting for more than three months, resulting in structural or functional abnormalities that cannot return to normal.
Whether a condition qualifies as CKD must be determined by a specialist based on your glomerular filtration rate (GFR).
The GFR should be assessed considering your age, sex, and serum creatinine (Cr) levels.
It is recommended to discuss with your attending physician whether medication treatment and outpatient follow-up are necessary.
Thank you.

Reply Date: 2024/07/30

More Info

Understanding abnormal urine protein levels is crucial for assessing kidney health, especially in the context of your recent findings. Based on your reported results, you have a urine protein level of 0.4 g, which is considered elevated. This indicates the presence of protein in your urine, a condition known as proteinuria.
Proteinuria can be a significant marker of kidney dysfunction, and it is often categorized based on the amount of protein present in the urine. Normal urine protein levels are typically less than 150 mg per day. When protein levels exceed this threshold, it can indicate various underlying conditions, including kidney disease, hypertension, diabetes, or other systemic diseases.
In your case, the eGFR (estimated Glomerular Filtration Rate) of 99.8 suggests that your kidney function is still within the normal range, which is a positive sign. However, the presence of proteinuria, especially at a level of 0.4 g, raises concerns about potential kidney damage. According to the classification of chronic kidney disease (CKD), the presence of proteinuria alongside a normal eGFR can indicate early stages of kidney disease, particularly stage 1 or 2 CKD, depending on other risk factors and the duration of proteinuria.

Your history of kidney stones and the use of potassium citrate (去石寧) can also play a role in your kidney health. Potassium citrate is often prescribed to help prevent the formation of certain types of stones, and it can alter urine composition, potentially affecting protein levels. The fact that you noticed a change in your urine appearance, becoming clearer and with fewer bubbles, may suggest that your hydration strategy is effective, but it does not necessarily correlate with the protein levels detected.

The presence of bubbles in urine can sometimes be mistaken for proteinuria, but it is not always indicative of protein presence. Bubbles can form due to various reasons, including the concentration of urine, the speed of urination, or the presence of other substances. However, persistent foamy urine can be a sign of significant proteinuria, and it is advisable to monitor this symptom closely.

Given your situation, it is essential to follow up with your healthcare provider for further evaluation. They may recommend additional tests, such as a 24-hour urine collection for protein quantification or further imaging studies, to assess kidney structure and function. Additionally, lifestyle modifications, including maintaining good hydration, managing blood pressure, and monitoring blood sugar levels, are crucial in preventing further kidney damage.

In summary, while your kidney function appears to be normal based on the eGFR, the presence of proteinuria is a concern that warrants further investigation. Early detection and management of kidney issues can significantly impact long-term health outcomes, so it is vital to stay vigilant and proactive in your follow-up care.

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