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Urinalysis Done. What Does The Report Suggest? Treatment And Diet?

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Posted on Wed, 2 Jan 2013
Question: My father is 69 years old and all his reports are normal except there are findings of
Protein, Urine. : 30.3 High < 11.9 mg/dl.
Protein, 24 Hrs. Urine. : 1242.0 High < 149.1 mg/24 hrs.
Volume, 24 Hrs. Urine. : 4100 ML.
Urinalysis. : Result Pending.
What does this mean and what is the treatment for this ? Should he follow any diet to reduce this?
Can you tell if the kidneys are being affected or not ......if yes then how much and how and what treatment should be given.

doctor
Answered by Dr. Ravi Bansal (5 hours later)
Hello XXXXXXX

Thanks for the query.

The reports suggest that he has proteinuria i.e. he is passing proteins in urine.

To see the cause and extent of damage we need to know the following information-
1. Has he got hypertension (BP reading) or diabetes?
2. Is he on any other medications?
3. Has he got any swelling in the legs?
4. Other investigations like serum creatinine, urine routine, 24 hrs urine protein creatinine ratio, blood sugar fasting values?

With only urine protein report meaningful conclusion cannot be drawn. However I suggest your father to follow renal diet - avoid non-veg; take less salt and liquids 1.0 L /day

Kindly get back with more information with above parameters

Regards


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ravi Bansal (16 hours later)
Hello Dr. Bansal,

Thank for your answer. I am giving you some more details and answers to your questions:
1. He does not have hypertension or diabetes.
2. No he does does not take any medications. After his recent report of 24 hrs urine test , his doctor has prescribed 2 medicies : Riconia and Nefrozon, which he hasn't started yet.
3. He does have pain and swelling in his right foot. He also experiences fatigue sometimes and 2 weeks ago he had vomiting after his lunch.
4. The report for Blood Test---Serum Creatinine : 1.1mg/dl, Uric Acid Serum : 4.5mg/dl, Blood Urea Nitrogen :12mg/dl, Urea: 26mg/dl, Total protein Serum: 6.8g/dl , Albumin Serum:4g/dl, Globulin: 2.8g/dl, Electrolytes----Sodium:139, Potaasium :4.3, Cloride:104
5. Mean Corpuscular Hemoglobin comcentration: 30.4g/dl,(low) Eosinophils :0.8(high).
6. Urine TestReport: Protein Detected. Red Blood Cells 3-5 . Appeareance slightly hazy and colour pale yelow. Other things in the report are not detected.

The information I gave you in my first question was of the latest 24hrs urine test. The glucose level has not been detected or been negative in the reports.
I hope these numbers well give you a better idea of the situation and you can give me more specific answers. Would you be able to give more details on the renal diet.
Thank you
Regards
XXXXXXX
doctor
Answered by Dr. Ravi Bansal (11 hours later)
Hi XXXXXXX

The patient has mild proteinuria with normal kidney function with normal BP and blood sugar levels (as informed). In such case patient can be followed up at monthly intervals to see in protein in the urine is rising in a 24 hrs sample. You have to do 24 hrs urine protein and creatinine in the same urine sample. In addition, serum creatinine should be repeated every month. If there is deterioration in these then he may require a kidney biopsy for a specific diagnosis.

The kidneys are functioning normally as per the reports it is just that the filter barrier of kidney is affected and is filtering out proteins.

This disease will be called isolated proteinuria and should be followed up as advised under supervision of your nephrologist. Some patients will remain like this and others will show deterioration over time. This cannot be predicted. Therefore, regular follow up is important.

Diet does not have much role but you can limit him to vegetarian diet, less salt, total liquid intake to 1 to 1.5litre /day and no juices.

You can start the treatment mentioned by your doctor.

Other investigations which may identify certain pathologies are viral markers ( HBsAg, Anti HCV, HIV) and XXXXXXX XXXXXXX C3 but remain in supervision of your nephrologist.

Hope this helps.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Ravi Bansal (17 hours later)
Hello Dr. Bansal,

Thank you for your views. This is a great help. But I still have some doubts, I hope you would be able to clear them.

1) What is the treatment for the proper function of the filter barrier. Whether medicines would help or surgery is required?

2)His doctor has prescribed these investigations ----Sprectains eletrophoresis and HIV,HbsAg,HCU. Would these help us to know why has this problem occurred and what should be the treatment?

3)The doctor also prescribed Riconia and Nefrozon medicines to my father. Are these medicines good fro him to take when he does not have any other problem like BP or diabetes?

4)Regarding the diet you advised that he should not be given juices. But can he eat fresh fruits. Can he take vegetable soup?

5) My father experiences fatigue often. What can be done to overcome that? Also can he travel...specially to USA.

Please help me to know the line of treatment so that we can overcome the problem and cure it, if it has just started, rather waiting for it to spread and become worse.

Thank you
Regards
XXXXXXX

doctor
Answered by Dr. Ravi Bansal (5 hours later)
Hi XXXXXXX

1. THERE IS NO SURGERY REQUIRED. TREATMENT IS BY MEDICINES - "ACE-inhibitors" group of medicines and diet control, No tobacco at all. If any specific cause can be identified in the remaining tests I have listed OR if this protein increases and we go for kidney biopsy to identify the exact cause then - we can go for further medications to control proteinuria.
There is no one time treatment. Treatment is based on clinical examination and reports - to be analysed periodically by a nephrologist to chart the course of treatment.

2. The investigations advised are correct; please go for them as I already mentioned in my previous post.

3. Yes, these medicines are OK - you can give them to him

4. He can take fruits, but limit to XXXXXXX papaya and guava and only in mild amount (half a fruit per day). Fruits are XXXXXXX in potassium especially juicy fruits and kidney patients are prone to high potassium - therefore the restriction. He can take vegetable soups- but care to be taken to add very little or no salt.

5. He can travel - but it has to be under treatment of a nephrologist. Therefore I recommend at least one monthly visit to his nephrologist. Fatigue could be part of the disease process. Check TSH levels to rule out hypothyroid in addition.

I know you're concerned, but this is not like infection that it will spread. The proteinuric diseases are chronic diseases - they are here to stay just like BP or diabetes. Regular treatment would reduce chances of progressive disease.

Hope I answered all your queries. If you have any more queries, I will be glad to answer.
If all your queries are addressed, please close this discussion.

Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Ravi Bansal

Nephrologist

Practicing since :1996

Answered : 359 Questions

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Urinalysis Done. What Does The Report Suggest? Treatment And Diet?

Hello XXXXXXX

Thanks for the query.

The reports suggest that he has proteinuria i.e. he is passing proteins in urine.

To see the cause and extent of damage we need to know the following information-
1. Has he got hypertension (BP reading) or diabetes?
2. Is he on any other medications?
3. Has he got any swelling in the legs?
4. Other investigations like serum creatinine, urine routine, 24 hrs urine protein creatinine ratio, blood sugar fasting values?

With only urine protein report meaningful conclusion cannot be drawn. However I suggest your father to follow renal diet - avoid non-veg; take less salt and liquids 1.0 L /day

Kindly get back with more information with above parameters

Regards