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Diagnosed With Interstitial Cystitis. Why My Urine Dip Test Shows A Trace Of Protein?

Posted on Tue, 3 Dec 2013

Question: i was diagnosed with interstitial cystitis about two years ago. from time to time i will get blood and increase white blood cells in my urine with no growth of bacteria which is common for my condition. with this condition, i have to watch what i eat to prevent flares. i just had a urine dip test yesterday at the urgent care clinic. it shows +2 in white blood cells, +2 for blood, & a trace for protein levels in my urine. the urgent care doctor suggested uti and prescribe me antibiotic. i am currently taking the antibiotic while waiting for my culture results. however, my concern is why there is a trace of protein my in urine? the urgent care doctor just thinks that trace protein could be associated with the infection. i get these urine test done about 2 times a year with my urologist and he had not mentioned about traces of protein my urine. i am worried about my kidney functions since i have problems which urinary retention as well. i had blood work and ultrasound of my bladder and kidneys about 1 1/2 ago for interstitial cystitis which was normal. i do not have family history of kidney disease. no history of diabetes or high blood pressure. please advise if the trace of protein is normal.

Answered by Dr. Aditya Bhabhe (4 hours later)

Brief Answer: See detailed answer Detailed Answer: Hi XXXXXXX Thank you for sending in your query. Presence of protein in the urine is not normal. However a number of conditions other than kidney diseases could cause this problem. For example trace protein may be seen after an episode of fever, dehydration or heavy exercise. If you have a UTI, then it could well be the cause of trace proteins in the urine dip stick. At this point you should not worry too much. You should complete the course of antibiotics as prescribed and see what the urine culture shows. Once you have finished the course of antibiotics we should repeat the urine dip (say after 4-6 weeks). At this point if it still shows the presence of proteins we should quantify the protein loss (i.e., determine the amount of protein in the urine). This can be done by a spot urine test called a urine protein to creatinine ratio (UPCR). Once we have this result it will tell us if you really have a significant protein leak in the urine and we could plan the further course of action. Prima facie I do not see a cause of major concern at present. I hope this was helpful. I will be happy to provide answers to any other questions which you may have. Regards Dr. Bhabhe

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aditya Bhabhe (10 hours later)

thanks for the reply. research on line also stated that traces of protein in urine is common or normal if no there is no significant increase or persistent of protein. my culture results should be ready by tomorrow. i'm just worried if the culture comes back negative (no bacteria) then what might be causing the trace of protein in my urine. u had mentioned about other conditions that can cause trace of protein. however, i have not had any fevers or heavy exercise. i only had little to drink on that day. my white blood cells did show an increased of 2+ which indicate an infection but i've always had this with no bacteria growth since i have interstitial cystitic which has similar symptoms. anyways, i will wait and see what the culture shows. should i stop the antibiotic if my culture comes back negative with no bacteria?

Answered by Dr. Aditya Bhabhe (1 hour later)

Brief Answer: See detailed answer Detailed Answer: Hi again I have the following suggestions for your problems: 1) Suspected UTI: Even if the urine culture is sterile, I think you should complete the course of antibiotics. That is because we may not be able to grow some atypical bactera in the culture. Also, if I not mistaken, your previous dip was not positive for leucocyte esterase. 2) Protein in the urine: What you have read online is correct. We need to investigate proteinuria further only if it is persistent and in large quantities. That is precisely why I have asked you to repeat the test in 4-6 weeks. This will tell us if there is persistent protein leak. The urine dipstick is not very reliable when it shows trace or 1+ protein. So, if it is positive the second time, we should do a more specific test i.e., urine protein to creatinine ratio (UPCR). A UPCR will tell us if it is a significant protein loss or not. Based on the results we can decide the further plan of action. From my clinical experience, I feel that UPCR is unlikely to show a significant reading if there is only trace protein in the urine dip. So at this point, I will ask you to not worry much and wait for the results from the next set of tests. I hope this was helpful. Feel free to contact me if you need any more clarifications. Regards Dr. Bhabhe

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Above answer was peer-reviewed by : Dr. Yogesh D