What do high protein levels post pregnancy indicate?

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Posted on Mon, 8 Jun 2015 in Kidney Conditions
Question: My Wife (XXXX) had very high level of protein during both of the pregnancies. She had undergone quarterly review with a nephrologist after pregnancy and protein level is still high but doctor suggested we can ignore this for now as its not alarming and advised to reduce weight and that will bring the protein level down. As of now we are not monitoring it. So I need the second opinion on this case from a specialist. The question I have primarily are

1. is this level of high protein always even after pregnancy is OK?
2. what we should do to fix this? we are working on weight but that is not coming down as of now probably need more effort. is there any medication needed?
3. what are the risks having this level on daily basis?
4. do we need to monitor this periodically? if yes how frequently?

Thanks,
XXXX
doctor
Answered by Dr. Rakesh Madhyastha 1 hour later
Brief Answer:
Need more info

Detailed Answer:
Hello

Thanks for the query

I understand your concern and I will be answering to all your questions one by one. Howeve in order to give your accurate information I need a few more details. Please get back to me with the following

1. How long has it been post pregnancy ? as in how many months ?
2. is she a hypertensive or a diabetic ?
3. Is she on any medications right now ?
4. is there any swelling of the legs?
5, was any time 24 hour urine collection for protein done ?

Please get back to me with the details, I will be awaiting your reply

regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Rakesh Madhyastha 20 minutes later
Thanks for quick reply. Please find each answers given below.

1. How long has it been post pregnancy ? as in how many months ?
Ans: It's 18 month post pregnancy till now. Last she was tested in XXXXXXX 2015 and almost every quarter prior to that she had high protein in tests.

2. is she a hypertensive or a diabetic ?
And: Post pregnancy she is not having high BP or diabetic. This problem was only there till pregnancy. Occasionally she has BP at border line post pregnancy.

3. Is she on any medications right now ?
Ans: No medication as of now.

4. is there any swelling of the legs?
Ans: No. this problem was only till pregnancy.

5, was any time 24 hour urine collection for protein done ?
Ans: Yes, Post pregnancy two 24 hour urine protein done and result was having high protein.

Please let me know if any other information needed.

Thanks,
XXXX
doctor
Answered by Dr. Rakesh Madhyastha 3 hours later
Brief Answer:
Follow up

Detailed Answer:
Hello

Thanks for getting back in detail

Persitance of protein in urine 18 months post pregnancy is definitely abnormal and needs further care. Here is what I would do

1. quantify the protein once again with 24 hour urine collection
2. if protein loss is present then I would do a renal biopsy to know the cause for protein loss. There is no such thing as loss of protein due to body weight
3. renal biopsy would show the cause I would start on treatment
4. for now I would start ace/arb tablets to reduce the protein loss. Loss of protein in urine is toxic to the kidneys. It is very important that she is on ace/arb. I usually start telmesartan 20 mg once a day

Please get the things as I have jotted down as soon as possible without any delay

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4360 Questions

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