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April 27, 2003

Other Illnesses

Question from Flint, Michigan, USA:

My son's endocrinologist does not do urine testing, and recently during his annual physical, the urine test showed traces of blood, but the culture showed nothing. We went back a week later and had the same results so I'm concerned because blood in the urine is not normal. Is there another specialist that we should take our son to? Could he have some kidney damage?

Answer:

There’s not very much reason to do a routine urinalysis for diabetes followup unless there is known protein being lost or suspected kidney infection. It could be useful if there are high sugar levels to see if there are also ketones present but this isn’t very common.

You are correct that blood in the urine isn’t normal. If there is no infection, then the question is why is the test positive. Could it be something called a false positive test, something interfering with the test strip results, etc. You should discuss this with your son’s diabetes doctor and also his primary doctor and see how this can be better evaluated. If there is still some question, then consultation with a kidney specialist (nephrologist) may also be helpful but usually your primary doctor or endocrinologist can do the next diagnostic steps to find out what is going on.

Usually earliest kidney abnormalities in those with diabetes is protein leakage. Most sensitive of the protein tests is called microalbumin. This can be done on a 24 hour urine specimen or a random specimen as well as an overnight specimen. Every one has their favorite way and all of them are okay.

SB