My son, who has had type 1 diabetes for two and a half years and plays high school football, was recently was told that he was showing signs of protein in his urine. The amount of protein was above normal but borderline and the creatinine level was normal. The doctors want to repeat microalbumin tests (two 48 hour tests and a 24 hour test), and then measure his blood creatinine. How much would football factor into the amount of protein being spilled into his urine?

Heavy exercise or activity of any kind is associated with protein leakage in the urine. That is one of the reasons some of us prefer overnight urine collections that are timed rather than full 24 hour collections. Another variable has to do with glycemic control as well as family history of kidney problems and hypertension, cigarette smoking or exposure and protein intake.

You should discuss all these concerns as well as your specific questions with your child’s physicians so that they can better explain the current abnormalities and how they plan to approach these (protein restrictions, improve glycemic control, antihypertensive medications, etc.). Either way, the tests need to be repeated several times to be certain what they represent and then repeated sequentially so that they can be followed over time, tracked and a plan of response formulated. Aggressive treatment with any or all of these options is associated with decreased microalbuminuria and presumably decreased eventual kidney problems clinically as well.

SB