July 6, 2008
Complications
Question from Dallas, Texas, USA:
As a part of regular laboratory work, my doctor ordered a urine total protein test. On a range of zero to 10, my test came back 10.2. I have well controlled diabetes, an A1c of 6.5 or less, generally closer to 6.0 for almost the entire duration of my disease. I have basal joint arthritis (I play the piano) and had a flare up a couple of months ago. I have been taking lessons and practice a couple of hours daily. Thus, I started taking NSAIDs at the maximum dosage for about the past six weeks. Could this have any effect on the total protein? Previous tests have not been high. Also, my urine was very concentrated – yellow; I was probably dehydrated. Could this have had an effect?
I was seen by nurse practitioner this time. My TSH had jumped from 1.27 to 5.368 since my last panel six months ago. I have Hashimoto’s disease, had the gland removed years ago. She ordered a follow-up in three months. I also asked for a follow-up urine total protein test. Could there be any correlation among any of this? Should I be worried about the urine protein?
Answer:
I have problems interpreting the results of your urine test because I am not sure what type of test it was. Was it a 24-hour urine collection and expressed as mg per 24 hours? What it a random test? Was it qualitative or expressed as a ratio to urine creatinine? I know these are technical questions and you may not have the results. My suggestion is that screening for microalbuminuria should be done with a random urine for microalbumin:creatinine ratio. Results greater than 30 mcg/mg creatinine should be repeated and a 24-hour urine should be considered. I don’t know what the total protein test is measured in. It may not be the best test to screen for kidney involvement with diabetes as urine microalbumin is most specific. I doubt that your thyroid status or pain medication had an effect on these results, but repeating an abnormal urine test is a good idea.
JTL
