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What causes excretion of high protein in urine?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I am a 57-year-old female with diabetes and high blood pressure. I have experienced protein loss in urine, confirmed by a 24-hour urine test which showed a result of 1368 mg/24hrs. I have also undergone a retinal checkup, abdominal scanning, and an ECG, and the results are good. Additionally, I have noticed skin blisters developing over the last two years.

Please help.

Thank you.

Hello,

Welcome to icliniq.com.

I understand your concern.

According to your history, you had skin blisters for which a dermatologist treated you. Please answer a few questions so I can guide you better:

  1. What medications you were prescribed for your skin issues?
  2. How long have you been taking those medications?
  3. Did you use any herbal, homeopathic, or ayurvedic medications to improve your skin condition? If yes, please let me know how long you were taking those.
  4. Are you experiencing any swelling of your feet or face, decreased urine output, or any other recent difficulties?
  5. Did you undergo any tests other than the 24-hour protein excretion test? If yes, could you share those results as well?

Now, regarding the reports you attached (attachments removed to protect the patient’s identity), you have significant protein excretion in urine. This is called nephrotic range proteinuria. To be more precise, it would be better to conduct a few more blood and urine tests to confirm what we are dealing with. If there is a substantial loss of protein in urine, you may experience a lot of issues. I would like to start you on a medication now, but please begin taking it after the blood and urine tests are completed.

If the diagnosis is membranous nephropathy, you will be started on tablets for three months, and we will monitor your response. If there is no improvement, a stronger dose of medications will be considered. The diagnosis will be confirmed through a kidney biopsy if proteinuria exceeds 0.105 ounces. Following blood and urine tests, you will start Losartan 50mg once daily.

I hope you find this information helpful.

Thank you.

The Probable causes

The probable causes include: 1. Skin issues. 2. Medications.

Investigations to be done

Investigations to be done include: 1. CBC (Complete blood count). 2. Urea, creatinine, and electrolyte levels. 3. Urine protein creatinine ratio. 4. USG abdomen (Ultrasonography of abdomen).

Regarding follow up

Follow up after 2 days with the reports.

Medically reviewed byiCliniq medical review team

Published At July 3, 2024
Reviewed AtJuly 17, 2024

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