What's up with my kidneys?

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Sarita
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   Posted 1/1/2008 11:53 PM (GMT -7)   
Two weeks ago when I was in the hospital for 3 liters of IV fluids, they eventually had to catheterize me to get a urine sample. I was told that I had proteinuria. On vacation I was 99% sure I had a UTI (pain upon urinating, etc.) so went to the urgent care by my in-laws' house and asked for a urinalysis. Turns out I did not have a UTI - no blood, no leukocytes - but again I was told I have significant proteinuria (3+). The doctor told me I need to see a nephrologist and get a 24-hour urine test and a renal sonogram. I am clueless about how this might be related to my bowel issues. Has anyone else experienced proteinuria that lasted longer than a few weeks?
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stkitt
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   Posted 1/2/2008 9:18 AM (GMT -7)   

Dear Sarita,

This may be nothing so I will not go into what it might be. :) I would prefer you follow up and just stay cool until you get answers from the physician.

I also don't know what your meds are as sometimes meds may cause this same problem.

I am sure you will be ok and I will be following you to see what you find out.

I am here for you so know you have support.  (((((HUGS)))))

Kitt


 
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Sarita
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Date Joined Mar 2005
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   Posted 1/4/2008 10:57 AM (GMT -7)   

Thank you, Kitt.  I know there's a lot of things that can cause this.

I saw my PCP this morning and he did another urinalysis, and again I'm spilling lots of protein (third time in a month).  Plus I dropped 11 pounds since I saw him in early December.  So he gave me a stat referral to a nephrologist.  I don't know.  Trying not to freak out but jeez louise I don't know how much more of this I can take!  I have 10 exams this month.  First one is on Monday morning. 

Sometimes I wonder what the breaking point will be?  I'm sitting here at the library trying to get ready for a physiology workshop and the absolute last thing I want to do is hang around with a bunch of gunners and talk about EKGs.

Okay, I'm done whining.  You guys are awesome for listening.


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Matthew
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Date Joined Oct 2004
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   Posted 1/4/2008 11:10 AM (GMT -7)   
Yes, there are a lot of things that could cause this. Including my favorite ( but so very rare) Glommerulonephritis. I assume they are checking for THAT possibility. Of course, that might actually also lead to a final dx for you-Crohn's. Of course.
I hope not, I STILL have mysterious kidney problems likely linked to that (idiopathic hematuria, weird looking urines, etc.) besides the bloody kidney stones.
Take care of yourself,

Matthew

Sarita
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   Posted 1/7/2008 11:03 PM (GMT -7)   
Hey guys, my PCP got my records from the GI and turns out I've been spilling protein for a few months now, according to all the urinalyses that have been done. Sometimes people just randomly spill protein in their urine, so I guess that's why my doc didn't follow up on it. But four separate occasions with this much protein is crazy. And, being the dipstick med student I am (pun definitely intended), I didn't put two-and-two together that the fact that my urine looks like a white CLOUD most of the time could be an indication of a problem. Oh, and all that weight loss...this might be the culprit. The diarrhea? Who knows. Maybe this stunning new nephrologist will have a clue. I see him on the 24th.

In the meantime, my PCP told me he thinks I should see a psychologist because "this is a lot to handle as a med student" and he wants me to be able to talk about it with someone. At times I just feel like I'm on the brink of a meltdown here. The feeling comes and goes. It's worse if I'm unmotivated and don't study enough and bomb an exam (like I imagine occurred today). It's like running on a treadmill that keeps picking up speed and you feel like you might burst.

Thanks for listening.
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gumby44
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Date Joined Nov 2007
Total Posts : 4099
   Posted 1/8/2008 1:39 AM (GMT -7)   
Wow Sarita,
I wish you could catch a break for once! I hate it that you have to suffer. Anybody would feel "on the brinkof a meltdown" with all you are going through. Do you think it would help to take a medical leave of absence from med school until you can sort all of this out? You seem like someone who never quits, but maybe you'd concentrate better and actually enjoy med school if you were medically stable first. I know that would be a HUGE decision...that's the kind of stuff a mental health therapist could help you sort out. I don't know the first thing about kidney stuff, but my heart goes out to you, and I hope you can hang in there until the 24th!
49 yr. old female, diagnosed with Crohn's in small intestine and terminal ileum Sept-Oct. 2007
currently taking Pentasa 2750 mg- 9pills/day and on and off Prednisone for flares


LynnRN
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Date Joined Oct 2007
Total Posts : 289
   Posted 1/8/2008 8:59 AM (GMT -7)   

Hang in there,I know how hard that is,trust me. I hope you get some "good news" soon.

Lynn:)


Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 1/9/2008 12:01 AM (GMT -7)   
Thank you darlings!

I talked to my sister yesterday (a family practice doc) and she thought maybe I should get a test or two done before I see the nephrologist. I e-mailed the suggestion to my PCP and got an e-mail back from him that was like, "Let's have a chat so I can make suggestions about how to talk to your family members about this." Maybe he thinks I was undermining him? Now I just feel silly. Do any of you have doctor family members that give you advice?

The last time I got medical "advice" from my dad, I ended up with a ruptured appendix and emergency surgery, so I understand the dangers inherent in this...but I wasn't asking my sister for advice, just keeping her somewhat abreast of what's going on.

The problem of course is that my PCP is also a faculty member at my school. Maybe I should re-think this.
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Sharann
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Date Joined Sep 2005
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   Posted 1/9/2008 2:15 AM (GMT -7)   
Hi,
Spilling urine protien can be cause by nutritional deficits such as increased protien catabolism. You may have low protien levels. Are you eating ok? It could be UTI as well that is subclinical(they just are not diagnosing it correctly) Also, could be from dehydration as well as kidney issues as you stated. Good luck.
I am a Certified Doxie Lover(Weinerdogs)


Marie-Claire
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Date Joined Mar 2007
Total Posts : 900
   Posted 1/9/2008 11:42 PM (GMT -7)   
Good luck Sarita. Am keeping you in my prayers.
Mary
50 yr.old retired RN,Crohn's D for last35 yrs..severe esophagitis, migraines,strictures,urethral stricture,depression,probable MS.
 
 


Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 1/9/2008 11:49 PM (GMT -7)   
Thanks for the replies Sharann and Marie-Claire. They don't think a UTI is present since I don't have leukocytes or blood in the urine, just protein, and no culture growth that I know of...but I'll do a little research into that! Nutritionally...I've lost a lot of weight since September (25 pounds) but the last time they checked my pre-albumin, which is the best test to check your nutritional status, it was within normal limits. That was a few weeks ago. But I will look into that as well!
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njmom
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Date Joined Apr 2006
Total Posts : 1884
   Posted 1/10/2008 12:36 AM (GMT -7)   
Sarita, about the PCP...you asked him a question. All he had to do was answer it. It wasn't necessary for him to pull the "Let's chat" routine. 
 
Am hoping you get to see that nephrologist, soon. 
 

Writer
Regular Member


Date Joined Aug 2006
Total Posts : 443
   Posted 1/10/2008 10:46 AM (GMT -7)   
There is a kidney disease called renal amyloidosis that can occur in conjunction with Crohn's disease (generally in under 3% of cases of Crohn's). You might discuss this possibility with the nephrologist, because protein loss in urine is one of the main signs of renal amyloidosis.

Matthew
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Date Joined Oct 2004
Total Posts : 3932
   Posted 1/10/2008 2:23 PM (GMT -7)   
Sarita,

This sounds a bit like the problem I had during my last major flare in 2004. I had cloudy urine, sometimes even old dishwater urine. I don't know if it is from my past Glommerulonephritis or just something from my CD. It was definitely connected though..
Anyway, I hope you get some answers soon ( yeah, I know your track record in that regards but luck!).
Have you talked about my suggestion AT ALL with your URO or have they already counted it out?
I am very concerned about this, please let me know!

Sincerely,
Matthew

Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 1/10/2008 3:16 PM (GMT -7)   
I have to wait two weeks to get into see the nephrologist. Right in the middle of mid-terms, ahh. Can't wait to haul a pee-jug around campus.

Matthew, how were you diagnosed with glomerulonephritis? Did they do a kidney biopsy? Did your 2004 protein spillage just resolve on its own? This could be glomerulonephritis. I hope not. It could about 23978 other things too.
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ski bum
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Date Joined Jan 2007
Total Posts : 451
   Posted 1/10/2008 7:00 PM (GMT -7)   
Sarita - have you had labs drawn, like BUN and creatinine? I'm sorry you have so much to deal with. If there's a positive to any of this, all the challenges you're facing and handling will make you a compassionate and caring doc (not that you wouldn't have been without all these challenges....)
50 y/o F. CD dx'd Aug 05. Initially on Pentasa, then Imuran 125 mg. Started Humira (very reluctantly) on 10/24/07. Currently on Humira, Imuran and Entorcort. Hope to dc Imuran and Entorcort within one month of starting Humira.


Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 1/11/2008 3:49 PM (GMT -7)   
Hey Skibum (love the name - wish I could ski - too bad I live in the desert now)...
I just got some records from my GI today - I am weird. My blood tests are all over the place. High prealbumin, low carotene. Prealbumin is a good measure of your nutritional status, so the fact that it was not low is encouraging, although the low carotene seems to contradict that. Urinalysis was off - showed proteinuria (duh), slight ketosis, and elevated urobilinogen. Ketones are produced when your body starts using ketone bodies as an energy source, often seen in diabetics. But my glucose ranges have always been normal, so I'm not diabetic. Weirder yet, my BUN/creatinine ratio was low. If you have kidney disease it tends to be high. Low BUN/creatinine can indicate rhabdomyelosis, low protein diet, malnutrition, liver disease, or a range of cancers. My BUN/creatinine has been low for the majority of all the blood work I've ever had done.

Thank goodness I'm not a doctor yet because I'm way too confused by these results.
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Sarita
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Date Joined Mar 2005
Total Posts : 2486
   Posted 1/11/2008 3:49 PM (GMT -7)   
Oh, and my urine culture was negative - so no UTI. I was kind of hoping it was a UTI so it'd be easy!
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yogaprof
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Date Joined Apr 2006
Total Posts : 1665
   Posted 1/11/2008 3:56 PM (GMT -7)   
I have no medical answers, but wanted to send you good wishes and I am sorry! of course you are overwhelmed and a bit crazy...we all are or have been. this is a lot to deal with, without medical school. keep breathing and every once in a while just assume it will be ok and do something fun. you won't fix it with your head, and sometimes it just takes time. hugs, B
48 y/o woman.  Diagnosed 4/06 after colonscopy, SBFT, CT-scan all showed crohns. 3 months later, after pred and remicade, all tests showed no crohns. In December had adhesions cut through a laparoscopy. Now just taking Glycolax, Ultra Fiber Plus and vicodin as needed.


Matthew
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Date Joined Oct 2004
Total Posts : 3932
   Posted 1/11/2008 8:44 PM (GMT -7)   

 

 

      Sarita,

       Well, after a few years of bleeding, & other UT problems, including elevated proteins which mysteriously came & went for that period, someone finally cut me open eyes . For 3-4 years thought it was cancer (inituial dx in 1979) versus Hypochondria!

      Anyway, finally had a Uro that had a hunch! Cauterized the offending blood vessels. But not a total cure.

     As for 2004, the weirdness ( gray, cloudy urine) went away with my remission. I was afraid it was the F word for awhile!

     Now, I just worry about my friendly Kidneystones. ARRGGGH! This DD really sucks. But you already knew that.

    Yep, could be many things. I hope its something minor for you!

 

   Sincerely,

   Matthew

 

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