Donating kidney in 2 weeks but I have protein in my urine. Should I be worried?

[WellGrounded]

Hi everyone, I am a 27 year old male who will be donating a kidney to my Dad in 2 weeks. I have been cleared for surgery by my nephrologist but I'm starting to have some concerns since all my 24 hour urine tests have all come back with protein levels of at least 150 mg, with one as high as 700 mg (think it was a false positive). However, my nephrologist believes it's not an issue since she also had me tested for microalbumin which came back negative. Do you guys think I"ll be ok? Would love a second opinion on this matter, thanks!

[Clark]

Have you discussed this with your independent donor advocate? Perhaps (s)he can provide a referral for a second opinion. Best wishes!

[sherri]

Like with any other surgery, a second opinion from a specialist not associated with the hospital or surgery may be prudent. You also need to understand fully what is considered a normal level for someone with 2 kidneys  and what would be acceptable once you give up 50% of your nephrons. Not sure what the reason is for your father's kidney failure but given that you are a family donor you would also want to investigate what the genetic risks are if any. Are you at higher risk of developing proteinuria from this disease?

 There should be a living donor advocate at the hospital whose job it is to represent the donor's needs exclusively. This is not the nurse coordinator or social worker or psychologist but rather someone who is not employed or benefits from  the transplant. This is according to UNOS guidelines. Ask to speak to that person to discuss your concerns as well as a recommendation for an independent nephrologist perhaps from your primary care doctor, to look over all your testing to make sure you will not suffer any adverse health outcomes from this elective surgery. You can get a copy of your medical records from the the medical records department. If need be, you can always post pone the surgery if you feel you are not ready to sign an informed consent just yet.

Please keep us posted. Hope everything works out for your family.

Sherri
 

[Nancy]

I hope your surgery is a success.  I'm donating in  less than 3 weeks and I haven't been given a 24 hour urine test.  I hope some donors who read this will weigh in with their opinons on whether or not the failure to receive this test is acceptable.
Thanks!

[sherri]

Nancy,

What type of testing have you had to determine your creatinine clearance? doing the usual blood tests (like the ones we all get when going for a routine physical) will give you your creatinine. For females it can run anywhere between 0.5 - 1.1 (lab values may differ). During routine testing for living kidney donation the donor's creatinine clearance needs to be determined to decide whether or not their kidney function is sufficient to remove 50% of the nephrons (the filtering units of the kidney) once left with a lone kidney. This is usually done with a 24 hour urine collection and blood draw. Sometimes other tests are used that inject a dye and watch clearance over time (glofil test). Unfortunately, there are no standard protocols set by a overseeing body and each institution decides for themselves how they will determine the eligibility of a donor.

I am going to bump up a thread with some good advice from Bill, a physician and a donor and Donna a nurse and a donor both extremely knowledgeable about kidney health.

I would ask for all your medical records, review everything with the nephrologist to make sure you know where your numbers are now, what the expectation is after donation so that you are fully educated and informed before you sign your consent. You can also contact another nephrologist for a second opinion to make sure that your kidney health is sufficient before donation. There should also be an independent living donor advocate (ILDA) at the hospital who is not affiliated with the transplant team. He or she is not the nurse coordinator or social worker or nephrologist on the team. They are there to represent the donor's needs without bias.

Keep us posted and good luck with the process.


Sherri

[WellGrounded]

Hey guys,

I donated my kidney last Friday to my Dad and it was a success! He went into the surgery with a creatinine level of 12 and now with the new kidney his creatinine is already at 6. My creatinine is at 2 but that is to be expected. I was discharged last night. Thanks everyone for your support and if any potential kidney donors have any questions, I'll be glad to help.

[Fr Pat]

Dear "WellGrounded",
        Congratulations to you both!
   Fr. Pat

[elephant]

Dear WellGrounded

 Congratulations and welcome to the other side.  I'm glad you and your beloved father are through surgery and recovering.  Daddy and I just passed our two-year kidneversary and are grateful for every day we have together.

Love, elephant

[Snoopy]

Dear WellGrounded,
  Congratulations, and welcome to the club!
  For anybody else for whom protein in the urine is an issue:  I had this not long before my donation, and the nephrologist who was my centre's medical director was NOT amused.  She wanted to disqualify me, but I negotiated a "stay of execution" according to which I had to have three perfect re-tests, which thankfully I had.
   I think in my case what caused the test result was some combination of the fact that I had just increased my exercising, and had also eaten lots of tofu, just before my urine test.  Apparently, either can throw off this test.
    That said, I'd also stress that a genuine issue of protein in the urine is no joke, and should be very carefully investigated before somebody donates.
   Good luck to all!
   Snoopy