microalbumin

[sherri]

I went to do blood and urine for my 4 year post donation (actually 4 years+ donated in Nov 2007). I had found a nice PCP last year and saw her once or twice and then got notice that she is going fee for service so I am back again looking for a new PCP. In the meantime, I figured I really needed to get labs done so I made an appointment with a nephrologist who I saw as a second opinion before the surgery and I had seen him last in 2009. Everything came back ok, creatinine was .97 which is consistent for me post surgery (pre was about .7 - ., but the microalbumin in the urine was high. This has never been high pre or post surgery. He wasn't really sure what to make of it and felt it needed to be repeated just to see if it is a fluke so I am going to do another urine sample in a couple of weeks.

Anyone else have this? Any feedback from our "medical experts?" I have been working very hard at keeping my weight down. I have reached and been maintaining my BMI goal of 25 (no clothes on and shaved legs! LOL) watch my salt intake, don't take NSAIDS, exercise by walking and even do yoga, pilates and stretching. My BP has gone up after the surgery and of course I have aged 4 years (am now 48). My BP was 116/62 on the automatic cuff which I knew to be inaccurate but would have gladly taken that number. On the manual cuff it was 128/78 which is more my trend. I tend to run between 120- 130/ 70-80 . Would really like to have it lower. no meds so far but I know I will most likely end up on an ACE inhibitor at some point given my family history of high blood pressure.

Just thought I would update since we all like to know how donors do down the road. Will update again when I redo the urine and I hope the increase  in microalbumin is a false positive or related to exercise or some other detail.

Thanks,

Sherri

[dodger]

Hi Sherri, I just did a Google search to refresh my memory.  Lot of information there is you do it.  Food allergies,  eating too much protein, exercise, illness.

I do hope it was just a random reading.  Best wishes,   Janice

[lawphi]

I would suspect you were a little dehydrated and run down. Your other labs are perfect.

My husband occasionally has microalbumin in his urine and it typically relates to how he feels.

[Orchidlady]

Sherri, when did you last exercise before your labs? I remember when I was first going through the testing phase that I was told no strenous exercise a minimum of two days before or it could affect the result of protein in the urine due to muscle breakdown.

Hope the repeat shows the original one to be nothing more than a testing anomoly.

[sherri]

I usually make sure to be well hydrated before testing and not to do strenuous exercise (not that I ever do!). I did a zumba class (took my Mom to a seniors exercise so it couldn't have been too strenuous) and it was an hour before testing. My creatinine was .97 so not elevated for me so why would one value be affected by exercise and another not? In any case, I will repeat the urine next week and hope that it really just was a fluke. Will try to get blood work done again in 6 months if I find a new PCP. Hard to find experienced doctors taking new patients. Will keep searching. This is why I would love for my hospital, Hopkins, to have a donor clinic open to all donors for follow up. I think they see donors who have had complications, which if that happens then I will contact them. I am more than willing to use my insurance, I would have to anyway but at least my information would be in one place and available for comparison. Seems so simple to me!

[Orchidlady]

That hour of even low level exercise before the testing might have done it, Sherri. While it wouldn't affect creatinine,  exercise causes a number of hormonal and metabolic processes that will cause waste products, including protein, that have to be filtered through - you guessed it - the kidneys - and would ultimately show up in the urine. Let us know how next week goes - and no Zumba before the test!

[Donna Luebke]

Sherri,

Have the nephrologist explain the microalbumin level to you.  All of us should have a microalbumin checked as part of our lifelong care.  I would not attribute this to what you ate or related to exercise.  Is a trend to follow because microalbmin is much more sensitive than tracking protein.  Would determine now what this means for you.  Mine has been low to normal.  As I understand this per a nephrologist--what does the microalbumin test result mean for me with one kidney vs if I had two kidney (what is normal for me is maybe not normal since I only have one kidney.  Is a normal level even too high?  When should there be concern as to whether or not kidney damage is occurring or not?)  Similar to issue as how do we determine our GFR. History, physical, labwork (both blood and urine studies), vital signs are all important to follow.  If this is new finding, would figure out why now and what to do next??

Key is to make sure you and your lone kidney are OK.  Good you had micralbumin checked.  What does the nephrologist recommend?  Good to repeat tests and be seen earlier rather than just annually. If still high, might target those processes which cause high microalbumin.  At what point are the compensatory mechanisms of hyperfiltration and hypertrophy not good for us?  Could mean an ACE inhibitor and bicarbonate are indicated.   

Best to you. 

[sherri]

Thanks, Donna. I did ask him what this means for me. Does this mean my kidney isn't compensating? Would this have happened had I had two kidneys? He wasn't quite sure yet.  He gave me an article about microalbumin and its significance for diabetics but I am not a diabetic. I am inclined that he isn't really quite sure what to make of it yet, as you said a lot is about trends. This is a first for me. My blood pressure is definitely on the higher side ranges between 120-130/70-80 on a good day so I did ask about the ACE inhibitor. Will reevaluate when I repeat but I am considering discussing taking the ACE really as a protective measure and maybe just a very low dose. I have a family history of kidney disease (both brothers) and my mom has hypertension. All of her siblings have diabetes. What is the deal with taking bicarbonate for kidney protection?

Thanks,

Sherri

[Snoopy]

but the microalbumin in the urine was high....  I have reached and been maintaining my BMI goal of 25 (no clothes on and shaved legs! LOL)....

Dear Sherri,
  I was sorry to hear about the microalbumin reading, but indeed tests are easily thrown off by exercise, dehydration, etc.  Last summer that happened with my protein tests, too.  Good luck.  And congratulations on sticking to your BMI of 25 (fortunately, my center only demanded 30, and that was hard enough. But then, being a man, I hadn't thought of shaving my legs....)
     Be well, Snoopy