High albumin in urine, would like thoughts on my labs

[Antje77]

Got some lab results back today with raised albumin (protein? not sure about the usual English terms) in my morning urine.
I'll have my endo appointment on the 16th so I'd like to come prepared with some more knowledge.
I know next to nothing about kidneys (except a good recipe), thinking myself invincible by keeping my BG in the non diabetic range.
Wrong, apparently.

I did the google thing of course, and I expect to have to turn in another portion of urine or a 24 hour urine container. Provided I'm not on my period on the day before my appointment, I guess I can simply bring this with me to save me another trip to the hospital in case labs are ordered.

I also expect BP medication to be upped, which is fine with me, and be told to adjust my diet which is not so much fine with me. Oh, and quit smoking, which I think is impossible at the moment.

What I couldn't find on google is how alarming those results are and what the expected prognosis is with those numbers, in other words, I have no idea if I'm looking at some background thing (like background retinopathy which can stay more or less the same for decades) or at a very big problem.
For now, I'm not too worried by this but I have no idea if I should be!
So any insight from people more knowledgable than I am on kidneys is welcome.


More possibly relevant information:

- I had my labs done right after a covid infection.
- I'm fat.
- I smoke a lot and drink more than is advised.
- Sedentary lifestyle.
- Hba1c has been well under 42 for almost 6 years but I was likely undiagnosed for over two years with high BG before that.
- BP right on the threshold for more medication. Currently on 10 mg of enalapril.



My lab results as received today:

Albumin morning urine over the years.
We dismissed the last one on 12-10-'21 because I was on my period, looks like it was a significant result after all.

And albumin/creatinin ratio, within the normal margins still but only just:

 

[Antje77]

Don't give me all the 'hug' emoji's, they're scary!
I do hope I'm getting them because I don't know how to interpret my results and not because you know something I don't!

 

[Goonergal]

Don't give me all the 'hug' emoji's, they're scary!
I do hope I'm getting them because I don't know how to interpret my results and not because you know something I don't!

It was only to show support because I don’t know enough to offer any intelligent answer to your question.

 

[Antje77]

It was only to show support because I don’t know enough to offer any intelligent answer to your question.

Phew!

Thought so (or you would have replied), but for now I'll go with the assumption that hugs aren't needed!

 

[MrsA2]

I don't know either, but I know I scared myself silly when first testing ketones with sticks that showed me all sorts of other things too . None of my high levels then came to anything, just things passing through fleetingly.

And no you can't have a hug!

 

[EllieM]

Hmm, I don't know much but interestingly in NZ they reckon the upper limit for albumin is 30 not 15 ... (and yes it's the same units). And the "high" levels are over 300, so you are a long way from that? Maybe drink lots of water before the next test to make sure dehydration isn't a factor. (Plus there's the covid elephant in the room?)


I think it's one of those things that means they need to check whether you have kidney issues, rather than you necessarily do?

And my googling suggests that while eGFR can't be increased, the albumin ratio can be improved, so yes, am guessing you can expect the smoking lecture.... Do you know what your eGFR is?

All I know about CKD is that people can have it for a long time , and it's good to be diagnosed early.

Hopefully you don't need the virtual hugs.

 

[Pipp]

Don’t stress, @Antje77 .
The covid infection could be a cause.
I would ask have you had symptoms such as needing to pee more, frothy urine, muscle cramps? I had these, following a chest infection, a few years ago, and test showed protein in urine. Tweeked diet slightly, ate less meat, and a test a few weeks lter showed everything was fine. Has been fine since.

Virtual hug for the anxiety these things can cause.

 

[Grant_Vicat]

Hmm, I don't know much but interestingly in NZ they reckon the upper limit for albumin is 30 not 15 ... (and yes it's the same units). And the "high" levels are over 300, so you are a long way from that? Maybe drink lots of water before the next test to make sure dehydration isn't a factor. (Plus there's the covid elephant in the room?)


I think it's one of those things that means they need to check whether you have kidney issues, rather than you necessarily do?

And my googling suggests that while eGFR can't be increased, the albumin ratio can be improved, so yes, am guessing you can expect the smoking lecture.... Do you know what your eGFR is?

All I know about CKD is that people can have it for a long time , and it's good to be diagnosed early.

Hopefully you don't need the virtual hugs.

I'm glad you said this, because I too investigated my results, but my creatinine etc is all done via blood tests. I noticed also that dehydration may be a factor. Like you I found it said 30 rather than 15. If it's any help to @Antje77 I can bear out your last medical comment - I had CKD for 40 years! So she could be put on blood pressure tablets and ace/inhibitors or simply closely monitored.

 

[Antje77]

And no you can't have a hug!

But I like hugs! Just not scary hugs.

 

[Antje77]

Hmm, I don't know much but interestingly in NZ they reckon the upper limit for albumin is 30 not 15 ... (and yes it's the same units).

I guess you must be a tougher species over there!

And the "high" levels are over 300, so you are a long way from that? Maybe drink lots of water before the next test to make sure dehydration isn't a factor. (Plus there's the covid elephant in the room?)

Isn't the 300 number for the 24 hours urine? Not sure, I did enough googling for the day but the number seems to ring a bell.
I'm definitely putting my cards on covid this time and period last time until proven otherwise.
I think dehydration isn't a factor because they check the albumin/creatinin ratio at the same time, but I'm not at all sure I understood that part correctly.

And my googling suggests that while eGFR can't be increased, the albumin ratio can be improved, so yes, am guessing you can expect the smoking lecture.... Do you know what your eGFR is?

I don't remember if it was tested this time, if so, results aren't in yet.
All previous tests (including the last one in 2021 with the elevated albumin) showed >90 so all perfect.

Don’t stress, @Antje77 .
The covid infection could be a cause.
I would ask have you had symptoms such as needing to pee more, frothy urine, muscle cramps? I had these, following a chest infection, a few years ago, and test showed protein in urine. Tweeked diet slightly, ate less meat, and a test a few weeks lter showed everything was fine. Has been fine since.

Virtual hug for the anxiety these things can cause.

No symptoms at all, never even had a UTI in my life as far as I know.
I definitely hope it was just the covid, tested positive 8 days before labs and had only just recovered.
Anxiety not a problem really, I don't feel like there's anything wrong, if that makes sense.

If it's any help to @Antje77 I can bear out your last medical comment - I had CKD for 40 years!

Uh, and we all know how that ended...
On the other hand, in 40 years I'll likely be dead anyway, so that's ok.
I had thought about tagging you, but then thought that even if it turns out I have early kidney disease, things are completely different from when you had early kidney disease some, what, 50 years ago.

So she could be put on blood pressure tablets and ace/inhibitors or simply closely monitored.

We'll see!
I have high hopes it's just coincidence with the covid this time and the period last time.


Thanks everyone for sharing your thoughts, it's much appreciated!
And it looks like there's no reason to panic right away.

 

[AndBreathe]

@Antje77 @ what ^^^^^ they all said, but also I recall a presentation on CKD where the Renal Bod told us an astonishing (can’t recall the number, except it wa smush Parker than I’d have guessed) percentage of the population have CKD. Only another proportion of that related to diabetes.

Sooooooo, in your shoes, I’d want properly checked out, but until that interaction, I’d be trying to put it down to an unwanted inconvenience. Easier said than done, I know.

Get your big girl pants on, wait for the rest of your results for the bigger picture.

(Not a scary hug in sight. Ok?)

 

[MrsA2]

But I like hugs! Just not scary hugs.

You can have a hug if and when you are ever diagnosed with anything new.

 

[Antje77]

@Antje77 @ what ^^^^^ they all said, but also I recall a presentation on CKD where the Renal Bod told us an astonishing (can’t recall the number, except it wa smush Parker than I’d have guessed) percentage of the population have CKD. Only another proportion of that related to diabetes.

But I I'd rather not have CKD at all, even if it's not related to diabetes!

Sooooooo, in your shoes, I’d want properly checked out, but until that interaction, I’d be trying to put it down to an unwanted inconvenience. Easier said than done, I know.

Get your big girl pants on, wait for the rest of your results for the bigger picture.

No problem, not too worried to be honest, I just wanted to be as prepared as possible.
My ideal doctors appointments are the ones where I tell them what I think and then they tell me if they think the same and point out possible flaws in my thinking.
Works out very well on diabetes related stuff (took this approach from my very first appointment, six days after getting my diagnosis. Poor practice nurse was blown away with what I'd managed to learn in less than a week, not at all the consult she had in mind ) and even works amazingly well at the vets, the internet is a marvellous thing if you know how to sift information.

So for now I'm all fine, and I plan to come with some home BP readings taken throughout the week (no use taking it there, it will be sky high) and if not on my period some pee as well. First step seems to be a re-test so makes sense to do that right away.

With all other labs being perfect (assuming hba1c and lipids are still completely normal), I think it's odd that this one is high.

 

[MommaE]

I found my endocrinologist to be fond of saying “ don’t look so much at each individual result we need to consider them in relation to each other and their history to see how they all relate to each other.” Don’t know if that is the case in your situation but might might be worth a consideration?

 

[Antje77]

More results are in, looks like I'm pretty healthy!

EGFR is fine too. No idea if it's usual to have elevated albumin only, with everything else just fine if something's wrong though.
Does anyone know?

Off to google TSH, which seems to be just outside of 'normal', and it looks like there are no other interesting results to google!

Oh, the lipids are fasted of course, even though the form says not fasted. They seem to think T1s will drop dead right away if they don't eat breakfast so we're always told not too fast.
Not having my morning coffee before having bloods taken does feel a bit like dying but I don't think that counts.

 

[Goonergal]

No idea if it's usual to have elevated albumin only, with everything else just fine if something's wrong though.
Does anyone know?

No knowledge, but my googling did suggest that one reason for elevated albumin is insulin! That was in relation to blood albumin, so may not be the same for a urine test - towards the bottom of this page: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=albumin_blood

 

[Antje77]

No knowledge, but my googling did suggest that one reason for elevated albumin too is insulin! That was in relation to blood albumin, so may not be the same for a urine test - towards the bottom of this page: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=albumin_blood

Now that's interesting!
However, it looks like this doesn't apply here:

"When your kidneys start to fail, albumin starts to leak into your urine. This causes a low albumin level in your blood."
and
"Certain medicines can raise your albumin levels. These include insulin,"

 

[Antje77]

Off to google TSH, which seems to be just outside of 'normal', and it looks like there are no other interesting results to google!

Looks like it's not far enough over the threshold to be very interesting, especially with the T4 being normal.

A possible cause can be my changed diet. LCHF means that I hardly eat any ready made product with added salt (like bread, pizza, ready made meals). I also use very little kitchen salt with added iodine, preferring to flavour my food with tastier salty condiments. No idea if those condiments have salt with extra iodine too, but if not, I might not be getting enough.

I guess I'll have to find out where to buy seaweed and how to turn it into a tasty meal, and see if that changes my next blood results.

 

[AndBreathe]

Looks like it's not far enough over the threshold to be very interesting, especially with the T4 being normal.

A possible cause can be my changed diet. LCHF means that I hardly eat any ready made product with added salt (like bread, pizza, ready made meals). I also use very little kitchen salt with added iodine, preferring to flavour my food with tastier salty condiments. No idea if those condiments have salt with extra iodine too, but if not, I might not be getting enough.

I guess I'll have to find out where to buy seaweed and how to turn it into a tasty meal, and see if that changes my next blood results.

View attachment 58634

Antje, TSH is Thyroid Stimulating Hormone - a pituitary function which signals the thyroid to get a move on.

Your Free T4 is nearer the bottom end of the scale than the top. Many folks feel better with higher T4. Bearing in mind your TSH , in your shoes I would want a full thyroid panel done, including antibodies and T3. Hashimoto's thyroiditis is auto-immune, so worth keeping an eye on.

(The Bobby Basic thyroid function is, pituitary gland releases the relevant amount of TSH to stimulate the thyroid to work. The thyroid gland then produces T4 (hormone) which the body must the convert to T3. T3 is the real thyroid work horse, and a cornerstone of our metabolic health.

Whilst TSH can be indicative in assessing thyroid health it is a bit like assessing diabetes from urine.)

In many countries low thyroid function is often diagnosed at a TSH of more than 5. (USA is 3) In UK treatment isn't routinely offered with a TSH under 10 unless very symptomatic. Not great, in my view. Euthyroid is often considered a TSH of less than 2.

Apologies if my basic explanation seems patronising.

 

[Hopeful34]

Interestingly I've just had a discussion around thyroid levels, as for the first time my TSH is 5.1 having had 2 episodes of overactive thyroid years ago. T4 not tested unfortunately.