Worried about Kidneys

I recently had a check-up at my endocrinologist and my A1c and C-Peptide were so good! In fact, she said I've got my blood sugar levels basically under control. Hypoglycemia is her main concern, so I'm just changing my diet a little.

The thing that concerns me is there was a LOT of protein in my urine. The microalbumin number was >800. (It's supposed to be 00.0-20.0).

Then my microbl/creat ratio was 340. (No more than 300 I believe is a good number.)

I have an appointment with a nephrologist coming up, so I'm trying to push it out of my mind. But should I be expecting another health problem with my kidneys?


The microalbumin/creatinine ratio test is extremely sensitive to conditions. Certainly, if you exercise or engage in any strenuous activity within 24-48 hours of your urine sample, you can show a false positive.

A normal ratio is less than 30 micrograms of microalbumin/mg of creatinine.

I made the mistake of doing heavy squats in the weight room within 24 hours of a urinalysis and my ratio came back in the 300s.

Also, being dehydrated can affect the test. I had a couple of glasses of beer the night before another urinalysis and did not rehydrate. The test the next morning came back in the 200s.

Every other test I've ever done has come back well within the normal range, usually less than 1, but never higher than 10.

You are relatively recently diagnosed and I can't imagine a situation where you'll damage your kidneys significantly a year after diagnosis. As much as it is a pain in the ■■■, a 24 hour urine sample, done properly, where they measure total microalbumin output over a 24 hour period is much less sensitive to conditions than a spot urine test that measures microalbumin/creatinine ratio. That test is hardly done these days given the accuracy of a spot urine test (if all the precautions are observed) but you can always ask for a 24 hour urine test to be performed. That's what I opted for after my second spot urine testcame back postive and the 24 hour urinalysis showed that the spot urinalysis was most likely a false positive. I had hardly any microalbumin showing in my 24 hour urinalysis.

Beyond that, the ARBs and ACE inhibitors used primarily lower blood pressure have been shown to be very effective at protecting kidneys agsinst further damage and, in some cases, reversing any early damage that has already occured. I would not be surprised if your endo or nephrologist opts to put you on an ARB or ACE inhibitors even if further testing comes back negative. I am currently in an ARB and have had no problems with the low, protective, dose I'm taking.

Good luck and try not to worry too much about it.

That's good to know! I hadn't exercised recently or done strenuous activity. But I was fasting the night before, so it's possible I was more dehydrated than normal.

I agree - A couple of test should not scare you into the "what next" mode. I have had many kidney tests that were suspicious and then became normal a couple months later. But it's good that they caught this early, for there are many things you can do to preserve the function and frequent monitoring will help you. Keep your blood pressure as low as possible. ACE inhibitors and ARBS are great and you must not take any anti-inflammatory NSAIDS like ibuprofen or advil - use tylenol and aspirin instead.
Be informed. Make a list of questions for the nephro and don't stop until you're satisfied.
Do NOT let fear prompt you to bury your head in the sand. Deal with it and get on with your life.
My best wishes for a good outcome/

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I confirm FHS on this, I also exercised before a urine test (squats as well) and must have squeezed some protein out. Freaked my doctor, but since remembering to not exercise before a urine test, I've been clean for a number of years.

I'd really be surprised to see a young woman in college that is pre-diabetic have kidney damage caused by diabetes already.

Does anyone know the umol/l of measuring. I see Albumin on lab results, is this the same as microalbumin though ?

The Albumin test is a test for protein your liver makes (it's about 60% of the fluid your red and white blood cells float around in, it's not the same test as micro albumin but the word Albumin is just medical term for protein. If your Albumin is high this usually means your suffering from dehydration, if its very low it can mean your suffering from liver failure. I have tested both high and low...;-( Micro albumin is usually associated with a urine test, random or 24 hour test.

Albumin is albumin is albumin. As John says, it is a protein produced by the liver. There are any number of different types of "proteins" produced by various cells and released into the blood.

In general, kidneys are impervious to protein loss and any proteins that are secreted are usually reabsorbed by the kidney. So, any "protein" found in the urine may be indicative of some type of kidney damage.

Compared to most other proteins found in the blood, albumin is physically smaller in size so when it is found in the urine, that may indicate early kidney damage that can be reversed. If a small amount of albumin shows up in the urine, it is called "micro" albumin in reference to the amount found. As levels found in the urine increase, it may be referred to as "macro" albumin.

As John also mentioned, any amount of albumin found in the urine can just be referred to as Albuminuria.

The albumin found in blood can also be measured and this is called serum albumin as John mentioned. If significant amounts of albumin are lost to urine, the serum albumin levels will begin to decrease which is why serum albumin levels are also monitored closley in diabetics.

Thank you for the thoughts!
I am going to do my best to put it out of my mind for the next week and a half until I'm at the nephro. Then answers will be given and I will hopefully have more peace of mind :-)