T Nation

High Protein Values in Urine? Kidneys?

Hi,
Just putting a feeler out for a friend. He just had triceps surgery and they said he had high protein in his urine which could be kidney issues, and told him to back off eating and drinking protein. He is late 60s, competing in bodybuilding for 35 years, and in amazing health. I thought he was mid 50s until I went to support him in a show and they announced how old he is!

He has been on TRT for I do not know how many years. I know doctors are quick to bash high protein diets cause kidney damage, but the studies people used way back to spread those rumors were folks who already had kidney issues.

Would something with surgery cause his labs to come out like this? They are sending his results to someone at UCLA to review.

Just looking out for him and wondering if anyone else has experienced this and what some possible explanations are.

Thanks

How high is his protein ? It could be caused by diet but he needs to see a doctor. High protein is a sign of kidney inflammation which can lead to kidney loss. Hopefully it’s not too high and can be treated. My wife had extremely high protein which eventually took out her kidneys. Her protein level was as high as 60 x normal. Once you go on dialysis, doctors treat you like the walking dead.

Proteiuria-patient has approx 1.8g proteinura per day. Etiology unclear but patient with M spike on SPEP. Kidney biopsy ordered.

Notes about patient being seen for elevated serum creatinine. Hmmm, he did not tell me this and just sent his labs. I have had high creatinine values in my yearly blood work every single year from my early 20s on. I think that is from training right?

Something about Protein total, 24 HR UR (1848- high), range <150mg /24 HR

High creatinine is associated with more muscle mass. Since it’s a product of muscle metabolism the more muscle, the more creatinine. You didn’t give any values for the results so I don’t know if you mean HIGH or High-normal proteinuria. Elevated results are associated with high protein diets but also suggests inflammation in the filtration units of the nephron or a pathology of the pedicles of the podocytes(foot processes that filter the larger proteins). The smaller proteins require a charge be present to repel then away from filtration. Too many pass and the proximal tubule cells will become saturated with excess material, edema, and result in dysfunction of the nephron.

I don’t agree with the 1g/lb of protein/day mantra. I use 20g in my smoothie once, maybe twice/day.

There are 4 pages of results, I thought the 1.8g was the value they might be asking for. I cannot copy and paste off the pdf or I would include more info. There is so much stuff written and values I do not understand.

Just worried about my buddy. He for sure has a ton of muscle mass, especially for his age. And surely has been on high protein diet forever.

Can you post BUN, creatinine, and the protein content of the urine? Was the urine positive for casts or leukocytes?
When you post the lab results, include the range(in brackets usually) because there’s a lot of different units and labs use various ranges. It just simplifies analysis. There are some other values like Hgb, RBC, and Hct Id like to see.

“the biopsy shows a small focus of dense inflammatory infiltrate containing lymphocytes and plasma cells, the possibility that this represents a chronic interstitial nephritis cannot be ruled out. No morphologic bases to explain this patients proteinuria were identified. The possibility of unsampled focal segmental glomeruosclerosis cannot be excluded”

Creatinine Clearance Creatinine, 1.51 (H) range .70-1.25mg/dL

Creatinine 24 hour urine, 2.53 (H) range .63 - 2.50g/24h

Protein, total w/creat, 24 hr urine creatinine 2.53 (H) range 0.63 - 2.50g 24h

Protein/Creatinine 730 (H) range < or = 84mg/g

Protein total, 24h 1848 (H) range < 150mg/24h

I cannot find the BUN but I will keep looking

RBC 5.98 (H) range 4.2 - 5.8 million/uL

Hemoglobin 18.4 (H) range 13.2- 17.1 g/dL

Hematocrit 56.5 (H) range 38.5 - 50%

This guy needs a doctor. He’s at pretty big risk with hematocrit like that if it isn’t simply dehydration. Is the sodium and chloride within normal? BUN is sometimes called ‘urea or blood urea’.

With Hct that high the finest networks of blood vessels and areas of turbulence become a high risk for stroke, heart attack, lung and kidney infarcts etc. The high Hct is a common side-effect of supraphysiological levels of androgens. Moderation might be the best choice for your friend.

The creatinine and protein should be monitored for changes. Since the creatinine is high in the urine, it’s proof the kidneys can do their job. If the proteinuria doesn’t resolve on a modest intake level or protein and steroids then I would look into reasons why like biopsies. 30 years of training and competing I would imagine it would take a ton of convincing to change his ways. Good luck!

Would a surgery have anything to do with it? I think this was taken during a hospital stay for a torn tricep surgery?

I am going to tell him to hurry up and get himself to another doctor…they said they were sending his results for someone else to look at, but I do love this guy and do not want anything happening. He cut back on protein foods and protein shakes as they suggested.

Thanks for your input

Absolutely a surgery would affect creatinine levels. I assumed this was preop BW. I’m not worried about the creatinine, I’m more concerned with the hematocrit which isn’t due to surgery but either excess androgens and/or severe dehydration.

Creatinine isn’t harmful it’s just a marker they commonly use to assess the ability of the kidneys to filter, reabsorb, and excrete. They estimate kidney clearance and glomerular filtration rates with the numbers. However the more muscle you have the more you make and they don’t factor muscle mass anywhere in the equation. It’s just one detail that suggests being able to read beyond the obvious numbers comes in. Also, I think it’s pretty funny how people diagnose lab results alone without any patient history. Based on the information you’ve provided though I’m not convinced of anything.