Test results from 24hr urine and UA

Question
QUESTION: Dr. Shah,



I am a 46 yr old w/lupus. I just got back my test results from my 24hr urnine and renal profile and would like you opinion and expertise. There were some abnormal results:



*U24 protein 1230mg/hr

*UA Postive RBC 2+ (20-30), protein 1+, trace Reenal Epi, trace squam and trans Epi

*blood creatine is 1.4



Still waiting for renal profile to return



THank You!







ANSWER: Hi Laura,



Thanks for asking my help on "Allexperts".



When you said you had lupus, it was not clear whether you have systemic lupus or lupus nephritis. From your reports (proteinuria and microscopic hematuria), you seem to have kidney involvement due to Lupus.



If I were your doctor, I would advise a kidney biopsy to characterize the disease and plan treatment. Lupus Nephritis is classified based on the extent of kidney involvement and treatment differs in different classes.



Sincerely,



Dr. Shah



---------- FOLLOW-UP ----------



QUESTION: THanks for your response. Yes, I do have SLE. I currently take medrol and imuran to control the lupus. All tests for lupus including ESR, Complement levels and DsDNA are all in the norm right now. The only think abnormal is the protein in the urine and RBC's in the urine.  My questions are:



Is the 24hr Urine protein(1230mg) considered to be really high? I thought as long as it was below the 2000/mg per day it was ok. What does this result mean?



Can I still have lupus nephrits and not have current active signs of SLE because of med's keeping me stay in control. If so, why would the med's help the lupus symptoms go away, but not the kidney problems.



THe creatine is borderline and the total protein in blood is normal. I thought that the creatine should be high and total protein low if you have lupus nephritis?



All the other blood chemistry looked in the normal range, except of course the RBC's(20-30mg)in urine.



WHat does Urine renal Epi mean? THat was also positive.



THanks for all your time. Really appreciate it!




Answer
Hi Laura,



Thanks for following up with me.



Urinary albumin more than 200 mg in 24 hours is considered abnormal.



You can have no systemic features of SLE but still have Lupus Nephritis. It is not necessary that serum creatinine be elevated. Renal epi means the presence of epithelial cells in urine.



Sincerely,



Dr. Shah