From America On-Line:
My 13 year old daughter was diagnosed with Type 1 diabetes when she was 8 years old. She has been under the care of a Pediatric Endocrinologist and her blood sugars have been fairly good. Last year her pediatrician did a urine spot test in the office for protein. It tested very positive. Her endocrinologist, whom I consulted, and I were quite upset said that more than likely she did not have protein in the urine as one test is not reliable. We did an overnight (12 hour) collection and her protein level was very normal at 4.
Again, we are faced with a single spot urine test with a dipstick which resulted in protein in the urine. We will again do a 12 hour collection to be sure everything is okay. Why is it that you can do several dipsticks in one day's time and most of them are negative or trace but we always seem have the one or two that test very positive for protein?
I would appreciate any information you can give me as these spot tests are very disturbing and worry me silly till we get the results from the overnight test.
Dipstick tests for urine protein are only semi-quantitative and the reaction is in any case an indirect one. They can easily be contaminated if the specimen is not a 'clean' one. Besides this, it is very unlikely indeed that at 13 your daughter has developed a kidney problem that is in any way connected with her diabetes unless she has been in exceptionally poor control for a number of years. Other forms of nephritis (kidney disease) can occur at an earlier age as well as urinary tract infections which can give rise to proteinuria; but not with a pattern of only occasional positives.
You might want to talk to your daughter's endocrinologist about getting a 'microalbumin' assay. This is usually carried out on a timed overnight urine collection and is looking for amounts of protein that are abnormal; but which are below or at the threshold of what can be measured with a dipstick. Normal levels are less than 8 micrograms per minute. This test is however a more reliable herald of renal complications than a dipstick test. Some centers use microalbumin tests for routine screening annually after the age of 15.
Original posting 24 Mar 1998
Posted to Complications
Last Updated: Tuesday April 06, 2010 15:08:58
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