Understanding Nephrology Concerns: A Personal Account
I’m a 21-year-old intersex individual, measuring 5’8” and weighing 125 pounds, and I was diagnosed with juvenile systemic lupus erythematosus (SLE). My current treatment regimen includes vitamin D, magnesium, a B-complex, as well as B12, B3, and hydroxychloroquine. I consume approximately 4 to 6 gallons of water daily, as I often experience significant thirst. My tests show a normal A1C level, normal blood glucose, and no ketones detected in my urine, indicating that I do not have diabetes. Additionally, my bladder functions normally, and after consulting with a urologist, the only issue identified was a tight pelvic floor. My blood pressure consistently remains within a healthy range, fluctuating between 90/50 to 120/80. A recent CT scan revealed slight renal atrophy; however, the medical team concluded that this finding was not a cause for concern. Since around the age of 16, my urinalysis results have consistently indicated the presence of protein, white blood cells (WBCs), and abnormal sedimentation (SEC), along with increased turbidity. Cultures have always returned normal results. Initially, my rheumatologist attributed these anomalies to a less critical issue but after observing protein consistently in three separate samples, she decided to refer me to a nephrology specialist. This has sparked worries within me concerning the possibility of developing lupus nephritis. I seek clarity on whether these findings warrant genuine concern or if they can still be deemed within acceptable limits.
Answers (1)
7/27/2025, 4:50:40 PM
OpenHealth AI
It's completely understandable to feel worried about your renal health, especially with your history of lupus and the findings from your tests. The presence of protein and white blood cells in your urine can be concerning, particularly in the context of systemic lupus erythematosus (SLE).
Main Points:
- Ongoing Monitoring is Crucial: Regular follow-up and monitoring of your kidney function are essential, especially given your history and symptoms.
- Understanding Your Results: Protein and WBCs in urine can indicate inflammation or infection, but might not always signify a severe problem.
- Prioritize Communication with Healthcare Providers: Maintaining open communication with your nephrology specialist is key to managing any risks.
Explanation:
- Kidney Concerns: Your findings of protein and white blood cells in the urine can sometimes indicate inflammation, which, in the case of someone with lupus, could potentially lead to kidney involvement (lupus nephritis). However, these findings alone do not confirm kidney disease.
- Nephrology Referral: Your rheumatologist's decision to refer you to a nephrologist shows a proactive approach to monitoring your kidney health. It's important to view this as an opportunity for further assessment rather than a cause for panic.
Next Steps:
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Continue Drinking Water: While 4 to 6 gallons of water a day is high, ensure that hydration remains adequate without leading to over-hydration. Monitor your body's responses and adjust if you experience discomfort.
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Document Symptoms: Keep track of any new or worsening symptoms, such as changes in urination (frequency or color), fatigue, or swelling. This can provide valuable information for your doctors.
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Follow Up with Your Nephrologist: Ensure you have a follow-up appointment scheduled to discuss the proteinuria and any further tests your nephrologist may recommend, such as a kidney biopsy or additional blood tests (like serum creatinine or complement levels).
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Ask Questions: During your next visit with your nephrologist, don’t hesitate to ask about the significance of your test results, the potential for lupus nephritis, and what specific monitoring you will undergo.
Remember, you are actively engaging in your health management, which is a strong step toward ensuring your well-being. If you have immediate concerns or experience new symptoms, seek medical advice promptly.
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