الجمعة، 13 يوليو 2012

women with a little protein


I work as a nurse in a birthing center. We often see women with a little protein in their urine. This can be for several reasons, and you have to treat this a piece in a puzzel. What else is going on? Diet? Blood pressure? Swelling? Activity?

When we see a trace, we usually don't worry about it, unless mom's blood pressure is rising and/or she is having more swelling than we feel is normal for where she is at in her pregnancy. Protein in her urine can just be one of those things, nothing dangerous at all. It could also be due to diet and/or fluid intake, and we just need to reenforce good dietary habits. Or it can be the beginnings of eclampsia/toxemia, and we need to be on the ball.

I have seen women have some protein in their urine if they have a urinary tract infection, if they have just eaten a large protein meal right before providing the specimen, if they aren't drinking enough, and also for no apparent reason.

Drinking plenty of water, eating a cucumber a day (I can't tell you why it works....Susun Weed recommends it, and we have found this to be successful), eating lots of protein, and eliminating all caffeine and as many refined foods as possible are all modifications that we recommend to our clients who are starting to show protein in their urine. We also look for signs of a UTI, of eclampsia, and we look at the mom's diet and activity levels.

And I would like to throw something else out there...I would like any midwife, doula, nurse or knowledgable woman to comment on it. Here is my theory for the explanation of trace protein in otherwise healthy women. I think that these women have some underlying kidney damage, probably from a urinary tract infection, or maybe a congenital problem. Protein is a larger molecule that usually in not able to fit through the filtration system of the kidneys. In nursing school, I remember learning that a non pregnant person is usually not symptomatic until they have lost a large amount of kidney function, something like greater than 80%. So, it would seem to me that if someone has a small amount of kidney damage, like I said perhaps due to a congenital malformation or a previous infection, it wouldn't be a problem when they weren't pregnant, as they probably still have a significan't amount of kidny function,more than enough for a normal, healthy person. But when they are pregnant, the additional fluid and other demands on the body combined with the fact that someone is actually testing their urine several times, we find that there is a little protein in their urine. No other symptoms, no other problems. Diet and activity are great. My theory is that that damaged area of the kidney is letting a little protein through. It isn't a problem, it is no big deal. They might very well have protein in their urine all the freakin time; we just aren't testing for it usually, like we are in pregnancy. There is probably a significant amount of the population walking around with a mild to moderate amount of kidney damage. They don't even know it; it doesn't cause any problems, because the kidneys are such awesome organs, they work well with only a small amount of available kidney function.

What are your thoughts on that? I don't think that anyone has ever done a long term study on it....looking at pregnant women who have had trace amounts of protein in their urine with no other process going on, seeing if, in 50 years they develop kidney disease in their elderly years. It is just a theory of mine. Anyone have any thoughts on this, one way or another?

Lori

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I'm 35 weeks with trace of protein and now PUPPPS (?)!!
I assume it's PUPPPS (you know, the itching all over that drives you nuts!). I go to my OB on Wednesday. He told I had a trace of protein at my last appt. 3 weeks ago, but my BP was normal, and I have had some swelling. I drink at least a gallon of water a day, if not more (plus milk with meals), and I have limit myself to 1-2 Dr. Peppers a week (I know, but last pregnancy it was 2-3 a day!). This is my 6th child. I have never experienced any of this before. The itching is about to make me go insane. My SIL also had PUPPPS, and her OB told her to use the Benedryl Cream, so I have been using it also (read an article that it was ok), but another member on this site told me not to use it. :

Now to find out that my mother may not be able to come to help me, so I am kinda bummed, but I know I will be able to do it. I will have to. I will have no other choice
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. Protein in your urine can be anything from a bit of dehydration to HELLP. You have to look at a lot of variables. I've had protein in my urine off and on for weeks and it has been a variety of factors. This last time I Had "+1" and the nurse told me that I need to be drinking more. My bp was normal and my urine was dark so it was pretty obvious...and I knew it as well. I have a hard time drinking water.
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From what I know is that you can have some major problems from it. If you have protein in your urine then you should increase you protein and completely cut all drinks except water out of your diet. You can never have too much water. If you are susceptible to high protein then you should also cut out any unecessary sugars as well.
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I had protein in my urine due to preeclampsia. I also had high bp. They tested me for HELLP syndrome and I didnt have that. I think if they detect it they check your kidney/liver function and go from there. I had protein in my urine from 16 weeks on. I did end up getting induced 1 day before my due date because they used the ole scare tactic on me but in reality, it wasnt any worse than it was when I was 16 weeks so I shouldnt have listened.

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