Dr. Khant Shahil Ramesh Bhai
Urology
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Patient's Query
Hello doctor,
I have diabetes type 2. I have had two out of three abnormal urinalyses in the last six months. Six months back results were albumin 332.0, creatinine 297, ratio 111.8, glucose 3+, gravity 1.039, protein 1+ and everything else within the normal range. Two months back results were creatinine 164 and everything else within normal range. This month results are as follows albumin 177, creatinine 419, ratio 42.2, urine dark yellow, glucose trace, ketones trace, protein 1+, squamous epithelial 39, microscopic urinalysis, urine mucus 3+, hyaline cast 21 to 50, gran cast 3 to 5, renal EPI absent. What results should I focus on to determine if this is a chronic kidney disease? I have also had gout for the past year. Is it possible the kidney is having problems getting rid of uric acid. Are there specific questions or test I should be asking my primary care doctor about my urinalysis? I am currently taking Lisinopril, Metformin, Glipizide, Lipitor, and Aspirin.
Hello,
Welcome to icliniq.com.
Relax and do not worry. You have uncontrolled diabetes mellitus. HbA1c should be less than 7. Regarding urine analysis, ACR (albumin-creatinine ratio) should be watched carefully. Less than 30 means normal. 30 to 300 means microalbuminuria means starting of CKD (chronic kidney disease). More than 300 means macroalbuminuria risk of CKD is very high. So keep your diabetes and ACR under control. In gout, the problem is not with the kidney. So now your kidney excretes normal uric acid only. So focus on ACR.
Patient's Query
Thank you doctor,
What should levels of gran and hyaline cast be concerning? Are my levels a concern?
Hello,
Welcome back to icliniq.com.
Hyaline and gran cast can be found in a normal individual. Yes, but if the hyaline cast is more than 100 and gran cast more than 10 than it is abnormal. At present your values are fine. Repeat urine analysis after two months. ACR is the main component to see.
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Urology
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