New and may need dialysis

I went to a screening and it showed I have too much blood and protein in my urine. I am also at risk as a family member was on dialysis. My other screening numbers were in the normal range. I have been reading about home nocturnal dialysis at this site and would like to go in that direction if the time comes that I should need dialysis. My question is what are patients told currently about diet changes they should make, ways they should be monitored and medications they should take to delay the onset of dialysis? Thank you.

Dear Jennifer

While I appreciate that you have been found to have protein and blood in your urine and that a member of you family has required dialysis, I think you may possibly be jumping the gun at this site. This site is primarily to deal with dialysis questions - and haemodialysis to be even more specific - and blood and protein in the urine, while clearly unsettling for you, does not necessarily mean you are either approaching or ever will need dialysis yourself.

For instance, you have not mentioned your kidney function - which may very well be normal, as it is with many (even most) patents with proteiuria (protein in the urine) or haematuria (blood in the urine). The cause of your family member’s renal failure is also unknown … and may not be the same as your own. There are not many ‘hereditary’ forms of renal disease (perhaps apart from reflux nephropathy, adult polycystic kidney disease and Alports syndrome - to name the three main hereditary diseases of the kidney - but even should your family fall into any of those categories, it by no means seals the deal on your fate or means you will progress to CKD5 and dialysis.

This is a question for your doctors, not me. They must first arrive at your diagnosis. In my country, with blood and protein in the urine and assuming it is there because of a glomerular disease (ie: nephritis: by far the most common cause of proteinuria and haematuria), we would make that diagnosis with a renal biopsy. I, too, am ‘jumping the gun’ here for I know so little about your problem that anything I might say may still be far wide of the mark.

Many of the causes of blood and protein in the urine are relatively benign and do not progress to CKD. Even should that happen, most progress so slowly that it can be decades before trouble (in the form of advanced CKD) flares up. By that stage, who knows what may be the ‘preferred’ or ‘best’ treatment.

Even the issue of dietary intervention would depend both on the cause of your kidney disease and the level (good or bad) of your kidney function.

I would suggest you discuss this with your doctor. A diagnosis is the first key to any sort of predictive thinking. The current level of your kidney function is the next key. Your doctor will be able to fill in both these blanks. Knowing the diagnosis will allow he/she and you to know if your kidney problem is in any way linked to that of your relative … remembering that even if you have the same disease as your relative who required dialysis, this does not mean that you will follow the same course.

Your doctor will advise what dietary changes (if any) might be indicated at this stage … and this will vary depending upon the diagnosis, your renal function, your lipid status, your glucose status, your blood pressure levels, your blood albumin status, your iron status, your blood count, your weight, your age, your activity levels … and far more … none of which I know.

I don’t mean to ‘fob you off’ … but, unfortunately, simply knowing you have blood and protein in the urine (and not even knowing how much, especially the severity of your proteinuria) … unfortunately I cannot be any more helpful that this.

Go chat to your doctor. Tell him/her of your fears. That is your next step - not an Internet Q&A page like this.