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Nephrology/Daughter's test results


I have a 7 year old daughter who has a history of frequent UTI's. After the last one, albumin was found in her urine (Nov, 2014).  She was treated and tests (urinalysis, culture and albumin) repeated and found normal (Dec, 2014). She complained of "ouch" in her private area. Another test was performed (urinalysis and culture) and were normal (March, 2015). Her pediatrician wanted her to see a specialist just to check her. He ordered an ultrasound which revealed that everything is normal except that:
-she doesn't empty her bladder completely
-a little thickening in the bladder wall which the doctor attributed to her frequent UTI's
He recommended putting her on antibiotics low dose for two months. All that ended May 2015. Yesterday she complained of pain and burning and cried a lot. We are traveling and currently in a  very hot country and she doesn't drink enough water sometimes.  I took her to the nearest clinic.  I was given a collection jar but no cleansing wipes. I remember that her pediatrician back home always insisted on thoroughly cleaning before collection and I wasn't sure what to do. I took her  to the bathroom anyway. She usually passes a nice stream. I let the first few drops pass then collect midstream.  This time, she passed a few drops then I tired to catch as many drops as I can because this time she didn't pass a stream.  We got the results of the urinalysis and have to wait for the culture. I'll send you a pic of the results of the urinalysis now,  and the culture when we get it in a follow up question. My relative who has medical training expressed a lot of worry that she has protein in the urine. I told her about her history and tests. She was still worried and won't explain to me anymore.  
We are traveling and don't have insurance for more or extensive tests.  I'm planning to take everything to her doctor when we go back home where we do have insurance.  I have two questions:
-is the presence of protein a bad thing?
-do you recommend giving her antibiotics?
My relative made me really worried about the protein and  would not give me any other info but kept telling me it could be serious. My child  does have some redness in her privates but not terrible. She said her side hurts one time. And remember the collection was not the best.  im leaning towards waiting till we go home because now she doesn't have any burning or anything. But can you explain to me what the presence of protein means and should I be concerned?


Thanks for asking my opinion on Allexperts.

The urinalysis result that you have sent suggests a urinary tract infection. I would go ahead and start antibiotics based on the sensitivity patterns of your daughter's earlier urine cultures. If the present culture results are different, the antibiotic can be changed according to the sensitivity pattern.

Meanwhile, please make sure she drinks plenty of fluids.

I would not be worried too much about the presence of protein in the urine now, because she has a urinary tract infection. However, I encourage you to get a 24 hour urine analysis done when you return home.


Dr. Shah


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Dr. Shamik Shah, MD, DNB (Nephrology), ISN Fellow


I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am an Indian-Board certified Nephrologist. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury.

Please mention the units in which your lab results were reported and the normal reference range for your laboratory.

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Ten years as a Critical Care & Transplant Nephrologist

International Society of Nephrology
Indian Society of Nephrology
Indian Medical Association
European Renal Association

- Shah SH, Cerda J. Acute Tubular Necrosis; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4, pp. 191-198
- Shah SH, Cerda J. Management of Acute Kidney Injury; Lerma, Edgar V., Rosner, Mitchell eds. Clinical Decisions in Nephrology, Hypertension and Kidney Transplantation. Springer ISBN 978-1-4614-4453-4
- Cerda J, Tolwani A, Shah SH, Ronco C. Continuous Renal Replacement Therapies in Modeling and Control of Dialysis Systems edited by Azar AT, Springer-Verlag, Heidelberg, Germany (In Press)
- Shah SH, Cerda J, Kellum JA. Acute Kidney Injury in Special Circumstances. John Kellum, Jorge Cerda, eds. Renal and Metabolic Disorders, Oxford University Press (In press)
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare, NY 2007. ISBN 0-8247-2920-X
- Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
- Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182

MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Educational Ambassador of the International Society of Nephrology 2010
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

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