[mishmosh]

Urine protein up, lambda down - I am confused

by mishmosh on Wed Sep 16, 2015 3:51 pm

Hi all,

I did blood and urine tests this morning and have confusing (and disappointing) partial results. I was diagnosed with SMM IgA lambda at the end of 2013. My total protein in urine went up 'significantly' (from a stable range of about 100 mg/24 hours to 340 mg/24 hours). My lambda in urine went down a fair bit (which sounds good).

So what on earth is the rest of the protein in the urine?! My lambda in blood went up from around 200 mg/l to nearly 300 mg/l, while IgA remained stable in the normal range. How come lambda can go up in blood and down in urine? Any input appreciated.

I've eaten a fair bit of eggs and salty cheese over the last few weeks. Might that affect my results?

[Multibilly]

Re: urine protein up, lambda down. I am confused.

by Multibilly on Wed Sep 16, 2015 4:59 pm

Mishmosh,

It's easier to figure out issues if you think in terms of trends and what's going on with all of your markers. What were the values for the items below for your last 3 or so tests?

Serum M-spike
Serum Lambda
Serum Free light chain ratio
Serum IgA, IgG and IgM

I'm not a doc so verify all this with yours. But the most common protein in the body and in one's urine is albumin. I bet if you compare your urine albumin numbers between the two tests, that your urine albumin level went up and that would account for the urine protein level bump (but the UPEP test will break down all the different protein values that make up the total protein count, so you just need to look at which ones changed the most). An increase in urine albumin levels can "possibly" signify kidney problems, but it also can "just happen" with no apparent cause. So, your doc would need to weigh in on this. If you suspect kidney issues, the first thing you would want to do is look at your serum creatinine level and see what it's been doing for the last few tests.

But again, you should really be discussing this with your doc, who will have the best picture of what' going on.

[mishmosh]

Re: Urine protein up, lambda down - I am confused

by mishmosh on Sun Sep 20, 2015 5:36 am

Thanks Multibilly,

I answered your questions with a smile (since everything except for the urine protein is pretty stable)
Serum M-spike - I do not have an M-Spike according to SPEP or UPEP!
Serum Lambda - increasing slightly over time.
Serum Free light chain ratio - pretty stable - around 0.05.
Serum IgA, IgG and IgM - all in the normal range.

I'm not a doc so verify all this with yours. But the most common protein in the body and in one's urine is albumin. I bet if you compare your urine albumin numbers between the two tests, that your urine albumin level went up and that would account for the urine protein level bump (but the UPEP test will break down all the different protein values that make up the total protein count, so you just need to look at which ones changed the most). An increase in urine albumin levels can "possibly" signify kidney problems, but it also can "just happen" with no apparent cause. So, your doc would need to weigh in on this. If you suspect kidney issues, the first thing you would want to do is look at your serum creatinine level and see what it's been doing for the last few tests.

serum creatinine level - stable!!!
But again, you should really be discussing this with your doc, who will have the best picture of what' going on.

>> my doctors appointment isn't for a few weeks - and I do not want to worry that entire time!