HRT - damage to the kidneys?

[Ava]

So yes, I'm 18 years old and at one point I was taken to emergency because I thought that I had appendicitis, they did the blood and urine tests and found nothing, except that in the urine there was protein 2+ (which means proteinuria) so the doctor said that it's not normal and that it maybe be because of my hrt and that I should probably see my endocrinologist to get my kidneys checked. The strange thing, is that I had the same tests a month ago and nothing was found, and ten days ago my endocrinologist (before the emergency) prescribed me a higher dose of estrace, I don't really believe that my kidney could be damaged in 9 - 10 days with hormones. I should say that I ate lots of almonds those last two or three months, like one bag of 500 g per day, could it be because of this?

The meeting with my doctor is one month away, it's 15 april...so I don't know what to do until then, should I continue taking new dose or reduce to the old one?

I'm really nervous about it and there is no way I will stop my hrt. =(

[Ms. OBrien CVT]

This is exactly why we need people to understand that DIY HRT is not a good thing.  Your endo must not see anything that worries they, but check back with them.

I hope you get it figured out.

[Ava]

I don't even know which doctor I should see for the kidney, because in Canada someone should write you a "recommendation" letter for another doctor if you're seeing him for the first time. So I guess I'll ask my endocrinologist to write me this letter.

[peky]

This is exactly why we need people to understand that DIY HRT is not a good thing.  Your endo must not see anything that worries they, but check back with them.

I hope you get it figured out.

It seems that HRT actually reduced proteinuria

BJOG. 2000 Aug;107(:1017-21.

Postmenopausal hormone replacement improves proteinuria and impaired creatinine clearance in type 2 diabetes mellitus and hypertension.

Szekacs B, Vajo Z, Varbiro S, Kakucs R, Vaslaki L, Acs N, Mucsi I, Brinton EA.


Source

Department of Medicine, Semmelweis University, Budapest, Hungary.


Abstract


OBJECTIVE:

To determine whether hormone replacement therapy can reverse established renal microvascular damage in type 2 diabetes and hypertension.

DESIGN:

Prospective, single centre clinical trial.

SETTING:

Outpatient clinics.

PARTICIPANTS:

Sixteen diabetic and hypertensive postmenopausal women (age 47-57 years)

METHODS:

Administration of a cyclic combination of oestradiol and norgestrel orally for 3.5 monthly cycles.

RESULTS:

Comparing the baseline values, mean (SD) 24-hour urine protein excretion was reduced from 0.452 g (0039) to 0.370 g (0.047) (P < 0.01) and creatinine clearance was increased from 1.68 mL/sec (0.11) to 1.77 mL/sec (0.08) (P < 0.05). Fasting plasma glucose also improved from 6.92 mmol/L (0.47) to 6.51 mmol/L (0.28) (P < 0.05), as did serum total cholesterol from 7.26 mmol/L (0.28) to 6.65 mmol/L (0.14) (P < 0.05). Blood pressure did not change significantly. Univariate linear regression analysis showed no significant correlation between the individual changes in blood pressure, fasting plasma glucose or serum cholesterol and the individual changes in proteinuria or creatinine clearance.

CONCLUSIONS:

This study shows that hormone replacement therapy may reduce proteinuria, and even improve creatinine clearance, in diabetic and hypertensive postmenopausal women. These effects are additive to nephroprotective therapy, and the mechanisms appear unrelated to conventional risk factors for vascular complications, such as high blood pressure, elevated plasma glucose or serum cholesterol

[Ava]

Well, I read that lots of people leak proteins in the urine periodically so I don't even know what to think. This may be the case of kidney as it can be not. I read that if we eat excessive amount of elements (iron, calcium or pretty match anything else) that they can begin to show in the urine. After all, it's pretty stupid to have proteinuria at the age of 18, no one in my family had any problems with kidneys and I don't drink or smoke.  But oh well, I don't want to go into denial either, the only question that I have is should I reduce my new dose of estrace to the previous one? And no one can respond to this one here, I'm perfectly aware of that. =)

UPDATE: My brother said that it's normal because I ate a lot of almonds, and they have lots of proteins in them. He is an athlete and he is on the protein milkshakes regiment, so he says that if you eat (or drink) food high in proteins you should stop eating it a month before the blood and urine tests, otherwise you'll get the proteinuria results.

[Dana_H]

I can't speak to the protein issue, but I had pains like appendicitis a number of months back. The pain started in my side/back, then migrated to my lower front. It kinda felt like my innards were being ripped by a tiny razor blade. I couldn't keep anything down, not even liquids, because the pain would just make me barf it all up a while later anyway. It hurt so bad I really thought I was going to die. Turns out it was a kidney stone. Once it moved into my bladder, the pain went away for awhile until it settled down into the urethra and I passed it, which also hurt but was followed by an instant sense of relief. I took a day off just to get rested up and was back at work the following day.

Internal pain can be tricky to diagnose sometimes. My rule of thumb is to get attention right away in case it really is serious, but to keep telling myself it is something totally minor until/unless the doc says otherwise. In most cases, it'll be something simple or treatable anyway. Try not to focus on the "worst case" any sooner than you have to. (Easier said than done, I know.)

[Ava]

Dana_H, thank you for your response! =) I hope that my kidneys or liver will wait till my appointment with my doctor, I'm really not sure what to think about all of this but oh well, I heard some people lived with terribly damaged kidneys and liver for more than 3 years, so I hope that I'll get adequate treatment until then. =) The worst part in hormonal therapy is that you forget what hurt before and what hurt after you've began it, so because you want your transition to go well you begin to obsess even with the smallest pain and symptom, and then you can become hypochondriac or you just don't bother much like me and you wait patiently the doctor and hope that you won't die before that time.