Can extreme emotional stress cause proteinuria?

Elizabeth,

Reading your post gave me some hope. I am a 44 year old female and lost my right kidney January of 2015 do to misdiagnosed hydronephrosis (I had a kink in my ureter that was kinking and unkinking) when I left the hospital and for the next 8 months after my kidney was removed my kidney function maintained around 72% but then for some reason dropped in the fall of 2015 to 53%

It has fluctuated so much this past year even once going back up to 71% and then right back down in the 50's. They ran all sorts of tests to see if I had any underlying factors and everything looked great. My bp is 90/60 usually.. Potassium a little high 5.2 so I don't eat bananas, tomatoes or potatoes any more. Doctors keep assuring me I can live a long life off this kidney but I'm just honestly scared of losing this kidney too. Hearing you have been stable for the last 20 years made me feel like it is possible. Thank you so much for posting your experience.

I have not taken anything for acid reflux long-term.

According to my gastro, the reflux is mild and if I don'y pay attention, I normally don't even notice it. Then again, this didn't prevent me from agonizing over the odds of esophageal cancer which controbuted to these few months of extreme anxiety.

I had a GERD flare-up recently and got scared again, so I went back to the gastro and he put me on a month of PPI-s. I took them for a month to ensure any inflammation of the esophagus would heal but after a month, I stopped when I saw they didn't make much of a difference, plus with the effect on the kidneys in mind. 

The gastro too agreed that I should stop them because I have non-erosive/functional GERD and I don't benefit much from them - so I stopped.

So I only took them for about a month - but still wonder whether this could have caused the proteinuria.

During this same period I also went through horrible emotional stress and anxiety (related to fear of bad disease, plus some terrible stress at work).

I told all this to the nephrologist in a message but he shrugs - saying that the proteinuria is likely NOT related to either the PPI-s or the stress.

I assume that since everyone today complains that they are "stressed out", drs. have come to underestimate cases where the stress and anxiety ate not just routine "modern, busy lifestyle", but it is actually so bad and anxiety-producing that it takes a real toll on health.

I am even starting to wonder how much you can trust drs' opinions - when he clearly ignores tons of legitimate health info that says emotional stress can cause proteinuria; also plenty of studies on Pub Med are now showing how only a few weeks of PPI-s can cause acute kidney damage - but he still insists these have nothing to do with it.

And yet, only back in June my urine analysis came back just fine at the OBGYN's office.

The online dr. also said emotional stress is most probably the cause.

So now I am terrified this is not just transient proteinuria and that I will be diagnosed with kidney disease .

Hi,

There is a key word there tha you have mentioned yourself, that word is acute.  Which means whatever is going on is reversable, so if you have protien in your urine due to the stress/anxiety or the meds it is reversable.  You have the best sort believe it or not.  Spare a thought for chronic CKD patients oh and I would love a GFR of 70 or 80%.

You need to try and calm down as you have identified one of the possible issues as when you get worked up.  Do you do any exercise at all? as this can help when we find ourselves in high pressured situations that you describe such as work deadlines.  Also stress anxiety is not good for your acid issue.  Your doctor is carrying out various tests so they are taking what you are saying seriously, I would suggest a repeat of the 24 hr urine collection in about about a months time to see where you are at then.  The fact your bloods came back ok is a plus as it means you are not loosing protien from your blood and all your other figures seem ok so this is good.  I wouldn't worry about something you have no control over.  Has your docotr explained next steps to you and what they will do in the future to keep an eye on you? You may not be referred regularly to a neph as your GFR doesn't warrent it at the moment nor do your blood results, but a GP can carry out a 24 hr test and bloods for you and I would not be alarmed if they suggest every 6 months at this stage.  Try and keep your chin up wont you this is coming from someone who eas on dialyisis for 2 years and have just had a transplant which incidently could be acutely rejecting so back to the hospital for three days of IV steriods for me yipee kidney doing well HB levels holding their own, iron the best it has been and that is all my new kidney nothing on the scan looks beautiful very odd but I will do what they say as my best friend went/is still going through hell for me so I owe it to her to look after her generous gift.  Keep us posted wont you and I know if you suffer from anxiety people don't always understand but you have to get in the mind set of not worrying about things you have no control over it will help I promise

The 24 h urine protein was 183.

I freaked out because this officially placed me in CKD stage 2.

after less than a month i repeated the test though the nephro Didn't think I should because "I am driving myself crazy"....and it came back 219. 

I have developed horrific anxiety and panic attacks since, several er and urgent care trips due to huge anxiety...and one ecg (apparently a crappy one) spat out an automatic read suggesting I may have had a prior heart attack ....though the dr.reading it was not worried.

Although I have zero risk factors for CVD and a stellar cholesterol that my GP always gushes over....this was enough to put me over the edge. 

Trips ps to ER with panic and shortness of breath resulted in other Ekg-s after that, all showed normal, plus a cardio workup - also normal...but all of this after spending over a week in sheer He*l, with panic attacks so horrible i could not even begin to describe. 

 My nephrologist does not think I have CKD at this point, though technically  I qualify with the mildly elevated protein....he also speculated "benign nephrosclerosis" despite not having HBP. 

So there I am - trying to come to terms with what CKD mignonette mean in terms of life expectancy. This has been the worst time of my life so far. 

my egfr has been fluctuating between 75-86 for 2 years now...so nephrologist says I am stable and nothing to lose sleep over...and says weird stuff such as my kidneys will last me 90 more years, etc. 

But I cannot find any peace in what he says given all I read on the net about inevitable progression, link to CVD, shortened life expectancy even for CKD dtage 1-2, or for those with mild proteinuria. All of this is beyond scary. 

Any words of comfort will help. 

Hi,

My word you have got yourself in a right state. Firstly CKD is staged by your GFR.  If you have a GFR of over 60 this is classed as normal so yours being in the 80's is excellent as our GFR declines as we get older anyway.  I have had protien in my urine all of my life and I have Alports syndrome which is the reason for my kidney failure but I managed a whole 39 years with severe protien leakage.  You have not been diagnosed with any chronic kidney disease that you mention so there is not reason that you would develope CKD.  You have said your blood pressure is fine, your creatinine is fine, these are the things that matter.  A GFR is only a best guess that is why creatinine is used more as it is acurate, a GFR can change depending on a lot of factors.  Medicatons can alter it to name but one thing but there are lots of other things that can effect it. I know it is difficult if you suffer with anxiety but you need to try and stop panicing about this everything you have said suggests that you are fine.  I was on dialysis for 2 years and have just had a kidney transplant and I am fine and intend to be for a long time to come.  If you were to develope CKD you won't drop dead there are lots the doctors can do and they wont let anything happen to you too much paperwork involved lol that is what I was told lol.  Sometimes it is best not to read thiings online as half the time it is not accurate and if you are prone to worry anyway you are doing yourself no good. You need to try and get in the mindset of not worrying about things you have no control over easier said than done I know take one day at a time x

Thank you so much for your encouraging reply.

It is my understanding that CKD is diagnosed both with GFR and any other evidence of kidney damage, including protein in urine. Even if GFR is above 90, any evidence of persistent protein in urine of over 30mg per 24h can be a sign of early stage CKD. At least this is what the textbook says.

At this point, my nephrologist is very ambivalent about a diagnosis. He said that while my  collection is consistent with some CKD stage 2, he does not believe, clinically, that I have cronic kidney disease at this point. He also said I might have benign nephrosclerosis, even though I never had cronic HBP.

I still wonder what level of proteinuria is still considered within normal range for 24h urine. All other tests are fine, including creatinine clearance, BUN ultrasound, etc.

This diagnosis has taken over my life and has amplified my anxiety million times over.  

I was diagnosed with Type 11 in August of this year and it has literally taken over my life. I am so anxious and miserable. I'm on Janumet/Metformin twice a day and my stomach is upset most of the time. The other day when I used the bathroom, I noticed a few bubbles in my urine. I do have an endocrinologist and spoke to him about this. I don't think he was even interested, saying my urine test less than a month ago was normal. I am too afraid to have it checked, scared I now have kidney disease. I am anxious every morning when I check my BS and now this. This diagnosis has taken over my life. I have lost tons of weight, mainly because I am afraid to eat. Is there any hope for me?

I just wanted to agree with Helen's comments. It really does sound like you do not meet the diagnostic criteria for CKD. But I'm not a doctor. You're working with a medical team who are running the appropriate medical tests. The test results are not showing any problems.

I do have CKD. Mine has progressed to Stage V, end stage. I'm preparing for dialysis. I'll also undergo transplant eligibility testing after the new year. 

As a 64-year-old woman, I expect to live an additional 20-25 years. That's whether I qualify for a transplant or not. I'm planning to try PD dialysis when it is time for me to start dialysis, I've selected that type of dialysis for several reasons:

I can do PD at home independently on a daily basis

PD is supposed to be easier on your cardiovascular system

PD will preserve my remaining renal function longer which will be good if I do qualify for a transplant

I should be able to keep working while using PD dialysis 

So I do expect to live while using dialysis. I've heard many encouraging stories about the ease of using PD dialysis from persons like Helen in this discussion forum. 

Why am I sharing this with you? To highlight two things:

First, CKD is NOT a death sentence. Life continues. And it will be as good as I choose to make it.

Second, thankfully, your situation is totally different than mine. Hopefully you can see how different your situation is--you truly have no reason to worry. Your data looks good. So trust your data. Definitely get out and do things you enjoy. Get your mind off of this. Eat a healthy diet; exercise regularly; sleep enough every night; and try something like meditation to calm yourself🐶

You're kidneys are fine. Your job is to get in for medical testing on s regular basis; do what the doctors say; and then get out and enjoy your life😀

Marj

Thank you so much for your encouraging words. I am 70 years old and have always (even as a child) been very anxious so now I'm on my guard since getting this diagnosis. I realize I am not rational when it comes to having this condition. I know there are people who are dealing with a lot worse. I guess I will have to break down and have my urine checked for protein. If it's there, I will have to deal with it. My BP is 116/65 so that's good. Again, I appreciate your kind words and encouragement. My husband is also diabetic, has 3rd stage kidney disease and eats whatever he wants. He hasn't lost a pound. He tells me he has bubbles in his urine all the time but I doubt it. I wish I had his attitude. He thinks I'm ridiculous. Thank you again. 

Janice,

Thank you for your kind words😀

I hope yo hear that you've gotten in for the testing. And, actually, you may get good news when your tests results are back!

Marj

Give Syrcusa a break...  he is frightened and perused this site for reassurance rather than to be reminded that there are others who have it worse than him. 

4 of 5 people will experience mental health concerns in their lives and these issues, like kidney concerns, are not always easily resolved.