I am doing a case study where the pt didn't reveal accurate symptoms and past medical history and the outcome wasn't good. she ended up having permanent damage because the doctors didn't act quick enough. is this her fault for not describing the symptoms and past medical history? List some resources to support your answer please.

I believe so. Patients are responsible for reporting their medical history, allergies, current medications, etc. Granted, that stuff may be, and probably should be, found in medical records in a non-emergency situation. Also their symptoms should be accurately reported, and they assume all responsibility for that.

As a medical professional, you are responsible for observing signs that the patient presents with. Also, when the patient gives you allergies, medications, history, you need to be able to relate it to your diagnosis and treatment. That's pretty much the extent of it.

Diabetes? Kidney Disease/failure? Proteinuria? Ovarian Cyst? Something else? Any information, symptoms? ThanksI’ve had bad pains in my lower left side since Feb. 08 and was told it was most likely an ovarian cyst (they run in my family) I finally got an ultrasound and got the results back today: All clear! (although that doesn’t help or solve the pain!) recently my pain has moved farther up and into my lower back at times. My doctor then informed me that I had a lot of protein in my urine and I had a lot in my urine for my Feb. 08 visit as well. She suggested I may have diabetes, kidney disease, or proteinuria and ordered blood and urine tests to be done and ordered me to stay out from work for the next week. while we’re waiting to be able to get the tests completed I’m trying to research how serious any or all of this is and what the symptoms or warnings are for each. also, what should I be on the lookout for in an emergency situation? I read up on ovarian cyst and I’m at a loss now that it’s something completely different. How serious are these diseases? Anything is appreciated! thanks!!also, any information on what tests may be run and what to expect please let me know. I’m totally clueless on all of this and my doctor was not willing to answer many questions at all.

Answer by RetroBladerMost likely, the proteinuria was an incidental finding — it was picked up “by accident” when your doctor did a urine dipstick test as part of the workup for the back pain.

The kidneys (most of us are born with two) have no nerve endings, so they only cause pain when their outer covering (called the capsule) is stretched due to inflammation or swelling. That’s why most kidney diseases are silent / asymptomatic until they become quite advanced.

The kidneys’ main function is filtering blood and getting rid of waste products (and excessive fluids) in the form of urine. Since most proteins are useful, normal-functioning kidneys will not let proteins go to waste in the urine.

The presence of large amounts of protein in the urine (called proteinuria) is therefore a sign of kidney disease. Diabetes is the leading cause (by far) of kidney disease in North America, and can certainly cause proteinuria. However, just know that there are many other kinds of kidney diseases which also cause proteinuria.

Sometimes even people with normal kidneys can spill proteins into the urine for a short amount of time (for example, after vigorous exercise), that’s why your doctor wanted to repeat the urine test for protein — to see if it was a one-time thing.

More advanced tests can also be done on the urine to help determine the cause of kidney disease. for example, your doctor may want you to collect urine for 24 hours, or collect a sample after sleep while another after you’ve been up for a few hours.

The blood tests can achieve a few things:1) Measure your kidney function: in moderate or severe kidney diseases, a test called “creatinine” becomes eleveated.2) Measure your blood sugars: People with diabetes will have high blood sugars, even after fasting overnight.3) Check consequences of kidney dysfunction: some minerals like potassium and phosphorus become out of balance with kidney failure4) Check for some specific causes of kidney diseases (although there are many many diseases with many many different tests, and often only kidney specialists called nephrologists know what test to order for which disease)

Finally, how serious this is depends on how advanced the kidney disease is (if you have one at all). Since you haven’t had much in the way of symptoms (again, your back pain is most likely NOT related to your kidney disease), chances are your kidney diseases are still mild, in stages 1 to 3. However, some kidney diseases can progress to End-Stage Renal Disease (ESRD), at which point dialysis becomes needed to sustain life.

The test results will become available in a few days. if necessary, your doctor will refer you to a kidney specialist for further management. But for now, just sit tight — no need to freak yourself out until the test results return.

In case you are wondering, at least 10% of the population have some degree of chronic kidney disease (jama.ama-assn.org/cgi/content/abstract/298/17/2038), but many don’t even know it. so you are not alone!

• Quick Question: I need to know what are the symptoms of kidney disease?
• Q&a: Quick Question: if you are using a juicer whats the best tonic to treat diabetes or chronic kidney disease?
• Quick Question: Kidney problem symptoms?
• Quick Question: what are some symptoms of having kidney problems?