@sultanvr If your husband was dehydrated at the time of the labwork, that might play with the numbers. Other factors could be the time of day, did he exercise not long before the labs were pulled, was he recently sick [even a slight head cold]. And not to forget, if a different lab was used than normal, for processing his samples.

You also mentioned calcitriol. This medication, which really is activated Vitamin D3, is used for calcium requirements, not usually protein. I take it three times a week for my kidney issues. I just looked it up and saw it does bind protein to Vitamin D3, but its used more for the calcium regulation.

I hope that your husband and yourself can check into a second referral to another nephrologist who might treat your case with more concern. Does his endocrinologist have any thoughts, or recommendations? We all know that having multiple specialists can lead to a precarious situation. Having a medical team who is in communication with each other and has the best interest of you at heart, can sometimes be difficult!
Ginger