| peter.n 2006-09-05, 2:26 am |
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REP wrote:
<snip>
>
> You need to speak to your doctor first.
>
> Proteinuria associated with diabetic nephropathy (well, most
> proteinuria) is usually treated with either ACE inhibitors or ARBs.
> These are both antihypertensives that have a side-effect of protective
> action on the kidneys and retard proteinuria even in normotensive
> patients. If you do have high blood pressure, do whatever it takes to
> get within normal range.
>
> You should also ask your doctor about whether a modified diet is right
> for you; mot nephrologist recommend a diet limiting phosphorus, sodium
> and postassium for those with a 24-hour proteinuria value over 3 grams
> (protein restrictions have fallen out of favor with nephrologists who
> follow the lastest research). Avoiding NSAIDs - drugs like ibuprofen,
> aspirin, Toradol, etc - is extremely important in the patient with
> proteinuria; these drugs are nephrotoxic and can can increase
> proteinuria and in some cases, even bring on complete renal failure.
>
> Control your diabetes; keep your HbA1c at 7.1% or lower. 6% or lower is
> better.
>
> How long can it last? No one can tell you. It depends upon how much
> damage is done to your kidneys; your genetic propensity; the care you
> take of yourself; and if it is diabetic nephropathy that is causing the
> proteinuria (I'm diabetic, but I have FSGS). Generally speaking, if your
> proteinuria is 3 grams per day and your GFR is normal, it may be 20
> years before they fail. If your proteinuria is lower, than longer; if
> your GFR is poor; than shorter.
>
Definitions :
Macroalbuminuria = albumin/creatinine ratio in urine , greater than or
equal to 30 mg/mmol.
BTW , I thought ACE inhibitors and ARB's were only useful if you had
microalbuminuria ? i.e albumin/creatinine ratio less than or equal to
30 mg/mmol but greater than 2.5 mg/mmol ?
I have been tested for urine albumin . Here they use the
albumin/creatine ratio . the maximun normal is 2.5 mg/mmol . I had 43.5
mg/mmol . I don't know my GFR . But I think it is normal (?) . I have
just given a 24 hr urine sample and await the results . My blood
pressure is normal .
The thing is that I was just diagnosed with Type 2 Diabetes 2 years ago
in Los Angeles 2004 . Unfortunately for me , the doctor examining me
for the U.S Immigration Visa health requirement here in Australia told
me he found albumin in my urine before I left for America in Jan 2003
and I did not attend to it .
Anyway , I now live here back in Australia .
In a week or so I will get back here to post what was said by my
doctors the endocrinologist and nephrologist .
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