My son was born with Down Syndrome. At age 2, he was diagnosed with type 1 diabetes. He is now 16 years old. We just found out that his kidneys are starting to fail. What should we expect to happen in the days to come? Our main concern is his projected life expectancy.

You need to be more specific. When you say that his kidneys are starting to fail, I would assume that this would mean that your physician has screened for kidney disease associated with diabetes and found microalbuminuria. This indicates some protein leakage in a very sensitive assay. It does not mean “small albumin” since the name is a misnomer. However, the good news is that there are excellent medications available, i.e. ACE inhibitors such as lisinopril and many others, that can be safely taken once a day and protect the kidney function from further deterioration. If there is also hypertension, then this should also be treated with this or similar medications. Improved glucose control is a very important adjunct to improving kidney function under such circumstances. If you really mean kidney failure, this is the long term result of such problems and can, of course, happen for many other reasons besides diabetic nephropathy. You should ask these questions of your diabetes team since they would know specific details and be able to give you more individualized advice and counsel as to what may or may not be expected.

SB