August 14, 2000
Complications
Question from Alexandria, Virginia, USA:
I am a 27 year old male who has had diabetes for three and a half years. Recently, I did my yearly 24 hour protein test and it came back with a result of 151. My endocrinologist was concerned so I did a creatinine clearance and another 24 urine two months later. My clearance levels were above normal (signs of hyperfiltration) and my protein was 174. I then consulted a nephrologist who said I definitely have kidney complications due to diabetes.
I need clarification as the time frame for complications? From all the literature I have read, kidney disease from diabetes usually does not manifest itself for about five to eight years after diagnosis. Why do I have it at three and half years? Will these early problems lead to end stage renal disease much sooner than normal? What would be a much more realistic time frame?
Answer:
Your doctors are doing all the right things. We know that some people develop renal complications earlier than others. I expect you have started or are about to start an ACE inhibitor. It likely will help a lot and can reduce the protein quite a bit. It also helps preserve kidney function.
Watch your blood pressure and take medications, if needed, over and above the ACE inhibitor. Tight glucose control will also help a great deal. Take heed of the fact that your kidneys are not going to fail any time soon and doing all of the above will improve your chances of stabilizing the disease process.
LD
