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September 2, 1999

Complications

Question from Houston, Texas, USA:

I have been a diabetic for 22 years and am 26 years old. Three years ago I was told they found a trace of protein in my urine. My doctor was not concerned because he said 24 was normal and mine was 25. I have since been on Zestril [an ACE inhibitor medication] and am a vegetarian (low protein). My doctor said I do not have nephropathy -- yet putting me on Zestril seems as if he is treating me for kidney disease. I have been negative for the last three years. I am concerned about kidney failure. Do I seem to have the symptoms?

Answer:

Your question is a good one and you are to be congratulated that you are watching your lab results. You have lived with diabetes a long time and appear to have done very well.

Kidney disease is usually diagnosed very early now with microalbuminuria tests rather than, like the old days, waiting until high levels of protein appears in your urine and your creatinine and BUN levels in your blood rise above normal.

It would appear that your physician has added Zestril as a preventative tactic as is done often now. With no progression of your microalbumin results, it would appear that you are not progressing to kidney disease. If and when your microalbumin begins to rise, it is appropriate to increase the ACE inhibitor until the microalbumin stabilizes or improves.

As you know, keeping your blood sugar and blood pressure within goal range and keeping your intake of protein less than 20% of your total daily calories is your best defense again kidney disease and other problems associated with diabetes.

KS
Additional comments from Dr. Quick:

Also, see How to Protect your Kidneys.

WWQ