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July 17, 1999


Question from Harpenden, Hertfordshire, England:

My 15 year old daughter was diagnosed when she was 6. For at least the past two years she has had proteinuria. She has low blood pressure and I am told her eyes are fine. My endocrinologist says some teenagers have protein in their urine and it is not diabetes related. Should I be worried? Could this the first sign of kidney involvement?


Persistent proteinuria (either microalbumin or macroalbuminuria) in a adolescent with long-standing type 1 diabetes should always be treated, with a low protein diet as well as low dose ACE-inhibitors [medications that reduce the urinary loss of protein], even if blood pressure and eye examination are normal, if other causes of protein in the urine have been excluded (a nephrologist [kidney specialist] can be of great help here).