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June 30, 2008

Complications

Question from Santa Clara, California, USA:

My 35-year-old brother recently went to a doctor for a general check-up. The doctor gave him lisinopril, 20 mg, for high blood pressure (150/90) and simvastatin, 20 mg, for high cholesterol level. His blood sugar was within the impaired level (5.5%). His urine albumin level was 2.9 mg/l; urine creatinine level was 40.04 mg/dl and urine albumin creatinine ratio was 7.2 mg/g; and his serum creatinine was 0.8 mg/dl. The doctor said everything is normal, but the laboratory report mentioned he was in the early stage of diabetic nephropathy and should be re-screened within one year. We are very anxious about it. My brother had a panic attack due to this result. The doctor said that he was in the pre-diabetic range. His A1c was 5.5%. Is it possible that his urine albumin is due to high blood pressure?

Answer:

There must be some misunderstanding. The serum creatinine and urine albumin:creatinine ratio are both normal. On the basis of the test results provided, this is not early diabetic nephropathy. I would urge you get clarification. Albumin:creatinine ratio will go up before serum creatinine will become abnormal. The upper limits in most laboratories for albumin:creatinine ratio is 30.0 mg/g creatinine.

JTL