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February 18, 2005

Complications, Other

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Question from Columbus, Ohio, USA:

I am a 12 year type 1 diabetic with very recent A1c of 7.3. I also have hypothyroidism, Addison’s and vitiligo. I am experiencing good health, work out regularly and eat well.

I recently, 60 days ago, started Lipitor due to an LDL of 155, total cholesterol of 210. My cholesterol is now well in control with an LDL of 85 and a total cholesterol of 130.

While checking all my blood statistics they found a mildly elevated microalbumin of 19, heretofore never elevated. Is there any connection or possible connection between a sudden increase in microalbumin and my use of Lipitor?

Answer:

From: DTeam Staff

I am not aware that there is a relationship between an increase in albumin excretion and the new use of a statin drug like Lipitor. However, there has been literature on the use of drugs, of the type similar to Lipitor, that have shown beneficial effects on the progression of any diabetes-related kidney disease. I am not sure what type of urine test you had. It could have been a 24 hour urine or it could have been a random urine collected for both albumin and creatinine with the results expressed as mcg albumin per mg creatinine. The latter test is now more common. Most laboratories suggest abnormal levels are greater than 30. However, I would suggest anything above 20 is abnormal. Your value of 19 may not necessarily be in that range, unless your laboratory has a markedly different normal range. There is also a fairly large intraindividual variability with the test. False positives can occur with intensive exercise, high protein diet, or high blood sugars. That is why more than one collection is helpful, especially in light of a higher reading. You may want to talk to your physician about repeating the test on an early morning specimen without having exercised before submitting the specimen. Frankly, high values should initiate a discussion about the use of medications that potentially protect the kidney from diabetes-related kidney disease. These include drugs from the category of medications called ACE inhibitors or ARBs as a second choice. However, before starting any drug you may have to take for a lifetime, you want to collect more than once specimen.

JTL