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April 17, 2000


Question from Kentucky, USA:

To protect the kidneys, would physicians put a child on ACE inhibitors before signs of problems? Why wait until problems begin? My son is 12, type 1 since age 9.


I measure microalbumin. There are several techniques: albumin to creatinine ratio; spot urine for microalbumin or timed urine for microalbumin. I do spots in the clinic. As long as they are essentially zero, all is okay. Any rise is quanitated with a timed urine. Any pathology is treated with ACE inhibitors. I do treat very early with the very least sign of any change in the kidney.