Saturday, 13 July 2019
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Hi I am a 36 yr old Black female I have type 1 diabetes which is controlled my blood pressure does fluctuate I jus switched to a ACE inhibitor coversyl. I jus did some recent blood work and I am concerned about my kidneys.

Protein is high in urine
ACR 137.7 in urine
Erythocytes 0.3 in urine
Gfr normal
Creatinine in blood normal
A1C 6.5


I attached my blood work results please advise on what I need to do and it I have kidney disease
more than a month ago
·
#1764
Hello,

The urine tests do indicate that there is very substantial amount of protein there. I would agree with starting an ACE inhibitor and you might get significant reduction in the protein levels with that intervention. I would also ensure that your blood pressure is below 130/80 and would consider adding additional medication to ensure you are remaining within this target.

Dr. Jordan Weinstein
more than a month ago
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#1765
I’m so confused because my sugar is controlled from my A1C number my gfr and creatinine is also normal so why am I spilling so much protein

Does this mean I have chronic kidney disease ? Or heading there
more than a month ago
·
#1766
Also is there a high chance the ACE inhibitor will lower my protein in urine

Also what do you think about the rest of my numbers are there any tests that you recommend I should do?
more than a month ago
·
#1767
Hello,

Having protein in the urine is a sign of chronic kidney disease if persistent for at least three months. If your diabetes was previously under poor control, it could have led to lasting damage. Alternatively, you could have a cause of kidney disease other than diabetes (such as previously poorly controlled hypertension or something else entirely). Ultimately, the only way to know what is causing your underlying kidney disease might be to undergo a kidney biopsy but of course this is something that must be discussed in person with your kidney specialist. And yes, an ACE inhibitor can lower protein excretion substantially.

Dr. Jordan Weinstein
more than a month ago
·
#1768
Ok thank you

So if the ace inhibitor lowers my protein will that keep my kidneys from going further down hill

My dr shared that yes I’m spilling a lot of protein and that is why she is being aggressive with the ace she shared that she does not want my gfr to start going lower and that catching it now will save me from further damage

What do you think just looking for second opinions
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