As part of the annual review for diabetes and/or high blood pressure, you are asked to provide a urine specimen which looks for small amounts of protein. Your sample shows that protein is present and the medical name for this is called Microalbuminuria (and also sometimes called proteinuria)
Microalbuminuria is a very early sign of kidney disease and over months or years may go away, persist or worsen. The reason for picking this up is that there are things that you can do to improve the condition and limit its progression
These are:
- Make sure you are well hydrated. Being well hydrated protects your kidneys.
- If you are not on one already, start an ACE inhibitor medication – unless there is a specific reason or contraindication, we advise starting an ace inhibitor capsule such as Ramipril or Lisinopril, the usual advice is to gradually increase it to the maximum tolerated dose.
ACE inhibitors work by reducing the amount of a chemical called angiotensin II that you make in your bloodstream. This chemical tends to narrow (constrict) blood vessels. Therefore, less of this chemical causes the blood vessels to relax and widen and so the pressure of blood within the blood vessels is reduced.
ACE inhibitors are medicines that are often used to treat high blood pressure. However, the way they work also seems to have a protective effect on the kidneys and heart. This means that they help to prevent or delay the progression of the kidney disease.
3. Make sure that you have good blood pressure control by monitoring this at home if possible, see https://bmg.link/BPhelp and https://bmg.link/MeasureBP
4. Having good control of blood sugars as part of your diabetes management
5. Considering starting a statin if you’re not already on one (even if you have “normal” cholesterol numbers), patients with microalbuminuria are at higher risk of heart attack and strokes and statins have been shown to reduce that risk, even if you do not have high cholesterol.
6. For people with diabetes with an elevated cardiovascular risk, we normally recommend a medicine is added called Dapagliflozin even if your blood sugars are good, as again this protects the kidneys and reduces cardiovascular risk. A leaflet with information on this medicine can be found here https://bmg.link/DapaDiabetes
7. Follow sick day rules. If you are unwell, particularly with an illness causing dehydration, your kidneys may be at risk. You may be advised to stop some of your medication such as ACE inhibitors and diuretics. Please discuss this at your next diabetic check or call for advice if you become unwell.
Please see the following for further information
https://www.diabetes.org.uk/guide-to-diabetes/complications/kidneys_nephropathy