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Diabetic, had lipid profile test. Findings?

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Practicing since : 2003
Answered : 495 Questions
Hi Doctor ,

My father aged 49 years was suffering from Diabetes from past 15 years, And yesterday for the first time in 15 yrs he went for the check up and i've attached the report here ..

And as per the report Doctor has warned that his kidney might have damaged ..

Please help and tell how to reduce the danger to kidney as Doctor said more protein is going out from his urine..

Thanks in advance .
Posted Sat, 14 Sep 2013 in Kidney Conditions
Answered by Dr. Aditya Bhabhe 1 hour later
Brief Answer:
Labs suggestive of Kidney disease

Detailed Answer:
Thanks for sending in your query.

The reports you have sent in are consistent with what your doctor has told you, i.e., your dad is losing a lot of protein in urine and his kidney function is also reduced (As can be seen in the elevated creatinine report). Both of these are the likely result of many years of Diabetes.

I also noticed the following important things (which affect the kidneys indirectly) in the reports:
1) His Blood sugar control has been quite poor (hbA1c of 12)
2) His LDL Cholesterol (LDL: 146) and potassium (6) are high.
3) His White cell count is high which means that he might be having some infection.

One of the first things to do is to get the potassium under control by diet and special medications like K-Bind which your doctor will prescribe.

Further, I suggest the following line of treatment which I prescribe to my clinic patients to prevent the progression of diabetic kidney disease:
1) Strict control of blood sugar with diet and insulin with target of achieving HbA1c <7
2) Strict control of cholesterol with statins and diet (target LDL<100)
3) Blood pressure control (Target BP<130/80)
4) Use of a class of drugs known as ACE inhibitors or ARBs. However they can be given ONLY after his potassium has been brought down to normal. These drugs reduce protein loss in the urine but have to be administered under the supervision of a nephrologist.
5) We have to look for active source of infection by doing X XXXXXXX of the chest, Ultrasound etc.and treat it with antibiotics.
6) We also need to check his serum calcium, phosphorus and bicarbonate levels and an Ultrasound of the kidneys.
7) Strict adherence to a protein restricted, low potassium, low salt diet (please see a dietician for the same).
With the above measures we need to monitor his blood and urine tests and see the results.

I hope I have provided you some useful suggestions.
Feel free to contact me if you have any more questions.

Regards and best wishes.

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