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I am diabetic. Having normal BP and sugar levels. Taking insulin and proper diet. What is the effect on kidney?

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I am diabetic patient for last 2 years.In my urine microalbumin is present e.i 37 mg/l and the normal range is <20 mg/l.
one month before suger level is 140(Fasting)and Bp is normal.

Now I am control the suger level e.i 90(Fasting) and 132(after food)
My BP also normal e.i 120/85
I have prescribed Cardace 2.5 mg for microalbumin.
I am taking insulin and medicine for suger.
I am taking a good diet.

I have so much concerned that this create serious problem in future.

My question is how microalbumin in urine comes to normal range.and how many month to take microalbumin level to normal range or it is like this only?
And how it effect my kidney function?And how many years it take to End Stage Renal Disease.

Posted Sun, 2 Sep 2012 in Kidney Conditions
Answered by Dr. Ravi Bansal 1 hour later

Thanks for writing in,

Diabetes is a multisystem disease where 50% of diabetic patients may have kidney involvement. One of the early sign of kidney involvement is protein/albumin in urine. If left untreated these patients start developing fall in glomerular filtration rate (GFR after 10 years and another 10 years before the patient reaches End stage kidney disease.

But there are lot of factors which can influence the rate of renal failure. They include:
1. Uncontrolled blood pressure. Target blood pressure under 130/70. Your current BP seems OK.
2. Uncontrolled sugar. Glycosylated hemoglobin (Hba1C) needs to be monitored frequently and it needs to be kept under 6.5%. Your current sugar levels seem fine, but I would be pleased if your Hba1c level is also fine.
3. Smoking - increases rate of damage by 10 times faster.
4. Cholesterol - keep LDL cholesterol <100mg/dl
5. Treat urine infections early.
6. Use of Pain killers- like diclofenac, ibuprofen needs to be restricted if not avoided.
7. Do not take any medications over the counter. Discuss with a doctor if they are nephrotoxic.
8. Restrict/avoid non vegetarian diet.

From the above list, I hope you can see that you are doing fine your age is not mentioned though.
In any case you should not be disheartened. 30% patients revert to normal protein excretion after treatment. Another 30% stabilize and the others have progressive disease. Generally it takes three to 6 months to see response.

So do not worry. Avoid bad influences and continue to live normally.

Hope this helps. Let me know if you have any other queries.

Above answer was peer-reviewed by
Follow-up: I am diabetic. Having normal BP and sugar levels. Taking insulin and proper diet. What is the effect on kidney? 9 hours later
I am 31 years old.
my hba1c is 6.8%.
I take non veg food in 2 times in a week.

My cholesterol level isalso normal.
i have prescribed medicine Rozavel for cholesterol.

Is there any concerned for this ?
And I want to know that in this stage can i stop taking non veg or weekly one or two time taking not harm my kidney?

pls give suggestion how i comes down microalbumin level to normal range ?
my microalbumin level is 37 mg/l and normal range is <20 mg/l.
And how many times it will take?
Answered by Dr. Ravi Bansal 9 hours later

I must inform you that even anxiety and tension can worsen proteinuria. So relax and do not worry.

I would suggest that:
- Your Hba1c can improve further - get in touch with doctor and keep sugar monitored.
- If you are taking non-veg food, take only one or two pieces once a week. Do not test your urine sample the morning after the non-veg intake
- Cholesterol medicine is fine.

Other treatment is going fine. As I have answered earlier effect on proteinuria is visible after 3 to 6 months. Keep in touch with your nephrologist.

Hope this helps. If you have any more queries, feel free to ask.
If all your queries are answered, please close this discussion.

Above answer was peer-reviewed by
Follow-up: I am diabetic. Having normal BP and sugar levels. Taking insulin and proper diet. What is the effect on kidney? 23 hours later
I have precribed Cardace 2.5 mg of ramorill medicine. chould u pls tell me that this medicine is good for protine in urine or i have to take other medicine for this.

And i have one more question that
if my protine in urine continue like this then with in how many years to take the kidney problem start.

And for this ACE inhibitors is there nothing side effect occurs like kidney impairment?

And if suger,BP,cholesterol is normal then In future nothing problem is happened?
PLS give idea.
Protine in urea is due to kidney problem?
Could u pls tale me it never be repaired?
With protine in urine one pertion can never leave normally?
Answered by Dr. Ravi Bansal 3 hours later

You should first understand that you are perfectly normal. Human body may have some damage, but life goes on normally. For example, you are diabetic, so you have to take diabetes medicines for long time. But this should not stop you from leading a normal life. Similarly with kidney disease you should be able to lead a normal life. The society attaches a lot of stigma to "Kidney disease" but is not true. So please relax yourself.

Cardace is a good medicine for proteinuria and yes protein in urine is a sign of kidney disease. But as I told you it can improve with treatment.

Common side effect or Cardace (Ramipril) is on serum keratinise and potassium levels. This has to be monitored during regular OPD visits. Please follow up with your doctor regularly.

A patient in your disease profile should XXXXXXX the doctor once in 2 months and rest of the things will fall into place. So don't get disheartened at all, and continue your life normally.

Don't worry,

Hope this helps. Let me know if you have any further concerns.

Above answer was peer-reviewed by
Follow-up: I am diabetic. Having normal BP and sugar levels. Taking insulin and proper diet. What is the effect on kidney? 12 hours later

---With trace in microalbumin in urine how many years to take over nepropathy.
---After treatment like diet and regular excirsize I lost 4 kg.Is there any problem.
e.i before i was 73kg and my hight is 5.11'' and now after treatment i am 69 kg.
Is there any serious problem?
---I am taking insulin daliy.After eating sweating is there.So what is the reason?
---Pls u tell me Can i completely reduced the microalbumin level to normal range?
how it is normal.What i can do so that it is down to narmal range.
---and one more question with microalbumin in urine how i completely avoid kidney problem in future?

My microalbumin level is 37mg/l and normal range is <20 mg/l.Is this create any problem in future?
Answered by Dr. Ravi Bansal 7 hours later


Thanks for the query.

With presence of microalbumin you already have a nephropathy, but moving on to next stage which is "OVERT nephropathy" will take at least 5 to 10 years. If the risks persist, kidney function is expected to drop after another 10 years.

- The weight loss is Ok; no problem with it.

- Sweating after eating is a feature of autonomic disturbance. So do not worry. But at the time of sweating please do blood sugar levels once or twice to rule out low blood sugars.

- Microalbumin may or may not come to normal range and you are already on treatment for the same. In addition I have already listed the measures which regulate microalbumin- including avoiding nonveg, better control of BP and sugar.

- We cannot completely avoid kidney problem; but we can control it with medicines. So for now, do not worry about future kidney problems and strictly consider the measures which I listed earlier.

Hope this answers all your queries.

Above answer was peer-reviewed by
Follow-up: I am diabetic. Having normal BP and sugar levels. Taking insulin and proper diet. What is the effect on kidney? 30 hours later

If in case I will feel fever or pain in the body then Nimesulide is preferable or not?
beacuse i am taking this medicine.

In some time I feel sleepy Is there any problem?
My urine is little darker after taking the Cardace and Rozavel for last 15 days.
Is there any problem?Or any difficulty is there?

In my case The Cardace 2.5 mg 1 tablet per day is sufficient or dose will increase.What is ur suggestion?
Answered by Dr. Ravi Bansal 8 hours later

Nimesulide should be avoided. Instead we can use paracetamol(crocin) or tramadol

Kindly test TSH (thyroid stimulating Hormone) to rule out hypothyroid which is generally associated with renal disease. This could be one of the causes of sleepiness. Serum sodium level should also be seen - if it is low, it can cause sleepiness.

Mild darkness in urine colour is generally of no clinical relevance.

If your BP is above 130/80 an attempt can be made to increase the dose of car dace but this should be done under strict guidance of your nephrologists.

Hope this helps.
If all your queries are answered satisfactorily, please close this discussion.

Above answer was peer-reviewed by
Follow-up: I am diabetic. Having normal BP and sugar levels. Taking insulin and proper diet. What is the effect on kidney? 51 minutes later

---I am taking 1 litter of water daily now a day's.
so u tell me how much water i can take in this condition?
My creatinine,urea is normal and trace microalbumin in urine.BP is also nomal.

---In my diet pattern i am not taking any protine dhal,chana,soya,pulses etc
so in ur view this protine diet is avoidable or what?little carbohydrate diet is adviciable or what like rice one time,castard,drumstick etc.?
now my suger level is normal.

---In holiday can i go outside for 3 to 4 days?
---in diet along wih non veg which i should be avoided in vegetarian food?
---idly,dosa XXXXXXX sandwich,cornflakes etc. can i eat in breakfast or not?

sir u just give idea about diet pattern so that i came to know that which i should eat and which i should't eat?

Thanks for ur replay in advance....
Answered by Dr. Ravi Bansal 17 hours later
I am sorry for the delay i was travelling.

Water - you can can take upto 1.5 to 2 litres/day
Protein - take 0.7gm/kg/day, amounts to 40 -50 gm/day. You can take all vegetarian protein but restrict non veg to once a week. avoid palak and sarson in diet
All other south indian food products can be eaten but with less salt
Carbohydrates - should avoid free sugar containing food stuffs like rice and potato
Avoid fruit juices
Avoid tobacco products
Decrease salt in diet
You can definitely go on holidays
Hope this answers your query

take care,
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