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Have high urine albumin level. Have diabetes. How can I reduce level?

I have a reading of Urine Albumin of 46 which is very high. I am also a diabetic, my HBA1C is 6.6. I cycled minimum 4 times per week of minimum 16km each time or an hour. I also on strict diet with only lean meat, chicken breast without skin, and a lot vegetable and fruits. Can you please advise how I can bring down my Urine Albumin?
Asked On : Sun, 3 Feb 2013
Answers:  3 Views:  147
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General & Family Physician 's  Response
high urine albumine levels deserve evaluation of the kidney function. Hope you also control well your Blood pressure levels. Other tests like Blood Urea Nitrogen, Serum creatinine, serum Electrolytes especially potassium and Calcium are of utmost importance in ascertaining the integrity of the kidneys.
Depending on the results of these tests, the nephrologist or internist shall be well placed to give advice on diet habits to adopt in order to reduce urine albumine. This most of the time involves regulation of protein consumption.
Remember that having diabetes is a risk factor for developing kidney disease, and a well controlled blood glucose levels, certain in your case especially with normal HbA1c levels should be maintained. Other factors can lead to a transient increase in urine albumine levels like exercise. At times, its usually worth repeating the test. If it remains continually high, consulting in ideal situations, a nephrologist is the most appropriate option.
Thanks and hope this helps,
Luchuo, MD.
Answered: Sun, 3 Feb 2013
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
Your reading of urine albumin at 46 means you are having microalbuminaria.Elevated albuminuria (30 to 300 mg/d albumin is the definition of microalbuminuria) is an early predictor of progressive renal function loss in diabetes.

 Microalbuminuria is an important clinical finding because it is not only associated with an increased risk of progression to overt proteinuria (macroalbuminuria) and renal failure, but also cardiovascular events. In patients who progress to overt nephropathy, microalbuminuria usually precedes macroalbuminuria by an interval of 5 to 10 years. 
Large clinical trials have demonstrated that achieving tight glycemic (i.e. HbA1c

It has been seen that lowering of BP with agents that interfere with the renin-angiotensin-aldosterone system, such as ACE inhibitors or ARB is most effective for lowering urinary albumin excretion.
Your goals of treatment should be

Tight blood sugar control
Lowering of BP to below 120/80 with either ACE inhibitors or ARB's
Controlling dyslipidemia
Quitting smoking if any.
Avoiding all nephrotoxic drugs
Prompt control of any urinary tract infection
Low protein and low potassium diet
Avoiding potassium sparing diuretics like spironolactone.
Be on regular touch with your diabetologist as well as nephrologist.
Answered: Mon, 4 Feb 2013
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Internal Medicine Specialist Dr. Chaitanya Buch's  Response
Hi ,it IS importntto reduce the micro albuminuria in all type 2 DM
Glycemic control can prevent progression to microalbuminuria.
Preventing the progression of each step of renal disease in patients with diabetes — microalbuminuria, diabetic nephropathy, and ESRD or death — can be achieved with blood pressure control and the use of antiangiotensin therapies such as angiotensin-converting-enzyme (ACE) inhibitors and angiotensin II receptor blockers so meet your Doc and start ACE inhibitors if not on it already
Answered: Mon, 4 Feb 2013
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