HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Have Diabetes, Elevated Microalbumin In Urine. Prescribed Cardace. Will Medication Increase Creatinine Level?

Posted on Mon, 17 Sep 2012

Question: hi,
I am diabetic patient for last 2 years.my microalbumin in urine is 20 mg/l and the normal range of the lab is <15 mg/l.I have prescribed cardace 2.5 mg/l of ramprill.I have concerned that for this cardace medicine my creatinine level increase or not because Ace inhibitors have some side effect like kidney impairment.
And i have one question that if my suger level is normal and BP is nprmal then how many days to recover my micro albumin in urine to normal range i.e < 15 mg/l..

Answered by Dr. L K Shankdhar (7 hours later)

Dear XXXXXXX
Thanks for utilizing this forum for your queries.
Your micro albumin level is 20 mg/L but it needs to be rechecked, preferably after antibiotic therapy and if found to continue only then label of microalbuminuria to be used.
Its management needs meticulous glycemic control ( which means your sugar control needs to be proper), besides lipid control, control of raised Uric acid and control of BP if ever found raised.
You are already taking Ramipril which is known to reduce albuminuria.
I would like to quote a recent study in which it was found that 50% patients, although had albuminuria but had no renal failure ever in their life time while 50% patients had no albuminuria still had renal failure.
Enough is to say that mere presence of albumin in urine, although is regarded a marker of future renal involvement but need not be taken with despair.
Hope you will find this much useful.
I would be happy to answer any more query from you if any.
With best wishes for good health
Prof. LK Shankhdhar

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. L K Shankdhar (2 days later)

Hi,
My suger level is normal and BP is also normal and my HbA1c is 6.8% and microalbumin urea is present little.
pls sussgest me how to control my albumin in urine and how its ge normal range?
And u guide me presence of albumin in urine trace is how much Danger.
If i control all these above things then how many year to take END STAGE RENAL DEASES.
PLS SUGGEST ME.I HAVE SO MUCH CONCERED ABOUT THIS.
I have take the cardace 2.5 mg of ramprill medicine.And i have taken a good diet.
I am not at all taking any high protine diet.
U also suggest me proper diet pattern for this stage.

Answered by Dr. L K Shankdhar (2 hours later)

Dear XXXXXXX

I have amply emphasized in my previous communication that mere presence of little microalbuminuria should not create panic; even I quoted a study in which no renal failure occurred in rest of the life in 50% cases even with macroalbuminuria (albumin in urine >200 mg/day.

It should just issue an alert to keep your risk factors under control.

Mere current control shall not matter; it has to be sustained.

Regarding chances of renal failure later in life, the literature says that only 20% patients lapse into ESRD (End Stage Renal Failure) in Type 2 Diabetes after 20 years.

Hope this much information shall release your tension, which I would like to call over concern.

Wishing good health

Prof. LK Shankdhar

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. L K Shankdhar (4 days later)

i have done the test of microalbuminuria.it is present in the urine.
i.e 37 mg/l.i have control Suger level,BP,colestroal all these things.
So i want to know that in how many months the microalbumin will under control.Or it should be like this only.
Can u give idea about this.

Answered by Dr. L K Shankdhar (44 minutes later)

Dear Friend,

Thanks for writing back.

I am sorry; it would be difficult to predict when your microalbuminuria shall disappear. Just take care of the risk factors already elaborated and get periodic check of the urine examination done.

Wishing good health.
Prof. LK Shankhdhar

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. L K Shankdhar (24 hours later)

hi
If i conrol my suger and BP level to normal for a long lime then also it is difficult to say microalbumin in urine is disappear or not.and the condition is like this then any concerned is there for future and how many year to take for dialysis.

Answered by Dr. L K Shankdhar (1 hour later)

Dear Friend,

I understand your apprehension.

First aim of therapy is to stop rise in microalbumin and often that is enough.

I have already described a research in my previous communication that 50% patients remain normal despite MACRO ALBUMINURIA and 50% develop renal failure without ever passing any albumin in urine. So this is not possible to predict anything because one more factor needs to be mentioned at this junction and that is genetic predilection which cannot be changed.

My advice to you now shall be to forget microalbumin for some time and focus on your treatment - managing sugars and hypertension well.

Hope it is clear to you.

Wishing good health

Regards
Prof. LK Shankhdhar

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. L K Shankdhar (17 days later)

hi sir,

I have concern that if little microalbumin is present in urine than what is my diet pattern?

i am non vegetarian.I reduced a lot of non veg in my diet but i am eating fish and chicken in 2 times in one week.so is this create any problem in my kidney or not?

And eating fish also XXXXXXX ?
If is this then how many fish in one week is adviceble or i quit eating non veg ?

One more question is that how many liter of water is preferable in this condition ?
only in urine little albumin is leaking and the other is normal like creatinine,BUN, uric acid,cholesterol and BP.Suger also normal.And my HbA1c is 6.8%.

I have lost 3kg weight.my previous weight is 73 and now it is 69.is there any problem ?

I have prescribed Cardace 2.5 mg for albumin in urine.It is good medicine or i changed the medicine.

So pls give me the Idea about these above question.

Thank You.

Answered by Dr. L K Shankdhar (7 hours later)

Dear XXXXXXX
It has been found that low protein diet, meaning 50G/Kg of body weight/day reduces passage of albumin in urine. For such diet, you should consult some medical nutrition therapist.
Since all your other questions belong to nutrition, please see a Nutritionist.
Bye
Prof. LK Shankhdhar

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. L K Shankdhar (15 hours later)

hi sir,

Is back acne(reddish) relatted to diabeties ?

In my foot reddish small nerve is shown.Is it related to diabeties ?
In my foot nothing is shown only small little reddish small nerve is shown.

Ramprill Cardace 2.5 mg medicine have any side effect like kidney impairment?
Can it reflect in my case ?

Answered by Dr. L K Shankdhar (7 hours later)

Hi,
Its unlikely that the backacne or the broken capillary on your foot is related to diabetes. For the backacne, consult a dermatologist. Cardace will not harm your kidneys unless there are special circumstances like renal artery stenosis which I dont think you have.
regards
Prof. LK Shankhdhar

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. L K Shankdhar (1 hour later)

hi,
for this broken capillary of the foot I have to take medicine or not ?
This is due to damage of blood vessel or wath ?
It is reverse or not ?
And how it is reverse pls tell me about this ?

One more question with control of suger and BP Can I reverse the albumin level in urine ?

Answered by Dr. L K Shankdhar (22 hours later)

Hi XXXXXXX

Urine albumin can be reversed during early days once the blood pressure and sugar are controlled. However it depends on the extent of damage to the kidney.

I am afraid that the other queries should better be answered by a Dermatologist after examination.

Prof. LK Shankhdhar

Note: For further follow-up, discuss your blood glucose reports with our diabetologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar