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Hi, I’m Very Concerned. I Had A Microalbumin/creatine Ratio Of

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Posted on Sun, 16 Aug 2020
Question: Hi, I’m very concerned. I had a Microalbumin/creatine ratio of 33mg/g. My Microalbumin is 55.7 ug/ml and creatinie was 168.2mg/dL. I do not have diabetes but am on several high blood pressure medicines including Losartan potassium - 50mg twice a day - 100 mg total (others listed below). How concerned should I be? What is life expectancy.
My urine has been foamy for long time-as long as I can remember. I thought that was normal.
Regarding other Recent labs - Blood: My EGFR is 79. My BUN is 17mg/dL, Creatine is .97 mg/dL. bUN-Creatine ratio is 17.5
Other medications that I am on besides the Losartan. I take 10 mg amlodipine, 20 mg atorvastatin10 mg bystolic, 25 mg chlorthalidone. I am 58 years old. I am a vegetarian for the most part.
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Follow up: Dr. Rakesh Madhyastha (1 hour later)
Medicines: Losartan potassium - 50mg twice a day (100 mg total). I also take 10 mg amlodipine, 20 mg atorvastatin’ 10 mg bystolic, 25 mg chlorthalidone. I have been on these medications for 4 years. Blood pressure has always been great since then. Is there any other medications that might help?
doctor
Answered by Dr. Rakesh Madhyastha (22 hours later)
Brief Answer:
Albuminuria

Detailed Answer:
Dear XXXXXXX

Thank you for reaching out to healthcaremagic.com. I understand you are concerned about albuminuria.

The albuminuria is most likely from hypertension however it is mild so the prognosis is good. Your recent creat is normal which is an added bonus.

Now coming your question, here are the things that can help reduce proteinuria
1. No additional medication is needed apart from the Losartan that you are already on, this is the best medication one can take to reduce protein (albumin) loss in urine. The other thing is to make sure your blood pressure is well under control, which you have mentioned is appropriately controlled.
2. If you are over weight cutting down your weight to achieve normal BMI is beneficial not only for your albuminuria but also helps reduce blood pressure ( in your case number of drugs you take)
3. I am happy that you are a vegetarian as we commonly ask people to avoid red meat.
4. Follow a low salt diet.
5. Please avoid any protein supplements like Whey protein
6. You could avoid NSAID group of drugs as pain killers. i.e ibuprofen, Naproxen, higher doses of Aspirin.

I advice my patients to stop Losartan if they develop loose stools or vomiting until they recover. Losartan can sometimes push the creatinine high leading to reversible acute kidney injury when a patient is dehydrated, please speak to your doctor about this if not discussed already.


Please feel free to get back to me for any additional queries

Warm regards
Rakesh
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Rakesh Madhyastha (54 minutes later)
Thanks for the the answer, sir. I have a few more questions:
1. Is the amount of albumin in my urine enough to cause the foamy urine I see? I have read that a person will see foam when it’s extreme. 2.Do you think the medications I am on will prevent further damage or will it progress? Is it inevitable that it will progress? 3. Do you think there is already damage to my glomeruli?-obviously it’s already leaking. 4. Will this have a great impact on my life expectancy? Will I end up on dialysis?

I am am not over-weight. 5’10, 179 pounds.
doctor
Answered by Dr. Rakesh Madhyastha (25 hours later)
Brief Answer:
Follow up

Detailed Answer:
Thanks for getting back. I am sorry for the short delay in my reply.
1. The foaming of the urine is not considered a marker for kidney disease anymore. Foaming is basically due to surfactant action of the urine. Back in the day when tests were not accurate this used to be a crude method to inaccurately diagnose someone with proteinuria
2. Control of hypertension will prevent further damage to the kidneys, losartan will help delay the progression of kidney disease. Even in normal individuals there is fall in renal function as one ages so progression just like ageing is inevitable, the aim is to slow it down.
3. Presence of proteinuria signifies some structural damage, however in your case it seems to be mild
4. At this moment I do not think there will be any difference in your life expectancy and if things go well you will never needs dialysis.

Please do get back to me for any pending queries
Thank you
Warm regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Rakesh Madhyastha

Nephrologist

Practicing since :2009

Answered : 4364 Questions

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Hi, I’m Very Concerned. I Had A Microalbumin/creatine Ratio Of

Medicines: Losartan potassium - 50mg twice a day (100 mg total). I also take 10 mg amlodipine, 20 mg atorvastatin’ 10 mg bystolic, 25 mg chlorthalidone. I have been on these medications for 4 years. Blood pressure has always been great since then. Is there any other medications that might help?