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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Leak of protein in urine. Have diabetes, hypertension. Precautions?

Hello Doctor I am female of 43 years, since October 2012 I m getting high leak of protein in urine around 207 mg/L per day. My renal profile is normal. I have very slight diabetes and hypertension for which i m taking Zestril 10mg. Today my report for Vitamin D came deficient 20.69 nmol/L. Doctor please advice what is the reason for protein leak and Vitamin D. What precaution i have to take.
Mon, 25 Mar 2013
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Cardiologist 's  Response
IN YOUR CASE -PROTEIN LEAK IN URINE IS STAGE 1 KIDNEY DISEASE IS DUE TO DIABETES ( CALLED DIABETIC NEPHROPATHY -Glomerular diseases are also accompanied by disruption and loss of the epithelial foot process covering of the basement membrane.

OTHER CAUSE MAY BE
High blood pressure
Infection
Reflux nephropathy
Glomerulonephritis
Minimal change nephritis
FOR PROTEIN LEAK - MAINTAIN BP BELOW 130/80 MMHG

VITAMIN D DEFICIENT IS DUE TO LESS INTAKE, POOR SUN EXPOSURE - FOR IT YOU CAN TAKE VITAMIN D SACHET ORALLY /WEEK FOR 3 MONTH
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General & Family Physician Dr. Pavan Kumar Gupta's  Response
Hello,
High blood sugar in diabetes results in damage of various blood vessels of body.
When the blood vessels of kidney get damaged,then bigger molecules of protein in blood start getting leaked in the urine which otherwise should not have leaked.
The gold standard for diagnosis of mcroalbuminaria is 24 hours urine estimation of protein.
DIABETIC NEPHROPATHY is preceded by micro albuminaria and is an incipient nephropathy which can be reversed by proper medications and precautions.
MICROALBUMINARIA is defined as albumin level of 30-300 mg albumin/24 hours.
MICROALBUMINARIA precedes overt proteinuria by several years.OVERT PROTEINURIA IS DEFINED AS more than 300 mg albumin/24 hours
It is said that average time taken from the appearance of overt proteinuria to end stage renal failure is 5 years.
You must consult a diabetologist as well as a nephrologist
Do's for you..
Control your diabetes and blood pressure meticulously.
Avoidance of nephrotoxic drugs like pain killers
Prompt control of UTI's
Must take ACE inhibitors or ARB's as these will slow down the progression to frank diabetic nephropathy.
Low potassium and low proteins if nephropathy has developed.
Take regular supplement of VIT D .
Thanks
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3 Doctors agree with this answer

General & Family Physician Dr. Gopal Krishnam Raju's  Response
continue zestril take calciriol sachets 1 sachet/week for 8weeks :)
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