Microalbuminuria

[Felinia]

I thought I was managing my diabetes quite well but have just got an abnormal blood result, with a diagnosis of Microalbuminuria. My ACR (albumin/creatinine ratio) was 4.3 mmol/l. I know it means my kidneys are not working as well as they should. 18 months ago I had several bouts of infection and at one stage I was in AKI Stage 1 (acute kidney injury). After antibiotics my kidney function returned to normal, albeit in the upper ranges. I was put on Canagliflozin 6 months ago, and I know that affects the composition of urine - I pee out excess glucose. My GP appointment (the first available) is not for another 4 weeks. In the meantime can anyone offer me any information and advice on how to manage until the appointment? Advice on foods etc. I already aim for less than 90gm carbs daily and do 3 exercise classes a week. Thanks.

 

[gll]

I swear you get one thing in check and another thing flags up.

Very low carb (keto ish) and the SGLT2 meds shouldn't be done together due to the increased DKA risk so please do be very careful there about dropping more carbs.

As much as they tell you they will be okay for your kidneys etc, they doubled my empag at one point and it shot my blood pressure right up and feet ballooned. (not on them now)

Honestly, I would get your pushy pants on and ask for a sooner appointment and basically tell them you are at the point that you feeling stressed out taking your diabetes medication because of side effects/kidney blood results and are unsure if it puts your DKA risk up if you body is not functioning properly and would at least want immediate clarity on that question which a receptionist shouldn't be able to answer legally. (make sure they know what DKA is 😉 )

I really do understand how frustrating it is when everything seems leisurely and in no rush to do anything yet you are sitting there stressed to the max. Super hugs x

 

[Felinia]

I swear you get one thing in check and another thing flags up.

Very low carb (keto ish) and the SGLT2 meds shouldn't be done together due to the increased DKA risk so please do be very careful there about dropping more carbs.

As much as they tell you they will be okay for your kidneys etc, they doubled my empag at one point and it shot my blood pressure right up and feet ballooned. (not on them now)

Honestly, I would get your pushy pants on and ask for a sooner appointment and basically tell them you are at the point that you feeling stressed out taking your diabetes medication because of side effects/kidney blood results and are unsure if it puts your DKA risk up if you body is not functioning properly and would at least want immediate clarity on that question which a receptionist shouldn't be able to answer legally. (make sure they know what DKA is 😉 )

I really do understand how frustrating it is when everything seems leisurely and in no rush to do anything yet you are sitting there stressed to the max. Super hugs x

Thanks for your support. I've just got the rest of my test results. Both my HbA1c and total cholesterol have dropped slightly, so together with my BP my results have been stable for a year since my illness. My renal function and serum lipid tests were reported as abnormal, but serum sodium, serum potassium and serum creatinine were all within normal limits, albeit near the top of the range, like last year. So I'm puzzled, but I feel a bit happier that other measures have not shot out of control. I've taken on board what you said about carb levels and will stick to my 75-90 gm a day. I've managed to get an earlier nurse appointment - she's the diabetes specialist at the practise - as my GP is away. I hope what all this means is that I am on the edge, and prompt action, plus a possible change of medication, will bring me back under control.

 

[Flower]

Hi @Felinia

Sorry something else has been flagged up, diabetes is a relentless condition for sure.

I've lived with microalbuminuria for about 25 years now. I've taken an assortment of different drugs -ACE inhibitors - over that time to try and limit any damage and to protect my kidneys as much as possible. Most recently I was taking Irbesartan to protect my kidneys, its other effect is to reduce blood pressure but I've had to stop taking it as my blood pressure wasn't high to start with and I was getting too dizzy. My egfr has reduced over time but relatively slowly thank goodness and I do have CKD.

Microalbuminuria is an early indication that the kidneys aren't working optimally but certain things can cause it to appear temporarily such as dehydration, injuries, inflammation, certain drugs etc. I expect you'll have to do a repeat test and hopefully it will have disappeared but if not there are drugs that can be prescribed to give protection usually ACE inhibitors - if you don't already take one. Wishing you well.

 

[Felinia]

Hi @Felinia

Sorry something else has been flagged up, diabetes is a relentless condition for sure.

I've lived with microalbuminuria for about 25 years now. I've taken an assortment of different drugs -ACE inhibitors - over that time to try and limit any damage and to protect my kidneys as much as possible. Most recently I was taking Irbesartan to protect my kidneys, its other effect is to reduce blood pressure but I've had to stop taking it as my blood pressure wasn't high to start with and I was getting too dizzy. My egfr has reduced over time but relatively slowly thank goodness and I do have CKD.

Microalbuminuria is an early indication that the kidneys aren't working optimally but certain things can cause it to appear temporarily such as dehydration, injuries, inflammation, certain drugs etc. I expect you'll have to do a repeat test and hopefully it will have disappeared but if not there are drugs that can be prescribed to give protection usually ACE inhibitors - if you don't already take one. Wishing you well.

Thanks for your support. As my other tests are OK, I'm hoping it's temporary, as I had a kidney problem last year after a very persistent infection. It finally cleared up after antibiotics. I was on Losartan at one time but it had very bad side effects and I got taken off. I also had 2 different ACE inhibitors at one time, also with side effects. I have to do another test which I will do the week before my appointment. Fingers crossed!

 

[everydayupsanddowns]

Sorry to hear about your microalbuminuria @Felinia

I’m pretty sure I had a bit of that back in the day, but I think recent results have been clear.

 

[Felinia]

Sorry to hear about your microalbuminuria @Felinia

I’m pretty sure I had a bit of that back in the day, but I think recent results have been clear.

Thanks. This Forum has been very reassuring and helped my understanding - at first I was very concerned. Just one more thing to manage now!

 

[Felinia]

My appointment has been postponed - what a surprise - until 27 July! I am already following a low carb diet (diabetes) and a low fat diet (high cholesterol). Reading Dr Google (bad idea I know) says if you have kidney disease follow a low protein diet. So I kind of said to myself - what's left? Yesterday I made a large batch of veggie soup and a large batch of veggie ratatouille. Tongue in cheek, but I'll have to find a compromise somewhere. 😡

 

[gll]

sorry you are being messed about with
while you are at it, don't forget to use a joy extractor to remove all of that too 🙄
sending hugs, hopefully it wont feel like forever with the wait and you can muddle on by x

 

[trophywench]

One of the Google links - think it was the BUPA one - says straight off that whilst albuminuria certainly signifies too much of it, microalbuminuria automatically signifies it's only a micro amount too much.

Do you ever get anything else iffy reported kidney-wise? I know e-GFR is one of the tests they do pretty normally for kidney function purposes and is more prone to being done on certain types of BP medications. (is it ACE inhibitors, ~prils? or summat else pretty common?)

I don't think for a minute you won't survive !