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Kidney Diseases

Chronic Renal Insufficieny: Diabetes

06/04/2010

Question:

I have had Type 1 diabetes for 38 years and have just received my lab panel back. My A1C over the past year has been between 5.9 and 6.4. My lipids are desirable; my creatinine was 1.96 and my egfr 37. My hemocrit was 40.3. MY urine prtein/creatine ratio was .34. I am on vytorin (10/40), lisinopril 40mg BID, cozaar 50mg; norvasc 5mg and hydroclorathazide 50mg. I am wondering at what level I need to be omore worried about kidney dialysis or if I can continue to stave this off with the management I currently am under for my diabetes and renal insufficiency?

Answer:

The most important part of your care is to control the sugars and the blood pressure, and avoid any meds that can hurt your kidneys (for example, the non-steroidal anti-inflammatory drugs or NSAIDs).

Your labs look good. Your are on a good regimen of medication. It sounds like your doctor is doing a good job and so are you. You did not provide a BP report but the usual target would be a systolic BP of about 125, which might be adjusted by your physician to suit individual patient needs.

This is the same advice I give to all my patients. I also tell them I don't have a crystal ball so the future is uncertain about the outlook for the kidneys. One can hope for the best. Good luck!

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Response by:

Thomas   Zipp, MD Thomas Zipp, MD
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University