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How can a high level of microalbumin be reduced?

Friday, 25 January 2008
Answered by: Dr. Ashutosh Singh
Consultant Nephrologist
Knoxville,
USA
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Q. My dad's age is 50. He had a test for microalbumin. The result is 1100 mg/day. As per my knowledge this is very high. Can you please suggest how to reduce the microalbumins level and what type of diet he should follow and also suggest some tablets for this? We are really worried about this.

A.  Persistent presence of protein (albumin) in urine (called proteinuria or albuminuria) above a certain amount is a sign of underlying kidney disease. Commonest among the causes would include diabetes. High blood sugar damages the kidney’s filtering cells resulting in increased leakage of protein in the urine. Persistent leakage of protein over a significant period of time can result in the impairment of kidney’s filtering function. Your father would need to undergo further lab investigations including blood tests for checking serum creatinine (needed to estimate his kidney’s filtering function), fasting lipid panel and other specialized tests to rule out other causes of significant proteinuria. Management would include strict blood sugar control, treatment of elevated cholesterol if any and strict blood pressure control (goal BP being <130/80mmHg). Certain blood pressure medications called angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) have been proven to reduce the protein leakage in the urine beyond its blood pressure lowering affect. They have hence been able to delay the progression of both diabetic and non-diabetic kidney disease over a long period of time. Besides, one would be advised to lead an active and a healthy lifestyle including intake of diet low in carbohydrate and saturated fat and rich in protein and plenty of green leafy vegetables and fruits in addition to increased outdoor exercise. These dietary modifications need to be tailored to your father’s underlying medical condition.

A.  Persistent presence of protein (albumin) in urine (called proteinuria or albuminuria) above a certain amount is a sign of underlying kidney disease. Commonest among the causes would include diabetes. High blood sugar damages the kidney’s filtering cells resulting in increased leakage of protein in the urine. Persistent leakage of protein over a significant period of time can result in the impairment of kidney’s filtering function. Your father would need to undergo further lab investigations including blood tests for checking serum creatinine (needed to estimate his kidney’s filtering function), fasting lipid panel and other specialized tests to rule out other causes of significant proteinuria. Management would include strict blood sugar control, treatment of elevated cholesterol if any and strict blood pressure control (goal BP being <130/80mmHg). Certain blood pressure medications called angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) have been proven to reduce the protein leakage in the urine beyond its blood pressure lowering affect. They have hence been able to delay the progression of both diabetic and non-diabetic kidney disease over a long period of time. Besides, one would be advised to lead an active and a healthy lifestyle including intake of diet low in carbohydrate and saturated fat and rich in protein and plenty of green leafy vegetables and fruits in addition to increased outdoor exercise. These dietary modifications need to be tailored to your father’s underlying medical condition.

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