Q: I am a 77 years old man. My BP is maintained at 160/90 with Repace 50 mg twice a day. I am also diabetic for the last 20 years (with fasting blood sugar at 105 to 110 and PP at 150 and random at 180). I am taking Diapride-2; one morning and half evening. The 24 hours urine collection report shows albumin of 1450 mg while serum creatinine is 1.4. I have undergone prostrate operation 3 years ago and have no post-operative complications or discomfort. I was told that my kidneys are slightly damaged, which cannot be reversed and also that further progress of kidney damage cannot be prevented. Kindly advise.

A:The presence of albuminuria in your urine and a S. creatinine of 1.4 is indicative of slight damage to your kidneys. At present the best course of action will be to have a strict control of B. Sugar & blood pressure. A blood pressure target of < 125/75 is strongly advised to prevent further deterioration of kidney function. You should see a nephrologist on a regular basis and have your blood pressure, blood sugar and urine albumin excretion monitored on a regular basis. The nephrologist can add an ACE inhibitor to help achieve the BP target and also to control the urine albumin excretion.