Are my mother's kidneys functioning well?

Q: My mother is 55 years old. She is suffering from diabetes for the last 22 years and has family history of diabetes. She lost her father and 2 brothers due to kidney failure. She recently got her tests done, the reports are as follows: Sugar fasting: 270; Creatinine: 1.5; Urine Protein: 2+; Blood urea: 51.0; HB: 12; urine RBC count are 10; blood RBC count is 3.89 and WBC count: 230. Is this alarming? Are her kidneys OK?

A:Clearly your mother suffers from long standing and poorly controlled diabetes which may have affected the kidneys since there is evidence of protein excretion in the urine. With the laboratory values provided, it may be safe to say that her kidneys are perhaps working 60% of their normal capacity. To prevent further kidney damage and make kidneys work better and last longer:

• Strictly control diabetes (your mother has a poor control)
• Control high blood pressure
• Avoid any medicines that may damage the kidneys (especially over-the-counter pain medications)
• Limit salt intake
• Lose weight (if she is obese)
• Control cholesterol

If the proteinuria is not controlled, 1/3rd of such individuals may lose their kidney function at rate of 5-10 % /year! The use of high blood pressure medicines called angiotensin converting enzyme (ACE) inhibitors or yet another class of medicines called Angiotensin Receptor Blockers (ARBs) have been shown to help slow the loss of kidney function to 1-2% per year.