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Re: [IP] kidney function tests

In a message dated 11/2/99 9:46:26 PM Eastern Standard Time, 
email @ redacted writes:

<< Changes beyond the normal range of albumin indicate kidney 
 damage before it truly shows up in creatinine.
Dawn and Cindy:
    And sometimes, it can show up long long before the creatinine is 
affected. My daughter's urine showed protein from the time she was 6 yrs old 
( 3 yrs pre-dx) but it was labelled "orthostatic proteinuria" (meaning she 
"shed" protein when she was standing)....It however continued to increase 
after her dx & since in those days, ped endos were more conservative, nothing 
was done. When it sky-rocketed well beyond the 300 mg level (30-300 is 
microalbuminuria/ below 30 is normal/ above 300 is proteinuria) into the 
500,1200, 1500 and then 2600 level (did you all hear the thud when I hit the 
floor that day???), a kidney biopsy was ordered to determine if there was any 
other plausible explanation ( i.e. kidney disease unrelated to diabetes - 
thankfully, not)...
    She's now been on ACE inhibitors for over 2 years, taking 10 mgs of 
Vasotec daily & within a year of beginning, her protein level was 288 mgs & a 
year later (this past spring) it was 300 mgs....so, thus far, the ACE 
inhibitor IS all it's cracked up to be, as far as halting progression of 
kidney deterioration.
    That said, and acknowledging that Melissa's case is VERY aberrant ( we 
call her the "leaky kidney" kid), nonetheless, it bears mentioning that her 
a.m. spot urine was NORMAL, but her 24 hr was NOT!!!
    Also bears mentioning that her former Children's Hospital endo now 
routinely starts kids on ACE inhibitors once they show 30 mgs of protein as a 
prophylactic measure! The times they-are-a-changing......thankfully!

Regards, Renee (pump-mom & annual 24 hr urine check proponent!!!)
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