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RE: [IPk] Urine testing for kidney function - children/adolescents



Hi Caroline,


Excellent point. If a dipstick shows proteinuria that's one thing, if it 
shows albuminuria that's another thing.

As the Bad Old Days were characterised by proteinuria dipsticks perhaps 
those of us who remember protein dispticks think that the only dipstick test 
is for proteinuria while albumin may be the thing that's being looked for 
now? Trust the medical profession to ask us to pee in a cup and not tell us 
why!!!!

I would like to qualify my previous posts with your point that we all ought 
to ask what is being dipped for and why before being sure of whether the 
test is appropriate for the circumstance.


Melissa

----Original Message Follows----
From: "Caroline Batistoni" <email @ redacted>
Reply-To: email @ redacted
To: email @ redacted
Subject: RE: [IPk] Urine testing for kidney function -  children/adolescents
Date: Wed, 07 Jun 2006 18:42:40 +0000

I'd be very surprised if there were any diabetes clinic in the UK that 
actually does protein 'dipstick' tests anymore. That sample they always ask 
you to take with you is usually used for an ACR test - Albumin to Creatine 
Ratio. The results of this test correlate closely to the results of the 24 
hour collection, especially, if you provide a morning specimen. (This 
information was given to me by a biomedical scientist working with this 
test.)

Not only is the ACR the test endorsed by NICE (sorry, them again) but if you 
read closely it is also included in the ISPAD document that Melissa 
mentioned as an accepted alternative to overnight or 24 hour collections.

Besides that, it can be performed at a fraction of the cost in terms of 
patient time and effort, laboratory resources as well as financially - 
leaving more funds for insulin pumps, better glycaemic control and reduced 
risk!

Before asking for a 24 hour collection, it might be wise to check that the 
ACR test is being performed and what recent results have been.

HTH

Caroline
Type 1 23+ Pumper 4+

>
>Marion, I never mind you asking anything! Don't be silly ;)
>
>Here are just a couple of links regarding kidney function testing of 
>children and adolescents with diabetes. They might be all you need at the 
>moment, certainly if you want more info I can help you find some.
>
>http://tinyurl.com/s2f7a
>
>ISPAD guidelines:
>http://www.diabetesguidelines.com/health/dwk/pro/guidelines/ispad/16_04.asp
>highlight: Recommendation of age for microalbumin screening
>Prepubertal onset of diabetes: 5 years after onset or at age 11 years, or 
>at puberty (whichever is earlier), and annually thereafter
>Pubertal onset of diabetes: 2 years after onset, and annually thereafter
>
>If you feel your team might not take seriously your concerns regarding 
>Alex's kidneys, feel free to print off the ISPAD document and take it to 
>them. Any diabetologist or DSN ought to have a strong case prepared if he 
>or she wishes to object to an ISPAD consensus document.
>
>
>Melissa
>Type 1 13 years; MiniMed pumper 7.5 years; Animas pumper 2 years 5 months
>
>
>----Original Message Follows----
>From: "Marion Malik" <email @ redacted>
>Reply-To: email @ redacted
>To: <email @ redacted>
>Subject: RE: [IPk] Urine testing for kidney function
>Date: Wed, 7 Jun 2006 15:50:49 +0100
>
>Melissa,
>
>Alex is nearly 12 and has had D for 9 years, other than the dip stick
>test she has her standard annual bloods done, before being diagnosed she
>had a kidney scan etc as they thought there was a problem and I would
>like to mention this test you mentioned.  I take it that they will know
>what it is but do you think they will think I'm being over sensitive?
>
>Hope you don't mind me asking
>
>Marion
>.

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