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



Hi Caroline

Six weeks ago my prescription told me to get a creatine rest done but did 
not enclose the form.  When I asked the receptionist for the form she said 
it was not written on my notes that I needed one but might be as I have been 
on stronger statins since Christmas.  The burst then said if I am going to 
the hospital at the end of June they would leave it to them as there was no 
point in doubling up an expensive test.  Trouble is I feel this keeps 
happening and the hospital do not explain to me the results of any tests 
except the HbA1c.  I do not go to a local hospital but one in London and it 
seems they do not send all the results down.  The result is I am left like a 
piggy in the middle.  I only started wondering about this when the statin 
thread started up.

June

----- Original Message ----- 
From: "Caroline Batistoni" <email @ redacted>
To: <email @ redacted>
Sent: Wednesday, June 07, 2006 7:42 PM
Subject: RE: [IPk] Urine testing for kidney function - children/adolescents


> 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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