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50 y/o female diagnosed with t2 dm a year ago. recent test…

hi. 50 y/o female diagnosed...
hi. 50 y/o female diagnosed with t2 dm a year ago. recent test results: bun 11, creatinine .96, egfr greater than 60 (per reference range on report, these are all normal), urine tests: microalbumin 18.6 mg/L, crea concentration .36 g/L, and albumin/ creatinine ratio 51.67 mg/G ( no reference ranges given, except last one should be 25 or less per report).1). is this diabetic nephropathy?
2). my blood pressure runs 150/85 on atenolol and chlorthalidone; is my hbp damaging my kidneys?
3). if in kidney failure, what stage?
4). should i be on an ACE inhibitor or ARB instead? but i also tend to have a slightly high heart rate before being on atenolol. would an Ace or Arb help lower heart rate like atenolol?thanks!kate
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Answered in 30 minutes by:
3/9/2018
drphophalia
drphophalia, Doctor
Category: Endocrinology
Satisfied Customers: 38,766
Experience: Do adrenal, thyroid and parathyroid surgery regularly.
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Customer reply replied 4 months ago
ok-thanks!

Hello and welcome, Kate.

Following are the answers of your questions;

1) It can be considered as very mild nephropathy. This can be due to diabetes or hypertension or both.

2) Your blood pressure may damage the kidneys in long term. Systolic blood pressure needs to be around 130 and less than 140.

3) You are not in kidney failure.

4) ACE inhibitor or ARBs, any can be started. They may not lower heart rate. But mild increase in heart rate would not be an issue at all.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 4 months ago
i guess i thought nephropathy was kidney failure-so i can have nephropathy without actual failure? sounds like i need better control of BP- will i likely stay on the atenolol and add an Ace/arb med? or just switch from atenolol to an ace/arb med? my a1c has never been higher than 7.1 (at least as tested)- how did nephropathy happen? is there anything else i should ask my doctor when i see her tomorrow? thanks so much for your help! kate

Kate,

Nephropathy is not kidney failure. Nephropathy is just kidney disease which can be mild.

You need to get your blood pressure better controlled by adding medicine.

A combination of atenolol and ACE/ARB is better for hypertension and nephropathy.

A good control of diabetes and blood pressure is key here.

Decreased salt in food, good physical activity, optimum body weight and relaxed life style is the best prescription, overall.

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drphophalia
drphophalia, Doctor
Category: Endocrinology
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Experience: Do adrenal, thyroid and parathyroid surgery regularly.
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