Protein in the pee

[hoolyuk]

What would be considered high for protein in a urine test?

Had first set of test results since going onto 1000mg of metformin per day, my hba1c was 7.3 am now on 1500mg per day.

But a locum doctor has recommended i switch my bp meds from losartan to ramipril because a urine sample was reading 67 for protein....it had been 32 last november, which was apparently too high also, but neither my practice nurse nor normal gp had mentioned it in the past.

 

[anniep]

I don't know what the reading should be i'm afraid but the same thing happend to me earlier this year, they cahnged my BP medication from propranalol to lisinopril because of protein in my wee.

 

[Sid Bonkers]

I dropped off a sample yesterday so am waiting for next week and the results.

Extract from UK Kidney Federation Web Site.

"A PCR of less than 2 mg/mmol is normal.

Levels of up to 50 usually do not indicate serious kidney disease, so long as the kidney function (measured by blood creatinine level or eGFR) is normal.

However, a PCR of 20-50 in someone who has diabetes will require further action, especially to reduce the blood pressure, improve the control of diabetes and check the blood cholesterol level .

A PCR of 50-300 usually requires some further testing. A PCR of greater than 300 may mean that nephrotic syndrome is present."

Source http://www.kidney.org.uk/Medical-Info/k ... turia.html

Further info "Diabetes and the Kidney" http://www.kidney.org.uk/Medical-Info/k ... betes.html

 

[hoolyuk]

Thanks.

Am further puzzled because am just after reading the bumf for losartan [50mg], my current bp meds, and it specifically mentions that it helps in the case of high protein content in urine, wereas the ramipril [2.5mg] leaflet doesn't refer to the kidneys at all.....think i'll hold back on starting ramipril until i talk to practice nurse on monday.

Losartan has controlled my bp perfectly for around 18 months now, last reading was 120/84.

 

[Sid Bonkers]

Hi hoolyuk, my wife worked for a very well respected cardiologist at the time I was diagnosed and as I also had an SVT (fast erratic heart beat) he offered to come and see me on the ward when she told him I had been admitted. After reading my notes and having a quick chat the first thing he did was switch one of my bp pills (Amlodipine) to Ramipril, and he said "Ramipril has the beneficial side effect of protecting the kidneys against the ravages of diabetes" I can remember his words like it was yesterday. I would not have seen this consultant had my wife not worked for him and I have no doubt that his is advice was sound. He has since emigrated to Australia so sadly the Uk has lost a brilliant young cardiologist.

Hence I have no problem at all taking Ramipril. In fact it was his words "the ravages of diabetes" that connected with me and made me take my diabetes so seriously from the beginning.

 

[Hobs]

a locum doctor has recommended i switch my bp meds from losartan to ramipril because a urine sample was reading 67 for protein....it had been 32 last november, which was apparently too high also, but neither my practice nurse nor normal gp had mentioned it in the past.

A recent new policy at my surgery saw them trying to switch me from candesartan to ramipril and I remembered it gve me an irritating tickly dry cough and also made my Raynaud's worse before, so I challenged the decision and finally was told it was mainly a costing exercise and my candesarten was £14.54p more expensive per month. So I would suggest you enquire why you are being switched and it is for your benefit and not a financially driven decision.

I've had this cost cutting exercise tried on me with other meds (such as non scored tabs for scored where 1/2 has to be divided) but after challenging the decision everything was switched back to where it was before.

Ya gotta watch these penny pinching accountants .. LOL

 

[catherinecherub]

Been reading through this thread.
Propanolol is a beta blocker and that will not protect the kidneys.
Both Ace inhibitors,Ramipril, and ARB's, Losartan, are used to protect the kidneys so it may well be down to cost.

 

[anniep]

I don't know that the locum doctor would be too bothered about the practices drug bill! But all the same if you have any questions discuss them with the people you know and trust.

 

[mehdave]

If you do get put on ramiprill don't get generic capsules, Ask for Tritace its a tiny pill and by senofi aventis so from a decent company.
They tried swapping me onto a giant generic one made in Israel that was 3 times the size.

Im on it to protect my kidneys and lower bp as I have allot of protein in the urine and was then diagnosed with kidney problems so get them checked

 

[hoolyuk]

Got a chat with practice nurse today, am staying on losartan but doubling the dose her and my normal gp had agreed this before the locum switched me to ramapril....Would have concerns now about BP dropping too low as was 124/80 at last reading

 

[sugar2]

Hi. I am T1, but in my experience, they are trying to put all T1s (not sure about T2s..sorry!) on ACE inhibitors. my practice nurse put it quite bluntly....we will try and give you as much as you can take, to protect your kidneys from any further damage. She questioned my dose becasue I am on 1.25...which is really low, but it seemed to be doing the trick. I am now on Ramipril, after moving from lisinopril becasue it gave me a dry, tickly cough.

My BP is OK, as is my cholosterol...so it is just teh kidneys it is for...everything else is a bonus I guess!

 

[ShyGirl]

 

[hoolyuk]

I wouldn't get too despondent yet, my last protein reading had dropped by about a third......the further along my diabetes moves the more i realise its not an exact science and i suspect many of the "professionals" haven't a clue what they are talking about.

 

[mehdave]

Try not to get to worked up yet. Protein in the urine can be a symptom of many conditions if they believe it may be serious they will usually do some further testing and after ruling out things that can cause proteinuria will move onto a kidney biopsy etc.

So untill then try not to worry.

 

[sugar2]

Hi Shygirl,


2 things, that will hopefully make you feel a bit better??!

If the rama pril doesn't work for you, ask you Dr to awap to another drug. I was on Lisinoril,,that gave ame a slightly irritating, but not major cough. I mentioned to my GP, who switched me to ramapril..and teh cough went. maybe you just need a similar switch?

The damaged forever thing is a scary thing...but, if can be improved. Yes, you kidneys are not perfect, but they are far from useless, and you can make them work as well as possible by keeping control of your diabetes. When I was pregnant, my PCR results went up to the mid 500s...ecck! but once I had my baby, and went back on teh ramoril, they came back down to 30. OK, not great, but not too bad. You can improve things.

I think I mayhave said this already, but I know that some consultant believe that all diabetics should be put on ACE inhibitors as a precautionary measure.

Think I am on teh cheepy ones though.. they are capsules. i am on a really low dose, as my blood pressure is OK.

 

[donnellysdogs]

Apparently I had protein in my pee last year, and nobody mentioned it to me. It was only when I saw the pump specialist and had another bha1c and pee test, that she told me that I had protein in the previous sample, but none in this one??

I'm on 2.5mg of ramipril, but does anybody know how the dosage you should take should be worked out, as many people I know are on higher doses. I was told by a GP previously that they recommended all diabetics to take them because it protected the kidneys for diabetics, and he never mentioned blood pressure. Even when I have had really low blood pressure readings nobody has ever said anything about the ramipril.

 

[cugila]

DD said : I'm on 2.5mg of ramipril, but does anybody know how the dosage you should take should be worked out, as many people I know are on higher doses.

Sharon.
The dose instructions for Ramipril are as follows. As you will see it varies depending on what it is actually prescribed for...........

• Hypertension, initially 1.25–2.5 mg once daily, increased at intervals of 2–4 weeks to max. 10 mg once daily; if used in addition to diuretic see notes above

• Heart failure (adjunct), initially 1.25 mg once daily under close medical supervision (see notes above), increased gradually at intervals of 1–2 weeks to max. 10 mg daily if tolerated (preferably taken in 2 divided doses)

• Prophylaxis after myocardial infarction (started at least 48 hours after infarction), initially 2.5 mg twice daily, increased after 3 days to 5 mg twice daily

Note
If initial 2.5-mg dose not tolerated, give 1.25 mg twice daily for 2 days before increasing to 2.5 mg twice daily, then 5 mg twice daily; withdraw if dose cannot be increased to 2.5 mg twice daily

• Prophylaxis of cardiovascular events, initially 2.5 mg once daily, increased after 1–2 weeks to 5 mg once daily, then increased after a further 2–3 weeks to 10 mg once daily

• Nephropathy, initially 1.25 mg once daily, increased after 2 weeks to 2.5 mg once daily, then increased after a further 2 weeks to 5 mg once daily if tolerated.

Source : BNF61 (2011)

 

[donnellysdogs]

Ken
Thanks for the info...but what am I??? I have low blood pressure normally (except under DVLA stress!!!!) and as far as I knew no kidney probs....the article you highlighted...didn't say 'general diabetic' so I don't know what catgory I fall in!!!! I know I am thick....thank you for the info that I haven't quite grasped what actually applies to me!!! I been taking this drug for at least 8 years at this quantity, and haven't got a clue actually what dose applies to me....
Thanks Sha x

PS...may have to have another look tomorrow, as hubby's birthday and have already started on a bottle of drambuiee he bought me for HIS birthday....bless him!!!! Perhaps it will make more sense tomorrow!!!

 

[cugila]

If you don't know it might be an idea next time you see the Doc to ask just why you are on it ?

As for the Drambuie......hubby is in for a 'rough' night then...... :lol: Some of us Men are glutton's for punishment !! Happy Birthday to the 'old man' and enjoy the rest of the Night........ :wink:

 

[donnellysdogs]

Yep, veering off the subject of the protein and ramipril have bought him a metal detector-can't wait to use it at the weekend...... have also got him a mini collapsible digging spade!!!! Can't wait, he'll have a rough night tonight, already had to set pump to working at 250% extra!!!!!! Thank you Ken, I will ask GP next week....