Raised ACR

[pau1200]

hi, I am a type 2 diabetic and have been for about 4 years. I have been struggling a bit with my blood sugars but it’s been 2 years since my last checkup because of covid. I have just lost a family member to liver failure due to diabetes and one of the nurse mentioned keeping an eye on things like urine. I have had foamy/bubbly urine for years. I have managed to get access to my last lot of lab work 2 years ago and I had a raised ACR of 13 with albumin of 316mg/L. My eGFR was 90 at the time but I feel it should have been checked more often knowing what I have read. The doctors have agreed to a blood test which is being done tomorrow but I’m not sure what I am facing and questions I need to ask etc

[Bassetmommer NKF Ambassador]

Sometime diabetes can lead to CKD. It is important to keep your blood sugar as steady as possible and try to get the number down. A GFR of 90 is excellent but you should get it checked annually, or even twice a year. Ask to have a renal panel run so you have a base line of your numbers. Getting a referral to a dietician can make a big difference. Exercise and diet play an important role in management of diabetes.

Just having foamy urine really means nothing. Everyone says it's a sign, but not really. It good just be the air that gets churned up when you urinate.

Let us know how the blood test turns out.

[pau1200 in reply to Bassetmommer]

hi,

So I have finally had my results back, my egfr was 90 which the doctor said was normal. My ACR was 1.92mg/mmol with albimum of 24mg/L and creatinine if 12.5mmol/L.

I did mention that it have been suffering with bubbly foamy urine most of the times with the odd time of no foam. He said there is protein leaking but they only look at the ratios and that is fine. I did ask if it should be checked again and he said there is no point, if I had ckd it would be shown in the acr test. He told me to keep an eye on it but I have no idea what that means. I did ask the question about is there a chance the test results may have got mixed up but he said no. He said we will check it in another 12 months but it could just be my body loosing excess sugar through urine which is causing the froth.

Not sure what to do but I will continue with losing weight and exercise and if it starts to get worse go back. Does that sound like the best thing to do or should I be demanding more tests

[Bassetmommer NKF Ambassador in reply to pau1200]

What do you mean you do not know what to do. You got a good report. NO CKD, move on with your life with a happy dance. Take care of your diabetes and you should be ok. Stop the worrying about the foam, for heaven's sake. Test again in a year, or if you really think you need to, in six months.

[pau1200 in reply to Bassetmommer]

Thankyou I will, I think losing a family member to diabetic complications has made me worry. Thanks for your excellent and appreciated advice

[orangecity41 NKF Ambassador]

Here is a link to information on eFGR that might help you in discussion with your Doctor on eGFR test results. kidney.org/atoz/content/gfr

[Blackknight1989]

It’s a US site but should be relevant. Instead of the link I just copied it for you. Here you go:

Ask your health care provider questions

Ask your health care provider the following key questions about your kidney health during your next medical visit. The sooner you know you have kidney disease, the sooner you can get treatment to help protect your kidneys.

Key questions for your health care provider:

What is my glomerular filtration rate (GFR)?

What is my urine albumin result?

What is my blood pressure?

What is my blood glucose (for people with diabetes)?

How often should I get my kidneys checked?

Other important questions:

What should I do to keep my kidneys healthy?

Do I need to be taking different medicines?

Should I be more physically active?

What kind of physical activity can I do?

What can I eat?

Am I at a healthy weight?

Do I need to talk with a dietitian to get help with meal planning?

Should I be taking ACE inhibitors or ARBs for my kidneys?

What happens if I have kidney disease?

Fairly comprehensive without being too specific or too much. It’ll be a whirlwind so take a notebook and pen and write these down before the appointment. I understand your choices of docs are different in the UK but if the doc won’t take the time and answer to your satisfaction if possible can him/her and go find another. My best to you

[Darlenia]

Hi! It's fortunate that you've noticed the impact of diabetes on your family and it's implications for you. Yes, it's true - diabetes is the leading cause of kidney failure. It happened to my hubby. Many don't realize that high glucose levels stiffens and shuts down blood vessels throughout the body - eyes, legs, kidneys, and more. Diabetes will shorten one's life if allowed to do so. So removing sugar and carbs (which turn into sugar) from one's diet is essential for a quality life. Thankfully, you're in the window of time to turn matters around since it generally takes about a decade or two for major complications to strike. Sadly, my hubby simply relied on medications and didn't take it seriously. His mother, on the other hand, immediately took charge, changed her diet, lost weight, and never needed any meds. She lived well into her 80s. Two different people, two different choices. It can be done - my hubby got off all insulin and related while on dialysis. (Almost everyone at his center were diabetics.) Please seek assistance from a dietician or doctor if needed for diet guidance. Label reading will play a huge part in all of this. I know this is hard to hear - looking back, however, we wish our medical team had been more direct with us. You're blessed in that you have time to change matters. Sending you encouragement! I sense you will be successful in doing so. Blessings.

[pau1200 in reply to Darlenia]

Hi, Since my diabetes diagnosis I havnt coped well and had my head in the sand and just took the medication. I have now changed tact and take responsibility fir sorting it out. Regular testing of blood sugar has my reading in the 6mmol range and now do an hour a day of medium paced walking. Diet like you said has changed and I’ve lost about 10kg so far. There is just a lack of advice from the doctors and nurses I have met so far, if I had realised I had high albumin and what that meant 2 years ago I may have panicked and taken my diabetes more serious. I have had my bloods taken today but won’t see the doctor for another week, just trying to prepare myself and now what to ask but I’m a little scared. Hopefully I will get my results back before the appointment to at least have an idea of what’s going on.

[Darlenia]

Fantastic! You're exercising and paying attention to weight and nutrition. You're also paying attention to lab data. Few do that that in a serious way - but you're doing so. I'm very optimistic that your new labs will show improvement! Keep on keeping on!