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Forum Name: Miscellaneous Nephrology Topics

Question: Treatment Protocol for Kidey Disease


 Dan Theman - Fri Aug 13, 2004 2:30 pm

I am 48 yrs old and have microscopic hematuria and heavy proteinuria. In Nov 2003 my protein expulsion was 1.4g; June 2004 it was 3.4g. I have been taking Altace (5mg) since Jan 2004. My Neprologist increased it to 7.5mg in July and wants to recheck the protein in October. All the Kidney blood and urine tests are normal as are the CT scans and Kidney ultrasound I took. With the 3.4G protein loss I guess I would be considered borderline nephrotic syndrome but according to the doctor I am asymptomatic. My question is the following: Is this protocol of increased Altace and waiting a reasonable one? I want to be sure there isn't anything else that should be considered rather than wait and get worse. I am of healthy weight, normal BP (avg 115/75) and otherwise feel in good health. Any info is appreciated. Thanks.
 Dr. Yasser Mokhtar - Tue Aug 17, 2004 8:54 am

User avatar Dear Dan,

i am not a nephrologist.

Altace is one of group of medications that has been proven to delay progress of kidney disease and decrease in proteinuria especially in diabetics.

He will be increasing the altace till the maximum dose or till the maximum tolerable dose.

What your nephrologist is doing is a good approach, i think the next thing to do is to have a kidney biopsy but since you are asymptomatic, i don't think that there is a need for the biopsy now.

Thank you very much for using our website http://doctorslounge.com and i hope that this information helped.

Yasser Mokhtar, M.D.
 Dan Theman - Wed Sep 15, 2004 12:23 pm

I went to a prestigious medical university and got a second opinion on my condition and treatment protocol and while the Nephrologist there basically agreed on my physician's course of action (Altace and retake 24hr test) he felt some additional blood tests should be done and that the Altace dosage was too low. (7.5mg daily) He wrote up some lab forms and said I could follow up with my own physician if I chose too or I could have them do the follow up. I am comfortable with my current physician but question why he wouldn't have ordered these tests as well. Also, how do I approach him with this info? If there is a Nephrologist monitoring this board, any info would be appreciated. Thanks.

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