From New York, New York, USA:
Doctors usually suggest that people with diabetes should have their kidney function examined for any sign of the microalbuminuria at least once a year. Does this mean that it can be reversed or cured with ACE inhibitors if detected before it progresses over a maximum of one year? Can ACE inhibitors only delay its long-term progress to a more serious nephropathy including the renal failure? I think there is a big difference between reversing and simply delaying the progress of the disease. Can diabetic nephropathy can be cured if detected early enough?
We think that microalbuminuria is a marker for increased risk of nephropathy. However, it is not established that microalbuminuria ends in chronic end-stage renal failure. Intervention studies using ACE inhibitors have shown that patients with microalbuminuria, who are treated with ACE inhibitors, have protection from long-term kidney function deterioration.
We do not yet have such information as it applies to patients with diabetes and no microalbuminuria. When the medications are instituted, I would titrate the medication to allow for normalization of the albumin excretion rate or until there are side effects of the medicine.
Original posting 21 Mar 2001
Posted to Complications
Last Updated: Tuesday April 06, 2010 15:09:19
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