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Kidney Diseases

ALB/CREATININE RATIO

08/24/2007

Question:

32 YEAR OLD,INDIAN FEALE,MOTHER OF A ONE YEAR OLD CHILD, URINE EXAMINATION SHOWED BLOOD ++,CULTURE :NO GROWTH,NORMAL BLOOD SUGAR,CATECHOLAMINE,RENIN ALDOSTERONE LEVEL NORMAL,AND OTHER KIDNEY RELATED TESTS ARE NORMAL EXCEPT ALB/CRET RATIO OF 27.1mg/mmol creat.RECENTLY DIAGNOSED AS HYPERTENSIVE AND IS ON COVERSYL 7.5 MG(PERINDOPRYL ARGININE).MY FIRST BLOOD PRESSURE READING WAS 160/96 AND THE DOCTOR PUT ME ON 5 MG COVERSYL .THE NEXT READING WAS 140\80 BUT THE DOSE HAS INCREASED TO 7.5 mg IS THIS REPORTS INDICATE ANY SERIOUS KIDNEY PROBLEM? DO I HAVE TO CONTINUE THIS MEDICATION FOR LONG TIME? AS THIS INVESTIGATIONS WERE ,PART OF VISA APPLICATION,ARE THESE RESULTS ENOUGH TO DENY MY VISA?

Answer:

Since you do not provide the results of your blood tests (BUN and creatinine), I cannot tell whether your kidney function is completely normal.  The microalbumin/creatinine ratio indicates that your kidneys are leaking a small amount of protein, which is a sign of damage.  You also mention that you have some blood on urinalysis. 

In your area of the world, a disease called IgA nephropathy (sometimes called Berger's disease) is common, and this can cause blood and protein in the urine, and sometimes high blood pressure.  This disease is diagnosed by kidney biopsy.

On the other hand, you could have just high blood pressure, which can result in kidney damage and protein in the urine.  In either case, the blood in your urine does need further investigation.  If you were having your menstrual period at the time, the blood may be as a result of that; but if the blood was truly in your urine, at least an ultrasound of the kidneys needs to be done to see if any reason for bleeding shows up. 

As far as treatment for your blood pressure: you will probably need to take medication for the rest of your life.  Good blood pressure control (120/75 or lower) is very important in preventing further damage to the kidneys.  You should be seen by a kidney specialist, who can help to decide what studies (such as ultrasound or biopsy) are needed at this time.  Once the tests are completed, your physicians may be able to advise you whether your kidney abnormalities will affect your visa application.  Best of luck to you! 

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Response by:

Mildred   Lam, MD Mildred Lam, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University