Proteinuria >500 @ 12 weeks

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Proteinuria >500 @ 12 weeks

Postby lisamk » Mon Mar 29, 2004 03:41 pm

Can you tell me what this means?

I'm a type II diabetic, as I have been since the birth of my daughter (only child) 2-1/2 years ago. I normally take glucophage, but since I found myself to be pregnant I have switched to insulin. My blood sugars are well under control at this time.

At 12 weeks my 24 hour urinalysis showed:

547 mg/dl protein
Normal creatinine clearance is 75-125 mL/min and mine is 280
Normal creatinine is .8-1.8 gm/spec and mine is 2.4

Any help would be appreciated.



Other info: I've been experiencing swelling (6 pound gain in the past 2 weeks) and headaches in the past few weeks. Not sure if that is related.

Blood pressure today was 118/70 and last week was 132/80.


Thank you for your time!

Lisa
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Re : Proteinuria >500 @ 12 weeks

Postby annegarrett » Mon Mar 29, 2004 08:03 pm

Response from our Expert:

You are not eating too much protein. Unfortunately, you have significant proteinuria in the face of type II diabetes. Given that you are 12 weeks, I am confident that you had the problem BEFORE you became pregnant.

You probably have diabetic nephropathy. It is important that when you are not pregnant your blood sugar AND blood pressure are treated aggressively. BP's should be < 130/80. Treatment with an ACE-inhibitor should decrease your proteinuria and protect your kidneys.

While you are pregnant, your BP might be treated to a similar standard. In general, aggressive treatment of BP in pregnancy is controversial - but not in women with diabetic nephropathy. Your health condition is manageable in pregnancy, but it needs an aggressive approach by someone with experience with diabetic nephropathy in pregnancy.

I would recommend looking for care with a perinatologist in one of the medical centers in LA. You might best ask for someone with experience with diabetic nephropathy in pregnancy.

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From me:

If you need help finding a referral in the LA area--we have a local support group. Please let us know and we will see what we can find.

Take care,

Anne Garrett
Executive Director
Preeclampsia Foundation
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