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please advise on pts with proteinuria
Maggy

21 Posts

Posted:  11-Apr-2018 20:38
Hi, i am still struggling to understand this: if a diabetic pt already has proteinuria do we not need to continue doing annual ACR ?? what do we do ?? do we exclude them from testing ??

Maggy
angel66

1077 Posts

Posted:  11-Apr-2018 20:56
Persistent proteinurea needs to be investigated. Could be many things.Often end up under c/o nephrologist and have PCR or other urine test
Maggy

21 Posts

Posted:  11-Apr-2018 21:07
thanks angel66..im reading we don't need to investigate further if they are diabetic and appropriately managed, however I cant get my head around that NICE guidelines state send ACR in the ABSENCE of proteinuria and UTI, yet I thought we have to send ACR annually anyway and also to monitor if the proteinuria is getting worse?? .. Aw its difficult to get my head around

Maggy
angel66

1077 Posts

Posted:  12-Apr-2018 11:19
There is no point sending ACR as that is only looking for microscopic amounts of protein.If have proteinurea on dipstick test, ACR will be inappropiate test.
Should be looking for underlying cause eg renal damage, nephrotic syndrome, heart failure, infection etc etc. Need to code it as persistent proteinurea if ruled out all that and send PCR annually instead.Appropiately managed normally means they are under consultant care and they then do other tests.
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