A 14 yr-old girl with type-1 diabetes (T1D) attends clinic for her annual review appointment. An albumin creatinine ratio (ACR) on spot urine is 7.3mg/mmol. Her blood pressure is 125/67 and HbA1c 9.2%. Subsequently, three consecutive early morning urine samples have ACR of 6.8, 5.7 and 7.3 mg/mmol, respectively and when repeated a further 3 and 6 months later, they remain elevated. You are aware that in adult women with diabetes persistent microalbuminuria (MA) is defined as an ACR greater than 3.5 mg/mmol on 2 out of 3 successive occasions, and that in such adults, treatment with angiotensin converting enzyme inhibitors (ACEi) confers renoprotection. You wonder whether your patient should be treated.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.