Diabetic Nephropathy

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Diabetic Nephropathy

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new_n_lost
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04/02/07 - 04:48 PM

A 57 year old man with diabetic nephropathy has a plasma creatinine of 380µmol/l. He has the following blood results : potassium 5.2 mmol/l, calcium 2.20 mmol/l, albumin 42 g/l, phosphate 1.55 mmol/l, and PTH 1.6 pmol/l (NR 1.1-6.8). Which of the following statements is correct?

A. Alucaps should be given
B. There is tertiary hyperparathyroidism
C. An ACE inhibitor will make things worse
D. He should be commenced on alfacalcidol
E. Calcium acetate should be started

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Justice
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04/02/07 - 05:34 PM

doc_clotaire
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04/02/07 - 06:50 PM

C would hurt this dude Big Time

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new_n_lost
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04/02/07 - 11:30 PM

doc_clotaire wrote:
C would hurt this dude Big Time

lol yes

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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

sprint123
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04/03/07 - 08:44 AM

Hey new..Can u exlain more on this???

Justice
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04/03/07 - 09:35 AM

The Pt has the end-of-the stage disease. ACE will induce hypoperfusion of glomeruli ==> worsening of the function. Am I correct?

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new_n_lost
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04/03/07 - 10:18 AM

ACEIs Although said to be reno protective but when the pt is in Renal Damage or in a Diabetic Pt their effects r said to be not protective so its advisable to avoid the ACEIs

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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

docnikki
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04/04/07 - 09:03 AM

hey new and lost..just want to make one correction.

ACE I are preferred in diabetics as long as there cr is below 2. they delay the nephropathy..but if Cr is over 2.5-3.5 they cause damage instead.

So when we Give ACE I we must check Cr and if in aweek the Cr has risen more than 25% or if the serum K is elevated to >5.5 then we must stop the drug. smiling face

GOODLUCK

new_n_lost
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04/04/07 - 12:13 PM

Thanks Doc Nikki

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"never argue with a fool, they'll bring you down to their level and beat you with experience" FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

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