Dmii, proteinuria reduced with lisinopril but still present after 4mos. is this diabetic nephropathy & can pcp handle or do i need specialist?

Most likely: Common things are common. Fits diabetic nephropathy. I am a nephrologist so I am biased toward having you see someone like me. We can ensure that any other possible causes of kidney damage have been considered and we can assist your primary care doctor in caring for you using the latest recommendations for the evaluation and treatment of kidney disease.

Nephrologist answer: I would not expect proteinuria to go away completely, even with lisinopril. The idea is to put you on max level of the drug that your blood pressure and your kidneys can tolerate. Goal blood pressure is 125/75. Creatinine needs to be followed carefully and diabetes needs to be controlled as well. If your pcp feels comfortable doing this, power to them. If not, get a nephrologist. Good luck!

Proteinuria: You should go to a nephrologist (n) to help you reduce your proteinuria (p). First of all make sure your Lisinopril (l) is at the highest dose, as p is reduced directly related to the dose of drugs like l. Drugs like dhp calcium channel blockers can also lower p, as well as drugs of the arb class. The higher the p, the greater the incidence of heart attacks, strokes and kidney failure. See a n.

Proteinuria DM ACEI: Proteinuria from DM type 2 is not uncommon. An ACE inhibitor is a standard of care treatment. It is best to titrate the dose of ACEI upwards every 2 months until proteinuria declines more than 50%. It is best to see a nephrologist. Perhaps dose of verapamil can be decreased to permit higher dosing of lisinopril. Target BP is about 120-130/75