Limited Care
• Check annually for proteinuria in an early morning urine sample (or a random sample) using a dipstick. If test is positive exclude UTIs by microscopy (and culture if possible).
• Measure serum creatinine and calculate eGFR annually.
• A simple inexpensive screening procedure for urinary protein excretion which can be used as a diagnostic test in outpatient has been reported in Indian population. Estimated proteinuria is useful in serial evaluation of kidney function.
• Manage those with proteinuria as follows:
▫ Consider use of ACE inhibitors or ARBs and SGLT2 inhibitors unless contraindicated or issues with tolerability
▫ Aim for BP ≤130/80 mm Hg using any BP lowering medication and control of salt intake [Table 13]
▫ Aim to achieve targets for blood glucose control
▫ Aim to improve lipid profile using available medications
▫ Check proteinuria status annually
▫ Measure serum creatinine and calculate eGFR annually