I had Nephrotic Syndrome when I was younger..

[PatrickBelaga]

From ages 3 until 6, I had Nephrotic Syndrome and was on medications like prednozone.  Now that I am diagnosed with Autoimmune Diabetes I am worried that my kidneys may be strained.  The doctors said that it never completely goes away but it has been dormant since age 6.  I know it is one of the complications associated with Type 1 Diabetes and I was wondering if I should get it checked out. The doctors said I was extremely healthy but they only came to this conclusion from bloodwork.  Is there another method of checking my kidneys like an x-ray or an ultrasound?

[JDRF-VOL-SG]

In my experience (as a long-time type 1 diabetic), checking of kidney function nowadays is done with lab bloodwork, but a more accurate test is sometimes done by collecting urine for 24 hours. This is the way that kidney testing used to be done every year for me, but nowadays, the lab bloodwork is thought to be almost as accurate. You could ask your doctor whether the lab he or she uses can do the testing with 24-hour urine collection and whether there is any benefit to doing this test for creatine clearance. Most doctors check all diabetics' kidney function every year during our annual lab tests. In your case, you may want to ask your doctor if he should be testing kidney function every 6 months because of your early kidney problems. But the two should not be related... if no permanent damage was done by the early kidney problem, and you have not been one of the unlucky kids who has frequent relapses, I don't think I would worry if I were you. But if it makes you feel better to be checked more often than most folks, you may want to have kidneys checked more often than annually. Doesn't hurt to run the test.

But the blood test that your doctor ran that seems to be OK is the normal way that kidney function is tested in modern times, so you probably are absolutely fine as your doctor said. X-ray or ultrasound is not necessary, for the blood test shows whether kidneys are clearing proteins from the urine or not. Even if a small amount of protein seems to be present, from what I have read, this can be a false alarm (can even be caused by being a bit dehydrated, so always drink plenty of water before you have your annual lab tests). I have read that what you need to look for is a pattern of several annual tests showing some protein and that protein becoming more and more present if kidneys are starting to fail. It doesn't happen overnight, but is a slow failure as small blood vessels become damaged in time if it happens.

In any event, it happens when people do not manage their glucose levels well, and tests have shown that if the hemoglobin a1c test (done every time you come to your doctor for regular checkups) is under the magic number of 7, complications are not likely to happen. If your kidneys are fine now, and you keep your sugar levels under good enough control that the a1c test is 7 or below, you probably needn't worry.

The a1c test, by the way, is a blood test that shows how well overall control has been for the past 3 months. Since your glucose levels have been high for a while until being diagnosed, it may be that your a1c may be high for a while, but in about 6 months, you will be able to look at that number when you go in for a checkup and see how well you are doing. In my experience, some doctors don't tell you what that number is unless it is out of whack, but I recommend that you call him after your lab work each time you go in for a checkup and ask for the results of the a1c test. The better educated you are, the better off you will be. You are asking very smart questions right now. Good for you! I hope you are healthy forever.