What can and should be done in patients with microalbuminuria to reduce the cardiovascular and renal risks?
A knowledge of an existing microalbuminuria and other risk factors, together with an unhealthy lifestyle, means the patient can be offered better care. Known insulin resistance (prediabetic metabolism, metabolic syndrome) should be used to motivate the patient to more exercise and to lose weight if he/she is overweight. When prescribing antihypertensive agents, it is worth checking for metabolic neutrality of the active substance. Diuretics, which can cause glucose tolerance to deteriorate, should preferably not be prescribed as monodrug therapy. Disorders of lipid metabolism, usually hypertriglyceridaemias, which (together with overweight, disturbances of glucose tolerance and hypertension) are known to be components of the “metabolic syndrome”, require correction of eating habits and, if the lipid concentrations do not then fall sufficiently, additional therapeutic measures are needed. Does the sparing use of salt lower the blood pressure? If so, this is an indication of salt sensiti
