I just posted the question regarding what to do regarding the 24-hour urine protein of 530 mg’s (along with an undiagnosed, long-standing autoimmune disease). I should have also added that I am a 55-year old male and my kidney filtration rate was just checked and is entirely normal. For several months at least I have had very minor facial and ankle swelling in the morning as well as extreme thirst. I also notice some slight foaming of my urine at times. I just had a 24-hour urine protein test that came back at 530 mg’s. As a bit of background: I have had symptoms (Raynaud’s, heart arrhythmias, etc.) of scleroderma or a related autoimmune disease for years but no underlying diagnosis yet as I have no skin involvement and all antibody tests are always negative. At any rate, from a kidney perspective, what would you recommend for me or what is my next step? I take Nifedipine for heart issues and my blood pressure is fairly low (typical 95/55 to 110/60) so wouldn’t it be difficult for me to take an ACE inhibitor in addition?

I am unable to provide a specific diagnosis based on the information that you present.  Scleroderma and protein in the urine (proteinuria) are both treated with ACE-inhibitors or ARB agents.  I cannot recommend treatment without performing a complete history and physical examination.  You may need further consultations with your nephrologist and your rheumatologist.  I suggest further consultation regarding your diagnosis and treatment plan.

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