To be included need to have a code for Proteinuria OR microalbuminuria
Codes for proteinuria
- R110. [D]Proteinuria
- R1100 [D]Albuminuria
- R110z [D]Proteinuria NOS
- C10EK Type 1 diabetes mellitus with persistent proteinuria
- C10FL Type 2 diabetes mellitus with persistent proteinuria
- K190X Persistent proteinuria, unspecified
- Kyu5G [X]Persistent proteinuria, unspecified
Codes for microalbuminuria
- R1103 [D]Microalbuminuria
- C10EL Type 1 diabetes mellitus with persistent microalbuminuria
- C10FM Type 2 diabetes mellitus with persistent microalbuminuria
-
Ace inhibitor contraindications; persistent
- 14LM. H/O: angiotensin converting enzyme inhibitor allergy
- U60C4 [X]Angiotensin-converting-enzyme inhibitors causing adverse effects
in therapeutic use
- ZV14D [V]Personal history of angiotensin-converting-enzyme inhibitor allergy
TJC77 Adverse reaction to captopril
TJC78 Adverse reaction to enalapril
TJC79 Adverse reaction to ramipril
Ace inhibitor contraindications; expiring (15 months)
- 8I28. Angiotensin converting enzyme inhibitors contraindicated
- 8I3D. Angiotensin converting enzyme inhibitor declined
- 8I64. Angiotensin converting enzyme inhibitor not indicated
- 8I74. Angiotensin converting enzyme inhibitor not tolerated
AII antagonist contraindications: persisting
- 14LN. H/O: angiotensin II receptor antagonist allergy
- U60CB [X]Angiotensin II receptor antagonists causing adverse effects in
therapeutic use
- ZV14E [V]Personal history of angiotensin II receptor antagonist allergy
AII antagonist contraindications: expiring (15 months)
- 8I2H. Angiotensin II receptor antagonists contraindicated
- 8I3P. Angiotensin II receptor antagonist declined
- 8I6C. Angiotensin II receptor antagonist not indicated
- 8I75. Angiotensin II receptor antagonist not tolerated
Ace inhibitor prescription codes (prescribed in
the last 6 months)
- bi...%
- bA…%
- bk6..%
AII antagonist prescription codes (prescribed in the last 6 months)
- bk3.. - bk5z.
- bk7.. - bk9z.
- bkB..%
bkD..% (v12)
DM 15.1 Rationale
The progression of renal disease in patients with diabetes is slowed by treatment
with ACE-I, and trial evidence suggests that these are most effective when given
in the maximum dose quoted in the BNF. Although trial evidence is based largely
on ACE-I, it is believed that similar benefits occur from treatment with Angiotensin
II antagonists (A2) in patients who are intolerant of ACE-I.
Patients with a diagnosis of microalbuminuria or proteinuria should be commenced
on an ACE-I or considered for Angiotensin II antagonist therapy.
Further information
SIGN clinical guideline 116 (2010). Management of diabetes.
http://www.sign.ac.uk/guidelines/fulltext/116/index.html
DM 15.2 Reporting and verification
The practice reports the number of patients with a prescription for ACE-I or
A2 antagonist in the preceding six months as a percentage of patients on the
diabetic register who have microalbuminuria or proteinuria.
Prepared By Jean Keenan