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 inhibitors, and trial evidence suggests that these are most effective
when given in the maximum dose quoted in the British National Formulary (BNF).
Although trial evidence is based largely on ACE inhibitors, it is believed that
similar benefits occur from treatment with angiotensin II antagonists (A2) in
patients who are intolerant of ACE inhibitors.
Patients with a diagnosis of microalbuminuria or proteinuria should be commenced
on an ACE inhibitor or considered for angiotensin II antagonist therapy.
Grade A Recommendation SIGN 55
Further information: www.sign.ac.uk/guidelines/fulltext/55/index.html
DM 15.2 Reporting and verification
Practices should report the number of patients with a prescription for ACE
inhibitor or A2 antagonist in the last six months as a percentage of patients
on the diabetic register who have microalbuminuria or proteinuria.
Prepared By Jean Keenan