Frequency of microalbuminuria in diabetic patients of Islamabad and Rawalpindi

ABSTRACT

To assess the frequency of microalbuminuria and correlate it with the risk of renal failure in diabetic patients and correlate microalbuminuria with serum Creatinine, a marker of renal damage. Type of study and Setting: This was a descriptive study done at Public Health Laboratories Division [PHLD] of National Institute of Health from May 2004 to April 2005. Two hundred known diabetic patients [both type I and type II] visiting were included in the study. Data on age, gender, family history, systolic and diastolic blood pressure, height and weight was recorded on a questionnaire. Urine and blood specimen were collected and analyzed for proteinuria, microalbuminuria, blood glucose and Creatinine, using Randox kit methods. Fasting plasma glucose level of 126 mg/dl or above was taken as diagnostic criteria for diabetes mellitus, as per standards of WHO. All patients of both genders irrespective of age who had type I or II diabetes for over 5 years and a negative urine dipstick test were selected for the study. Patients with other causes of proteinuria, recent respiratory and urinary tract infection, high grade fever and with clinical proteinuria were excluded. Out of 200 cases 56 [28%] had microalbuminuria. Thirty three patients [59%] had microalbuminuria of less than 75 mg/L. The mean age of the patients was 46.5 years and mean duration of diabetes was 7.63 years. Both in type-1 and type-II diabetes microalbuminuria positivity rate [microalbumin level 20 to 300mg/L] was almost similar i.e. 29% and 27.8%, respectively. No significant relationship was found between gender and microalbuminuria in both types of diabetics. Serum Creatinine, a marker of renal damage, was also measured in all 200 cases and out of 56 microalbuminuria positive cases, only 20 [36%] had a raised serum Creatinine. Patients with microalbuminuria of less than 75 mg/L are the candidates for therapeutic and dietary interventions as they are at the risk of nephropathy and other complications. For the early diagnosis of renal damage in diabetic patients, microalbuminuria is the better marker than serum Creatinine