Prevalence of Diabetic Nephropathy in Type II Diabetes Mellitus Patients Admitted to a Tertiary Care Centre in Mizoram

ABSTRACT

Diabetic Nephropathy is a microvascular complication leading to impairment of renal function which occurs in the patient with long standing diabetes mellitus. Diabetic nephropathy is the leading cause of chronic kidney disease (CKD), end stage renal disease (ESRD) and CKD requiring renal replacement therapy. Furthermore, the prognosis of diabetic patients on dialysis is poor, with survival comparable to many forms of cancer. Fortunately, in the recent years, apart from better metabolic control of diabetes, specific nephro-protective interventions have become available. The true prevalence of diabetic nephropathy is underestimated because proteinuric patients are usually asymptomatic. The aim of this research is to find out the prevalence of microalbuminuria, overt proteinuria and ESRD in diabetic patients. Methods: The study was conducted in the Department of General Medicine, Civil Hospital, Aizawl. Type II Diabetes Mellitus patients admitted in the General Medicine ward were included in the study. 117 cases of type 2 diabetes were subjected to detailed clinical examination and investigations. Blood glucose estimation, urinary albumin excretion rate, 24 hours urinary protein excretion and renal function tests were performed. Based on the results of these tests, patients were classified into four groups Normoalbuminuria-54 cases, Microalbuminuria-38 cases, Macroalbuminuria-15 cases & ESRD-10 cases. Results: The prevalence of microalbuminuria was 32.5% and prevalence of macroalbuminuria was 21.4%. 8.5% patients had ESRD. 40% of macroalbuminuria patients had end stage renal disease. Conclusion: Age of the patients who had microalbuminuria, macroalbuminuria and ESRD were significantly higher when compared to normoalbuminuric patients. The glycemic control was poorer in patients having microalbuminuria, macroalbuminuria and ESRD group as compared to patients having normoalbuminuria.