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- DOI 10.18231/pjms.v.15.i.2.470-474
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CrossMark
Assessment of microalbuminuria and urinary albumin-to-creatinine ratio in patients with type 2 diabetes mellitus at a tertiary care hospital
- Author Details:
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Alak Kumar Das
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Poulami Paul
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Jinia Ghosh *
Alak Kumar Das
Jinia Ghosh *
Introduction: Urinary albumin-to-creatinine ratio (UACR) in random samples has been considered as the most appropriate investigation to detect early renal impairment. Present study was conducted to assess the microalbuminuria (MA) and UACR in patients with type 2 diabetes mellitus (T2DM) and to evaluate the factors associated with MA at a tertiary care hospital.
Materials and Methods: This observational, cross-sectional study was conducted at a tertiary care hospital over a period of three months. Adult subjects of 18-70 years attending the diabetic outpatient department (OPD) who were advised for investigation of UACR were included. The subjects were interviewed using a pre-designed and pretested data collection form to collect the relevant data including demographic characteristics, co-morbidities and investigational reports of urine samples.
Results: Majority of the subjects were female (51.48%) and belonged to the age group of 50 – 59 years (33.73%). Mean (± SD) duration of diabetes was 7.10 (± 7.27) years. Hypertension was the most common co-morbidity (60.94 %). Mean (± SD) value of urinary microalbumin, creatinine and UACR were 63.15 (± 140.56) mg/dl, 94 (± 81.3) mg/dl and 73.04 (± 146.51) respectively. MA was found in 33.73% study subjects. A significant positive correlation was detected between MA and UACR (r=0.4335, p=0.000756).
Conclusion: About one third of our study subjects were found to have MA. For early detection of diabetic nephropathy regular assessment and monitoring of UACR should be considered.
References
- Reutens AT, Prentice L, Atkins R. The epidemiology of diabetic kidney disease. In: Ekoe J, editor. The Epidemiology of Diabetes Mellitus. 2nd ed. Chichester: John Wiley & Sons Ltd; 2008:499–
- Cordonnier D, Bayle F, Benhamou PY, Milongo R, Zaoui P, Maynard C, et al. Future trends of management of renal failure in diabetics. Kidney Int. 1993;43:8–13.
- Mogensen CE, SteVes MW, Deckert T, Christiansen JS. Functional and morphological renal manifestations in diabetes mellitus. Diabetologia. 1981;21(2):89–93. 474 Das et al/ Panacea Journal of Medical Sciences 2025;15(2):470-474
- Groop L, Ekstrand A, Forsblom C, Widén E, Groop PH, Teppo AM, et al. Insulin resistance, hypertension and microalbuminuria in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1993;36(7):642–7.
- Damsgaard EM, Froland A, Jorhgensen OD, Mogensen CE, et al. Microalbuminuria as a predictor of increased mortality in elderly people. BMJ. 1990;300(6720):297–300.
- Abbate M, Zoja C, Remuzzi G. How does proteinuria cause progressive renal damage? J Am Soc Nephrol. 2006;17(11):2974–
- Salmon AH, Neal CR, Harper SJ. New aspects of glomerular filtration barrier structure and function: Five layers (at least) not three. Curr Opin Nephrol Hypertens. 2009;18(3):197–205.
- Mogensen CE. Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes. N Engl J Med. 1984;310(6):356–60.
- Warram JH, Gearin G, Laffe L, Krolewski AS. Effect of duration of type I diabetes on the prevalence of stages of diabetic nephropathy defined by urinary albumin/creatinine ratio. J Am Soc Nephrol. 1996;7(6):930–7.
- Lièvre M, Marre M, Chatellier G, Plouin P, Réglier J, Richardson L, et al. The non-insulin-dependent diabetes, hypertension, microalbuminuria or proteinuria, cardiovascular events, and ramipril (DIABHYCAR) study: Design, organization, and patient recruitment. DIABHYCAR Study Group. Control Clin Trials. 2000;21(4):383–96.
- King H, Auberti RE, Herman WH. Global burden of diabetes, 1995–
- Prevalence, numerical estimated and projections. Diabetes Care. 1998;21(9):1414–31.
- Sarika A. Renal function in diabetic nephropathy. World J Diabetes. 2010;1(2):48–56.
- Keane WF, Eknoyan G. Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): A position paper of the national kidney foundation. Am J Kidney Dis. 1999;33(5):1004-10.
- Viberti GC, Hill RD, Jarrett RJ, Argyropoulos A, Mahmud U, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin- dependent diabetes mellitus. Lancet. 1982;1(8287):1430–2.
- Varghese A, Deepa R, Rema M, Mohan V. Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetes centre in southern India. Postgrad Med J. 2001;77(908):399–402.
- Molefe-Baikai OJ, Molefi M, Cainelli F, Rwegerera GM. The prevalence of microalbuminuria and associated factors among patients with type 2 diabetes mellitus in Botswana. Niger J Clin Pract. 2018;21(11):1430–7.
- Mather HM, Chaturvedi N, Kehely AM. Comparison of prevalence and risk factors for microalbuminuria in south Asians and Europeans with type 2 diabetes mellitus. Diabet Med. 1998;15(8):672–7.
- Neil A, Hawkins M, Potok M, Thorogood M, Cohen D, Mann J. A Prospective population-based study of microalbuminuria as a predictor of mortality in NIDDM. Diabetes Care. 1993;16(7):996–
- Gupta DK, Verma LK, Khosla PK, Dash SC. The prevalence of microalbuminuria in diabetes: a study from north India. Diabetes Res Clin Pract. 1991;12(2):125–8.
- Klein R, Klein BEK, Moss SE. Prevalence of microalbumin- uria in older-onset-diabetes. Diabetes Care. 1993;16(10):1325–9.
- John L, Rao PS, Kanagasabapathy AS. Prevalence of diabetic nephropathy in non insulin dependent diabetes. Indian J Med Res. 1991;94:24–9.
- Vijay V, Snehalatha C, Ramachandran A, Viswanathan M. Prevalence of proteinuria in non-insulin dependent diabetes. J Assoc Phy- sicians India. 1994;42(10):792–4.
- Gatling W, Knight C, Mullee MA, Hill RD. Microalbuminuria in diabetes: a population study of the prevalence and an assessment of three screening tests. Diabet Med. 1988;5(4):343–7.
- HaVner SM, Morales PA, Gruber MK, Hazuda HP, Stern MP. Cardiovascular risk factors in non-insulin dependent diabetic subjects with microalbuminuria. Arterioscler Thromb. 1993;13(2):205–10.
- Nelson RG, Kunzelman CL, Pettit DJ, Saad MF, Bennett PH, Knowler WC. Albuminuria in type 2 (non-insulin-dependent) diabetes mellitus and impaired glucose tolerance in Pima Indians. Diabetologia. 1989;32(12):870–6.
- Collins VR, Dowse GK, Finch CF, Zimmet PZ, Linnane AW. Prevalence and risk factors for micro and macroalbuminuria in diabetic subjects and entire population of Nauru. Diabetes. 1989;38(12):1602–10.
- Hamman RF, Franklin GA, Mayer EJ, Marshall SM, Marshall JA, Baxter J, et al. Microvascular complication of NIDDM in Hispanics and non-Hispanic whites. Diabetes Care. 1991;14(7):655–63.
- Karar T, Alniwaider RAR, Fattah MA, Tamimi WA, Alanazi A, Qureshi S. Assessment of microalbuminuria and albumin creatinine ratio in patients with type 2 diabetes mellitus. J Nat Sci Biol Med. 2015;6(Suppl 1):S89–S92.