Resum
Background: Most patients with Diabetic Nephropathy (DN) in developing countries are detected at the rather late stage of clinical nephropathy by routine semi-quantitative dip-stick urinalysis. Some patients with DN have been reported to have renal insufficiency at the time of diagnosis. Little is known about the GFR status of such macroalbuminuric Nigerian diabetic patients. The aim of this study was to assess levels of creatinine and GFR in dip-stick positive type 2 diabetic patients at the University College Hospital (UCH), Ibadan, Nigeria.
Methodology: A cross-sectional study was carried out. Forty dip-stick positive out of 79 randomly screened patients with T2DM attending the Diabetes Clinic of UCH, Ibadan who met selection criteria were recruited. Data were obtained on demography, diabetes history, and blood pressure. Samples were collected and analysed for 24-hour urinary protein, creatinine, and blood glucose. Creatinine clearance was estimated by CockroftGault formula.
Results: There were 25 (62.5%) females and 15 (37.5%) males. The mean age of subjects was 59.4 years (SD 11.25). Twenty-seven (67.5%) had elevated serum creatinine, 33 (82.5%) were macroalbuminuric, while 36 (90%) had creatinine clearance indicating renal insufficiency. Also 18 (45%) patients and 19 (47.5%) had suboptimal blood pressure control and glycaemic control.
Conclusion: We concluded that there appears to be excess renal insufficiency among type 2 diabetic patients with overt proteinuria in UCH, Ibadan. Diabetic patients with overt proteinuria should immediately be assessed for renal insufficiency and appropriate measures instituted to prevent or delay progression to ESRD.
Keywords: Excess, renal insufficiency, type 2 diabetes, dip-stick-positive proteinuria
Résumé
Plusieurs patients ayant la néphropathie diabétique (ND) dans les pays développés sont détectés plus tard dans l’étape clinique avancée de la néphropathie par la routine analyse semi quantitative des urines. Le but de cette étude était d’évaluer les taux de créatinine et de TFG au test de kit d’urine positif aux diabétiques de type 2 au centre universitaire hospitalier (UCH), Ibadan, Nigeria. Quarante tests à kit positif sur 79 échantillons des patients choisis au hasard et ayant remplis les critères de sélection avec la collecte des données démographiques, histoire du diabète et la pression artérielle. Les échantillons étaient collectés et analyses en 24 heures en taux de protéine en urine, créatinine et du taux de glucose sanguin. La clairance en Créatinine était estimée par la formule de Cockroft-Gault. Les résultats montraient que 25 (62.5%) femelles et 15 (37.5%) males. La moyenne d’âge des sujets était de 59.4 ans (SD 11.25). Vingt-sept (67.5%) avaient un taux élevé de créatinine dans le sérum, 33 (82.5%) avaient de la macroalbuminurie, alors que 36 (90%) avaient leurs taux de créatinine indiquant une insufficience rénale. Aussi 18 (45%) patients et 19 (47.5%) avaient une pression artérielle en sous de la normale et une glycémique. En conclusion, il parait qu’un excès d’insufficience rénale parmi les diabétiques de type 2 ayant une protéinurie à UCH, Ibadan. Les patients diabétiques avec cette protéinurie doivent être immédiatement examines pour insufficience rénale et les mesures appropriées instituées pour la prévenir ou retarder la progression au ESRD.
Correspondence: Dr. W.O. Balogun, Department of Medicine, College of Medicine, University of Ibadan. Ibadan, Nigeria.
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