Rizwana Muzaffar, Rashida Qasmi, Zarfishan Tahir.
Microalbuminuria and early diagnosis of Diabetic Nephropathy in Insulin Dependent and Non Insulin Dependent Diabetese Mellitus
Biomedica Jul - Dec 2003;19:60-7.
Department of Nutrition and Dietetics Institute of Public Health, Birdwood Road, Lahore

Diabetic nephropathy is one of the microvascular complications of diabetes and accounts for almost a third of all causes of end stage renal disease. Microalbuminuria screening among diabetics can offer early detection of incipient nephropathy. The study was designed to explore if an elevated albumin excretion would predict the development of overt proteinuria and to describe risk factors associated with the development and progression of microalbuminuria. The study was conducted at Diabetic Research Clinic of Sir Ganga Ram Hospital, Lahore. The study subjects included 25 insulin dependent diabetes mellitus patients, 25 non-insulin dependent diabetes mellitus (NIDDM) patients between 18-60 years of age. 25 age matched normal subjects were taken as control group. Of the 25 patients with IDDM 4% had overt nephropathy. Microalbuminuria was present in 40% of patients, each in IDDM and NIDDM. 56% patients in IDDM and 60% patients in NIDDM had normal albumin excretion rate. Hypertension was present in 20% of IDDM patients and 28% of NIDDM patients. The microalbuminuric patients both insulin dependent and non-insulin dependent diabetics had longer duration of diabetes, higher diastolic, systolic blood pressure and glucose concentration than did the normoalbuminuric subjects. There was no difference between the normoalbuminuric and microalbuminuric subjects in terms of age and sex. A significant correlation was found between hypertension, duration of diabetes, metabolic control and development of diabetic nephropathy. In conclusion early detection of patients at high or low risk of developing persistent proteinuria is possible by using a sensitive method for urinary albumin excretion. Microalbuminuria above 20ug/min carries the conviction of its predictive value for clinical proteinuria, a known precursor of renal failure.

Category: Internal Medicine
Keywords: Diabetes Mellitus. Diabetic Complications. Albumin. Albuminuria. Nephropathy.

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