Review of Diabetic Nephropathy Naive Patients in Endocrinology Clinic: A Teaching Hospital Experience

Abstract

Background: Diabetes mellitus has continued to be a worrisome public health challenge with global prevalence estimated at 6.4%  population of about 300 million in 2010. Local studies in Nigeria have submitted prevalence ranging between 3 to 5.7%. Diabetic  nephropathy or diabetic kidney disease is a progressive microvascular complication of diabetes mellitus characterized by increased  hyper-albuminuria and or progressive deterioration in glomerular filtration rate. The highest global prevalence of developing chronic  kidney disease from DM was documented in Asia at an average of 36% while Africa reported a range from 2 to 41%.

Methodology: This  was a hospital- based crosssectional, observational retrospective of 251 patients that attended the clinic of the university from February  2020 to February 2021. Consent for the study was obtained from the university management. The inclusion criteria comprised all subjects  diagnosed with diabetes and on treatments, presence of positive urine protein albustix repeated at two to four weeks interval  with no other clinical or laboratory evidence of kidney diseases. Data were retrieved and analyzed with SPSS 23.0.

Result: A total number  of 251 subjects who attended the university clinic were enlisted in this study. The average age was 52.6±13.1. There were more females  144(57.4%) than males 107(42.6%). The mean duration of diabetes was 10±5.5yrs. The average BMI was 27.9±5.8 (kg/m² ). The mean  fasting blood sugar was 9.7 += 4.0 mmol/l. The prevalence of diabetic nephropathy as indicated by proteinuria was 8.4%. There was a  significant association between elevated HBAIC, proteinuria and serum creatinine with (P≤0.05). Logistic regression results showed that  subjects with FBS ≥ 7.0 mmol/l were 14 times more likely to develop proteinuria with confidence intervals at 95% (11.688-108.263).  

Conclusion: This study revealed that 8.4% of the patients were diabetic nephropathy naive and majority of the subjects were captured in  stage 3 CKD. The study also showed significant association between poor glycaemic control, anaemia and serum creatinine. This group of  patients requires close monitoring and follow up in the clinic to prevent regression of renal functions.