The screening for diabetic nephropathy in diabetes clinic in Khartoum- Sudan

Abstract

Background: diabetes mellitus and its complications is one of the major
health problems. This study is about the screening for one of these complications -diabetic nephropathy- in our clinical practice in Khartoum Sudan. Objectives: The main objective is to determine whether the clinical practice in the diabetes clinics in Khartoum- Sudan is following the recommended guidelines for the screening for diabetic nephropathy.
Study Design: Prospective cross- sectional study. Populations: during the period from Jan-March 2008, 98 diabetic patients with type 1 or type 2 were randomly selected from patients attending the outpatient diabetes clinic in Omdurman Teaching Hospital.
Methodology: ninety eight adult type1 and 2 diabetic patients were studied using simple, direct, standardized questionnaire, previous records were seen and a urine sample for each patient was examined for proteinuria.
Results: 6.1% of the total number of patients had urine examination on regular bases, 75.5% rarely had urine examination, while 18.4% had their urine never been examined before in the diabetes clinics. None of patients was diagnosed as having diabetic nephropathy or seen by a nephrologist. Only 7.1% of the total patients were using ACE inhibitors or ARB agents and these were prescribed for indications other than diabetic nephropathy. Testing urine of our patients we found that 18.4% had macroalbuminuria, 40.8% microalbuminuria, while40.8% had negative results. The majority of
the patients with either type of albuminuria were in the age group 51-65 years and most of them had type 2 diabetes.
Conclusion: A large number of our patients had evidence of diabetic nephropathy. However, none of them had been screened before for that. Despite the small number of patients, this study raises a serious alarm regarding the clinical practice in our diabetes clinics in Khartoum Sudan and it strongly recommends urgent intervention by the authorities to implement the international guidelines of screening and management of these patients.

Keywords: macroalbuminuria, microalbuminuria, proteinuria, chronic kidney disease

Sudan Journal of Medical Science Vol. 3 (4) 2008: pp. 285-290