Excess renal insufficiency among type 2 diabetic patients with dip-stick positive proteinuria in a tertiary hospital

Abstract

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: Across-sectional study was carried out. Forty dip-stick positive out of 79 randomly screened patients with T2DM attending the Diabetes Clinic of UCH, Ibadan w h o 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 Cockroft-Gault formula. Results: There were 25 (62.5%) female s and 15 (37.5%) males. The mean age of subjects was 59.4 years (SD 11.25). Twenty-seven (67.5%) had elevated senim 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.