A study in prevalence of diabetic nephropathy in recently detected cases of type 2 diabetes mellitus as evidenced by altered creatinine clearance, urinary albumin and serum creatinine, with special emphasis on hypertension, hypercholesterolemia and obesity

Authors

  • Vitan Patel Department of Medicine, Medical College, Baroda, Gujrat, India
  • Minal Shastri Department of Medicine, Medical College, Baroda, Gujrat, India
  • Nisha Gaur Department of Medicine, Medical College, Baroda, Gujrat, India
  • Prutha Jinwala Department of Medicine, Medical College, Baroda, Gujrat, India
  • Abhishek Y. Kadam Department of Medicine, Medical College, Baroda, Gujrat, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20180999

Keywords:

Diabetic nephropathy, Diabetes, Hypertension, Hypercholesterolemia, Microalbuminuria, Obesity

Abstract

Background: Diabetic nephropathy is one of the commonest and most dreaded complications of Diabetes. The Aim was to evaluate the significance of microalbuminuria and creatinine clearance for detecting incipient diabetic nephropathy, and to find out the prevalence of nephropathy among freshly detected Type 2 diabetic patients with vs. those without hypertension, hypercholesterolemia and/or obesity.

Methods: In this prospective study, 100 recently diagnosed diabetics were studied. Group A had 50 patients with at least one risk factor are hypertension, hypercholesterolemia and obesity. Group B had 50 patients without any of the aforementioned factors. Patients were investigated for presence of Diabetic nephropathy with abnormal serum Creatinine, creatinine clearance and urinary albumin levels.

Results: As many as 43 out of 100 patients were found to have Diabetic nephropathy. The number was significantly higher in group A compared to group B (34/50 vs. 9/50). Incidence of nephropathy was higher with higher number of associated risk factors. Urinary microalbuminuria was the commonest abnormality, Serum creatinine was found in only 30.23% of total positive cases.

Conclusions: Incidence of diabetic nephropathy is much larger than imagined in freshly diagnosed/new onset cases of DM type 2. Author also conclude that hypertension, obesity and hypercholesterolemia can contribute to development of nephropathy (68% vs. 18% in those who had the factors vs. those who didn’t). Also, urinary microalbuminuria appears to be much more sensitive than serum creatinine as screening tool.

References

Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australasian Medical Journal. 2014;7:45-8.

American Diabetes Association Diagnosis and classification of diabetes mellitus. Diabetes Care. 2010;33:S62-9.

Viazzi F, Leoncini G, Conti N, Tomolillo C, Giachero G, Vercelli M, et al. Microalbuminuria is a predictor of chronic renal insufficiency in patients without diabetes and with hypertension: The MAGIC study. Clin J Am Soc Nephrol. 2010;5:1099-106.

Nuttall FQ. Body Mass Index: Obesity, BMI, and Health: A Critical Review. Nutr Today. 2015;50:117-28.

Czernichow S, Kengne AP, Stamatakis E, Hamer M, Batty GD. Body mass index, waist circumference and waist-hip ratio: which is the better discriminator of cardiovascular disease mortality risk?: evidence from an individual-participant meta-analysis of 82 864 participants from nine cohort studies. Obes Rev. 2011;12(9):680-7.

Daskalopoulou SS, Khan NA, Quinn RR. The 2012 Canadian Hypertension Education Program (CHEP) recommendations for the management of hypertension: Blood pressure measurement, diagnosis, assessment of risk and therapy. Can J Cardiol. 2012;28:1-38.

Mohan EA, Monagham B. Nephropathy in newly diagnosed type 2 Diabetes. Diabetes cone. 1994;17:1545-6.

Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR. Development and progression of nephropathy in type 2 Diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int. 2003;63:225-32.

Ghai R, Verma ND, Goel A, Bhatnagar MK, Kapoor P, Vashishta A. Microalbuminuria in non-insulin dependent Diabetes and essential hypertension: A marker of severe disease. J Assoc Physicians India. 1994;42:771-4.

Chowta NK, Pant P, Chowta MN. Microalbuminuria in Diabetes mellitus: Association with age, sex, weight, and creatinine clearance. Indian J Nephrol. 2009;19:53-6.

Agarwal N, Sengar NS, Jain PK. Nephropathy in newly diagnosed type 2 Diabetics with special stress on the role of Hypertension. JAPI. 2011;59:145-7.

Femando DJ, Weerasuriya N, Dissanaluye: long term complications in newly diagnosed Diabetics. QJM. 1998;91:439-48.

Chowdhury TA, Slasher SS. complications in south Asians and Europeans with early onset type 2 Dm. QJM. 2002;95:241-6.

Shin SJ, Hsiao PJ. Association of nephropathy, retinopathy, blood pressure, age in newly diagnosed Diabetics. Kaohsiung Journal of medical sciences. 2001;17:294-301.

Turner RC, Holman RR, Matthews DR, Bassett PA, Coster R, Stratton IM, et al. Hypertension in diabetes study (eds). 1. Prevalence of hypertension in newly presenting Type-2 diabetic-patients and the association with risk-factors for cardiovascular and diabetic complications. J Hypertens. 1993;11(3):309-17.

Joglekar CU, Bhat DS, Raut KN. Circulating lipids and cardiovascular risk in newly diagnosed type-II Diabetes. Diabetes Med. 1997;14:757-61.

Bannerji MA, Faridi N. Body composition, visceral fat, leptin and Insulin resistance in Asian Indian men. J Clin Endocrinol Metab. 1999;84:137-44.

National Institute of Diabetes and Digestive and Kidney Disease: (NIDDK). National Diabetes Statistics. National Diabetes Information Clearing house Website. 2004. Available at http://Diabetes.niddk.nih.gov/dmlpubs/statistics/index.htm.

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Published

2018-03-21

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Original Research Articles