PREVALENCE OF MICROALBUMINURIA AMONG DIABETIC PATIENTS IN ABUTH, SHIKA ZARIA
PREVALENCE OF MICROALBUMINURIA AMONG DIABETIC PATIENTS IN ABUTH, SHIKA ZARIA
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Date
2009-10
Authors
BELLO, MOHAMMAD AHMAD
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Abstract
Diabetic nephropathy accounts for a significant reduction in life expectancy of diabetic
patients. Diabetic patients with microalbuminuria have increased risk of progression to
overt proteinuria and later progress to renal failure which is usually irreversible and
eventually leads to death. The prevalence and risk factors of microalbuminuria are not
fully described among black African diabetic patients.
The objective of the present study was to determine the prevalence of micro-albuminuria
and associated factors among diabetic patients in ABUTH, Shika, Zaria.
This was a cross-sectional study of diabetic patients attending ABUTH, Zaria.
Concentrations of Fasting blood glucose (FBG), serum creatinine (SCr), Urinary
creatinine (UCr), and glycated haemoglobin (GHbA1c) were measured in 170 diabetic
patients and 100 apparently healthy individuals. Microalbuminuria was measured using
immunoturbidimetric method and was defined as Albumin-creatinine ratio ACR between
3–30 mg/mmol. Duration of diagnosis (DOD), Body mass index (BMI), systolic blood
pressure (SBP) and diastolic blood pressure (DBP) were also measured, where
applicable, in both patients and controls.
The prevalence of microalbuminuria among the diabetic patients in this study was 23%.
Mean values in patients versus controls of BMI (26.8±0.43 vs 23.4±0.43kg/m2, p<0.001),
DBP (80±0.56 vs 72±0.69mmHg, p<0.001), FBG (6.3±0.22 vs 3.5±0.07mmol/L,
p<0.001), UAlb (20.2±2.17 vs 8.0±0.31mg/L, p<0.001), GHbA1c (7.2±0.16 vs
4.9±0.07%, p<0.001) and ACR (2.7±0.29 vs 1.0±0.04 mg/mmol, p<0.001) were observed
to be higher with statistically significant differences in patients than controls (p<0.05).
Similar higher and statistically significant values were also observed in mean values of
FBG, GHbA1c, UCr, UAlb and ACR in microalbuminuric patients than
normoalbuminuric patients (p<0.05).
Sixty one (35.9%) had good glycaemic control with 11.5% having abnormal ACR, 42
(24.7%) at borderline had 14.3% with abnormal ACR and 67(39.4%) those with poorly
controlled glycaemia had 28.4% with abnormal ACR. One hundred and eighteen (69.4%)
were within 0-5years of duration having 25(21%) with abnormal ACR, those within 6-
10yr of duration were 37(21.8%) had 10(27%) with abnormal ACR while those with
duration of ≥11years were 15(8.8%) had 6(40%) indicating linear relation with both
GHbA1c and DOD. There was a positive and significant correlation between serum
creatinine and age in both patients (p=0.031, r=0.216) and controls (p=0.014, r=0.244).
Positive correlation was also observed between duration of diagnosis and serum
creatinine among patients (p=0.047, r=0.152). ACR was found to correlate positively
with GHbA1c in patients (p=0.013, r=0.189) and with BMI among controls (p=0.031,
r=0.216). A reference range of 0.14-1.78 mg/mmol and clinical decision limit of 2.19
mg/mmol for microalbuminuria and of 3.43-6.39 % and a clinical decision limit of 7.13
% for glycated haemoglobin were established.
The only modifiable predictor identified in this study was poor glycaemic control for the
development of microalbuminuria. Other non modifiable risk factors related to
progression of microalbuminuria were age and duration of diagnosis. Aggressive
glycaemic control is hereby recommended for better management and preventive
measures to halt or slow the progression rate of renal involvement in diabetic patients.
Description
A THESIS SUBMITTED TO THE POSTGRADUATE SCHOOL
AHMADU BELLO UNIVERSITY, ZARIA
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS OF THE AWARD OF
MASTERS DEGREE IN CHEMICAL PATHOLOGY
DEPARTMENT OF CHEMICAL PATHOLOGY FACULTY OF MEDICINE,
AHMADU BELLO UNIVERSITY, ZARIA.
Keywords
PREVALENCE,, MICROALBUMINURIA,, DIABETIC,, PATIENTS,, ABUTH,, SHIKA, ZARIA