THE CLINICAL PROFILE OF DIABETIC PATIENTS PRESENTING WITH MICROALBUMINURIA AT THE UNIVERSITY OF BENIN TEACHING HOSPITAL

Abstract

Microalbuminuria is defined as the urinary albumin excretion rate between

20-200μl/min or ACR of 30-300mg/g. It is a useful marker of diabetic renal

disease as its presence predicts worsening of renal disease to overt diabetic

nephropathy and subsequently end stage renal disease.

The objectives of this study were to relate microalbuminuria with

sociodemographic features of diabetic patients and to relate microalbuminuria

with renal function, duration of diagnosis and degree of glycaemic control.

It was a cross-sectional study carried out at the University of Benin Teaching

Hospital, Edo state on type 2 diabetics from January –December 2008. A total

of 125 participants were studied, all participants completed an interviewer

administered questionnaire and underwent medical assessment. Morning urine

samples were collected and were tested for microalbuminuria using the Folin-

Lowry method (a quantitative colorimetric method).

Results obtained from the study showed that microalbuminuria was found in

68.4% of the DM patients and the mean values were significantly (p<0.05)

higher in the diabetes than controls (60.3 +/-41.8 and 51.3+/-12.93mg/g)

respectively. The mean ACR in males were of significantly higher values than

the females with microalbuminuria (66.05+/-10.9 and 57.56+/-5.36mg/g)

respectively (p<0.05). Microalbuminuria was positively related to BMI with

higher mean values in the Diabetics (25.3+/-4.52kg/m2 ) than controls with

microalbuminuria ( 22.8+/-2.51kg/m2) p<0.05.


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There were significantly higher (p<0.05) mean values of systolic and diastolic

blood pressure in the diabetic group than controls (138.2+/-23.8, 84.0+/-

10.3mmHg) and (126.3+/-14.1, 83.3+/-15.1mmHg)) respectively. The lipid

values (TC, TG and LDL) were also significantly higher in diabetics with

microalbuminuria as follows :( 206.6 +/-61.5, 122.8+/-53, 140+/-56mg/dl)

than the control with microalbuminuria (170.4+/-34.5, 168.5+/-36 and

95.6+/-28mg/dl). There was also a high likelihood that the DM patients with

microalbuminuria had higher urea values, higher creatinine values and poor

glycaemic control with Odd’s ratio (OR) and Confidence interval (CI) as follows

(OR=2.34,CI= 0.78-7.15,OR= 2.85 CI= 0.56-7.90 and OR= 1.31 CI= 0.42-4.60)

respectively.

In conclusion the prevalence of microalbuminuria was considerably high

among diabetics, it was higher in males than females and it was positively

related with poor renal function and poor glycaemic control. Therefore, regular

screening for microalbuminuria is recommended for all diabetic patients, as

early treatment is critical in reducing cardiovascular risk and slowing the

progression of late stages of diabetic nephropathy (overt proteinuria) and end

stage renal disease.