FREQUENCY OF NEPHROPATHY an‎d ITS RELATION TO METABOLIC CONTROL IN PATIENTS WITH DIABETES MELLITUS

INTRODUCTION: Diabetic nephropathy is a serious complication of both type 1 and type 2 diabetes, and unless arrested, leads to end-stage renal disease. The aim of this study was to find the prevalence of kidney dysfunction in patients with diabetes mellitus and to determine its correlation with metabolic control. METHODS: We randomly selected 1203 cases with diabetes mellitus presenting to the Institute of Endocrinology and Metabolism. Urinary protein and creatinine were determined in a sample of 24-hour urine collection by the enzymatic methods and spot urine dipstick blood urea nitrogen, serum creatinine, HbA1c and fasting blood glucose were assessed. RESULTS: In this study, 1203 patients (438 patients with type 1 diabetes mellitus [T1DM] and 777 with type 2 diabetes mellitus [T2DM]) were randomly selected. They consisted of 512 females and 721 males. Mean ± SD (standard deviation) of HbA1c was 7.9±3.4 in T1DM and 7.4±3.5 in T2DM. Based on HbA1c levels, good control was detected in 50.2% of patients, fair control in 20.4% and bad control in 29.4%. Of 1022 patients who were evaluated for proteinuria, 201 (19.7%) had albuminuria or clinical proteinuria. Of 931 patients, 19% had high levels of blood urea nitrogen and serum creatinine. End-stage renal disease (ESRD) was seen in 10 (0.8%) of all the cases. A statistically significant positive correlation was found between duration of DM, serum creatinine and 24-hour urinary protein (P< 0.001). CONCLUSION: We found a high prevalence of clinical proteinuria in diabetic patients. Duration of diabetes and poor metabolic control were identified as a strong predictors of kidney damage in patients with diabetes.