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.
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.

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