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

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Supervisor: PROF. O.A. AFONJA DR. E.S. IDOGUN
Faculty: PATHOLOGY
Month: 5
Year: 2009

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) 1 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 2 stage renal disease.

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