تقييم البيلة الألبومينية الزهيدة و علاقتها مع ضغط الدم و ضبط السكر لدى مرضى السكري النمط الثاني

الملخص EN

Glomerular nephropathy is one of the most common and serious long-term complications of diabetes, and early identification of renal disease is considered essential for diabetes care.

So this research aimed to assess the micro-albuminuria in the diagnosis of diabetic nephropathy in type II diabetic patients, by measuring the urinary albumin creatinine ratio (ACR) and estimated creatinine clearance rate (eCcr) and determine its correlation with glycemic control and blood pressure.

This study included 118 type 2 diabetic patients and 25 apparently healthy subjects (controls).

Urinary levels of albumin and creatinine, serum levels of creatinine, fasting glucose and glycated hemoglobin were measured.

Both the systolic and diastolic pressure were measured.

The albumin: creatinine ratio (mg/g) and eCcr (ml/min) according to Cockroft-Gault formula-were calculated.

Depending on urinary albumin excretion, the patients were divided into two groups: normo-albuminuric diabetic patients (group A: 79 patients) and micro-albuminuric diabetic (group B: 39 patients).

The mean ± standard error of urinary A: C ratio levels were: 5.5±0.88 mg/g in controls, 8.1±1 mg/g in normo-albuminuric group and 83.9±8.1 mg/g in micro-albuminuric group.

The mean ± standard error of HbA1c levels were: 6.2±0.11% in controls, 8.2±0.2% in normo-albuminuric and 8.8±0.4% in micro-albuminuric group.

The mean ± standard error of systolic blood pressure values were: 11.7±0.16 mmHg in controls, 13.4±0.18 mmHg in normo-albuminuric group and 14.1±0.39 mmHg in micro-albuminuric group.

Decreased eCcr values 90 ml/min were found in 25% and 31% of normo-albuminuric and micro-albuminuric groups, respectively.

Urinary A: C ratio levels showed significant positive correlation with HbA1c levels (r=0.33, p<0.0001) and significant positive correlation with systolic blood pressure values (r=0.2, p<0.0001) in micro-albuminuric diabetic patients.

As a conclusion, low values of estimated creatinine clearance rate do not always associate with increased urinary albumin excretion.

So eCcr should be always measured to evaluate the renal dysfunction in normo-albuminuric type 2 diabetic patients, with consideration of systolic blood pressure value and glycemia control degree.