International Journal of Research in Medical Sciences | February 2021 | Vol 9 | Issue 2 Page 565
International Journal of Research in Medical Sciences
Gokhale VS et al. Int J Res Med Sci. 2021 Feb;9(2):565-568
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Original Research Article
Diabetic nephropathy: early markers for monitoring and prevention
Vijayashree S. Gokhale*, Kshithija R. Sajjan, Rupesh Parati, Keyuri Mehta
INTRODUCTION
According to the international diabetes federation, 592
million (1 in 10 persons) worldwide will have DM by
2035. The macrovascular and microvascular
complications of diabetes are the culprits of high
mortality and morbidity of diabetes. They include
coronary artery disease, hypertension, retinopathy, end-
stage renal disease, peripheral vascular disease and
neuropathy. In India, there are about 69.2 million people
with diabetes and are expected to cross 123.5 million by
2040. Epidemiologic studies have shown that a fifth of all
diabetes patients suffer from two or more micro vascular
complications.
Diabetic kidney disease (DKD) is diagnosed when there
is persistent albuminuria, increasing serum creatinine and
a progressive decline in estimated GFR (eGFR)
glomerular filtration rate. 20-40% of diabetic
nephropathy patients will progress to End stage renal
disease. Early diagnosis, treatment of modifiable risk
factors, optimum glycemic control and renoprotective
anti-diabetic and anti-hypertensive medications may help
prevent or at least postpone chronic kidney disease and
renal replacement therapy.
1
Aims and objectives of the study were to study Early
Nephropathy by UACR (urinary albumin/creatinine
ratio), RFT (renal function test) and e-GFR in Type 2
Department of Medicine, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
Received: 10 December 2020
Accepted: 12 January 2021
*Correspondence:
Dr. Vijayashree S. Gokhale,
E-mail: Gokhale.vijayashree@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Type 2 diabetes, with its complications is perpetually on the rise more so in India .Diabetic
Nephropathy progresses silently, and manifests at a stage where, patient can be offered only renal replacement. This
study was undertaken to detect early markers of Diabetic Nephropathy. Aims and objective of the study was to study
early nephropathy by UACR (urinary albumin/creatinine ratio), RFT (renal function test) and e-GFR in Type 2
diabetic patients of more than 2 years duration, with and without hypertension.
Methods: A hospital based cross-sectional observational study, of 100 patients, 18-60 years of age, of type 2 Diabetes
of 2 year duration and above, of which 50 were only diabetic and 50 had diabetes and hypertension. Patients who had
an established renal disease were excluded from study.
Results: Our study of 100 patients, 18-60 years of age, had 23 male and 77 female patients. Maximum patients were
in age group 41-50 years, and 52% had diabetes of 2-4 years duration. Of the renal parameters studied, BUN was
normal in 72% and S. Creatinine normal in 67%. UACR was normal in only 38%, and e-GFR was normal in 49%.
Conclusions: In our study age and sex, duration of Diabetes and HbA1c did not have any bearing on renal
parameters. UACR followed by e-GFR, were deranged early. UACR was more deranged in diabetics with
hypertension.
Keywords: Diabetic nephropathy, e-GFR, Hypertension, UACR
DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20210443