Assessment of Albumin to Creatinine Ratio and Glomerular Filtration Rate in Type 2 Diabetic Patients in Khartoum state

Abstract

Background: diabetic nephropathy is the most common cause of end stage renal disease, the aim of this study was to assess the levels of albumin to creatinine ratio and glomerular filtration rate as an early indicators of diabetic nephropathy. Materials and methods: this comparative cross- sectional study was carried out in prof. Mahdy center for diabetes and zenam specialist hospital in Khartoum state from September 2019 to October 2020, fifty Sudanese long standing diabetic patients (29 males and 21 females) in addition to fifty Sudanese newly diagnosed diabetic patients (19 males and 31 females) were enrolled , measurements of albumin , creatinine and albumin creatinine ratio were done by using Cobas (C311) fully automated analyzer , collected data were analyzed by a computer system using statistical package for Social sciences (SPSS) program. Results: there was insignificant difference between the mean of GFR and ACR of newly diagnosed and long standing diabetic patients p-value = 0.398 ,0.491 respectively, the study also showed significant increase in the mean of urine albumin and ACR among insulin medication when compare with metformin in long standing diabetic patients (p-value =0.018, 0.031 respectively ), the present study also showed that 28% of type 2 diabetic patients had microalbuminuria and 7% had macroalbuminuria (40% of long standing diabetic patients had MA while only 16% of newly diagnosed patients had MA) ,there was insignificant defference between the mean of age, BMI , urine albumine, urine creatinine, serum creatinine, ACR, and GFR of males and females in long standing diabetic patients (p-value = 0.414 , 0.325 , 0.348, 0.403 ,0.413 ,0.636 0.592 respectively) , the result also revealed a positive correlation between ACR and diabetes mellitus duration and negative correlation between GFR and the duration of the disease(r=0.65 , r= -0.208 , p=0.054 , p=0.047 respectively ) The present study also revealed a weak negative correlation between the age of diabetic patients and the e-GFR ( r= -0.484 , p=0.000 ) Conclusion : forty percent of long- standing diabetic patients had microalbuminuria while only 16% of newly diagnosed diabetic patients had microalbuminuria. Insulin treated diabetic patients had increased urine albumin, the e-GFR is decreased and the level Of ACR is increased as the duration of diabetes increases.