Impairment of Renal Function in Non-proteinuric Diabetic Patients

Abstract

Objective: To evaluate renal function in non-proteinuric diabetic patients.
Material and Methods: It was a descriptive analytical study, conducted in University of Health
Science Lahore, from February 2010 to January 2011, with a sample size of 195 diabetic
subjects. They were divided equally among normoalbuminuric, microalbuminuric and
macroalbuminuric groups, according to their daily urinary albumin excretion rate (AER), with 65
patients in each group. Their renal function status and GFR was evaluated by conducting tests on
serum and urine samples.
Kruskal-Wallis test and Mann-Whitney U test were used to observe differences of medians in
different groups. p value less than 0.05 was taken statistically significant.
Results: There was predominance of males in microalbuminuric and macroalbuminuric groups
while females were more in number in normoalbuminuric group. Majority of normoalbuminuric
individuals were unmarried, while married individuals were prevalent in microalbuminuric and
macroalbuminuric group. Significant differences were found in serum urea concentration, serum
creatinine concentration, serum uric acid concentration, glomerular filtration rate, urinary
creatinine concentration, urine flow rate, daily albumin excretion rate and urinary albumin
concentration among the three groups. Urinary creatinine concentration and glomerular filtration
rate were in the highest ranges in normoalbuminuric group and in the lowest ranges in
macroalbuminuric group. While rest of the parameters (ie. age, duration of diabetes, serum urea
concentration, serum creatinine concentration, urine flow rate, daily AER , urinary albumin
concentration and serum uric acid concentration) were in the lowest ranges in normoalbuminuric
group and in the highest ranges in macroalbuminuric group. There was significant renal function
impairment in microalbuminuric stage of diabetic nephropathy. p <0.05 was taken statistically
significant.
Conclusion: It is concluded that impairment in renal function occurs even in microalbuminuric
stages of diabetic nephropathy. Renal functions are impaired even in the diabetic patients who
have not yet developed frank proteinuria.