Author :
Dr. Vilas U. Chavan, Dr. Pushpa P. Durgawale, Dr. Ajit V Sontakke, Dr. Hasit D Lad
Volume :
1
Issue :
1
Abstract :
Background: Microalbuminuria (MAU) has been considered the first indication of renal injury in patients with diabetes and associated with a higher cardiovascular risk. It is evident from epidemiological studies that urine albumin concentration (UAC) or albumin: creatinine ratio (ACR) in spot urine sample gives similar result like 24-hour urinary albumin excretion (UAE).
Objectives: The study was aimed to find out whether UAC and/or ACR calculated in 24-hour urine sample correlate or not with same 24-hour UAE and what is diagnostic outcome by various measures of albumin excretion calculated in 24-hour urine samples in type 2 diabetic patients?
Methodology: We collected 24-hour urine sample from 125 type 2 diabetic patients and urinary albumin and creatinine were measured. We calculated different parameter of albumin excretion in 24-hour urine sample and interpretation of each parameter was derived. Data was expressed as median and range. Results: The median ACR was 187.30 (mg/g), UAC was 135.5 (mg/L) and UAE was 270.92(mg/24 hours) in 24-hours urine sample. Clinical outcome of nephropathy by different calculated measures of albumin excretion in 24-hour sample was different. 72 patients had similar interpretation while 53 patients showed different diagnostic interpretation by different measures of albumin excretion in the same 24-hour urine sample.
Conclusion: Various measures of urine albumin excretion like UAC, ACR calculated in 24-hour urine sample in type 2 diabetic patients showed different diagnostic interpretation. We recommend when the urinary albumin concentration exceeds 10 mg/L in spot or random urine sample, another 24-hour sample should be collected for confirmed diagnosis of the stage of the albuminuria / nephropathy. We conclude that 24-hour urine sample is gold standard for diagnosis of nephropathy in diabetic patients. Further prospective studies are needed to confirm our findings.
Key Words: Microalbuminuria, Type 2 diabetes mellitus, Urine albumin concentration, albumin: creatinine ratio, Urinary albumin excretion, 24-hour urine, Diabetic nephropathy, Measures of albuminuria.