Association Between Estimated Glomerular Filtration Rate and Microvascular Complications in Type II Diabetes Mellitus Patients: A 1-Year Cross-Sectional Study

• Published in: Journal of the National Medical Association Vol. 111; no. 1; pp. 83 - 87
• Main Authors: Babaliche, Prakash, Nadpara, Rishit A., Maldar, Arif
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2019; Elsevier Limited
• Subjects: Adult; Age; Aged; Aged, 80 and over; Albuminuria - etiology; Albuminuria - physiopathology; Blood pressure; Chi-square test; Creatinine - blood; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - pathology; Diabetic Angiopathies - etiology; Diabetic Angiopathies - pathology; Diabetic Angiopathies - physiopathology; Diabetic Nephropathies - etiology; Diabetic Nephropathies - pathology; Diabetic Nephropathies - physiopathology; Diabetic nephropathy; Diabetic neuropathy; Diabetic retinopathy; Female; Glomerular Filtration Rate; Hemoglobin; Humans; Hypertension; Kidney diseases; Male; Microvessels - pathology; Middle Aged; Nephropathy; Neuropathy; Retinopathy; Serum creatinine; Studies; Urine; Urine microalbumin; Nephropathy; Retinopathy; Neuropathy; Urine microalbumin; Serum creatinine; Glomerular filtration rate
• ISSN: 0027-9684; 1943-4693
• DOI: 10.1016/j.jnma.2018.06.003

Previous studies have indicated that reduced estimated glomerular filtration rate (eGFR) is not only the predictor of renal function impairment in patients with diabetic nephropathy, but also in patients with diabetic neuropathy, diabetic retinopathy, and other diabetic-related complications. Therefore, evaluation of eGFR is critical in diabetic patients. However, there is a paucity of data regarding the association of various stages of kidney disease with microvascular complications. The objective of the study was to evaluate the association between eGFR and microvascular complications in type II diabetes mellitus (DM) patients. The present 1-year cross-sectional study involved a total of 50 type II DM patients with duration of >5 years. Descriptive data, detailed history regarding the duration of DM, and clinical investigations were performed according to a predesigned and pretested proforma. Specific investigations such as urine microalbumin excretion test and serum creatinine test were also performed. Serum creatinine test was done to calculate the eGFR by modification of diet in renal disease (MDRD) formula. All the type II DM patients were divided into various stages of kidney disease by calculating the eGFR by MDRD. Chi-square test was used to find the association of eGFR with microvascular complications. P < 0.05 was considered statistically significant. The mean age of the study patients was 57.76 ± 10.35 years with a male predominance. Most of the patients were identified with diabetic nephropathy (33) and diabetic neuropathy (32). Many (21) patients were in stage I kidney disease. Reduced eGFR was associated significantly with diabetic neuropathy (P = 0.007) and diabetic nephropathy (P = 0.0092); whereas, no significant association was observed with diabetic retinopathy (P = 0.285). Furthermore, reduced eGFR led to reduction in glycated hemoglobin levels, and increased the risk of hypertension (P = 0.0401) in patients with type II DM. Overall, eGFR can be considered as a rational noninvasive mode of assessing the renal status in patients with type II DM. Reduction in eGFR is significantly associated with microvascular complications, such as diabetic neuropathy and diabetic nephropathy.