Diagnosis and Management of Early Stage Diabetic Kidney Disease
Abstract
Background: Diabetes mellitus causes the majority of end-stage renal impairment that necessitates replacement in order to survive. Cardiovascular morbidity and death increase with diabetic renal disease. Early detection and therapy can halt the course of renal disease. This case-control study investigated the clinical significance of serum creatinine, blood urea, and eGFR in predicting renal impairment and assessing renal function in normoalbuminuric and microalbuminuric type 2 diabetics.
Methodology: From October 2021 to June 2022, a 9-month case-control study divided 70 patients with type 2 diabetic renal impairment admitted to the Private Clinic Laboratory of Basrah, aged 40 to 68 (24 males and 46 females), into three groups (mild, moderate, and severe renal impairment) based on their sine and symptoms. Alternatively, 60 healthy participants (28 men and 32 women) were recruited.Participants in the control group ranged in age from 40 to 70 years old. Sugar, HbA1c, Urea, Creatinine, albuminuria, and e GFR were measured in venous blood samples from research participants using standard procedures.
Results; When compared to controls, patients with type 2 diabetes exhibited significantly higher mean values of fasting blood glucose, glycated hemoglobin, blood urea, and serum creatinine (P 0.05) and non-significantly lower eGFR (p > 0.05). The study discovered that 45.7% of individuals had poor glycemic control (HbA1c% 8.5) and were treated in a variety of ways: 10% with insulin therapy, 62.85% with oral
hypoglycemic medications, 12.85% with both, and 14.3% with simply a regulated diet. 43.6% of diabetics had a family history of Type 2 diabetes. There were significant (P 0.05) changes in DM duration, B. Urea, S. Creatinine levels, and GFR between normoalbuminuric and microalbuminuric type 2 diabetic patients, but no differences in age, FBS, or HbA1c. In a study of 33 microalbuminuric patients, 12 were classified as stage 1 (eGFR (90-90) mL/min/1.73 m2), 10 as moderate (eGFR (60-90) mL/min/1.73 m2), and 11 as severe.
Conclusions: Elevated serum creatinine and blood urea, as well as a decline in eGFR, predict renal impairment in normoalbuminuric type 2 diabetes. Diabetic nephropathy rates rose due to poor glycemic control. Albumin and/or reduced eGFR (60 ml/min/1.73m2) were seen in patients.
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