Incidence and Determinants of Incipient Diabetic Nephropathy

Diabetic nephropathy is a late complication of diabetes mellitus. Microalbuminuria is considered to be an early sign of diabetic renal disease. It precedes persistent proteinuria and represents a potentially reversible stage of diabetic nephropathy. This cross-sectional analytical study was carried out on 180 type 2 and 145 type 1 diabetic patients. Patients having clinical albuminuria and with other causes of proteinuria were excluded. Microalbuminuria was observed in 34.48% patients with type 1 diabetes mellitus (DM) and in 28.33% patients with type 2 DM. In logistic regression analysis, high HbA1c, and hypertension were strongly associated with increased albumin excretion in both types of diabetes mellitus. For type 1 DM, other independently associated factors, in order of importance were duration of disease, LDL-C and total cholesterol. Therefore, regular screening for microalbuminuria is recommended for all diabetic patients. Early screening for incipient diabetic nephropathy and aggressive management of these risk factors is important in optimising the renal outcome of patients with diabetes mellitus.