Prevalence of microalbuminuria in type 2 diabetes patients in Tirana, a preliminary multicenter study

Abstract

Background: Microalbuminuria is often the first sign of renal involvement predicting overt nephropathy. For this reason, monitoring microalbuminuria and other risk factors associated with this condition is important to take measures to prevent or postpone overt nephropathy. This study aimed to investigate the prevalence of microalbuminuria in type 2 diabetes patients attending three diabetes centers in Tirana city. Patients and Methods: Two hundred and twenty patients with type 2 diabetes attending diabetes centers in Tirana were recruited in this cross sectional study. Medical records were used to collect data on duration of diabetes, waist cir cumference, history of hypertension, smok ing. Blood samples were drawn after 12 h overnight fasting to measure glycosylated hemoglobin (HbA1c), serum cholesterol, triglyceride and creatinine. Microalbuminuria was assessed using dipstick kits in early morning urine samples. Results: The prevalence of normoalbuminuria was 58.3%, microalbuminuria 38.6% and macro albuminuria 3.1%. Systolic and diastolic blood pressure ( p < 0.01), HbA1c( p < 0.01) and fasting plasma glucose ( p < 0.001) were significantly higher in microalbuminuric than in nor moalbuminuric subjects. Multiple logistic regression analysis using microalbuminuria as the dependent variable in males shows that inde pendent risk factors for diabetes patients with microalbuminuria were duration of diabetes, systolic blood pressure and waist circumference. We found that the OR for microalbuminuria became statistically significantly increased only at 16 years after the diagnosis of type 2 diabetes. At this time, 43.7% of patients had microalbuminuria. Conclusions: We found a high proportion of type 2 diabetes patients with microalbu minuria which raises implications for health policy inAlbania. This calls for early detection and good control of diabetes to reduce the bur den of diabetic kidney disease in the future. Screening programs and optimized control of modifiable risk factors are needed to reduce the risk of diabetic nephropathy.