Diabetic nephropathy in a tertiary care clinic in South Africa : a cross-sectional study

Abstract

OBJECTIVE : The aim of this study was to determine the prevalence of micro- or macroalbuminuria in type 1 and type 2 diabetic patients, and to examine the relationship with the diabetes control parameters such as haemoglobin (Hb)A1c, blood pressure (BP) and lipids. DESIGN : This was an analytical cross-sectional study. SETTING AND SUBJECTS : The study consisted of 754 patients with either type 1 or type 2 diabetes, attending a diabetes clinic at the Kalafong Hospital in Pretoria, South Africa. OUTCOME MEASURES : Micro- or macroalbuminuria and estimated glomerular filtration rate (eGFR) were the outcome measures. RESULTS : An HbA1c > 7% was recorded in 88.9% of the patients, and low-density lipoprotein cholesterol ≥ 1.8 mmol/l in 81%. Overall, the prevalence of micro- or macroalbuminuria was 33.6%. Logistic regression revealed that HbA1c, the duration of diabetes, systolic BP, male sex and triglycerides were predictive of microalbuminuria. CONCLUSION : The prevalence of micro- or macroalbuminuria in this study fell within the ranges of what has previously been reported in Africa. HbA1c and the duration of diabetes were the strongest predictors of microalbuminuria in all of the patients, and age was the strongest predictor of a low eGFR. Diabetes was poorly controlled, making the progression to end-stage renal failure a real concern in these patients.