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

Abstract

Objective: The aim of this study was to determine the prevalence of micro- or macroalbuminuria among type 1 and type 2 diabetic patients and to examine the relationship with diabetes control parameters: haemoglobin A1C (HbA1C), blood pressure (BP) and lipids. Design: Analytical cross-sectional study. Setting and subjects: The study consisted of 754 patients with either type 1 or type 2 diabetes mellitus, attending a diabetic clinic at the Kalafong Hospital in Pretoria, South Africa. Outcome measures: Micro- or macroalbuminuria and estimated glomerular filtration rate (eGFR). Results: Of all patients, 88.9% had HbA1C > 7%, and 81% had low-density lipoprotein (LDL) cholesterol ≥1.8 mmol/l. Overall prevalence of micro- or macroalbuminuria was 33.6%. Logistic regression revealed that HbA1C, duration of diabetes, systolic BP, male sex and triglycerides predicted microalbuminuria. Conclusion: The prevalence of micro- or macroalbuminuria in this study falls within the ranges of what has been previously reported in Africa. In all patients, HbA1C and duration of diabetes were the strongest predictors of microalbuminuria, 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.