Microalbuminuria among Type 1 and Type 2 diabetic patients of African origin in Dar Es Salaam, Tanzania (original) (raw)
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2021
Background Regular screening for microalbuminuria among type 2 diabetes patients is less common in most low-income countries while it is an early marker of diabetic nephropathy and cardiovascular complications. Objective This study aims to assess the need for regular screening for microalbuminuria among type 2 diabetes patients. Methodology with cross-sectional approach, 124 diabetic patients were recruited at Muhimbili National Hospital, in Tanzania; their age, gender, body mass index, fasting blood sugar levels (by Accu Chek Active Glucometer), random urine albumin levels (by Microalbumin 2-1 Combo Test Strips), and the duration of diabetes were recorded. Results The study indicated that 62.1% of the participants were microalbuminuric while 2.4% were macroalbuminuric. The risk of microalbuminuria was 4.55 higher in patients aged 60-69 years (95% CI: 1.32-16.51), and 17.4 times higher in patients aged 70 and above (95% CI: 1.49-202.86) compared to individuals aged below 50 years. P...
Microalbuminuria in Diabetic Patients in the Bamenda Health District
Science Journal of Clinical Medicine
Diabetic nephropathy (DN) is the most common cause of end stage renal disease (ESRD) and it accounts for one third of all patients requiring renal replacement therapy in Africa. Diabetic patients with microalbuminuria (MA) have an increased risk of progression to macroalbuminuria and later to ESRD. So detecting MA which is a marker of DN helps to alert the clinician to intervene at a time when future renal damage is still preventable. The main goal of this study was to determine the prevalence of MA in diabetic patients at the Bamenda Regional Hospital. This study was a prospective cross sectional study involving diabetic patients at the Bamenda Regional Hospital. A random (spot) or first morning urine specimen was collected and MA was measured by a semi quantitative dipstick method using the URS-14H urine test strips. The prevalence of MA in the present study was 34.6%, which is high but similar to the results of other studies done in sub-Saharan Africa. Although MA was more common (50%) in individuals with diabetes more than 16 years, a high proportion (42.85%) of patients with MA had a duration of diabetes of ≤ 5years. There was no significant difference in the occurrence of MA with respect to age, gender and duration of diabetes. This study showed a high prevalence of MA in the diabetic population presenting at the Bamenda Regional Hospital. Consequently, measures of glycemic control should be enhanced in this population to prevent the progression to macroalbuminuria and ESRD.
2007
OBJECTIVE To evaluate the prevalence and predictors of microalbuminuria in diabetics in Kumasi, Ghana. DESIGN Prospective, cross-sectional study of diabetic patients. SUBJECTS Patients with diabetes, 20 to 78 years of age. MAIN OUTCOME MEASURES Microalbuminuria METHODS All patients (109) attending an outpatient diabetic clinic at the Komfo Anokye Teaching Hospital Diabetes Centre in Kumasi, Ghana from January to July 2005 were enrolled in the study. RESULTS The mean overall age of the cohort was 54.1 +/- 10.9 years, and 28% were male. The proportion of subjects who had microalbuminuria was 43.1% (n=47). The median duration of diabetes before development of microalbuminuria was 10 years. Duration of diabetes, blood urea nitrogen, serum concentration of creatinine, and triglyceride were significantly higher in patients with microalbuminuria (P<.05). Urinary potassium concentration and fractional excretion of potassium were also significantly higher in the patients with microalbumin...
Journal of Obesity and Weight-loss Medication, 2018
Background-Microalbuminuria is an early marker of nephropathy, cardiovascular diseases and severe ocular morbidity in adults with diabetes mellitus. This subclinical condition is associated with high morbidity and mortality. Microalbuminuria precedes the development of overt diabetic nephropathy by 10-14 years. At this stage, one can reverse diabetic nephropathy or prevent its progression. Unfortunately, tests to detect microalbuminuria in diabetics are not routinely done in Uganda. This study sought to determine the prevalence and factors associated with microalbuminuria among newly diagnosed diabetic patients in the National Referral Hospital in Uganda. Methods-In this cross-sectional study conducted between June 2014 and January 2015, we recruited 175 newly diagnosed adult diabetic patients. Information on patients' sociodemographics, biophysical profile, blood pressure measurement, biochemical testing and echocardiographic findings was obtained for all the participants using a pre-tested questionnaire. Microalbuminuria was defined as Albumin to Creatinine Ratio (ACR) between 30 and 299 mg/g. Bivariate and multivariate logistic regression analyses were used to investigate the association of several factors with microalbuminuria. Results-Of the 175 patients recruited, males were 90 (51.4%) and the mean age was 46 ± 15 years. Majority of patients had type 2 DM 140 (80.0%) and the rest had type 1 DM 35 (20.0%). The mean HbA1C was 13.9 ± 5.3%. Mean duration of diabetes was 2 months. Prevalence of This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
International Journal of Diabetes Mellitus
Background: Type 1 diabetes (T1DM) in sub-Saharan Africans is rare and is associated with high mortality from nephropathy. We studied the prevalence and potential risk factors for microalbuminuria (MA) in African and in age-of-onset matched white patients with T1DM. Risk factors for MA were evaluated prospectively in an African cohort. Materials and Methods: 68 African and 134 white patients, age at diagnosis 10-40 years, duration of diabetes > 2 years, were evaluated for MA; 48 Africans were followed prospectively. Results: Africans had shorter duration of diabetes (median, 8 years vs 11 years), higher HbA1c (10.62(SD 2.52)%, vs 9.02(2.44)%, lower cholesterol (4.45(1.04) vs 5.45(1.16)mmol/l), and fewer (23.5% vs 54.5%) had adolescent diabetes onset (p 0.0030 for each); the prevalence of MA was 39.7% and 24.6% respectively (p = 0.0155). In multiple regression analysis MA was associated with mean HbA1c (p < 0.0001), younger age at diagnosis (p = 0.0060), SBP (p = 0.0012) and African race (p = 0.0287). Prospectively, Africans developing MA (45%) had higher mean HbA1c levels (p = 0.0001), were more likely to have had adolescent onset of DM (33.3% vs 8.0%, p = 0.0310) and lower BMI (p = 0.0340); logistic regression revealed that higher HbA1c and SBP, and lower BMI predicted MA. Nine of 16 African subjects progressed to macroalbuminuria; they were characterised only by extremely poor glycaemic control (mean HbA1c, 13.49(2.00)%). Conclusions: Microalbuminuria, and severe hyperglycaemia, are common in diabetic Africans with short duration TIDM; MA may rapidly progress to macroalbumiuria. African race may be associated with increased susceptibility to diabetic nephropathy.
African Health Sciences
Background: The aim of this study was to determine the prevalence and factors associated with microalbuminuria among newly diagnosed diabetic patients in Mulago National Referral Hospital, Uganda. Methods: In this cross-sectional study conducted between June 2014 and January 2015, we collected information on patients' socio-demographics, biophysical profile, blood pressure, biochemical testing and echocardiographic findings using a pre-tested questionnaire. Bivariate and multivariate logistic regression analyses were used to investigate the association of several factors with microalbuminuria. Results: Of the 175 patients recruited, males were 90(51.4%) and the mean age was 46±15 years. Majority of patients had type 2 DM 140 (80.0%) and the rest had type 1 DM 35 (20.0%). Mean glycated hemoglobin (HbA1C) was 13.9±5.3%. Mean duration of diabetes was 2 months. Prevalence of microalbuminuria was 47.4 % (95% CI: 40.0%-54.9%) overall. Pregnancy was associated with microalbuminuria (OR7.74[95%CI.1.01-76.47] P=0.050) while mild and moderate physical activity at work were inversely associated with microalbuminuria respectively (OR0.08[95%CI0.01-0.95] P=0.046) and (OR0.07[95%CI0.01-0.77] P=0.030). Conclusion: Prevalence of microalbuminuria was high in this group. Physical activity at work may be protective against microalbuminuria and this calls for longitudinal studies. Early detection and management of microalbuminuria in diabetics may slow progression to overt diabetic nephropathy (DN).
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2023
Background: Microalbuminuria (MAU) is considered the earliest sign of diabetic nephropathy among diabetes patients. In order to effectively manage diabetic nephropathy and its consequences early, detection of microalbuminuria as soon as possible, especially for diabetes patients, is critical. Therefore, the present study aimed to determine the pooled prevalence of microalbuminuria among diabetes patients in Africa. Methods: Electronic databases such as Google Scholar, PubMed, African Journals Online, Web of Science, Cochrane Library, EMBASE, and ResearchGate were searched for articles and grey literature. The STATA version 14 software was used to conduct the meta-analysis. I 2 and Cochran's Q test were employed to assess the presence of heterogeneity between studies. Due to the presence of heterogeneity, a random effect model was used. The publication bias was assessed using the symmetry of the funnel plot and Egger's test statistics. Moreover, subgroup analysis, trim and fill analysis, and sensitivity analysis were also done. Results: The overall pooled prevalence of microalbuminuria among diabetes patients in Africa was 37.11% (95% CI 31.27-42.95). Substantial heterogeneity was observed between studies, with I 2 values of 94.7%. Moreover, this meta-analysis showed that the pooled estimate of microalbuminuria among type 1 and type 2 diabetes patients was 35.34% (95% CI: 23.89-46.80, I 2 =94.2), and 40.24% (95% CI: 32.0-48.47, I 2 =94.9) respectively. MAU, on the other hand, was more common in people with diabetes for more than 5 years 38.73% (95% CI: 29.34-48.13) than in people with diabetes for less than 5 years 31.48% (95% CI: 18.73-44.23). Conclusion: This systematic review and meta-analysis found a high prevalence of microalbuminuria among diabetes patients. As a result, early detection of microalbuminuria is critical for preventing and treating microvascular complications such as diabetic nephropathy and the onset of end-stage renal disease.
Prevalence of microalbuminuria among adults with Type 2 Diabetes mellitus at OOUTH, Sagamu
Annals of Health Research
Background: Diabetes mellitus is a serious global epidemic. The menace of this chronic disease is attributable to its chronic complications which threaten both the world economy and life expectancy, especially in Sub- Saharan Africa. Nephropathy is a complication of Diabetes mellitus and a leading cause of End Stage Renal Disease. Objectives: To determine the prevalence of microalbuminuria as well as the effects of co-morbidities on the pattern of microalbuminuria among adults with Type 2 Diabetes mellitus. Methods: A total of 325 adults with Diabetes mellitus and 100 controls without Diabetes mellitus were studied. The subjects with diabetes were classified into four groups ([i] diabetes only, [ii] diabetes with hypertension, [iii] diabetes with obesity and [iv] diabetes with hypertension and obesity). Urinary protein, microalbuminuria, fasting plasma glucose and Glycated Haemoglobin (HbA1c) were measured using standard methods. Results: The overall prevalence of microalbuminuria ...
Microalbuminuria and the metabolic syndrome in non-diabetic black Africans
Diabetes & vascular disease research : official journal of the International Society of Diabetes and Vascular Disease, 2007
I t is recognised that the metabolic syndrome promotes the development of cardiovascular disease. Although several studies have shown a relationship between the metabolic syndrome and kidney disease, few of these have used non-diabetic subjects, especially in the African population. This was a cross-sectional study of subjects of African origin, using the metabolic syndrome (MS) criteria of the National Cholesterol Education Program (NCEP) third Adult Treatment Panel (ATP III). Subjects with impaired fasting glucose, with two-hour glucose > 11.1 mmol/L after a glucose tolerance test, were excluded. Spot urine for albuminto-creatinine ratio (ACR) was measured and the glomerular filtration rate (GFR) was estimated using the Modification of Diet in Renal Disease (MDRD) equation. Microalbuminuria was defined as ACR between 3-30 mg/mmol. There was a significant decline in GFR and a significant increase in ACR with increasing number of MS traits. ACR increased four-fold between subjects with no MS traits and those with four or more traits. In subjects with the metabolic syndrome, there was a significant correlation between ACR and systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting glucose. Estimated GFR correlated significantly and inversely with body mass index (BMI) and serum leptin. These observations raise major clinical and public health concerns for developing countries, where both the metabolic syndrome and kidney disease are being reported more and more frequently. The potential economic impact is huge.
Microalbuminuria in Young Sudanese Patients with Type 1 Diabetes
Annals of Saudi Medicine, 1993
Overnight urinary albumin excretion (UAE) was measured in 51 patients, nine to 18 years old, with type 1 (insulin-dependent) diabetes mellitus and in 22 healthy subjects using radioimmunoassay. Thirteen diabetic patients (25.5%) had microalbuminuria defined as UAE rate between 20 and 200 (μg/min. Eleven of these patients were over 13 years of age. This gives a frequency of microalbuminuria of 42% (11/26) in the diabetic children and adolescents in the age group 14-18 years. UAE rate was positively correlated with both age at diagnosis and duration of diabetes. Arterial blood pressure, systolic and diastolic, glycosylated hemoglobin (HbA 1c) and insulin dosage U.kg-1.day-1 were significantly higher (P<0.001) in the diabetic patients with microalbuminuria compared to the diabetic patients with normal UAE rate. Retinal changes were also more common in the microalbuminuric diabetic patients than in the diabetic patients without microalbuminuria (P<0.01). This study has revealed a high prevalence of microalbuminuria in young Sudanese patients with type 1 (insulin-dependent) diabetes mellitus and emphasized the importance of routine screening of diabetic children after the age of 12 years. Despite the marked reduction in the incidence of diabetic nephropathy that occurred in recent decades, it is estimated that between 30% to 35% of the patients with type 1 (insulin-dependent) diabetes mellitus are still at risk of developing this complication [1]. Nephropathy is regarded as the most serious late diabetic complication because it is associated with 100 times greater risk of mortality than in the background population [2]. The median survival period of diabetic patients after onset of overt albuminuria was reported as less than 10 years [3]. In 1963, a sensitive method for detecting urinary albumin in low concentrations was described [4], and since then, many studies have been performed to establish the rate of urinary albumin excretion (UAE) that is predictive of later nephropathy. It was concluded from several reports that a cutoff level of 20 μg/min would include almost 80% of the patients at risk [5-7]. A rate of UAE between 20 and 200 (μg/min was therefore defined as microalbuminuria and is thought to signify incipient nephropathy [8]. Previous studies have shown recognizable variations in the prevalence of microalbuminuria in diabetic patients and have been inconclusive regarding the relationship between UAE and metabolic control [9-12]. The aim of the present study was to determine the prevalence of at risk values of UAE in young Sudanese diabetic patients and to explore its relation to age and glycemic control. Subjects and Methods Subjects The subjects were selected from the children and adolescents with type 1 diabetes who regularly attend the diabetic clinic at the University Hospital in Khartoum, Sudan. The patients who were between nine and 18 years of age and who had the disease for more than one year (62 children) were invited to participate in the study. Thirty healthy nondiabetic schoolchildren, matched for age and sex, were also invited to participate as a control group. All the selected patients were on insulin since the day of diagnosis and nonketotic at the time of investigation. None of these patients were taking any other drug(s) nor had a history of cardiac or nondiabetic renal disease. Methods The UAE was measured in a single, timed overnight urine collection. In accordance with the given instructions, all subjects passed urine immediately before going to bed, discarded this sample and recorded the time. The urine