The Pattern of Diabetic Nephropathy Among Saudi Patients with Noninsulin-Dependent Diabetes Mellitus

Huraib, Sameer; Abu‐Aisha, Hassan; Sulimani, Riad A.; Famuyiwa, Funsho O.; Al-Wakeel, Jamal; Askar, Akram; Sulimani, Fathia

doi:10.5144/0256-4947.1995.120

Cited by 23 publications

(29 citation statements)

References 30 publications

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“…Controlling FBS is important in the follow-up and control of diabetes patients. HbA1c was not correlated statistically with albumin concentration in urine, which is consistent with a similar finding in the study conducted by Huraib et al 21 The Diabetes Control and Complications Trial 22 study found that for every 1% reduction in HbA1c, there was a 28% reduction in nephropathic complications in type 1 diabetes, as compared to 34% in type 2 diabetes at 12 years' follow-up. The duration of diabetes was another variable that correlated with albuminuria (P=0.012).…”

Section: Discussionsupporting

confidence: 80%

Microalbuminuria Among Patients with Diabetes Type 1 and Type 2 at the Armed Forces Hospital in Jubail

2001

Annals of Saudi Medicine

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Nephropathy is one of the common complications of diabetes, and can lead to end-stage renal failure. The number of diabetic subjects accepted for renal dialysis treatment is increasing yearly.1 Nephropathy takes several years to develop after the diagnosis of diabetes, but if it is diagnosed early, the process can be aborted or even reversed by strict metabolic control. 2Nephropathy presents first as intermittent microalbuminuria (incipient), progressing to persistent microalbuminuria, and then to macroalbuminuria. A useful method of early detection of albumin in urine is by quantifying microalbuminuria. The usual way to do this is by measuring albumin in a 24-hour urine sample. But the patient's compliance is a limiting factor. An easier method is to measure the concentration of albumin in urine at the patient's regular visit, especially the concentrated morning sample.Several investigators used this method and reported comparable results. 3,4 In fact it has been recommended as a screening test for early detection of nephropathy.5 In this study, the investigator tried to identify the extent of microalbuminuria among the regular diabetic patients attending the primary health care clinic. Patients and MethodsMore than 300 diabetic patients are seen regularly at the diabetic clinic in the Primary Care Department of the Armed Forces Hospital in Jubail, Saudi Arabia. A full history, physical examination and the necessary investigations were done for most of the patients attending this clinic.One random sample of urine was obtained (from 104 patients with diabetes, randomly selected from the Primary Care Clinic) for quantifying albumin concentration in urine. This method is superior to the excretion rate 6 and an accurate method for screening of micro-and macroalbuminuria. 7 The method used was the urinary protein (UP) method developed for aca™ discrete clinical analyzer. In this method, the turbidimetric method of Iwata and Nishikaze, 8 as well as the benzethonium chloride method for precipitating urinary protein in a basic medium, were used for quantifying microalbuminuria. The specimens were analyzed within one hour in the same hospital laboratory. The urine samples were random single-sample (i.e., not a 24-hour sample) collected from the patients as they were seen at the clinic. The single-sample method was also used before by several authors. 3,9,10

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Section: Discussionsupporting

confidence: 80%

Microalbuminuria Among Patients with Diabetes Type 1 and Type 2 at the Armed Forces Hospital in Jubail

2001

Annals of Saudi Medicine

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“…Studies in Hong Kong revealed a prevalence of 13.4% (13) and 22.7% in young diabetic patients (14). A study by Huraib et al in Saudi Arabia denoted a prevalence of microalbuminuria of 16.8% (15). In Kuwaiti individuals with Type 2 diabetes, the prevalence of microalbuminuria was 27.3% (16).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors of Microalbuminuria and Macroalbuminuria in Type 2 Diabetic Patients in North of Iran - Rasht

Ansar¹,

ShahrokhiRad²,

Lebady³

2016

Nephrourol Mon

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Background: Higher urinary albumin excretion has been suggested as a predicting diabetic nephropathy. Objectives: The present study aimed at determining the prevalence and risk factors associated with albuminuria in patients with Type 2 diabetes mellitus in north of Iran, Rasht. Methods: Two hundred and four patients who referred to a diabetes center in north of Iran were enrolled in the current study. Urinary albumin excretion (UAE) was measured by immunoturbidimetric assay. Microalbuminuria and macroalbuminuria were considered as a UAE rate of 30 to 300 mg /24-h and more than 300 mg/24-h, respectively. Risk factors associated with albuminuria were evaluated by backward stepwise logistic regression. Results: The prevalence of micro and macroalbuminuria was 17.2% and 17.6%, respectively. Microalbuminuria was significantly associated with longer diabetes duration, increased fasting plasma glucose, and diastolic blood pressure. It was also found that higher plasma glucose and BUN (blood urea nitrogen) were risk factors for macroalbuminuria. Conclusions: Prevalence of both micro-and macroalbuminuria was high in the patients of this study. Therefore, it seems that controlling blood glucose and lowering blood pressure, even in the absence of hypertension-prehypertension, should be considered for patients with microalbuminuria.

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“…There are tremendously increasing trends in the incidence of diabetes and DN, signaling a medical catastrophe in dialysis units which results in a greater consumption of economic resources 34. In Saudi Arabia alone, approximately 11 000 patients have ESRD, and 20% is due to diabetes 45. The cost of care with dialysis in Saudi Arabia amounts to US$14 000 per patient per year and the total economic burden exceeds US$540 million 6.…”

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confidence: 99%

Factors affecting the progression of diabetic nephropathy and its complications: A single-center experience in Saudi Arabia

Al-Wakeel

Isnani

Alsuwaida

et al. 2011

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVES:One out of five Saudi diabetics develops end-stage renal disease (ESRD). Factors associated with progressive loss of renal function have not been extensively studied and reported in our community. We sought to evaluate the pattern and progression in glomerular filtration rate (GFR) and investigate the potential risk factors associated with progression to diabetic nephropathy (DN) among Saudi patients.DESIGN AND SETTING:Hospital-based retrospective analysis of type 2 diabetic patients seen between January 1989 and January 2004 at Security Forces Hospital and King Saud University in Riyadh, Saudi Arabia.PATIENTS AND METHODS:DN was defined as persistent proteinuria assessed by urine dipstick [at least twice for at least two consecutive years and/or serum creatinine >130 μmol/L; and/or GFR <60 mL/min/1.73m2].RESULTS:Of 1952 files reviewed, 621 (31.8%) met the criteria for DN, and 294 (47%) were males. The mean (SD) age of the patients at baseline was 66.9 (11.4) years, and mean duration of diabetes was 15.4 (7.5) years. GFR deteriorated from a baseline value of 78.3 (30.3) mL/min/1.73m2 to 45.1 (24.1) mL/min/1.73m2 at the last visit, with a mean rate of decline in GFR of 3.3 mL/min/year. Progression of nephropathy was observed in 455 (73.3%) patients, with 250 (40.3%) patients doubling their first–hospital-visit serum creatinine level in a mean of 10.0 (6.0) years. At the end of the study, 16.5% of the cohort developed ESRD and were dialyzed. GFR >90 mL/min/1.73m2 at the first hospital visit; duration of diabetes >10 years; persistent proteinuria; systolic blood pressure >130 mm Hg; and presence of retinopathy were significant markers associated with progression of nephropathy.CONCLUSION:Diabetic nephropathy tends to be progressive among Saudis, with GFR deteriorating at a rate of 3.3 mL/year and with a doubling of serum creatinine level in 40.3% of patients in 9.9 years.

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The Pattern of Diabetic Nephropathy Among Saudi Patients with Noninsulin-Dependent Diabetes Mellitus

Cited by 23 publications

References 30 publications

Microalbuminuria Among Patients with Diabetes Type 1 and Type 2 at the Armed Forces Hospital in Jubail

Microalbuminuria Among Patients with Diabetes Type 1 and Type 2 at the Armed Forces Hospital in Jubail

Risk Factors of Microalbuminuria and Macroalbuminuria in Type 2 Diabetic Patients in North of Iran - Rasht

Factors affecting the progression of diabetic nephropathy and its complications: A single-center experience in Saudi Arabia

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