Assessment of Renal Function, in Diabetic Patients Compared to those without Diabetes in a Cameroonian Population
Author(s): Céline Sylvie Mimboe Bilongo, Henriette Thérèse Dimodi, Aristine Augustine Nnomo Assene, Raissa Hermine Hell, Constel Emakam Tchokokam, Santy Steve Bidja, Clergé Tchiegang
Background: Diabetes is a metabolic disease that affects several organs including the kidneys. It is a major public health problem and the leading cause of kidney failure worldwide. Early management of diabetes with strict control of blood glucose levels reduces microalbuminuria and progression to diabetic nephropathy. The aim of this study was to compare the glomerular filtration rate of two groups of diabetic patients: those under medical supervision and those who are not under supervision and taking no treatment with normal individuals.
Methods: A case-control study was conducted from June to August 2015 at the Cité Verte District Hospital. Socio-demographic data were collected using a questionnaire, followed by blood tests for urea/creatinine, urine sampling for glycosuria and proteinuria for each eligible participant. The data were analysed using SPSS version 20.0 software, with a significant P value at P>0.05. Glomerular filtration rate was calculated using the Modification of Diet with Renal Disease (MDRD) formula.
Results: The sample consisted of 99 participants, distributed as follows: 36.4% were diabetics under treatment and medically monitored, 32.3% were naïve diabetics not medically monitored and 31.3% were healthy patients. The majority of the patients were women (69.7%), with a mean age of 47.86 ±16.32 years. The parameters of renal function evaluation, showed that the mean uremia (1.15±4.17 g/l), and creatinemia (13.22±6.77 mg/l) were significantly higher in naive diabetics (p<0.05) compared to the other two subgroups. No significant differences were observed for proteinuria and glycosuria in the different subgroups. The glomerular filtration rate was significantly lower in the diabetic naïve group (65.88±23.19 ml/ min/1.73m2). In the diabetic population, the independent risk factors for impaired glomerular filtration rate were age > 50 years (OR=1.53; 95% CI: 0.43-5.49); no treatment (OR= 27.2; 95% CI: 3.31-223.84); hyper-creatinemia (OR=26.40; 95% CI: 6.07-114.7); hyper-uremia (OR= 8.16; 95% CI: 1.91-34.85).
Conclusion: Although diabetic patients are predisposed to nephropathy, it should be noted that medical management, including therapeutic and dietary follow-up, improves the metabolic health of these patients and slows the development of long-term complications.