FREQUENCY OF NEPHROPATHY AND ITS RELATION TO METABOLIC CONTROL IN PATIENTS WITH DIABETES MELLITUS

Introduction: diabetic nephropathy is a serious complication of both type 1 and type 2 diabetes, and unless arrested, leads to end-stage renal disease. the aim of this study was to find the prevalence of kidney dysfunction in patients with diabetes mellitus and to determine its correlation with metabolic control.methods: we randomly selected 1203 cases with diabetes mellitus presenting to the institute of endocrinology and metabolism. urinary protein and creatinine were determined in a sample of 24-hour urine collection by the enzymatic methods and spot urine dipstick blood urea nitrogen, serum creatinine, hba1c and fasting blood glucose were assessed.results: in this study, 1203 patients (438 patients with type 1 diabetes mellitus [t1dm] and 777 with type 2 diabetes mellitus [t2dm]) were randomly selected. they consisted of 512 females and 721 males. mean ± sd (standard deviation) of hba1c was 7.9±3.4 in t1dm and 7.4±3.5 in t2dm. based on hba1c levels, good control was detected in 50.2% of patients, fair control in 20.4% and bad control in 29.4%. of 1022 patients who were evaluated for proteinuria, 201 (19.7%) had albuminuria or clinical proteinuria. of 931 patients, 19% had high levels of blood urea nitrogen and serum creatinine. end-stage renal disease (esrd) was seen in 10 (0.8%) of all the cases. a statistically significant positive correlation was found between duration of dm, serum creatinine and 24-hour urinary protein (p< 0.001).conclusion: we found a high prevalence of clinical proteinuria in diabetic patients. duration of diabetes and poor metabolic control were identified as a strong predictors of kidney damage in patients with diabetes.