Spectrum of Diabetic Kidney Disease in India - A Tertiary Care Centre Experience

Objectives / Aim of study: To assess the magnitude, clinico-social risk factors and associations of diabetic kidney disease in type 2 diabetes subjects attending a tertiary care centre in Eastern India. Materials and Methods: It was a cross-sectional hospital based observational study. Approximately two fifty (250) consecutive type 2 diabetes subjects aged 18 to 60 years attending the OPD of Endocrinology, Nilratan Sircar Medical College and Hospital were recruited and screened for DKD on the basis of urine ACR and eGFRvalues. Type 2 diabetes subjects with pregnancy, eGFR less than 15 ml/min /1.73 m2, urinary tract infection, hematuria, decompensated heart failure, liverfailure, systemic infections, debilitating illness were excluded from the study. After detailed history taking and clinical examination, necessary investigations were done for each patient and the results were analyzed. Results: The prevalence of DKD was 34% and moderately increased albuminuria (ACR 30 to 300 microgm/mg) was the commonest form of presentation of DKD. Patients with DKD had a significantly higher DM duration, higher BMI, lower HbA1c, higher serum potassium, more dylipidemia and anemia. Malesex, smoking, family history of DKD, erectile dysfunction, VPT abnormality and foot ulcer were significantly associated with DKD. Conclusion: The prevalence of albuminuria was considerably high among diabetes subjects in this area. Longer duration of diabetes, malesex, smoking, family history of DKD and neuropathy were the important risk factors for DKD. Regular screening for DKD and early intervention for multiple modifiable risk factors may prevent this dreaded complication of Type 2 Diabetes Mellitus.