Prevalence of microalbuminuria in patients with diabetes mellitus in the Czech Republic: Project IDN-Micro

Czech version

Authors: Ondřej Pátek; Miroslava Horáčková; Milan Kvapil
Authors‘ workplace: Interní klinika 2. LF UK a FN v Motole, Praha
Published in: Vnitř Lék 2016; 62(Suppl 6): 21-24
Category: Original Contributions

Overview

Introduction:
Prevalence of a positive testing for microalbuminuria (MA) in patients with diabetes mellitus in the Czech Republic is not described in the available literature. The data is important with regard to monitoring effectiveness of the comprehensive therapy for diabetes mellitus, from the prognostic and pharmacoeconomic perspective.

The aim of the study was to assess the prevalence of presence of microalbuminuria or proteinuria (PU) in randomly chosen patients with diabetes mellitus aged up to 65 years in a cross-cutting study. The secondary aim was to assess the distribution of eGFR (estimated glomerular filtration) in the same population.

Methodology:
2 024 patients with diabetes aged up to 65 years were examined within the project. The median of diabetes duration was 6.0 years, the BMI median was 30.7 kg/m², the creatinine median 74.9 µmol/l, the median of HbA_1c 5.45 %, the blood pressure median 132/80 mm Hg. 1 888 patients had type 2 diabetes (DM2T).

Results:
19.96 % of the examined patients tested positive for MA (24.24 % of them with type 1 diabetes – DM1T, 19.16 % DM2T). 11.36 % tested positive for PU (17.78 % DM1T, 10.21 % DM2T). Glomerular filtration was established through calculation (MDRD), with a normal value identified in 44.7 %, a mild decrease (eGFR 1.0–1.49 ml/s) in 46.7 %, medium (eGFR 0,5–0,99 ml/s) in 7.7 %, and a severe decrease (eGFR < 0.5 ml/s) identified in 0.7 %, hemodialysis in 0.2 %. The median of diabetes duration in MA-negative patients was 5 years, in MA-positive patients 7 years and in patients with proteinuria 11 years. Regarding patients with eGFR between 0.5–0.99 ml/s/1.73 m², 63.23 % of them tested negative for MA and 71.62 % for PU, regarding those with eGFR in the range of 0.25–0.49 ml/s/1,73 m², 15.38 % tested negative for MA and 7.69 % were PU-negative.

Conclusion:
The IDN-Micro project shows high prevalence of positive MA and PU findings in individuals with diabetes mellitus younger than 65. For a significant proportion of individuals, the most likely cause of the decrease in eGFR is other than hyperglycemia. It is apparent that examination of serum concentrations of creatinine and evaluation of eGFR is also necessary for relatively younger patients with diabetes.

Key words:
diabetes mellitus – eGFR – microalbuminuria

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