ROLE OF DURATION OF DIABETES IN THE DEVELOPMENT OF NEPHROPATHY IN TYPE 2 DIABETIC PATIENTS

Abstract

Introduction: Diabetes has now become the most common single cause of end stage renal disease and about 40% of diabetic patients develop nephropathy. The present study was conducted to find out the relation between duration of diabetes & development of renal disease.

Methodology: The study was conducted in 120 patients with Type 2 diabetes. Three groups were selected with 40 patients in each group – with diabetes of <5year duration, 5-10year duration and >10year duration. 40 normal healthy adults were included in the control group. Parameters like BP, blood urea, serum creatinine, urine microprotein were compared with controls.

Results: As duration increases, there is impairment of renal function as evidenced by increase in blood urea, serum creatinine & microproteinuria. Statistically significant increase in BP was also observed with increase in duration. Both metabolic & hemodynamic factors play a decisive role in the development of nephropathy. AGEs, PDGF, TGFβ, VEGF, and Angiotensin II etc. stimulate growth & fibrotic factors leading to renal damage.

Conclusion: Screening for microalbuminuria will allow early identification of patients with nephropathy. It has been shown that meticulous glycemic & bloodpressure control can slow the progression of diabetic nephropathy. Developing countries like India with its large burden of diabetes should evolve strategies for prevention of its secondary complications.