ROLE OF ALBUMIN-CREATININE RATIO AND HBA1C IN PRE-DICTING RENAL INVOLVEMENT AMONG TYPE 2 DIABETIC PATIENTS

Abstract

Introduction: Diabetes mellitus (DM) prevalence rise worldwide, and it also increases the healthcare challenges. Diabetic kidney disease(DKD) is a major long-term complication of type 2 diabetes(T2DM) and the most common cause of chronic kidney disease(CKD) and end-stage kidney disease(ESKD) worldwide. The study aims to assess the prevalence of kidney involvement among T2DM patients, classify them according to glomerular filtration rate(GFR), and determine the predictive value of HbA1C and albumin-creatinine ratio(ACR) for declining GFR.

Methodology: The study is a cross-sectional analysis of patients diagnosed with T2DM. The sample size 106 was determined based on the prevalence of DKD among T2DM. Data collection included medical record review, face-to-face interviews, blood and urine sample analysis, and calculation of eGFR. Patients were classified based on GFR and urinary ACR, and those with kidney involvement were identified. Statistical analyses were performed using SPSS, and significance was set at p ≤ 0.05.

Result: The study included 106 T2DM patients, of which 46.2% had kidney involvement based on elevated ACR. Among these patients, 28.6% had a GFR <15 ml/min/1.73m² and were on hemodialysis. Significant differences were observed between the patients with kidney involvement and the patients without kidney involvement in terms of age, HbA1C levels, ACR, GFR, duration of diabetes, and tobacco use history. ROC curve analysis showed that HbA1C and ACR were reliable markers for predicting kidney involvement, with specific cutoff values identified.

Conclusion: The study demonstrates that individuals with T2DM and kidney involvement have higher HbA1C levels, greater albuminuria (ACR), reduced GFR, and longer duration of diabetes compared to those without kidney involvement. Monitoring HbA1C and ACR levels is crucial in identifying individuals at risk of kidney involvement. The study concludes that HbA1C and ACR can serve as useful markers for predicting kidney involvement in T2DM patients.