Prevalence of proteinuria and its clinical implications in type 2 diabetic patients treated at a primary health care centre in Abha City.

The aim of the present study is to describe the prevalence of proteinuria in a series of type 2 diabetic patients registered and followed up in the diabetes clinic of a primary health care center (PHCC) in Abha city, southern Saudi Arabia and to relate the proteinuria to some clinical manifestations. The study involved the files of 208 diabetic patients (118 females and 90 males). They were chosen from 475 files of diabetic patients receiving care in the PHC center of Shamasan in Abha City. The selection was based on the fulfillment of certain criteria: type 2 diabetic patients, registered for at least 12 months and visited the clinic for at least once during that period. For each patient the diabetes duration, the last readings of fasting blood sugar, total cholesterol level, were used. Proteinuria was considered whenever the last and any of the preceding 3 urine analysis revealed it by the dipstick test. Proteinuria is present in more than half the patients (54.3%). The fasting blood sugar shows a considerably high mean of 218.0 +/- 72.0 mg/dl. The total cholesterol level on the other hand showed a slight high average of 233.7 +/- 55.2 mg/dl. The results of the three different types of compliance as scored by the treating physician showed that the poor scores dominate with 74%, 82.7% and 78.4% of patients' diet, drug and appointment compliances. The outcome of the logistic regression model for proteinuria showed that the significant factors were the poor glycemic control with an odds ratio (OR) of 3.13, diabetes duration (OR = 1.08 for every year) and diastolic blood pressure (OR = 6.11). Diabetic patients treated in the PHC level should be regularly monitored for microalbuminuria and not gross proteinuria to prevent progression to overt nephropathy which will eventually lead to ESRD. The risk increases with poorly controlled and hypertensive patients.