[Nephropathy and microalbuminuria in type II diabetes].

OBJECTIVE

To study the population receiving care to find the prevalence of diabetic Nephropathy (DNP) and its association with possible risk factors in type 2 Diabetes Mellitus.

DESIGN

A descriptive crossover study.

SETTING

An urban health district with an aged and socio-economically depressed population.

PATIENTS

Randomised sampling among the health district's registered diabetics (n = 198).

MEASUREMENTS AND MAIN RESULTS

Among other parameters, the values of Proteinuria and Microalbuminuria in 24 hour's urine and of serum Creatinine were analysed. On the basis of these values the four stages of DNP were established: I) Normality, II) Microalbuminuria, III) Proteinuria, IV) Renal failure. The prevalences recorded were 33.8%, 51%, 11.1% and 4%, respectively. Also studied was the value of Microalbuminuria measured at random by reactive strips dipped in urine, which displayed 78% sensitivity and 68% specificity. The most notable of the DNP risk factors were how long the DM had evolved (p = 0.005). Age (p = 0.02), the value of the glucosilated haemoglobin (p = 0.03) and of the triglycerides (p = 0.03) were also related factors. On analysing the association of DNP with other chronic complications of DM, a statistical relationship to the presence of Retinopathy (p < 0.001) and peripheric Vasculopathy (p < 0.001) was observed.

CONCLUSIONS

The presence of some stage of DNP among the type 2 DM population is very common. Only 33.8% of the sample was normal regarding the urinary excretion of proteins. Microalbuminuria quantified at random with reactive strips has low specificity. The highest risk factor for DNP is the length of the DM's evolution, with age and metabolic control of the disease also being important.