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Analysis Study Research Paper | Diabetology | India | Volume 12 Issue 7, July 2023
Correlation of Estimated Glomerular Filtration Rate with Microvascular Complications in Type - 2 Diabetes Mellitus Patients
Dr. Pashaura Singh Sandhu [2] | Dr. Chandan [12] | Dr. Surinder Kumar Salwan [2]
Abstract: Background: Diabetes mellitus (DM) is a global health problem which carries a risk for a myriad of microvascular and macrovascular complications, including retinopathy, nephropathy, and neuropathy (microvascular) and ischemic heart disease, peripheral vascular disease, and cerebrovascular disease (macrovascular). GFR is the best measure of kidney function. Changes in GFR appear earlier than microalbuminuria in diabetic patients. The present study was conducted to investigate the potential association of estimated glomerular filtration rate with prevalence of microvascular complications as well as to evaluate the effect of decline in estimated glomerular filtration rate with severity of microvascular complications of diabetes. Materials & Methods: This was conducted on 100 patients in the department of Medicine, Government Medical College, Amritsar. The study protocol was approved by the institutional ethics committee. The patients were enrolled in the study after obtaining written informed consent. The urine microalbumin excretion test and serum creatinine test were performed. Serum creatinine test was done to calculate the eGFR by modification of diet in renal disease (MDRD) formula. The results were then analysed. Results: Out of 100 patients, eGFR was <15 mL/min in 30% patients, 15 - 30 mL/min in 35% patients, 30 - 60 mL/min in 33% patients, 60 - 90 mL/min in 4% patients and >90 mL/min in 1% patient. There was a negative correlation between eGFR and systolic blood pressure which was statistically significant (p=0.01). However, there was no correlation between eGFR and diastolic blood pressure. Though a downward trend in eGFR change was demonstrated alongside an HbA1C reduction, however, no statistically significant correlation between HbA1C and eGFR was found. There was a negative correlation between eGFR with Urinary Albumin Creatinine Ratio (Pearson Coefficient - 0.39), implied that more was the Urinary Albumin Creatinine Ratio, less was the eGFR. Similarly, there was also a negative correlation between eGFR with Serum Creatinine, and Systolic BP (Pearson Coefficient - 0.48 and - 0.30, respectively). Conclusion: eGFR estimation is an indicator of kidney function which enables the identification and classification of the level of renal impairment in diabetic nephropathy. Retinopathy, neuropathy, and nephropathy are the microvascular complications of diabetes that are strongly and substantially correlated with a reduction in eGFR. The worsening severity of microvascular consequences of diabetes are related to lower levels of eGFR. Controlling the pace of eGFR drop will lessen the likelihood of complications, which will lower the burden of the condition and enhance patient quality of life. Therefore, new treatment approaches should focus on maintaining steady renal function in diabetics.
Keywords: Diabetes mellitus, Diabetic neuropathy, Diabetic nephropathy, Estimated glomerular filtration rate
Edition: Volume 12 Issue 7, July 2023,
Pages: 1687 - 1690