REVERSE EPIDEMIOLOGY OF BODY MASS INDEX AND ALBUMIN IN DIABETICS PATIENTS WITH END STAGE RENAL DISEASE, EVALUATION OF HYPOALBUMINEMIA IN DIABATIC PATIENTS WITH END STAGE RENAL DISEASE.

Sumaiya Qayyum, Shaheen Bibi*, Fahad Naseem, Mehwish Qamar

ABSTRACT

Background: Hypoalbuminemia is one of the major predictor of mortality in ESRD patients. Several risk factors for hypoalbuminemia have been recognized in ESRD patients including advancing age and female gender. Diabetes mellitus is also found as a risk factor for low albumin in dialysis patients. The problem is under-recognized in our part of the world. In this study, we aimed to establish the incidence of hypoalbuminemia in ESRD with Diabetic patients and to study the correlation between low albumin and body mass index. Material and method: It was a cross-sectional study conducted at the Department of Nephrology, Liaquat national hospital Karachi. Patients of either gender who were known diabetic and were having End Stage Renal Disease were included in the study. Those patients who were having liver disease, some known malignancy, and malnutrition were excluded. Data was collected through an interview, a physical examination to measure BMI and a lab test for serum albumin. All the information was recorded in a manual proforma/Excel sheet by the principal investigator. Data analysis: The patient’s data was compiled and analyzed through the statistical package for Social Sciences (SPSS) Version 26. The chi-square test / Fisher's Exact test was applied to determine the significance of outcome variables. P value ≤0.05 was considered significant. Results: 109 patients were included. .Mean age was 61.4 years. 61 patients were male while 48 were female. Hypertension was noted in 96 patients. Ischemic heart disease was found in 37 patients. Mean height was 1.63 m. Mean weight was 70.40 kg. Mean body mass index was 26.80 kg/m2. Mean duration of hemodialysis and duration of ESRD was 2.78 years . We noted hypoalbuminemia in 74 patients and Mean serum albumin was 3.35 g/L. 58 patients had BMI > 24 Kg/m2 while 51 patients had BMI between18 to 24 Kg/m2. Conclusion: Hypoalbuminemia is common in diabetic patients with ESRD. Over weight patients has more hypoalbuminemia. Likewise, low albumin is more prevalent in those patients who commenced on hemodialysis for less than 3 years. Apart from poor nutritional status, presence of hypoalbuminemia in diabetic patients with ESRD may point towards inadequacy of dialysis. Checking serum albumin in diabetic patient with ESRD is recommended to improve nutrition and dialytic therapy in this group of patient.

Keywords: Hypoalbuminemia, End Stage Renal Disease, Diabetes Mellitus, Hemodialysis, Body Mass Index.