ASSESSMENT OF URINARY ALBUMIN-TO-CREATININE RATIO IN PATIENTS WITH DIABETIC NEPHROPATHY IN SOUTH-SOUTH NIGERIA

*Orugbo V. P.

ABSTRACT

Introduction: Screening for diabetic nephropathy (DN) facilitates early detection, evaluation, and treatment. A spot urine sample used to measure the albumin to creatinine ratio (ACR) accurately reflect the total 24 hour level of urine albumin excretion and the ACR is now recommended by the American Kidney Foundation as the screening tool for patients with diabetes. There are however many drawbacks to the cut off value of 30mg/g. Thus this study aimed to assess the diagnostic accuracy of spot Urinary albumin-to-creatinine ratio in diabetic nephropathy based on the cut off value of 30mg/g. Method: A hospital based cross sectional study involving 80 DN cases being managed in the University of Benin Teaching Hospital. The controls were 80 non diabetic persons from the University of Benin Teaching Hospital. The cases were selected using systematic sampling method and data collected using structured questionnaire after obtaining informed consent. They were sampled for Serum Creatinine, Serum Urea, Urinary Albumin and Creatinine. Urinary albumin-to- creatinine ratio and creatinine based glomerular filtration rate were calculated from the results. Data was analyzed using IBM SPSS version 25 and presented in form of tables, charts and graphs. Results: Of the total of 160 patients, 80 were DN cases and 80 were non diabetic controls. The study showed a significant difference between the mean levels of serum creatinine and urea, urinary creatinine and albumin, urinary albumin –to- creatinine ratio, and eGFR between the cases and controls. The diagnostic accuracy of UACR was higher with cut off value 57.8182mg/g. Conclusion: Serum UACR was shown to have a higher diagnostic accuracy in diagnosing diabetic nephropathy at 57.8182mg/g compared to 30mg/g.

Keywords: Urinary Albumin-to-Creatinine Ratio(UACR), Diabetic Nephropathy(DN), Estimated Glomerular Filtration Rate(eGFR), Urinary Albumin, Urinary Creatinine.