Early diagnosis of diabetic nephropathy and its screening

Abstract

Introduction: Diabetic nephropathy constitutes the leading cause of chronic kidney disease and renal function substitution all over the world and without exception, given the rapid deterioration of renal function suffered by patients who fail to achieve diabetes metabolic control goals and the associated comorbidities representing additional progression factors. All these cause an unavoidable drop in glomerular filtration rate and a subsequent dialysis treatment. Considering that nowadays there are not any preventive interventions in nephrology focused on diabetes, we present the results of a program conducted on patients treated for the first time at Hospital General Guillermo Álvarez Macías, Tula de Allende, Hidalgo, México. Objective: Early diagnosis of diabetic nephropathy and identification of associated risk factors. Methods: A descriptive, retrospective, cross-sectional study, which included a 24-hour albumin test, was conducted by means of renal function tests deliberately looking for abnormal findings. Data were analyzed using the SPSS 15 statistical software for Windows. Results: By means of traditional techniques used to treat diabetic patients in general, it was possible to diagnose diabetic nephropathy in 61% of the patients vs. 30%. Persistent hyperglycemia was found to be the main factor associated with nephropathy, lengthy suboptimal control levels being the common factor that distinguishes these patients from the population not suffering from diabetic nephropathy (p 0.002). Conclusions: Given that diabetic nephropathy is a preventable disease, it is easy to diagnose it through an adequate screening at first- and second-level care, which allows a timely referral to a nephrology specialist to treat it.