Renal Function in Type 2 Diabetes Patients in Ile-Ife, Southwest Nigeria: A Clinicopathological Study

Akinwumi, Akinbodewa Ayodeji and Oluyomi, Okunola and Kayode, Adelusola A. and Abefe, Sanusi Abubakr and Abiola, Arogundade Fatiu and Rosemary, Ikem T. and Adewale, Akinsola (2021) Renal Function in Type 2 Diabetes Patients in Ile-Ife, Southwest Nigeria: A Clinicopathological Study. In: Highlights on Medicine and Medical Science Vol. 18. B P International, pp. 153-164. ISBN 978-93-91595-95-1

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Abstract

Aims: To determine the prevalence and clinico-pathological correlates of diabetic nephropathy among type 2 diabetics in Southwest Nigeria.

Study Design: Descriptive, cross-sectional.

Place and Duration of Study: Renal Unit, Medicine Department, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Southwest Nigeria.

Methodology: Percutaneous ultrasound-guided renal biopsy was carried out in 40 consenting type 2 diabetic adults out of 88 patients in stages 3 and 4 chronic kidney disease using the Kidney Disease Improving Global Outcomes classification.

Results: Eighty eight (48.1%) of the one hundred and eighty three subjects with mean age of 58.05(±6.10) years had clinical Diabetic Nephropathy. The duration of diabetes was 9.55(±4.1) years. Median protein excretion was 0.55 g/day. Mean estimated Glomerular Filtration Rate was 45.1(±12) ml/min. Thirty nine renal (97.5%) tissues showed glomerular basement membrane thickening.

There was a positive correlation between the systolic blood pressure and severity of glomerular lesions (r=0.480, p=0.002), interstitial changes (p=0.602, r<0.001) and vascular lesions (0.429, 0.006). The diastolic blood pressure correlated with glomerular lesions (r=0.500, p=0.001), interstitial changes (0.479, 0.002), vascular lesions (p=0.431, r=0.006), nodular glomerulosclerosis (r=0.333, p=0.036) and diffuse glomerulosclerosis (r=0.372, p=0.018). Urinary protein excretion correlated with severity of glomerular lesions (r=0.457, p=0.003), vascular changes (r=0.483, p=0.002) and diffuse glomerulosclerosis (r=0.407, p=0.009). Diabetic retinopathy correlated positively with severity of glomerular lesion (r=0.406, p=0.009) and diffuse glomerulosclerosis (r=0.547, p<0.001).

Conclusion: The prevalence of diabetic nephropathy among type 2 diabetics in Ile-Ife is high. Glomerular basement membrane thickening was the most prevalent renal pathology. There was a positive correlation between blood pressure, protein excretion, retinopathy and renal histology. The management of diabetes mellitus should be multidisciplinary once diagnosis is made especially in developing countries.

Item Type: Book Section
Subjects: Journal Eprints > Medical Science
Depositing User: Managing Editor
Date Deposited: 26 Oct 2023 04:01
Last Modified: 26 Oct 2023 04:01
URI: http://repository.journal4submission.com/id/eprint/2953

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