Albuminuria And Cardiovascular Complications In Diabetic Patients.

Abstract

The objective of our study was to determine whether presence of micro- or macroalbuminuria in diabetic patients predicts the presence of coronary heart disease and other risk factors. Eighty patients with history of diabetes of more than 10 years duration were studied. Their urine was tested for albumin with dipstick and radioimmunoassay. Patients were divided into three groups: group-I with macroalbuminuria, group-II with microalbuminuria and group III without albuminuria. The first two groups collectively had higher prevalence of ischaemic heart disease (38.3% vs. 27.3%) and had significantly higher mean value of serum cholesterol (222.3 ± 67,4 vs. 187.6 ± 25.1 p<.001) as compared to group-111 (without albuminuria). They also had significantly higher mean serum creatinine and urea level (1.6 ± 1.3 vs. 0.88 ± 0.24 p <.001) and 52.6 ± 29.1 vs. 34.1 ± 8.4 p <.001). In patients with micro- or macroalbuminuria, values for mean blood pressure, triglycerides and low density lipoprotein were higher; and high density lipoprotein were lower than those without albuminuria, but this difference did not reach the level of statistical significance. We conclude that the patients with diabetes of more than 10 years duration frequently have micro- or macro albuminuria. These patients have more chances of having compromised renal functions and co existent coronary heart disease. The later can be best explained on the basis of higher frequency with which other well known risk factors particularly hypercholesterolemia is seen in this group. Strategy for routine screening of albuminuria in long standing diabetics appears justified to identify people at greater risk. Meticulous metabolic control in such patients may reduce the prevalence of coronary heart disease and end-stage renal failure.