Endocrine Abstracts

Introduction: Diabetic nephropathy remains a major cause of morbidity and mortality for persons with diabetes mellitus. Globally, most patients with diabetes are in developing countries that do not have the resources or health infrastructure to provide universal renal replacement therapy. The ADA recommends that estimated glomerular filtration rate (eGFR) be calculated using serum creatinine for diabetics at least once a year.

Objectives: To determine the correlation between glycated haemoglobin and eGFR by CKD-EPI among Type 2 diabetics. To assess validity and reliability of CKD- EPI, MDRD and Cockcroft- Gault equations in diagnosing diabetic nephropathy.

Methods: A cross sectional study was carried out in the Endocrine outpatient clinic in DELSUTH, a tertiary hospital in Delta State, Nigeria. 150 patients were selected. Inclusion criteria included type 2 diabetics seen in the clinics in the last 24 months who consented in the study. Exclusion criteria included known CKD patients, very ill patients. Each patient’s biodata was taken and samples were taken for FBS, HbA1c, PCV and creatinine. eGFR was calculated using the MDRD, CKD-EPI and Cockroft- Gault formulae.

Results: Hundred and fifty patients participated in the study. 79 (52.7%) were females and 71 (47.3%) males. 69 (46%) of them were in the 50–59 year- age- group. The average duration of time passed since diagnosis of DM was 8 years. There is a negative correlation between the mean HbA1c (8.34±2.59) and eGFR CKD-EPI (86.95±24.69) with correlation coefficient =0.13. CKD- EPI has a sensitivity of 80%, specificity 62.9%, accuracy of 64%. MDRD has a sensitivity of 90%, specificity of 57.9%, accuracy of 60%. Cockroft- Gault has a sensitivity of 90%, specificity 44.3%, accuracy 47.3%.

Conclusion: eGFR increases as glycaemic control improves in type 2 diabetics. CKD- EPI has the highest accuracy though it also appears to have the lowest sensitivity.