Endocrine Abstracts

Introduction: Proteinuria is a condition in which urine contains an abnormal amount of protein. Proteinuria is a sign of chronic kidney disease (CKD), which can result from diabetes, high blood pressure and other diseases that cause inflammation in the kidneys. If CKD progresses, it can lead to end-stage renal disease, when the kidneys fail completely.

Case presentation: Sixty-three years old female patient attended our clinic as her glycaemia was poor controlled. She is diagnosed with diabetes mellitus (DM) type 2 during 9 years. Laboratory studies were performed: HbA1c- 9.4%, elevated plasma creatinine 176.32 (N53, 0–97.2) and proteinuria in urine with dipstick 1.01 g/l was observed. Additional investigations were performed: kidney ultrasound, which revealed shrunken kidneys, Urea- 64.21 (N 15.0–45.0), Phosphorus-1.98 (N 0.48–2.19), Parathyroid hormone-273.76 (N 9.0–79.5),Vitamin D-7 (N 30.0–100.0); Potassium-5.59 (N3, 5–5), pH-7.26 (N 7.32–7.72) Hemoglobin-10.2 (N 12–16). The patient had no diabetic specific complications. When DM was diagnosed the patient has already got dipstick proteinuria 0.3 g/l and it was considered as the result of diabetes. Therefore no further investigations were performed to find out the cause of proteinuria. We have not performed renal biopsy to diagnose the real cause of proteinuria, we just started to treat CKD.

Conclusion: Often proteinuria is revelaed when DM is diagnosed, that’s why, no further investigations are performed to precise the real cause of it. Yes, hyperglycemia can cause various damages of kidney, but not in all cases. So, we always have to remember that in diabetic patients the cause of proteinuria may be due to other reasons. We always have to pay attention to other diabetic specific complications and always ask about detail clinical history, for correct diagnosis, better management and prevention of progression of renal disease.