Endocrine Abstracts

Introduction: The pathophysiology of diabetic nephropathy is characterized by proteinuria which often precedes the decline in creatinine clearance. The objective of our study was to describe the clinical and metabolic characteristics of a population of diabetic femele patients with renal failure without proteinuria.

Methods: This is a retrospective study that included 37 diabetic women who had been hospitalized at the National Institute of Nutrition of Tunis (Departement B) for diabetes equilibration. Clinical and metabolic data were collected from medical records. All patients had at least two normal 24 H microalbuminurias. No patient had a clear etiology that explains renal impairment. Creatinine clearance was calculated by the formula CKD-EPI.

Results: The mean age was 57.8±6.5 years. Diabetes was type 2 in 100% of cases evolving since 13.8±2.9 years on average. The average BMI was 33.3±2.8 kg/m². 45.04% of patients were dyslipidemic. 62.16% were hypertensive, poorly balanced in more than 60% of cases. 35.15% were polymedicated with an average of 4 drugs per prescription. Degenerative complications Diabetes was myocardial infarction (8.1%), stroke (10.8%), chronic arteritis of the lower limbs (2.7%) and diabetic retinopathy (43.24%). The mean HbA1C was 11.8±1.3%. The mean creatinine clearance was 53.5±12.6 mmol/L.

Conclusion: Diabetes remains the most common etiology of kidney failure worldwide. In our population, normal proteinuria and the presence of other factors that can alter kidney function, made us retentive before retaining the diagnosis of diabetic nephropathy. Other studies with larger numbers are needed to better characterize similar cases of nephropathy.