Prevalence of Proteinuria among Type 2 Diabetic Patients in Dhamar Governorate, Yemen

Background: Diabetic nephropathy remains the most common cause of end-stage renal disease (ESRD) worldwide. Microalbuminuria is the first clinical sign of renal dysfunction in patients with diabetes mellitus. A urine total protein: creatinine ratio (TPCR) is a convenient and inexpensive measure of proteinuria and could be used to predict the presence of microalbuminuria in diabetic patients. Objective: The aim of this study was to assess the prevalence and associated risk factors of proteinuria among type2 diabetic patients in Dhamar governorate, Yemen. Method: This was a cross sectional study, spot urine TPCR was performed on 200 diabetic patients who attended the diabetic clinic at Dhamar General Hospital and Al-Wahda Teaching Hospital from March 2016 to June 2016. Results: This study indicated higher prevalence of pathological proteinuria (TPCR ≥ 150 mg/g of creatinine) 64% of the study population. Estimated urine albumin-to-creatinine ratio (ACR) revealed that 49% of the diabetic patients had microalbuminuria (ACR 30-300 mg/g) and 25.5% was estimated as macroalbuminuria (ACR > 300 mg/g). Multivariate analysis revealed that the Hypertension (Ad OR: 3.44; % CI: 1.57-7.55; p: 0.002), duration of diabetes 5-10 years (Ad OR: 5.55; % CI: 2.22-13.89; p: 0.000) and beyond 10 years (Ad OR: 8.88; % CI: 3.04-24.77; p: 0.000) and obesity (Ad OR: 0.15; % CI: 0.03-0.69; p: 0.015) were associated with a progressively greater likelihood of pathological proteinuria. Conclusion: The present study revealed high prevalence of nephropathy among Type-2 diabetic patients. Hypertension, duration of diabetes and obesity are the risk factors associated with diabetic proteinuria. Screening for TPCR and estimation of microalbuminuria allow early identification of nephropathy which help in implementing effective interventions to manage the risk factors and prevent the serious diabetic complications.