Diabetic Nephropathy Screening for Microalbuminuria at the Paediatric Endocrine Department -Tripoli Medical Center, Libya

الملخص

Diabetic nephropathy is a clinical syndrome characterized by an increased urinary albumin excretion rate of 30-300 mg/
day (20-200ug/min). The risk of nephropathy increases with increased duration of diabetes and poor glycemic control.
There are five histopathology stages in the development of diabetic nephropathy from early renal hyperfilitration to endstage renal disease (ESRD). This study was conducted at the Paediatric Endocrine department, Tripoli Medical Center.
1209 patients with type I diabetes mellitus (DM) were screened by 24-hour urine collections to detect microalbumne
in 2 successive occasions 6 months apart. It was considered positive, if it is more than 30 mg/day.
374 patients (31%) were positive for microalbuminuria; 194 (52%) females and 180(48%) males. Microalbuminuria
was seen maximally after 8 years of the onset of diabetes. Their mean hemoglobin A1c (HbA1c) over the last 3
years prior to microalbuminuria development was 10%. All patients with microalbuminuria were put on angiotensinconverting enzyme inhibitor (ACEI) drugs even in the absence of hypertension and all being followed up by annual
icroalbuminuria assessment after diagnosis. 52 patients with overt proteinuria were put on a combination of ACEI
and ARB (angiotensin receptor blocker) drugs to slow the progress to ESRD. Diabetic nephropathy is also a sign
of worsening blood vessel throughout the body. Good glycemic control can prevent the development and slow the
progress of diabetic nephropathy as well as other diabetic complications.