Renal function in adult Nigerian diabetics

Renal function was studied in 31 stable adult diabetic patients and 17 healthy non-diabetic adults of similar age groups and sex distribution. 14 patients (45%) were insulin dependent and 9 (27%) were hypertensive. Glomerular function was studied by creatinine clearance and 24 hour urinary protein excretion, tubular function early morning urine concentration, urine pH and urinary excretion of sodium, potassium and uric acid. 24 hour urine protein excretion was significantly higher (p less than 0.05) in the diabetics than the controls, mean values 345 +/- 94.5 mg and 109 +/- 10 mg, respectively. 42% of the patients had values well above 200 mg per day in contrast to 16% with clinical proteinuria by albustix testing. 24 hour protein excretion was higher in insulin dependent diabetic than in non-insulin diabetic patients. Mean values of creatinine clearance were similar in diabetics and controls. Increased uric acid excretion was observed in the diabetic patients. This study emphasizes the superiority of 24 hours urinary protein estimation in the detection of early nephropathy in diabetic patients. Further studies to elucidate the mechanisms and implication of the hyperuricosuria need to be carried out.