The prevalence of microalbuminuria in children and adolescents with type 1 Diabetes mellitus at the outpatient clinic in Kenyatta National Hospital

Abstract

OBJECTIVE: The purpose of this study was to determine the prevalence of micro albuminuria, and to relate it to sociodemographic features and glycemic control, among children and adolescents with type 1 diabetes mellitus. RESEARCH DESIGN: This was a hospital- based prospective cross-sectional study. SUBJECTS: The study included 65 children (31 male) with a mean age of 10.9 ± 4.5 years attending the Kenyatta National Hospital diabetic outpatient clinic in Nairobi between June 2009 and January 2010. The median duration of diabetes (lQR) among the subjects was 2 (1- 4) years. METHODS: A structured questionnaire was used for evaluation of sociodemographic data. Urine and blood samples were collected and analysed for urine albumin-to-creatinine ratio using the CLINITEK Urine Chemistry Analyser, and Hemoglobin Ale using the Hemoglobin Ale Immunoturbidimetric test, respectively. Persistent micro albuminuria was defined as a urine albumin to creatinine ratio of 30-299/-lg/mg on at least two occasions within a 3 to 6 month period. Subjects with a urine albumin to creatinine ratio of 20-29/-lg/mg on at least two occasions within a 3 to 6 month period were categorized as being at risk of developing micro albuminuria. Other information obtained included age, gender, duration of diabetes, body mass index, blood pressure, economic status, level of education and knowledge of the patient and caregiver. RESULTS: The prevalence of persistent microalbuminuria was 6.2%, while another 6.2% of the subjects had overt proteinuria. Three (4.6%) subjects were at risk of developing micro albuminuria. No significant differences in sociodemographic features and glycemic control were found among patients with persistent microalbuminuria compared with those without persistent microalbuminuria. CONCLUSION: A prevalence of persistent microalbuminuria of 6.2% was found in this population of children and adolescents with type 1 diabetes mellitus. These children and adolescents may thus be at particular risk of cardiovascular morbidity and mortality, as well as later end-stage renal disease. This study detects, however, a much lower prevalence than reported in previous studies from sub-Saharan Africa.