CORRELATION BETWEEN SERUM CREATININE & URINE ALBUMIN IN DIABETIC NEPHROPATHY PATIENTS: A STUDY IN A TERTIARY LEVEL HOSPITAL OF BANGLADESH

Abstract

Serum creatinine is a very common tool of renal assessment in diabetic nephropathy. Specially due to its availably and cost-effectiveness, serum creatinine has been a popular choice among the clinicians even in rural areas. Also, the staging of diabetic nephropathy is done on the basis of eGFR which is calculated mainly with serum creatinine level. Sometimes, clinicians , even overlook the other investigations ,such as urine routine examinations or ultra sonogram of kidney, when the serum creatinine level is within normal limit.

This study aims at observation of existing correlation between serum creatinine and urine albumin in diabetic nephropathy patients. This cross sectional observational study has been conducted on 50 patients in a period of 6 months in the medicine department of Dhaka Medical College Hospital.

50 diabetic patients admitted to Dhaka Medical College Hospital were enrolled in this study after fulfilling inclusion and exclusion criteria. Among the total 50 patients, 34 patients were diagnosed on the basis of microalbuminuria and the rest had raised urinary total protein. No correlation was found between serum creatinine and urine albumin or urine total protein. Staging of the kidney disease was done according to eGFR (calculated by MDRD equation).  Only 41.37% of the patients with microalbuminuria, showed eGFR consistent with its staging while 31.5% of the patients with proteinuria showed respective expected eGFR. The rest of the patient’s eGFR was inconsistent with the staging. And the difference between the mean serum creatinine in two groups was insignificant.

This study has shown that, the serum creatinine has no linear correlation with urinary albumin in diabetic nephropathy patients. So, commonly used serum creatinine based formula to calculate the eGFR can misinterpret the staging of the disease which can delay the appropriate treatment thereafter.

Keywords: Diabetic Nephropathy, Proteinuria, Microalbuminuria, Serum Creatinine