Suma M N, Vishwanath Prashant1, Prashant Akila. Murli Dhar, Basavanagowdappa H, Anjalidevi B S
Early detection of diabetic nephropathy relies on tests for urinary excretion of albumin. The two methods used to determine if a patient is microalbuminuric are the 24-hour albumin excretion rate (AER) and the spot albumin: creatinine ratio (ACR). However, the strength of correlation of ACR in comparison with 24 hr AER needs to be established and hence we intended to study the utility of ACR in estimating microalbuminuria and predicting diabetic nephropathy. A total of 100 subjects with type2 diabetes mellitus (T2DM) and an equal number of non-diabetics in the age range 40-60 years were included in the study. Urinary albumin was estimated in both the 24 hours and spot urine samples by immunoturbidimetric method and urinary creatinine was analyzed by JaffeÃ?¢Ã?â?¬Ã?â?¢s method. Urinary ACR was calculated by dividing the urinary albumin concentration in micrograms by the urinary creatinine in milligrams. The average ACR and AER were 24.4Ã?â??Ã?±12.6 Ã?ŽÃ?¼g/mg of creatinine and 24Ã?â??Ã?±12 mg/day respectively in T2DM and 9.6Ã?â??Ã?±1.6 Ã?ŽÃ?¼g/mg of creatinine and 9.4Ã?â??Ã?±1.6 mg/day respectively in non-diabetics. The combined regression analysis showed Y (24 hour Micro Alb) = .363 + .948 (Spot ACR). The study clearly brought out that the ACR provides an equivalent result compared to 24 hours AER.
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