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Aim. To assess the condition of renal function in hypertensive men in conditions of disorders of purine and carbohydrate metabolism Material and methods. 60 male patients (aged from 18 to 65 years) with stage I–II of arterial hypertension (AH) and purine and carbohydrate metabolism disorders were examined. In these patients, the level of uric acid (UA) in daily urine, fractional excretion of UA, creatinine in daily urine, microalbumin in urine and the cystatin C level were determined. Hemodynamics was studied by daily blood pressure monitoring. Assessment of kinetics and deformation of the myocardium in offline mode using the Xstrain software package integrated into the ultrasound device (Esaote, Italy) was made. Patients were divided into 2 clinical groups – 1 group of AH with hyperuricemia, 2 – AH without uricemia. Statistical analysis of the results was performed using the Statistica 13.0 software package (Statsoft, USA). Results. Correlation analysis in group 1 showed a positive correlation of cystatin C with the average daytime systolic blood pressure (SBP) (r = 0.408) and the variability of diastolic blood pressure (DBP) at night (r = 0.405), urinary microalbumin with the average SBP at night (r = 0.390) and average pulse blood pressure (r = 0.402), LV posterior wall thickness (r = 0.438), LV myocardial mass index (r = 0.621), end-diastolic index (EDI) (r = 0.492), end-systolic index (ESI) (r = 0.426), LV anterior-posterior size (r = 0.385). A negative correlation was established between blood serum SC and ejection fraction (EF) of the LV (r = -0.410), urinary microalbumin with cardiac index (SI) (r = -0.555) and the speed of movement of the lateral (e’ lat) part of the annulus fibrosus mitral valve (r = -0.453). Conclusions. As a result of the studies, the negative influence of hyperuricemia and hyperglycemia in patients with AH on renal function was established. These changes were evidenced by an increase in microalbuminuria level, a decrease in the fractional excretion of UA, an increasing the serum UA level, remodeling of the myocardium, and worsening of the heart systolic function, worsening of the daily blood pressure profile.

Introduction: Microalbuminuria presents significant health risks for the progression of endstage renal-failure (ESRF) among type 2 diabetes mellitus (T2DM) patients. This study aims to determine the proportion and associated factors of microalbuminuria among T2DM patients in Kuala Selangor district, Malaysia. Methods: A retrospective cross-sectional study was conducted from December 2020 to February 2021 using secondary data from the National Diabetic Registry (NDR), Malaysia, and reviewed patients’ diabetic records for the year 2020. All T2DM patients aged ≥18 years who were registered with the NDR in 2020 and fulfilled the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were performed. Data were analysed using SPSS version 26.0. A total of 343 samples were included in this study for the determination of the proportion of microalbuminuria and its associated factors. Results: Of 343 respondents, 34.4% had microalbuminuria. HbA1c >7.0% (AdjOR 2.19, 95% CI: 1.35, 3.55, p=0.001), HDL

Abstract Background The utility of dipstick proteinuria for predicting microalbuminuria in non-diabetic lifestyle-related diseases compared with the urine protein-to-creatinine ratio (uPCR) and the effect of dipstick proteinuria on the cut-off value (CO) and accuracy of uPCR are unclear. Methods The subjects included Japanese patients ≥ 18 years old with lifestyle-related diseases who had an estimated glomerular filtration rate of ≥ 15 ml/min/1.73 m2 and uPCR of

Lijuan Zhang,1,&ast; Yuanjun Zhang,2,3,&ast; Juxiang Liu,2,3,&ast; Yonghong Li,4 Jinxing Quan2,3 1Department of Blood Transfusion, Gansu Provincial Hospital, Lanzhou, People’s Republic of China; 2Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, People’s Republic of China; 3Key Laboratory of Endocrine and Metabolic Diseases of Gansu Province, Lanzhou, People’s Republic of China; 4Institute of Clinical and Translational Medicine, Gansu Provincial Hospital, Lanzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jinxing Quan, Tel +18109440427, Email quanjxxt@163.comPurpose: Intestinal flora imbalance has been implicated in the activation of innate immunity in the kidneys. However, little is known about the potential links between lipopolysaccharide (LPS)-toll-like. receptor 4 (TLR4) signaling activated by intestinal barrier dysfunction and microalbuminuria in type 2 diabetes mellitus (T2DM).Patients and Methods: 61 patients with T2DM were stratified based on the absence (n=32) or presence (n=29) of microalbuminuria. There were also 28 control subjects. Urinary albumin excretion rate (UAER), serum levels of LPS, D-lactic acid (DLA), diamine oxidase (DAO), fasting blood glucose (FBG), interleukin-6 (IL-6), glycosylated hemoglobin A1 (HbA1c), and high-sensitivity C-reactive protein (hs-CRP), and TLR4 expression in peripheral blood mononuclear cells (PBMCs) were measured.Results: hs-CRP, IL-6, LPS, DLA, DAO, and TLR4 were markedly increased in subjects with T2DM compared to the controls (P < 0.05 for all). Moreover, LPS was positively correlated with FBG, HbA1c, hs-CRP, IL-6, UAER, DLA, DAO, and TLR4 (P < 0.05 for all). In addition, TLR4 was positively correlated with UAER, hs-CRP, FBG, DLA, HbA1c, and LPS (P < 0.05 for all). In regression analyses, TLR4, LPS, HbA1c, and hs-CRP were independently associated with UAER (P < 0.05 for all), while FBG, LPS, TLR4, and hs-CRP (P < 0.05 for all) were found to be risk factors for microalbuminuria in T2DM.Conclusion: Intestinal integrity is compromised in subjects with T2DM, and the activation of LPS-TLR4 signaling might play an important role in the development of microalbuminuria in T2DM.Keywords: intestinal mucosal barrier, microalbuminuria, type 2 diabetes mellitus, lipopolysaccharide, toll-like receptor 4

Background Sickle cell disease causes microvascular occlusion in different vascular beds. In kidneys, it leads to occult glomerular dysfunction causing asymptomatic microalbuminuria, proximal tubulopathy causing hyposthenuria and increased free water loss and distal tubulopathy causing poor urine acidification. We studied the prevalence of various types of renal dysfunction, the ability of different tests to detect it at an early stage and the correlation of these parameters in children receiving hydroxyurea (HU). Procedure Fifty-six children (sample size calculated using SAS9.2 package) attending paediatric clinical services in a tertiary care hospital between 2 and 12 years of age diagnosed by high-performance liquid chromatography (HPLC) were enrolled. Their demographic and laboratory data including renal and urine parameters were collected. Parameters like fractional excretion of sodium (FeNa), trans tubular potassium gradient (TtKg) and free water clearance (TcH2O) were derived by calculations. Data were analysed using IBM SPSS Version 21.0 and Microsoft Office Excel 2007. Results We found a significant number of children to have microalbuminuria (17.8%), hyposthenuria (30.4%) and impaired renal tubular potassium excretion (TtKg) (81.3%). A significant correlation was found between the dose of HU with urine osmolality (p  < 0.0005) and free water clearance (p  = 0.002), while all parameters showed a significant correlation with compliance with HU. Derangement in urine microalbumin and TcH2O correlated significantly with low mean haemoglobin levels (<9 g/dl). Conclusion Renal dysfunction is common in children with SCD and can be detected early using simple urine parameters and can be prevented with an early and appropriate dosage of HU with good compliance. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine the urinary levels of kidney injury molecule-1 (KIM-1) and angiopoietin-like protein-4 (ANGPTL-4) in individuals with diabetic kidney disease (DKD) and their association with established DKD diagnostic markers such as albuminuria and estimated glomerular filtration rate (eGFR). Levels of ANGPTL-4 and KIM-1 were estimated in urine samples. A total of 135 participants were recruited into three groups: 45 diabetes type 2 patients in the control group and 90 DKD patients in two disease groups. Concentrations of ANGPTL-4 and KIM-1 were conclusively related to the urinary albumin–creatinine ratio (UACR). Also, the levels of both ANGPTL-4 and KIM-1 were negatively associated with the eGFR. Multivariable Poisson regression analysis showed that urinary ANGPTL-4 (PR: 3.40; 95% CI: 2.32 to 4.98; p < 0.001) and KIM-1 (PR: 1.25; 95% CI: 1.14 to 1.38; p < 0.001) were prevalent in DKD patients. Receiver operating characteristic (ROC) analysis of urinary ANGPTL-4 and KIM-1 in the combined form resulted in an area under curve (AUC) of 0.967 (95%CI: 0.932–1.000; p < 0.0001) in the microalbuminuria group and 1 (95%CI: 1.000–1.000; p < 0.0001) in the macroalbuminuria group. The association of urinary levels of ANGPTL-4 and KIM-1 with UACR and eGFR and significant prevalence in the diabetic kidney disease population illustrates the diagnostic potential of these biomarkers. [ABSTRACT FROM AUTHOR]

Background: Silent myocardial ischemia (SMI) is more prevalent in type 2 diabetes mellitus (T2DM) patients, resulting in worse cardiovascular outcomes in the future. Therefore, it's early and prompt diagnosis is the need of the hour. It can be identified by traditional cardiac stress testing such as exercise tolerance test. Presence of SMI can also be predicted by microalbuminuria as it can significantly forecast any future cardiovascular event. The objective of this study was to find out the frequency of SMI in T2DM patients with microalbuminuria. Materials & Methods: A cross-sectional survey was carried out at the Diabetes Research Centre Outpatients Clinic, Nishtar Hospital, Multan, 01/01/2020 to 30/06/2020. After taking informed consent, patients having T2DM and microalbuminuria were included. Every participant had to undergo exercise tolerance test (ETT). Patients were regarded as having SMI if they fulfilled Bruce protocol and had myocardial ischemia on stress ETT. All gathered data was analyzed using SPSS version 24. Mean and standard deviation was measured for age and duration of DM. Frequency and percentage was measured for gender and presence or absence of SMI as confirmed by ETT. Results: This study comprised of a total 81 patients. Mean age of patients was 49.72±6.75 years, with range of 30. Male patients were 49(60.5%) whereas 32(39.5%) were female. Mean duration of T2DM was 12.52±4.71 years. SMI was present in 34 (41.9%) T2DM patients with microalbuminuria, as confirmed by ETT. Among the positive cases, majority belonged to 51-60 years age group (50.0%) and most of them were males 20 (58.8%). The majority of patients aged more than 60 years had SMI (85.7%), detected by ETT. Conclusion: Frequency of SMI in the current study (41.9%) is startling and direct us for earlier diagnosis and management of T2DM and microalbuminuria to prevent any cardiovascular event. Screening with ETT should be done for SMI in every diabetic patient with microalbuminuria. [ABSTRACT FROM AUTHOR]

Objectives: Hypertension is one of the essential modifiable risk factors in causing stroke, renal disease, cardiovascular diseases, and peripheral artery disease. Epicardial fat tissue is regarded as endocrine organ and is metabolically active as it produces angiotensinogen and free fatty acids which are proinflammatory cytokines and are atherogenic. The presence of microalbuminuria has been associated with endothelial dysfunction that predisposes to cardiovascular events. The aim of this study is to determine the association of epicardial fat tissue with age, sex, serum creatinine, left ventricular (LV) mass, serum albumin, low-density lipoprotein (LDL), and triglycerides in patients with essential hypertension. Materials and Methods: One hundred patients with essential hypertension were divided into two groups each having 50 patients. Group A included urinary albumin creatinine ratio (UACR) <30 mg/g. Group B included UACR >30 mg/g. Age, body mass index, blood pressure, creatinine, urea, albumin, LDL, triglycerides, and epicardial adipose tissue thickness (EAT) were evaluated and compared between two groups. All patients underwent UACR, transthoracic echocardiography to determine EAT, LV mass, and ejection fraction. Results: In our study, EAT ranged from 2 mm to 6.9 mm, with mean value of 3.21 mm and 5.12 mm in Groups A and B, respectively. Mean EAT values were found to be higher in Group B compared to A and was found to be statistically significant. Similarly, LDL, triglycerides, serum albumin levels, and LV mass showed significant difference among two groups. Serum albumin level in Group B was significantly reduced than the patients with normal urine albumin creatinine ratio. Conclusion: EAT serve as an important indicator in patients with essential hypertension to determine target organ damage and to stratify high risk group. [ABSTRACT FROM AUTHOR]

Microalbuminuria is associated with adverse outcomes in acute coronary syndrome (ACS) patients. To evaluate the very long-term association between Microalbuminuria and the overall mortality and causes of death in this clinical setting, we prospectively studied 579 unselected ACS patients admitted to three hospitals. The baseline albumin-to-creatinine ratio (ACR) was measured on days 1, 3, and 7 in 24-h urine samples. Patients were followed for 22 years or until death. Virtually all patients completed follow-up; 449(78%) had died: 41% due to non-sudden cardiac death (non-SCD), 19% sudden cardiac death (SCD), 40% due to non-cardiac (non-CD) death. Using unadjusted Cox regression analysis, ACR was a significant predictor of all-cause mortality (hazard ratio [HR] 1.26;95%confidence interval [CI] 1.22–1.31; p˂0.0001) and the three causes of death (HR 1.40;95%CI 1.32–1.48; p˂0.0001), (HR 1.22;95%CI 1.12–1.32; p˂0.0001) and (HR 1.16;95%CI 1.09–1.23; p˂0.0001) for non-SCD, SCD and non-CD respectively. Using a fully adjusted model, ACR was a significant independent predictor of all-cause mortality (HR 1.12; 95%CI 1.08–1.16; p˂0.0001) and only non-SCD (HR 1.21; 95%CI 1.14–1.29; p˂0.0001). There was a positive interaction between ACR level and history of AMI (HR 1.15; 95%CI 1.03–1.29; p = 0.01) and the presence of heart failure at admission (HR 1.11; 95%CI 1.01–1.24; p = 0.04), and negative interaction with higher than median LVEF (HR 0.89; 95%CI 0.80–0.99; p = 0.03) for all-cause mortality at the multivariable level. Based on the present analysis, baseline urinary albumin excretion during ACS is a strong independent predictor of the very long-term mortality risk, chiefly due to non-sudden cardiac death. Nelson-Aalen cumulative hazard estimates for all-cause and causes of death during 22 years of follow-up according to baseline ACR level. ACR= Urinary albumin-to-creatinine excretion ratio (mg/g); non-SCD= non-sudden cardiac death; non-CD= non-cardiac death; SCD= sudden cardiac death. * Values from the Cox regression analysis using a model adjusted for baseline age, gender, smoking, diabetes mellitus, hypertension, history of infarction, presence of heart failure at admission, and plasma total cholesterol level [Display omitted] • Microalbuminuria is associated with all-cause mortality in patients with ACS. • Little is known about its association with different causes of death. • In this study, ACS patients were enrolled and prospectively followed for 22 years. • Baseline microalbuminuria is a strong independent predictor only of non-SCD. • An independent interaction was found between ACR and indicators of heart failure. [ABSTRACT FROM AUTHOR]

Prediabetes is a significant metabolic status since there is high potential for future progression of diabetes mellitus (DM). People with prediabetes are at increased risk of cardiovascular disease (CVD) and mortality. Endothelial and microvascular dysfunction is considered a key step towards the development and progression of CVD. Importantly, endothelial and microvascular dysfunction can be detected and monitored using non-invasive procedures in peripheral organs and tissues, including the retina, kidney, skin and skeletal muscle. Structural and functional alterations of the microvasculature have been consistently documented in the above microvascular beds in patients with diabetes mellitus. In contrast, such alterations remain understudied in prediabetes, but are currently receiving attention as markers of subclinical and future CVD. The aim of this review is to summarize available evidence regarding the presence of subclinical microvascular and endothelial dysfunction in prediabetes and their impact on cardiovascular risk. [ABSTRACT FROM AUTHOR]

Early diagnosis of CKD patients at risk for microalbuminuria or macroalbuminuria could facilitate clinical outcomes and long-term survival. Considering the few and limited efficacy of current biomarkers in early detection, we aim to discover plasma lipids that effectively predict the development of CKD paitents with microalbuminuria or macroalbuminuria. A total of 380 healthy controls and 1156 patients with CKD stages 3 to 5 were stratified by urine albumin-creatinine ratio as microalbuminuria (30-300 mg/g) and macroalbuminuria (>300 mg/g). Fasting plasma samples were determined by UPLC-HDMS based on lipidomics. Quantitative real-time polymerase chain reaction, Western blot and immunohistochemical analyses were used to validate the lipid metabolism-associated pathways. Pathway analysis demonstrated that these lipids were closely associated with PPARγ, inflammatory mediator regulation of TRP channels and RAS signaling, which were intimately involved in activated NF-κB and Nrf2 pathways. We further carried out pathway validation and demonstrated that NF-κB pathway was activated in patients with macroalbuminuria compared with CKD patients with microalbuminuria, while Nrf2-associated protein expression was downregulated, which was accompanied by the up-regulation of Wnt/β-catenin signaling pathway. Four lipids including DTA, 5,8-TDA, GGD3 and DHA that showed great potential in the discrimination of CKD patients with microalbuminuria and healthy controls were selected by logistic regression analysis. Additionally, six lipid species including CDCA, glucosylceramide, GGD2, TTA, DHA and EDA that contributed to the discrimination of CKD patients with microalbuminuria and macroalbuminuria were selected by logistic LASSO regression Gangliosides were first identified and might be promising therapeutic targets for CKD patients with the different degree of albuminuria. Collectively, this study first demonstrates the association of plasma inflammation, oxidative stress, Wnt/β-catenin and lipid metabolism in CKD patients with microalbuminuria and macroalbuminuria.

Ahmed Abdallah Salman,1 Mohamed Abdalla Salman,2 Mohamed H Aon,1 Reem Ezzat Mahdy,3 Ahmed Abdallah,2 Gamal Galal Shemy,4 Ahmed M Hassan,4 Fatema Alzahraa Samy Amin,5 Safa Labib1 1Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 2General Surgery Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 3Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt; 4General Surgery Department, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt; 5Clinical Pathology Department, Faculty of Medicine, Cairo University, Cairo, EgyptCorrespondence: Ahmed Abdallah Salman, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt, Tel +20 1000468664, Email awea84@kasralainy.edu.egAim: To examine the effect of weight-loss induced bariatric procedures on albuminuria levels among diabetic patients suffering from obesity.Methods: Adults patients who suffer from morbid obesity and type 2 diabetes mellitus (T2DM) were included in a prospective cohort study. Subjects were scheduled to undergo laparoscopic sleeve gastrectomy (LSG) or one-anastomosis gastric bypass (OAGB). The albumin-to-creatinine ratio (ACR) was adopted to assess the degree of albuminuria. Microalbuminuria was determined as a ratio of > 2.5– 30 mg/mmol and > 3.5– 30 mg/mmol for males and females, respectively, while macroalbuminuria was diagnosed when the ACR exceeded > 30 mg/mmol.Results: The mean uACR decreased significantly from 20.95± 16.89 to 9.92± 12.69mg/mmol in LSG cohort (p < 0.001), and from 19.52± 16.65 to 9.34± 11.77mg/mmol in the OAGB cohort, with no statistically considerable differences between both cohorts at the end of follow-up (p = 0.78). Twelve months after the procedures, the percentages of cases with microalbuminuria decreased significantly to 23.8% and 23.9%, respectively (p < 0.001); likewise, the percentages of cases with macroalbuminuria significantly decreased to 7.9% and 7.5% in the LSG and OAGB groups, respectively (p < 0.001). There were no statistically considerable differences between LSG and OAGB regarding the percentages of patients with micro or macroalbuminuria at the end of follow-up. Besides, there were no significant associations between the degree of weight loss and improvement (p = 0.959) or remission (p = 0.73) of microalbuminuria.Conclusion: Bariatric surgery significantly reduced the severity of albuminuria 1-year after the procedure, with no preference for one procedure over the other.Keywords: bariatric surgery, laparoscopic sleeve gastrectomy, one-anastomosis gastric bypass, microalbuminuria

Background: Microalbuminuria, used as a marker of endothelial dysfunction, is a predictor of mortality and of cardiovascular events. Microalbuminuria (MAB) in chronic obstructive lung disease (COPD) is attributed to generalized endothelial dysfunction as a result of systemic inflammation, which could be a significant marker for early cardiovascular abnormality. Objectives: Study the relationship between microalbuminuria and disease class in subjects with COPD classified according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018 “A, B, C, D” classification in absence of hypertension and diabetes ,and to Evaluate the clinical features that may predict cardiovascular risk in subjects with COPD. Setting: Chest Department and outpatient clinic, Beni-Suef University Hospital. Methods: Prospective Study included 60 patients who were diagnosed as COPD by Pulmonary function tests. All patients were subjected to clinical examination, Chest x ray, spirometry and Urinary albumin/creatinine ratio. Results: Urinary albumin/creatinine ratios were significantly higher in subjects who have more symptoms and high future risk (categories C, D) than in those with fewer symptoms and low future risk (categories A, B). A Significant differences were noted when the subjects were grouped based on PaO2 (65mmHg), PaCO2 (41mmHg), arterial oxygen saturation (92%), FEV1 (median split 60%). There was a statistically significant strong negative correlation between the alb/creat ratio and FEV1% (r=-0.937, p=0.000), PaO2 (r=-0.929, p=0.000) and SaO2(r=-0.934,p=0.000). There was a statistically significant strong positive correlation between the alb/creat ratio and Severity of COPD Gold categories (r=0.931, p=0.000), PaCO2 (r=0.930, p=0.000) and number of hospital admissions last year (r=0.946, p=0.000). There was a highly significant association between high level alb/creat ratio and the presence of pulmonary hypertension (P

Background: Diabetes mellitus is a major public health problem with multiple medical complications. Microvascular complications of diabetes including diabetic retinopathy, depend on the duration and severity of hyperglycemia. There is a paucity of data about the relationship among diabetic retinopathy, microalbuminuria and HbA1c in newly diagnosed type 2 diabetes mellitus (T2DM) patients. The study was conducted on the prevalence of diabetic retinopathy and its association with microalbuminuria and HbA1c among newly diagnosed T2DM patients. Material and method: It was a hospital-based, cross-sectional study conducted at a tertiary care hospital in Rajasthan. After obtaining written informed consent, data were collected from 150 newly diagnosed T2DM patients. Data were analysed using SPSS 20.0. Categorical variables were presented as proportion and continuous variables were presented as mean (SD). Chi square test and one way ANOVA tests were used for bivariate analysis. Results: The mean (SD) age of patients was 50.43 (12.73) years. About 52.7% (n=79) patients were male. About 30% (n=45) of newly diagnosed T2DM patients had microalbuminuria. Thirty patients (20%) had diabetic retinopathy (DR). About 8% (n=12) participants had mild DR, 10.7% (n=16) had moderate to severe DR and 1.3 (n=2) % had proliferative DR. Microalbuminuria was found significantly associated with HbA1c (P

Background: Regular screening of levels of glycosylated hemoglobin and microalbuminuria (MA), diabetic nephropathy can be prevented.Recent studies found some of the sensitive and specific biomarker for early detection and progression of nephropathy in type 2 diabetes mellitus (T2DM) patients. Aim and Objectives: This study was carried out to correlation of glycosylated hemoglobin with urinary albuminuria for early detection and progression of nephropathy in patients with T2DM. Materials and Methods: This was a case–control study was conducted at tertiary care institute of India. A total 300 subjects included in the present study diagnosed with T2DM according to American diabetes association criteria and the cases are sub grouped based on albumin creatinine ration, the 100 patients T2DM with normoalbuminuria (NA) (ACR Ratio:

Abstract Background Microalbuminuria is an independent risk factor for cardiovascular and kidney disease and a predictor of end organ damage, both in the general population and in persons with HIV (PWH). Microalbuminuria is also an important risk factor for mortality in PWH treated with antiretroviral therapy (ART). In the ongoing Renal Risk Reduction (R3) study in Nigeria, we identified a high prevalence of microalbuminuria confirmed by two measurements 4–8 weeks apart in ART-experienced, virologically suppressed PWH. Although Stage 1 or 2 hypertension and exposure to potentially nephrotoxic antiretroviral medications were common in R3 participants, other traditional risk factors for albuminuria and kidney disease, including diabetes, APOL1 high-risk genotype, and smoking were rare. Co-infection with endemic pathogens may also be significant contributors to albuminuria, but co-infections were not evaluated in the R3 study population. Methods In Aim 1, we will cross-sectionally compare the prevalence of albuminuria and established kidney disease risk factors in a cohort of PWH to age- and sex-matched HIV-negative adults presenting for routine care at the Aminu Kano Teaching Hospital in Kano, Nigeria. We will leverage stored specimens from 2500 R3 participants and enroll an additional 500 PLWH recently initiated on ART (≤ 24 months) and 750 age- and sex-matched HIV-negative adults to determine the contribution of HIV, hypertension, and other comorbid medical conditions to prevalent albuminuria. In Aim 2, we will follow a cohort of 1000 HIV-positive, ART-treated and 500 HIV-negative normoalbuminuric adults for 30 months to evaluate the incidence and predictors of albuminuria. Discussion The findings from this study will support the development of interventions to prevent or address microalbuminuria in PWH to reduce kidney and cardiovascular morbidity and mortality. Such interventions might include more intensive monitoring and treatment of traditional risk factors, the provision of renin-angiotensin aldosterone system or sodium-glucose cotransporter-2 inhibitors, consideration of changes in ART regimen, and screening and treatment for relevant co-infections.

Introduction: Metabolic syndrome (MetS) predicts cardiovascular disease, and patients with this condition and type 2 diabetes have increased albuminuria, significantly impacting cardiovascular mortality and kidney disease progression. A considerable number of interventions to control MetS exist and are considered efficient, including the use of medication and changes in lifestyle. However, which approaches are effective in controlling albuminuria remains unclear. This systematic review protocol aims to map in the available literature whether lifestyle, medication, and surgical intervention for MetS have an impact on reducing albuminuria in adult patients. Methods: The Joanna Briggs Institute methodology for systematic reviews will be followed. Cochrane Database of Systematic Reviews, Scopus, Embase, and MEDLINE/PubMed databases will be used. For the Gray Literature, the DART-Europe E-theses Portal. There will be no language restriction. Studies written after 2009 will be included due to the consensus and definition of metabolic syndrome. This review will include studies considering pharmacological and non-pharmacological treatments for controlling albuminuria in patients with MetS. Studies where MetS is described in children and adolescents, animals, pregnant women, and patients with type 1 diabetes will be excluded. First, the selection will be based on reading the title and summary of the texts retrieved in the search strategy, followed by reading the relevant texts in full by two reviewers. After the selection of the studies, the extraction of the data, analysis, and synthesis will be conducted according to the JBI methodology.

Objectives: To determine the frequency of Hyperuricemia in patients with type-2 Diabetes Mellitus and to compare frequency of Diabetic Nephropathy in Hypouricemic vs Normouricemic patients with type-2 Diabetes. Study Design: Cross-sectional analytical study. Duration and Place of Study: Medicine Department Combined Military Hospital Peshawar, from Dec 2018 to May 2019. Methodology: Patients from both genders with type 2 Diabetes having glycosylated hemoglobin (HbA1c) ≥6.5%, Fasting Blood glucose ≥ to 7.0 mmol/L or random blood glucose ≥11.1 mmol/L were recruited from out Patient department. Participants were tested for serum uric acid, fasting blood glucose, Glycosylated hemoglobin (HbA1c) and Spot Urine Albumin Creatinine Ratio after 8 hours fasting. Results: Out of 111 patients enrolled Hyperuricemia was present in 40 (36.04%) patients of which 21 (52.50%) were male and 19 (47.50%) were female. Diabetic Nephropathy was present in 43(38.74%). Out of 43 patients having diabetic nephropathy, 25 (58.14%) were having hyperuricemia. The study observed a linear relationship between serum uric acid and type-2 diabetes duration, fasting blood glucose levels, glycosylated hemoglobin (HbA1c) and urinary Albumin creatinine ratio. Conclusion: Hyperuricemia is positively linked with diabetic complications in majority of patients with type-2 diabetes. Serum uric acid levels can be used as an early diagnostic parameter and can prognosticate diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Purpose: There is no clear information about the level of Apelin-13 in patients with diabetic nephropathy (DN). In this study, we investigated whether there is a relationship between Apelin-13 level and the severity of the disease in patients with DN. Methods: In our case–control study, we included patients who applied to the endocrinology outpatient clinic in 2019. Patients without a history of diabetes were determined as the healthy group (group 1). The patients were divided into 4 groups according to their microalbumin and creatinine levels. Venous blood samples were obtained from all patients for routine laboratory parameters and Apelin-13 levels. Homeostatic Model Assessment-Insulin Resistance (HOMA-IR) for insulin resistance was calculated using the formula: plasma glucose X insulin level/405. Results: Albumin was found to be significantly lower in group 5 (p = 0.032), hemoglobin A1c, microalbumin/creatinine and HOMA-IR values were found to be significantly lower in group 1 (p < 0.001 for each). Apelin-13 level was found to be significantly higher in group 4 and group 5 (p < 0.001). A negative correlation was found between Apelin-13 and GFR (r = − 0.286, p = 0.003). A positive correlation was found between Apelin-13 and HOMA-IR (r = 0.309, p = 0.009) and microalbumin/creatinine (r = 0.296, p < 0.001). Conclusion: In patients with DN, Apelin-13 level increases with the severity of the disease and can be used as a biomarker for staging of DN. [ABSTRACT FROM AUTHOR]

Background: Cyanotic nephropathy (CN), was found in about 30%-50% of patients with congenital cyanotic heart disease (CCHD), causing significant proteinuria, decreasing the glomerular filtration rate (GFR) and azotemia. This study aimed to show the frequency of CN in children with CCHD and the associated risk factors. Methods: A cross sectional study was conducted in cardiology unit, pediatric department, Zagazig University Hospitals from March 2018 to June 2019. This study included 49 children of age ranged from 2 months to 11 years selected randomly from those admitted to the pediatric cardiology unit and diagnosed as having CCHD. They were subjected to full history taking, general examination and local examination of the heart, chest X-ray and echocardiography. Early morning urine and blood sample were taken for measuring urine albumin, protein, creatinine, urinary protein to creatinine ratio [UPCR], urinary albumin to creatinine ratio, serum creatinine level, complete blood count (CBC), prothrombin time (PT), partial thromboplastin time (PTT), and serum ferritin. Results: 65% of CCHD patients had renal impairment as regard to albuminuria also, 83.6% of them had CN depending on proteinuria. 37% of CCHD patients with significant albuminuria had renal insufficiency. Patients with CN had higher hematocrit (Hct)level, lower platelet count and longer time waiting for surgery. Conclusions: Children with CCHD are in high risk of renal insufficiency. Microalbuminuria, proteinuria, increased Hct level, decreased platelet count, longer time waiting for surgery, are risk factors of renal disease. [ABSTRACT FROM AUTHOR]

Introduction: Renin-angiotensin system inhibitors have been reported to exert protective effects against organ damage and failure; however, the impact of the direct renin inhibitor as monotherapy has not been assessed. Here, we investigated the effects of 24-week monotherapy with aliskiren compared to amlodipine in hypertensive patients with type 2 diabetes or obesity. Methods: In this randomized intervention study, 62 adult hypertensive patients with visceral obesity (defined as a body mass index [BMI] greater than 25 kg/m2 and a visceral adipose tissue area [VFA] greater than 100 cm2) or type 2 diabetes mellitus (age 57 ± 13, 65% men, BMI 28.8 ± 4.8 kg/m2, VFA 134.8 ± 47.0 cm2, blood pressure 141 ± 16/86 ± 13 mm Hg) were randomized to receive 24-week treatment with aliskiren (max. 300 mg) or amlodipine (max. 10 mg). The primary outcome was the change in VFA at 24 weeks post-treatment. Results: Change in VFA did not differ significantly from baseline in either group. Systolic blood pressure significantly decreased at 12 weeks (−10 mm Hg, p = 0.001) and 24 weeks (−10 mm Hg, p = 0.001) in the amlodipine group and at 24 weeks (−11 mm Hg, p = 0.001) in the aliskiren group. Diastolic blood pressure significantly decreased at 24 weeks (−6 mm Hg, p = 0.009) only in the amlodipine group. Although the estimated glomerular filtration rates did not significantly change in either group, the logarithm of urinary albumin excretion significantly decreased at 24 weeks only in the aliskiren group (−0.60, p < 0.001). The 24-week changes in the urinary albumin excretion significantly correlated with the changes in the plasma renin activity in the aliskiren group (r = 0.51, p = 0.008). Conclusion: Aliskiren monotherapy did not show any superiority to amlodipine monotherapy on VFA, estimated glomerular filtration rates, or urinary albumin excretion in obese or type 2 diabetic hypertensive patients. [ABSTRACT FROM AUTHOR]

Background: This study was devised to evaluate the predictive value of neutrophilto-lymphocyte ratio (NLR), mean platelet volume (MPV), and red blood cell distribution width (RDW) to detect microalbuminuria in type 2 diabetic patients. This can help in early detection of microalbuminuria and assessment of prognosis inn patients suffering from type 2 diabetes mellitus (DM). Aims and Objectives: The objectives of the study were to assess the diagnostic accuracy of microalbuminuria using neutrophil-to-lymphocyte ratio and red blood cell distribution width in diabetic patients. Materials and Methods: A total of 188 patients with type 2 DM were selected for this study. Subjects were classified into three groups based on hemoglobin A1c and microalbuminuria. Group A had 63 patients with controlled diabetes, Group B had 62 patients with uncontrolled diabetes, both without microalbuminuria, and Group C had 62 patients with uncontrolled diabetes with microalbuminuria. Levels of NLR, MPV, and RDW between the study groups were analyzed. Results: A significant difference in NLR was found between Group C and Groups A and B (P<0.001 and P=0.005, respectively). RDW was significantly different between Groups B and C (P=0.014). Receiver operating characteristic curve analysis was done between NLR and RDW. The area under curve was found to be of 0.678 for NLR (confidence interval: 0.59-0.75, P<0.001) and 0.616 for RDW (confidence interval: 0.49-0.73, P=0.013). The study shows that an NLR cutoff point of 2.54 has 39.7% sensitivity, 78.8% specificity, and 45% positive predictive value (PPV). An RDW cutoff point of 14.44 has 37.9% sensitivity, 76% specificity, and 41.5% PPV. Conclusion: NLR and RDW can be beneficial to detect microalbuminuria in diabetic patients. [ABSTRACT FROM AUTHOR]

Introduction: Metabolic syndrome (MetS) predicts cardiovascular disease, and patients with this condition and type 2 diabetes have increased albuminuria, significantly impacting cardiovascular mortality and kidney disease progression. A considerable number of interventions to control MetS exist and are considered efficient, including the use of medication and changes in lifestyle. However, which approaches are effective in controlling albuminuria remains unclear. This systematic review protocol aims to map in the available literature whether lifestyle, medication, and surgical intervention for MetS have an impact on reducing albuminuria in adult patients. Methods: The Joanna Briggs Institute methodology for systematic reviews will be followed. Cochrane Database of Systematic Reviews, Scopus, Embase, and MEDLINE/PubMed databases will be used. For the Gray Literature, the DART-Europe E-theses Portal. There will be no language restriction. Studies written after 2009 will be included due to the consensus and definition of metabolic syndrome. This review will include studies considering pharmacological and nonpharmacological treatments for controlling albuminuria in patients with MetS. Studies where MetS is described in children and adolescents, animals, pregnant women, and patients with type 1 diabetes will be excluded. First, the selection will be based on reading the title and summary of the texts retrieved in the search strategy, followed by reading the relevant texts in full by two reviewers. After the selection of the studies, the extraction of the data, analysis, and synthesis will be conducted according to the JBI methodology. [ABSTRACT FROM AUTHOR]

Migraine is a common headache disorder that causes significant disabilities. Headache developed or significantly worsened during medication overuse (for simple analgesics and combination acute medications, intake must be 15 days or more per month for triptans, ergotamines, opioids, and combination analgesics; 10 days per month sufficient to get a diagnosis of Medication-overuse headache-MOH). A recent epidemiologic study on drug-induced disorders demonstrated that excessive drug use can lead to nephrotoxicity. Microalbuminuria was common in patients under the influence of nephrotoxic drugs. Subclinical renal damage cannot be identified by routine tests (serum creatinine), and microalbuminuria is a more sensitive indicator of renal dysfunction. The aim is to confirm the sensitivity of certain biomarkers when comparing patients treated with NSAIDs in combination with other drugs (analgesics, triptans and antidepressants) with patients treated with monotherapy by NSAIDs Besides conventional markers of renal functioning (serum/urine creatinine determined by Jaffe methods), enzymatic assay for urea serum and Jon selective electrode (ISE) are used for determination of electrolyte in serum. Imunoturbodimetric assay for determination of urinary albumin, microalbuminuria and ß2-microglobulin will be used. In the case of combined therapy with NSAIDs and other medications (analgesics, triptans and antidepressants), a significant effect on the increase of microalbuminuria has been demonstrated, which signals us for a more sensitive indicator in compared to ß2M which as specific bioindicator did not show a measured sensitivity for the detection of early changes in the tubular level. Significant glomerular damage has been reported in patients with combination therapy than patients treated with NSAID monotherapy. Following the levels of specific biomarkers, we can use them as signals for early detection of nephrotoxicity, especially in patients treated with combination therapy requiring special attention when administering them. [ABSTRACT FROM AUTHOR]

Background: Adverse pregnancy outcomes occur more commonly in developing countries and are still prevalent in our sub‑region. Microalbuminuria is a marker of endothelial dysfunction and has been proposed as an aetiological factor in the development of some adverse pregnancy outcomes such as pre‑eclampsia, intrauterine growth restriction (IUGR) and pre‑term labour. Aim: The aim is to determine the prevalence of microalbuminuria and its association with adverse pregnancy outcomes. Methods: This was a prospective cross‑sectional study with follow‑up amongst women in early pregnancy presenting at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Three hundred and thirty women with singleton pregnancy at gestational age <20 weeks, blood pressure <140/90 mmHg, normal fasting blood sugar and normal renal function were recruited. Those with a history of hypertension, diabetes mellitus, chronic kidney disease, sickle cell anaemia were excluded, multiple pregnancies, urinary tract infection or positive dipstick proteinuria at first contact were excluded. They were recruited consecutively and a structured interviewer‑administered questionnaire was completed. Single‑spot urine analysis for albumin was performed. The women were followed up to the time of delivery and the puerperium and any adverse outcome were documented. Results: The prevalence of microalbuminuria was 58.4%. The maternal and foetal adverse outcomes such as hypertensive disorders of pregnancy, pre‑mature rupture of membrane, IUGR, preterm birth and stillbirth occurred more amongst the women with microalbuminuria. However, there was no statistically significant association between microalbuminuria and having these adverse outcomes (P > 0.05). Conclusion: There was a high prevalence of microalbuminuria amongst healthy pregnant women and pregnancy complications occurred more frequently in women with microalbuminuria than in those without. However, this association was not sufficient to predict adverse outcomes in pregnancy. [ABSTRACT FROM AUTHOR]

Background: The incidence of Thyroid dysfunction in diabetics is higher than that of general population. Undiagnosed thyroid dysfunction may affect the metabolic control and enhance cardiovascular and other chronic complications in diabetic patients. Diabetes mellitus is one of the most common disease in the world and is acquiring epidemic Proportions in developed and developing countries. Indians are genetically more susceptible to diabetes. The prevalence of Type 2DM is on the rise much more rapidly, which is due to increasing obesity and reduced activity levels. Several studies have assessed the relationship between thyroid function and micro-vascular complications in patients with T2DM. Few studies have examined the relationship between subclinical hypothyroidism(SCH) and vascular complications in patients with Type 2 diabetes mellitus. Objectives: To study the association between TSH levels and microvascular complications of Type 2 DM. Materials and Methods: A total of 100 type 2 diabetes patients (40 males and 60females) were enrolled in this cross-sectional study. Subjects were evaluated for neuropathy, thyroid function, diabetic retinopathy, and diabetic kidney disease. TSH was divided into 3 levels: 0.27-2.49 mU/l, 2.5-4.2 mU/l and >4.2mU/l and <10 mU/l with normal FT4 Results: Our study found statistically positive association of elevated TSH and microalbuminuria, macroalbuminuria, low GFR and impaired vibration sensation. Our study found no association between elevated TSH and age, diabetes duration, HbA1c levels and retinopathy. Conclusion: In our study we could not establish an association between TSH levels and diabetic Retinopathy. However, we found an association between elevated TSH levels and Diabetic Neuropathy and DKD. Hence it is ideal to screen all patients with Diabetes for Thyroid dysfunction, as elevated TSH levels in these patients can be an indicator of underlying micro-vascular complications. However, more research, involving more subjects is required with regard to the above. [ABSTRACT FROM AUTHOR]

Introduction: Microalbuminuria in essential hypertension is associated with the increased mortality. Microalbuminuria is the independent risk factor to develop cardiovascular and cerebrovascular diseases. Furthermore, Microalbuminuria has been described as an early sign of kidney damage and a predictor for end stage renal disease and cardiovascular disease. Aims & objectives: 1:-To study the prevalence of microalbumiuria in patients of essential hypertension. 2:-To study the relationship between microalbuminuria and target end organ damage in essential hypertensive patients: hypertensive retinopathy, left ventricular hypertrophy and cerebrovascular accident. Materials & methods: This is a cross sectional study conducted over 90 patients of essential hypertension admitted in department of general medicine, R D Gardi medical college and C R Gardi Hospital, Ujjain (M.P) during the period from Jan 18 to June 19 after applying the inclusion and exclusion criteria. Observation and results: Chi-square test showed that there was significant association between i) abnormality in fundus(p<0.00005) ii) presence of LVH(p<0.001) iii) abnormal CT scan of brain (p=0.02) with the microalbuminuria. The risk of abnormality of fundus was 4.94 times more, presence of LVH was 7.06 times more and abnormal CT scan of brain was 5.0 times more in patients with microalbuminuria as compared with the patients without microalbuminuria. The risk was significant. Discussion: 46.7% of the patients had abnormal fundus and the risk of abnormal fundus was 4.94 times more in the patients having microalbuminuria. 18.9% of the patients of had LVH and the risk of LVH was 7.06 times more among the patients having microalbuminuria. 50% of the patients had abnormal CT scan findings and risk of abnormal CT scan of brain was 5 times more in patients having microalbuminuria. Studies conducted by Hitha B et al (p<0.001), Badiger S (p=0.011), Dayal A (p<0.05), Agarwal B (p<0.001), Yuyun MF (p <0.001 for stroke), showed a significant association between target end organ damage with microalbuminuria. Conclusion: Microalbuminuria was significantly associated with duration and severity of hypertension and target organ failure; left ventricular hypertrophy, retinopathy and cerebrovascular accidents. Therefore measurement of microalbuminuria should be incorporated with in standard management protocols for all patients with hypertension. [ABSTRACT FROM AUTHOR]

Introduction: The urinary sodium-to-potassium ratio is an indicator of dietary sodium intake and has been associated with reduced kidney function. However, less is known about its association with albuminuria, the other key component of chronic kidney disease, in the community-dwelling adult population. We examined the association of the spot urinary sodium-to-potassium ratio with albuminuria and compared spot urinary and dietary sodium-to-potassium ratios. Methods: We quantified the association of the urinary sodium-to-potassium ratio with albuminuria in 6,274 Japanese adults (aged 40–97 years; 50.9% women) based on spot urine samples. We performed linear and logistic regression modeling to account for potential confounders. Elevated albuminuria was defined as a spot urinary albumin-to-creatinine ratio (ACR) ≥30 mg/g. We secondarily evaluated the dietary sodium-to-potassium ratio based on a food-frequency questionnaire. Results: The median spot urinary and dietary sodium-to-potassium ratios were 2.70 (interquartile interval, 1.87–3.83) and 1.50 (1.21–1.84), respectively. The median ACR was 11.0 (6.0–24.0) mg/g. In a multivariable linear regression model, the spot urinary sodium-to-potassium ratio (per increment) was significantly associated with the natural logarithm of the ACR (regression coefficient, 0.023 [95% confidence interval {95% CI}, 0.007–0.038]). This result was consistent in a multivariable logistic regression model (adjusted odds ratio, 1.08 [95% CI: 1.04–1.12]). The corresponding estimates for the dietary sodium-to-potassium ratio were 0.139 (95% CI: 0.087–0.191) and 1.28 (95% CI: 1.14–1.45), respectively. Conclusions: Both spot urinary and dietary sodium-to-potassium ratios were associated with elevated albuminuria in community-dwelling Japanese adults. Our findings further support the potential usefulness of the spot urinary sodium-to-potassium ratio as an indicator of sodium intake and suggest a link between sodium intake and kidney damage. [ABSTRACT FROM AUTHOR]

Metabolic effects of physical activity may be reno-protective in the context of hypertension, although exercise stresses kidneys. Aldosterone participates in renal disease in hypertension, but exercise affects the plasma concentration of aldosterone. This study was designed to evaluate whether physical activity and pharmacological treatment by aldosterone have additive effects on renal protection in hypertensive rats. Female spontaneously hypertensive rats (SHR) or normotensive Wistar rats performed voluntary running wheel activity alone or in combination with aldosterone blockade (spironolactone). The following groups were studied: young and pre-hypertensive SHR (n = 5 sedentary; n = 10 running wheels, mean body weight 129 g), 10-month-old Wistar rats (n = 6 sedentary; n = 6 running wheels, mean body weight 263 g), 10-month-old SHRs (n = 18 sedentary, mean body weight 224 g; n = 6 running wheels, mean body weight 272 g; n = 6 aldosterone, mean body weight 219 g; n = 6 aldosterone and running wheels, mean body weight 265 g). Another group of SHRs had free access to running wheels for 6 months and kept sedentary for the last 3 months (n = 6, mean body weight 240 g). Aldosterone was given for the last 4 months. SHRs from the running groups had free access to running wheels beginning at the age of 6 weeks. Renal function was analyzed by microalbuminuria (Alb/Cre), urinary secretion of kidney injury molecule-1 (uKim-1), and plasma blood urea nitrogen (BUN) concentration. Molecular adaptation of the kidney to hypertension and its modification by spironolactone and/or exercise were analyzed by real-time PCR, immunoblots, and histology. After six months of hypertension, rats had increased Alb/Cre and BUN but normal uKim-1. Voluntary free running activity normalized BUN but not Alb/Cre, whereas spironolactone reduced Alb/Cre but not BUN. Exercise constitutively increased renal expression of proprotein convertase subtilisin/kexin type 9 (PCSK9; mRNA and protein) and arginase-2 (mRNA). Spironolactone reduced these effects. uKim-1 increased in rats performing voluntary running wheel activity exercise irrespectively of blood pressure and aldosterone blockade. We observed independent but no additive effects of aldosterone blockade and physical activity on renal function and on molecules potentially affecting renal lipid metabolism. [ABSTRACT FROM AUTHOR]

Objective: We aimed to study the cut-off values of estimated glomerular filtration rate (eGFR) and the urinary albumin creatinine ratio (UACR) in the normal range for diabetic kidney disease (DKD). Methods: In this study, we conducted a retrospective, observational cohort study included 374 type 2 diabetic patients who had baseline eGFR ≥60 mL/min/1.73 m2 and UACR <30 mg/g with up to 6 years of follow-up. The results were further validated in a multi-center, prospective cohort study. Results: In the development cohort, baseline eGFR (AUC: 0.90, cut-off value: 84.8 mL/min/1.73 m2, sensitivity: 0.80, specificity: 0.85) or UACR (AUC: 0.74, cut-off value: 15.5mg/g, sensitivity: 0.69, specificity: 0.63) was the most effective single predictor for DKD. Moreover, compared with eGFR or UACR alone, the prediction model consisted of all of the independent risk factors did not improve the predictive performance (P >0.05). The discrimination of eGFR at the cut-off value of 84.80 mL/min/1.73 m2 or UACR at 15.5mg/g with the largest Youden's index was further confirmed in the validation cohort. The decrease rate of eGFR was faster in patients with UACR ≥15.5mg/g (P <0.05). Furthermore, the decrease rate of eGFR or increase rate of UACR and the incidence and severity of cardiovascular disease (CVD) were higher in patients with eGFR ≤84.8 mL/min/1.73 m2 or UACR ≥15.5mg/g (P <0.05). Conclusions: In conclusion, eGFR ≤84.8mL/min/1.73 m2 or UACR ≥15.5mg/g in the normal range may be an effective cut-off value for DKD and may increase the incidence and severity for CVD in type 2 diabetic patients. [ABSTRACT FROM AUTHOR]

Background and purpose: Diabetic kidney disease (DKD) is highly prevalent among patients with diabetes mellitus. It affects approximately 20% of diabetic patients, who are believed to be more than 400 million individuals. The objectives of the present work were to assess patterns of albuminuria and determine microalbuminuria predictors among patients living with type 2 diabetes (T2D) who attended the family medicine department of Jazan Armed Forces Hospital. Methods: A case–control design was used and included two groups (n, 202/group), one with microalbuminuria and the other with a normal urine albumin/creatinine ratio (ACR). Data regarding patient history, glycosylated hemoglobin (HbA1c), lipid profile, renal function tests, ACR, ASCVD (atherosclerotic cardiovascular disease) risk, etc., were collected. Results: The prevalence rates of microalbuminuria and macroalbuminuria were 26.4% and 3.9%, respectively. HbA1c was significantly higher in patients with microalbuminuria (9.3 ± 2.2; P˂0.001) and macroalbuminuria (10.5 ± 2.3; P˂0.001) than in those with normal ACR (8.3 ± 1.9%). The predictors of microalbuminuria were poor glycemic control with HbA1c ≥ 7% {OR, 2.5 (95% C. I, 1.5–4.2)}; hypertension {(OR, 1.8 (95% C. I, 1.2–2.8)}; estimated glomerular filtration rate (eGFR) of ˂90 mL/min/1.73 m2 {OR, 2.2 (95% C. I, 1.4–3.6}; smoking {OR, 1.3 (95% C. I, 0.7–2.6}; and body mass index {OR, 1.05 (95% C. I, 1.01–1.09}. Conclusion: Microalbuminuria is highly prevalent among patients with type 2 diabetes and is associated with poor glycemic control and hypertension, necessitating aggressive and timely screening and treatment. [ABSTRACT FROM AUTHOR]

Serum cystatin C (CstC) is a type of protein produced by cells at the normal level; when the kidney is in normal condition or function, it inhibits the interstitial cysteine protease. The objective of the current study is to evaluate the levels of CstC and inflammation markers in type 2 diabetes mellitus (T2DM) patients with early diagnosed microalbuminuria (MBA) and find if there is a relationship between CstC and different parameters. Fifty T2DM patients with a mean age of 44.41 ± 6.51 years in the Al-Yarmouk Teaching Hospital were recruited according to the presence of MBA, and they were compared with 40 nondiabetic individuals with a mean age of 42.22 ± 5.33 years as control. Serum CstC, interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were estimated by enzyme-linked immunosorbent assay. The mean values of serum CstC, IL-6, and TNF-α in the diabetic patients with MBA were all significantly increased compared to those of the nondiabetic individuals (P < 0.001). In T2DM patients with MBA, there were positive correlations between serum CstC levels and serum creatinine, creatinine urea, and cystatin-c/creatinine ratio. Similarly, there was a strong positive correlation between serum CstC and serum of the inflammatory markers IL-6 and TNF-α. However, there was a negative association between CstC and the estimated glomerular filtration rate-Larson equation. The results of the current study suggest that serum CstC, IL-6, and TNF-α may potentially serve as biomarkers for the early detection of MAB in patients with T2DM. [ABSTRACT FROM AUTHOR]

Background. Diabetes has become more often in all over the world, magnesium is an essential element of the body and has lots of vital functions. There has been a trend to investigate magnesium’s effect on type 2 diabetes pathogenesis and its complications. Still, more data is needed to reveal magnesium and T2 diabetes mellitus (DM) association, therefore we aimed to investigate how common magnesium deficiency in Turkish T2DM patients, and its effect on diabetes control and diabetes complications. Materials and methods. 296 patients with type 2 DM and 96 healthy controls aged between 18–65 years were enrolled in the study. After exclusion criteria, T2DM patients were divided into 2 groups according to magnesium deficiency, metabolic and physical properties of the groups were compared. Also, hypertension, metabolic syndrome, coronary artery disease, and microalbuminuria were also compared according to magnesium deficiency. Results. Magnesium deficiency was found 35.5 % (86/242) in patients with type 2 DM, 4.1 % (4/96) in the control group. Magnesium deficiency was more in female patients (64/86, 74.4 %), male patients had more normal magnesium levels 89/166, 53.6 %) (p

Licui Qi,1 Ning Kang,2 Xiaoyi Chen,3 Zelin Li,2 Chenqian Deng,3 Shuchun Chen1 1Endocrinology Department, Hebei General Hospital, Shijiazhuang, 050051, People’s Republic of China; 2Graduate School, Hebei Medical University, Shijiazhuang, 050000, People’s Republic of China; 3Graduate School, Hebei North University, Zhangjiakou, 075000, People’s Republic of ChinaCorrespondence: Shuchun Chen, Endocrinology Department, Hebei General Hospital, 348, Heping West Road, Shijiazhuang, Hebei, 050051, People’s Republic of China, Email chenshuc2014@163.comPurpose: This study aims to explore the predictive value of plasma atherogenic index of plasma (AIP) for microalbuminuria (MAU) in newly diagnosed patients with type 2 diabetes mellitus (T2DM).Methods: This study was a retrospective study, which included 335 newly diagnosed T2DM patients. They were divided into microalbuminuria group (group A, n = 105 cases) and no microalbuminuria group (group B, n = 230 cases) according to whether microalbuminuria occurred. General information and laboratory examination indexes of patients were collected, and AIP was calculated. Multivariate logistic regression analysis was used to analyze the independent risk factors of microalbuminuria in T2DM patients, and receiver operating characteristic curve (ROC) was established to evaluate the predictive value of AIP on MAU of newly diagnosed T2DM patients.Results: According to general data analysis, AIP level in group A was significantly higher than that in group B (P < 0.05). Multivariate logistic regression analysis showed that AIP was an independent risk factor for microalbuminuria (P < 0.05). The receiver operating characteristic curve showed that the area under the curve (AUC) of AIP was 0.772 (P < 0.05), which had a good predictive value for the occurrence of MAU in newly diagnosed T2DM patients. The waist-hip ratio, triglyceride, high-density lipoprotein cholesterol, fasting blood glucose, glycosylated hemoglobin and AIP were used to make a joint model, and the AUC was 0.841 (P < 0.05), which had a better predictive value for the occurrence of MAU.Conclusions: AIP is an independent risk factor and could predict the occurrence of MAU in newly diagnosed T2DM patients. AIP provides clinicians a reliable basis to quickly identify high-risk patients and formulate appropriate treatment strategies.Keywords: plasma arteriosclerosis index, microalbuminuria, type 2 diabetes, dyslipidemia, diabetic nephropathy

Abstract Background Data on the long-term effects of neonatal acute kidney injury (AKI) are limited. Methods We invited 302 children who had neonatal AKI and survived to hospital discharge; out of 95 patients who agreed to participate in the study, 23 cases were excluded due to primary kidney, cardiac, or metabolic diseases. KDIGO definition was used to define AKI. When a newborn had no previous serum creatinine, AKI was defined as serum creatinine above the mean plus two standard deviations (SD) (or above 97.5th percentile) according to gestational age, weight, and postnatal age. Clinical and laboratory features in the neonatal AKI period were recorded for 72 cases; at long-term evaluation (2–12 years), kidney function tests with glomerular filtration rate (eGFR) by the Schwartz formula, microalbuminuria, office and 24-h ambulatory blood pressure monitoring (ABPM), and kidney ultrasonography were performed. Results Forty-two patients (58%) had stage I AKI during the neonatal period. Mean age at long-term evaluation was 6.8 ± 2.9 years (range: 2.3–12.0); mean eGFR was 152.3 ± 26.5 ml/min/1.73 m2. Office hypertension (systolic and/or diastolic BP ≥ 95th percentile), microalbuminuria (> 30 mg/g creatinine), and hyperfiltration (> 187 ml/min/1.73 m2) were present in 13.0%, 12.7%, and 9.7% of patients, respectively. ABPM was performed on 27 patients, 18.5% had hypertension, and 40.7% were non-dippers; 48.1% had abnormal findings. Female sex was associated with microalbuminuria; low birth weight (

To compare the time in range (TIR) obtained from self-monitoring of blood glucose (SMBG) with that obtained from continuous glucose monitoring (CGM), and explore the relationship of TIR with microalbuminuria outcome, HOMA-IR and HOMA-β test. We recruited 400 patients with type 2 diabetes to carry out blood glucose monitoring by both SMBG and CGM for 3 consecutive days. TIR, TAR, TBR and other blood glucose variation indices were calculated respectively through the glucose data achieved from SMBG and CGM. The HOMA-IR and HOMA-β test was evaluated by an oral glucose tolerance test. Urinary microalbumin-to-creatinine ratio completed in the laboratory. The median (25 %, 75 % quartile) of TIR CGM and TIR SMBG were 74.94(44.90, 88.04) and 70.83(46.88, 87.50) respectively, and there was no significant difference, p = 0.489; For every 1 % increase in TIR CGM , the risk of microalbuminuria decreased by 1.6 % (95%CI:0.973, 0.995, p = 0.006) and for every 1 % increase in TIR SMBG , the risk of microalbuminuria decreased by 1.3 % (95%CI:0.975, 0.999, p = 0.033). Stepwise multiple linear regression analysis showed an independent positive correlation between TIR (including TIR CGM and TIR SBMG) and LnDI30 and LnDI120 levels (p = 0.000). The TIR calculated by SMBG was highly consistent with that reported by CGM and was significantly associated with the risk of microalbuminuria and the HOMA-β. Higher TIR quartiles were associated with lower incidence of microalbuminuria as well as higher lever of HOMA-β. For patients with limited CGM application, SMBG-derived TIR may be an alternative to CGM-derived TIR, to assess blood glucose control. • The TIR calculated by SMBG was highly consistent with that reported by CGM. • Both TIR SMBG and TIR CGM was significantly associated with the risk of microalbuminuria outcome, HOMA-IR and HOMA-β test. • Higher TIR quartiles were associated with lower incidence of microalbuminuria outcome as well as higher lever of HOMA-β. • For patients with limited CGM application, TIR SMBG may be an alternative to TIR CGM , to assess blood glucose control. [ABSTRACT FROM AUTHOR]

We aimed to examine the role of circulating immature granulocytes (IGs) in assessing Diabetic Nephropathy (DN) mainly and also associations of other leukocyte parameters with DN. In this retrospective cross-sectional study, a total of 164 Diabetes Mellitus patients were grouped as normoalbuminuric and microalbuminuric according to urinary albumin excretion in the course of admission. Neutrophil-lymphocyte ratio (NLR), IG count (IG#) and IG percentage (IG%) levels were compared between the groups. The value of IG# and IG% levels in detecting microalbuminuria was analyzed with the Receiver operating characteristic (ROC) curve. NLR was remarkably higher in the microalbuminuric group (p = 0.036). Correlation results in the microalbuminuric group were as follows: A feeble positive correlation between neutrophil count (NEU#) and serum creatinine and albumin-to- creatinine ratio (ACR) (p = 0.036, r = 0.261; p = 0.005, r = 0.347, respectively), a feeble positive correlation between lymphocyte count (LYM#) and estimated glomerular filtration rate (p = 0.021, r = 0.285). Correlation results in the normooalbuminuric group were as follows: A feeble positive correlation between NEU# and ACR (p = 0.043, r = 0.204), a feeble negative correlation between LYM# and serum creatinine (p = 0.042, r = −0.205), a poor positive correlation between IG# and ACR and HBA1C% (p = 0.048, r = 0.199; p = 0.004, r = 0.290, respectively), a positive poor correlation between IG% and HBA1C% (p = 0.019, r = 0.235). Area under the ROC curve values for IG# and IG% were not statistically noteworthy in detecting microalbuminuria (p = 0.430; p = 0.510, respectively). IG# and IG% values are insufficient to predict immediate microalbuminuria, but could be considered a weak biomarker for renal damage in normoalbuminuric (<30 mg/g) diabetic patients. Further researches are needed for the use of leukocyte parameters in evaluating DN. • Inflammatory cells could be used to screen for diabetic kidney disease • Neutrophil-lymphocyte ratio value is higher in microalbuminuric diabetics • Renal functions are positively associated with lymphocyte count in diabetics • Immature granulocytes, may be a poor marker in screening normoalbuminuric diabetics [ABSTRACT FROM AUTHOR]

Background: Endothelial dysfunction constitutes an early pathophysiological event in atherogenesis and cardiovascular disease. This study aimed to assess the prevalence, determinants, and degree of endothelial dysfunction in antiretroviral therapy (ART)–treated people living with HIV (PLWH) in northwestern Nigeria using brachial flow-mediated dilatation (FMD). Methods: This was a comparative, cross-sectional study. A total of 200 ART-treated adults living with HIV with no evidence of kidney disease were compared with 200 HIV-negative participants attending a tertiary hospital in Kano, Nigeria, between September 2020 and May 2021. Endothelial function was evaluated by measuring FMD with a high-resolution vascular ultrasound transducer. FMD was calculated as the ratio of the brachial artery diameter after reactive hyperemia to baseline diameter and expressed as a percentage of change. Blood and urine samples were obtained from participants in both arms. Urine albumin-to-creatinine ratio (uACR) was calculated using the 2021 CKD-EPI estimated glomerular filtration rate (eGFR) creatinine-cystatin C equation without the race variable, and low-density lipoprotein (LDL) cholesterol was measured using enzymatic method. Results: The overall mean age (± standard deviation) of the study participants was 42 ± 11 years. Participants in the comparison arm were younger than PLWH (38 ± 11 versus 46 ± 10 years, respectively). The median (interquartile range) uACR was 41.6 (23.2–162.9) mg/g for the ART-treated PLWH versus 14.5 (7.4–27.0) mg/g for healthy controls. PLWH had a significantly lower mean percent FMD when compared to HIV-negative participants (9.8% ± 5.4 versus 12.1% ± 9.2, respectively). Reduced FMD was independently associated with HIV infection (β = –2.83%, 95% CI, –4.44% to –1.21%, p = 0.001), estimated glomerular filtration rate (β = –0.04%, 95% CI, –0.07% to –0.01%, p = 0.004) and LDL cholesterol (β = –1.12%, 95% CI, –2.13% to –0.11%, p = 0.029). Conclusion: HIV-positive status, lower estimated GFR, and higher LDL cholesterol levels were independently associated with endothelial dysfunction. Future prospective studies with larger cohorts of persons living with HIV (and age- and sex-matched HIV-negative controls) are needed to gain further insight into these important findings. In the interim, aggressive management of modifiable risk factors is warranted.

BACKGROUND: Sickle cell nephropathy, a heterogeneous group of renal abnormalities resulting from complex interactions of sickle cell disease (SCD)-related factors and non-SCD phenotype characteristics, is associated with an increased risk for morbidity and mortality. AIMS: The aims of this study were to determine the frequency of microalbuminuria (MA) among pediatric patients with SCD and to determine risk factors for MA among those patients. SUBJECTS AND METHODS: A case–control study was carried out on 120 patients with SCD, 2–18 years old, registered at Basrah Center for Hereditary Blood Diseases, and 132 age- and sex-matched healthy children were included as a control group. Investigations included complete blood panel, blood urea, serum creatinine (Cr), urinalysis, and urinary albumin-to-Cr ratio (ACR). Logistic regression analysis was used to assess the predictors of MA. RESULTS: Among SCD patients, 39 (32.5%) had MA compared to 6 (4.5%) in the control group. The mean levels of blood urea, serum Cr, and ACR were significantly higher, and the urine-specific gravity was significantly lower in SCD patients than in the control group (P < 0.05). Logistic regression analysis revealed that frequent painful crisis (odds ratio [OR]: 12.146, confidence interval [CI]: 3.439–42.952), high serum ferritin (OR: 8.146, CI: 1.802–36.827), deferoxamine therapy (OR: 23.423, CI: 3.961–60.509), and female sex (OR: 4.590, CI: 1.225–17.202) are independent risk factors for MA (P < 0.05). CONCLUSION: The frequency of MA was high among our pediatric SCD patients. Risk factors for MA include female sex, nutritional factors, painful episodes, and iron overload. This is important for planning for future follow-up and management of this common disease in our locality.

Background: Human immunodeficiency virus (HIV) infection affects multiple organs and the kidney is a common target, thereby making renal disease one of the recognised complications of HIV infection. Microalbuminuria represents an early, important marker of kidney damage in several disease conditions including HIV-infected highly active antiretroviral therapy (HAART)-naïve patients. Early detection of microalbuminuria is critical to slowing down the progression of kidney dysfunction to chronic kidney disease in HIV-infected patients. Determination of predictive factors for microalbuminuria in these group of patients may serve as avenues for intervention to prevent HIV-associated renal diseases. Aim: The aim of the study was to determine the prevalence and risk factors of microalbuminuria in HIV/AIDS-infected adults on HAART at Aminu Kano Teaching Hospital, Kano, Nigeria. Patients, Materials and Methods: A descriptive cross-sectional study was carried out among 500 subjects including 250 HAART-treated and 250 HAART-naïve HIV/AIDS participants. An interviewer-administered structured questionnaire was used to collect relevant demographic and clinical information. Blood and urine samples were collected for serum creatinine and urinary albumin and creatinine measurements, respectively, and the results were collated and analysed. Comparison of categorical variables was done using Chi-square/Fisher's exact test, where applicable with level of significance set at P < 0.05. Results: The prevalence of microalbuminuria among the two groups studied was found to be high (22.8% for HAART naïve versus 18.4% for HAART treated, respectively) while the risk factors identified were estimated glomerular filtration rate, low CD4 count, and duration of HIV treatment. Conclusion: The major predictors of microalbuminuria include low CD4 count, duration of HIV infection (

Introducción: El mercurio es reconocido como contaminante ambiental que causa efectos graves a la salud humana. Uno de los daños menos estudiados producto de la exposición ocupacional es la enfermedad renal crónica, problema que tiene que enfrentar el Sistema de Salud, ya que se diagnostican muchos casos en etapas avanzadas de la enfermedad y no se les identifica como relacionados con el trabajo. Objetivo: Evaluar la utilidad de la microalbuminuria como biomarcador de daño renal precoz por exposición a mercurio, en los trabajadores de la industria de cloro. Métodos: Se realizó un estudio descriptivo, de corte transversal, con componente analítico a una muestra de 70 trabajadores expuestos en el periodo 2017-2018. Se analizó la microalbuminuria, el mercurio inorgánico y algunos indicadores de la función renal. La utilidad diagnóstica se determinó empleando la curva ROC, mediante el cálculo de los parámetros sensibilidad y especificidad. Se realizó un análisis a partir del coeficiente de correlación lineal Spearman, considerando una significación estadística de p < 0,05. Resultados. El 60 % tenía más de 10 años de exposición; el 60 % presentó niveles de exposición a mercurio en orina; y el 18,6 % de los trabajadores exhibió microalbuminuria superior al límite normal. Se obtuvo una correlación lineal ascendente entre microalbuminuria y niveles de mercurio en orina. Conclusiones. Con niveles dentro del rango de exposición a mercurio se evidenciaron alteraciones en la microalbuminuria. Esta es una prueba diagnóstica útil para el daño renal precoz en los pacientes expuestos a mercurio Introduction: Mercury is recognized as an environmental pollutant that causes serious effects on human health. One of the least studied damages resulting from occupational exposure is chronic kidney disease, a problem that the health system has to face, since many cases are determined in advanced stages of the disease and are not identified with work. Objective: To evaluate the usefulness of microalbuminuria as a biomarker of early kidney damage due to mercury exposure in workers in the chlorine industry. Methods: A descriptive cross-sectional study was carried out, with an analytical component to a sample of 70 exposed in the period 2017-2018. Microalbuminuria, inorganic mercury and some indicators of kidney function were analyzed. The diagnostic utility was determined using the ROC curve, by calculating the sensitivity and specificity parameters. An analysis was performed using the Spearman linear correlation coefficient considering a statistical significance of p

BACKGROUND: Obesity is a universal health issue of the present time. Nearly 2 billion people were estimated to be either overweight or obese in 2020, with nearly 3.4 million deaths worldwide. Proteinuria is now widely known to be a significant predictor of renal pathologies including end-stage renal disease. This study aimed to assess the relationship between the presence of microalbuminuria (MA) in obese individuals. MATERIALS AND METHODS: This cross-sectional study was conducted among patients attending the outpatient department of Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha. From the subjects meeting the study criteria, selected 150 individuals with BMI ≥ 25 that formed the obese group. Obese individuals were further subdivided as metabolic healthy obese (MHO) and metabolic abnormal obese (MAO) based on metablic syndrome criteria. From the non-obese patients (BMI≤25), one age and gender matched control was selected for each obese subject. All subjects were tested for MA by dipstick method. Data was analyzed using SPSS and Chi-square test was performed to test for statistical significance. RESULTS: The study reflected the association of MA in the groups studied. The metabolic abnormal obese group was noted as having the highest percentage of positive cases (53.7%) of MA, followed by the MHO group (31.3%). A significant association of prevalence of MA was seen in MHO and MAO obese individuals (P < 0.001). MA was present in the urine samples of 26 (31.3%) obese subjects in the MHO group, 36 (53.7%) in the MAO group, and 8 (5.3%) in the control population. CONCLUSION: Both MHO and MAO subgroups of obese individuals showed higher proportion of MA indicating adverse renal function. Therefore, primary prophylactic measures such as health education and lifestyle modification should be promoted for the obese to reduce their body weight and thereby possibly reduce the risk of future obesity-related renal complications.

Introducción: las complicaciones microvasculares más frecuentes de la diabetes involucran, principalmente, a la retina y al riñón. Se ha reconocido una estrecha relación entre la retinopatía diabética y la microalbuminuria. Objetivo: determinar el comportamiento de la microalbuminuria en pacientes con diabetes tipo 2 y retinopatía diabética. Métodos: estudio observacional, descriptivo, de corte transversal en pacientes con diabetes tipo 2 y retinopatía diabética en el Hospital “Arnaldo Milián Castro” en el período de tiempo comprendido entre los años 2018 y 2019. Resultados: las mujeres mayores de 60 años fueron las más afectadas con retinopatía diabética (43,2%). La retinopatía diabética proliferativa (47,7%) prevaleció en los pacientes con más de 10 años de evolución. En el 38,6% de los pacientes estudiados se registraron valores de microalbuminuria elevada. El 32,4% de los pacientes con microalbuminuria elevada tenía una retinopatía diabética proliferativa con mal control metabólico. El número de pacientes con retinopatía diabética proliferativa, hipertensión arterial asociada y microalbuminuria elevada fue menor al que se esperaba. Conclusiones: poco más de un tercio de los pacientes con diabetes y algún grado de severidad de retinopatía diabética presentan microalbuminuria elevada. Más de la mitad de los pacientes con valores elevados de microalbuminuria tienen un mal control metabólico, de estos la mayoría con retinopatía diabética proliferativa. El número de pacientes con retinopatía diabética proliferativa, hipertensión arterial asociada y microalbuminuria elevada fue menor al que se esperaba hallar en esta serie.

Abstract Background Diabetic nephropathy is known to be a leading complication of diabetes mellitus, characterized by diverse aspects such as high urinary albumin level, elevated blood pressure, and genetic susceptibility leading to end-stage renal disease. The current study was carried out to investigate the association of eNOS and TGFβ1 gene polymorphisms in the progression of diabetic nephropathy among type 2 diabetic patients in the South Indian population. The eNOS and TGFβ1 genetic variants were genotyped in 280 T2DM patients, 140 with DN, 140 without DN, and 140 controls. Genotyping was performed using ARMS PCR and the genomic variants were confirmed by the Sanger sequencing method. Results A significant (p T) polymorphism in the T2DM patients with diabetic nephropathy when compared to controls. The frequency of TT (heterozygous) genotype was observed to increase in patients with type 2 diabetes and DN when compared to the diabetic patients without DN and controls. This indicates that diabetic patients with TT genotype are at an increased risk to develop DN. However, TGFβ1 (G > C) polymorphism did not show any association in the allele and genotypic frequencies with DN when compared with T2DM and controls. Conclusion The results of the study propose a strong influence of TT genotype of eNOS gene be significantly linked with diabetic nephropathy in T2DM patients. Whereas no association was examined concerning TGFβ1 gene polymorphism and DN. Nevertheless, large sample size studies are required to confirm the part of these genetic variants in the development of DN.

Background: Sickle cell disease is related to many health issues (such as stroke, severe infections, and sickle cell crisis) and elevated risk of death. This study was aimed to investigate and compare microalbuminuria (MAU), creatinine, and glomerular filtration rate (GFR) between sickle cell disease (SCD) patients and healthy individuals. Methods: A total of 156 cases and 156 control subjects were included. MAU, creatinine, GFR, and body mass index (BMI) were measured. Results: The estimated levels of MAU and creatinine were significantly higher in cases than controls, but the mean of BMI and GFR was significantly lower in cases than the control group. In patients of sickle cell disease, the mean MAU, GFR, creatinine, and BMI levels in females, rural area residents, and subjects aged 2–13 years were higher than controls, P < 0.05. MAU and GFR were also higher (P < 0.05) in males and subjects aged 14–25 years of study cases than controls. Conclusion: Accordingly, this study indicated the impact of SCD in MAU, creatinine, GFR, and BMI, which are significant in the diagnosis of nephropathy.

Objectives: To determine the frequency of Hyperuricemia in patients with type-2 Diabetes Mellitus and to compare frequency of Diabetic Nephropathy in Hypouricemic vs Normouricemic patients with type-2 Diabetes. Study Design: Cross-sectional analytical study. Duration and Place of Study: Medicine Department Combined Military Hospital Peshawar, from Dec 2018 to May 2019. Methodology: Patients from both genders with type 2 Diabetes having glycosylated hemoglobin (HbA1c) ≥6.5%, Fasting Blood glucose ≥ to 7.0 mmol/L or random blood glucose ≥11.1 mmol/L were recruited from out Patient department.Participants were tested for serum uric acid, fasting blood glucose, Glycosylated hemoglobin (HbA1c) and Spot Urine Albumin Creatinine Ratio after 8 hours fasting. Results: Out of 111 patients enrolled Hyperuricemia was present in 40 (36.04%) patients of which 21 (52.50%) were male and 19 (47.50%) were female. Diabetic Nephropathy was present in 43(38.74%). Out of 43 patients having diabetic nephropathy, 25 (58.14%) were having hyperuricemia. The study observed a linear relationship between serum uric acid and type-2 diabetes duration, fasting blood glucose levels, glycosylated hemoglobin (HbA1c) and urinary Albumin creatinine ratio. Conclusion: Hyperuricemia is positively linked with diabetic complications in majority of patients with type-2 diabetes. Serum uric acid levels can be used as an early diagnostic parameter and can prognosticate diabetic nephropathy. Keywords: Diabetes mellitus, Diabetic nephropathy, Hyperuricemia, Microalbuminuria

IntroductionSelenium is a critical trace element with antioxidant activities that has been related to the preservation of kidney function. Few studies, however, have looked at the effects of excess selenium on kidneys. The purpose of the present study was performed to investigate the relationship between dietary selenium intake and the prevalence of microalbuminuria in American adults with obesity.MethodsA total of 8,547 participants with obesity in the National Health and Nutrition Examination Survey (NHANES) with the age of 19 years or older were included in the present study. Multivariable regression and subgroup analyses were performed to examine the association between dietary selenium and microalbuminuria in the two genders, separately. A selenium intake above the median was defined as high selenium intake.ResultsDietary selenium intake was significantly higher in men compared to women (139.49 μg/day vs. 101.06 μg/day; P < 0.0001). Among female participants, the prevalence of microalbuminuria was significantly higher in participants with a high selenium intake compared with those without a high selenium intake (13.82 vs. 9.96%; P = 0.008), whereas this difference did not exist in male participants (10.79 vs. 11.97%; P = 0.40). Dietary selenium is not significantly correlated with microalbuminuria (P = 0.68) in the male population, whereas each 1 μg/day of increase in selenium consumption was independently associated with a 6h higher risk of microalbuminuria (OR = 1.006; 95% CI, 1.001–1.011, P = 0.01) in females.ConclusionAccording to our research, excessive selenium consumption is positively correlated with microalbuminuria in females with obesity, but not in males with obesity.