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To study the urinary neutrophil gelatinase-associated lipocalin (NGAL) and beta-2-microglobulin (β2M) levels as markers of tubular damage in children with type 1 diabetes (T1DM). Forty T1DM children and 40 age-matched controls were enrolled. Subjects with coexisting kidney disorder, intake of oral glucose lowering drugs and syndromic diabetes mellitus were excluded. Fasting plasma glucose, glycated hemoglobin (HbA1c), kidney function, urinary albumin-creatinine ratio (UACR), NGAL and β2M were measured and compared in cases and controls. The median (IQR) age of cases and controls was 10.6 (8, 14.2) and 10.7 (8.4, 13.7) years, respectively. Cases had disease duration of 4 (3, 6.8) years and HbA1c 10.9 (9, 13.1) %. Microalbuminuria was seen in 14 (35 %). Median (IQR) levels of UACR were higher in cases than controls [19.38 (10.27, 35.26) and 6.49 (3.10, 11.65) µg/mg; p<0.001], similarly NGAL/creatinine [352.21 (191.49, 572.45) and 190.54 (125.91, 322.83) ng/mg; p=0.006], unlike β2M/creatinine [1.7 (0.43, 6.02) and 2.12 (1.05, 4.47) µg/mg; p=0.637]. Children with higher HbA1c (≥10 %) had higher urinary ACR and tubular biomarkers than HbA1c<10 % (p>0.05). Urinary ACR showed positive correlation with NGAL/creatinine (r=0.38, p=0.019) and β2M/creatinine (r=0.42, p=0.009). Urinary biomarkers NGAL and β2M were elevated in the presence of normal urinary microalbumin levels suggestive of early tubular damage in T1DM. [ABSTRACT FROM AUTHOR]

Objectives: Renal impairment and some systemic diseases are associated with hearing loss (HL) in adults. However, studies of these relationship in adolescents are rare. The objective of this study was to determine the association between HL and renal or systemic disease in adolescents. Methods: Subjects were extracted from the 5th Korea National Health and Nutrition Examination Survey from 2011 to 2012. We included adolescents aged 10–19 years old with normal tympanic membrane and those who underwent a physical and laboratory examination and pure tone audiometry. HL, high‐frequency hearing loss (HFHL), albuminuria, impaired glomerular filtration rate, hypertension, diabetes, and obesity were evaluated based on the data. Results: Individuals with microalbuminruia (MIA) exhibited higher prevalence of HL (p = 0.003) and HFHL (p = 0.012) than those without MIA. The prevalence of HL and HFHL appeared to increase according to the severity of albuminuria. Additionally, individuals with HL or HFHL showed lower transferrin saturation (TSAT) than individuals without HL (p = 0.002) or HFHL (p = 0.001). And, HFHL was associated with lower ferritin levels (p = 0.017). HL and HFHL were related to MIA (p = 0.004 and p = 0.022, respectively) and TSAT (p = 0.005 and p = 0.011, respectively) after controlling other factors. Conclusion: MIA and TSAT level were independently associated with the HL and HFHL. Since MIA can be easily detected by dipstick test and urine analysis, hearing evaluations for individuals with MIA might be helpful to identify hearing impairments earlier in adolescents. Level of Evidence: 3 (individual cross‐sectional study) Laryngoscope, 134:3329–3334, 2024 [ABSTRACT FROM AUTHOR]

Background: Microalbuminuria as an early marker of certain diseases including those affecting the renal system is widely acknowledged. Its performance in this regard vis a vis routine use of serum creatinine in sickle cell anaemia (SCA) patients known to be prone to renal complications has however not been fully explored, particularly in the study locale. Objective: To compare the usefulness of serum creatinine and microalbuminuria in the early detection of renal changes in children with SCA in Benin City. Methods: A cohort of 69 children with SCA aged 1-16 years were consecutively enrolled into this cross sectional and descriptive studywhich was conducted between November 2006 and February 2007. Using the Micral Test strips, microalbuminuria in early morning urine specimen (spot) was determined in each subject. Also determined were serum creatinine, urea, electrolytes and creatinine clearance. Results: The prevalence of microalbuminuria in the study subjects was 20.3 percent. Serum creatinine values in all subjects were normal but increased with increasing age. Similarly, serum urea, creatinine clearance and electrolytes in the subjects were within normal limits. Apart from the negative predictive value of 79.7 percent, other indices such as sensitivity (0.0 percent), specificity (0.0 percent) and positive predictive value (0.0 percent) of serum creatinine were low as a gold standard in the early detection of renal changes when compared with microalbuminuria. Conclusion and recommendation: Microalbuminuria is common enough in children with SCA to warrant routine screening for it. Reliance on serum creatinine for the detection of early renal changes would be misplaced. Measures that could assist in the early detection of ensuing renal diseases and improve case management of the child with SCA, who is particularly prone to renal complications, are warranted and these could be partially determined by using the presence of microalbuminuria. Interventional measures known to retard the rate of deterioration of kidney function following prolonged proteinuria could thus be instituted.

Background: Obesity is a risk factor for metabolic syndrome with insulin resistance. Its effect on renal and cardiovascular diseases is reported in developed countries, but rarely established among adolescents in developing countries. Subjects and methods: A crosssectional study of 846 adolescents selected from 12 secondary schools in Port Harcourt, Nigeria. Obese subjects with Body Mass Index (BMI) equal to or greater than the 95th percentile for age and sex on the United States CDC growth chart were selected and studied. Urine samples of subjects without overt proteinuria were tested for microalbuminuria using the micral test strips. Results: Seventy-three of the subjects were obese giving the preva lence of obesity to be 8.6%. Microalbuminuria was present in 23 (35.4%) of the 65 obese subjects without overt proteinuria. The proportional prevalence was higher in females (42.9%), in age group 10- 14years (42.2%), in subjects with hypertension (57.1%), and family history of hypertension (50.0%) and diabetes mellitus (37.5%) [p > 0.05]. Conclusion: There is high prevalence of adolescent obesity, and a high prevalence of microalbuminuria among obese adolescents in Port Harcourt. We recommend efforts at reducing obesity as a means of preventing renal disease in adolescents.

Background: Hypertension is a serious public health issue in the general population, with a considerable proportion of cases inadequately being treated. Methods: This hospital-based prospective study was carried out at our tertiary care teaching hospital between November 2019 and November 2021. One hundred patients who were recently diagnosed to have hypertension were studied. Results: The age of the subjects ranged from 31 to 78 years with a mean age of 49 years. Of these, 40% were in the 40–49 years’ age group; there were 68 males. The body mass index (BMI, Kg/m2) distribution of the study subjects showed 22% with normal weight, 62% in overweight and 16% in obese category. Microalbuminuria was evident in 28% of newly diagnosed hypertensives. The sex-wise distribution of microalbuminuria revealed that 17 of 68 males (25%) and 11 of 32 females (34.4%) had microalbuminuria. Conclusions: The chronicity of hypertension, age and BMI were the main factors determining microalbuminuria.

Background Microalbuminuria is a sensitive indicator of early renal microvascular damage and an independent risk factor for cardiovascular diseases. Previous studies have shown that long-term chronic inflammation plays an important role in the occurrence and development of microalbuminuria. However, the correlation between blood inflammatory markers and microalbuminuria has been less frequently reported. Objective To investigate the correlation of systemic immune inflammatory index (SII) and systemic inflammatory response index (SIRI) with microalbuminuria in a middle-aged and elderly physical examination population. Methods This was a cross-sectional study in which 2 105 medical examiners over the age of 40 years who underwent health check-ups from April to July 2023 at the Department of Health Medicine, General Hospital of the Eastern Theatre of Operations were selected as study subjects. The study subjects were divided into two groups based on the urinary microalbumin/urinary creatinine ratio (UACR) values: the non-microalbuminuric group (1 857 cases, UACR0.05) ; age, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, 2 h blood glucose, glycosylated hemoglobin, triglycerides, homocysteine, glomerular filtration rate erythrocyte sedimentation rate, SII, and SIRI levels were higher in the microalbuminuria group than those in the non-microalbuminuria group, and high density lipoprotein cholesterol level was lower than that in the non-microalbuminuria group (P

Background: Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system. While previous studies have indicated that albumin, the primary protein in human plasma, may exert influence on the inflammatory process and confer beneficial effects in neurodegenerative disorders, its role in the context of MS has been underexplored. Here, we aimed to explore the link between albumin and the risk of MS. Methods: Employing data from the UK Biobank, we investigated the association between baseline levels of serum and urine albumin and the risk of MS using Cox proportional hazards regression analysis. Results: A higher baseline level of serum albumin was associated with a lower risk of incident MS (HR=0.94, 95% CI: 0.91-0.98, P=7.66E-04). Subgroup analysis revealed a more pronounced effect in females, as well as participants with younger ages, less smoking and deficient levels of vitamin D. Conversely, no association was identified between baseline microalbuminuria level and risk of incident MS. Conclusion: Higher serum albumin level at baseline is linked to a reduced risk of MS. These results contribute to an enhanced understanding of albumin's role in MS, propose the potential use of albumin as a biomarker for MS, and have implications for the design of therapeutic interventions targeting albumin in clinical trials. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is an important independent risk factor for the development of cardiovascular and renal disease which has been the cause of death in majority of the diabetic population. Albuminuria has been shown to predict cardiovascular morbidity and mortality in diabetics. Objective: The purpose of this study was to correlate microalbuminuria and left ventricular diastolic dysfunction (earliest manifestation of heart disease) in type 2 diabetes mellitus to aid in subclinical diagnosis, risk stratification, and prompt management of cardiovascular disease in diabetic patients. Methods: This study assessed the incidence of left ventricular diastolic dysfunction (LVDD) using echocardiography and its correlation with microalbuminuria and with other parameters like age, gender, BMI, duration of diabetes mellitus, and glycosylated hemoglobin in 90 normotensive, type 2 diabetic patients in a tertiary care hospital in Western India. Results: The prevalence of LVDD in our study is 59% (n = 53). The mean age of the study subjects was 60.7 years. Out of 59 subjects with BMI ≥ 25 kg/m2, diastolic dysfunction was seen in 31 patients. The mean duration of diabetes mellitus in our study is 11.5 years. Good glycemic control, i.e., HbA1c ≤ 7.0, was seen in 13 patients with LVDD. Out of 53 subjects with LVDD, 48 (90.5%) subjects had microalbuminuria. Conclusion: There is a significant correlation between microalbuminuria and LVDD in type 2 diabetes mellitus, independent of other parameters studied (age, sex, BMI, glycemic control, and duration of diabetes). [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus has become increasingly common worldwide, with many serious complications. Diabetic nephropathy is one such complication that affects the kidney and leads to end-stage renal failure worldwide. Microalbuminuria represents an abnormal elevation in urine albumin levels, which is an early marker of diabetic nephropathy. It is likely to be found in one-third or more of diabetic patients. Early recognition of microalbuminuria in diabetic nephropathy permits successful therapeutic intervention and significant postponement of terminal renal failure. Objective: To investigate the prevalence of microalbuminuria in type 2 diabetes patients attending AL-Thawra Hospital and Saref Medical Centre in Sana'a City. Materials and Methods: This study was carried out in AL-Thawra Hospital and Saref Medical Center in Sana'a City, during the period (from 1 February to 30 April 2021). 125 Type 2 diabetic patients (diagnosed according to American Diabetes Association (ADA) criteria for diagnosis of diabetes) were selected). Medical records were used to collect data on duration of diabetes, gender, age and body mass index (BMI). Microalbuminuria was assessed using mispa-i3 kits in spot of the morning urine samples. Results: The prevalence of microalbuminuria and macroalbuminuria among type 2 diabetic patients was 44.8% and 12 %, respectively. Microalbuminuria had a statistically significant association with longer duration (P = 0.031), and no statistically significant association was found between microalbuminuria and gender (P = 0.419), age (P = 0.299) and body mass index (P = 0.390). Conclusion: The prevalence of microalbuminuria in this study was considerably high (44.8%) in type 2 diabetes. 44.8% (nearly half) of type 2 diabetic patients in this study are at risk of developing kidney disease due to their high microalbuminuria level. This calls for regular and early screening for microalbuminuria is recommended for all diabetic patients, as early treatment is critical for reducing the progression to the late stage of diabetic nephropathy (overt proteinuria and end-stage renal disease). [ABSTRACT FROM AUTHOR]

Urinary microalbumin (mALB) serves as an exceptionally sensitive indicator for the early detection of kidney damage, playing a pivotal role in identifying chronic renal failure and kidney lesions in individuals. Nevertheless, the current fluorescent methodologies for point‐of‐care (POC) diagnosis of mALB in real urine still exhibit suboptimal performance. Herein, the development and synthesis of QM‐N2, an albumin‐activated near‐infrared (NIR) aggregation‐induced emission (AIE) fluorescent probe, are presented. The strategic incorporation and positioning of quaternary ammonium salts within the quinoline‐malononitrile (QM) scaffold significantly influence solubility and luminescence characteristics. Specifically, the quaternary ammonium salt‐free variant, QM‐OH, and the quaternary ammonium salt integrated at the donor function group (DFG) site, QM‐N1, display limited solubility in aqueous solutions while demonstrating a distinct fluorescence signal. Conversely, the incorporation of quaternary ammonium salt at the conformational functional group (CFG) site in QM‐N2 imparts superior dispersibility in water and reduces the initial fluorescence. Furthermore, the integration of a well‐defined D‐π‐A structure within QM‐N2 enables itself with near‐infrared emission, which is crucial for mitigating interference from autofluorescence present in urine samples. Upon interaction with albumin, QM‐N2 forms a tight bond with the IIA site of the subdomain of human serum albumin (HSA), inducing alterations in protein configuration and constraining the intrinsic motion of fluorescent molecules. This interaction induces fluorescence, facilitating the sensitive detection of trace albumin. Ultimately, QM‐N2 is applied for POC testing of mALB using portable equipment, particularly in the diagnosis of mALB‐related diseases, notably chronic renal failure. This positioning underscores its potential as an ideal candidate for self‐health measurement at home or in community hospitals. [ABSTRACT FROM AUTHOR]

Objective: To find the correlation of serum uric acid with microalbuminuria in Type-2 diabetic patients with normal creatinine. Methods: This cross-sectional study was conducted in the Department of Diabetes, Endocrinology and Metabolic diseases, Hayatabad Medical Complex, Peshawar, Pakistan from 1st April, 2022 to 30th September, 2022. Total 160 diabetic patients between the age of 30 and 65 years were enrolled in the study. Type-2 diabetic patients with microalbuminuria between 2.5 and 30 mg/mmol were included. The demographic details of patients were recorded in the questionnaire after taking consent. Fasting Uric acid, lipid profile and glucose along with creatinine and HbA1C were estimated from patient's venous blood samples. Ratio of albumin to creatinine (ACR) in the random spot urine sample was used to detect microalbuminuria. Results: Out of 160 participants enrolled in the study there were 86 (54%) males and 74 (46%) females with the mean age of 50.15 ± 11.1 years and BMI of 20.93 kg/m2. Ninety six (60%) of the patients had Type-2 DM for less than five years, while remaining 64 (40%) were more than five years diabetic. Mean serum uric acid calculated was 6.85±2.06(mg/ dl), while microalbuminuria was calculated as 8.02±0.78 (mg/mmol). The Pearson correlation of serum uric acid and microalbuminuria based on sex and age was statistically significant(p<0.05). Conclusion: We found that uric acid level was significantly associated with microalbuminuria in people with Type-2 diabetes with normal serum creatinine. Uric acid level can be a potential screening tool for early detection of DKD. [ABSTRACT FROM AUTHOR]

Objective: Diabetes is a chronic disease that causes the development of microalbuminuria. CoQlO deficiency is common in people with type 2 diabetes. This study aims to evaluate whether coenzyme Q10 (CoQlO) levels are a risk factor for diabetes and microalbuminuria in newly diagnosed diabetes and advanced microalbuminuria. Material and Method: The study was conducted with patients who came to the internal medicine outpatient clinic. Plasma CoQlO and malondialdehyde (MDA) values of 90 people in total, including 30 people in each group, newly diagnosed Type 2 diabetes (Group D), diabetes mellitus with microalbuminuria (Group M), and the control group (Group C) were examined. Results: There was no difference between plasma CoQlO and MDA levels of newly diagnosed type 2 diabetes patients and those with microalbuminuria (p>0.05). There was a negative correlation between CoQlO and fasting glucose and HbAlc in all groups (p<0.05). A positive correlation was observed between CoQlO and MDA (p<0.05). CoQlO level of the control group was found to be higher than Group D and M (p<0.05); the difference between Group M and Group D was not significant (p>0.05). As a result of regression analysis, increasing the CoQlO value was found to have a protective effect on the risk of diabetes (95 %CI: p=0.005). Conclusion: This study showed that individuals with low blood sugar and HbAlc had high CoQlO levels. We think that CoQlO can be considered a risk factor for diabetes, and further studies examining total CoQlO and ubiquinol/ubiquinone ratio would be beneficial. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic ketoacidosis (DKA) is characterized by a triad of hyperglycemia, acidosis and ketonemia. Microalbuminuria is an early predictor of diabetic nephropathy and is associated with higher levels of HbA1c. The present study aimed to evaluate the role of Microalbuminuria and HbA1c in the assessment of diabetes control in children with T1DM hospitalized with diabetic ketoacidosis Material & Methods: After taking approval from IEC, this prospective study was conducted on 38 children <18 years of age who presented for the first time with T1DM or with established T1DM admitted to Pediatric ICU at IMCHRC, Indore. Patients qualifying inclusion criteria and exclusion criteria were enrolled after obtaining written informed consent. Detailed history including the duration of diabetes in established T1DM children along with clinical examination and investigations such as blood glucose, arterial blood gases, serum electrolytes, urine sugar, and urine ketone bodies was done. Statistical analysis was done by SPSS 22.0 version software with P value <0.05 statistically significant. Results: 21.1% had debut and 78.9% had established T1DM. On admission, 60% had poor HbA1c control and microalbuminuria was found in 18% with established T1DM (mean duration: 4.28 ± 1.25 years. A significant association was found between urine microalbuminuria and HbA1c > 9% and duration of diabetes > 4 years. A significant difference was found between the mean HbA1c value at the time of admission and three months after treatment (P <0.05). Conclusion: Assessment of microalbuminuria is needed in pediatric T1DM patients, especially in those with HbA1c > 9% and duration of diabetes > 4 years, to evaluate the risk of diabetic nephropathy. [ABSTRACT FROM AUTHOR]

Background: One of the strongest risk factors for coronary artery disease is diabetes mellitus. Therefore, it is crucial to identify CAD in diabetic patients as soon as feasible. This study aimed to assess the relation between microalbuminuria and the angiographic severity of CAD patients with type 2 DM by SYNTAX I, SYNTAX II and Gensini scores. Patients and Methods: The study comprised 82 type II DM patients who were referred for elective coronary angiography due to a suspected CAD. All patients had their urinary albumin-creatinine ratio (UACR) determined, and the Gensini, SYNTAX, and SYNTAX II scores were used to determine how severe each patient's CAD was. Results: There were 26 (31.7%) females and 56 (68.3%) males in the study population. They were 56.29 + 9.18 years old on average. According to the UACR level, patients were divided into two groups: group 1 included patients with UACR less than 30 mg/g (41 patients), and group 2 included patients with UACR greater than or equal to 30 mg/g (41 patients). According to the study, patients in group 2 had considerably higher Gensini scores than patients in group 1 (P=0.001) and significantly higher SYNTAX scores than patients in group 1 (P=0.001). Age and the duration of DM and UACR had a positive association (p=0.003), and hypertension (HTN) and the duration of DM and UACR had a positive correlation (p=0.049). Conclusion: In type II DM, microalbuminuria can be utilized to predict the presence and severity of CAD. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a serious public health issue in the general population, with a considerable proportion of cases inadequately being treated. Methods: This hospital-based prospective study was carried out at our tertiary care teaching hospital between November 2019 and November 2021. One hundred patients who were recently diagnosed to have hypertension were studied. Results: The age of the subjects ranged from 31 to 78 years with a mean age of 49 years. Of these, 40% were in the 40-49 years' age group; there were 68 males. The body mass index (BMI, Kg/m2) distribution of the study subjects showed 22% with normal weight, 62% in overweight and 16% in obese category. Microalbuminuria was evident in 28% of newly diagnosed hypertensives. The sex-wise distribution of microalbuminuria revealed that 17 of 68 males (25%) and 11 of 32 females (34.4%) had microalbuminuria. Conclusions: The chronicity of hypertension, age and BMI were the main factors determining microalbuminuria. [ABSTRACT FROM AUTHOR]

Abstract Microalbuminuria and hyperuricemia management are crucial for the integrated management of hypertensive patients. This retrospective post hoc analysis aims to evaluate the optimal allisartan‐isoproxil‐based combination regimen for hypertensive patients with microalbuminuria or hyperuricemia. A total of 460 hypertensive patients with microalbuminuria and 486 hypertensive patients with hyperuricemia were included in this study. All patients were initially treated with allisartan‐isoproxil for 4 weeks. Thereafter, patients with blood pressure (BP)

Background: Diabetes mellitus (DM) is increasing drastically and affecting the individuals globally, especially in the low- and middle-income countries like India. The poor glycaemic control results in micro-vascular and macro-vascular complications, leading to dysfunction of multiple organs. This study aimed to evaluate the association between the risk factors and microalbuminuria levels among patients with type 2 DM on oral hypoglycaemic agents. Materials and Methods: Hundred type 2 DM patients fulfilling the inclusion and exclusion criteria were selected by convenient random sampling. Demographic details, biochemical markers, and anti-diabetic medication details were collected. The findings were analyzed statistically using Chi-square test and one-way analysis of variance (ANOVA) with SPSS software 21.0. Results: Among the different combination therapies, 59% were commonly using metformin and teneligliptin. There was a significant association noted between microalbuminuria and risk factors like age, duration of disease, body mass index (BMI) (25.5 ± 2.9), fasting blood sugar (151 ± 53.2 mg/dL), post prandial blood sugar (227.01 ± 70.9 mg/dL), blood urea (24.42 ± 9.3 mg/dL), and serum creatinine (1.5 ± 0.2 mg/dL) (P < 0.001). One-way ANOVA showed statistical significance between microalbuminuria and the different treatment groups (P < 0.0001). Conclusion: Microalbuminuria was associated with age, duration of diabetes, glycaemic control, and BMI. In contrast, there was no significant difference noted between the genders and microalbuminuria. Microalbuminuria is an early indication of nephropathy in diabetes patients. The early identification of the risk factors is important, and it is always recommended to screen for microalbuminuria in all the diabetic patients for early detection and prevention of diabetic nephropathy and their associated complications.

Background: Diabetic nephropathy is a progressive condition and a leading cause of end-stage renal disease. Oxidative stress and inflammation play an important role in its pathogenesis. In pre-clinical studies, Montelukast had shown renoprotective and anti-oxidant properties, hence the study was planned to evaluate the effect of Montelukast in a Streptozotocin (STZ) induced model of diabetic nephropathy. Methods: 40 Wistar rats of either sex were randomly divided into four groups viz. 1. Vehicle control group, 2. Enalapril (5 mg/kg), 3. Montelukast low-dose (10 mg/kg) and 4. High-dose (20 mg/kg) group. On day 1, diabetes was induced using a single dose of STZ (60 mg/kg) intraperitoneally. Diabetes induction was verified based on fasting blood glucose (FBG) levels on day 7 and from day 8 to day 42, rats were given study drugs. FBG, serum creatinine, blood urea nitrogen (BUN) and urine microalbumin levels were assessed pre-study and post-study. Assessments of kidney malondialdehyde (MDA), reduced glutathione (GSH) and renal histopathology were carried out at the end of the study. Results: Montelukast 10 mg/kg group showed significantly lower urine microalbumin levels compared to the vehicle control group (p < 0.05). Montelukast 20 mg/kg group showed significantly lower levels of FBG, serum creatinine, BUN and urine microalbumin compared to the vehicle control group (p < 0.05). In addition, Montelukast 20 mg/kg group also showed better effects on kidney MDA and GSH levels (p < 0.05) and histopathological scores compared to the vehicle control group. Conclusion: Montelukast showed a protective effect in the model of diabetic nephropathy because of its antioxidant effect.

Background: Improvements in sickle cell disease (SCD) care have resulted in the survival of many patients into adulthood, although this is accompanied by the increased incidence of end-organ damage, including chronic kidney disease (CKD). Objectives: This study assessed the prevalence, pattern and predictors of renal dysfunction in SCD patients and investigated the associated renal histopathologic changes. Methods: We evaluated 105 patients with SCD, for proteinuria, estimated glomerular filtration rate (eGFR), and tubular dysfunction. Renal biopsy was conducted on 22 patients who qualified. Data were analysed using SPSS package version 23. Results: Thirty-seven (35.2%) of the 105 patients had CKD, as defined by an eGFR of 60 ml/min/1.73 m2 and/or proteinuria. The fractional excretion of potassium (FEK) was elevated in all patients, whereas the fractional excretion of sodium (FENa) was elevated in 98.1%. Glomerular filtration rate was negatively correlated with irreversible percentage sickle cell count (r = −0.616, P = 0.0001), FEK (r = −0.448, P = 0.0001) and FENa (r = −0.336, P = 0.004). Age, irreversible percentage sickle cell count, haemoglobin levels and FENa were the major predictors of CKD. The histological pattern in the 22 patients who had biopsies was consistent with mesangioproliferative glomerulonephritis 11 (50%), minimal change disease 6 (27.3%), focal segmental glomerulosclerosis 3 (13.6%) and interstitial nephritis 2 (9.1%). Conclusions: CKD was prevalent in SCD patients, and it was characterised by tubular dysfunction and mesangioproliferative glomerulonephritis. The main predictors of CKD were increased age, severity of vaso-occlusive crisis, worsening anaemia and tubular dysfunction.

ABSTRACT Background Diabetic peripheral neuropathy (DPN) and diabetic nephropathy (DN) are common complications of type 2 diabetes mellitus (T2DM). Although nerve conduction studies (NCS) and sympathetic skin response (SSR) can detect DPN, the more sensitive method for early diagnosis remains unclear. Furthermore, whether DPN can be used as a predictor for diabetic nephropathy needs clarification. Methods We evaluated nerve conduction studies, sympathetic skin response, and the diabetic nephropathy indicator microalbuminuria (MAU) in 192 patients with type 2 diabetes mellitus and 50 healthy controls. Results Patients with type 2 diabetes mellitus showed a lower sensory nerve conduction velocity (SCV), sensory active nerve potential (SNAP), motor nerve conduction velocity (MCV), and compound motor action potential (CMAP) than the controls on NCS. Abnormal rates for nerve conduction studies and sympathetic skin response were 75.0% and 83.3%, respectively, in patients with type 2 diabetes mellitus. Interestingly, 54.2% of patients with normal nerve conduction studies had an abnormal sympathetic skin response. Moreover, we found a positive correlation between sympathetic skin response and microalbuminuria for the first time. The abnormal rate of microalbuminuria was 53.8%, lower than that of abnormal nerve conduction studies or sympathetic skin response patients. Conclusion Sympathetic skin response is a more sensitive method than nerve conduction studies for the early diagnosis of diabetic peripheral neuropathy. Abnormal sympathetic skin response might serve as an indicator for early diabetic nephropathy. Additionally, diabetic peripheral neuropathy may occur earlier than diabetic nephropathy in the development of type 2 diabetes mellitus.

Background Fatty liver, metabolic syndrome, and cardiovascular disease are just a few of the well-known cardiometabolic complications associated with childhood obesity. Microalbuminuria (MA) is a sign of early kidney impairment, as seen in adults, and recent research supports its presence in children with obesity as well as its potential relationship with cardiometabolic variables. Both adults and children share this well-established pathophysiological theory. Indicated a close connection with the main aspect of fatness, such as IR, through the renal hemodynamic effects of insulin. More scientific consideration must be given to the assessment of primary kidney injury in obese children, given the pathological and prognostic implications of this association in everyday practise (counting an elevated danger of developing long term renal disorder over time). Method case-control study is going to be conducted among the patients of AVBRH hospital. A total of thirty participants with fifteen obese and fifteen non obeses controls were included in this study. Result The expected result of the study can determine the correlation between obesity and microalbuminuria, The value of microalbuminuria is high in obese patients as compared to nonobese patients. Conclusion The risk of problems in obese patients can be predicted using microalbuminuria, which can help lower the overall morbidity and mortality associated with renal function. Complications

Diabetic kidney disease (DKD), previously encountered predominantly in adult patients, is rapidly gaining center stage as a childhood morbidity and one that pediatric nephrologists are likely to encounter with increasing frequency. This is in large part due to the obesity epidemic and the consequent rise in type 2 diabetes in children and adolescents, as well as the more aggressive diabetes phenotype in today's youth with more rapid β-cell decline and faster development and progression of diabetes-related complications along with lower responsiveness to the treatments used in adults. DKD, an end-organ complication of diabetes, is at the very least a marker of, and more likely a predisposing factor for, the development of adverse cardiovascular outcomes and premature mortality in children with diabetes. On an optimistic note, several new therapeutic approaches are now available for the management of diabetes in adults, such as GLP1 receptor agonists, SGLT2 inhibitors, and DPP4 inhibitors, that have also been shown to have a favorable impact on cardiorenal outcomes. Also promising is the success of very low-energy diets in inducing remission of diabetes in adults. However, the addition of these pharmacological and dietary approaches to the management toolbox of diabetes and DKD in children and adolescents awaits thorough assessment of their safety and efficacy in this population. This review outlines the scope of diabetes and DKD, and new developments that may favorably impact the management of children and young adults with diabetes and DKD.

Objective To investigate the relationship between 24 一 hour urinary sodium, urinary potassium, sodium 一 potassium ratio and microalbuminuria among people in elderly care institutions. Methods Questionnaire survey, physical examination blood and 24 h urine samples collection were carried out in the elderly people of 16 elderly care institutions in southeastern Shanxi from September 2017 to November 2017, which were selected using the random cluster sampling method. A multivariate logistic regression model was used to analyze the association between 24 h urinary sodium excretion, urinary potassium excretion, sodium - potassium ratio and MAU. Results A total of 502 subjects including 467 males (93.03%) and 33 MAU (6. 57%) were included in this study (average age: 65. 77 ± 8. 54 years old). The 24 h urinary sodium excretion was (193. 02 ±87. 64) mmol, urinary potassium excretion was (27. 95 ± 15. 02) mmol, and the sodium 一 potassium ratio was (7.44 ± 2.62), respectively. Multivariate logistic regression analysis showed that group with the highest urinary sodium excretion and the sodium 一 potassium ratio (Q4) compared to the lowest group (QI) was associated with an increased risk of MAU (OR 二4. 026, 95%C/: 1.045 - 15.515; OR 二4. 043, 95%C7: 1.252-13.057). Conclusion The 24 - hour urinary sodium and sodium - potassium ratio are positively associated with the prevalence of MAU, while 24 - hour urinary potassium is not related to the prevalence of MAU. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM) is increasing drastically and affecting the individuals globally, especially in the low- and middle-income countries like India. The poor glycaemic control results in micro-vascular and macro-vascular complications, leading to dysfunction of multiple organs. This study aimed to evaluate the association between the risk factors and microalbuminuria levels among patients with type 2 DM on oral hypoglycaemic agents. Materials and Methods: Hundred type 2 DM patients fulfilling the inclusion and exclusion criteria were selected by convenient random sampling. Demographic details, biochemical markers, and anti-diabetic medication details were collected. The findings were analyzed statistically using Chi-square test and one-way analysis of variance (ANOVA) with SPSS software 21.0. Results: Among the different combination therapies, 59% were commonly using metformin and teneligliptin. There was a significant association noted between microalbuminuria and risk factors like age, duration of disease, body mass index (BMI) (25.5 ± 2.9), fasting blood sugar (151 ± 53.2 mg/dL), post prandial blood sugar (227.01 ± 70.9 mg/dL), blood urea (24.42 ± 9.3 mg/dL), and serum creatinine (1.5 ± 0.2 mg/dL) (P < 0.001). One-way ANOVA showed statistical significance between microalbuminuria and the different treatment groups (P < 0.0001). Conclusion: Microalbuminuria was associated with age, duration of diabetes, glycaemic control, and BMI. In contrast, there was no significant difference noted between the genders and microalbuminuria. Microalbuminuria is an early indication of nephropathy in diabetes patients. The early identification of the risk factors is important, and it is always recommended to screen for microalbuminuria in all the diabetic patients for early detection and prevention of diabetic nephropathy and their associated complications. [ABSTRACT FROM AUTHOR]

Microalbuminuria and hyperuricemia management are crucial for the integrated management of hypertensive patients. This retrospective post hoc analysis aims to evaluate the optimal allisartan‐isoproxil‐based combination regimen for hypertensive patients with microalbuminuria or hyperuricemia. A total of 460 hypertensive patients with microalbuminuria and 486 hypertensive patients with hyperuricemia were included in this study. All patients were initially treated with allisartan‐isoproxil for 4 weeks. Thereafter, patients with blood pressure (BP) < 140/90 mmHg continued the monotherapy for 8 weeks; patients with BP ≥140/90 mmHg were randomly assigned in a 1:1 ratio to receive allisartan‐isoproxil + amlodipine (Group A + C) or allisartan‐isoproxil + indapamide (Group A + D) for 8 weeks. The changes of BP, urinary albumin and serum uric acid (UA) were measured. In patients with microalbuminuria, the urinary albumin/creatinine ratio (UACR) significantly decreased by 10.4 mg/g in Group A + C (vs. baseline p =.0035) and 24.2 mg/g in Group A + D (vs baseline p <.0001), intergroup p = NS. In patients with hyperuricemia, serum UA level decreased by 44.5 µmol/L in Group A + C (vs. baseline p =.0003), but increased by 27.2 µmol/L in Group A + D (vs. baseline p =.0167), intergroup p <.0001. The results suggest that for hypertensive patients with microalbuminuria, angiotensin receptor blocker (ARB) + calcium channel blocker (CCB) or ARB+ diuretic both are good choices based on their improvement of microalbuminuria and BP. But for patients with hyperuricemia, ARB + diuretic may further increase the level of UA. [ABSTRACT FROM AUTHOR]

This article discusses the potential use of the neutrophil-lymphocyte ratio (NLR) as a diagnostic marker for predicting early-stage diabetic nephropathy in patients with diabetes mellitus (DM). The study found a correlation between NLR and microalbuminuria, suggesting that NLR could be used to assess the onset and progression of diabetic nephropathy. The article also mentions other studies that have explored the use of NLR as a diagnostic marker for various complications of DM. However, further research with larger sample sizes is needed to evaluate the accuracy and implications of using NLR in clinical practice. [Extracted from the article]

Background: To evaluate the efficacy and safety of Keluoxin (KLX) capsules and provide validated evidence for the application of KLX in the treatment of diabetic kidney disease (DKD). Methods: A multicenter, randomized, double-blind, placebo-controlled trial design was used to screen 129 patients with DKD (urinary albumin-to-creatinine ratio [UACR]: male, 2.5–30 mg/mmol; female, 3.5–30 mg/mmol) and with Qi and Yin deficiency and blood stasis symptoms. Written informed consent was obtained from all patients. The patients were randomly divided into KLX and control groups. The KLX group was orally administered KLX (6 g/day) and irbesartan tablets (150 mg/day), whereas the control group was administered KLX placebo (6 g/day) and irbesartan tablets (150 mg/day). Patients were observed for 24 weeks to evaluate the natural logarithm of the UACR (log-UACR), the odds ratio (OR) for a sustained increase in the UACR of at least 30% and 40%, estimated glomerular filtration rate (eGFR), changes in symptoms and quality–of-life scores, and adverse events. Results: The changes of the natural log-UACR during the 24 weeks compared with baseline in the KLX group were better than those in the control group (LS mean ± standard error, −0.26 ± 0.10 vs. 0.01 ± 0.09, p = 0.0292). The incidence of a sustained increase in the UACR of at least 30% and 40% was found to be significantly lower in the KLX group (OR, 0.26; 95% confidence interval [CI], 0.09–0.75; OR, 0.29; 95% CI, 0.10–0.82). Changes in symptoms and quality-of-life scores in the KLX group were better than those in the control group. There was no statistically significant difference in eGFR or the incidence of adverse events between the groups. Conclusions: Overall, these results suggest that KLX capsules combined with irbesartan can reduce microalbuminuria, relieve the symptoms, and improve the quality of life for patients with type 2 early DKD compared with the use of irbesartan alone. Trial registration: Chinese Clinical Trial Registry, registration number: ChiCTR2100052764. [ABSTRACT FROM AUTHOR]

Microalbuminuria is an early symptom and prognostic marker of the progression of renal pathology. The analysis of the role of anionic components of the renal glomeruli in the albumin retention and the development of a model of minimal changes in the glomerular filter leading to the appearance of microalbuminuria are relevant. The effect of organic cations D-arginine methyl esters (D-AME) and D-nitroarginine (D-NAME) on the excretion of albumin by the kidneys in rats was studied. D-AME had no effect on urinary albumin excretion in rats. D-NAME caused microalbuminuria, which persisted for more than a day and sharply increased after injection of vasopressin. The number of anionic sites labeled with polyethyleneimine decreased in the structures of the glomerular filter. D-NAME-induced microalbuminuria can later serve as a model for studying nephroprotective or damaging factors. [ABSTRACT FROM AUTHOR]

Background Microalbuminuria is an early indicator for renal and cardiovascular diseases, especially among patients with diabetes mellitus (DM) and hypertension (HTN). We determined the prevalence and the factors associated with microalbuminuria among patients with type 2 DM and/or HTN in the urban areas of the Puducherry district in India. Methods We included 225 patients aged 40–69 years with DM and/or HTN from a non-communicable diseases (NCDs) survey conducted during 2019–2020 in the urban areas of Puducherry district. The prevalence of microalbuminuria and various biological risk factors of NCDs were assessed as per the WHO STEPS methodology. The prevalence of microalbuminuria was presented as proportions (95% CI), and the adjusted prevalence ratio (aPR) was estimated using weighted forward stepwise generalized linear modelling. P -value ≤0.05 was considered statistically significant. Results The mean (SD) age of the patients was 54 (11) years. Over one-third (38.2%) (95% CI: 31.6–44.4) of patients with DM and/or HTN had microalbuminuria. The prevalence was highest among those having both DM and HTN 48% (95% CI: 37–59), followed by those having only DM 40.6% (95% CI: 29–52.2) and only HTN 27.7% (95% CI: 18.1–38.6). The prevalence of microalbuminuria was twice (aPR = 2.1, 95% CI: 1.1–3.9) higher among women and 2.4 times (95% CI: 1.12–5.1) higher among those having both DM and HTN as compared to those with only HTN. Conclusion The prevalence of microalbuminuria among patients with DM and/or HTN is concerningly high. Population-based screening for microalbuminuria, especially among women and those having both DM and HTN, needs to be undertaken in the urban areas of Puducherry district. [ABSTRACT FROM AUTHOR]

Objectives: To determine whether Microalbuminuria, is a risk factor for ischemic cerebrovascular diseases, in our patients with essential hypertension. Study Design: Case Control study. Setting: Department of Medical, Khyber Teaching Hospital, Peshawar. Period: 28th July, 2022 till 28th February, 2023. Material & Methods: The patients were divided into two groups, one without cerebrovascular disease (CVD) and other with CVD. Data of all patients was recorded on a predesigned proforma. Results: Amongst the total of 200 patients enrolled, 58(29%) patients’ age was in range of 16-40 years and 142(71%) patients’ age was in range of 41-120 years. Mean age of our patients was 53 years with standard deviation ± 20.12. As far as gender is concerned, 110(55%) patients were males and 90(45%) patients were females. Approximately 83(41.5%) patients had microalbuminuria and 110(58.5%) patients had no microalbuminuria. Only hypertension but no CVD was present in 145(72.5%) patients, while 55(27.5%) patients had hypertension and CVD, 47.47% of these, had microalbuminuria. Conclusion: Amongst the hypertensive patients, microalbuminuria was present in significantly higher number of patients with ischemic Cerebrovascular Disease as compared to patients who had no cerebrovascular disease. [ABSTRACT FROM AUTHOR]

Background: Diabetic peripheral neuropathy (DPN) and diabetic nephropathy (DN) are common complications of type 2 diabetes mellitus (T2DM). Although nerve conduction studies (NCS) and sympathetic skin response (SSR) can detect DPN, the more sensitive method for early diagnosis remains unclear. Furthermore, whether DPN can be used as a predictor for diabetic nephropathy needs clarification. Methods: We evaluated nerve conduction studies, sympathetic skin response, and the diabetic nephropathy indicator microalbuminuria (MAU) in 192 patients with type 2 diabetes mellitus and 50 healthy controls. Results: Patients with type 2 diabetes mellitus showed a lower sensory nerve conduction velocity (SCV), sensory active nerve potential (SNAP), motor nerve conduction velocity (MCV), and compound motor action potential (CMAP) than the controls on NCS. Abnormal rates for nerve conduction studies and sympathetic skin response were 75.0% and 83.3%, respectively, in patients with type 2 diabetes mellitus. Interestingly, 54.2% of patients with normal nerve conduction studies had an abnormal sympathetic skin response. Moreover, we found a positive correlation between sympathetic skin response and microalbuminuria for the first time. The abnormal rate of microalbuminuria was 53.8%, lower than that of abnormal nerve conduction studies or sympathetic skin response patients. Conclusion: Sympathetic skin response is a more sensitive method than nerve conduction studies for the early diagnosis of diabetic peripheral neuropathy. Abnormal sympathetic skin response might serve as an indicator for early diabetic nephropathy. Additionally, diabetic peripheral neuropathy may occur earlier than diabetic nephropathy in the development of type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

Background: Diabetic nephropathy is a progressive condition and a leading cause of end-stage renal disease. Oxidative stress and inflammation play an important role in its pathogenesis. In pre-clinical studies, Montelukast had shown renoprotective and anti-oxidant properties, hence the study was planned to evaluate the effect of Montelukast in a Streptozotocin (STZ) induced model of diabetic nephropathy. Methods: 40 Wistar rats of either sex were randomly divided into four groups viz. 1. Vehicle control group, 2. Enalapril (5 mg/kg), 3. Montelukast low-dose (10 mg/kg) and 4. High-dose (20 mg/kg) group. On day 1, diabetes was induced using a single dose of STZ (60 mg/kg) intraperitoneally. Diabetes induction was verified based on fasting blood glucose (FBG) levels on day 7 and from day 8 to day 42, rats were given study drugs. FBG, serum creatinine, blood urea nitrogen (BUN) and urine microalbumin levels were assessed pre-study and post-study. Assessments of kidney malondialdehyde (MDA), reduced glutathione (GSH) and renal histopathology were carried out at the end of the study. Results: Montelukast 10 mg/kg group showed significantly lower urine microalbumin levels compared to the vehicle control group (p < 0.05). Montelukast 20 mg/kg group showed significantly lower levels of FBG, serum creatinine, BUN and urine microalbumin compared to the vehicle control group (p < 0.05). In addition, Montelukast 20 mg/kg group also showed better effects on kidney MDA and GSH levels (p < 0.05) and histopathological scores compared to the vehicle control group. Conclusion: Montelukast showed a protective effect in the model of diabetic nephropathy because of its antioxidant effect. [ABSTRACT FROM AUTHOR]

Introduction: Uric acid is produced during the metabolism of nucleotide and adenosine triphosphate and contains the final product of human purine metabolism. It acts both as an antioxidant and pro-inflammatory marker and has a positive association with visceral fat in overweight subjects. The aim of the present study is to find an association of uric acid level with certain anthropometric parameters in subjects having type 2 diabetes. Materials and Methods: The study included 124 urban drug-naive diabetic Indian subjects above 18 years of age from the general population of the city of North India. Uric acid concentrations were estimated by the uricase method. Fasting plasma glucose (FPG) concentrations were estimated by the glucose oxidase-peroxidase method. Anthropometric measurements and information on lifestyle factors and disease history were collected through in-person meeting. Results: All participants of the study subjects had a body mass index (BMI) of more than 23.5. BMI, waist-to-hip ratio (WHR), waist-to-height ratio, waist circumference, neck circumference, weight, age, sagittal abdominal diameter (SAD), skinfold thickness, and body roundness index were positively correlated with the serum uric acid level. The correlation of weight, BMI, SAD, and WHR was statistically significant. Conclusion: We found that serum uric acid level increases as body fat content increases. Statistical data show remarkable results for a significant correlation of uric acid level with BMI, WHR, SAD, and FPG. Hypertrophy occurs as a result of inflammatory processes and oxidative stress when the supply of energy starts to exceed the storage capacity of adipocytes, as a result, adipokines such as interleukin (IL)-1, IL-6, and tumor-necrosis factor-alpha are released more frequently which lead to low-grade chronic inflammation. Uric acid levels are much lean toward visceral obesity than overall body fat content. [ABSTRACT FROM AUTHOR]

Background: Improvements in sickle cell disease (SCD) care have resulted in the survival of many patients into adulthood, although this is accompanied by the increased incidence of end-organ damage, including chronic kidney disease (CKD). Objectives: This study assessed the prevalence, pattern and predictors of renal dysfunction in SCD patients and investigated the associated renal histopathologic changes. Methods: We evaluated 105 patients with SCD, for proteinuria, estimated glomerular filtration rate (eGFR), and tubular dysfunction. Renal biopsy was conducted on 22 patients who qualified. Data were analysed using SPSS package version 23. Results: Thirty-seven (35.2%) of the 105 patients had CKD, as defined by an eGFR of 60 ml/min/1.73 m2 and/or proteinuria. The fractional excretion of potassium (FEK) was elevated in all patients, whereas the fractional excretion of sodium (FENa) was elevated in 98.1%. Glomerular filtration rate was negatively correlated with irreversible percentage sickle cell count (r = −0.616, P = 0.0001), FEK (r = −0.448, P = 0.0001) and FENa (r = −0.336, P = 0.004). Age, irreversible percentage sickle cell count, haemoglobin levels and FENa were the major predictors of CKD. The histological pattern in the 22 patients who had biopsies was consistent with mesangioproliferative glomerulonephritis 11 (50%), minimal change disease 6 (27.3%), focal segmental glomerulosclerosis 3 (13.6%) and interstitial nephritis 2 (9.1%). Conclusions: CKD was prevalent in SCD patients, and it was characterised by tubular dysfunction and mesangioproliferative glomerulonephritis. The main predictors of CKD were increased age, severity of vaso-occlusive crisis, worsening anaemia and tubular dysfunction. [ABSTRACT FROM AUTHOR]

Abstract Urinary microalbumin (mALB) serves as an exceptionally sensitive indicator for the early detection of kidney damage, playing a pivotal role in identifying chronic renal failure and kidney lesions in individuals. Nevertheless, the current fluorescent methodologies for point‐of‐care (POC) diagnosis of mALB in real urine still exhibit suboptimal performance. Herein, the development and synthesis of QM‐N2, an albumin‐activated near‐infrared (NIR) aggregation‐induced emission (AIE) fluorescent probe, are presented. The strategic incorporation and positioning of quaternary ammonium salts within the quinoline‐malononitrile (QM) scaffold significantly influence solubility and luminescence characteristics. Specifically, the quaternary ammonium salt‐free variant, QM‐OH, and the quaternary ammonium salt integrated at the donor function group (DFG) site, QM‐N1, display limited solubility in aqueous solutions while demonstrating a distinct fluorescence signal. Conversely, the incorporation of quaternary ammonium salt at the conformational functional group (CFG) site in QM‐N2 imparts superior dispersibility in water and reduces the initial fluorescence. Furthermore, the integration of a well‐defined D‐π‐A structure within QM‐N2 enables itself with near‐infrared emission, which is crucial for mitigating interference from autofluorescence present in urine samples. Upon interaction with albumin, QM‐N2 forms a tight bond with the IIA site of the subdomain of human serum albumin (HSA), inducing alterations in protein configuration and constraining the intrinsic motion of fluorescent molecules. This interaction induces fluorescence, facilitating the sensitive detection of trace albumin. Ultimately, QM‐N2 is applied for POC testing of mALB using portable equipment, particularly in the diagnosis of mALB‐related diseases, notably chronic renal failure. This positioning underscores its potential as an ideal candidate for self‐health measurement at home or in community hospitals.

Objective: This study investigates the prevalence of lipid abnormalities among adolescents diagnosed with Type 1 Diabetes Mellitus (T1DM) and explores potential associations with microalbuminuria and cardiovascular disease (CVD) risk factors.Research Design and Methods: A retrospective study analyzed lipid profiles, microalbuminuria, and CVD risk in adolescents with T1DM. Six hundred individuals were assessed for lipid levels, BMI, and microalbuminuria. Results: Dyslipidemia prevalence was 59.7 %, with 22.7 % exhibiting abnormal total cholesterol (TC) and triglycerides (TG), and 15.8 % with elevated TC alone. A2 microalbuminuria was found in 59.2 %, with 14.6 % showing A3. Females had higher A2 prevalence and mild eGFR decrease (P = 0.02). Lipid levels correlated significantly with microalbuminuria (TC: r = 0.761; TG: r = 0.572, P = 0.03 and 0.04, respectively). The prevalence of high total cholesterol (TC) + high triglycerides (TG), as well as the high TG alone, was considerably higher in patients belonging to the A2 Microalbuminuria group. AIP, HbA1c, and UACR showed a strong positive correlation (r = 0.542, P = 0.04; r = 0.621, P = 0.02). Conclusion: Our study highlights the prevalence of elevated or borderline lipid levels among adolescents with Type 1 Diabetes Mellitus (T1DM), indicating a heightened risk of dyslipidemia in this population. Particularly concerning is the significantly increased incidence of dyslipidemia among young individuals with T1DM, with females exhibiting a notable susceptibility to cardiovascular disease (CVD) due to dyslipidemia's impact on the Atherogenic Index of Plasma (AIP). Furthermore, Microalbuminuria, specifically type A2 and A3, was prevalent among our study participants, with females showing a significantly higher occurrence of A2 microalbuminuria compared to males. The association between microalbuminuria and dyslipidemia, especially the combination of high total cholesterol (TC) and high triglycerides (TG), emphasizes the importance of comprehensive screening protocols for both microalbuminuria and dyslipidemia in managing the cardiovascular risk profile of individuals with T1DM.

Objective: To evaluate the frequency of hyperlipidemia in type 2 diabetes mellitus (DM) patients with microalbuminuria attending a tertiary care hospital. Study Design: Cross-sectional study Place and Duration of Study: Combined Military Hospital, Jhelum Pakistan, from Jan 2020 to Feb 2021. Methodology: All patients aged 30 years or above with type 2 DM mellitus presented with or without microalbuminuria were consecutively enrolled. Hyperlipidemia was defined based on the presence of an elevated lipid profile. This information, along with baseline and other predicting factors, was noted. Results: Of 236 patients, hyperlipidemia was observed in 107(45.3%) patients with type 2 DM having microalbuminuria. The odds of hyperlipidemia were 53% less likely among patients aged ≤59 years than that of patients aged>59 years [aOR: 0.47, 95% CI: 0.27-0.85], 47% less likely among patients with ≤7 years of diabetes duration as compared to >7 years of duration of diabetes [aOR: 0.53, 95% CI: 0.29-0.96], and 75% less likely among patients with ≤140 mm Hg SBP as compared to the patients with >140 mm Hg SBP [aOR: 0.25, 95% CI: 0.14-0.46]. Conclusion: In the current study, hyperlipidemia was observed to be considerably higher in patients with type 2 DM having microalbuminuria. Moreover, elderly patients, longer diabetes duration, and elevated blood pressure are some of the risk factors reported in our patients.

Over the past 10 years of studying the complications of type 2 diabetes mellitus (DM) and ways to deal with them, significant progress has been made in one of the most important areas of treatment — the prevention of cardiovascular and renal complications. Thus, when using inhibitors of type 2 sodium-glucose cotransporter, a significant reduction in the risks of cardiovascular mortality and progression of chronic heart failure, which occupy the main place in the structure of mortality in this cohort of patients, as well as a positive effect on diabetic nephropathy, one of the most common complications of type 2 diabetes, has been proven. However, there are other complications that significantly affect the duration and quality of life of patients. In particular, these include stroke, which occupies the 2nd-3rd place in the frequency of death of people with type 2 diabetes, and albuminuria, a frequent manifestation of diabetic kidney disease, which is associated with an increased risk of cardiovascular complications (including stroke) and chronic renal failure. Recent studies indicate the important role of sodium-glucose cotransporter type 1 in the development of these complications. Canagliflozin has the highest affinity for these transporters among iSGLT-2 registered in the Russian Federation. This article aims to evaluate the mechanisms of action of canagliflozin and its possible role in the prevention of stroke and albuminuria.

Introduction: A number of metabolic disorders are linked to obesity, which is a global health concern. Although renal impairment is a serious side-effect of obesity, its connection to insulin resistance is still a subject of discussion. Aim: To assess the correlation between microalbuminuria and HbA1c levels, as well as the association between Insulin Resistance (IR) and renal function in obese individuals. Materials and Methods: The present study was a crosssectional study conducted in patients attending the obesity clinic, in Endocrinology department, of a tertiary hospital in Kerala, India. A total of 144 obese individuals participated, meeting age, Body Mass Index (BMI), and health-related. Insulin resistance was measured using Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), while renal function was measured using the Urine Albumin Creatinine Ratio (UACR). Correlation analysis was conducted to investigate relationships between variables. Results: The study found a weak association between UACR and HbA1c levels and insulin resistance (r-value=0.159, p-value=0.056). Subjects with insulin resistance had significantly higher levels of microalbuminuria. Despite these connections, the mean UACR levels remained within the typical reference range. Conclusion: This study emphasises the importance of early renal health screening in obese individuals, with HbA1c and microalbuminuria measurements as promising methods for preventing kidney impairment. To establish causation in the complex interplay between metabolic variables and renal function in obesity and insulin resistance, future research should focus on understanding the underlying mechanisms and conducting longitudinal examinations.

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 Objective To study the development of microalbuminuria (MAU) in essential hypertension (EHT), we investigated the association of MAU with central blood pressure (CBP), direct renin concentration (DRC), plasma aldosterone (PA), and uric acid (UA). Method We determined 24 h-urinary albumin excretion (24 h-UAE) in patients with EHT who were hospitalized at TEDA International Cardiovascular Hospital from June 2020 to May 2022. We defined MAU as 24 h-UAE in the range of 30 mg/24 h to 300 mg/24 h. Univariate and multivariate analyses were conducted to determine the associations of MAU with CBP, DRC, PA, and UA in EHT, considering demographic and clinical information. We also plotted receiver operating characteristic curves (ROCs) for predicting MAU using these results. Results More than a quarter of patients (26.5%, 107/404, 95% CI: 22.2–31.1%) were diagnosed with MAU in EHT. A higher body mass index (BMI), longer duration of hypertension, and higher severity were associated with MAU. Also, nearly 10% more creatinine levels were recorded in the MAU group than in the control group (69.5 ± 18.7 µmol/L vs. 64.8 ± 12.5 µmol/L, P = 0.004). The increase was also observed for PA (15.5, 9.7–20.6 ng/dL vs. 12.3, 9.0–17.3 ng/dL, P = 0.024) and UA (419.8 ± 105.6 µmol/L vs. 375.1 ± 89.5 µmol/L, P

Hyperuricemia (elevated serum uric acid) has emerged as one of the strongest risk factors for the development of prehypertension, primary hypertension and resistant hypertension. Hyperuricemia also confers increased risk for cardiovascular mortality, especially in women. Hospital based prospective observational study was done on 60 cases for Period of 3 years in the department of General Medicine. Microalbuminuria was present in 81.6% (41/60). 18.3% showed no urine albumin excretion. 83.3% cases showed ECG changes of left ventricular hypertrophy (>5). 70% (42/60) showed Grade II retinal changes. 16.6% (10/60) showed Grade III retinal changes. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality in patients with Type 2 Diabetes Mellitus (DM). Microalbuminuria has been suggested as a potential marker for CVD risk in these patients. Objective: To evaluate the association between microalbuminuria and CVD in patients with DM attending Medicine and Endocrinology OPD. Methods: A cross-sectional study was conducted involving 300 patients with DM. Patients were categorized based on the presence or absence of microalbuminuria. The prevalence of CVD was compared between the two groups. Logistic regression models were used to adjust for potential confounding factors and determine the strength of the association. Results: Of the 300 patients included, 155 (51.7%) had microalbuminuria. Patients with microalbuminuria had a significantly higher prevalence of CVD compared to those without (58.7% vs. 41.2%, p<0.05). After adjusting for age, gender, duration of DM, and other potential confounders, the presence of microalbuminuria was significantly associated with a higher risk of CVD (OR=2.3, 95% CI: 1.53.4). Conclusion: In patients with DM attending Medicine and Endocrinology OPD, microalbuminuria was found to be a significant predictor of CVD. Routine evaluation of microalbuminuria could aid in identifying high-risk individuals and guiding preventive measures. [ABSTRACT FROM AUTHOR]

Patients with diabetes mellitus type II may have a pre-diabetic phase known as "period" prior to the onset of the condition. Insulin resistance is a key factor in the pathophysiology of pre-diabetes. This study aims to examine the prevalence of microalbuminuria in a non-diabetic population with elevated metabolic risk and determine if there is any association between microalbuminuria and data related to glucose metabolism. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to investigate changes in serum tumor markers in type 2 diabetes mellitus (T2DM) with microalbuminuria and analyze the relationship between tumor markers and microalbuminuria. Methods: A total of 956 T2DM patients aged 40–70 years hospitalized in the Department of Endocrinology, Xinhua Hospital, China, affiliated with Shanghai Jiaotong University School of Medicine, were enrolled from January 2018 to December 2020. The sample comprised 313 T2DM patients with microalbuminuria and 643 T2DM patients with normal urinary microalbumin levels. After assessing the changes in serum tumor markers in T2DM with microalbuminuria, we analyzed the risk of microalbuminuria by the serum tumor marker category using multiple logistic regression analysis. Results: Serum CEA, CA199, CA125, CA153, CA211, SCC, CA242, and CA50 levels were significantly higher in T2DM patients with microalbuminuria than in those without microalbuminuria, while serum AFP levels were lower in the microalbuminuria group (P < 0.05). Following adjustment of confounders, serum CEA, CA211, and SCC were independently associated with microalbuminuria in T2DM. An ROC curve was used to estimate the cutoff point of tumor markers for microalbuminuria. Taking the values under the cutoff points as a reference, values for CEA, CA211, and SCC above the cutoff points indicated a significantly high risk of microalbuminuria. The OR of increased CEA for microalbuminuria was 2.006 (95%CI 1.456–2.765), the OR of increased CA211 for microalbuminuria was 1.505 (95%CI 1.092–2.074), and the OR of increased SCC for microalbuminuria was 1.958 (95%CI 1.407–2.724). Conclusion: Several serum tumor markers were related to microalbuminuria in T2DM. Serum tumor markers such as CEA, SCC, and CA211 may indicate early diabetic nephropathy, particularly when elevated in combination. [ABSTRACT FROM AUTHOR]

A recent change in the diabetes Quality and Outcomes Framework (QOF) retired the mandatory testing of urinary ACR. We designed a study demonstrates the impact of this change in a primary healthcare setting. This is relevant as a significant proportion of the NHS budget is spent on managing microvascular and macrovascular complications that result from type 1 and 2 Diabetes mellitus. Our cross-sectional study collected testing data for 482 patients in a primary care setting. Based on the results seen from the first set of data collection, an intervention was offered to the clinicians by way of clinical presentation that emphasised and refreshed the knowledge of the latest NICE guidelines on urine ACR collection. Subsequently, a second set of data collection was conducted to assess the success, if any, of changes implemented based on the intervention made Our study demonstrates the drastic decrease in uptake of ACR testing in the primary care setting that took place following the change in the diabetes QOF. The study highlights the need for the reintroduction of such a QOF measure to enable regular monitoring of early signs of nephropathy, thereby allow the timely commencement treatment as deemed appropriate. Furthermore, detecting the development of such complications in diabetic patients, in a timely manner, has the potential to reduce the financial footprint associated with treating the complications resulting from this condition. • Recently, there was a change to the diabetes Quality and Outcomes Framework (QOF). • This change retired the mandatory annual urinary ACR testing. • Our study collected data from 482 patients in a primary healthcare setting. • This illustrated the drastic decrease in uptake of testing since the QOF was retired. • This demonstrates the need to reintroduce this measure to enable regular monitoring. [ABSTRACT FROM AUTHOR]

Aims and objectives- To study the association between microalbuminuria and qt interval prolongation in type 2 diabetes mellitus. Methods-This cross-sectional study with sample size 60 patients attending OP and IP in ACSR govt general hospital, Nellore in a period of 18 months mainly on patients with age group 50 years – 70 years of both males and females. simple random sampling method is used, Informed consent and ethical committee approval obtained. complete clinical examination is carried out. The investigations done are Complete blood picture, Blood urea,s. Creatinine, Complete urine exam, Urine microalbumins and ECG. Results- There is a significant association between QTc prolongation and microalbuminuria. Hypertension longer duration of Type 2 DM, higher glycemic index, higher HbA1C levels, higher serum creatinine levels. Conclusion: Most patients were in their 6 th and 7 th decade of life and male preponderance was noted. Higher duration of diabetes, higher age groups have increased risk of cardiac autonomic neuropathy. There is a significant association between QTc interval prolongation and microalbuminuria as evidenced by, more number of microalbuminuria cases seen with prolonged QTc interval. As duration of diabetes increases prevalence of microalbuminuria increases. 20% of peripheral neuropathy cases are associated with CAN and 20% of retinopathyare associated with CAN. [ABSTRACT FROM AUTHOR]