Audit of Screening for Diabetic Nephropathy in a Teaching Hospital in Nigeria

Abstract

Background: Diabetes nephropathy is the commonest cause of end stage kidney disease worldwide. The high incidence of the disease highlights the need to detect it early and commence prompt intervention. The aim of this study is to audit the screening for diabetic nephropathy in patients with diabetes mellitus attending a teaching hospital in Nigeria. Methodology: This a retrospective study and the study population was adult patients with diabetes mellitus who attended medical outpatient clinic (MOP) of ESUTH from 1st January 2010 to 31st December 2011.Their medical records were retrieved from the hospital data bank and their biodata, clinical and laboratory parameters were documented. Data was analysed using SPSS Vs 15. Results: Two hundred and three patients were selected for the study, 32% were males, mean age of 60.0 ± 13.5 years and range of 27 to 94 years. The duration of DM ranges from 2 to 312 months, 4.1% had type 1 DM, 88.1% were hypertensive. The eGFR ranges from 11 to 205 ml/min/1.73 m2, 37.6% of the patients had eGFR less than 60 ml/min/1.73 m2 and 22.3% had proteinuria. Duration of diabetes mellitus and duration of hypertension were assessed in 91 and 25% of the patients respectively; weight, oedema and sensation were assessed in less than 7%. BMI and fundoscopy was not assessed in any of the patients. 92.6% and 97% of the patients had records of their blood sugar on the first and last follow up. Less than 50% of the patients had record of serum electrolyte, urea, creatinine, urinalysis and packed cell volume. None of the patients had records of HbA1C or eGFR. Conclusion: The patients were poorly screened for diabetic nephropathy.