Abstract
Serum creatinine is a very common tool of renal assessment in diabetic nephropathy. Specially due to its availably and cost-effectiveness, serum creatinine has been a popular choice among the clinicians even in rural areas. Also, the staging of diabetic nephropathy is done on the basis of eGFR which is calculated mainly with serum creatinine level. Sometimes, clinicians , even overlook the other investigations ,such as urine routine examinations or ultra sonogram of kidney, when the serum creatinine level is within normal limit.
 This study aims at observation of existing correlation between serum creatinine and urine albumin in diabetic nephropathy patients. This cross sectional observational study has been conducted on 50 patients in a period of 6 months in the medicine department of Dhaka Medical College Hospital.
 50 diabetic patients admitted to Dhaka Medical College Hospital were enrolled in this study after fulfilling inclusion and exclusion criteria. Among the total 50 patients, 34 patients were diagnosed on the basis of microalbuminuria and the rest had raised urinary total protein. No correlation was found between serum creatinine and urine albumin or urine total protein. Staging of the kidney disease was done according to eGFR (calculated by MDRD equation). Only 41.37% of the patients with microalbuminuria, showed eGFR consistent with its staging while 31.5% of the patients with proteinuria showed respective expected eGFR. The rest of the patient’s eGFR was inconsistent with the staging. And the difference between the mean serum creatinine in two groups was insignificant.
 This study has shown that, the serum creatinine has no linear correlation with urinary albumin in diabetic nephropathy patients. So, commonly used serum creatinine based formula to calculate the eGFR can misinterpret the staging of the disease which can delay the appropriate treatment thereafter.
 Keywords: Diabetic Nephropathy, Proteinuria, Microalbuminuria, Serum Creatinine
Highlights
The word "Diabetes" means "passing through", referring to the polyuria, a symptom historically present on those affected by the disease[1]
This study aims at observation of existing correlation between serum creatinine and urine albumin in diabetic nephropathy patients
This cross sectional observational study has been conducted on 50 patients in a period of 6 months in the medicine department of Dhaka Medical College Hospital. 50 diabetic patients admitted to Dhaka Medical College Hospital were enrolled in this study after fulfilling inclusion and exclusion criteria
Summary
The word "Diabetes" means "passing through", referring to the polyuria, a symptom historically present on those affected by the disease[1]. About 30% of diabetic patients develops nephropathy after 20 years of diagnosis[2]. The disease is progressive and may cause death in two or three years after the initial diagnosis and is more frequent in men[3]. The prevalence of diabetes and nephropathy is high in the world as well as in Bangladesh. Based on 2002 US data, diabetes is the cause of renal disease in 44% to 45% of ESRD (end stage renal disease) cases worldwide[3].About 5.6 % of the affected population thought to be leading to ESRD and being the cause of morbidity and mortality among diabetic patients in Bangladesh[4]. Diabetic nephropathy has several distinct stages of development. Functional changes occur in the nephron at the level of the glomerulus, including glomerular hyperfiltration and hyperperfusion, before the onset of any measurable clinical changes (eGFR >90 ml/min/1.73m2).The stage is the “Normal Albuminuria” where the GFR remains elevated but urine albumin expelling is normal and glomerular basement membrane (GBM)
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