Abstract
Purpose: The presence of albuminuria of ≥ 20 mg/dL, detectable on urine dipstick, represents significant early nephropathy requiring intervention. This study aimed to identify the incidence of previously undiagnosed renal impairment in patients attending a Diabetic Eye Clinic at the Birmingham and Midland Eye Centre, which has a diverse social and ethnic catchment area.Methods: An observational cohort audit was performed and a total of 42 consecutive patients’ urine samples were tested for albuminuria by dipstick. Results: Albuminuria was found in 17/42 (40.5%) patients, but only 5 patients were aware of having renal impairment. In 10/17 (58.8%) patients General Practitioners (GP) were also unaware of the renal impairment. Patients with previously undiagnosed albuminuria tended to be younger, have a shorter duration of diabetes and have a higher systolic and diastolic blood pressure (p<0.05).Conclusion: Our results suggest that a significant proportion of patients attending diabetic eye clinics have renal impairment that is not known to their General Practitioners. Performing this quick and simple test in the clinic may aid early diagnosis and improve clinical care and prognostic outcomes.
Highlights
The UKPDS has recognised diabetic retinopathy to be a risk factor in the development of renal impairment in Type 2 diabetics [1]
It has been previously shown that measuring blood pressure is of value in diabetic eye clinics, providing an opportunity to allow the identification of new hypertensive patients and those with inadequate control [16]
The results demonstrated that albuminuria was found in a large proportion of the sample, 17/42 (40.5%) patients
Summary
The UKPDS has recognised diabetic retinopathy to be a risk factor in the development of renal impairment in Type 2 diabetics [1]. The presence of albuminuria is a strong risk factor for the development of other microvascular disease [2]. Patients developing renal impairment in the interim may not be diagnosed until their visit. It has been previously shown that measuring blood pressure is of value in diabetic eye clinics, providing an opportunity to allow the identification of new hypertensive patients and those with inadequate control [16]. This study aimed to ascertain if urinalysis with urine dipstick on a routine basis was of value in patients attending diabetic eye clinic. Chi square 0.90df 1 p 0.76 Follow up 21 16.
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