Pakistan Journal of Medical Research (Jul 2020)
Association of Estimated Glomerular Filtration Rate with HbA1c and Microvascular Complications in Type 2 Diabetes
Abstract
Objective: To determine the association of estimated Glomerular Filtration Rate (eGFR) with HbA1c and microvascular complications in patients with type 2 diabetes. Study design, settings & duration: This retrospective study was based on a hospital data record of patients visiting the outpatient department of Baqai Institute of Diabetology and Endocrinology, Baqai Medical University from January 2018 to October 2018. Methodology: Data was obtained from hospital management system (HMS). Records of Patients with type 2 diabetes having data on eGFR were included. Calculation of eGFR was done by MDRD formula. Following clinical practice guideline (KIDGO) eGFR was grouped into five GFR Categories of CKD Stage 1, 2, 3, 4 and 5. Results: Total of 3165 patients, 1773 (56%) males and 1392 (44%) females with type 2 diabetes were recruited. Mean age of patients was 50.4±10.84 years. Frequency of patients were higher 57.7% in eGFR category 2 (60-89 ml/min/1.73 m2) and 32.1% eGFR category 3 (30-59 ml/min/1.73 m2). Very low eGFR (<15 ml/min/1.73 m2) was significantly associated with reduction of glycated HbA1c (%) and HDL-Cholesterol. While, decreased eGFR was significantly (p <0.0001) associated with increased risk of diabetic nephropathy, neuropathy, retinopathy and hypertension. Conclusion: Overall, eGFR reduction especially in combination with longer disease duration is significantly associated with decreased HbA1c but increased risks of microvascular complications in patients with type 2 diabetes.
