PROSPECT OF GLYCATED ALBUMIN AS PREDICTOR OF GFR IN T2DM PATIENT WITH CHRONIC KIDNEY DISEASE
Prof. R. Ramesh*, Dr. R. Reeta, V. Kuzhandai Velu, Dr. Kulkarni Sweta, Swathi Sivakumar
ABSTRACT
Introduction: Diabetes Mellitus (DM) is a worldwide public health problem that affects millions of people from
all racial and ethnic groups and also the leading cause for Chronic Kidney Disease (CKD).[1] The rapidly
increasing prevalenceof Type 2 Diabetes Mellitus (T2DM) worldwide and especiallyin India assures that the
proportion of CKD attributable to T2DM willcontinue to rise. Materials And Methods: The study was conducted
in the Department of Biochemistry at Mahatma Gandhi Medical College and Research Institute, Puducherry, in
collaboration with the Department of Nephrology. 100 patients between 35 – 65 years diagnosed as T2DM and
CKD were included. Non-diabetic CKD, ESRD patients, hepatobiliary, endocrine and cardiovascular disorders
were excluded. Blood glucose, serum creatinine, total protein, Glycated albumin and Cystatin C were analyzed.
eGFR using cockroft – Gault, MDRD, CKD-EPI and Cystatin C formula was calculated. Results: The creatinine
concentration had an average of 4.89mg%, cystatin C levels varied from 3.98 to 5.80mg/L with an average of 4.89
mg/dl. The calculated GFR shows that the mean eGFR as estimated by MDRD formula is 37.2ml/min, cystatin C
based formula is 38.29ml/min, CKD-Epi formula 34.92ml/min and CCF formula 41.8ml/min. the mean values of
eGFR calculated by MDRD and cystatin C based formula were almost equal while eGFR CCF calculated and
CKD Epi formula gave higher and lower values respectively. Conclusion: Glycated albumin has been directly
implicated as a causal factor in the development of nephropathy due to its direct interaction with the receptors on
mesangial cells so following T2DM patients with CKD by estimating glycated albumin which is a simple test can
provide insight about both their GFR and glycemic status.
Keywords: T2DM, CKD, glycated albumin, eGFR, Cystatin C, MDRD, Creatinine.
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