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Revista Cubana de Medicina General Integral
versão On-line ISSN 1561-3038
Resumo
GONZALEZ-MILAN, Zoraida Caridad et al. Detection of Hidden Chronic Kidney Disease by Determining Albumin Estimates in Patients with Diabetes Mellitus. Rev Cubana Med Gen Integr [online]. 2021, vol.37, n.4 Epub 01-Fev-2022. ISSN 1561-3038.
Introduction:
Diabetes mellitus is the second cause of chronic kidney disease in Cuba. Albumin estimates would facilitate its early identification.
Objective:
To determine the predictive value of albuminuria in hidden chronic kidney disease among patients with diabetes mellitus at primary healthcare level in Las Tunas.
Methods:
An analytical case-control study was carried out in 360 patients with diabetes mellitus belonging to Manuel Fajardo Rivero Polyclinic, in the period from January 2019 to February 2020. The study population was divided into two groups: occurrence (cases) or not (controls) of kidney damage. The discriminatory power of albuminuria as a predictor of hidden chronic kidney disease was determined by the area under the ROC curve, while its optimal cut-off point was also identified. Multivariate analysis was used to identify independent predictors of kidney disease.
Results:
Albuminuria over 160 mg on 24 hours was identified as a predictor of hidden chronic kidney disease (OR: 2.278; 95% CI: 1.637-2.908) together with age over 65 years, evolution of diabetes mellitus over 8 years, and hypoalbuminemia. The discriminatory power was good: The C index was 0.843 (95% CI: 0.762-0.929). The identified cut-off point of 160 mg in 24 hours reached a sensitivity and specificity of 90.00% and 97.60%, respectively.
Conclusions:
Albuminuria could be an important independent predictor of hidden chronic kidney disease in patients with diabetes mellitus at primary healthcare level.
Palavras-chave : hidden chronic kidney disease; albumin; diabetes mellitus; primary healthcare.