Prevalence and risk factors of albuminuria in Type 2 diabetes in Bahrain

Microalbuminuria is the earliest sign of diabetic nephropathy, and is a marker of increased diabetic cardiovascular morbidity and mortality. We investigated the prevalence of albuminuria and associated risk factors among Type 2 diabetes (T2DM) patients, who were attending diabetes clinics at primary healthcare facilities in Bahrain. This was a cross-sectional study on 712 adult T2DM Bahraini patients screened for albuminuria using albumin:creatinine ratio test (ACR), in 9 selected primary healthcare centers in Bahrain in the period February–March 2006. Of the 702 participants, 196 (27.9%) were albuminuric. The prevalence of microalbuminuria (ACR>3.4 mg albumin/mmol creatinine) and macroalbuminuria (protein:creatinine ratio >22 mg protein/mmol creatinine) were 22.0% (no.=155) and 5.8% (no.=41), respectively. Univariate analysis demonstrated significant associations between albuminuria and older age (>65 yr), longer duration of diabetes, high glycated hemoglobin (HbA 1c ), elevated triglycerides, total- and LDL-cholesterol, systolic (>160 mmHg) and diastolic (>90 mmHg) blood pressure (BP), and retinopathy. Multivariate regression analysis showed that high HbA 1c , higher systolic BP, and long duration of diabetes, were significant predictors of albuminuria, while older age, male gender, and higher triglycerides were borderline predictors. Albuminuria in Bahraini T2DM patients was related to poor glycemic control, higher systolic BP, and longer duration of diabetes. Effective preventive and control strategies of those factors should be urgently implemented.