A SHORT-TERM EVALUATIVE STUDY OF DIABETIC NEPHROPATHY PATIENT

Abstract

Background: Rising diabetes incidence globally and consequently diabetic nephropathy is a major concern. Being chronic disease patients are continuously monitored. Clinical improvement of major sign/symptoms in short course of therapy may lead to satisfaction of the patient’s that will increase better compliance to the treatment. Objective: To evaluate signs/symptoms and GFR status of diabetic nephropathy patient in short course of treatment therapy and nutritional management Material & Methods: All 170 incident cases of diabetic nephropathy (DN) based on glomerular filtration rate and creatinine level registered on pre-fixed dates during May 2007 to May 2010, but 127 followed inclusion criteria. Patients were recorded for demographic, biological & biochemical characteristics and presenting major sign/symptoms at registration time; further, evaluated for presenting sign/symptoms after six months of medicine and dietary intervention. Statistical Analysis: Statistical significance for association was tested by c2 (unrelated samples) and McNemar (related samples) and for the differences of number of signs/symptoms by Mann Whitney (unrelated samples) and Wilcoxon Signed Rank tests (related samples). Results: No statistical association was seen between GFR status and presence of edema/swelling in any part of the body. After six months of treatment and dietary management, the edema/swelling presenting in 69.6% of the cases was found only in 33.3%. Pedal edema was found in 43.1%; while either eye lid or facial swelling was in 12.9% of the cases but after six months of drug treatment and dietary care these were present only in 18.6% and 3.9% cases respectively. GFR status of one third cases also improved after 6 months, while 57.8% were unchanged; very few (9.8%) deteriorated. The GFR improvement was more in cases reporting with GFR 60 and above. Conclusion: Though, for the drug compliance and dietary intake patient’s statement was believed, after six months of treatment and dietary care, edema/swelling, the major signs/symptoms of diabetic nephropathy that reduced significantly and moreover on an average one third reduction of all signs/symptoms among the cases may satisfy the cases resulting to better compliance to drug and dietary management. Better improvement in cases with higher GFR indicated that early detection of diabetic nephropathy cases is essential.