CLINICAL AND BIOCHEMICAL CORRELATES OF DIABETIC KIDNEY DISEASE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Diabetic kidney disease (DKD) is a major microvascular complication of type 2 diabetes mellitus and remains a leading cause of chronic kidney disease (CKD) and end-stage renal disease worldwide. Poor glycemic control contributes to renal function decline and increases cardiovascular morbidity. This study aimed to evaluate the relationship between glycated hemoglobin (HbA1c), estimated glomerular ltration rate (eGFR), and albuminuria in patients with DKD. A cross-sectional observational study was conducted at Sri Ramachandra Hospital, Chennai, including 188 patients with type 2 diabetes and DKD, dened by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Clinical, demographic, and biochemical data were collected, including HbA1c, eGFR, and urine albumin-to-creatinine ratio (ACR). Patients were staged according to KDIGO GFR and albuminuria categories, and correlations were assessed using Pearson's correlation analysis. The mean age of the cohort was 52.1 ±6.2 years with 117 males and 71 females. The mean HbA1c was 8.4 ±1.4%, mean eGFR 47.1 ±20.0 mL/min/1.73 m², and mean ACR 290.9 ±214.5 mg/g. Moderately increased albuminuria (A2) was seen in 66.5% of patients and severely increased albuminuria (A3) in 33.5%. By GFR staging, 22.3% were in G2, 39.4% in G3a, 27.7% in G3b, and 10.6% in G4, with nearly 70% classied in high or very high KDIGO risk categories. Coronary artery disease was present in 71.3% and was signicantly more common in patients with HbA1c ≥ 8% and advanced CKD. HbA1c showed a signicant inverse correlation with eGFR (r = –0.24, p < 0.01) and a positive correlation with albuminuria (r = 0.28, p < 0.01). Poor glycemic control in DKD patients is strongly associated with impaired renal function, increased albuminuria, and higher cardiovascular burden, underscoring the importance of early detection and comprehensive risk management.