Clinical profile of nonproteinuric kidney disease in Type 2 diabetic patients.

Abstract

Objective: To compare the demographic, clinical, and biochemical characteristics of nonproteinuric versus proteinuric diabetic kidney disease (DKD) among patients with type 2 diabetes mellitus (T2DM). Study Design: Cross-sectional Observational study. Setting: Department of Nephrology, Nishtar Hospital, Multan. Period: November 2024 to April 2025. Methods: Adult patients diagnosed with T2DM attending the Nephrology Department of Nishtar Hospital, Multan, were enrolled through non-probability consecutive sampling based on predefined inclusion criteria. Participants were classified into nonproteinuric and proteinuric DKD groups according to standard albuminuria cut-offs and estimated glomerular filtration rate (eGFR) values. Baseline demographic details, clinical data, and biochemical profiles were systematically documented and compared between both groups using appropriate statistical tests. A p-value < 0.05 was considered statistically significant. Results: Among 300 patients, nonproteinuric diabetic kidney disease (DKD) was observed in 32.3%. Compared to the proteinuric group, nonproteinuric DKD had mean age (55.33 ± 7.99 vs 58.67 ± 7.43 years, p < 0.001), shorter diabetes duration (10.75 ± 3.65 vs 12.80 ± 4.25 years), higher hemoglobin (11.27 ± 1.05 vs 10.35 ± 1.61 g/dL), higher serum albumin (3.87 ± 0.62 vs 3.42 ± 0.31 g/dL), lower serum creatinine (1.15 ± 0.26 vs 1.42 ± 0.39 mg/dL, p < 0.001), lower HbA1c (7.02 ± 1.15% vs 7.71 ± 1.31%), and higher eGFR (54.90 ± 13.17 vs 41.94 ± 8.21 ml/min/1.73m²). Hypertension, dyslipidemia, and RAAS inhibitor use were more frequent in the proteinuric group (all p < 0.05). Conclusion: Nonproteinuric diabetic kidney disease is common in type 2 diabetes and exhibits distinct demographic and biochemical features compared to proteinuric DKD, underscoring the need for targeted recognition and management.