CHU St Denis, Reunion Island
Title: High prevalence of proteinuric nephropathy in Type 2 diabetes: Album, a community-based general practitioners screening study in French overseas territories
Xavier Debussche is specialist in Endocrinology and Metabolism, head of Department, Chronic Pathologies and Metabolic Diseases, and clinical research manager in the University hospital of the Reunion Island. He took part as principal or associate Investigator in several epidemiological research, randomized controlled trials, and mixed method studies. He has published more than 30 scientific articles referenced in Medline. He has participated actively in the development and structuring of care networks with a global integrative approach in chronic diseases.
Chronic kidney disease is a major public health problem. This observational epidemiological study aimed to evaluate the prevalence of proteinuric nephropathy in patients with type 2 diabetes by consulting community-based general practitioners in French overseas departments and territories (DOM-TOM). Screening was carried out with reagent strips Albustix® for proteinuria and, in case of trace amounts or a negative result, Microalbustix® for microalbuminuria. Ninety one general practitioners participated in the study and 402 patients were included (54% female, mean age 60.1±11.2 years). Duration of diabetes was 8.9±6.6 years and mean HbA1c was 7.3±1.4% (52.2% with HbA1c < 7%). Screening was positive for 45.7% of the patients: 23.6% positive for proteinuria with Albustix® [95%CI: 19.5%; 27.8%] and 22.1% with Microalbustix® [95%CI: 18.1%; 26.2%] (macroalbuminuria 6.2% [95%CI: 4.1%; 9.0%], microalbuminuria 15.9% [95%CI: 12.5%; 19.9%]. In conclusion, screening with reagent strips revealed that nearly half of the patients had proteinuria or albuminuria, thus confirming the high prevalence of nephropathy in type 2 diabetes patients living in the DOM-TOM and illustrating the need for frequent renal function screening in type 2 diabetics in general medicine for the prevention of chronic kidney disease.