title: Prevalence of microalbuminuria and risk factor analysis in type 2 diabetes patients in Albania: the need for accurate and early diagnosis of diabetic nephropathy.
abstract: BACKGROUND
  Microalbuminuria is often the first sign of renal dysfunction in diabetes. This study aimed to investigate the prevalence of microalbuminuria in Albanian type 2 diabetes patients and its association with other cardiovascular risk factors.
  
  
  METHODS
  Three hundred and twenty-one patients with type 2 diabetes attending, diabetes centers in Albania were enrolled in this cross-sectional, multicenter study. The subjects, aged 40-70 years, had no known proteinuria or other kidney disease. Pregnant women and patients with acute infections were excluded. Data including waist circumference, duration of diabetes and history of hypertension were obtained by questionnaire. Blood samples were drawn after 12 h overnight fasting to measure glycosylated hemoglobin (HbA1c), serum cholesterol, triglyceride and creatinine. Microalbuminuria was assessed using dipstick kits in early morning urine samples.
  
  
  RESULTS
  The prevalence of normoalbuminuria was 56.3%, microalbuminuria 40.8% and macroalbuminuria 2.8%. Systolic and diastolic blood pressure (p<0.01), HbA1c (p<0.01) and fasting plasma glucose (p<0.001) were significantly higher in microalbuminuric than in normoalbuminuric subjects. Independent risk factors for microalbuminuria were duration of diabetes (OR: 2.785, 95% CI: 1.156-3.759), systolic blood pressure (OR: 2.88, 95% CI: 1.85-6.85) and waist circumference (OR: 2.15, 95% CI: 1.01-5.45) in males and poor glycemic control (OR: 4.51, 95% CI: 1.45-13.98), duration of diabetes (OR: 2.568, 95% CI: 1.702-3.778) and waist circumference (OR: 4.87, 95% CI: 1.80-13.11) in females.
  
  
  CONCLUSIONS
  The high proportion of type 2 diabetes patients with microalbuminuria raises implications for health policy in Albania. Screening programs and optimized control of modifiable risk factors are needed to reduce the risk of diabetic nephropathy.
authors.affiliation: Department of Nephrology Dialysis and Transplant, University Hospital Center, Tirana, Albania.
authors.forename: N
authors.initials: N
authors.lastname: Pasko
authors.affiliation: Department of Endocrinology, University Hospital Center, Tirana, Albania.
authors.forename: F
authors.initials: F
authors.lastname: Toti
authors.affiliation: Department of Nephrology Dialysis and Transplant, University Hospital Center, Tirana, Albania.
authors.forename: A
authors.initials: A
authors.lastname: Strakosha
authors.affiliation: Department of Internal Medicine, Regional Hospital, Pogradec, Albania.
authors.forename: E
authors.initials: E
authors.lastname: Thengjilli
authors.affiliation: Laboratory "Intermedica", Tirana, Albania.
authors.forename: A
authors.initials: A
authors.lastname: Shehu
authors.affiliation: Service of Clinical and Biochemical Laboratory, University Hospital Center, Tirana, Albania.
authors.forename: T
authors.initials: T
authors.lastname: Dedej
authors.affiliation: Department of Endocrinology, University Hospital Center, Tirana, Albania.
authors.forename: A
authors.initials: A
authors.lastname: Ylli
authors.affiliation: Department of Nephrology Dialysis and Transplant, University Hospital Center, Tirana, Albania.
authors.forename: N
authors.initials: N
authors.lastname: Thereska
keywords: Albania; Microalbuminuria; epidemiology; type 2 diabetes