Diabetic kidney disease affects approximately 30–40% of patients with T2DM and remains a leading cause of end-stage renal disease. Progressive renal damage often develops silently during the early stages, making timely diagnosis challenging. Albuminuria reflects glomerular endothelial and basement membrane injury, while eGFR estimates overall renal filtration function. Some patients may develop reduced eGFR without significant albuminuria, whereas others may exhibit albuminuria despite preserved filtration capacity. Therefore, reliance on a single marker may underestimate the presence and severity of early diabetic kidney damage. Contemporary clinical guidelines recommend integrated evaluation of both albuminuria and eGFR for diagnosis, prognosis, and therapeutic decision-making.
The aim of the study was to evaluate the combined diagnostic significance of albuminuria and estimated glomerular filtration rate as integrated markers for early detection of kidney damage in patients with type 2 diabetes mellitus.
The study included 140 patients aged 40–75 years with confirmed T2DM. Clinical assessment included medical history, blood pressure measurement, anthropometric evaluation, and duration of diabetes. Laboratory investigations included glycated hemoglobin (HbA1c), serum creatinine, urinary albumin-to-creatinine ratio (UACR), lipid profile, and estimated glomerular filtration rate calculated using the CKD-EPI equation. Patients were categorized according to albuminuria stages and eGFR categories. Statistical analysis was performed to assess correlations between albuminuria, eGFR, glycemic control, and cardiovascular risk factors.
Albuminuria was detected in 46.4% of patients, while reduced eGFR (<60 mL/min/1.73 m²) was observed in 28.6%. Patients with both albuminuria and reduced eGFR demonstrated significantly higher HbA1c levels, longer diabetes duration, higher systolic blood pressure, and more frequent cardiovascular comorbidities (p<0.05). A significant inverse correlation was identified between UACR and eGFR (r = -0.58, p<0.001). Integrated assessment identified early kidney damage in a substantial proportion of patients with preserved eGFR but elevated albuminuria. Combined evaluation showed greater sensitivity for early diabetic kidney disease detection compared with isolated assessment of either marker.
Albuminuria and estimated glomerular filtration rate represent complementary and integrated markers of early kidney damage in patients with type 2 diabetes mellitus. Combined assessment improves early diagnosis, risk stratification, and identification of patients at increased risk of renal and cardiovascular complications. Routine evaluation of both UACR and eGFR should be considered an essential component of comprehensive diabetic kidney disease screening and long-term management.
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