European Journal of Molecular & Clinical Medicine

Introduction: Obesity has become the leading global health problem. In numerous large population-based studies-Higher BMI associated with presence and development of low estimated GFR and many other renal diseases.
Objective: To study the renal functions in obese adults of rural area.
To do comparative analysis of renal functions with age and sex matched non obese adults.
Material and Methods: The present cross-sectional study was carried out in the General Medicine OPD of BPS GMC for Women, Khanpur Kalan, Sonipat, Haryana. A sample of convenient 100 obese patients were taken. A total of 200 patients attending General Medicine OPD were taken, out of which 100 were obese and 100 were non obese.
Results: Statistically significant P values were obtained for Blood Urea, Serum Creatinine, Serum Calcium, Serum Phosphorus, and urine albumin among obese and non-obese adults. Study shows no significant gender differences between obese and non-obese. Statistical analysis shows some age-related differences among obese and non-obese large population studies-showing positive association of BMI with chronic kidney disease.

AIM:  To correlate relationship of NLR Ratio in Type 2 DM patients having raised Albumin in urine/ elevated UACR and no Albuminuria / normal UACR.
MATERIAL & METHODS: Analytical Cross Sectional study involving data from 96 patients visitng JSS Hospital OPD and Inpatients of JSS Hospital, Mysuru over a period of 18 months. General physical examination was done which included weight, body mass index, height, heart rate, blood pressure, any cyanosis, clubbing, pallor, yellowish discoloration of sclera. Routine Investigations such as Complete Hemogram, Glycated hemoglobin (HbA1c) ,Hepatic function tests (LFTs), Renal function (RFT), Urine microscopy and routine, Chest Xray & specific investigation such as spot urine Albumin(Protein) to creatinine(UACR) ratio was done.
RESULTS: The majority of subjects with and without nephropathy were among the age group of 51 to 60 years & majority of subjects with and without nephropathy were males. There was no correlation between gender and nephropathy (P = 1.0). The mean FBS levels were significantly higher among subjects with diabetic nephropathy compared to their normal counterparts (P= 0.038). The mean HbA1c levels among subjects with and without diabetic nephropathy were almost similar (P = 0.878) and was not significant. It was observed that, the median spot UACR, mean  N/L ratio, mean blood urea, mean serum creatinine  & GFR(glomerular filtration rate) was higher among subjects with diabetic nephropathy(DN) compared to their normal counterparts and p value was found to be significant.
CONCLUSION: The study revealed that elevated NLR was associated with the development of DN(diabetic nephropathy), suggesting that inflammation and the dysfunction of the endothelium could be contributing factors to this condition. The NLR test is an easy-to-use and inexpensive way and can be calculated using differential leukocyte count. The NLR test will allow researchers to gain a deeper understanding of  role of inflammation in the development of DN and how it could be used as a prognostic and predictive marker of diabetic nephropathy especially in areas with limited resources.

Diabetes mellitus (DM) has a high prevalence worldwide. Anaemia is one of the most common conditions seen in diabetic patients which is the leading cause of morbidity in these patients. It leads to various complications, including microvascular and macrovascular complications. The nephropathy may undermine the renal production of erythropoietin, positively contributing to an increased anemia framework. The inflammatory situation created by kidney disease also interferes with intestinal iron absorption. Therefore, diabetic patients with kidney disease have higher risk for developing anemia.
Aim : The aim of this work was to determine the prevalence and various types of anemia in patients with type 2 DM.
Methods : After obtaining informed written consent, all diabetics as well as control individuals were subjected to detail history, clinical examination, and investigations as follows: fasting blood glucose, postprandial blood glucose, glycated hemoglobin, complete blood count, peripheral smear for type of anemia, reticulocyte count and renal function test, creatinine clearance, urine examination, albuminuria, and stool examination through routine and microscopic fecal occult blood test.
Results : The prevalence of anemia among our studied patients with type 2 DM was 65%, with significant increase compared with the control group (10%). Diabetics had microcytic hypochromic anemia among 55%, whereas 44.6% had normocytic normochromic anemia. There was a significant negative correlation between hemoglobin level and degree of albuminuria and a significant positive correlation between hemoglobin level and creatinine clearance.
Conclusion : Anemia is a common finding in patients with type 2 DM when compared with the general population. Hence in diabetic patients, it would be desirable to evaluate the hemoglobin levels often, even when the renal parameters are within the normal limits, for better quality of life.