Prevalence of microalbuminuria and associated factors among diabetic patients attending a general hospital in Central Uganda

Abstract

Introduction: Microalbuminuria is an early indicator of kidney damage and a strong predictor of diabetic nephropathy in diabetic patients. Its prevalence and associated factors vary across populations, necessitating region-specific studies. This study evaluated the prevalence of microalbuminuria and its associated factors among diabetic patients attending a general hospital in Central Uganda. Methods: From September 2024 to December 2024, a structured questionnaire was used to carry out a descriptive and analytical cross-sectional study among patients with diabetes at Nakaseke General Hospital in Central Uganda. Blood and urine samples from each participant were also analysed for determination of HbA1c, serum gamma glutamyl transferase (GGT), and microalbumin respectively. Microalbuminuria was defined as urine microalbumin levels of 20–200 mg/L. Logistic regression analysis was used to assess associated factors. Results: Of 298 participants, 220 (73.8%, 95% CI: 68.52–78.52) had microalbuminuria. The majority were females: 193 (64.8%). GGT levels were significantly higher in participants with microalbuminuria: 45.5IU/L (IQR: 33.5–57) than in those with normoalbuminuria: 39.5IU/L (IQR: 29–50), p = 0.011. HbA1c levels, indicative of glycaemic control, were noticeably greater in the microalbuminuria group: 8.2% (IQR: 7.2–9.65) as compared with those with normoalbuminuria: 7.6% (IQR: 6.9–9.1), p = 0.012. After adjustment for confounders, factors significantly associated with microalbuminuria were HIV-positive status (aOR = 3.20, p = 0.030), hypertension (aOR = 4.43, p = 0.011), and unemployment status (aOR = 2.32, p = 0.023). Conclusion: Microalbuminuria is prevalent among patients with diabetes. Microalbuminuria is associated with elevated GGT, and HbA1c levels, HIV positivity, hypertension, and unemployment. Screening, more stringent glycaemic and blood pressure control, and targeted interventions are warranted in high-risk groups to prevent the onset of diabetic nephropathy.