Serum Aldosterone Level in Different Stages of Diabetic Kidney Disease in Type 2 Diabetes Mellitus

Abstract

Background: New evidence links elevated blood aldosterone levels to endothelial dysfunction which cause insulin resistance and kidney damage in diabetics. In this study, we aimed to measure serum aldosterone levels and assess the severity of renal injury in different stages of diabetic nephropathy.Methods: The 52 participants in this case-control study were classified according to albuminuria and ACR, and they all had type 2 diabetes mellitus (T2DM): Group (A): 13 healthy individuals as control, Group (B): 13 controlled patients with T2DM with normoalbuminuria and normal albumin/create ratio ≤30mg/gm, Group (C): 13 patients with T2DM with microalbuminuria and albumin/create ratio 30-300mg/g, and Group (D): 13 patients with T2DM with macroalbuminuria and albumin/create ratio ≥300mg/g. Serum aldosterone and serum renin were assessed.Results: Serum aldosterone and renin differed significantly between the four groups (p<0.001). In the microalbuminuria diabetic group, a statistically significant strong negative correlation was found between s. aldosterone and high-density lipoprotein (HDL) (p= 0.025), and a statistically significant strong positive correlation was found between s. aldosterone and Alb/Cr ratio & s. renin (p=.0.037, 0.007 respectively). In the macroalbuminuria diabetic group, a statistically significant strong negative correlation was found between s. aldosterone and all of the Alb/Cr ratios, as well as total leucocytic count (TLC) (p=0.009, 0.029 respectively), and a statistically significant strong positive correlation was found between s. aldosterone, HDL, and K (p=0.042, 0.013, respectively).Conclusion: serum aldosterone level could have a significant role in the progression of diabetic kidney disease.