Systematic Review of the Role of Albuminuria on Kidney Function in Type 2 Diabetes

Abstract

Objective: This systematic review explores the impact of albuminuria on renal function in patients with type 2 diabetes
(T2D), assessing its role in diagnosing diabetic kidney disease (DKD) and its correlation with reduced glomerular filtration
rate (GFR). Materials and methods: A systematic review was conducted following PRISMA guidelines. Searches in PubMed,
Embase, Cochrane Library, and Medline included studies from 2019 to 2023. Inclusion criteria were adults (≥18 years) with
T2D, studies assessing impact of albuminuria on kidney function, including randomized controlled trials, observational
studies, or meta-analyses. Primary outcomes included albuminuria progression, renal function decline (estimated GFR [eGFR]
or creatinine clearance), and DKD progression. Secondary outcomes evaluated the safety and tolerability of interventions
managing albuminuria in T2D patients. Two reviewers independently extracted data and assessed risk of bias. Results: From
1,748 records, nine studies involving 9,91,285 patients were included. Studies consistently showed higher albuminuria levels
to be significantly associated with reduced eGFR and increased DKD progression risk. Conclusions: Our findings underscore
albuminuria as a crucial indicator of kidney damage and eGFR as a key marker for DKD severity in T2D patients. This review
highlights the need for patient-centered care in managing T2D to reduce renal complications and calls for further research
to comprehensively understand DKD outcomes