Dear Editor,
We read the recent publication entitled “ Study of microalbuminuria as a nephropathic marker in type 2 diabetes mellitus and its correlation with the glycated hemoglobin” published by Patil A R, et al.1 with great interest in which the authors have suggested that microalbuminuria as a nephropathic marker in type 2 diabetes mellitus. The possibility, delay or reverse the progression of diabetic nephropathy can be achieved only by perfect long term metabolic control.1 Diabetic nephropathy is an important cause of chronic kidney disease that frequently leads to end stage kidney disease.2 Diabetic nephropathy is first manifested as microalbuminuria, which progresses to overt albuminuria and then to renal failure.3
We found certain discrepancies which we want to bring to your notice. The selection of study subjects seems to be as biased. The authors have studied 50 subjects in each group (50 healthy controls and 50 type 2 Diabetes Mellitus patients). However, in a case-control study, it is very unusual to have the same number of total subjects in each group. If subjects have been selected randomly, then the authors should have mentioned the selection criteria of these subjects. Moreover, the sample size is too small to derive any conclusion, so authors should be done study on large population.
Variations in urine flow rate in a study subject may be corrected by expressing urine albumin as a ratio to urine creatinine. Urine samples for measurement of urinary albumin excretion rate should not be collected after exertion, during acute illness, immediately after surgery, or after an acute fluid load.4 The urinary albumin excretion rate is affected by a variety of physiological factors, i.e. exercise within 24 hours, posture, diuresis, and the variability is such that reliance cannot be placed upon a single estimation,5 so authors should be measured urine creatinine along with urine albumin and express the results as urine albumin to creatinine ratio in addition to total albumin concentration6 to validate the results of study.
