Assessment of Estimated Glomerular Filtration Rate and Total Kidney Volume in Newly Diagnosed Type 2 Diabetes Mellitus: A Case–Control Study

Background: Type 2 Diabetes Mellitus (T2DM) is a major public health concern and a leading cause of diabetic kidney disease. Renal structural and functional alterations may develop early in the course of diabetes, even before the appearance of overt nephropathy. Assessment of estimated glomerular filtration rate (eGFR) and total kidney volume (TKV) may facilitate early detection of diabetic renal involvement. The objective is to assess estimated glomerular filtration rate and total kidney volume in newly diagnosed Type 2 Diabetes Mellitus patients and compare them with healthy controls, and to evaluate their relationship with glycemic parameters. Material and Methods: This hospital-based case–control study was conducted over one year from March 2025 to February 2026 at a tertiary care teaching hospital. A total of 320 participants were enrolled, comprising 160 newly diagnosed T2DM patients and 160 age- and sex-matched healthy controls. Clinical evaluation, anthropometric measurements, biochemical investigations, and ultrasonographic assessment of kidney dimensions were performed. eGFR was calculated using the CKD-EPI equation, and total kidney volume was determined using the ellipsoid formula. Statistical analysis was performed using SPSS version 26.0, with a p-value <0.05 considered statistically significant. Results: Newly diagnosed T2DM patients demonstrated significantly higher fasting blood glucose, postprandial blood glucose, HbA1c levels, serum creatinine, and total kidney volume compared with controls (p<0.001). Mean eGFR was significantly lower among cases (94.6 ± 15.3 mL/min/1.73 m²) than controls (103.8 ± 13.1 mL/min/1.73 m²; p<0.001). Total kidney volume was significantly higher in cases (290.1 ± 38.6 cm³) compared with controls (260.7 ± 34.8 cm³; p<0.001). HbA1c showed a significant negative correlation with eGFR and a positive correlation with total kidney volume. Conclusion: Newly diagnosed T2DM patients exhibit significant early renal structural and functional alterations characterized by increased kidney volume and reduced eGFR. These parameters may serve as useful early markers of diabetic kidney involvement and aid in timely intervention to prevent progression of diabetic kidney disease.

Keywords: Type 2 Diabetes Mellitus, Estimated Glomerular Filtration Rate, Total Kidney Volume, Diabetic Kidney Disease, Renal Hypertrophy, CKD-EPI.