Frequency of Diabetic Nephropathy among Patients of Type 2 Diabetes Mellitus
DOI:
https://doi.org/10.51253/pafmj.v75i6.10339Keywords:
Chronic Kidney Disease, Diabetes Mellitus, Diabetic Nephropathy, Hypertension, Microalbuminuria, Neuropathy, Retinopathy.Abstract
Objective: To determine the frequency and prevalence of diabetic nephropathy in patients of Type 2 diabetes mellitus.
Study Design: Cross Sectional Study.
Place and Duration of Study: Department of Medicine, Combined Military Hospital, Bahawalpur Pakistan, from Jul to Nov 2021.
Methodology: One hundred and sixty patients of type 2 diabetes were included and comprehensive initial assessment, including detailed history, demographic data, and detection of microvascular complications through fundoscopy and neurological examinations, was done. All patients were checked for albuminuria for diagnosis of diabetic nephropathy and frequency of diabetic nephropathy was studied.
Results: There were 82(51.3%) males and 78(48.7%) females. Microalbuminuria was found in 20(12.5%) patients and macroalbuminuria in 62(38.8%). The mean serum creatinine level and eGFR was 1.156±0.53 mg/dl and 68.12±24.39% respectively. The mean HbA1c and Fasting Blood Sugar (FBS) levels were 8.38±1.84% and 136.86±19.25mg/dl respectively. Diabetic nephropathy was most commonly seen in 50-59 years age group i.e. 34(21.2%) patients. Fifteen (9.37%) patients with FBS ≤140 mg/dl and 44(27.5%) with FBS more than 140 md/dl had diabetic nephropathy (p<0.001). Twenty-one (13.1%) patients had eGFR 45-59%, 32(20.0%) had eGFR 30-44% and 6(3.7%) patients with diabetic nephropathy had eGFR 15-29% (p<0.001). Diabetic nephropathy in patients with HbA1c level ≤7.5% and >7.5% was seen in 12(7.5%) vs 47(29.3%) respectively (p=0.006).
Conclusion: There was significantly higher risk of Diabetic Nephropathy among patients having poor glycemic control, a long diabetes history, systolic hypertension, and a high Body Mass Index.
Downloads
References
REFERENCES
1. Bae JH, Han KD, Ko SH, Yang YS, Choi JH, Choi KM, et al. Diabetes fact sheet in Korea 2021. Diabete Metab J 2022; 46(3): 417-426.
https://doi.org/10.4093/dmj.2022.0106
2. Alicic RZ, Rooney MT, Tuttle KR. Diabetic kidney disease: Challenges, progress, and possibilities. Clin J Am Soc Nephrol 2017; 12(12): 2032–2045.
https://doi.org/ 10.2215/CJN.11491116
3. Kebede SA, Tusa BS, Weldesenbet AB, Tessema ZT, Ayele TA. Incidence of Diabetic Nephropathy and Its Predictors among Type 2 Diabetes Mellitus Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. J Nutr Metab 2021; 2021(1): 6757916.
https://doi.org/10.1155/2021/6757916
4. Odegaard JI, Chawla A. Connecting type 1 and type 2 diabetes through innate immunity. Cold Spring Harb Perspect Med 2012; 2(3): a007724.
https://doi.org/10.1101/cshperspect.a007724
5. Kung K, Chow KM, Hui EMT, Leung M, Leung SY, Szeto CC, et al. Prevalence of complications among Chinese diabetic patients in urban primary care clinics: A cross-sectional study. BMC Fam Pract 2014; 15(1): 8.
https://doi.org/10.1186/1471-2296-15-8
6. Dash SC, Agarwal SK, Panigrahi A, Mishra J, Dash D. Diabetes, hypertension and kidney disease combination “DHKD syndrome” is common in India. J Assoc Physicians India 2018; 66(3): 30–33.
7. Dias JP, Shardell M, Golden SH, Ahima RS, Crews DC. Racial/Ethnic Trends in Prevalence of Diabetic Kidney Disease in the United States. Kidney Int Reports 2019; 4(2): 334–337.
https://doi.org/10.1016/j.ekir.2018.10.018
8. Ang YG, Heng BH, Saxena N, Liew STA, Chong PN. Annual all-cause mortality rate for patients with diabetic kidney disease in Singapore. J Clin Transl Endocrinol 2016; 4: 1–6.
https://doi.org/10.1016/j.jcte.2016.01.002
9. Meo SA, Zia I, Bukhari IA, Arain SA. Type 2 diabetes mellitus in Pakistan: Current prevalence and future forecast. J Pak Med Assoc 2016; 66(12): 1637–1642.
10. Farah RI, Al-Sabbagh MQ, Momani MS, Albtoosh A, Arabiat M, Abdulraheem AM, et al. Diabetic kidney disease in patients with type 2 diabetes mellitus: a cross-sectional study. BMC Nephrol 2021; 22(1): 223.
https://doi.org/10.1186/s12882-021-02429-4
11. Pavkov ME, Knowler WC, Bennett PH, Looker HC, Krakoff J, Nelson RG. Increasing incidence of proteinuria and declining incidence of end-stage renal disease in diabetic Pima Indians. Kidney Int 2006; 70(10): 1840–1846.
https://doi.org/10.1038/sj.ki.5001882
12. Al-Rubeaan K, Youssef AM, Subhani SN, Ahmad NA, Al-Sharqawi AH, Al-Mutlaq HM, et al. Diabetic nephropathy and its risk factors in a society with a type 2 diabetes epidemic: A Saudi national diabetes registry-based study. PLoS One 2014; 9(2): e88956.
https://doi.org/10.1371/journal.pone.0088956
13. Zhang XX, Kong J, Yun K. Prevalence of Diabetic Nephropathy among Patients with Type 2 Diabetes Mellitus in China: A Meta-Analysis of Observational Studies. J Diabetes Res 2020; 2020(1): 2315607.
https://doi.org/10.1155/2020/2315607
14. Aboelnasr MS, Shaltout AK, AlSheikh MR, Abdelhameed AH, Elrefaey W. Diabetic kidney disease in patients newly diagnosed with type-2 diabetes mellitus: Incidence and associations. Saudi J Kidney Dis Transpl 2020; 31(1): 191–199.
https://doi.org/10.4103/1319-2442.279940
15. Elhefnawy KA, Elsayed AM. Prevalence of diabetic kidney disease in patients with type 2 diabetes mellitus. Egypt J Intern Med 2019; 31(2): 149–154.
https://doi.org/10.4103/ejim.ejim_113_18
16. Sana MA, Chaudhry M, Malik A, Iqbal N, Zakiuddin A, Abdullah M. Prevalence of Microalbuminuria in Type 2 Diabetes Mellitus. Cureus 2020; 12(12): e12318.
https://doi.org/10.7759/cureus.12318
17. Afkhami-Ardekani M, Modarresi M, Amirchaghmaghi E. Prevalence of microalbuminuria and its risk factors in type 2 diabetic patients. Indian J Nephrol 2008; 18(3): 112-117.
https://doi.org/10.4103/0971-4065.43690
18. Adil S, Farhan S, Nadeem MA, Rasheed S, Mohsin A. Frequency of diabetic nephropathy in tertiary care hospital. Pakistan J Med Heal Sci 2016; 10(2): 402–404.
19. Alfehaid AA. Prevalence of microalbuminuria and its correlates among diabetic patients attending diabetic clinic at National Guard Hospital in Alhasa. J Fam Community Med 2017; 24(1): 1–5. https://doi.org/10.4103/2230-8229.197174
20. Sheikh AS, Baig JA, Tehseen I, Tehseen K, Baig M, Husain SS. Prevalence of microalbuminuria in relation to glycemic control in type-2 diabetic patients in Mymensingh. J Ayub Med Coll Abbottabad 2009; 21(3): 83–86.
21. Alrasheedi AA, Alqesair MH, Aljurbua HF, Alfanoud GA, Almakrami MH, J. Mohammad JE. Knowledge of Complications of Diabetes Mellitus Among Patients Visiting the Diabetes Clinics: A Cross-Sectional Study in the Qassim Region. Cureus 2023; 15(12): e49896.
https://doi.org/10.7759/cureus.49896
22. Boye KS, Thieu VT, Lage MJ, Miller H, Paczkowski R. The Association Between Sustained HbA1c Control and Long-Term Complications Among Individuals with Type 2 Diabetes: A Retrospective Study. Adv Ther 2022; 39(5): 2208–2221.
https://doi.org/10.1007/s12325-022-02106-4
23. Abdelwahid HA, Dahlan HM, Mojemamy GM, Darraj GH. Predictors of microalbuminuria and its relationship with glycemic control among Type 2 diabetic patients of Jazan Armed Forces Hospital, southwestern Saudi Arabia. BMC Endocr Disord 2022; 22(1): 307.
https://doi.org/10.1186/s12902-022-01232-y
24. Wagnew F, Eshetie S, Kibret GD, Zegeye A, Dessie G, Mulugeta H, et al. Diabetic nephropathy and hypertension in diabetes patients of sub-Saharan countries: A systematic review and meta-analysis. BMC Res Notes 2018; 11(1): 565.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Hira Iqbal; Syed Waqar Abbas, Ahmar Rasheed, Muhammad Faheem ur Rehman, Muhammad Asad, Hafiz Asad Saeed, Irfan Jamil
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
