Chronic kidney disease screening and renoprotection in type 2 diabetes

Agaba, Emmanuel I; Puepet, FH; Ugoya, SO; Agaba, PA; Adabe, Ruth; Duguru, Mary; Rowland, AI

doi:10.4103/1596-3519.55765

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…Most studies were categorised as having some concern for bias with two (10%) 37 46 studies being deemed to have high risk of bias. Two studies 32 44 (11.1%) had a moderate risk of bias, while 16 studies 29–31 33–36 38–43 45 47 48 (80%) had a low risk of bias. The inter-rater agreement for the risk of bias assessment was 0.65.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of uncontrolled hypertension in people with comorbidities in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2021

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BackgroundThe burden of uncontrolled hypertension in sub-Saharan Africa (SSA) is high and hypertension is known to coexist with other chronic diseases such as kidney disease, diabetes among others. This is the first systematic review and meta-analysis to determine the burden of uncontrolled hypertension among patients with comorbidities in SSA.MethodsA comprehensive search was conducted on MEDLINE, Excerpta Medica Database (Embase) and Web of Science to identify all relevant articles published between 1 January 2000 and 17 June 2021. We included studies that reported on the prevalence of uncontrolled hypertension among people in SSA who report taking antihypertensive treatment and have another chronic condition. A random-effects meta-analysis was performed to obtain the pooled estimate of the prevalence of uncontrolled hypertension among patients with comorbid conditions while on treatment across studies in SSA.ResultsIn all, 20 articles were included for meta-analyses. Eleven articles were among diabetic patients, five articles were among patients with HIV, two were among patients with stroke while chronic kidney disease and atrial fibrillation had one article each. The pooled prevalence of uncontrolled hypertension among patients with comorbidities was 78.6% (95% CI 71.1% to 85.3%); I² 95.9%, varying from 73.1% in patients with stroke to 100.0% in patients with atrial fibrillation. Subgroup analysis showed differences in uncontrolled hypertension prevalence by various study-level characteristicsConclusionThis study suggests a high burden of uncontrolled hypertension in people with comorbidities in SSA. Strategies to improve the control of hypertension among people with comorbidities are needed.PROSPERO registration numberCRD42019108218.

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Section: Resultsmentioning

confidence: 99%

Prevalence of uncontrolled hypertension in people with comorbidities in sub-Saharan Africa: a systematic review and meta-analysis

et al. 2021

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“…Other similar studies showed varying results with a South African study reporting a more than 90% compliance with these bedside tests whilst another African study showed less than 50% compliance. 10,11 There was no identifiable reason for their omission in this study. It is possible that a lack of understanding of their significance in the guidelines may have contributed to their omission.…”

Section: Discussionmentioning

confidence: 98%

“…5,7,12 Patients with diabetes and hypertension are therefore more likely to develop target organ damage. 5,7,11,12 A 2009 study published in the Annals of African Medicine showed that the major predictor of resource use in type 2 DM patients in developing countries was the presence of complications as well as inadequate glycaemic control. 11 Diabetic retinopathy is possibly the most common microvascular complication of diabetes and is responsible for approximately 10 000 new cases of blindness every year in the USA.…”

Section: Discussionmentioning

confidence: 99%

“…5,7,11,12 A 2009 study published in the Annals of African Medicine showed that the major predictor of resource use in type 2 DM patients in developing countries was the presence of complications as well as inadequate glycaemic control. 11 Diabetic retinopathy is possibly the most common microvascular complication of diabetes and is responsible for approximately 10 000 new cases of blindness every year in the USA. 9,[12][13][14] Studies in Africa have recorded the prevalence of diabetic retinopathy to range from 7% in Kenya to 63% in South Africa.…”

Section: Discussionmentioning

confidence: 99%

“…A 2009 study conducted in a teaching hospital in Nigeria showed similar poor results with urinalysis and serum creatinine done only 50% of the time. 11 Foot examinations and education on foot care is an essential step in diabetic care. It is aimed at identifying persons at risk for ulceration and lower extremity amputation.…”

Section: Discussionmentioning

confidence: 99%

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Compliance with local diabetic guidelines at a district hospital in KwaZulu-Natal, South Africa

Rampersad

Rangiah

Kendon

2018

South African Family Practice

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Background: Diabetes mellitus (DM) represents a major health-related problem in South Africa and throughout the world. The management goals of diabetes are first to maintain normal blood glucose levels and second to prevent the development of complications. Local guidelines developed by the Society for Endocrine Metabolism and Diabetes South Africa (SEMDSA) have shown that tight glycaemic control and appropriate monitoring can prevent or delay the development of diabetic complications. The demographic profile of patients with type 2 DM and the compliance of doctors to the guidelines were determined. Methods: Five hundred records of patients with type 2 DM were selected from the medical outpatients' department (MOPD) by systematic sampling. Demographic information on age, sex and ethnicity was obtained. The performance and timing of recommended investigations were recorded and compared with the 2012 SEMDSA guidelines. Results: The mean age of patients was 61 years. Black and Indian patients formed the majority, comprising 44.4% and 43.0% respectively. Glycated haemoglobin was measured in 29.2% of patients once and 13.2% of patients twice in the past year. Lipid studies were done on 40.4% of patients. A serum creatinine (sCr), estimated glomerular filtration rate (eGFR) and serum potassium were done on 38.2% of patients. Eye examinations were done on 13.60% patients and examination of the foot was done on 7.8% of patients. Some 15% had a urine dipstick test done at least once in the past year and 10.4% had a urine albumin/creatinine ratio (ACR) requested. Only 21 patients (4.2%) were compliant with the SEMDSA guidelines. Measurements of blood pressure and blood glucose were 100% compliant. Anthropometric measurements (height, weight and body mass index), dietitian referral and foot examinations were the least compliant, being performed 4.2%, 5.0% and 7.8% of the time respectively. Conclusion: Black and Indian patients formed the majority of the study population. The screening for chronic complications of type 2 DM was poor in the majority of patients. Evaluation of selected records demonstrated compliance with the SEMDSA guidelines in only 4.2% of patients. There is an urgent need to review barriers to the implementation of guidelines in South Africa.

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