Prevalence and Risk Factors of Chronic Kidney Disease among Type 2 Diabetes Patients: A Cross-Sectional Study in Primary Care Practice

Abstract

This cross-sectional study aimed to investigate the prevalence and risk factors of chronic kidney disease (CKD) among 1,096 primary care type 2 diabetes (T2DM) patients in northern Thailand between October 2016 and September 2017. CKD was defined as estimated glomerular rate filtration values of <60 mL/ min/1.73 m 2 . Prevalence with confidence intervals across CKD advanced stages 3-5 were estimated. Factors associated with CKD were evaluated by multivariate logistic regression. The overall prevalence of CKD was 24.4% (21.9-27.0), with severities of 11.4% (9.7-13.4), 6.8% (5.5-8.5), 4.6% (3.5-6.0), and 1.6% (1.0-2.5) for stages 3 A, 3B, 4, and 5, respectively. Regarding age and glycaemic control, individuals older than 75 years and those with a haemoglobin A1c ≥ 8% had the highest prevalence of 61.3% (51.7-70.1) and 38.6% (34.3-43.2), respectively. The multivariable logistic regression model explained 87.3% of the probability of CKD. The six independent significant risk factors of CKD were older age, retinopathy, albuminuria, haemoglobin A1c ≥ 7%, anaemia, and uric acid>7.5 mg/dL. A relatively high prevalence of CKD, especially in older patients and those with diabetic complications-related to poor glycaemic control, was encountered in this primary care practice. Early identification may help to target optimise care and prevention programs for CKD among T2DM patients.Globally, the total number of people with diabetes is estimated to increase from 415 million (8.8%) in 2015 to 642 million (10.4%) in 2040, with the largest alterations expected to occur in the urban population of low-to middle-income countries (LMICs) 1 . Of them, type 2 diabetes mellitus (T2DM) accounts for more than 90% of people with diabetes 2,3 . By 2040, the difference worldwide is projected to broaden, with 477.9 million affected people living in urban areas and 163.9 million in rural areas 1 . It has been postulated that the burden of diabetes and its complications in the LMICs may be contributed by the economic development and rapid urbanisation via increased caloric intake and the adoption of a sedentary lifestyle 2,4,5 . More importantly, the most striking demographic change to diabetes prevalence in global terms also seems to be related to the growth of the proportion of the elderly population 6 .Despite rates of diabetes-related complications such as cardiovascular disease decreasing significantly in the past two decades, it has not translated nearly as well as kidney complications 7 . Approximately 10% of deaths in people with T2DM are attributable to kidney failure 8 . It is well-established that diabetes-related chronic kidney disease (CKD) is the leading cause of end-stage kidney disease (ESKD) in T2DM patients worldwide 9,10 . In the United States, 2013-2016, approximately 36% of patients with diabetes develop diabetic kidney disease resulting in persistent albuminuria, a reduced estimated glomerular filtration rate (eGFR), or both 11 . Interestingly, the risk of diabetes-related CKD is observed much higher in Asian countries than ...

The multifactorial burden of Type 2 Diabetes mellitus: a study from clinical settings of University Hospital, Karachi, Pakistan

“…T2DM is one of the leading causes of CKD worldwide 30 . Globally, the overall prevalence of CKD among T2DM patients varied from 6.0-39.3 % 31 . In our study group, CKD was the most prevalent comorbidity amongst all T2DM patients affecting a large number of males of age group 41-50 years as compared to females (16 %; 10 % in males and 6 % in females).…”

Collagen Deposition in Diabetic Kidney Disease Boosts Intercellular Signaling: A Mathematical Model

“…Diabetes is a significant burden on public health. In 2015 over 400 million people had been diagnosed with diabetes worldwide, a number that is expected to rise to over 600 million by 2040 (1). One third of these diabetic patients are expected to develop diabetic kidney disease, the leading cause of kidney failure (1, 2).…”

“…In 2015 over 400 million people had been diagnosed with diabetes worldwide, a number that is expected to rise to over 600 million by 2040 (1). One third of these diabetic patients are expected to develop diabetic kidney disease, the leading cause of kidney failure (1, 2). Our lack of understanding of how diabetic kidney disease progresses and affects cellular and tissue function has contributed to our inability to mitigate the rapidly rising burden of diabetic kidney disease.…”

Do descendants of families contribute to type 2 diabetes mellitus?

“…Most patients with T2DM had complications (e.g., cardiovascular, kidney disease, etc. ), and its complication is the leading cause of morbidity and mortality in these patients [12][13][14].…”