Characterization of Diabetic Nephropathy and Its Correlates in a Selected Outdoor-Based Diabetic Clinic in Rangpur, Bangladesh
AbstractBackground:The rising burden of diabetic complication associated with the diabetes mellitus (DM) pandemic. DM is a global public health problem. Diabetic nephropathy (DN) is one of the life-threatening and irreversible microvascular complications of DM. Methods:A cross-sectional study was conducted from November 2017 to April 2018 to characterize and associate of possible DN among people living with diabetes where 40 T1DM, 200 T2DM as cases group and 50 non diabetic as a control groupwere selected conveniently. Data were collected using structured questionnaire and analyzed by SPSS-22. Stages of DN were classified according ‘Revised Classification of DN’ given by the ‘Joint Committee on Diabetic Nephropathy’, Japan, 2014. Results:The mean FBS was 6.81±0.87 mmol/L in T1DM, 7.98±3.25mmol/Lin T2DM and 4.55±0.58 mmol/L in controls. The prevalence of pre-nephropathy (PN), incipient nephropathy (IN) and overt nephropathy (ON) was 10%, 82.5% and 7.5% respectively in T1DM. Similarly, in T2DM the prevalence of PN, IN, ON and chronic kidney failure (CKF) was 5.5% 81%, 10%, and 3.5% respectively. One way ANOVA followed by post hoc-LSD suggested, in T1DM the mean FBS was significantly lower in PN group than IN (p=0.017) and ON (p=0.048) group. Further in T1DM and T2DM, the mean estimated Glomerular Filtration Rate was significantly (p=0.032) lower in IN group than PN and significantly (p=0.026, 0.006) lower in ON than PN and IN respectively. Irrespective of diabetic group, according to multivariate analysis, older age (adjusted OR =1.05, CI: 1.01-1.08; adjusted OR: 2.33, CI: 2.01-2.99), sCreatinine (adjusted OR: 7.73, CI: 2.26-22.47) and female sex (adjusted OR = 0.39, CI: 0.19-0.77) were independently associated with DN adjusting BMI, SBP, DBP and FBS level. Conclusion:This study showed the prevalence rate of DN was high among diabetic and mostly in type 2 diabetics with severe stage.
WHO. Diabetes Fact Sheet. NMH Fact Sheet Febr 2010. 2010. doi:10.3343/alm.2017.37.1.28
World Health Organization. Diabetes: The Problem. 2008:1-2. https://www.who.int/nmh/publications/fact_sheet_diabetes_en.pdf.
Jian W. Peng W. Jin J. et al. Metabolism(Press). Diabetes Care. 2011.
Farag YMK, Al Wakeel JS. Diabetic nephropathy in the arab gulf countries. Nephron - Clin Pract. 2011. doi:10.1159/000328909
Sanz M, Ceriello A, Buysschaert M, et al. Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International diabetes Federation and the European Federation of Periodontology. In: Diabetes Research and Clinical Practice. ; 2018. doi:10.1016/j.diabres.2017.12.001
Wen CP, Cheng TYD, Tsai MK, et al. All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in Taiwan. Lancet. 2008. doi:10.1016/S0140-6736(08)60952-6
Chandie Shaw PK, Baboe F, Van Es LA, et al. South-Asian type 2 diabetic patients have higher incidence and faster progression of renal disease compared with Dutch-European diabetic patients. Diabetes Care. 2006. doi:10.2337/dc06-0003
National Guideline Clearinghouse. Standards of medical care in diabetes. V. Diabetes care. Natl Guidel Clear. 2013;Suppl1:S11-66. http://www.guideline.gov/content.aspx?id=45153&search=diabetes.
Nah EH, Cho S, Kim S, Cho HI. Comparison of urine albumin-to-creatinine ratio (ACR) between acr strip test and quantitative test in prediabetes and diabetes. Ann Lab Med. 2017;37(1):28-33. doi:10.3343/alm.2017.37.1.28
MA, R., Zaman, S., Habib, S.H., Afsana, F., Haque, W.M. and Iqbal, S. 2020. Evaluation of risk factors for diabetic nephropathy among newly diagnosed type 2 diabetic subjects: preliminary report from a tertiary care hospital of Bangladesh. BIRDEM Medical Journal. 10, 2 (Jun. 2020), 88-91. DOI:https://doi.org/10.3329/birdem.v10i2.47732.
Haneda M, Utsunomiya K, Koya D, et al. A new Classification of Diabetic Nephropathy 2014: A report from Joint Committee on Diabetic Nephropathy. J Diabetes Investig. 2015. doi:10.1111/jdi.12319
Collins AJ, Li S, Gilbertson DT, Liu J, Chen S-C, Herzog CA. Chronic kidney disease and cardiovascular disease in the Medicare population. Kidney Int. 2003;64:S24-S31. doi:10.1046/j.1523-1755.64.s87.5.x
Hussain F, Maan M, Medical MF-BJ of, 2010 U. Plasma protein glycation status in Pakistan type 2 diabetic patients with or without nephropathy. BanglajolInfo. 2010;9(2):68-75. https://www.banglajol.info/index.php/BJMS/article/view/5654.
Vimalkumar VK, Moses CA, Padmanaban S. Proportion & Risk Factors of Nephropathy in Type 2 Diabetic Patients. Int J Collab Res Intern Med Public Heal. 2011;3(8):598-615.
Dayanidhi S, Ramadevi K, Periyandavar I. Prevalance and predictors of microalbuminuria in patients with type 2 diabetes mellitus. Int J Pharma Bio Sci. 2013;4(4).
Yarasini A. Microalbuminuria As a Marker of Cardiovascular and Renal Risk in Type Ii Diabetes Mellitus. J Evol Med Dent Sci. 2014;3(28):7701-7707. doi:10.14260/jemds/2014/2959
Preity S, Delwer M, Hawlader H, Akhter S, Abdullah AS, Biswas A. Views of the Parents of Autistic Children about Autism and Schools for Autistic Children : A Qualitative Study in Urban Bangladesh. Int J Public Heal Res. 2017;5(5):56-61.
Jyothirmayi B. Study of microalbumin in type 2 diabetes mellitus with less than and more than five years of duration. Int J Pharma Bio Sci. 2014.
Varghese A, Deepa R, Rema M, Mohan V. Proportion of microalbuminuria in type 2 diabetes mellitus at a diabetes centre in southern India. Postgrad Med J. 2001. doi:10.1136/pmj.77.908.399
Ahmedani MY, Hydrie MZI, Iqbal A, Gul A, Mirza WB, Basit A. Proportion of microalbuminuria in type 2 diabetic patients in Karachi: Pakistan - A multi-center study. J Pak Med Assoc. 2005;55(9):382-386.
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