IDENTIFYING RISK FACTORS ASSOCIATED WITH DIABETIC KIDNEY DISEASE IN TYPE 2 DIABETICS: A SINGLE-CENTER STUDY
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Keywords
Hypertension, Obesity, Diabetes, Diabetic Kidney Disease, ACR, eGFR.
Abstract
Objective: To determine and assess the risk factors for diabetic kidney disease in individuals with type 2 diabetes.
Methodology: The prevalence of risk factors for diabetic kidney disease (DKD) was examined in this cross-sectional study, which used data collected in the duration from January, 2018 to July, 2018 among type 2 diabetes mellitus (T2DM) patients of 18 years or above age, pursuing medical treatment at the Medicine Department of Medical B Unit, Lady Reading Hospital Peshawar, Pakistan. Excluded were patients with incomplete data, end-stage renal disease (ESRD) on dialysis, and other etiologies of chronic kidney disease (CKD) or proteinuria. Informed consent was obtained, and the study adhered to ethical standards. Data on medical history, comorbidities, glycemic control, medication use, lifestyle factors, physical measurements, and laboratory parameters were collected. DKD was defined as per established criteria. SPSS version 23.0 was used for the statistical analysis, with a significance level of p < 0.05.
Results: Of the 163 T2DM patients in this study, 42.94% had DKD. DKD was significantly associated with age over 50 (82.86% vs. 48.39% in non-DKD patients), female gender (68.57% vs. 31.43% in males), diabetes duration over 10 years (57.14% vs. 30.11%), hypertension (82.86% vs. 55.91%), and peripheral neuropathy (57.14% vs. 21.51%). DKD patients had higher BMI (50.00% vs. 19.35% in non-DKD patients) and waist circumference (mean 37.8 cm vs. 33.8 cm in non-DKD patients), along with insulin therapy (64.29% vs. 32.26% in non-DKD patients) and elevated HbA1c levels (85.71% with HbA1c ≥7% vs. 46.24%). Adverse lipid profiles were observed in DKD patients, with higher LDL and triglycerides, and lower HDL levels. DKD patients exhibited elevated serum creatinine (1.7± 0.7mg/dL vs. 1.2± 0.5mg/dL in non-DKD patients), lower serum albumin (3.5± 0.4g/dL vs. 4.0± 0.5g/dL in non-DKD patients), higher ACR (42.86% with ACR ≥300 mg/g vs. 16.13%), and low eGFR (71.43% vs. 19.35%).
Conclusion: According to our research, diabetic people have a notable tendency to develop diabetic kidney disease (DKD) (42.94%), with older age, longer diabetes duration, hypertension, peripheral neuropathy, and dyslipidemia as key associated factors. Elevated HbA1c levels, reduced eGFR, and high albuminuria prevalence underscore DKD severity. This emphasizes the critical need for comprehensive management, including stringent glucose control, blood pressure regulation, and lipid management, with regular kidney function monitoring. These proactive measures can potentially curb DKD progression and improve health outcomes for diabetic patients in Pakistan.
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Dr Abdul Jabbar
Trainee Medical Officer, Medical B Unit, Lady Reading Hospital Peshawar, Pakistan, Pakistan
Dr Aziz Ur Rahman
Trainee Medical Officer, Medical D Unit Khyber Teaching Hospital, Peshawar, Pakistan
Dr Abdul Waris Khan
Trainee Medical Officer, Medical D Unit Khyber Teaching Hospital, Peshawar, Pakistan
Dr Hashimuddin
Professor, Medical D Unit Khyber Teaching Hospital, Peshawar, Pakistan
Dr Muhammad Yaseen Khan
Professor, Medical B Unit, Lady Reading Hospital Peshawar, Pakistan
Dr Butt
Assistant Professor, Department of Medicine, FUSH, Pakistan