Prevalence of Diabetic Nephropathy among Patients of Type 2 Diabetes at Tertiary Care Hospital Lahore
Article Sidebar
Main Article Content
Abstract
Background: Diabetic nephropathy is a significant complication of Type 2 Diabetes Mellitus, often leading to chronic kidney disease (CKD) and potentially progressing to End-Stage Renal Disease (ESRD). Approximately 90% of individuals with diabetes and hypertension may develop ESRD in the later stages of the disease.
Objective: The study aimed to determine the prevalence of diabetic nephropathy among patients with type 2 diabetes at a tertiary care hospital in Lahore.
Methods: This retrospective study included 100 reports from the chemical pathology and microbiology laboratory at Fatima Memorial Hospital, Lahore, covering renal function tests (RFT) such as Urea, Blood Urea Nitrogen (BUN), Creatinine, and estimated Glomerular Filtration Rate (eGFR), as well as HbA1c levels and Albuminuria. Data collection involved accessing electronic medical records (EMRs) to obtain comprehensive clinical data, including patients' medical history, duration of diabetes, glycemic control measurements, blood pressure, and prescribed medications. The study included patients with type 2 diabetes and kidney disease, excluding those without renal disease. Ethical approval was obtained from the Institutional Review Board (IRB) of FMH College of Medicine and Dentistry, adhering to the principles of the Declaration of Helsinki. Data were analyzed using IBM SPSS version 25, with categorical variables expressed as frequencies and percentages and continuous variables as mean ± standard deviation (SD). Correlation analysis was conducted, with a p-value of less than 0.05 indicating statistical significance.
Results: The study included 100 participants, with 53% being male and 47% female. The mean age was 59.19 years (SD = 18.812), ranging from 18 to 91 years. Albuminuria was present in 88% of participants. Elevated serum creatinine was observed in 93%, HbA1c levels >6.4% in 68%, high urea levels in 87%, and eGFR <60 in 14%. Correlation analysis showed a significant positive correlation between HbA1c and eGFR (Spearman's rho = 0.432, p < 0.001) and between urea and serum creatinine (Spearman's rho = 0.701, p < 0.001).
Conclusion: The high prevalence of albuminuria and elevated renal function markers among individuals with type 2 diabetes underscores the importance of early detection and comprehensive management. Regular screening for urinary albumin, stringent glycemic control, and optimal blood pressure management are crucial for preventing the progression of diabetic nephropathy.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Sapra A, Bhandari P, Wilhite Hughes A. Diabetes Mellitus (Nursing). 2021.
Natesan V, Kim SJ. Diabetic Nephropathy–A Review of Risk Factors, Progression, Mechanism, and Dietary Management. Biomed Pharmacother. 2021;29(4):365.
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).
Lv JC, Zhang LX. Prevalence and Disease Burden of Chronic Kidney Disease. Ren Fail. 2019:3-15.
Esam El-Din Mostafa Amer Y, Khalil Ahmed Esa Y, El-Adl El-Adl H, Kidr AE-H. Study of Serum Ferritin and Diabetic Nephropathy in Type 2 Diabetes in Egyptians. Alexandria Med J. 2022;51(3):1637-54.
Chehade JM, Gladysz M, Mooradian AD. Dyslipidemia in Type 2 Diabetes: Prevalence, Pathophysiology, and Management. Diabetes Care. 2013;73:327-39.
Niewczas MA, Gohda T, Skupien J, Smiles AM, Walker WH, Rosetti F, et al. Circulating TNF Receptors 1 and 2 Predict ESRD in Type 2 Diabetes. J Am Soc Nephrol. 2012;23(3):507-15.
Motawi TK, Shehata NI, ElNokeety MM, El-Emady YF. Potential Serum Biomarkers for Early Detection of Diabetic Nephropathy. Diabetes Res Clin Pract. 2018;136:150-8.
Mohandes S, Doke T, Hu H, Mukhi D, Dhillon P, Susztak K. Molecular Pathways That Drive Diabetic Kidney Disease. J Clin Invest. 2023;133(4).
Hafner S, Gonzales C, Valdez R. Is Microalbuminuria Part of the Prediabetic State. Diabetologia. 1993;36:1002-6.
Kamal A, Aleem S, Kamal A, Shakeel A, Iftikhar M, Minhas K. The Risk factors of diabetic neuropathy in type 2 diabetic patient in Services Hospital Lahore. Esculapio Journal of SIMS. 2023 May 13;19(01):72-7.
Butt NI, Mahmood K, Kanwal N, Ashfaq F. Acanthosis Nigricans in Patients with Type II Diabetes Mellitus at a Tertiary Care Hospital of Lahore. Journal of Bahria University Medical and Dental College. 2023;13(01):13-7.
Nawaz S, Mushtaq R, Akhtar A. Awareness and Practices of Foot Care among Diabetic Patients: A Study at Lahore General Hospital, Lahore. Journal of Development and Social Sciences. 2024 Jan 13;5(1):278-84.
Asif MS, Khan MK, Nabeel MA, Ashfaq T, Nasir A, Abdullah RM, Kareem MA. Frequency of Gastroparesis Symptoms in Patients With Type-2 Diabetes Mellitus at a Tertiary Care Hospital in Pakistan. Cureus. 2023 Aug;15(8).
Bhatti SA, Ahmad HM, Khan MA, Babar ZU, Rafe A, Ahmad W. Incidence of Retinopathy in Newly Diagnosed Patients with Type-II Diabetes Mellitus. Pakistan Journal of Medical & Health Sciences. 2023 Feb 26;17(01):343-.
Akhtar S, Hassan F, Saqlain SR, Ali A, Hussain S. The prevalence of peripheral neuropathy among the patients with diabetes in Pakistan: a systematic review and meta-analysis. Scientific Reports. 2023 Jul 20;13(1):11744.
Yousaf Z, Anwar S, Imran F, Ahsan U, Dar YF, Jabeen K, Haider S. Frequency of Type 2 Diabetes Mellitus among Patients with Hepatitis C Virus Infection. Journal of Health and Rehabilitation Research. 2024 Mar 9;4(1):1170-4.
Butt MD, Ong SC, Rafiq A, Malik T, Sajjad A, Batool N, Chughtai AU, Wahab MU, Abdullah M, Babar ZU. An observational multi-center study on type 2 diabetes treatment prescribing pattern and patient adherence to treatment. Scientific reports. 2023 Dec 27;13(1):23037.