Incidence and predictors of diabetic kidney disease among type 2 diabetes mellitus adult patients in Ethiopia: a systematic review and meta-analysis.

IF 3.3 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Muluken Amare Wudu, Tarikua Afework Birhanu, Kirubel Dagnaw Tegegne, Endalk Birrie Wondifraw
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引用次数: 0

Abstract

Background: Diabetic kidney disease is a leading cause of end-stage renal disease and mortality among patients with type 2 diabetes mellitus worldwide. Currently, there are no pooled estimates of the incidence of diabetic kidney disease or its modifiable predictors among patients with type 2 diabetes mellitus in Ethiopia. Therefore, this review aimed to determine the pooled incidence and associated factors of diabetic kidney disease in Ethiopia, addressing the existing information gap.

Methods: Relevant studies were retrieved from PubMed, Scopus, EMBASE, and Google Scholar. Four reviewers independently screened studies, and data were extracted using a structured form. Quality assessment was conducted using the Joanna Briggs Institute critical appraisal checklist. Data analysis was performed in STATA version 17 using the Šidák-Jonkman random-effects model. Heterogeneity was evaluated using Cochrane's Q-test and the I² statistic, while publication bias was assessed using funnel plots, Egger's test, and a Doi plot.

Results: Of the 165,230 studies identified, eight studies involving 3,703 participants were included in the meta-analysis. The pooled incidence of diabetic kidney disease among patients with type 2 diabetes mellitus was 2.37 per 100 person-years (95% CI: 1.76-2.97; I² = 99.85%), based on 29,916.35 person-years of observation. Moreover, study setting and follow-up period (R²=83.21%) were considered as the source of heterogeneity. Furthermore, the pooled median time to develop diabetic kidney disease was 101.38 months (95% CI: 72.79-129.97). Factors associated with diabetic kidney disease included older age (> 60 years) (HR: 1.02, 95% CI: 1.01-1.03), hypertension (HR: 2.07, 95% CI: 1.83-2.34), cardiovascular disease (HR: 1.53, 95% CI: 1.29-1.81), and low high-density lipoprotein cholesterol (HDL-C) levels (< 40 mg/dL) (HR: 1.70, 95% CI: 1.42-2.05).

Conclusion: The incidence of diabetic kidney disease in this review was high, highlighting the need for intensified efforts to achieve the 2030 kidney health target and improve patients' quality of life. Moreover, older age, hypertension, cardiovascular disease, and low HDL-C levels were identified as risk indicators of diabetic kidney disease. This suggests strengthening early routine risk-based screening, especially in older adults, and implementing intensive management of hypertension, cardiovascular disease, and dyslipidemia to address the identified factors.

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埃塞俄比亚2型糖尿病成年患者糖尿病肾病的发病率和预测因素:一项系统回顾和荟萃分析
背景:糖尿病肾病是世界范围内2型糖尿病患者终末期肾病和死亡的主要原因。目前,尚无关于埃塞俄比亚2型糖尿病患者中糖尿病肾病发病率或其可修改预测因子的汇总估计。因此,本综述旨在确定埃塞俄比亚糖尿病肾病的总发病率和相关因素,解决现有的信息差距。方法:从PubMed、Scopus、EMBASE和谷歌Scholar中检索相关研究。四名审稿人独立筛选研究,并使用结构化表格提取数据。质量评估是使用乔安娜布里格斯研究所的关键评估清单进行的。数据分析采用STATA version 17,采用Šidák-Jonkman随机效应模型。异质性评价采用Cochrane’s q检验和I²统计量,发表偏倚评价采用漏斗图、Egger’s检验和Doi图。结果:在确认的165230项研究中,8项涉及3703名参与者的研究被纳入meta分析。2型糖尿病患者中糖尿病肾病的总发病率为2.37 / 100人-年(95% CI: 1.76-2.97;I²= 99.85%),基于29,916.35人年的观察。研究环境和随访时间(R²=83.21%)被认为是异质性的来源。此外,发展为糖尿病肾病的中位时间为101.38个月(95% CI: 72.79-129.97)。与糖尿病肾病相关的因素包括年龄较大(60岁以下)(HR: 1.02, 95% CI: 1.01-1.03)、高血压(HR: 2.07, 95% CI: 1.83-2.34)、心血管疾病(HR: 1.53, 95% CI: 1.29-1.81)、低高密度脂蛋白胆固醇(HDL-C)水平(结论:本综述中糖尿病肾病的发病率较高,强调需要加大力度实现2030年肾脏健康目标,提高患者的生活质量。此外,老年、高血压、心血管疾病和低HDL-C水平被确定为糖尿病肾病的危险指标。这建议加强早期常规的基于风险的筛查,特别是在老年人中,并实施高血压、心血管疾病和血脂异常的强化管理,以解决已确定的因素。
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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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