Incidence of Diabetic Nephropathy and Its Predictors among Type 2 Diabetes Mellitus Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.
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引用次数: 10
Abstract
Background: Although the rate of diabetic nephropathy which is the leading cause of end-stage renal disease (ESRD) continues to rise, there is limited information about the problem. This study aimed to assess the incidence and predictors of diabetic nephropathy among type 2 DM patients.
Methods: Institution-based retrospective follow-up study was conducted at UGCSH with 462 newly diagnosed type 2 DM patients from January 2001 to February 2016, and the data were collected by reviewing their records. The Schoenfeld residuals test was used to check proportional hazard assumption. The best model was selected by using Akaike information criteria (AIC). Hazard ratios (HR) with its respective 95% confidence interval were reported to show significance and strength of association.
Results: The incidence rate of diabetic nephropathy was 14 (95% CI 10.8-17.7) cases per 10,000 patient-month observation. In addition, 63 (13.6%) DM patients developed diabetic nephropathy. The median time to develop diabetic nephropathy was 94.9 months with interquartile range (IOR) of (64.1-127.4) months. Type 2 DM patients who had coronary heart disease (AHR = 2.69, 95% CI 1.42-5.13) and anemia (AHR = 1.94, 95% CI 0.97-3.87) were at higher hazard for developing diabetic nephropathy. Besides this, having a long duration (>10 years) (AHR = 0.24, 95% CI 0.11-0.56) and being female (AHR = 0.44, 95% CI 0.26-0.73) was found to be protective against diabetic nephropathy.
Conclusion: The incidence of diabetic nephropathy among type 2 diabetes patients remains a significant public health problem. Duration of diabetes >10 years and female sex reduced the risk of diabetic nephropathy. Coronary heart disease and anemia increased the risk of diabetic nephropathy among type 2 DM patients. In light of these findings, early screening for diabetes complication is needed, and health professionals should give targeted intervention for type 2 DM patients with coronary heart disease comorbidity and anemia.
背景:糖尿病肾病是终末期肾病(ESRD)的主要病因，尽管糖尿病肾病的发病率持续上升，但有关该问题的信息有限。本研究旨在评估2型糖尿病患者糖尿病肾病的发病率和预测因素。方法:对2001年1月至2016年2月在UGCSH新诊断的462例2型糖尿病患者进行基于机构的回顾性随访研究，通过查阅病历收集资料。采用舍恩菲尔德残差检验检验比例风险假设。采用赤池信息准则(Akaike information criteria, AIC)筛选最佳模型。风险比(HR)及其各自的95%置信区间显示了相关性的显著性和强度。结果:糖尿病肾病的发生率为14例(95% CI 10.8-17.7) /万患者-月观察。此外，63例(13.6%)DM患者发生糖尿病肾病。发生糖尿病肾病的中位时间为94.9个月，四分位数间距(IOR)为64.1-127.4个月。合并冠心病(AHR = 2.69, 95% CI 1.42-5.13)和贫血(AHR = 1.94, 95% CI 0.97-3.87)的2型糖尿病患者发生糖尿病肾病的风险较高。此外，病程长(>10年)(AHR = 0.24, 95% CI 0.11-0.56)和女性(AHR = 0.44, 95% CI 0.26-0.73)对糖尿病肾病有保护作用。结论:2型糖尿病患者糖尿病肾病的发病率仍然是一个重大的公共卫生问题。糖尿病病程>10年和女性降低糖尿病肾病的风险。冠心病和贫血增加了2型糖尿病患者发生糖尿病肾病的风险。鉴于这些发现，需要对糖尿病并发症进行早期筛查，卫生专业人员应该对伴有冠心病合并症和贫血的2型糖尿病患者进行有针对性的干预。
期刊介绍：
Journal of Nutrition and Metabolism is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies covering the broad and multidisciplinary field of human nutrition and metabolism. The journal welcomes submissions on studies related to obesity, diabetes, metabolic syndrome, molecular and cellular biology of nutrients, foods and dietary supplements, as well as macro- and micronutrients including vitamins and minerals.
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