Association Between Duration of Diabetes Mellitus and Chronic Kidney Disease Staging Among Type II Diabetes Mellitus Patients in Padang Terap, Kedah, Malaysia

Abstract

Background: Chronic kidney disease (CKD) is a global health burden with a high economic cost to health systems and diabetes mellitus (DM) is one of the significant predictors to the development of CKD. The study aimed to determine the association between the duration of DM and CKD staging among T2DM patients. Methods: A cross-sectional study was conducted using secondary data from the National Diabetes Registry’s (NDR) audited patients for the year of 2018 to 2020 at Padang Terap, Kedah. The eGFR was calculated from serum creatinine value and classified into six categories based on the KDIGO classification. Multinominal logistic regression analysis was used to determine the association. Results: A total of 963 patients were included in the study. The prevalence of CKD was 38.6%. The majority of T2DM patients were elderly Malay females. The prevalence of stage 1 was 6.95%, stage 2 was 5.4%, stage 3a was 12.35%, stage 3b was 8.10%, stage 4 was 3.86% and stage 5 was 1.93%. In the multivariable analysis, in model 1 (unadjusted) the p-value showed a significant association between duration of DM and CKD staging. By adjusting with other blocks of variables (Model 2 to Model 6) were also found to be in a significant association (p<0.05). Conclusion: It is concluded that there was an association between the duration of DM and CKD staging. Early detection of CKD and glycemic control are essential to delay the onset of diabetic kidney disease. Diabetes control should be optimized to reduce diabetes-related complications and minimize adverse events.