Abstract

BackgroundChronic kidney disease (CKD) is the known cause of morbidity and mortality among diabetes mellitus (DM) patients. Targeted screening of renal impairment based on estimated glomerular filtration rate (eGFR) among DM patients has potential benefits in early identification and treatment of CKD. Hence, this study was aimed to estimate the magnitude of renal impairment using eGFR among type 2 DM patients.MethodsAn institution-based cross-sectional study was conducted from February-1 to April 30/2020 among 422 type 2 DM patients in Northeast Ethiopia. Data were collected by the semi-structured questioner and serum creatinine measurement. The collected data were edited into Epi-data manager version 4.4.1.0, and the analysis was performed by SPSS-25. The Simplified Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI), and Cockcroft-Gault (C-G) equations were used to calculate eGFR.ResultsOf all study participants, 82(19.4%), 92(21.8%), and 103(24.4%) had eGFR < 60 ml/min/1.73 m2, according to the MDRD, CKD-EPI, and C-G equations, respectively. Female sex, (MDRD:AOR = 4.44, 95%CI:1.97–9.97, CKD-EPI:AOR = 3.17, 95%CI:1.27–6.17, and C-G:AOR = 2.65, 95%CI:1.35–5.21), duration ≥ 10 years (MDRD:AOR = 3.38, 95%CI:1.45–7.92, CKD-EPI:AOR = 3.09, 95%CI:1.07–7.77, and C-G:AOR = 2.92, 95%CI:1.29–6.61), age ˃60 years (MDRD:AOR = 2.29, 95%CI:1.09–4.77, CKD-EPI:AOR = 4.12, 95%CI:1.68–6.78, and C-G: AOR = 3.42, 95%CI:1.77–6.60), hypertension (MDRD:AOR = 3.12, 95%CI:1.51–6.45, CKD-EPI: AOR = 4.21,95%CI:2.07–7.98, and C-G:AOR = 3.99, 95%CI:2.08–7.65), poor glycemic control (MDRD:AOR = 2.82, 95%CI:1.13–7.05, and C-G:AOR = 2.34, 95%CI:1.09–5.04), and body mass index (MDRD:AOR = 1.11, 95%CI:1.01–1.22, and CKD-EPI:AOR = 2.43, 95%CI:1.27–5.76) were significantly associated with renal impairment.ConclusionRenal impairment was prevalent among type 2 DM patients. Older age, female sex, duration, hypertension, poor glycemic control, and BMI were significantly associated with renal impairment.

Highlights

  • Chronic kidney disease (CKD) is the known cause of morbidity and mortality among diabetes mellitus (DM) patients

  • Female sex, (MDRD:AOR = 4.44, 95%confidence interval (CI):1.97–9.97, Chronic Kidney Disease Epidemiology (CKD-EPI):AOR = 3.17, 95%CI:1.27–6.17, and C-G:AOR = 2.65, 95%CI:1.35–5.21), duration ≥ 10 years (MDRD:AOR = 3.38, 95%CI:1.45–7.92, CKD-EPI:AOR = 3.09, 95%CI:1.07–7.77, and C-G:AOR = 2.92, 95%CI:1.29–6.61), age60 years (MDRD:AOR = 2.29, 95%CI:1.09–4.77, CKD-EPI:AOR = 4.12, 95%CI:1.68–6.78, and C-G: AOR = 3.42, 95%CI:1.77–6.60), hypertension (MDRD:AOR = 3.12, 95%CI:1.51–6.45, CKD-EPI: AOR = 4.21,95%CI:2.07–7.98, and C-G:AOR = 3.99, 95%CI:2.08–7.65), poor glycemic control (MDRD:AOR = 2.82, 95%CI:1.13–7.05, and C-G:AOR = 2.34, 95%CI:1.09–5.04), and body mass index (MDRD:AOR = 1.11, 95%CI:1.01–1.22, and CKD-EPI:AOR = 2.43, 95%CI:1.27–5.76) were significantly associated with renal impairment

  • We found that using the C-G equation estimate a higher magnitude of renal impairment (24.3%) than the Modification of Diet in Renal Disease (MDRD) and CKD-EPI equations, which estimate19.4% and 21.8%, respectively

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Summary

Introduction

Chronic kidney disease (CKD) is the known cause of morbidity and mortality among diabetes mellitus (DM) patients. Targeted screening of renal impairment based on estimated glomerular filtration rate (eGFR) among DM patients has potential benefits in early identification and treatment of CKD. This study was aimed to estimate the magnitude of renal impairment using eGFR among type 2 DM patients. The Simplified Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI), and Cockcroft-Gault (C-G) equations were used to calculate eGFR. Due to the global epidemic of type 2 DM with disproportionate effects in the developing countries, the rate of diabetic kidney disease is growing rapidly in these countries [1, 2, 10].

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