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.
Highlights
Diabetic nephropathy (DN) is one of the most common microvascular complications of diabetes and a leading cause of morbidity and mortality in diabetic patients [1, 2]. is condition is a result of vascular abnormalities that accompany diabetes and increases mortality risk [3]
Several studies in Ethiopia have shown that the presence and severity of complications related to diabetic nephropathy like end-stage renal disease (ESRD) are steadily increasing, and these are the causes of premature death, disability, and negative economic impact [6, 16,17,18]
We found that coronary heart disease (CHD) is a risk factor for diabetic nephropathy. e finding is in agreement with a previous study [35] which shows that the cell adhesion molecules are raised in both cardiovascular disease and diabetic nephropathy, with levels increasing in stepwise fashion with increasing kidney disease. e possible justification could be that coronary artery stenosis increased renal oxidative stress, fibrosis, inflammation, tubular injury, and microvasculature remodelling [36]. is finding is inconsistent with the study performed in Spain [37]. is is unclear and needs further investigation
Summary
Diabetic nephropathy (DN) is one of the most common microvascular complications of diabetes and a leading cause of morbidity and mortality in diabetic patients [1, 2]. is condition is a result of vascular abnormalities that accompany diabetes and increases mortality risk [3]. E increasing prevalence of the diabetes mellitus is linked with the emergence of diabetes complication as a cause of premature death and disability. It is associated with a negative economic impact for many countries [6, 16, 17]. Several studies in Ethiopia have shown that the presence and severity of complications related to diabetic nephropathy like ESRD are steadily increasing, and these are the causes of premature death, disability, and negative economic impact [6, 16,17,18]. Estimating the incidence of DN and early detection of the risk factors is important for the prevention of DN. us, we determined the incidence and predictors of diabetic nephropathy among type 2 diabetes patients
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