MO623: Risk Factors of Diabetic Nephropathy Among Newly Detected Type 2 Diabetic Subjects: Preliminary Report from A Tertiary Care Hospital of Bangladesh

Abstract

Abstract BACKGROUND AND AIMS Patients with type 2 diabetes mellitus may present with different macro- and micro-vascular complications including diabetic nephropathy. This preliminary study was designed to evaluate the risk factors for diabetic nephropathy among type 2 diabetic patients at the time of diabetes diagnosis. METHOD A case-control study was done at a tertiary care hospital in Dhaka, Bangladesh from January to September 2017. Adult (≥18 years), type 2 diabetic patients, who were detected as diabetic for the first time within the previous 3 months and who tested, at least, two urine samples for urine albumin-to-creatinine ratio (UACR), at least 6 weeks apart, within a 6-month period, were consecutively enrolled for the study. Pregnant ladies, patients with diagnosed kidney disease, patients having features of glomerulonephritis and systemic diseases including systemic lupus erythematosus and vasculitis, history of recent fever, urinary tract infection and menstruation were excluded. Patients having UACR ≥30 mg/g in at least two (out of 3, if tested) samples were taken as cases and those with UACR <30 mg/g were taken as controls. Data were analyzed by statistical package for social sciences (SPSS) version 20. RESULTS Total patients were 224 with female predominance (150, 67%). Fifty one (22.8%) patients had diabetic nephropathy (microalbuminuria = 47 and overt proteinuria = 4). Multivariate regression analysis revealed that hypertension {odds ratio (OR) = 3.71 [95% confidence interval (CI) 1.23–4.31], P = 0.003}, smoking [OR = 3.27 (95% CI 2.91–4.79), P = 0.003], family history of diabetes [OR = 2.31 (95% CI 1.84–3.14), P = 0.005] and diabetic nephropathy [OR = 3.34 (95% CI 2.40–4.97), P = 0.001], dyslipidaemia [OR = 2.31 (95% CI 1.98–3.91), P = 0.023], increased body mass index (BMI) [OR = 2.11 (95% CI 1.54–4.87), P = 0.001] and high glycated haemoglobin (HbA1c) [OR 3.21 (95% CI 1.71–5.97), P = 0.034] were significant risk factors for diabetic nephropathy. CONCLUSION Almost 23% of type 2 diabetic patients had diabetic nephropathy during diabetes diagnosis in this study and most patients had microalbuminuria. Presence of hypertension, dyslipidaemia, smoking, family history of diabetes and diabetic nephropathy, increased BMI and high HbA1c were significant risk factors for diabetic nephropathy among patients with type 2 diabetes at diagnosis.