Prevalence and Associated Factors of Diabetic Kidney Disease in Senegalese Patients: A Cross-Sectional Study in Saint-Louis

Abstract

Introduction: Diabetes is a leading cause of chronic kidney disease in the world. During the next decade, its burden is expected to increase in Africa with potential complications such as chronic kidney disease. However, epidemiology and risk factors of diabetic kidney disease are poorly described at population level. This study aimed to determine prevalence of diabetic kidney disease (DKD) in adult diabetics living in Saint-Louis, northern Senegal. Methods: A cross-sectional study including diabetic patients followed-up aged ≥18 years during a five-year period (2013-2018) in Saint-Louis. Clinical and biological parameters were collected during annual community-based mass screening. Diabetes was defined as fasting blood glucose ≥ 1.26 g/L confirmed by a second lab dosage. DKD was defined as persistence of albuminuria ≥ 30 mg/24h and/or estimated glomerular filtration rate (eGFR) 2. Data were analyzed with Stata 12.0. Results: We included a total of 1310 diabetic patients among whom 3.7% (95% CI = 1.4% - 9.8%) presented DKD. Their mean age was 46.2 ± 11.8 years and sex-ratio was 0.7. Micro-albuminuria and macro-albuminuria were present respectively in 59.2% and 18.4% of patients with DKD and half of them had a normal eGFR. Before the survey 89.8% of patients with DKD were not aware of their renal disease and only four of them had seen a nephrologist. After multivariate analysis, age (OR = 1.5; 95% CI = 1.1 - 3.4), duration of diabetes (OR = 1.2; 95% CI = 1.6 - 4.4) and hypertension (OR = 2.5; 95% CI = 1.4 - 4.6) were associated with the presence of DKD in diabetic patients while no significant association was not found with gender, blood glucose level, smoking and familial history. Conclusion: DKD is a frequent complication in diabetic adult population living in Saint-Louis. Early detection and management should be promoted in order to prevent progression to end-stage renal disease.