Prevalence and Risk Factors of Chronic Kidney Disease among Type 2 Diabetes Patients: A Cross-Sectional Study in Primary Care Practice

Janjira Jitraknatee,Chidchanok Ruengorn,Surapon Nochaiwong

doi:10.1038/s41598-020-63443-4

Janjira Jitraknatee, Chidchanok Ruengorn + Show 1 more

Open Access

https://doi.org/10.1038/s41598-020-63443-4

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Abstract

This cross-sectional study aimed to investigate the prevalence and risk factors of chronic kidney disease (CKD) among 1,096 primary care type 2 diabetes (T2DM) patients in northern Thailand between October 2016 and September 2017. CKD was defined as estimated glomerular rate filtration values of <60 mL/min/1.73 m2. Prevalence with confidence intervals across CKD advanced stages 3–5 were estimated. Factors associated with CKD were evaluated by multivariate logistic regression. The overall prevalence of CKD was 24.4% (21.9–27.0), with severities of 11.4% (9.7–13.4), 6.8% (5.5–8.5), 4.6% (3.5–6.0), and 1.6% (1.0–2.5) for stages 3 A, 3B, 4, and 5, respectively. Regarding age and glycaemic control, individuals older than 75 years and those with a haemoglobin A1c ≥ 8% had the highest prevalence of 61.3% (51.7–70.1) and 38.6% (34.3–43.2), respectively. The multivariable logistic regression model explained 87.3% of the probability of CKD. The six independent significant risk factors of CKD were older age, retinopathy, albuminuria, haemoglobin A1c ≥ 7%, anaemia, and uric acid>7.5 mg/dL. A relatively high prevalence of CKD, especially in older patients and those with diabetic complications-related to poor glycaemic control, was encountered in this primary care practice. Early identification may help to target optimise care and prevention programs for CKD among T2DM patients.

Highlights

Www.nature.com/scientificreports compared to those in developed countries[13]
As renal replacement therapy (RRT) for ESKD treatment is not always available to chronic kidney disease (CKD) patients in LMICs owing to the limit of healthcare resources[21], the routine surveillance for and identification of T2DM patients who are at high risk of CKD is urgently needed to decrease healthcare burden and costs
This study examined the burden of CKD in adult T2DM patients in a suburban community in Thailand

Summary

Introduction

Www.nature.com/scientificreports compared to those in developed countries[13]. As the global burden of diabetes increases dramatically due to T2DM1,14,15, the annual growth rate of diabetes-related CKD is expected to rise as well, in LMICs. The aetiology of CKD among T2DM patients in LMICs are multifactorial and affected by the burden of both non-communicable and communicable diseases compared with high-income countries. It is critical to identify risk factors of diabetes-related CKD for its prevention, detection, and treatment to alleviate the rising burden of ESKD worldwide. To address this knowledge gap, this cross-sectional study investigated the prevalence and risk factors of CKD among T2DM patients in a primary care setting within a suburban community in northern Thailand

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