Inter-relationship of risk factors and pathways associated with chronic kidney disease in patients with type 2 diabetes mellitus: a structural equation modelling analysis

Background and Objective: Nowadays, diabetes is one of the main causes of blindness in the world. Identification and differentiation of risk factors for diabetic retinopathy depending on the type of diabetes gives us the opportunity to fight and prevent this complication. Aim of the research: To assess differences in the risk factors for diabetic retinopathy in type 1 and type 2 diabetes mellitus patients in Warmia and Mazury Region, Poland. Materials and Methods: Risk factors for diabetic retinopathy (DR) were assessed on the basis of an original questionnaire, which included: personal data, clinical history of diabetes and eye disease. Elements of clinical examination: blood pressure, BMI, waist circumference. Indicators of diabetes metabolic control: mean glycemia, glycated hemoglobin (HbA1c), total cholesterol and triglycerides, creatinine, glomerular filtration rate (GFR), albumin–creatinine ratio in urine. Results: The study group included 315 (26%) patients with DM1 and 894 (74%) patients with DM2. Risk factors were estimated on the basis of logistic regression and verified with Student’s t-test. Statistically significant dependencies were found in both groups between the occurrence of diabetic retinopathy and diabetes duration, HbA1c, triglyceride concentrations, indicators of kidney function and cigarette smoking status. In the DM2 group, the development of DR was significantly influenced by the implemented models of diabetic treatment. Conclusions: In the whole study group, the risk of DR was associated with the duration of diabetes, HbA1c, triglyceride concentrations and smoking. In DM1 patients, the risk of DR was associated with diabetic kidney disease in the G1A1/A2 stage of chronic kidney disease, and in DM2 patients with the G2 stage of chronic kidney disease. An important risk factor for DR in DM2 patients was associated with late introduction of insulin therapy.

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Prevalence of chronic kidney disease stages 3-5 among patients with type 2 diabetes mellitus in Bangladesh

IMC Journal of Medical Science ◽

10.3329/imcjms.v11i1.31934 ◽

2017 ◽

Vol 11 (1) ◽

pp. 19-24 ◽

Cited By ~ 1

Author(s):

Muhammad Abdur Rahim ◽

Palash Mitra ◽

Hasna Fahmima Haque ◽

Tasrina Shamnaz Samdani ◽

Shahana Zaman ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Kidney Disease ◽

Glycemic Control ◽

Significant Risk ◽

Duration Of Diabetes

Background and objectives: Diabetes mellitus is one of the most common causes of chronic kidney disease (CKD). The prevalence of CKD in type 2 diabetes mellitus (T2DM) in Bangladesh is not well described. The present study aimed to find out the prevalence of CKD stages 3-5 and its risk factors among selected Bangladeshi T2DM patients.Methods: This cross-sectional study was conducted in BIRDEM (Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital, Dhaka, Bangladesh from July to December 2015. Diagnosed adult T2DM patients were consecutively and purposively included in this study. Pregnant women, patients with diagnosed kidney disease due to non-diabetic etiology, acute kidney injury (AKI), AKI on CKD and patients on renal replacement therapy were excluded. Age, gender, body mass index (BMI) and laboratory parameters were recorded systematically in a predesigned data sheet. Diagnosis of CKD and its stages were determined according to Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guidelines 2012 and estimated glomerular filtration rate (eGFR). Estimated GFR was calculated by using Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault (CG) and Chronic Kidney Disease Epidemiology (CKDEPI) creatinine based formula.Results: A total of 400 patients with T2DM of various durations were enrolled in the study. Out of 400 patients, 254 (63.5%), 259 (64.75%) and 218 (54.5%) cases had CKD stages 3-5 according to MDRD, C-G and CKD-EPI equations respectively. CKD was significantly more common in females (p<0.001) and in cases with long duration of diabetes (?5 years; p=0.007). CKD stages 3-5 were significantly associated with hypertension (?2=5.2125, p =0.02) and good control of diabetes (HbA1c <7%) as evidenced by higher proportion of CKD in them (73.3%) compared to those with poor glycemic control (52.1%).Conclusions: More than half of T2DM patients had CKD stages 3-5. Female gender, duration of diabetes and hypertension were significant risk factors and should be emphasized for the prevention of CKD in T2DM. Glycemic control may not reduce CKD in diabetes.IMC J Med Sci 2017; 11(1): 19-24

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Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry

Nutrition Journal ◽

10.1186/1475-2891-12-159 ◽

2013 ◽

Vol 12 (1) ◽

Cited By ~ 65

Author(s):

Hiroki Fujii ◽

Masanori Iwase ◽

Toshiaki Ohkuma ◽

Shinako Ogata-Kaizu ◽

Hitoshi Ide ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Japanese Patients ◽

Fiber Intake ◽

Diabetes Registry ◽

Dietary Fiber Intake

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OBSERVATIONAL STUDY REGARDING RISK FACTORS AND COMORBITITES FOR CHRONIC KIDNEY DISEASE IN DIABETES MELLITUS PATIENTS FROM BIHOR COUNTY

Romanian Medical Journal ◽

10.37897/rmj.2021.2.10 ◽

2021 ◽

Vol 68 (2) ◽

pp. 188-193

Author(s):

Adriana Baidog ◽

◽

Cosmin Vesa ◽

Ioana Ratiu ◽

Monica Sabau ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Kidney Disease ◽

Observational Study ◽

Past History ◽

Diabetic Polyneuropathy

Introduction. Chronic kidney disease is a common comorbidity in diabetes mellitus type 2 patients because of presence of numerous risk factors such as obesity, hypertension, hyperglycemia and dyslipidemia. Material and methods. Our retrospective, observational study included 300 patients with type 2 diabetes mellitus from Bihor County and had the purpose to establish a clinical profile and to determine the risk factors associated with this pathology. Results. The prevalence of CKD was 75.67%. Older age, worse glucose control, presence of diabetic polyneuropathy and diabetic retinopathy, higher weight, past history of cardiovascular events, the presence of metabolic syndrome and hyperuricemia were associated with the presence of CKD. Conclusion. The clinical characteristics of type 2 diabetes mellitus patients with CKD is significantly worse compared with the population without CKD.

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PROGRESSING CHRONIC KIDNEY DISEASE AND THE 12-MONTH DYNAMICS OF CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS

CARDIOVASCULAR THERAPY AND PREVENTION ◽

10.15829/1728-8800-2013-5-16-21 ◽

2013 ◽

Vol 12 (5) ◽

pp. 16-21

Author(s):

A. V. Markova ◽

Yu. G. Schwartz

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Chronic Kidney Disease ◽

Type 2 Diabetes Mellitus ◽

Renal Function ◽

Cardiovascular Risk ◽

Medical History ◽

Ckd Stage

Aim. To assess the association between the 12-month dynamics of cardiovascular risk factors (CVD RFs), progressing chronic kidney disease (CKD), and individual baseline clinical and laboratory parameters in patients with arterial hypertension (AH) and Type 2 diabetes mellitus (DM-2) who received active antidiabetic treatment.Material and methods. In total, 122 patients with AH and DM-2 underwent the laboratory assessment of blood and urine samples at baseline and 12 months later, in order to evaluate the levels and dynamics of CVD RFs and CKD severity.Results. After 12 months of continuous therapy with antihypertensive and oral antidiabetic medications and statins, the carbohydrate metabolism parameters significantly improved. However, creatinine clearance decreased significantly (by 7,52%). The direction of renal function parameter changes was determined by the baseline CKD stage. Progressing CKD was also associated with obesity (O), atrial fibrillation (AF), and myocardial infarction (MI) in medical history. In patients with or without O, the albumin-creatinine ratio decreased by 59,8% and 34%, respectively. In participants with or without AF, microalbuminuria increased by 321% and decreased by 53,5%, respectively. In patients with MI in medical history, urine levels of creatinine decreased by 33,6%, while in the other patients, they increased by 5,4%. O was associated with a reduction in total cholesterol (TCH) by 5,5%, while in non-obese patients, TCH levels did not change substantially.Conclusion. In most patients with AH and DM-2, adequate glycemia control, standard antihypertensive treatment, and statin therapy for 12 months were associated with minimal changes in CVD RFs and with a significant deterioration in renal function. The latter was predicted by the CKD stage at baseline, O, MI in medical history, and AF.

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