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

2017 ◽  
Vol 11 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Palash Mitra ◽  
Hasna Fahmima Haque ◽  
Tasrina Shamnaz Samdani ◽  
Shahana Zaman ◽  
...  

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

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 177
Author(s):  
Wojciech Matuszewski ◽  
Magdalena M. Stefanowicz-Rutkowska ◽  
Magdalena Szychlińska ◽  
Elżbieta Bandurska-Stankiewicz

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.


Author(s):  
Samrat Mitra ◽  
Sanghita Barui

Background: The adequacy of haemodialysis in patients of type 2 diabetes mellitus with chronic kidney disease stage 5 depends on several clinical as well as laboratory parameters. Previous studies from Western literature have identified several clinical and laboratory markers for predicting adequacy of dialysis. There is a dearth of literature regarding the same in Indian patient populace. Authors aimed to find correlation, if any, between glycemic control and adequacy of dialysis in this cohort of patients.Methods: A set of 200 patients of type 2 diabetes mellitus who have undergone hemodialysis at a tertiary care hospital were included in the study. Random blood sugar (RBS), Glycated hemoglobin (HbA1c) were measured at admission. After 4 hours of dialysis, the urea reduction ratio (URR) and Kt/V was measured for each patient. The correlation coefficient as well as linear equation of the association between these variables were calculated. Standard statistical method and software were used in the process.Results: The study revealed a linear negative correlation between the variables RBS, HbA1c and URR as well as Kt/V. This suggests the importance of pre dialysis glycemic control in patients undergoing hemodialysis.Conclusions: Authors formulate the hypothesis that glycated hemoglobin and random blood sugar at admission correlate well with the outcome and adequacy of dialysis in patients of stage 5 chronic kidney disease undergoing haemodialysis.  Good glycemic control (HbA1c <6.5 % and RBS <120 mg/dL) have shown to be important predictive markers of adequate dialysis. The hypothesis needs to be tested with a larger study.


2021 ◽  
Vol 68 (2) ◽  
pp. 188-193
Author(s):  
Adriana Baidog ◽  
◽  
Cosmin Vesa ◽  
Ioana Ratiu ◽  
Monica Sabau ◽  
...  

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.


Author(s):  
Sajith Kumar Soman ◽  
Binu Areekal ◽  
Rosin George Varghese ◽  
Susan John ◽  
Radhika S. Gopan ◽  
...  

Background: Diabetes mellitus (DM) is one of the most common metabolic diseases characterized by increased blood glucose levels either due to insufficiency/absence of insulin or due to decrease in the insulin sensitivity. The prevalence of chronic kidney disease (CKD) in people with type 2 diabetes is three times higher than in non-diabetic population and majority of people developing end-stage renal diseases (ESRD) have Type 2 DM. The objectives of the study were to find out the prevalence of CKD, mean GFR and associated factors of CKD, in diabetics coming to a primary health care setting in Central Kerala.Methods: A cross-sectional study among all patients attending the NCD clinic of Health Centre, Ettumanoor with confirmed diagnosis of type 2 diabetes mellitus was done between February 2017 and April 2017.Results: The prevalence of CKD among the study population was 45.3%. The proportion of CKD was 34.9% among those with nil urinary protein, 57.1% among those with 1+ urinary protein, 88.9% for those with 2+ and 87.5% among those with 3+ urinary protein. Among those with CKD mean duration of diabetes was 121.92 months against 92.72 months among those without CKD. There was statistically significant difference between RBS values of those with CKD and without CKD (238.49 mg% versus 199.41 mg%). The proportion of CKD was found increase with duration of diabetes 5 years (31.2%), 5-10 years (47.8%), 10-15 years (52.6%) and >15 years (55%).Conclusions: The study showed high prevalence of CKD among diabetics. The duration of diabetes, urinary protein levels and RBS value were found to have strong association with CKD in diabetics.


2019 ◽  
Vol 41 (10) ◽  
pp. 2008-2020.e3 ◽  
Author(s):  
Carolina C. Betônico ◽  
Silvia Maria O. Titan ◽  
Aécio Lira ◽  
Tatiana S. Pelaes ◽  
Maria Lúcia C. Correa-Giannella ◽  
...  

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