Skip to main content

Prevalence of diabetic kidney disease in patients with type 2 diabetes mellitus

Abstract

Introduction

The increased prevalence of diabetes has led to an increase in its vascular complications such as coronary heart disease, stroke, diabetic nephropathy (DN), and end-stage renal disease. The growing epidemic of type 2 diabetes led to increased incidence of DN. DN is characterized by proteinuria.

Objective

The aim of the study was to estimate the prevalence of diabetic kidney disease in patients with type 2 diabetes mellitus.

Patients an methods

This study included 151 patients with type 2 diabetes mellitus. After fulfilling the inclusion and exclusion criteria, all patients were submitted to these investigations: complete blood count, fasting blood glucose, and glycosylated hemoglobin, blood urea, serum creatinine, serum uric acid, calculation of estimated glomerular filtration rate using modification of diet in renal disease equation, lipid profile, serum albumin, urine analysis, and urinary albumin creatinine ratio.

Results

Of the patients, 60.3% have normoalbuminuria, 31.8% have microalbuminuria, and 7.9% have macroalbuminuria. Regarding glomerular filtration rate grades, 25.8% of the patients are of G1, 31.8% G2, 16.6% G3a, 16.6% G3b, 6.6% G4, and 2.6% are of G5. There is a significant increase in grading in patients with macroalbuminuria; also, most normoalbuminuric patients are G1 and G2. Of the studied patients, 53.6% are at low risk of chronic kidney disease progression, 9.9% are at moderate risk, and 36.4% are at high risk.

Conclusion

The prevalence of DN is increasing, partly due to the growing epidemic of type 2 diabetes so we have to detect it as early as possible to apply the proper measures to prevent or delay its progression.

References

  1. Gaballa M, Farag MK. Predictors of diabetic nephropathy. Eur J Med 2013; 8:287–296.

    CAS  Google Scholar 

  2. Lopez-Parra V, Mallavia B, Egido J, Gomez-Guerrero C. Immunoinflammation in diabetic nephropathy: molecular mechanisms and therapeutic options. In: Chan JSD ed. Diabetic nephropathy. IIS-Fundacion Jimenez Diaz, Autonoma University, Madrid; Spain: InTech; 2012. 127–146

  3. Lei L, Mao Y, Meng D, Zhang X, Cui L, Huo Y, Wang Y. Percentage of circulating CD8+ T lymphocytes is associated with albuminuria in type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 2014; 122: 27–30.

    CAS  PubMed  Google Scholar 

  4. Odegaard JI, Chawla A. Connecting type 1 and type 2 diabetes through innate immunity. Cold Spring Harb Perspect Med 2012; 2:a007724.

    Article  Google Scholar 

  5. Rosolowsky ET, Skupien J, Smiles AM, Niewczas M, Roshan B, Stanton R, et al. Risk for ESRD in type 1 diabetes remains high despite renoprotection. J Am Soc Nephrol 2011; 22:545–553.

    Article  CAS  Google Scholar 

  6. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130:461–470.

    CAS  Google Scholar 

  7. Kidney Disease: Improving Global Outcomes (KDIGO). CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl 2013; 3:1–150.

    Google Scholar 

  8. Aldukhayel A. Prevalence of diabetic nephropathy among type 2 diabetic patients in some of the Arab countries. Int J Health Sci 2017; 11:60–63.

    Google Scholar 

  9. Ogurtsova K, da Rocha Fernandes JD, Huang Y, Linnenkamp U, Guariguata L, Cho NH, et al. IDF diabetes atlas: global estimates for the prevalence of diabetes for2015 and 2040. Diabetes Res Clin Pract 2017; 128:40–50.

    Article  CAS  Google Scholar 

  10. Parving HH, Gall MA, Skøtt P, Jørgensen HE, Løkkegaard H, Jørgensen F, et al. Prevalence and causes of albuminuria in non-insulin-dependent diabetic patients. Kidney Int 1992; 41:758–762.

    Article  CAS  Google Scholar 

  11. Campbell RC, Ruggenenti P, Remuzzi G. Proteinuria in diabetic nephropathy: treatment and evolution. Curr Diab Rep 2003; 3:497–504.

    Article  Google Scholar 

  12. Farahat TM, Elsaeed GK, Gazareen SS, Elsayed TI. Prevalence of proteinuria among type 2 diabetic patients in Menoufia governorate, Egypt. Menoufia Med J 2014; 27:363.

    Article  Google Scholar 

  13. Al-Salman RA, Al-Basri HA, Al-Sayyad AS, Hearnshaw HM. Prevalence and risk factors of albuminuria in type 2 diabetes in Bahrain. J Endocrinol Invest 2009; 32:746–751.

    Article  CAS  Google Scholar 

  14. Shebl M, Atteia M. High prevalence of microalbuminuria (MA) in type 2 diabetic patients. Health Care 2008; 21:221–232.

    Google Scholar 

  15. Al-Adsani A. Risk factors associated with albuminuria in Kuwaiti adults with type 2 diabetes. Saudi J Kidney Dis Transplant 2012; 23:860.

    Article  Google Scholar 

  16. Rahamtalla FA, Elagib AA, Mahdi A, Ahmed SM. Prevalence of microalbuminuria among Sudanese type 2 diabetic patients at Elmusbah center at Ombadda-Omdurman. IOSR J Pharm 2012; 2:51–55.

    Google Scholar 

  17. Afifa K, Asma SB, Nabil H, Ahlem B, Mounira S, Kawthar Y, et al. Screening for nephropathy in diabetes mellitus: Is micral-test valid among all diabetics? Int J Chronic Dis 2016; 2016:2910627.

    PubMed  PubMed Central  Google Scholar 

  18. Afkhami-Ardekani M, Modarresi M, Amirchaghmaghi E. Prevalence of microalbuminuria and its risk factors in type 2 diabetic patients. Indian J Nephrol 2008; 18:112.

    Article  CAS  Google Scholar 

  19. Ahmedani MY, Hydrie MZ, Iqbal A, Gul A, Mirza WB, Basit A. Prevalence of microalbuminuria in type 2 diabetic patients in Karachi: Pakistan: a multi-center study. J Pak Med Assoc 2005; 55:382–386.

    PubMed  Google Scholar 

  20. Wu AY, Kong NC, De Leon FA, Pan CY, Tai TY, Yeung VT, et al. An alarmingly high prevalence of diabetic nephropathy in Asian type 2 diabetic patients: the microalbuminuria prevalence (MAP) study. Diabetologia 2005; 48:17–26.

    Article  CAS  Google Scholar 

  21. Molnár M, Wittmann I, Nagy J. Prevalence, course and risk factors of diabetic nephropathy in type-2 diabetes mellitus. Med Sci Monit 2000; 6:929–936.

    PubMed  Google Scholar 

  22. Bruno G, Cavallo-Perin P, Bargero G, Borra M, Calvi V, D’Errico N, et al. Prevalence and risk factors for micro-and macroalbuminuria in an Italian population-based cohort of NIDDM subjects. Diabetes Care 1996; 19:43–47.

    Article  CAS  Google Scholar 

  23. Svensson M, Sundkvist G, Arnqvist HJ, Björk E, Blohmé G, Bolinder J, et al. Signs of nephropathy may occur early in young adults with diabetes despite modern diabetes management results from the nationwide population-based diabetes incidence study in Sweden (DISS). Diabetes Care 2003; 26:2903–2909.

    Article  Google Scholar 

  24. Meisinger C, Heier M, Landgraf R, Happich M, Wichmann HE, Piehlmeier W. Albuminuria, cardiovascular risk factors and disease management in subjects with type 2 diabetes: a cross sectional study. BMC Health Ser Res 2008; 8:1.

    Article  Google Scholar 

  25. Rodriguez-Poncelas A, Pepió JM, Roura P, Benito B, Franch-Nadal J, Saez M. Chronic kidney disease in the type 2 diabetic patients: prevalence and associated variables in a random sample of 2642 patients of a Mediterranean area. BMC Nephrol 2012; 13:87.

    Article  Google Scholar 

  26. Zhou J, Liu C, Shan P, Zhou Y, Xu E, Ji Y. Prevalence and distinguishing features of masked hypertension in type 2 diabetic patients. J Diabetes Complications 2013; 27:82–86.

    Article  Google Scholar 

  27. Hall JE, Henegar JR, Dwyer TM, Liu J, Da Silva AA, Kuo JJ. Is obesity a major cause of chronic kidney disease?. Adv Ren Replace Ther 2004; 11:41–54.

    Article  Google Scholar 

  28. Kempen JH, O’Colmain BJ, Leske MC, Haffner SM, Klein R, Moss SE, et al. Eye Diseases Prevalence Research Group. The prevalence of diabetic retinopathy among adults in the United States. Arch Ophthalmol 2004; 122:552–563.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Khaled A. Elhefnawy MD.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elhefnawy, K.A., Elsayed, A.M. Prevalence of diabetic kidney disease in patients with type 2 diabetes mellitus. Egypt J Intern Med 31, 149–154 (2019). https://doi.org/10.4103/ejim.ejim_113_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejim.ejim_113_18

Keywords