Incidence of Nephropathy and its Predictors among Type 2 Diabetic Patients in Iskan Primary Health Care, Jeddah, Saudi Arabia

Dr. Shroog Al-Muttairi

Joint Program Family & Community Medicine, Jeddah – 2014

Background and Objectives:

Diabetes mellitus is considered the single most common cause of chronic kidney disease responsible for a huge dialysis cost. (1) Although Saudi Arabia has a high prevalence of type2 diabetes, it has limited data of diabetic nephropathy that can be utilized for a better understanding of the magnitude of this chronic complication. Therefore, this retrospective cohort study was conducted as a trial to estimate the incidence of nephropathy among diabetic patients in Iskan primary health care, Jeddah throughout a period 2004-2014 as well as to identify the predictors of the development of diabetic nephropathy.

Methods:

A retrospective cohort study was conducted in Iskan PHC from 2004-2014. Files of 220 type 2 Diabetic patients attending Iskan PHC -who had been diagnosed with diabetes since 2004 or earlier-were included in the study . Sample size was calculated by using the Epi Info program with 95% confidence interval and 5% error.  The sample was selected by simple random technique through using the online random number generator. A data information sheet was used to collect the data. Data of demographic, anthropometric and clinical characteristics of patients were collected and recorded from the files of the patient. The laboratory test result extracted from the main database of the hospital computer. The primary outcome is the development of nephropathy. An ADA criterion of diabetic nephropathy was used to identify nephropathy. Chi-Square tests (X2) and multivariable logistic regression were used to test the association and differences. The odds ratio was estimated with 95% confidence interval.

Results:

The incidence of nephropathy in type2 diabetic patients who diagnosed at 2004 was 18.3 (14.1% microalbuminuria and 4.2% macroalbuminuria). Hypertension (OR=5.138; 95% CI, 2.150-12.276), uncontrolled HbA1c (OR=1.635; 95% CI, 1.244-2.149), serum creatinine level (OR=1.027; 95%CI, 1.003-1.051) and duration of diabetes (p-value 0.000) were significantly associated with development nephropathy.

Conclusions:

Saudi patients with type 2 diabetes in Iskan PHC had a high incidence of albuminuria. Hypertension, duration of diabetes, diabetic control, and serum creatinine level were significant predictors for diabetic nephropathy

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