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Prevalence & Risk Factors of Nephropathy in Type 2 Diabetic Patients

Author(s): Vimalkumar V K | C.R. Anand Moses | Padmanaban S

Journal: International Journal of Collaborative Research on Internal Medicine & Public Health
ISSN 1840-4529

Volume: 3;
Issue: 3;
Start page: 257;
Date: 2011;
Original page

Keywords: Diabetic nephropathy | risk factors | diabetes

Background: 31.7 million people in India suffer from diabetes. Diabetic nephropathy (Kimmelstiel-Wilson syndrome) is the leading cause of end-stage renal disease (ESRD) worldwide and a leading causeof DM-related morbidity and mortality. It is estimated that 79.4 million diabetic patients will be in Indiaby 2030. So a study was done on the prevalence rate of diabetic nephropathy (DN) and its associated riskfactors.Aims and Objectives: This study is a small cross sectional study conducted in a tertiary hospital (Dr.Ambedkar institute of diabetes, Kilpauk medical college hospital, Chennai.). The objective is to analyzethe prevalence of DN and to determine the factors leading to DN in type 2 diabetic patients (mainlycontaining urban Asian Indian population)Materials and Methods: 200 Type 2 diabetic patients were randomly selected. All the patients wereinterviewed with a questionnaire. A detailed history including risk factors like age ,sex , socio economicstatus, duration of diabetes , smoking , alcohol , family history of DM and kidney disease, Ischemic heartdisease(IHD), Oral Hypoglycemic Drugs(OHA) , Insulin was taken followed by measurement of bloodpressure, BMI assessment, urine analysis for albuminuria and microalbuminuria using dipsticks, lipidprofile, GFR estimation, retinopathy screening. Statistical analysis was done by SPSS software.Univariate analysis, Chi-square and Binary Logistic Regression Model was used.Results: In this study prevalence rate of overt nephropathy is 2.5% and microalbuminuria is 13%, UsingBinary logistic regression analysis, Woman gender, Duration of diabetes, family history of kidneydisease, Hypertension, BMI, GFR, retinopathy were found to be significantly associated with overt DN.There was no increased risk among IHD patients, smokers, alcoholics and no significant relationship withtreatment history.Limitations: This is a hospital based cross sectional study. Population based Case control studies shouldbe conducted for assessment of multiple risk factors. This triggers the need for studies with highersample size to assess various risk factors and mass screening programs.Conclusion: According to study, as the duration of diabetes increases, the incidence of nephropathy alsoincreases and is statistically significant. Hence all diabetic patients, especially those with increasedduration should be screened for nephropathy and made aware of the complications. Since nephropathy isa forerunner for end stage renal disease, preventive measures can help in preventing renal failure.

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