Renal impairrment and associated factors among type 1 and type 2 diabetic patients at jimma university medical center, south west Ethiopia

Abstract

BACK GROUND: Kidney disease is far more common in people with diabetes than in people without diabetes .About 20–40% all type of diabetic patients will develop a diabetic renal disease during the course of their disease. OBJECTIVE: -To assess renal impairment and associated factors among type1 and type 2 diabetic patients attending Jimma University Medical Center, South West Ethiopia. MATERIALS AND METHODS: - A hospital based comparative cross–sectional study was conducted among type 1 and type 2 diabetic patients and apparently healthy individuals, aged 18 years and above at Jimma University Medical Center from January 9 to March 22, 2017. A total of 234 diabetes (both type1 and 2) and 234 apparently healthy individuals were enrolled by consecutive sampling technique. Socio-demographic and clinical data were collected using a structured questionnaire. Fasting venous blood was collected from each study participant by trained nurses. Fasting blood glucose, serum creatinine and urea were analyzed by using Mindray BS_200E chemistry analyzer. Estimated glomerular filtration rate was calculated by Cockcroft & Gault formula. Descriptive statistics, Pearson’s Chi-square, Mann-Whitney test; spearman’s correlation coefficient and logistic regression analysis were done using SPSS version20 software. RESULTS: -About 21.8% and 13.8 % of diabetic patients had renal impairment (stage 3 CKDeGFR) by CG-BSA and MDRD respectively, whereas the renal impairment (stage 3 CKD-eGFR) among apparently healthy individuals was 2.6% by CG-BSA and 1.3% by MDRD equation. Age>50 year (OR 3.12, p=0.014); female sex (OR 3.35, p=0.008), duration of diabetes >10 year (OR 2.42, P=0.043, history of hypertension (OR 8.84, p<0.001), diastolic blood pressure ≥90mmHg (OR 5.48, p=0.004) and high blood glucose ≥130mg/dl (OR 8.44, p=0.003) were significantly associated with renal impairment calculated by CG-BSA in people with diabetes. CONCLUSION AND RECOMMENDATION:-The overall prevalence of renal impairment in diabetes was higher than non-diabetic individuals. Tight glycemic control should be a high priority in reducing the renal impairment burden in the study area.