Abstract

PREVALENCE OF CHRONIC KIDNEY DISEASES (CKD) AMONG IRAQI PATIENTS WITH TYPE 2 DIABETES MELLITUS

*Dr. Taha Hashem Abdulgafoor Al-Ani M. B. Ch. B, M.D

ABSTRACT

One of the serious complications of chronic type 2 Diabetes mellitus is the nephropathy, which is characterized by micro albuminuria that is in turn converted into macro albuminuria, where the glomerular filtration rate (GFR) deteriorates. In this nationwide, cross-sectional, observational, multi-centric study, the prevalence of CKD among T2DM patients was assessed. The primary endpoint of the study was to estimate proportion of T2DM patients with CKD (glomerular filtration rate (GFR) <60 ml/min/1.73 m2 or albumin creatinine ratio (ACR) ≥30 mg/g or ≥3 mg/mmol or both). The blood/plasma and urine samples, were collected for estimation of hemoglobin A1c, microalbuminuria, serum creatinine and urine creatinine. A total of 300 subjects were enrolled in this study. The results showed that 138(46%) of them were females and 162(54%) were males, with a mean age of 55.4 (±10.7) years, and a mean body mass index of (28.1±4.3) kg/m2. Both micro and macro vascular complications were reported. In the studied subjects with T2DM, 144(48%) had mildly decreased GFR, 45(15%) had mild to moderately decreased GFR, and 6(2%) had severely decreased GFR. In regard to ACR categorization, 183(61%) had normal to mildly increased ACR, 75(25%) had moderately increased and 21(7%) had severely increased ACR. We observed a significant (p<0.0005) weak negative correlation (-0.23) between eGFR< 60mL/ min/1.73 m² and urinary ACR in more than 60 patients. We found 144(48%) prevalence of CKD in T2DM patients. The results of HbA1c achievement analysis showed that the patients without CKD had a better success rate to achieve the target <7% of HbA1c compared to those who had CKD (29.4% vs. 232.9%). It can be concluded that higher prevalence of CKD was driven by the ACR levels and the majority of patients had reasonable eGFR.

Keywords: Type 2 Diabetes mellitus; CKD, HbA1c, GFR, Renal function tests.