Kidney Center, Sansai Hospital, Chiang Mai, 50290, Thailand.
Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, 50200, Thailand.
Sci Rep. 2020 Apr 10;10(1):6205. doi: 10.1038/s41598-020-63443-4.
This cross-sectional study aimed to investigate the prevalence and risk factors of chronic kidney disease (CKD) among 1,096 primary care type 2 diabetes (T2DM) patients in northern Thailand between October 2016 and September 2017. CKD was defined as estimated glomerular rate filtration values of <60 mL/min/1.73 m. Prevalence with confidence intervals across CKD advanced stages 3-5 were estimated. Factors associated with CKD were evaluated by multivariate logistic regression. The overall prevalence of CKD was 24.4% (21.9-27.0), with severities of 11.4% (9.7-13.4), 6.8% (5.5-8.5), 4.6% (3.5-6.0), and 1.6% (1.0-2.5) for stages 3 A, 3B, 4, and 5, respectively. Regarding age and glycaemic control, individuals older than 75 years and those with a haemoglobin A1c ≥ 8% had the highest prevalence of 61.3% (51.7-70.1) and 38.6% (34.3-43.2), respectively. The multivariable logistic regression model explained 87.3% of the probability of CKD. The six independent significant risk factors of CKD were older age, retinopathy, albuminuria, haemoglobin A1c ≥ 7%, anaemia, and uric acid>7.5 mg/dL. A relatively high prevalence of CKD, especially in older patients and those with diabetic complications-related to poor glycaemic control, was encountered in this primary care practice. Early identification may help to target optimise care and prevention programs for CKD among T2DM patients.
本横断面研究旨在调查 2016 年 10 月至 2017 年 9 月期间泰国北部 1096 例初级保健 2 型糖尿病（T2DM）患者中慢性肾脏病（CKD）的患病率和危险因素。CKD 的定义为估算肾小球滤过率<60ml/min/1.73m。估计了 CKD 各期（3-5 期）的患病率及置信区间。采用多元逻辑回归分析评估与 CKD 相关的因素。CKD 的总患病率为 24.4%（21.9-27.0），其中 3A、3B、4 和 5 期的严重程度分别为 11.4%（9.7-13.4）、6.8%（5.5-8.5）、4.6%（3.5-6.0）和 1.6%（1.0-2.5）。就年龄和血糖控制而言，年龄大于 75 岁和糖化血红蛋白 A1c≥8%的患者患病率最高，分别为 61.3%（51.7-70.1）和 38.6%（34.3-43.2）。多变量逻辑回归模型解释了 CKD 概率的 87.3%。6 个独立的 CKD 危险因素为年龄较大、视网膜病变、白蛋白尿、糖化血红蛋白 A1c≥7%、贫血和尿酸>7.5mg/dL。在这种初级保健实践中，CKD 的患病率相对较高，尤其是在老年患者和与血糖控制不佳相关的糖尿病并发症患者中。早期发现可能有助于针对 T2DM 患者的 CKD 进行优化护理和预防计划。
