Mariye Zemicheal Teklewoini, Bahrey Tadesse Degena, Tasew Atalay Hagos, Teklay Weldesamuel Girmay, Gebremichael Gebrewahd Bezabh, Tesfay Haben Nuguse, Haile Teklehaimanot Gereziher
Department of Adult Health Nursing, School of Nursing, College of Health Science and Comprehensive Specialized Hospital, Aksum University, Tigray, Ethiopia.
Department of Pediatric Nursing, School of Nursing, College of Health Science and Comprehensive Specialized Hospital, Aksum University, Tigray, Ethiopia.
Int J Endocrinol. 2020 Sep 21;2020:6396483. doi: 10.1155/2020/6396483. eCollection 2020.
Diabetic nephropathy is real damage resulting from having uncontrolled diabetes mellitus. Unmanaged diabetic nephropathy is one of the most leading causes of kidney failure. There is a scarcity of information on the determinants of diabetic nephropathy among diabetes mellitus patients in Ethiopia. Identification of the determinants can help devise a strategy to properly address the disease and its consequences. Therefore, this study was designed to assess the determinants of diabetic nephropathy among diabetes mellitus patients.
Unmatched case-control study design with 168 cases and 672 controls with a mean age of 45.18 and 62.12, respectively, participated in the study. An interviewer-administered questionnaire was employed for data collection, and a systematic sampling technique was used to select the study participants. Data were entered into Epi data and exported to SPSS for data clarification and analysis. Binary logistic regression analysis was carried out to check the level of association between diabetic nephropathy and the independent variables.
Comorbidity (AOR: 4.96 at 95 CI: 1.77-13.87), hypertension (AOR: 6.33, 95% CI: 2.51-16.02), poor glycemic control (AOR: 3.27, 95% CI: 1.31, 8.21), age (AOR: 1.14, 95%: 1.09-1.19), duration with diabetes mellitus since diagnosis (AOR: 1.83, 95 CI: 1.62-2.06), and nonadherence to diabetic medication (AOR: 3.3, 95% CI: 1.34, 8.15), diet (AOR: 5.96, 95%: 1.92-18.54), and exercise (AOR: 5.60, 95% CI: 1.94-16.21) were the determinants of diabetic nephropathy.
Adherence to medication, diet, and exercise should be empowered to achieve glycemic control and to prevent diabetic nephropathy. More attention has to be also given for old aged diabetic patients, long duration since diagnosis of diabetes mellitus, hypertension, and other comorbidities.
糖尿病肾病是糖尿病控制不佳导致的实际损害。未得到控制的糖尿病肾病是肾衰竭的主要原因之一。在埃塞俄比亚，关于糖尿病患者中糖尿病肾病决定因素的信息匮乏。确定这些决定因素有助于制定策略以妥善应对该疾病及其后果。因此，本研究旨在评估糖尿病患者中糖尿病肾病的决定因素。
采用非匹配病例对照研究设计，168例病例和672例对照参与研究，病例组和对照组的平均年龄分别为45.18岁和62.12岁。采用访谈式问卷进行数据收集，并使用系统抽样技术选择研究参与者。数据录入Epi数据软件，然后导出到SPSS进行数据清理和分析。进行二元逻辑回归分析以检验糖尿病肾病与自变量之间的关联程度。
合并症（比值比：4.96，95%置信区间：1.77 - 13.87）、高血压（比值比：6.33，95%置信区间：2.51 - 16.02）、血糖控制不佳（比值比：3.27，95%置信区间：1.31，8.21）、年龄（比值比：1.14，95%：1.09 - 1.19）、自诊断糖尿病以来的病程（比值比：1.83，95%置信区间：1.62 - 2.06）以及不坚持服用糖尿病药物（比值比：3.3，95%置信区间：1.34，8.15）、饮食（比值比：5.96，95%：1.92 - 18.54）和运动（比值比：5.60，95%置信区间：1.94 - 16.21）是糖尿病肾病的决定因素。
应加强对药物、饮食和运动的依从性，以实现血糖控制并预防糖尿病肾病。对于老年糖尿病患者、糖尿病诊断后病程较长者、高血压患者及其他合并症患者也应给予更多关注。
