埃塞俄比亚东北部2型糖尿病患者中使用估计肾小球滤过率评估肾功能损害：一项横断面研究。
Assessment of renal impairment using estimated glomerular filtration rate among type 2 diabetes mellitus patients in North-East Ethiopia: a cross-sectional study.
作者信息
Taderegew Mitku Mammo
机构信息
Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, P.O. Box 07, Wolkite, Ethiopia.
出版信息
J Diabetes Metab Disord. 2020 Nov 5;19(2):1473-1481. doi: 10.1007/s40200-020-00680-4. eCollection 2020 Dec.
BACKGROUND
Chronic kidney disease (CKD) is the known cause of morbidity and mortality among diabetes mellitus (DM) patients. Targeted screening of renal impairment based on estimated glomerular filtration rate (eGFR) among DM patients has potential benefits in early identification and treatment of CKD. Hence, this study was aimed to estimate the magnitude of renal impairment using eGFR among type 2 DM patients.
METHODS
An institution-based cross-sectional study was conducted from February-1 to April 30/2020 among 422 type 2 DM patients in Northeast Ethiopia. Data were collected by the semi-structured questioner and serum creatinine measurement. The collected data were edited into Epi-data manager version 4.4.1.0, and the analysis was performed by SPSS-25. The Simplified Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI), and Cockcroft-Gault (C-G) equations were used to calculate eGFR.
RESULTS
Of all study participants, 82(19.4%), 92(21.8%), and 103(24.4%) had eGFR < 60 ml/min/1.73 m, according to the MDRD, CKD-EPI, and C-G equations, respectively. Female sex, (MDRD:AOR = 4.44, 95%CI:1.97-9.97, CKD-EPI:AOR = 3.17, 95%CI:1.27-6.17, and C-G:AOR = 2.65, 95%CI:1.35-5.21), duration ≥ 10 years (MDRD:AOR = 3.38, 95%CI:1.45-7.92, CKD-EPI:AOR = 3.09, 95%CI:1.07-7.77, and C-G:AOR = 2.92, 95%CI:1.29-6.61), age ˃60 years (MDRD:AOR = 2.29, 95%CI:1.09-4.77, CKD-EPI:AOR = 4.12, 95%CI:1.68-6.78, and C-G: AOR = 3.42, 95%CI:1.77-6.60), hypertension (MDRD:AOR = 3.12, 95%CI:1.51-6.45, CKD-EPI: AOR = 4.21,95%CI:2.07-7.98, and C-G:AOR = 3.99, 95%CI:2.08-7.65), poor glycemic control (MDRD:AOR = 2.82, 95%CI:1.13-7.05, and C-G:AOR = 2.34, 95%CI:1.09-5.04), and body mass index (MDRD:AOR = 1.11, 95%CI:1.01-1.22, and CKD-EPI:AOR = 2.43, 95%CI:1.27-5.76) were significantly associated with renal impairment.
CONCLUSION
Renal impairment was prevalent among type 2 DM patients. Older age, female sex, duration, hypertension, poor glycemic control, and BMI were significantly associated with renal impairment.
背景
慢性肾脏病（CKD）是糖尿病（DM）患者发病和死亡的已知原因。基于估算肾小球滤过率（eGFR）对DM患者进行针对性的肾功能损害筛查，对于CKD的早期识别和治疗具有潜在益处。因此，本研究旨在使用eGFR评估2型DM患者的肾功能损害程度。
方法
2020年2月1日至4月30日在埃塞俄比亚东北部对422例2型DM患者进行了一项基于机构的横断面研究。通过半结构化问卷和血清肌酐测量收集数据。收集的数据录入Epi-data manager 4.4.1.0版本进行编辑，并使用SPSS-25进行分析。采用简化的肾脏病饮食改良（MDRD）公式、慢性肾脏病流行病学（CKD-EPI）公式和Cockcroft-Gault（C-G）公式计算eGFR。
结果
根据MDRD公式、CKD-EPI公式和C-G公式，所有研究参与者中，分别有82例（19.4%）、92例（21.8%）和103例（24.4%）的eGFR＜60 ml/min/1.73 m²。女性（MDRD：调整后比值比[AOR]=4.44，95%置信区间[CI]：1.97-9.97；CKD-EPI：AOR=3.17，95%CI：1.27-6.17；C-G：AOR=2.65，95%CI：1.35-5.21）、病程≥10年（MDRD：AOR=3.38，95%CI：1.45-7.92；CKD-EPI：AOR=3.09，95%CI：1.07-7.77；C-G：AOR=2.92，95%CI：1.29-6.61）、年龄＞60岁（MDRD：AOR=2.29，95%CI：1.09-4.77；CKD-EPI：AOR=4.12，95%CI：1.68-6.78；C-G：AOR=3.42，95%CI：1.77-6.60）、高血压（MDRD：AOR=3.12，95%CI：1.51-6.45；CKD-EPI：AOR=4.21，95%CI：2.07-7.98；C-G：AOR=3.99，95%CI：2.08-7.65）、血糖控制不佳（MDRD：AOR=2.82，95%CI：1.13-7.05；C-G：AOR=2.34，95%CI：1.09-5.04）和体重指数（MDRD：AOR=1.11，95%CI：1.01-1.22；CKD-EPI：AOR=2.43，95%CI：1.27-5.76）与肾功能损害显著相关。
结论
2型DM患者中肾功能损害普遍存在。年龄较大、女性、病程、高血压、血糖控制不佳和体重指数与肾功能损害显著相关。
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