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糖尿病患者慢性肾脏病的发病率及预测因素:埃塞俄比亚一家三级医疗机构的回顾性随访研究

Incidence and Predictors of Chronic Kidney Disease among Diabetes Mellitus Patients: A Retrospective Follow-Up Study at a Tertiary Health-Care Setting of Ethiopia.

作者信息

Debele Gebiso Roba, Hajure Mohammedamin, Wolde Haileab Fekadu, Yenit Melaku Kindie

机构信息

Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia.

Department of Psychiatry, College of Health Sciences, Mettu University, Mettu, Ethiopia.

出版信息

Diabetes Metab Syndr Obes. 2021 Oct 28;14:4381-4390. doi: 10.2147/DMSO.S335572. eCollection 2021.

DOI:10.2147/DMSO.S335572
PMID:34737594
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8560326/
Abstract

BACKGROUND

Chronic kidney disease (CKD) is one of the most common microvascular complications of diabetes mellitus (DM) and it is a major health burden worldwide. Despite the increasing trend of microvascular complications in developing countries, there is limited evidence on predictors of CKD among diabetic patients in Ethiopia. Therefore, this study was aimed to assess the incidence and predictors of CKD among DM patients.

METHODS

A retrospective follow-up study was conducted among type 1 and type 2 DM patients in Southwest Ethiopia. A total of 437 newly-diagnosed diabetes patients were selected using a simple random sampling technique. Data were extracted from patients' medical records. Cox proportional hazard model was fitted and a 95% confidence interval was used to select significant variables.

RESULTS

Overall, 15.56% of patients developed CKD, with an incidence rate of 2.29 per 1,000 person-month (PM) (95% CI=1.79-2.93). Female sex (AHR=0.51, 95% CI=0.27-0.94) was found to be a protective factor of CKD, while positive proteinuria (AHR=2.85, 95% CI=1.48-5.55), having hypertension (HTN) (AHR=2.31, 95% CI=1.03-5.56), and high-density lipoprotein cholesterol (HDL-C) <40 mg/dL (AHR=3.19, 95% CI=1.73-5.98) were significant predictors of CKD.

CONCLUSION

CKD among DM patients continues to be a significant public health problem in health-care settings of Ethiopia. The current study found being female was protective, while positive proteinuria, HTN, and HDL-C <40 mg/dL were risk factors for CKD. We recommend health professionals to give more attention to DM patients with the identified risk factors.

摘要

背景

慢性肾脏病(CKD)是糖尿病(DM)最常见的微血管并发症之一,也是全球主要的健康负担。尽管发展中国家微血管并发症呈上升趋势,但埃塞俄比亚糖尿病患者中CKD预测因素的证据有限。因此,本研究旨在评估糖尿病患者中CKD的发病率及预测因素。

方法

在埃塞俄比亚西南部对1型和2型糖尿病患者进行回顾性随访研究。采用简单随机抽样技术共选取437例新诊断的糖尿病患者。从患者病历中提取数据。拟合Cox比例风险模型,并使用95%置信区间选择显著变量。

结果

总体而言,15.56%的患者发生了CKD,发病率为每1000人月2.29例(95%CI=1.79-2.93)。女性(风险比=0.51,95%CI=0.27-0.94)被发现是CKD的保护因素,而蛋白尿阳性(风险比=2.85,95%CI=1.48-5.55)、患有高血压(HTN)(风险比=2.31,95%CI=1.03-5.56)和高密度脂蛋白胆固醇(HDL-C)<40mg/dL(风险比=3.19,95%CI=1.73-5.98)是CKD的显著预测因素。

结论

在埃塞俄比亚的医疗环境中,糖尿病患者的CKD仍然是一个重大的公共卫生问题。当前研究发现女性具有保护作用,而蛋白尿阳性、高血压和HDL-C<40mg/dL是CKD的危险因素。我们建议卫生专业人员更多关注具有已确定危险因素的糖尿病患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad63/8560326/58c6b060e8e4/DMSO-14-4381-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad63/8560326/0c2d68bb5eaf/DMSO-14-4381-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad63/8560326/3c2ef2d3cbb0/DMSO-14-4381-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad63/8560326/58c6b060e8e4/DMSO-14-4381-g0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad63/8560326/0c2d68bb5eaf/DMSO-14-4381-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad63/8560326/3c2ef2d3cbb0/DMSO-14-4381-g0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad63/8560326/58c6b060e8e4/DMSO-14-4381-g0003.jpg

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