Internal Medicine at the Faculty of Health Sciences, Busitema University, Mbale, Uganda.
Faculty of Health Sciences, Busitema University Mbale, Mbale, Uganda.
BMC Nephrol. 2024 Sep 27;25(1):319. doi: 10.1186/s12882-024-03764-y.
Chronic kidney disease (CKD) is one of the most common complications of diabetes mellitus (DM). Diabetes mellitus contributes to about 66% of CKD cases globally. CKD results in increased morbidity and mortality and advanced stages often require kidney replacement therapy that is unaffordable for the majority of the patients. Developing countries have scanty data regarding CKD burden in diabetic patients.
This study aimed at determining the prevalence of low estimated glomerular filtration rate (eGFR) and proteinuria and associated clinical and socio-demographic factors among adult diabetic patients attending the diabetic clinic of Mbale Regional Referral Hospital (MRRH).
A cross-sectional study was conducted at the adult diabetic clinic of MRRH in Eastern Uganda. A total of 374 adult diabetic patients were enrolled. A urine sample for urine albumin creatinine ratio (UACR) determination and a venous blood sample for measurement of serum creatinine were obtained from each participant. The eGFR was determined using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and CKD was staged according to the Kidney Disease Improving Global Outcomes (KDIGO) classification.
A total of 318 (85%) participants had an eGFR of ≤ 60 mL/min/1.73m2, UACR of ≥ 30g/g, or both. Only 6.1% were aware. Age, duration of DM, hypertension, and dyslipidemia were associated with low eGFR and proteinuria.
There is a high prevalence of low eGFR and proteinuria among DM patients, 85% of the participants had these markers of CKD and the majority of them were undiagnosed. Over half of the DM patients had an eGFR consistent with advanced CKD. Strengthening routine screening for CKD biomarkers and equipping DM clinics with more diagnostic resources is recommended.
慢性肾脏病（CKD）是糖尿病（DM）最常见的并发症之一。全球范围内，DM 导致约 66%的 CKD 病例。CKD 导致发病率和死亡率增加，晚期患者通常需要肾脏替代治疗，但大多数患者负担不起。发展中国家关于糖尿病患者 CKD 负担的数据很少。
本研究旨在确定在姆巴莱地区转诊医院（MRRH）的糖尿病诊所就诊的成年糖尿病患者中，估算肾小球滤过率（eGFR）降低和蛋白尿的患病率，以及相关的临床和社会人口统计学因素。
在乌干达东部的 MRRH 成人糖尿病诊所进行了一项横断面研究。共纳入 374 名成年糖尿病患者。从每位参与者中获取尿液样本以测定尿白蛋白肌酐比值（UACR），并抽取静脉血样以测量血清肌酐。使用慢性肾脏病流行病学合作（CKD-EPI）方程计算 eGFR，并根据肾脏病改善全球结局（KDIGO）分类对 CKD 进行分期。
共有 318 名（85%）参与者的 eGFR≤60 mL/min/1.73m2、UACR≥30g/g 或两者兼而有之。只有 6.1%的人知道。年龄、DM 持续时间、高血压和血脂异常与低 eGFR 和蛋白尿相关。
DM 患者中 eGFR 和蛋白尿降低的患病率很高，85%的参与者有这些 CKD 标志物，且大多数患者未被诊断。超过一半的 DM 患者的 eGFR 与晚期 CKD 相符。建议加强常规 CKD 生物标志物筛查，并为 DM 诊所配备更多诊断资源。
