Jaber Mohammad, Sharabati Anas, Nofal Khaled, Hassan Mohanad, Hamdan Zakaria, Nazzal Zaher
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
Internal Medicine, Internal Medicine Department, An-Najah National University Hospital, Nablus, Palestine.
BMC Nephrol. 2025 Feb 10;26(1):64. doi: 10.1186/s12882-025-03947-1.
Diabetic nephropathy is a significant complication of diabetes and a leading cause of chronic kidney disease (CKD) globally. This study aimed to assess the decline of renal function and all-cause mortality and identify the contributing risk factors among Palestinian patients with diabetes.
The study employed a prospective cohort design, enrolling 311 patients with type 2 diabetes mellitus (T2DM) attending primary health care centers in Palestine. Baseline data were collected in 2018 to determine the prevalence of CKD in patients with T2DM. Subsequently, the patients were followed up for three years to assess renal function and identify significant associated risk factors. The primary outcomes examined were estimated glomerular filtration rate (eGFR) decline and all-cause mortality.
During the three-year follow-up, 37.5% of the patients experienced eGFR decline, averaging 4.2 ml/min/1.73 m² per year. Males showed a significant association with eGFR decline with 5 times higher risk of developing eGFR decline. Hypertensive patients were 2.4 times more likely to experience decline. Regarding all-cause mortality, 14.1% of the patients died, with an incidence rate of 51.3 deaths per 1000 person-years. The risk of all-cause mortality was 5.5 times greater for patients with impaired renal function at baseline and 10.8 times greater for patients who had eGFR decline.
This study highlights the importance of early detection of CKD in patients with diabetes, prompting more comprehensive management of risk factors related to eGFR decline and mortality. Furthermore, it underscores the need for future research in this patient population, including investigations about other relevant risk factors and the impact of different medications, such as anti-diabetic and antihypertensive medications, on the GFR decline and mortality rate.
糖尿病肾病是糖尿病的一种严重并发症，也是全球慢性肾脏病（CKD）的主要病因。本研究旨在评估巴勒斯坦糖尿病患者的肾功能下降情况和全因死亡率，并确定相关危险因素。
本研究采用前瞻性队列设计，纳入了311名在巴勒斯坦初级卫生保健中心就诊的2型糖尿病（T2DM）患者。2018年收集基线数据以确定T2DM患者中CKD的患病率。随后，对患者进行了三年的随访，以评估肾功能并确定显著相关的危险因素。所检查的主要结局是估计肾小球滤过率（eGFR）下降和全因死亡率。
在三年的随访期间，37.5%的患者出现eGFR下降，平均每年下降4.2ml/min/1.73m²。男性与eGFR下降存在显著关联，发生eGFR下降的风险高5倍。高血压患者发生下降的可能性高2.4倍。关于全因死亡率，14.1%的患者死亡，发病率为每1000人年51.3例死亡。基线肾功能受损的患者全因死亡风险高5.5倍，eGFR下降的患者全因死亡风险高10.
