Prevalence and risk factors of diabetic nephropathy among Thai patients with type 2 diabetes mellitus

Abstract

Background: Diabetic nephropathy (DN) is the leading cause of end stage renal disease. Clinically, DN is classified into 3 stages: microalbuminuria (MA), macroalbuminuria and ESRD. The prevalence and risk factors of DN among patients with type 2 diabetes mellitus (T2DM) in Thailand have not been well studied.

Objective: To assess the prevalence of DN in patients with T2DM and to determine their associated risk factors.

Material and method: A cross-sectional study evaluating 877 T2DM patients from the out-patient department of seven public hospitals in Thailand was performed. Three random spot urine samples from all patients were collected during 3 consecutive months. Normoalbuminuria, MA and macroalbuminuria were defined as the presence of at least two out of three spot urine tests for urine albumin/creatinine ratio showing less than 30, 30-300 and more than 300 mg/gm respectively.

Results: Most patients were female, 60 years of age or older, with BMI above 25 kg/m2, a family history of DM, uncontrolled blood pressure, HbA1c above 7.0% and LDL above 100 mg/dl. The prevalence of normoalbuminuria, MA and macroalbuminuria was 62.8, 26.0 and 11.2% respectively. The prevalence of diabetic retinopathy in T2DM with normoalbuminuria, MA and microalbuminuria was 18.5, 35.5 and 48.0% respectively. Associated risk factors of DN were the duration of DM, HbA1c levels and uncontrolled hypertension.

Conclusion: The prevalence of all DN was 37.2%. Associated risk factors of DN were the duration of DM, HbA1c levels and uncontrolled hypertension.