Incidence of diabetic nephropathy in patients with type 2 diabetes mellitus at a tertiary healthcare setting in Ethiopia

Abstract

Background and aims: Diabetic nephropathy (DN) is a leading cause of morbidity and mortality in diabetic patients representing a huge health and economic burden. Despite the increasing number of patients with Diabetes Mellitus in Ethiopia, the incidence of diabetic nephropathy in patients with DM has not been well established. Therefore, this study aimed to estimate the incidence and predictors of DN in patients with T2DM at tertiary healthcare setting, Ethiopia.

Methods: An institution based retrospective follow study was conducted from March 1 to April 28, 2019. Kaplan-meier survival curve together with log rank test were used. Cox proportional hazard model was used at 5% level of significance to determine the net effect of each explanatory variable on diabetic nephropathy. An assumption was check by schoenfeld residual test.

Results: The incidence rate of diabetic nephropathy was 3.6% per 100 person-years (95% CI = 2.49-11.47). The median time to develop nephropathy was 100(95% CI, 96.7-107) months. Predictors of diabetic nephropathy were males (AHR: 2.7, 95%CI: 1.39, 5.23), long duration of diabetes (AHR: 1.03, 95%CI: 1.01, 1.06), HbA1c> 7% (AHR: 1.74, 95% CI: 1.67, 3.12), high density lipoprotein (AHR: 0.37, 95% CI: 0.16, 0.83), and mixed anti-diabetic therapy (AHR: 0.07, 95% CI: 0.01, 0.59).

Conclusion: The incidence of diabetic nephropathy among T2DM patients was relatively high. Males, longer duration of diabetes, HbA1c, and fasting blood glucose were increase the risk of diabetic nephropathy.

Keywords: Diabetes mellitus; Diabetic nephropathy; Ethiopia; Predictors.