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Meta-Analysis
. 2024 Feb 2;19(2):e0297082.
doi: 10.1371/journal.pone.0297082. eCollection 2024.

Determinants of diabetic nephropathy among diabetic patients in Ethiopia: Systematic review and meta-analysis

Abere Woretaw Azagew  1 , Zerko Wako Beko  1 , Chilot Kassa Mekonnen  1
Affiliations
Meta-Analysis

Determinants of diabetic nephropathy among diabetic patients in Ethiopia: Systematic review and meta-analysis

Abere Woretaw Azagew et al. PLoS One. .

Abstract

Introduction: Diabetic nephropathy (DN) is a long-term kidney disease among diabetic patients. It is the leading cause of end-stage renal failure. In Ethiopia, DN affects the majority of diabetic populations, but there were inconsistent findings about the determinant factors across the studies.

Methods: We have accessed studies using PubMed, Embase, EBSCO, Web of Science, OVID, and search engines including Google and Google Scholar published up to June 2023. The study populations were diabetic patients with nephropathy. The quality of each included article was assessed using the Newcastle-Ottawa quality assessment scale. The odds ratios of risk factors were pooled using a random-effect meta-analysis model. Heterogeneity was assessed using the Cochrane Q statistics and I-Square (I2). The publication bias was detected using the funnel plot and/or Egger's test (p< 0.05). Trim and fill analysis was carried out to treat the publication bias. The protocol has been registered with the reference number CRD42023434547.

Results: A total of sixteen articles were used for this reviewed study. Of which, eleven articles were used for advanced age, ten articles for duration of diabetic illness, ten articles for poor glycemic control, and eleven articles for having co-morbid hypertension. Diabetic patients with advanced age (AOR = 1.11, 95% CI: 1.03-120, I2 = 0.0%, p = 0.488), longer duration of diabetic illness (AOR = 1.23, 95% CI = 1.05-1.45, I2 = 0.0%, p = 0.567), poor glycemic control (AOR = 2.57, 95% CI: 1.07-6.14; I2 = 0.0%, p = 0.996), and having co-morbid hypertension (AOR = 4.03, 95% CI: 2.00-8.12, I2 = 0.0%, p = 0.964) were found to be factors associated with DN.

Conclusions: The findings of the study revealed that diabetic patients with advanced age, longer duration of diabetic illness, poor glycemic control status, and co-morbid hypertension were the determinant factors of DN. Therefore, treatment of co-morbid hypertension and high blood glucose and regular screening of renal function should be implemented to detect, treat, and reduce the progression of DN. Furthermore, healthcare workers should give due attention to diabetes with advanced age and a longer duration of diabetes illness to prevent the occurrence of DN.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram for the flow of information through the phases of the review.
Fig 2
Fig 2. The pooled effect of age on diabetic nephropathy.
Fig 3
Fig 3. Funnel plot shows the distribution of included studies.
Fig 4
Fig 4. Trim and fill analysis for the asymmetrical distribution of the included studies.
Fig 5
Fig 5. The pooled effect of duration of diabetes illness on Diabetic nephropathy.
Fig 6
Fig 6. Funnel plot shows the distribution of the included studies.
Fig 7
Fig 7. Trim and fill analysis for the asymmetrical distribution of the included studies.
Fig 8
Fig 8. The pooled effect of poor glycemic control on diabetic nephropathy.
Fig 9
Fig 9. The funnel plot shows the distribution of the included studies.
Fig 10
Fig 10. The pooled effect of elevated systolic hypertension on diabetic nephropathy.
Fig 11
Fig 11. The pooled effect of co-morbid hypertension on diabetic nephropathy.
Fig 12
Fig 12. Funnel plot shows the distribution of the included studies.
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