Prevalence & Risk Factors of Nephropathy in Type 2 Diabetic Patients

Background: 31.7 million people in India are suffering from diabetes. Diabetic nephropathy (Kimmelstiel-Wilson syndrome) is the leading cause of end-stage renal disease (ESRD) worldwide and a leading cause of DM-related morbidity and mortality. It is estimated that 79.4 million diabetic patients will be in India by 2030. So a study was done on the prevalence rate of diabetic nephropathy (DN) and its associated risk factors. Aims and Objectives: This study is a small cross sectional study conducted in a tertiary hospital (Dr. Ambedkar institute of diabetes, Kilpauk medical college hospital, Chennai.). The objective is to analyze the prevalence of DN and to determine the factors leading to DN in type 2 diabetic patients (mainly containing urban Asian Indian population) Materials and Methods: 200 Type 2 diabetic patients were randomly selected. All the patients were interviewed with a questionnaire. A detailed history including risk factors like age, sex, socio economic status, duration of diabetes, smoking, alcohol, family history of DM and kidney disease, Ischemic heart disease(IHD), Oral Hypoglycemic Drugs(OHA), Insulin was taken followed by measurement of blood pressure, BMI assessment, urine analysis for albuminuria and microalbuminuria using dipsticks, lipid profile, GFR estimation, retinopathy screening. Statistical analysis was done by SPSS software. Univariate analysis, Chi-square and Binary Logistic Regression Model was used. Results: In this study prevalence rate of overt nephropathy is 2.5% and microalbuminuria is 13%, Using Binary logistic regression analysis, Woman gender, Duration of diabetes, family history of kidney disease, Hypertension, BMI, GFR, retinopathy were found to be significantly associated with overt DN. There was no increased risk among IHD patients, smokers, alcoholics and no significant relationship with treatment history. Limitations: This is a hospital based cross sectional study. Population based Case control studies should be conducted for assessment of multiple risk factors. This triggers the need for studies with higher sample size to assess various risk factors and mass screening programs. Conclusion: According to study, as the duration of diabetes increases, the incidence of nephropathy also increases and is statistically significant. Hence all diabetic patients, especially those with increased duration should be screened for nephropathy and made aware of the complications. Since nephropathy is a forerunner for end stage renal disease, preventive measures can help in preventing renal failure.