Determinants of Diabetic Nephropathy among Diabetic Patients in General Public Hospitals of Tigray, Ethiopia, 2018/19

Abstract

Background. Diabetic nephropathy is real damage resulting from having uncontrolled diabetes mellitus. Unmanaged diabetic nephropathy is one of the most leading causes of kidney failure. There is a scarcity of information on the determinants of diabetic nephropathy among diabetes mellitus patients in Ethiopia. Identification of the determinants can help devise a strategy to properly address the disease and its consequences. Therefore, this study was designed to assess the determinants of diabetic nephropathy among diabetes mellitus patients. Methods. Unmatched case-control study design with 168 cases and 672 controls with a mean age of 45.18 and 62.12, respectively, participated in the study. An interviewer-administered questionnaire was employed for data collection, and a systematic sampling technique was used to select the study participants. Data were entered into Epi data and exported to SPSS for data clarification and analysis. Binary logistic regression analysis was carried out to check the level of association between diabetic nephropathy and the independent variables. Results. Comorbidity (AOR: 4.96 at 95 CI: 1.77–13.87), hypertension (AOR: 6.33, 95% CI: 2.51–16.02), poor glycemic control (AOR: 3.27, 95% CI: 1.31, 8.21), age (AOR: 1.14, 95%: 1.09–1.19), duration with diabetes mellitus since diagnosis (AOR: 1.83, 95 CI: 1.62–2.06), and nonadherence to diabetic medication (AOR: 3.3, 95% CI: 1.34, 8.15), diet (AOR: 5.96, 95%: 1.92–18.54), and exercise (AOR: 5.60, 95% CI: 1.94–16.21) were the determinants of diabetic nephropathy. Conclusion. Adherence to medication, diet, and exercise should be empowered to achieve glycemic control and to prevent diabetic nephropathy. More attention has to be also given for old aged diabetic patients, long duration since diagnosis of diabetes mellitus, hypertension, and other comorbidities.

Clinical Effects of Primary Nursing on Diabetic Nephropathy Patients Undergoing Hemodialysis and Its Impact on the Inflammatory Responses

“…Urea nitrogen is a nitrogenous compound in the plasma of the patient's organism that is filtered from the glomerulus and excreted out of the body, which is generally used to determine the severity of the disease. Fasting glucose can be used to assess the glycemic index of the patient [ 14 ].…”

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

“…Finally, sixteen articles were used to extract the determinant factors of DN. Of these, eleven articles were retrieved for age of diabetic patients [5,9,[31][32][33][34][35][36][37][38][39] (Table 1), ten for duration of diabetic illness [5,9,15,31,32,36,[38][39][40][41] (Table 2), ten for poor glycemic control [5,9,[32][33][34]36,39,[41][42][43] (Table 3), eight for elevated systolic blood pressure [9,15,33,34,36,38,41,44] (Table 4), and twelve for co-morbid hypertension [5,15,31,33,36,[38][39]…”

“…Diabetic nephropathy is also known as diabetic kidney disease (DKD). Clinically, DN is characterized by an increase in urine albumin excretion (microalbuminuria) and/or a decreased glomerular filtration rate (GFR) [5][6][7]. It is the only complication for diabetic populations compared with non-diabetics [8].…”

“…It is the only complication for diabetic populations compared with non-diabetics [8]. The causes of DN are multifactoral, but they are associated with being overweight, diet, exercise, smoking, co-morbidity, type of diabetes, and non-adherence to diabetic medications [5,7,[9][10][11][12][13][14].…”

“…The World Health Organization-led initiative is targeted at reducing diabeticassociated kidney disease by providing comprehensive care [18]. Preventive strategies improve glycemic control by adhering to medication, food, and exercise [5]. Early detection and screening for microalbuminuria should be done regularly [6,7].…”