Prevalence of Diabetes Mellitus in Patients with Chronic Kidney Disease

Abstract

BACKGROUND:Chronic kidney disease (CKD) became a new epidemic of the twentieth and twenty-first centuries. Diabetic nephropathy is one of the leading causes of end-stage renal failure as a result of the diabetes epidemic worldwide.AIM:The aim of our study was to assess the prevalence of CKD in the Republic of Macedonia and its association with diabetes mellitus.MATERIALS AND METHODS:The study was a part of a study conducted in 2006 in terms of screening for early detection of kidney disease. It was a cross-sectional study based on a random sample of patients aged > 20, consecutively consulting their primary physician for any cause. Fifty physicians throughout the country were included in the study. A total of 2637 patients have been analyzed based on integrity data. GFR was estimated using corrected values of serum creatinine and calculating kidney function by the Cockroft & Gault formula, adjusted for body surface using the Gehan & George formula. Patients with estimated glomerular filtration rate (eGFR) less than 60 ml/min were considered as having CKD. Blood pressure, body weight, height, serum creatinine, glucose, hemoglobin, hematocrit, urinalysis and medical history for presence of cardiovascular diseases or diabetes were also assessed.RESULTS:The mean age of the subjects was 45.97 ± 16.55 SD and 17.97% were older than 60. Regarding gender, 44.14% were males. The prevalence of diabetes mellitus was 13.9%. Subjects with CKD (eGFR less than 60 ml/min) were 7.53% of the total. Subjects aged 60 or above, had 20 times higher risk of having CKD (eGFR less than 60 ml/min/1.73 m2). Out of the total group of subjects, 13.9% had diabetes mellitus and they had 3.13 times higher risk of having CKD stage 3-5 (eGFR less than 60 ml/min/1.73 m2) when compared to non-diabetics. The results showed that diabetes was significantly more associated with lower eGFR (less than 60 ml/min/1.73 m2) in younger subjects (age less than 60) compared to older ones (odds ratio 3.29 versus 1.21).CONCLUSION:Our study showed that chronic kidney disease is frequent in the Republic of Macedonia and is associated with older age and diabetes. Diabetes had a significantly stronger association with CKD at younger age.

Doença renal crônica em adultos de Rio Branco, Acre: inquérito de base populacional

“…O diabetes também esteve associado à presença de DRC segundo a TFG e albuminúria em adultos. Outros trabalhos reportaram tal associação 21,44 . O mecanismo de lesão renal no indivíduo diabético inclui a alteração na perfusão, o aumento da pressão e a hiperfiltração glomerular que leva à proteinúria e resulta em glomeruloesclerose com diminuição da TFG 45 .…”

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“…Therefore, in our study, our patients were divided into two groups: those with a GFR <60 mL/min/1.73m² and GFR ≥60 mL/min/1.73m². GFR was calculated using the Cockroft-Gault formula (calculated creatinine clearance=[(140-age) x 1.23 x body weight (kg)/ serum creatinine (mg/dL)] x 0.85 if female) (19). The presence of DPN was determined by 10-g monofilament test.…”

Atorvastatin attenuates p-cresyl sulfate-induced atherogenesis and plaque instability in ApoE knockout mice

“…Chronic kidney disease (CKD), which affects up to 15% of adults in the USA, presents a significant threat to public health ( 1 – 3 ). Diabetes mellitus, hypertension, glomerulonephritis and idiopathic origins are the most common causes.…”