Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus: a Cross-sectional Study

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2021 Jun 17

PMID 34134654

Citations 6

Authors

Randa I Farah

Mohammed Q Al-Sabbagh

Munther S Momani

Asma Albtoosh

Majd Arabiat

Ahmad M Abdulraheem

Husam Aljabiri

Mohammad Abufaraj

Affiliations

Soon will be listed here.

Abstract

Aim: Diabetic kidney disease (DKD) is a major long-term complication of diabetes mellitus (DM). Given the paucity of data on DKD in Jordan, we aimed to evaluate the prevalence, characteristics and correlates of DKD in Jordanian patients with type 2 DM.

Methods: This cross-sectional study included 1398 adult patients with type 2 DM who sought medical advice in the endocrinology clinic between March and September 2019. Demographic, clinical and laboratory data were reviewed. DKD was defined as reduced eGFR, and/or albuminuria. Three regression models were constructed to identify factors associated with CKD stages, albuminuria and DKD.

Results: Overall, 701 (50.14%) patients had DKD, with a median age of 59.71 ± 11.36 years. Older age, high triglycerides, and low high-density lipoprotein were associated with DKD (multivariable odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01-1.03, p < 0.01; OR: 1.1, 95% CI: 1.01-1.2; and OR: 0.98, 95% CI: 0.97-0.99, p < 0.01 respectively). Metformin and renin-angiotensin system blockers were negatively associated with albuminuria and chronic kidney disease stages (p < 0.01).

Conclusion: Our study demonstrated that approximately one half of patients with type 2 DM had DKD. Further studies are necessary to understand this high prevalence and the underlying factors. Future research are needed to assess implementing targeted community-based intervention.

Citing Articles

Chronic kidney disease and its predictors among highly active antiretroviral therapy naïve and experienced HIV-infected individuals at the selected hospitals, Southwest Ethiopia: a comparative cross-sectional study.

Belay A, Manaye G, Kebede K, Abateneh D, Debebe S BMJ Public Health. 2025; 1(1):e000235.

PMID: 40017843 PMC: 11812716. DOI: 10.1136/bmjph-2023-000235.

The effectiveness of antioxidant agents in delaying progression of diabetic nephropathy: A systematic review of randomized controlled trials.

Rahayu I, Arfian N, Kustanti C, Wahyuningsih M Bioimpacts. 2025; 15:30129.

PMID: 39963561 PMC: 11830129. DOI: 10.34172/bi.30129.

Finding the new potential research on diabetic kidney disease and hemodialysis in healthcare insurance databases: A bibliometric analysis.

Kresnowati L, Suhartono S, Shaluhiyah Z, Widjanarko B Narra J. 2025; 4(3):e827.

PMID: 39816104 PMC: 11731930. DOI: 10.52225/narra.v4i3.827.

Effect of poor glycemic control on the prevalence and determinants of anemia and chronic kidney disease among type 2 diabetes mellitus patients in Jordan: An observational cross-sectional study.

Al-Dwairi A, Al-Shboul O, Al-Udatt D, Saadeh R, Alqudah M, Khassawneh A PLoS One. 2024; 19(11):e0313627.

PMID: 39541418 PMC: 11563440. DOI: 10.1371/journal.pone.0313627.

Prevalence and Risk Factors of Chronic Kidney Disease in Patients With Type 2 Diabetes in China: Cross-Sectional Study.

Shi L, Xue Y, Yu X, Wang Y, Hong T, Li X JMIR Public Health Surveill. 2024; 10:e54429.

PMID: 39213031 PMC: 11399742. DOI: 10.2196/54429.

References

Herman W, Aubert R, Engelgau M, Thompson T, Ali M, Sous E . Diabetes mellitus in Egypt: glycaemic control and microvascular and neuropathic complications. Diabet Med. 1998; 15(12):1045-51. DOI: 10.1002/(SICI)1096-9136(1998120)15:12<1045::AID-DIA696>3.0.CO;2-L. View

Alzaid A, Sobki S, De Silva V . Prevalence of microalbuminuria in Saudi Arabians with non-insulin-dependent diabetes mellitus: a clinic-based study. Diabetes Res Clin Pract. 1994; 26(2):115-20. DOI: 10.1016/0168-8227(94)90148-1. View

Taleb N, Salti H, Al-Mokaddam M, Merheb M, Salti I, Nasrallah M . Prevalence and determinants of albuminuria in a cohort of diabetic patients in Lebanon. Ann Saudi Med. 2008; 28(6):420-5. PMC: 6074245. DOI: 10.5144/0256-4947.2008.420. View

Kawanami D, Takashi Y, Tanabe M . Significance of Metformin Use in Diabetic Kidney Disease. Int J Mol Sci. 2020; 21(12). PMC: 7352798. DOI: 10.3390/ijms21124239. View

Brenner B, Cooper M, de Zeeuw D, Keane W, Mitch W, Parving H . Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001; 345(12):861-9. DOI: 10.1056/NEJMoa011161. View

Russo G, De Cosmo S, Viazzi F, Pacilli A, Ceriello A, Genovese S . Plasma Triglycerides and HDL-C Levels Predict the Development of Diabetic Kidney Disease in Subjects With Type 2 Diabetes: The AMD Annals Initiative. Diabetes Care. 2016; 39(12):2278-2287. DOI: 10.2337/dc16-1246. View

Brown D, Mokdad A, Walke H, Asad M, Al-Nsour M, Zindah M . Projected burden of chronic, noncommunicable diseases in Jordan. Prev Chronic Dis. 2009; 6(2):A78. PMC: 2687884. View

Davis T, Ting R, Best J, Donoghoe M, Drury P, Sullivan D . Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study. Diabetologia. 2010; 54(2):280-90. DOI: 10.1007/s00125-010-1951-1. View

Wu A, Kong N, de Leon F, Pan C, Tai T, Yeung V . An alarmingly high prevalence of diabetic nephropathy in Asian type 2 diabetic patients: the MicroAlbuminuria Prevalence (MAP) Study. Diabetologia. 2004; 48(1):17-26. DOI: 10.1007/s00125-004-1599-9. View

10.

Gheith O, Farouk N, Nampoory N, Halim M, Al-Otaibi T . Diabetic kidney disease: world wide difference of prevalence and risk factors. J Nephropharmacol. 2017; 5(1):49-56. PMC: 5297507. View

11.

Hemmelgarn B, Zhang J, Manns B, Tonelli M, Larsen E, Ghali W . Progression of kidney dysfunction in the community-dwelling elderly. Kidney Int. 2006; 69(12):2155-61. DOI: 10.1038/sj.ki.5000270. View

12.

Ritz E, Rychlik I, Locatelli F, Halimi S . End-stage renal failure in type 2 diabetes: A medical catastrophe of worldwide dimensions. Am J Kidney Dis. 1999; 34(5):795-808. DOI: 10.1016/S0272-6386(99)70035-1. View

13.

Lee M, Katerelos M, Gleich K, Galic S, Kemp B, Mount P . Phosphorylation of Acetyl-CoA Carboxylase by AMPK Reduces Renal Fibrosis and Is Essential for the Anti-Fibrotic Effect of Metformin. J Am Soc Nephrol. 2018; 29(9):2326-2336. PMC: 6115654. DOI: 10.1681/ASN.2018010050. View

14.

Penno G, Solini A, Bonora E, Fondelli C, Orsi E, Zerbini G . Clinical significance of nonalbuminuric renal impairment in type 2 diabetes. J Hypertens. 2011; 29(9):1802-9. DOI: 10.1097/HJH.0b013e3283495cd6. View

15.

Stevens P, Levin A . Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013; 158(11):825-30. DOI: 10.7326/0003-4819-158-11-201306040-00007. View

16.

Morton J, Zoungas S, Li Q, Patel A, Chalmers J, Woodward M . Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: results of the ADVANCE study. Diabetes Care. 2012; 35(11):2201-6. PMC: 3476889. DOI: 10.2337/dc12-0306. View

17.

Kramer H, Nguyen Q, Curhan G, Hsu C . Renal insufficiency in the absence of albuminuria and retinopathy among adults with type 2 diabetes mellitus. JAMA. 2003; 289(24):3273-7. DOI: 10.1001/jama.289.24.3273. View

18.

Parving H, Andersen S, Jacobsen P, Christensen P, Rossing K, Hovind P . Angiotensin receptor blockers in diabetic nephropathy: renal and cardiovascular end points. Semin Nephrol. 2004; 24(2):147-57. DOI: 10.1016/j.semnephrol.2003.11.003. View

19.

Qi C, Mao X, Zhang Z, Wu H . Classification and Differential Diagnosis of Diabetic Nephropathy. J Diabetes Res. 2017; 2017:8637138. PMC: 5337846. DOI: 10.1155/2017/8637138. View

20.

Lachin J, Viberti G, Zinman B, Haffner S, Aftring R, Paul G . Renal function in type 2 diabetes with rosiglitazone, metformin, and glyburide monotherapy. Clin J Am Soc Nephrol. 2011; 6(5):1032-40. PMC: 3087768. DOI: 10.2215/CJN.09291010. View