Prevalence and Risk Factors of Chronic Kidney Disease among Type 2 Diabetes Patients: A Cross-Sectional Study in Primary Care Practice

Janjira Jitraknatee, Chidchanok Ruengorn, Surapon Nochaiwong, Janjira Jitraknatee, Chidchanok Ruengorn, Surapon Nochaiwong

Abstract

This cross-sectional study aimed to investigate the prevalence and risk factors of chronic kidney disease (CKD) among 1,096 primary care type 2 diabetes (T2DM) patients in northern Thailand between October 2016 and September 2017. CKD was defined as estimated glomerular rate filtration values of <60 mL/min/1.73 m2. Prevalence with confidence intervals across CKD advanced stages 3-5 were estimated. Factors associated with CKD were evaluated by multivariate logistic regression. The overall prevalence of CKD was 24.4% (21.9-27.0), with severities of 11.4% (9.7-13.4), 6.8% (5.5-8.5), 4.6% (3.5-6.0), and 1.6% (1.0-2.5) for stages 3 A, 3B, 4, and 5, respectively. Regarding age and glycaemic control, individuals older than 75 years and those with a haemoglobin A1c ≥ 8% had the highest prevalence of 61.3% (51.7-70.1) and 38.6% (34.3-43.2), respectively. The multivariable logistic regression model explained 87.3% of the probability of CKD. The six independent significant risk factors of CKD were older age, retinopathy, albuminuria, haemoglobin A1c ≥ 7%, anaemia, and uric acid>7.5 mg/dL. A relatively high prevalence of CKD, especially in older patients and those with diabetic complications-related to poor glycaemic control, was encountered in this primary care practice. Early identification may help to target optimise care and prevention programs for CKD among T2DM patients.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Age, sex and glycaemic control adjusted prevalence rates of CKD in patients with T2DM. Abbreviations: CI, confidence interval; CKD, chronic kidney disease; HbA1c, haemoglobin A1c; T2DM, type 2 diabetes mellitus.
Figure 2
Figure 2
The AuROC curve and 95%CI of the risk factors of CKD in patients with T2DM. Abbreviations: AuROC, area under the receiver operating characteristic; CI, confidence interval; CKD, chronic kidney disease; T2DM, type 2 diabetes mellitus.

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