Prevalence of Nephropathy in Type 2 Diabetes Mellitus

Abstract

Background & objective:Diabetic Nephropathy (DN) is a leading cause of end-stage renal disease (ESRD) worldwide, contributing significantly to morbidity and mortality in Type 2 Diabetes Mellitus (T2DM) patients. In Bangladesh, while the burden of diabetes is rising, there is limited data regarding the prevalence and clinical profile of DN in the Rajshahi region. This study aimed to determine the prevalence of nephropathy among T2DM patients and to evaluate the demographic, behavioral, and clinical characteristics associated with the condition. Methods: This descriptive cross-sectional study was conducted at the Rajshahi Diabetic Association General Hospital between June 2012 and May 2015. Out of 21,000 T2DM patients (attended during the study period) initially screened, 5,424 were identified with clinical suspicion of DN. Diagnosis was confirmed through microalbuminuria screening (NycoCard Reader II) and macroalbuminuria assessment [Albustix and Protein-Creatinine Ratio (PCR)] and prevalence of DN was calculated among patients who underwent confirmatory tests for nephropathy. Finally, demographic and clinical characteristics of this cohort was studied using descriptive statistics. Results: A total of 211 patients were confirmed to have nephropathy, representing a prevalence rate of 3.9% among the screened population. The mean age of affected patients was 65.7 ± 6.8 years, with an average diabetes duration of 21.5 ± 3.5 years. Suboptimal glycemic control was evident with a mean HbA1c of 7.1 ± 0.6%. Significant comorbidities were observed, including anemia (51.7%) and hypertension (24.6%). Despite high reported rates of diet control (90.1%) and a mean BMI of 23.2 ± 2.8 kg/m², a notable proportion of patients progressed to advanced albuminuria. Conclusion: The prevalence of nephropathy in this cohort underscores the critical need for early screening and aggressive management of glycemic levels and blood pressure. The high incidence of anemia suggests that renal impairment is often advanced by the time of clinical detection. Early intervention with reno-protective agents such as ACE inhibitors and ARBs is recommended to delay progression to ESRD.

Ibrahim Card Med J 2025; 15 (2): 16-21