Prevalence of diabetic nephropathy and associated factors in type 2 diabetes mellitus in primary health care in Kuwait

ABSTRACT

Diabetic nephropathy is the leading cause of chronic kidney disease in patients starting renal replacement therapy. Optimal reduction in the morbidity and mortality of diabetic nephropathy cases require early identification of at risk patients allowing application of appropriate management protocols. This study aimed at identifying the prevalence rate of nephropathy among patients with type 2 diabetes attending primary health care centers, and determining risk factors associated with diabetic nephropathy. The study was conducted in 3 primary health care centers in Kuwait. The design can be differentiated into two components. The first one was a cross sectional descriptive study to determine the prevalence of nephropathy. The second one was case-control study to define factors associated with nephropathy. The prevalence of nephropathy in type 2 diabetes in primary care was 22.1%. The prevalence of microalbuminuria alone was 11.1%. Patient age 50-60 years, duration of diabetes >/= 5 years, smoking, blood pressure, Hb[Alc], HDL cholesterol, triglycerides were independently associated with diabetic nephropathy. The prevalence of diabetic nephropathy in type 2 diabetes in primary care in Kuwait is relatively low as compared with other countries. Many factors are associated with nephropathy in type 2 diabetic patients. Therefore attention needs to be paid to all these factors especially those, which are amenable to improvement. This would require intervention at a community level starting screening programs for early detection of microalbuminuria, control of glycemic state and blood pressure, treatment of dyslipidemia, and health education regarding smoking and dietary habits