Diabetic Nephropathy and Its Risk Factors in a Society with a Type 2 Diabetes Epidemic: A Saudi National Diabetes Registry-Based Study

Aims The prevalence of diabetic nephropathy and its risk factors have not been studied in a society known to have diabetes epidemic like Saudi Arabia. Using a large data base registry will provide a better understanding and accurate assessment of this chronic complication and its related risk factors. Methodology A total of 54,670 patients with type 2 diabetes aged ≥25 years were selected from the Saudi National Diabetes Registry (SNDR) and analyzed for the presence of diabetic nephropathy. The American Diabetes Association (ADA) criterion was used to identify cases with microalbuminuria, macroalbuminuria and end stage renal disease (ESRD) for prevalence estimation and risk factor assessment. Results The overall prevalence of diabetic nephropathy was 10.8%, divided into 1.2% microalbuminuria, 8.1%macroalbuninuria and 1.5% ESRD. Age and diabetes duration as important risk factors have a strong impact on the prevalence of diabetic nephropathy, ranging from 3.7% in patients aged 25–44 years and a duration of >5 years, to 21.8% in patients ≥65 years with a diabetes duration of ≥15 years. Diabetes duration, retinopathy, neuropathy, hypertension, age >45 years, hyperlipidemia, male gender, smoking, and chronologically, poor glycemic control has a significantly high risk for diabetic nephropathy. Conclusion The prevalence of diabetic nephropathy is underestimated as a result of a shortage of screening programs. Risk factors related to diabetic nephropathy in this society are similar to other societies. There is thus an urgent need for screening and prevention programs for diabetic nephropathy among the Saudi population.

[1]  D. Pavlović,et al.  Diabetic nephropathy: diagnosis, prevention and treatment , 2013 .

[2]  V. Viswanathan,et al.  Risk factors associated with the development of overt nephropathy in type 2 diabetes patients: A 12 years observational study , 2012, The Indian journal of medical research.

[3]  Chul-woo Yang,et al.  Prevalence of diabetic nephropathy in primary care type 2 diabetic patients with hypertension: data from the Korean Epidemiology Study on Hypertension III (KEY III study). , 2011, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[4]  S. Shaikh,et al.  Factors affecting the progression of diabetic nephropathy and its complications: A single-center experience in Saudi Arabia , 2011, Annals of Saudi medicine.

[5]  G. Savage,et al.  Identifying additional patients with diabetic nephropathy using the UK primary care initiative , 2010, Diabetic medicine : a journal of the British Diabetic Association.

[6]  N. Dreyer,et al.  Registries for Evaluating Patient Outcomes: A User’s Guide , 2010 .

[7]  Feng-Chih Shen,et al.  The Prevalence and Risk Factors of Diabetic Nephropathy in Taiwanese Type 2 Diabetes-A Hospital-Based Study , 2009 .

[8]  Elizabeth Selvin,et al.  Poor glycemic control in diabetes and the risk of incident chronic kidney disease even in the absence of albuminuria and retinopathy: Atherosclerosis Risk in Communities (ARIC) Study. , 2008, Archives of internal medicine.

[9]  K. Borch-Johnsen,et al.  The Danish National Diabetes Register: trends in incidence, prevalence and mortality , 2008, Diabetologia.

[10]  N. Tarif,et al.  Diabetes complications in 1952 type 2 diabetes mellitus patients managed in a single institution , 2008, Annals of Saudi medicine.

[11]  S. Hofer,et al.  Diabetic Nephropathy in 27,805 Children, Adolescents, and Adults With Type 1 Diabetes , 2007, Diabetes Care.

[12]  V. Mohan,et al.  Prevalence and Risk Factors of Diabetic Nephropathy in an Urban South Indian Population , 2007, Diabetes Care.

[13]  C. Deerochanawong,et al.  Thailand diabetes registry project: prevalence, characteristics and treatment of patients with diabetic nephropathy. , 2006, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[14]  Joseph K McLaughlin,et al.  Obesity and risk for chronic renal failure. , 2006, Journal of the American Society of Nephrology : JASN.

[15]  Rury R Holman,et al.  Risk Factors for Renal Dysfunction in Type 2 Diabetes , 2006, Diabetes.

[16]  Carlos Iribarren,et al.  Body Mass Index and Risk for End-Stage Renal Disease , 2006, Annals of Internal Medicine.

[17]  E. Manzato,et al.  Renal protection in diabetes: role of glycemic control. , 2006, Journal of the American Society of Nephrology : JASN.

[18]  M. Khalil,et al.  Obesity in Saudi Arabia. , 2005, Saudi medical journal.

[19]  M. Khalil,et al.  Diabetes mellitus in Saudi Arabia. , 2004, Saudi medical journal.

[20]  B. Brenner,et al.  The risk of developing end-stage renal disease in patients with type 2 diabetes and nephropathy: the RENAAL study. , 2003, Kidney international.

[21]  R. Deepa,et al.  Frequency of proteinuria in type 2 diabetes mellitus seen at a diabetes centre in southern India , 2000, Postgraduate medical journal.

[22]  A. Al-Nuaim,et al.  Prevalence and determinants of smoking in three regions of Saudi Arabia , 1999, Tobacco control.

[23]  P. Mehler,et al.  Smoking as a risk factor for nephropathy in non-insulin-dependent diabetics , 1998, Journal of General Internal Medicine.

[24]  M. Ravid,et al.  Main risk factors for nephropathy in type 2 diabetes mellitus are plasma cholesterol levels, mean blood pressure, and hyperglycemia. , 1998, Archives of internal medicine.

[25]  H. Parving,et al.  Population based study of rates of multiple pregnancies in denmark, 1980-94 , 1997, BMJ.

[26]  S. Sobki,et al.  Prevalence of microalbuminuria in Saudi Arabians with non-insulin-dependent diabetes mellitus: a clinic-based study. , 1994, Diabetes research and clinical practice.

[27]  R. Klein,et al.  Prevalence of Microalbuminuria in Older-Onset Diabetes , 1993, Diabetes Care.

[28]  R. Steenkamp,et al.  UK Renal Registry 12th Annual Report (December 2009): chapter 13: the UK Renal Registry advanced CKD study: frequency of incorrect reporting of date of start of RRT. , 2010, Nephron. Clinical practice.

[29]  C. Maric,et al.  Estrogens and the diabetic kidney. , 2008, Gender medicine.

[30]  Rury R Holman,et al.  Development and progression of nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). , 2003, Kidney international.