Characterization of Diabetic Nephropathy and Its Correlates in a Selected Outdoor-Based Diabetic Clinic in Rangpur, Bangladesh

Background:The rising burden of diabetic complication associated with the diabetes mellitus (DM) pandemic. DM is a global public health problem. Diabetic nephropathy (DN) is one of the life-threatening and irreversible microvascular complications of DM. Methods:A cross-sectional study was conducted from November 2017 to April 2018 to characterize and associate of possible DN among people living with diabetes where 40 T1DM, 200 T2DM as cases group and 50 non diabetic as a control groupwere selected conveniently. Data were collected using structured questionnaire and analyzed by SPSS-22. Stages of DN were classified according ‘Revised Classification of DN’ given by the ‘Joint Committee on Diabetic Nephropathy’, Japan, 2014. Results:The mean FBS was 6.81±0.87 mmol/L in T1DM, 7.98±3.25mmol/Lin T2DM and 4.55±0.58 mmol/L in controls. The prevalence of pre-nephropathy (PN), incipient nephropathy (IN) and overt nephropathy (ON) was 10%, 82.5% and 7.5% respectively in T1DM. Similarly, in T2DM the prevalence of PN, IN, ON and chronic kidney failure (CKF) was 5.5% 81%, 10%, and 3.5% respectively. One way ANOVA followed by post hoc-LSD suggested, in T1DM the mean FBS was significantly lower in PN group than IN (p=0.017) and ON (p=0.048) group. Further in T1DM and T2DM, the mean estimated Glomerular Filtration Rate was significantly (p=0.032) lower in IN group than PN and significantly (p=0.026, 0.006) lower in ON than PN and IN respectively. Irrespective of diabetic group, according to multivariate analysis, older age (adjusted OR =1.05, CI: 1.01-1.08; adjusted OR: 2.33, CI: 2.01-2.99), sCreatinine (adjusted OR: 7.73, CI: 2.26-22.47) and female sex (adjusted OR = 0.39, CI: 0.19-0.77) were independently associated with DN adjusting BMI, SBP, DBP and FBS level. Conclusion:This study showed the prevalence rate of DN was high among diabetic and mostly in type 2 diabetics with severe stage.