Prevalence and risk factors of chronic kidney disease among Palestinian type 2 diabetic patients: a cross-sectional stud
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RESEARCH ARTICLE
Open Access
Prevalence and risk factors of chronic kidney disease among Palestinian type 2 diabetic patients: a cross-sectional study Zaher Nazzal1* , Zakaria Hamdan2,3*, Dunia Masri4, Oday Abu-Kaf4 and Mohammad Hamad4
Abstract Background: Chronic kidney disease (CKD) is a global public health concern and diabetes is one of the main risk factors for its occurrence and progression. The aim of this research is to determine the prevalence of chronic kidney disease in a cross-sectional population of patients with type 2 diabetes in primary health centers in North West Bank. Methods: Patient data including patient characteristics, creatinine level, blood pressure, HbA1c, and hypertension and period of diabetes were obtained from primary health care centers. The eGFR has been determined using the CKD-EPI equation. CKD was staged according to the 2012 Kidney Disease Improving Global Outcomes Framework (KDIGO) guideline. Both univariable and multivariable statistical analysis was conducted using SPSS. Results: The prevalence of chronic kidney disease among diabetic adults in North West Bank was found to be 23.6% (95% CI: 19.4–28.1%) divided as follows: 19.7% had stage 3 CKD, 2.6% had stage 4 CKD and 1.3% had stage 5 CKD. In multivariable logistic regression, CKD was significantly associated with Age ≥ 60 years [adjusted OR: 3.2, 95% CI: 1.8–5.9], hypertension [adjusted OR: 5.7, 95% CI: 2.2–15.2], and smoking [adjusted OR: 2.3, 95% CI: 1.3–4.2]. Conclusions: CKD is very prevalent among diabetic adults in Palestine. Co-morbid hypertension, smoking and older age has been shown to increase the risk of developing CKD. Extensive screening for diabetic patients to diagnose CKD at an early stage and to follow more aggressive treatment methods for diabetes as well as other important risk factors, especially hypertension and smoking, is recommended. Keywords: Prevalence, Diabetes mellitus type two, Primary health care, Palestine, Renal insufficiency
Background Non-communicable diseases (NCDs), such as diabetes and kidney disease, are the leading cause of death and morbidity worldwide [1]. Diabetes Mellitus (DM) is known as the fastest-growing chronic disease in the world. Worldwide, one in every 11 adults has DM, 90% of whom have type 2 diabetes mellitus (T2DM). This number has * Correspondence: [email protected]; [email protected] 1 Department of Family and Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Box 7, 707, Nablus, Palestine 2 Department of Internal Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine Full list of author information is available at the end of the article
grown tremendously over the last three decades due to rising rates of sedentary lifestyle, unhealthy diet, smoking and alcohol consumption [2]. Unfortunately, all Arab countries in the Middle East and North African regions are burdened with the second highest prevalence of diabetes [3]. The prevalence of T2DM among Palestinians living in the West
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