Prevalence of diabetic nephropathy and chronic kidney disease in diabetes mellitus in Russian Federation


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Abstract

Purpose: Investigation of prevalence of diabetic nephropathy and CKD in adult patients with type 1 and type 2 diabetes mellitus in the Russian Federation.
Materials and Methods: In 20 regions of Russia, 7174 patients with type 1 and type 2 diabetes mellitus were examined. Laboratory examination included measurement of HbA1c level, blood creatinine, urea, and CL levels, albumin excretion in a spot urine sample, BP measurement, and examination of the ocular fundus. The concentration of albumin in spot urine sample of 20 mg/l to 200 mg/l was considered as a MAU, above 200 mg/l - as PU. GFR was calculated by Cockcroft-Gault formula. Statistical analysis of results of the study was performed using STATISTICA 6 software. The data are presented as median and 25th and 75th percentiles (Me [25%, 75%]). Values of P<0.05 were considered statistically significant for all measurements.
Results: The actual prevalence of DN was 40.1% (type 1 DM) and 39.3% (type 2 DM), reportable prevalence - 28.8% and 8.7%, respectively. Pathological urinary albumin excretion was observed in 42% of patients with type 1 DM and in 46,2% of patients with type 2 DM. The prevalence of this indicator was increased with patient age and duration of DM, as well as poor control of carbohydrate metabolism and blood pressure. The prevalence of CKD stages 2-3 was significantly higher in patients with type 2 DM than in patients with type 1 diabetes. Further examination for identification of causes of non-diabetic CKD is required in 15% (type 1 DM) and 41.2% (type 2 DM) patients with MAU and GFR <60 ml/min/1.73 m².
Conclusion: The annual screening can detect complications of diabetes mellitus at earlier stages. Compensation of carbohydrate metabolism and blood pressure in patients with diabetes mellitus inhibits the progression of DN.

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