Prevalence and factors associated with chronic kidney disease among patients with Type 2 diabetes millitus in the community medical unit Khon Kaen province.

Abstract

This was a cross-sectional, descriptive and analytical research study, using unmatched case-control to investigate the prevalence and factors associated with chronic kidney disease in type 2 diabetic patients treated at community health centers in the Khon Kaen province from 1 October 2016 to 30 September 2017. There were 358 participants in this study. Data was collected by means of structured interviews and the copying of data from medical records. Descriptive statistics were frequency, percentage, median, standard deviation, and multivariate analysis. Multiple logistic regression was employed to examine the correlation with adjusted odds ratio (OR_adj) and a 95% confidence interval. 

The study found that 3,453 diabetic patients were diagnosed with chronic kidney disease (eGFR <60 ml/min/1.73 m² for 3 consecutive months). Five hundred fifty-seven patients had a prevalence rate of 161.31 per 1,000 diabetic patients. The study divided the stages of chronic kidney disease as follows: stage 3 had a prevalence rate of 123.66 per 1,000 diabetic patients, stage 4 includeda prevalence rate of 26.64 per 1,000 diabetic patients and stage 5 showed a prevalence of 11.00 per 1,000 diabetic patients. The factors significantly associated (p<0.05)with chronic kidney disease in Type 2 diabetic patients, who had been admitted to the community health centers in Khon Kaen, included the following 1) over 70 years of age (OR_adj=5.00, 95%CI=2.43-10.29) 2) a family history of chronic kidney disease (OR_adj=28.87, 95%CI=11.54-72.22) 3)  moderate to poor eating behaviors (OR_adj=10.96, 95%CI=4.82-24.93) 4) moderate to poor emotional behaviors (OR_adj=8.82, 95%CI=4.17-18.6) and 5) hypertension (OR_adj=2.80, 95%CI=1.05-7.47).

      The results showed that the diabetic patients had exhibited poor healthcare behaviors. Therefore, local public health centers should provide patients with pro-active public services, screenings, and regular follow-ups to check on the severity of the disease in order to diagnose, provide appropriate care, and to prevent serious complications. These steps should especially be carried out for people who have a family history of chronic kidney disease. Moreover, training should be provided to patients with diabetes and to their caregivers on how to correctly read nutritional labels so that they can better understand the proper amount of nutrients (i.e., fats, proteins, carbohydrates, vitamins, iron, and sodium, etc.), which should be consumed daily. In addition, there should be activities which encourage changes in individual or group eating habits, particularly in the areas of salty foods, exercise, and emotions.