Prevalence and determinants of proteinuria among type 2 diabetics in Kumasi, Ghana

Abstract

Diabetic nephropathy is the leading cause of end stage kidney disease among type 2 diabetics worldwide. Proteinuria has been noted to be the cardinal symptom of progressive loss of renal func- tion. This study examined the impact of duration of diabetes, demography (age, gender) and meta- bolic factors on the frequency of proteinuria among type 2 diabetics visiting the Komfo Anokye Teaching Hospital (KATH). In this cross-sectional study, 350 type 2 diabetics aged between 28-87 years were randomly selected from January to April 2004, and parameters estimated include fasting blood glucose (FBS), body mass index (BMI), urine protein and blood pressure. Proteinuria among the study cohorts was graded no proteinuria, mild proteinuria to heavy proteinuria. The frequency of proteinuria for the varied grades in type 2 diabetics enrolled in the study ranged from 73.3% (no proteinuria), 15.2% (mild proteinuria) and 15.6% (heavy proteinuria). 1(100%) patient with heavy proteinuria presented with grade 3 hypertension; and 4(33.3%) and 11(20.8%) patients presented with grade 1 and isolated systolic hypertension respectively. Multiple logistic regression analysis showed study participants with duration of diabetes ranging from 11-15 years (OR=2.8; 95% CI=1.1- 7.2; p=0.028) and 16-20 years (OR=5.6; 95% CI=1.4-22.5; p=0.016) were at an increased risk of pro- teinuria. The frequency of nephropathy is promoted independently by advanced age, hypertension and duration of diabetes.