Prevalence and Risk Factors of Diabetic Nephropathy among Thai Patients with Type 2 Diabetes Mellitus
Udom Krairittichai MD*, Somkiat Potisat MD**, Amporn Jongsareejit MD***, Charnvate Sattaputh MD****
Affiliation : * Department of Medicine, College of Medicine, Rajavithi Hospital, Rangsit University, Bangkok, Thailand ** Institute of Medical Research and Technology Assessment, Department of Medical Services, MOPH, Nonthaburi, Thailand *** Prasat Neurological Institute, Department of Medical Services, MOPH, Bangkok, Thailand **** Lerdsin Hospital, Department of Medical Services, Ministry of Public Health, Bangkok, Thailand
Background : Diabetic nephropathy (DN) is the leading cause of end stage renal disease. Clinically, DN is classified into 3
stages: microalbuminuria (MA), macroalbuminuria and ESRD. The prevalence and risk factors of DN among patients with
type 2 diabetes mellitus (T2DM) in Thailand have not been well studied.
Objective : To assess the prevalence of DN in patients with T2DM and to determine their associated risk factors.
Material and Method: A cross-sectional study evaluating 877 T2DM patients from the out-patient department of seven public
hospitals in Thailand was performed. Three random spot urine samples from all patients were collected during 3 consecutive
months. Normoalbuminuria, MA and macroalbuminuria were defined as the presence of at least two out of three spot urine
tests for urine albumin/creatinine ratio showing less than 30, 30-300 and more than 300 mg/gm respectively.
Results : Most patients were female, 60 years of age or older, with BMI above 25 kg/m2, a family history of DM, uncontrolled
blood pressure, HbA1c above 7.0% and LDL above 100 mg/dl. The prevalence of normoalbuminuria, MA and
macroalbuminuria was 62.8, 26.0 and 11.2% respectively. The prevalence of diabetic retinopathy in T2DM with
normoalbuminuria, MA and microalbuminuria was 18.5, 35.5 and 48.0% respectively. Associated risk factors of DN were
the duration of DM, HbA1c levels and uncontrolled hypertension.
Conclusion : The prevalence of all DN was 37.2%. Associated risk factors of DN were the duration of DM, HbA1c levels and
uncontrolled hypertension.
Keywords : Diabetic nephropathy, Diabetes mellitus
