Diabetic nephropathy: prevalence and associated risk factor in a primary health care unit

Authors

DOI:

https://doi.org/10.11606/issn.2176-7262.rmrp.2025.219259

Keywords:

Diabetes mellitus, Diabetic Nephropathies, Albuminuria, Glomerular filtration rate, Renal insufficiency, Chronic

Abstract

Objective: This study aimed to evaluate the prevalence of diabetic nephropathy (DN) in primary health care and its association with risk factors. Methods: A cross-sectional study was conducted through the Family Health Strategy in an adult population with type 2 diabetes mellitus, encompassing 78 participants between May 2022 and February 2023. DN was identified using albuminuria and glomerular filtration rate. Chi-square tests and binomial logistic regression were used for association analyses. Results: The prevalence of DN was 38.5% in primary care and was associated with plasma urea levels > 40mg/dL and the use of antihypertensive medications. For the studied individuals, elevated glycated hemoglobin increased the odds by 1.52 times for developing DN. Conclusion: This study allowed for identifying the prevalence and profile of diabetic nephropathy in primary care. Additionally, factors such as glycated hemoglobin, the use of antihypertensive medications, and elevated urea were associated with the development this diabetic renal disease.

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Author Biographies

  • Israel Gonçalves de Carvalho Filho, Prefeitura Municipal de Francisco Beltrão. Secretaria Municipal de Saúde. Francisco Beltrão

    Médico da Pós-graduação em Ciências Aplicadas à Saúde

  • Geraldo Emílio Vicentini, Universidade Estadual do Oeste do Paraná. Centro de Ciências da Saúde

    Docente da Pós-graduação em Ciências Aplicadas à Saúde 

References

Sociedade Brasileira de Diabetes. Diretrizes da Sociedade Brasileira de Diabetes: 2019-2020. Clannad [Internet]; 2019 [cited 2020 Dec 6]. Available from: https://www.diabetes.org.br/profissionais/images/DIRETRIZES-COMPLETA-2019-2020.pdf

Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013 Jun 4;158(11):825–830. PMID: 23732715

Tuttle KR, Bakris GL, Bilous RW, Chiang JL, de Boer IH, Goldstein-Fuchs J, et al. Diabetic kidney disease: a report from an ADA Consensus Conference. Diabetes Care. 2014 Oct;37(10):2864–2883. PMCID: PMC4170131

Koye DN, Magliano DJ, Nelson RG, Pavkov ME. The Global Epidemiology of Diabetes and Kidney Disease. Adv Chronic Kidney Dis. 2018 Mar;25(2):121–132. PMID: 29580576

Jiang W, Wang J, Shen X, Lu W, Wang Y, Li W, el al. Establishment and Validation of a Risk Prediction Model for Early Diabetic Kidney Disease Based on a Systematic Review and Meta-Analysis of 20 Cohorts. Diabetes Care. 2020 Mar 12;43(4):925–933.

Drury PL, Ting R, Zannino D, Ehnholm C, Flack J, Whiting M, et al. Estimated glomerular filtration rate and albuminuria are independent predictors of cardiovascular events and death in type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. Diabetologia. 2011 Jan;54(1):32–43.

Ninomiya T, Perkovic V, de Galan BE, Zoungas S, Pillai A, Jardine M, et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol. 2009 Aug;20(8):1813–1821. PMCID: PMC2723977

World Health Organization. Active ageing : a policy framework. World Health Organization [Internet]. 2002. Report No.: WHO/NMH/NPH/02.8. Available from: https://apps.who.int/iris/handle/10665/67215

Associação Brasileira para o Estudo da Obesidade e Síndrome Metabólica. Diretrizes brasileiras de obesidade 2016 / ABESO [Internet]. [cited 2022 Jul 14]. Available from: https://portaldeboaspraticas.iff.fiocruz.br/biblioteca/diretrizes-brasileiras-de-obesidade-2016-abeso/

World Health Organization. Waist circumference and waist-hip ratio : report of a WHO expert consultation, Geneva, 8-11 December 2008. Geneva: World Health Organization [Internet]. 2011 [cited 2022 Jul 14]; Available from: https://apps.who.int/iris/handle/10665/44583

Browning LM, Hsieh SD, Ashwell M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr Res Rev. 2010 Dec;23(2):247–269. PMID: 20819243

de Boer IH, Caramori ML, Chan JCN, Heerspink HJL, Hurst C, Khunti K, et al. KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease. Kidney International. 2020 Oct;98(4):S1–S115.

American Diabetes Association Professional Practice Committee. 11. Chronic Kidney Disease and Risk Management: Standards of Medical Care in Diabetes—2022. Diabetes Care. 2021 Dec 16;45(Suppl 1):S175–S184.

Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, et al. New Creatinine- and Cystatin C–Based Equations to Estimate GFR without Race. N Engl J Med. 2021 Nov 4;385(19):1737–1749.

Faludi A, Izar M, Saraiva J, Chacra A, Bianco H, Afiune Neto A, et al. ATUALIZAÇÃO DA DIRETRIZ BRASILEIRA DE DISLIPIDEMIAS E PREVENÇÃO DA ATEROSCLEROSE - 2017. Arquivos Brasileiros de Cardiologia [Internet]. 2017 [cited 2023 May 15];109(1). Available from: http://www.gnresearch.org/doi/10.5935/abc.20170121

Abensur H. Biomarcadores na Nefrologia. São Paulo: Roche Diagnóstica Brasil Ltda. 2011.

ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Glycemic Targets: Standards of Care in Diabetes—2023. Diabetes Care. 2022 Dec 12;46(Supp 1):S97–S110.

Lopes JA, Ferreira MC, Otoni A, Baldoni AO, Domingueti CP. Is screening for chronic kidney disease in patients with diabetes mellitus being properly conducted in primary care? Braz J Nephrol. 2022 Dec;44(4):498–504.

Scheffel RS, Bortolanza D, Weber CS, Costa LA, Canani LH, Santos KG, et al. Prevalência de complicações micro e macrovasculares e de seus fatores de risco em pacientes com diabetes melito do tipo 2 em atendimento ambulatorial. Rev Assoc Med Bras. Associação Médica Brasileira; 2004 Sep;50:263–267.

Ortega Filártiga EA. Prevalencia y características clínicas de la nefropatía diabética. Revista del Nacional (Itauguá). 2013 Jun;5(1):18–27.

Laclé-Murray A, Valero F JL. Prevalencia de nefropatía diabética y sus factores de riesgo en un área urbano marginal de la meseta Central de Costa Rica. Acta Médica Costarricense. 2009 Mar;51(1):26–33.

Coresh J, Turin TC, Matsushita K, Sang Y, Ballew SH, Appel LJ, et al. Decline in estimated glomerular filtration rate and subsequent risk of end-stage renal disease and mortality. JAMA. 2014 Jun 25;311(24):2518–2531. PMCID: PMC4172342

Calvo-Vázquez I, Sánchez-Luna O, Yáñez-Sosa AL. Prevalencia de enfermedad renal crónica no diagnosticada en pacientes con diabetes mellitus tipo 2 en atención primaria a la salud. Med Int Mex. 2015 Feb 14;31(1):41–49.

Hu F, Zhang T. Study on Risk Factors of Diabetic Nephropathy in Obese Patients with Type 2 Diabetes Mellitus. IJGM. 2020 Jul;Volume 13:351–360.

Barrett-Connor E, Wingard D, Wong N, Goldberg R. Heart Disease and Diabetes. In: Cowie CC, Casagrande SS, Menke A, et al., editors. Diabetes in America [Internet]. 3rd ed. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases (US). 2018 [cited 2023 Jul 10]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK568001/ PMID: 33651559

Antero DC, Antero MAJ, Junkes SA, Siomara T, Lufchitz C, Silva MA da. Nefropatia Diabética nas Unidades de Diálise da Região Sul de Santa Catarina: perfil clínico-epidemiológico. ACM arq catarin med. 2008;70–75.

Elhefnawy KA, Elsayed AM. Prevalence of diabetic kidney disease in patients with type 2 diabetes mellitus. Egypt J Intern Med. 2019 Jun;31(2):149–154.

Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ. 2000 Aug 12;321(7258):412–419. PMCID: PMC27455

Chen WZ, Hung CC, Wen YW, Ning HC, Gau BR, Huang YY. Effect of glycemic control on microalbuminuria development among type 2 diabetes with high-normal albuminuria. Ren Fail. 2014 Mar;36(2):171–175. PMID: 24028605

Polanco-Flores NA, Rodríguez-Castellanos F. Results of a program of early detection of diabetic nephropathy. Medicina interna de México. 2019 Apr;35(2):198–207.

Published

2025-10-01

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Section

Original Articles

How to Cite

1.
Carvalho Filho IG de, Vicentini GE. Diabetic nephropathy: prevalence and associated risk factor in a primary health care unit. Medicina (Ribeirão Preto) [Internet]. 2025 Oct. 1 [cited 2026 Feb. 1];58(1):e-219259. Available from: https://revistas.usp.br/rmrp/article/view/219259