Prevalence of chronic kidney disease in type 2 diabetes in primary health care unit of Udon Thani province, Thailand.

OBJECTIVE: To determine the prevalence of chronic kidney disease (CKD) in Type 2 diabetes and risk factors of decreased kidney function in Type 2 diabetes at primary health care unit of Udon Thani province. MATERIAL AND
METHOD: A descriptive cross-sectional study, cluster random sampling method was conducted from April to August 2007. Seven hundred and sixteen patients were enrolled. Medical histories, physical examinations, and blood tests for glucose, creatinine, total cholesterol, and triglyceride after 9-12 hours fasting were collected. The definition and classification of CKD are classified according to K/DOQI guideline 2002.
RESULTS: The mean age of the diabetic patients was 58.70 +/- 9.83 years ranged from 30 to 92 years old. The mean duration of diabetes was 5.53 +/- 4.62 years, the majority (82.41%) had diabetes less than 10 years. More than half (51.82%) were obese (BMI > or = 25 kg/m2). Most of them (89.39%) had universal coverage health assurance. According to the ADA guideline 2006, the target systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, and triglyceride level could be achieved 55.45, 52.93, 36.31, 33.66, and 45.65% respectively. The prevalence of CKD stage 3 to 5 were 27.09 and 25.28% by using C-G and MDRD formulae respectively. The duration of diabetes, diabetes with history of hypertension, triglyceride level, and diabetic retinopathy were significant independent risk factors of the presence of decreased kidney function processed by logistic regression analysis.
CONCLUSION: The present study demonstrated the clinical characteristic and the prevalence of decreased kidney function in type 2 diabetes in a primary health care setting. Intensive and optimal treatment of diabetes to slow the progression of long-term complications should be effectively managed by a disciplinary team.