The Prevalence and Associated Factors of Glomerular Hyperfiltration Among Patients with Diabetes Mellitus Attending at Bugando Medical Centre, Mwanza, Tanzania.
Material type:
TextPublisher number: Wurzburg Road 35, Premises, Post Code: 33102 | P. O. Box 1464 Mwanza, Tanzania | Phone: (255) 28-298-3384 | Fax: (255) 28-298-3386 |Email: vc@bugando.ac.tz | Website: www.bugando.ac.tz.Language: English Language: Kiswahili Publication details: Mwanza, Tanzania | Catholic University of Health and Allied Sciences [CUHAS-Bugando] | 2024. Description: 94 Pages; Includes ReferencesSubject(s): Summary:
Abstract:
Background: Glomerular filtration rate is commonly elevated in early diabetes and patients with this symptom are arbitrarily considered to have hyperfiltration, as an adaptive response and compensatory mechanism for renal injury when there is decrease in nephrons number. GHF is an early marker of kidney damage which precedes decline in GFR progressing to chronic kidney disease (CKD) in diabetes. It is estimated to occur in up to 70% of patients with type 1 and 50% of those with type 2 diabetes at the time of diagnosis or in the early stages of disease. The prevalence in sub-Sahara Africa was from Seychelles islands study, defined GHF as a GFR greater than 140 ml/min, and was found to be 52.8% for diabetes patients. The use of drugs such as SGLT2i has been showed decrease glomerular hyperfiltration in diabetes.
Methodology: We analyzed cross-sectional data from 385 subjects with diabetes mellitus and estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m2 attending clinic at Bugando medical Centre, Mwanza following their consent. Data was collected using a designed data extraction tool and analyzed using STATA 17, Blood samples were collected for laboratory analysis. Glomerular hyperfiltration was defined as estimated glomerular filtration rate (eGFR) ≥125mL/min/1.73m2.
Results: Out of 385 participants included 230 (59.74%) were female with (mean age 61±1years), The prevalence of GHF was 8.3%. Factors associated with GHF were Age ≥65 (OR 0.92(0.85-0.99), P=0.04), shorter duration of diabetes defined as <5years (OR 0.7(0.61-0.95), P=0.01), poor glycemic control measured by glycated hemoglobin ≥7% (OR 10 (1.0-101), P=0.04), the uses of ACEI/ARB (OR 0.65 (0.06-0.720), P= 0.72).
Conclusion: Our findings show a low prevalence of Glomerular hyperfiltration and were associated with Age, duration of diabetes mellitus, poor glycemic control and the use of ACEI/ARB drugs. Regardless of the low prevalence which may be due to different methodology used comparing to the other studies, routine assessment of Glomerular hyperfiltration among patient with diabetes mellitus is recommended.
| Item type | Current library | Status | Barcode | |
|---|---|---|---|---|
| POSTGRADUATE DISSERTATIONS | MWALIMU NYERERE LEARNING RESOURCES CENTRE-CUHAS BUGANDO | Not for loan | 20241002103336.0 |
Abstract:
Background: Glomerular filtration rate is commonly elevated in early diabetes and patients with this symptom are arbitrarily considered to have hyperfiltration, as an adaptive response and compensatory mechanism for renal injury when there is decrease in nephrons number. GHF is an early marker of kidney damage which precedes decline in GFR progressing to chronic kidney disease (CKD) in diabetes. It is estimated to occur in up to 70% of patients with type 1 and 50% of those with type 2 diabetes at the time of diagnosis or in the early stages of disease. The prevalence in sub-Sahara Africa was from Seychelles islands study, defined GHF as a GFR greater than 140 ml/min, and was found to be 52.8% for diabetes patients. The use of drugs such as SGLT2i has been showed decrease glomerular hyperfiltration in diabetes.
Methodology: We analyzed cross-sectional data from 385 subjects with diabetes mellitus and estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m2 attending clinic at Bugando medical Centre, Mwanza following their consent. Data was collected using a designed data extraction tool and analyzed using STATA 17, Blood samples were collected for laboratory analysis. Glomerular hyperfiltration was defined as estimated glomerular filtration rate (eGFR) ≥125mL/min/1.73m2.
Results: Out of 385 participants included 230 (59.74%) were female with (mean age 61±1years), The prevalence of GHF was 8.3%. Factors associated with GHF were Age ≥65 (OR 0.92(0.85-0.99), P=0.04), shorter duration of diabetes defined as <5years (OR 0.7(0.61-0.95), P=0.01), poor glycemic control measured by glycated hemoglobin ≥7% (OR 10 (1.0-101), P=0.04), the uses of ACEI/ARB (OR 0.65 (0.06-0.720), P= 0.72).
Conclusion: Our findings show a low prevalence of Glomerular hyperfiltration and were associated with Age, duration of diabetes mellitus, poor glycemic control and the use of ACEI/ARB drugs. Regardless of the low prevalence which may be due to different methodology used comparing to the other studies, routine assessment of Glomerular hyperfiltration among patient with diabetes mellitus is recommended.
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