The study on risk factors, complications and management on diabetes mellitus with chronic kidney disease

Authors

  • Muthaka Gowthami Department of Pharmacy Practice, Saastra College of Pharmaceutical Education and Research, Nellore, Andhra Pradesh.
  • Sangati Sai Pranathi Department of Pharmacy Practice, Saastra College of Pharmaceutical Education and Research, Nellore, Andhra Pradesh.
  • Balla Devi Department of Pharmacy Practice, Nirmala College of Pharmacy, Mangalagiri, Andhra Pradesh.

Abstract

Introduction: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by elevated blood glucose level and associated with number of complications including acute metabolic and long-term vascular complications. Type 2 diabetes mellitus (T2DM) is the most common type of diabetes worldwide. Chronic kidney disease (CKD) in patients with T2DM is the major cause of end stage renal disease, characterized by proteinuria with a subsequent decline in glomerular filtration rate. Aim & Objectives: To evaluate the risk factors, complications and management of diabetes mellitus with chronic kidney disease. Methodology: A prospective observational study was conducted for 6months duration in Nephrology department. Based on the inclusion criteria and exclusion criteria the DKD patients were recruited in the study. We have obtained the informed consent forms from those who are willing to participate in the study. The data was collected from personal interviews (patient& / or patient representatives), professional interviews( doctors/nurses/technicians) by using a well structured patient data collection proforma and followed up. Results & Discussion: At the age above 50 yrs maximum high blood glucose and high BP patients were appeared in more number due to greater urbanisation, change in life styles and environmental factor. High cholesterol, obesity and diet are the major risk factors for DKD according to our observational studies. Diet shows a major impact on the diabetes when we eat extra calories and fat, our body creates an undesirable rise in blood glucose (hyperglycaemia), it may lead to serious problems that if persistent, may lead to long term complications, such as nerve, kidney and heart damage. Conclusion: The risk factors for DKD were assessed as age group, gender, obesity, high BP, high blood sugar, high cholesterol, illiteracy, urbanisation, life style modifications. Totally we concluded that most patients with DM will affect kidney that may prolong the renal failure.  The CKD. As per our study we finally stated that there are different stages of DKD (stage 1,2,3,4 and 5). Most of the patients in DKD are observed in stage 2.

Keywords:

Diabetes mellitus, CKD, Hyperglycaemia, Proteinuria, Diabetic complications

DOI

https://doi.org/10.70604/learnint.v2i2.75

References

1. de Boer IH, Khunti K, Sadusky T, Tuttle KR, Neumiller JJ, Rhee CM, et al. Diabetes management in chronic kidney disease: A consensus report by the American diabetes association (ADA) and kidney disease: Improving global outcomes (KDIGO). Diabetes Care (2022) 3:dci220027. doi: 10.2337/dci22-0027 [DOI] [PMC free article] [PubMed] [Google Scholar]

2. Roy S, Schweiker-Kahn O, Jafry B, Masel-Miller R, Raju RS, O'Neill LMO, et al. Risk factors and comorbidities associated with diabetic kidney disease. J Prim Care Community Health (2021) 12:21501327211048556.

3. Al-Rubeaan K, Siddiqui K, Alghonaim M, Youssef AM, AlNaqeb D. The Saudi diabetic kidney disease study (Saudi-DKD): Clinical characteristics and biochemical parameters. Ann Saudi Med (2018) 38(1):46–56. doi: 10.5144/0256-4947.2018.03.01.1010 [DOI] [PMC free article] [PubMed] [Google Scholar]

4. Al-Rubeaan K, Youssef AM, Subhani SN, Ahmad NA, Al-Sharqawi AH, Al-Mutlaq HM, et al. Diabetic nephropathy and its risk factors in a society with a type 2 diabetes epidemic: A Saudi national diabetes registry-based study. PloS One (2014) 9(2):e88956. doi: 10.1371/journal.pone.0088956 [DOI] [PMC free article] [PubMed] [Google Scholar]

5. Mahmoodi BK, Matsushita K, Woodward M, Blankestijn PJ, Cirillo M, Ohkubo T, et al. Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without hypertension: A meta-analysis. Lancet (2012) 380:1649–6. doi: 10.1016/S0140-6736(12)61272-0 [DOI] [PMC free article] [PubMed] [Google Scholar]

6. Wang TJ, Evans JC, Meigs JB, Rifai N, Fox CS, D’Agostino RB, et al. Low-grade albuminuria and the risks of hypertension and blood pressure progression. Circulation. (2005) 111:1370–6. doi: 10.1161/01.CIR.0000158434.69180.2D [DOI] [PubMed] [Google Scholar]

7. Amorim RG, Guedes GDS, Vasconcelos SML, Santos JCF. Kidney disease in diabetes mellitus: Cross-linking between hyperglycemia, redox imbalance and inflammation. Arq Bras Cardiol (2019) 112(5):577–87. doi: 10.5935/abc.20190077 [DOI] [PMC free article] [PubMed] [Google Scholar]

8. Kebede SA, Tusa BS, Weldesenbet AB, Tessema ZT, Ayele TA. Incidence of diabetic nephropathy and its predictors among type 2 diabetes mellitus patients at university of gondar comprehensive specialized hospital, Northwest Ethiopia. J Nutr Metab, 2021:6757916. doi: 10.1155/2021/6757916 [DOI] [PMC free article] [PubMed] [Google Scholar]

9. Gall MA, Hougaard P, Borch-Johnsen K, Parving HH. Risk factors for development of incipient and overt diabetic nephropathy in patients with non-insulin dependent diabetes mellitus: Prospective, observational study. BMJ. (1997) 314(7083):783–8. doi: 10.1136/bmj.314.7083.783 [DOI] [PMC free article] [PubMed] [Google Scholar]

10. Tapp RJ, Shaw JE, Zimmet PZ, Balkau B, Chadban SJ, Tonkin AM, et al. Albuminuria is evident in the early stages of diabetes onset: Results from the Australian diabetes, obesity, and lifestyle study (AusDiab). Am J Kidney Dis (2004) 44(5):792–8. doi: 10.1016/S0272-6386(04)01079-0 [DOI] [PubMed] [Google Scholar]

11. Hovind P, Tarnow L, Rossing P, Jensen BR, Graae M, Torp I, et al. Predictors for the development of microalbuminuria and macroalbuminuria in patients with type 1 diabetes: Inception cohort study. BMJ (2004) 328(7448):1105. doi: 10.1136/bmj.38070.450891.FE [DOI] [PMC free article] [PubMed] [Google Scholar]

12. Wagnew F, Eshetie S, Kibret GD, Zegeye A, Dessie G, Mulugeta H, et al. Diabetic nephropathy and hypertension in diabetes patients of sub-Saharan countries: A systematic review and meta-analysis. BMC Res Notes (2018) 11(1):565. doi: 10.1186/s13104-018-3670-5 [DOI] [PMC free article] [PubMed] [Google Scholar]

13. Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR, et al. Development and progression of nephropathy in type 2 diabetes: The united kingdom prospective diabetes study (UKPDS 64). Kidney Int (2003) 63(1):225–32. doi: 10.1046/j.1523-1755.2003.00712.x [DOI] [PubMed] [Google Scholar]

14. Shen FC, Chen CY, Su SC, Liu RT. The prevalence and risk factors of diabetic nephropathy in Taiwanese type 2 diabetes - a hospital based study. ActaNephrologica (2009) 23(2):90–5. [Google Scholar]

15. 31. Farah RI, Al-Sabbagh MQ, Momani MS, Albtoosh A, Arabiat M, Abdulraheem AM, et al. Diabetic kidney disease in patients with type 2 diabetes mellitus: A cross-sectional study. BMC Nephrol (2021) 22(1):1–8. doi: 10.1186/s12882-021-02429-4 [DOI] [PMC free article] [PubMed] [Google Scholar]

16. Agarwal R, Light RP. Physical activity and hemodynamic reactivity in chronic kidney disease. Clin J Am Soc Nephrol (2008) 3(6):1660–8. doi: 10.2215/CJN.02920608 [DOI] [PMC free article] [PubMed] [Google Scholar]

17. Bowlby W, Zelnick LR, Henry C, Himmelfarb J, Kahn SE, Kestenbaum B, et al. Physical activity and metabolic health in chronic kidney disease: A cross-sectional study. BMC Nephrol (2016) 17(1):187. doi: 10.1186/s12882-016-0400-x [DOI] [PMC free article] [PubMed] [Google Scholar]

18. Werner C, Fürster T, Widmann T, Pöss J, Roggia C, Hanhoun M, et al. Physical exercise prevents cellular senescence in circulating leukocytes and in the vessel wall. Circulation. (2009) 120(24):2438–47. doi: 10.1161/CIRCULATIONAHA.109.861005 [DOI] [PubMed] [Google Scholar]

19. Nylen ES, Gandhi SM, Kheirbek R, Kokkinos P. Enhanced fitness and renal function in type 2 diabetes. Diabetes Med (2015) 32(10):1342–5. doi: 10.1111/dme.12789 [DOI] [PubMed] [Google Scholar]

20. Macisaac RJ, Ekinci EI, Jerums G. Markers and risk factors for the development and progression of diabetic kidney disease. Am J Kidney Dis (2014) 63(2):S39–62. doi: 10.1053/j.ajkd.2013.10.048 [DOI] [PubMed] [Google Scholar]

21. Early Treatment of Diabetic Retinopathy study research group . Grading diabetic retinopathy from stereoscopic colour fundus photographs-an extension of the modified airlie house classification. ETDRS report number 10. Ophthalmology (1991) 98:786–806. doi: 10.1016/S0161-6420(13)38012-9 [DOI] [PubMed] [Google Scholar]

22. Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension guidelines. Treands Cardiovasc Med (2020) 30(3):160–4. doi: 10.1016/j.tcm.2019.05.003 [DOI] [PubMed] [Google Scholar]

23. Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF, 3rd, Feldman HI, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med (2009) 150(9):604–12. doi: 10.7326/0003-4819-150-9-200905050-00006 [DOI] [PMC free article] [PubMed] [Google Scholar]

24. De Fronzo R. From the triumvirate to the ominous octet: A new paradigm for the treatment of type 2 diabetes mellitus. Diabetes (2009) 58:773–95. doi: 10.2337/db09-9028 [DOI] [PMC free article] [PubMed] [Google Scholar]

25. Pecoits-Filho R, Abensur H, Betônico CC, Machado AD, Parente EB, Queiroz M, et al. Interactions between kidney disease and diabetes: Dangerous liaisons. Diabetol Metab Syndr (2016) 8:50. doi: 10.1186/s13098-016-0159-z [DOI] [PMC free article] [PubMed] [Google Scholar]

26. Alicic RZ, Rooney MT, Tuttle KR. Diabetic kidney disease: Challenges, progress, and possibilities. Clin J Am Soc Nephrol (2017) 12(12):2032–45. doi: 10.2215/CJN.11491116 [DOI] [PMC free article] [PubMed] [Google Scholar]

27. Kelly JT, Su G, Carrero JJ. Lifestyle interventions for preventing and ameliorating CKD in primary and secondary care. Curr Opin Nephrol Hypertens (2021) 30(6):538–46. doi: 10.1097/MNH.0000000000000745 [DOI] [PubMed] [Google Scholar]

Muthaka Gowthami

Published

2025-08-10
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How to Cite

Muthaka, G., Sangati, S. P., & Balla, D. (2025). The study on risk factors, complications and management on diabetes mellitus with chronic kidney disease. Learnovate-International, 2(2), 16-20. https://doi.org/10.70604/learnint.v2i2.75

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How to Cite

Muthaka, G., Sangati, S. P., & Balla, D. (2025). The study on risk factors, complications and management on diabetes mellitus with chronic kidney disease. Learnovate-International, 2(2), 16-20. https://doi.org/10.70604/learnint.v2i2.75