Association between microvascular complications and chronic kidney disease stages in type 2 diabetic patients

Background: Rapid urbanization and lifestyle changes have led to a surge in type 2 diabetes mellitus (T2DM) rates and its microvascular complications. Objective: : To assess the association between microvascular complications and the stages of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus and to compare HbA1c levels across the different stages of CKD. Methods: It was a cross sectional descriptive study conducted from 27th October 2022 to 26th April 2023 at outpatient Department of Nephrology, Liaquat University of Medical & Health Sciences (LUMHS), Jamshoro, Sindh, Pakistan. Data was collected after approval from the Ethical Research Committee (LUMHS/REC/-243). Informed consent was obtained from 136 patients, males and females, 45 to 65 years of age, type 2 diabetics (for more than 10 years) with diagnosed CKD. The modification of diet in renal disease (MDRD) formula was used to estimate eGFR for chronic kidney disease staging. Diabetic retinopathy was diagnosed using fundoscopic examination and diabetic neuropathy was confirmed by symptoms and positive signs on examination. Data analysis was performed using SPSS version 22. A p-value of ≤ 0.05 was deemed statistically significant. Results: Out of 136 patients, 75 (55.15%) were males and 61 (44.85%) were females. Mean age, eGFR, HbA1c, and duration of diabetes were 53.27 ±6.39 years, 54.55±27.26 mL/min/1.73 m², 9.02±1.67% and 14.06±4.05 years. The analysis showed that 8.1%, 40.4%, 22.05%, 22.05%, and 7.4% of patients were in CKD stages 1, 2, 3, 4, and 5, respectively. There was a significant association between diabetic microvascular complications, retinopathy and neuropathy, and the stages of CKD (p<0.05). Conclusion: There is an association between microvascular complications i.e. neuropathy and retinopathy and the stages of CKD in type 2 diabetic patients. Additionally, HbA1c levels varied across CKD stages, highlighting the relationship between glycemic control and kidney function.