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      Incidence and Predictors of Acute Kidney Injury Among Newly Diagnosed Type 2 Diabetes Patients at Chronic Follow-Up Clinic of University of Gondar Comprehensive Specialized Hospital: A Retrospective Follow-Up Study

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          Abstract

          Background

          Acute kidney injury is a common disorder worldwide, occurring in more than 13 million per year, 85% of whom live in developing countries. The high incidence of acute kidney injury among type 2 diabetic patients is a major cause of morbidity and mortality. There is limited data that address the incidence and predictors of acute kidney injury to apply evidence-based interventions in developing countries including Ethiopia specifically in the study area.

          Methods

          Institution-based retrospective follow-up study was conducted among 420 adults with newly diagnosed type 2 diabetes patients from January 1, 2014, to December 31, 2019. Log rank test and Kaplan–Meier curve were used to compare different categories of survival probability. In a multivariable analysis, variable having a p-value <0.05 in the Cox, proportional hazard model was considered as independent predictors.

          Results

          Overall, 19.76% (95% CI; 16.2–23.8) of the study population developed acute kidney injury, with a median follow-up period of 30.75 months. Congestive heart failure [adjusted hazard ratio (AHR): 2.89 (95% CI; 1.62, 5.13)], chronic kidney disease [AHR: 2.92 (95% CI; 1.56, 5.48)], hypertension [AHR: 2.87 (95% CI; 1.20, 6.90)], and diabetic nephropathy [AHR: 2.04 (95% CI; 1.13, 3.68)] were found to be predictors of acute kidney injury.

          Conclusion

          The incidence of acute kidney injury among type 2 diabetes patients was high in the study area. In patients with hypertension congestive heart failure, chronic kidney disease, and diabetic nephropathy efforts should be made to diagnose AKI early and treat it – in addition to better control accordingly among type 2 diabetes mellitus patients.

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          Most cited references26

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          WITHDRAWN: Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition

          To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045.
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            Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.

            The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has been changed since that time. There is however considerable new knowledge regarding the aetiology of different forms of diabetes as well as more information on the predictive value of different blood glucose values for the complications of diabetes. A WHO Consultation has therefore taken place in parallel with a report by an American Diabetes Association Expert Committee to re-examine diagnostic criteria and classification. The present document includes the conclusions of the former and is intended for wide distribution and discussion before final proposals are submitted to WHO for approval. The main changes proposed are as follows. The diagnostic fasting plasma (blood) glucose value has been lowered to > or =7.0 mmol l(-1) (6.1 mmol l(-1)). Impaired Glucose Tolerance (IGT) is changed to allow for the new fasting level. A new category of Impaired Fasting Glycaemia (IFG) is proposed to encompass values which are above normal but below the diagnostic cut-off for diabetes (plasma > or =6.1 to or =5.6 to <6.1 mmol l(-1)). Gestational Diabetes Mellitus (GDM) now includes gestational impaired glucose tolerance as well as the previous GDM. The classification defines both process and stage of the disease. The processes include Type 1, autoimmune and non-autoimmune, with beta-cell destruction; Type 2 with varying degrees of insulin resistance and insulin hyposecretion; Gestational Diabetes Mellitus; and Other Types where the cause is known (e.g. MODY, endocrinopathies). It is anticipated that this group will expand as causes of Type 2 become known. Stages range from normoglycaemia to insulin required for survival. It is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements.
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              Diagnosis, evaluation, and management of acute kidney injury: a KDIGO summary (Part 1)

              Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever, international, multidisciplinary, clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. In this review we summarize key aspects of the guideline including definition and staging of AKI, as well as evaluation and nondialytic management. Contrast-induced AKI and management of renal replacement therapy will be addressed in a separate review. Treatment recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided.
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                Author and article information

                Journal
                Res Rep Urol
                Res Rep Urol
                rru
                rru
                Research and Reports in Urology
                Dove
                2253-2447
                24 August 2021
                2021
                : 13
                : 613-622
                Affiliations
                [1 ]School of Nursing, College of Medicine and Health Sciences, Department of Medical Nursing, University of Gondar , Gondar, Ethiopia
                [2 ]School of Nursing, College of Medicine and Health Sciences, Departments of Community Health Nursing, University of Gondar , Gondar, Ethiopia
                [3 ]Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar , Gondar, Ethiopia
                Author notes
                Correspondence: Yemataw Zewdu Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar , P.O.Box 196, Gondar, Ethiopia Email yematawzewdu@gmail.com
                Author information
                http://orcid.org/0000-0003-2028-7953
                Article
                306467
                10.2147/RRU.S306467
                8403085
                51169cbc-c711-4eff-8ad5-528da796e57b
                © 2021 Chekol Tassew et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 18 May 2021
                : 11 August 2021
                Page count
                Figures: 2, Tables: 3, References: 28, Pages: 10
                Funding
                Funded by: no funding;
                There is no funding to report.
                Categories
                Original Research

                incidence,acute kidney injury,predictors,type 2 diabetes,gondar,ethiopia

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