La néphropathie diabétique au CHU de Brazzaville, Congo : aspects épidémiologiques, cliniques, et facteurs de risque

Diabetic nephropathy (DN) is the main cause of end-stage renal disease (ESRD) worldwide. Its occurrence and progression can be prevented by tight control of key risk factors. The aim of this study was to describe epidemiologic patterns and risk factors for DN in patients with diabetes attending an academic hospital. Retrospective analysis was performed on patients hospitalized in the nephrology and diabetology departments of university hospital in Brazzaville (Congo) between January 2006 and December 2010. Among 3700 patients, 661 were suffering from DN (group 1) and they were compared to a control group of 1300 diabetic patients without DN (group 2). The prevalence of DN was 20.5%. The mean age (±SD) of patients with DN was 55.9±10.4 years, and 75.0% were males. Mean diabetes duration was 16.1±5.5 years. Mean BMI was 27.0±3.9 Kg/m2 in group 1 (vs. 28.7±5.1 Kg/m2 in group 2). Hypertension prevalence was 93.0% in group 1 (vs. 42.1% in group 2); 70.5% of patients (group 1) had current poor glucose control (HbA1c >8.0%) vs. 22.8% in group 2. At the time of first hospitalization, ESRD was found in 19.8% of patients. The mean survival duration of ESRD patients was 2.7±1.7 months. DN was considered causal in 44.9% of ESRD patients, and was the first cause of ESRD in this study. Poor glucose control and hypertension were the main risk factors for ESRD and its progression.