Prevalence of Diabetic Nephropathy Among Diabetic Patients in Al_Wahda Hospitals, Yemen

Abstract

Mohammed Kassim Salah, Mohammed Ali Al-Madwami*, Esmail Yahya Ali Ali Obaid and Sabreen Mohammed Ali Al-jabri

Background: Diabetic nephropathy (DN) is a serious microvascular complication of diabetes mellitus, leading to significant morbidity and mortality. Its early detection is crucial for preventing progression.

Objective: This study aimed to determine the prevalence of DN and identify associated demographic and clinical factors among diabetic patients at Al-Wahda Hospitals/ in Dhamar, Yemen.

Methods: A retrospective, cross-sectional study was conducted on 110 diabetic patients. Data on demographics, clinical parameters (including HbA1c, blood pressure) and Albumin-to-Creatinine Ratio (ACR)were collected from medical records. DN was defined by ACR categories: normal (<30mg/g), microalbuminuria (30-300 mg/g) and macroalbuminuria (>300mg/g).

Results: The prevalence of DN (microalbuminuria and macroalbuminuria) was 80%. Microalbuminuria was present in 62.7% of patients, while macroalbuminuria was found in17.3%.Key factors significantly associated with DN included longer duration of diabetes (>10 years), poor glycemic control (HbA1c ≥6.5%, 71.8% of patients),and the presence of hypertension (30.9%).A striking diagnostic gap was observed,with only 9.1% of patients having a formal clinical diagnosis of nephropathy despite the high biochemical prevalence. Urine dipstick testing showed poor sensitivity for early detection compared to quantitative ACR.

Conclusion: There is a high, under-diagnosed burden of DN among diabetic patients in this setting. The findings underscore the critical need for implementing routine quantitative ACR screening, strict control of glycemia and blood pressure, and enhancing patient follow-up to enable early intervention and slow disease progression.

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