{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T13:42:24Z","timestamp":1785505344358,"version":"3.56.0"},"reference-count":32,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T00:00:00Z","timestamp":1677542400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,2,19]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To estimate the prevalence of chronic kidney disease (CKD) among patients with type 2 diabetes mellitus (T2DM) and determine the sociodemographic and clinical risk factors associated with CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and settings<\/jats:title>\n                    <jats:p>Cross-sectional study among diabetic outpatients of a tertiary hospital in Nepal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>201\u2009patients with T2DM above 18 years of age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Participants completed a questionnaire regarding their socioeconomic information and underwent pertinent physical and haematological examinations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes measure<\/jats:title>\n                    <jats:p>The prevalence and risk factors of CKD among patients with T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of CKD in T2DM was 86.6%. In univariable analysis, the variables like age (p=0.026), hypertension status (p=0.002), duration of diabetes (p=0.009) and haemoglobin levels (p=0.027) were significantly associated with CKD among the participants with T2DM. Kruskal-Wallis H test showed that age was significantly different between various CKD stages. Multivariate analysis demonstrated a significant relationship between CKD with age (Adjusted odds ratio (AOR) 3, 95% CI 1.1 to 8.8) and literacy status (AOR 5.8, 95% CI 1.4 to 24.6)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Advancing age, concomitant hypertension, increasing duration of T2DM and presence of anaemia were found to be important risk factors of CKD. Age is the most important predictor of CKD showing increasing prevalence in the elderly population. Periodic screening tests are essential at an early age to identify kidney diseases at incipient stages, thereby preventing progression to end-stage renal disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-067238","type":"journal-article","created":{"date-parts":[[2023,2,28]],"date-time":"2023-02-28T11:05:37Z","timestamp":1677582337000},"page":"e067238","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Prevalence and risk factors of chronic kidney disease among patients with type 2 diabetes mellitus at a tertiary care hospital in Nepal: a cross-sectional study"],"prefix":"10.1136","volume":"13","author":[{"given":"Rinku","family":"Joshi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prativa","family":"Subedi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine and General Practice, Rolpa District Hospital, Rolpa, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2195-9152","authenticated-orcid":false,"given":"Gopal Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0251-3817","authenticated-orcid":false,"given":"Sitaram","family":"Khadka","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaneshwar","family":"Rijal","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kapil","family":"Amgain","sequence":"additional","affiliation":[{"name":"Department of Human Anatomy and Cell Biology, Karnali Academy of Health Sciences, Jumla, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabin","family":"Rajbhandari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,2,28]]},"reference":[{"key":"2025120520111037000_13.2.e067238.1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/2047487319881021","article-title":"The global epidemics of diabetes in the 21st century: current situation and perspectives","volume":"26","author":"Standl","year":"2019","journal-title":"Eur J Prev Cardiol"},{"key":"2025120520111037000_13.2.e067238.2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/dom.14007","article-title":"An updated overview of diabetic nephropathy: diagnosis, prognosis, treatment goals and latest guidelines","volume":"22","author":"Selby","year":"2020","journal-title":"Diabetes Obes Metab"},{"key":"2025120520111037000_13.2.e067238.3","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1016\/j.mpmed.2019.06.010","article-title":"Epidemiology and causes of chronic kidney disease","volume":"47","author":"Noble","year":"2019","journal-title":"Medicine"},{"key":"2025120520111037000_13.2.e067238.4","unstructured":"Vaidya SR , Aeddula NR . Chronic renal failure. In: Statpearls [online]. Treasure Island, FL: StatPearls Publishing, 2022."},{"key":"2025120520111037000_13.2.e067238.5","unstructured":"National Kidney Foundation . How to classify CKD [internet]. 2015. Available: https:\/\/www.kidney.org\/professionals\/explore-your-knowledge\/how-to-classify-ckd"},{"key":"2025120520111037000_13.2.e067238.6","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs037"},{"key":"2025120520111037000_13.2.e067238.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.pop.2008.01.008"},{"key":"2025120520111037000_13.2.e067238.8","unstructured":"Annual report FY 2077\/78 (2020\/21) [online]. n.d. Available: https:\/\/dohs.gov.np\/annual-report-fy-2077-78-2019-20\/"},{"key":"2025120520111037000_13.2.e067238.9","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2017.10.011"},{"key":"2025120520111037000_13.2.e067238.10","unstructured":"Diagnosis | ADA [online]. 2022. Available: https:\/\/www.diabetes.org\/diabetes\/a1c\/diagnosis"},{"key":"2025120520111037000_13.2.e067238.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-016-0731-2","article-title":"Renal function estimation and cockroft-gault formulas for predicting cardiovascular mortality in population-based, cardiovascular risk, heart failure and post-myocardial infarction cohorts: the heart \u201c omics \u201d in ageing (homage) and the high-risk myocardial infarction database initiatives","volume":"14","author":"Ferreira","year":"2016","journal-title":"BMC Med"},{"key":"2025120520111037000_13.2.e067238.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12882-020-02138-4","article-title":"Prevalence and risk factors of chronic kidney disease among Palestinian type 2 diabetic patients: a cross-sectional study","volume":"21","author":"Nazzal","year":"2020","journal-title":"BMC Nephrol"},{"key":"2025120520111037000_13.2.e067238.13","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2369-14-183","article-title":"Prevalence of chronic kidney disease in diabetic adult out-patients in Tanzania","volume":"14","author":"Janmohamed","year":"2013","journal-title":"BMC Nephrol"},{"key":"2025120520111037000_13.2.e067238.14","doi-asserted-by":"crossref","first-page":"164","DOI":"10.47102\/annals-acadmedsg.V44N5p164","article-title":"Prevalence of chronic kidney disease in adults with type 2 diabetes mellitus","volume":"44","author":"Low","year":"2015","journal-title":"Ann Acad Med Singap"},{"key":"2025120520111037000_13.2.e067238.15","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0713"},{"key":"2025120520111037000_13.2.e067238.16","doi-asserted-by":"crossref","first-page":"41","DOI":"10.46405\/ejms.v2i1.39","article-title":"Drug dosage adjustment of chronic kidney disease patients at nephrology ward in tertiary care hospital of Nepal","volume":"2","author":"Pakhrin","year":"2020","journal-title":"Europasian J Med Sci"},{"key":"2025120520111037000_13.2.e067238.17","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2010.05.002"},{"key":"2025120520111037000_13.2.e067238.18","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2010.03.010"},{"key":"2025120520111037000_13.2.e067238.19","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2017.181"},{"key":"2025120520111037000_13.2.e067238.20","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gft351"},{"key":"2025120520111037000_13.2.e067238.21","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S39739"},{"key":"2025120520111037000_13.2.e067238.22","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.13.1555"},{"key":"2025120520111037000_13.2.e067238.23","article-title":"Angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists for preventing the progression of diabetic kidney disease","volume":"2006","author":"Strippoli","year":"2006","journal-title":"Cochrane Database Syst Rev"},{"key":"2025120520111037000_13.2.e067238.24","doi-asserted-by":"crossref","first-page":"212","DOI":"10.5001\/omj.2012.48","article-title":"Prevalence and risk factors of diabetic nephropathy in Omani type 2 diabetics in al-dakhiliyah region","volume":"27","author":"Alrawahi","year":"2012","journal-title":"Oman Med J"},{"key":"2025120520111037000_13.2.e067238.25","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-2554"},{"key":"2025120520111037000_13.2.e067238.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2362.2010.02317.x"},{"key":"2025120520111037000_13.2.e067238.27","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0779"},{"key":"2025120520111037000_13.2.e067238.28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02424.x"},{"key":"2025120520111037000_13.2.e067238.29","doi-asserted-by":"crossref","first-page":"117","DOI":"10.2174\/1570161117666190502103733","article-title":"Microvascular complications of type 2 diabetes mellitus","volume":"18","author":"Faselis","year":"2020","journal-title":"Curr Vasc Pharmacol"},{"key":"2025120520111037000_13.2.e067238.30","doi-asserted-by":"publisher","DOI":"10.1016\/1056-8727(94)90005-1"},{"key":"2025120520111037000_13.2.e067238.31","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu006"},{"key":"2025120520111037000_13.2.e067238.32","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2404"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-067238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:11:19Z","timestamp":1764994279000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-067238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2]]},"references-count":32,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2,28]]},"published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1136\/bmjopen-2022-067238"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-067238","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2]]}}}