Prevalence of nephropathy in type 2 diabetes patients in the Eastern Mediterranean Region: A systematic review and meta-analysis.

OBJECTIVES

The high prevalence of T2D leads to increased complications like diabetic nephropathy, a leading cause of end-stage renal disease and renal replacement therapies. As studies from the Eastern Mediterranean Region report various prevalence rates for this complication, we conducted a meta-analysis to estimate the prevalence of nephropathy in T2D patients in the Eastern Mediterranean Region.

METHOD: We searched for the relevant keywords in the titles and abstracts of articles indexed in Medline/PubMed, Scopus, EMBASE, Web of Science, and Google Scholar from January 1st, 2000, to December 13th, 2019. Two independent researchers carried out two-stage screening and then extracted the relevant data. We conducted summary proportions estimation, subgroup analysis, meta-regression analysis, and publication bias assessment.

RESULTS

Out of 3225 identified citations, 38 articles were entered into the meta-analysis, involving 112,235 patients. The prevalence of nephropathy in T2D patients was 26% (95% confidence interval (CI) = 22, 31%), and it was 30% (95% CI = 24, 37%) in males and 22% (95% CI = 17, 28%) in females. Meta-regression analysis showed that the hypertension and anti-hypertensive medications use were significant moderators (P = 0.040 and 0.005, respectively); however, the Human Development Index (HDI), publication year, mean T2D duration, mean age, and diagnostic test were not significant moderators (P = 0.283, 0.725, 0.280, 0.220, and 0.241, respectively).

CONCLUSIONS

Diabetic nephropathy's high prevalence in the Eastern Mediterranean Region highlights the importance of diabetes screening, periodic examinations, diabetes care, and risk factor control. Large-scale longitudinal studies should be conducted in the region to fill critical gaps in understanding the long-term effects of diabetes on kidney health, identify modifiable risk factors, and establish effective intervention strategies tailored to the specific populations of the region.