Risk Factors and Management of Kidney Diseases in Saudi Women with Diabetes

Author(s): Khalid Siddiqui*, Salini Scaria Joy

Journal Name: Current Women`s Health Reviews

Volume 16 , Issue 2 , 2020


Become EABM
Become Reviewer
Call for Editor

Graphical Abstract:


Abstract:

Background: The prevalence of diabetic kidney diseases (DKD) in the Saudi population is increasing and its prevalence has been reported as 37.4%. Recently, a higher prevalence of albuminuria in women has been proven through population-based studies.

Objective: Recently, the Kingdom of Saudi Arabia (KSA) has witnessed many changes in women’s activities, and women are more actively participating in the social and cultural development of the country. Thus, focusing on women’s health-related issues has become crucial. The necessity of research focusing on the influence of various risk factors on DKD has emerged as a priority.

Methods: The literature search was done by search engines and databases (PubMed, Google scholar and EMBASE). From a total of 21 selected articles, 18 articles are included in this study.

Results: This review emphasizes on the higher influence of certain DKD risk factors on Saudi women including a high prevalence of glucose intolerance during pregnancy, obesity due to lack of physical activity, and genetic predisposition due to consanguineous marriages, etc.

Conclusion: This study can raise awareness regarding the prevention and management of DKD in Saudi diabetic women.

Keywords: Diabetic kidney diseases, type 2 diabetes, end stage renal diseases, risk factors, management, diabetic women.

[1]
Saudi Arabia Population World Population Review Available from: http://worldpopulationreview.com/countries/saudi-arabia-population/ [updated 2019 June 19; Accessed on: Dec 17, 2019].
[2]
Saudi Arabia population Trading Economics Available from: https://tradingeconomics.com/saudi-arabia/population-female-percent-of-total-wb-data.html [Accessed on: Dec 17, 2019]
[3]
Kingdom of Saudi Arabia. Vision 2030. Available from:. https://vision2030.gov.sa/sites/default/files/report/Saudi_Vision2030_EN_2017.pdf [Accessed on: Dec 17, 2019]
[4]
Garawi F, Ploubidis GB, Devries K, Al-Hamdan N, Uauy R. Do routinely measured risk factors for obesity explain the sex gap in its prevalence? Observations from Saudi Arabia. BMC Public Health 2015; 15: 254.
[http://dx.doi.org/10.1186/s12889-015-1608-6] [PMID: 25848853]
[5]
M Alquaiz A, R Siddiqui A, H Qureshi R, et al. Women Health in Saudi Arabia: A review of non-communicable diseases and their risk factors. Pak J Med Sci 2014; 30(2): 422-31.
[PMID: 24772156]
[6]
International Diabetes Federation. IDF Diabetes Atlas 8th ed Brussels, Belgium: International Diabetes Federation; 2017.Available from: http://www.diabetesatlas.org [Accessed on: May 15, 2019]
[7]
Al-Rubeaan K, Youssef AM, Subhani SN, et al. Diabetic nephropathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National Diabetes Registry-based study. PLoS One 2014; 9(2): e88956
[http://dx.doi.org/10.1371/journal.pone.0088956] [PMID: 24586457]
[8]
Alsenany S, Al Saif A. Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center. J Phys Ther Sci 2015; 27(6): 1727-30.
[http://dx.doi.org/10.1589/jpts.27.1727] [PMID: 26180307]
[9]
Alotaibi A, Perry L, Gholizadeh L, Al-Ganmi A. Incidence and prevalence rates of diabetes mellitus in Saudi Arabia: An overview. J Epidemiol Glob Health 2017; 7(4): 211-8.
[http://dx.doi.org/10.1016/j.jegh.2017.10.001] [PMID: 29110860]
[10]
Alqurashi KA, Aljabri KS, Bokhari SA. Prevalence of diabetes mellitus in a Saudi community. Ann Saudi Med 2011; 31(1): 19-23.
[http://dx.doi.org/10.4103/0256-4947.75773] [PMID: 21245594]
[11]
AlFehaid AA. Prevalence of microalbuminuria and its correlates among diabetic patients attending diabetic clinic at National Guard Hospital in Alhasa. J Family Community Med 2017; 24(1): 1-5.
[http://dx.doi.org/10.4103/2230-8229.197174] [PMID: 28163568]
[12]
Dialysis in the Kingdom of Saudi Arabia. Saudi J Kidney Dis Transpl 2017; 28(4): 949-57.
[13]
Al-Shaikh A. Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetic clinic in King Abdulaziz University Hospital. Pak J Med Sci 2007; 23(2): 223-6.
[14]
Fatani HH, Mira SA, El-Zubier AG. The pattern of complications in Saudi Arabian diabetics. Ann Saudi Med 1989; 9(1): 44-7.
[http://dx.doi.org/10.5144/0256-4947.1989.44]
[15]
Famuyiwa OO, Sulimani RA, Laajam MA, Al-Jasser SJ, Mekki MO. Diabetes mellitus in Saudi Arabia: The clinical pattern and complications in 1,000 patients. Ann Saudi Med 1992; 12(2): 140-51.
[http://dx.doi.org/10.5144/0256-4947.1992.140] [PMID: 17589143]
[16]
Aziz KMA, Targeting LDL. Dyslipidemia for controlling progression of nephropathy in diabetic population: A cross sectional analytical study. JDUHS 2012; 6(1): 7-11.
[17]
Aziz KMA, Al-Qahtani MAA. Association between non-HDL and HDL cholesterol with microalbuminuria in patients with diabetes. J Diabetol 2013; 4(1): 6.
[18]
Aziz KMA. Association of microalbuminuria with ischemic heart disease, dyslipidemia and obesity among diabetic patients: Experience from 5 year follow up study of 1415 patients. Bioenergetics 2014; 3(2): 118.
[19]
Aziz KMA. Association of high serum triglycerides and triglycerides/ HDL ratio with raised HbA1c, creatinine, microalbuminuria and development of diabetic kidney disease and diabetic renal failure. Mathematical and statistical regression models of 10,370 diabetic patients. Clin Nephrol Res 2017; 1(1): 17-25.
[20]
Aziz KMA. Association of high levels of spot urine protein with high blood pressure, mean arterial pressure and pulse pressure with the development of diabetic chronic kidney dysfunction or failure among diabetic patients. statistical regression modeling to predict diabetic proteinuria. Curr Diabetes Rev 2019; 15(6): 486-96.
[http://dx.doi.org/10.2174/1573399814666180924114041] [PMID: 30246642]
[21]
Al Rashed AM. Pattern of presentation in type 1 diabetic patients at the diabetes center of a university hospital. Ann Saudi Med 2011; 31(3): 243-9.
[http://dx.doi.org/10.4103/0256-4947.81529] [PMID: 21623052]
[22]
Al-Agha AE, Ocheltree A, Hakeem A. Occurrence of microalbuminuria among children and adolescents with insulin-dependent diabetes mellitus. Saudi J Kidney Dis Transpl 2013; 24(6): 1180-8.
[http://dx.doi.org/10.4103/1319-2442.121276] [PMID: 24231481]
[23]
Alzaid AA, Sobki S, De Silva V. Prevalence of microalbuminuria in Saudi Arabians with non-insulin-dependent diabetes mellitus: a clinic-based study. Diabetes Res Clin Pract 1994; 26(2): 115-20.
[http://dx.doi.org/10.1016/0168-8227(94)90148-1] [PMID: 7705192]
[24]
Huraib S, Abu-Aisha H, Sulimani RA, et al. The pattern of diabetic nephropathy among Saudi patients with noninsulin-dependent diabetes mellitus. Ann Saudi Med 1995; 15(2): 120-4.
[http://dx.doi.org/10.5144/0256-4947.1995.120] [PMID: 17587920]
[25]
Al-Homrany MA, Abdelmoneim I. Significance of proteinuria in type 2 diabetic patients treated at a primary health care center in Abha City, Saudi Arabia. West Afr J Med 2004; 23(3): 211-4.
[http://dx.doi.org/10.4314/wajm.v23i3.28123] [PMID: 15587831]
[26]
Alwakeel JS, Sulimani R, Al-Asaad H, et al. Diabetes complications in 1952 type 2 diabetes mellitus patients managed in a single institution in Saudi Arabia. Ann Saudi Med 2008; 28(4): 260-6.
[http://dx.doi.org/10.5144/0256-4947.2008.260] [PMID: 18596402]
[27]
Alwakeel JS, Al-Suwaida A, Isnani AC, Al-Harbi A, Alam A. Concomitant macro and microvascular complications in diabetic nephropathy. Saudi J Kidney Dis Transpl 2009; 20(3): 402-9.
[PMID: 19414942]
[28]
Hasanato RM. Diagnostic efficacy of random albumin creatinine ratio for detection of micro and macro-albuminuria in type 2 diabetes mellitus. Saudi Med J 2016; 37(3): 268-73.
[http://dx.doi.org/10.15537/smj.2016.3.13567] [PMID: 26905348]
[29]
Khan AR, Al Abdul Lateef ZN, Fatima S, Al Yousuf SA, Khan Afghan SZ, Al Marghani S. Prevalence of chronic complication among type 2 diabetics attending primary health care centers of Al Ahsa district of Saudi Arabia: a cross sectional survey. Glob J Health Sci 2014; 6(4): 245-53.
[http://dx.doi.org/10.5539/gjhs.v6n4p245] [PMID: 24999139]
[30]
Kim C, Cheng YJ, Beckles GL. Cardiovascular disease risk profiles in women with histories of gestational diabetes but without current diabetes. Obstet Gynecol 2008; 112(4): 875-83.
[http://dx.doi.org/10.1097/AOG.0b013e31818638b5] [PMID: 18827131]
[31]
Gordin D, Hiilesmaa V, Fagerudd J, et al. FinnDiane Study Group. Pre-eclampsia but not pregnancy-induced hypertension is a risk factor for diabetic nephropathy in type 1 diabetic women. Diabetologia 2007; 50(3): 516-22.
[http://dx.doi.org/10.1007/s00125-006-0544-5] [PMID: 17216281]
[32]
Go RC, Desmond R, Roseman JM, Bell DS, Vanichanan C, Acton RT. Prevalence and risk factors of microalbuminuria in a cohort of African-American women with gestational diabetes. Diabetes Care 2001; 24(10): 1764-9.
[http://dx.doi.org/10.2337/diacare.24.10.1764] [PMID: 11574439]
[33]
Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002; 25(10): 1862-8.
[http://dx.doi.org/10.2337/diacare.25.10.1862] [PMID: 12351492]
[34]
Alzzaqani AHA, Alzemily MAM, Alshahrani HSA. A status on gestational diabetes mellitus in Saudi Arabia: A systematic review. CAJPH 2016; 2(2): 83-8.
[35]
Alfadhli EM, Osman EN, Basri TH, et al. Gestational diabetes among Saudi women: prevalence, risk factors and pregnancy outcomes. Ann Saudi Med 2015; 35(3): 222-30.
[http://dx.doi.org/10.5144/0256-4947.2015.222] [PMID: 26409797]
[36]
Ahmed MA, Kishore G, Khader HA, Kasturirangan MN. Risk factors and management of diabetic nephropathy. Saudi J Kidney Dis Transpl 2013; 24(6): 1242-7.
[http://dx.doi.org/10.4103/1319-2442.121310] [PMID: 24231493]
[37]
Alshaikh MK, Filippidis FT, Baldove JP, Majeed A, Rawaf S. Women in Saudi Arabia and the prevalence of cardiovascular risk factors: A systematic review. J Environ Public Health 2016; 20167479357
[http://dx.doi.org/10.1155/2016/7479357] [PMID: 27777590]
[38]
de Boer IH, Sibley SD, Kestenbaum B, et al. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study Research Group. Central obesity, incident microalbuminuria, and change in creatinine clearance in the epidemiology of diabetes interventions and complications study. J Am Soc Nephrol 2007; 18(1): 235-43.
[http://dx.doi.org/10.1681/ASN.2006040394] [PMID: 17151331]
[39]
Tapp RJ, Shaw JE, Zimmet PZ, et al. Albuminuria is evident in the early stages of diabetes onset: results from the Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Am J Kidney Dis 2004; 44(5): 792-8.
[http://dx.doi.org/10.1016/S0272-6386(04)01079-0] [PMID: 15492944]
[40]
Samet JM, Yoon SY. Gender, women, and the tobacco epidemic Geneva: World Health Organization. 2010.Available from: http://www.who.int/tobacco/publications/gender/women_tob_epidemic/en/index.html [Accessed on: Oct 10, 2019]
[41]
Liao D, Ma L, Liu J, Fu P. Cigarette smoking as a risk factor for diabetic nephropathy: A systematic review and meta-analysis of prospective cohort studies. PLoS One 2019; 14(2): e0210213
[http://dx.doi.org/10.1371/journal.pone.0210213] [PMID: 30716100]
[42]
Alwakeel JS, Isnani AC, Alsuwaida A, et al. Factors affecting the progression of diabetic nephropathy and its complications: a single-center experience in Saudi Arabia. Ann Saudi Med 2011; 31(3): 236-42.
[http://dx.doi.org/10.4103/0256-4947.81528] [PMID: 21623051]
[43]
Memish ZA, El Bcheraoui C, Tuffaha M, et al. Obesity and associated factors--Kingdom of Saudi Arabia, 2013. Prev Chronic Dis 2014; 11: E174
[http://dx.doi.org/10.5888/pcd11.140236] [PMID: 25299980]
[44]
Al-Raddadi R, Bahijri SM, Jambi HA, Ferns G, Tuomilehto J. The prevalence of obesity and overweight, associated demographic and lifestyle factors, and health status in the adult population of Jeddah, Saudi Arabia. Ther Adv Chronic Dis 2019; 10: 2040622319878997
[http://dx.doi.org/10.1177/2040622319878997] [PMID: 31632623]
[45]
Elhadd TA, Al-Amoudi AA, Alzahrani AS. Epidemiology, clinical and complications profile of diabetes in Saudi Arabia: a review. Ann Saudi Med 2007; 27(4): 241-50.
[PMID: 17684435]
[46]
Kari JA, Bockenhauer D, Stanescu H, Gari M, Kleta R, Singh AK. Consanguinity in Saudi Arabia: a unique opportunity for pediatric kidney research. Am J Kidney Dis 2014; 63(2): 304-10.
[http://dx.doi.org/10.1053/j.ajkd.2013.08.033] [PMID: 24239020]
[47]
Bockenhauer D, Medlar AJ, Ashton E, Kleta R, Lench N. Genetic testing in renal disease. Pediatr Nephrol 2012; 27(6): 873-83.
[http://dx.doi.org/10.1007/s00467-011-1865-2] [PMID: 21617915]
[48]
Al-Nozha MM, Al-Hazzaa HM, Arafah MR, et al. Prevalence of physical activity and inactivity among Saudis aged 30-70 years. A population-based cross-sectional study. Saudi Med J 2007; 28(4): 559-68.
[PMID: 17457478]
[49]
Dong L, Li J, Lian Y, et al. Long-term intensive lifestyle intervention promotes improvement of stage III diabetic nephropathy. Med Sci Monit 2019; 25(25): 3061-8.
[http://dx.doi.org/10.12659/MSM.913512] [PMID: 31022160]
[50]
McMahon EJ, Bauer JD, Hawley CM, et al. A randomized trial of dietary sodium restriction in CKD. J Am Soc Nephrol 2013; 24(12): 2096-103.
[http://dx.doi.org/10.1681/ASN.2013030285] [PMID: 24204003]
[51]
Look AHEAD Research Group. Effect of a long-term behavioural weight loss intervention on nephropathy in overweight or obese adults with type 2 diabetes: a secondary analysis of the Look AHEAD randomised clinical trial. Lancet Diabetes Endocrinol 2014; 2(10): 801-9.
[http://dx.doi.org/10.1016/S2213-8587(14)70156-1] [PMID: 25127483]
[52]
Lim AKh. Diabetic nephropathy - complications and treatment. Int J Nephrol Renovasc Dis 2014; 7: 361-81.
[http://dx.doi.org/10.2147/IJNRD.S40172] [PMID: 25342915]
[53]
Lee MY, Huang JC, Chen SC, Chiou HC, Wu PY. Association of HbA1C variability and renal progression in patients with type 2 diabetes with chronic kidney disease stages 3-4. Int J Mol Sci 2018; 19(12): 4116.
[http://dx.doi.org/10.3390/ijms19124116]
[54]
Sugawara A, Kawai K, Motohashi S, et al. HbA(1c) variability and the development of microalbuminuria in type 2 diabetes: Tsukuba Kawai Diabetes Registry 2. Diabetologia 2012; 55(8): 2128-31.
[http://dx.doi.org/10.1007/s00125-012-2572-7] [PMID: 22580991]
[55]
Luk AO, Ma RC, Lau ES, et al. Risk association of HbA1c variability with chronic kidney disease and cardiovascular disease in type 2 diabetes: prospective analysis of the Hong Kong Diabetes Registry. Diabetes Metab Res Rev 2013; 29(5): 384-90.
[http://dx.doi.org/10.1002/dmrr.2404] [PMID: 23463747]
[56]
Yang YF, Li TC, Li CI, et al. Visit-to-visit glucose variability predicts the development of end-stage renal disease in type 2 diabetes: 10-year follow-up of taiwan diabetes study. Medicine (Baltimore) 2015; 94(44): e1804
[http://dx.doi.org/10.1097/MD.0000000000001804] [PMID: 26554779]
[57]
Lin CC, Chen CC, Chen FN, et al. Risks of diabetic nephropathy with variation in hemoglobin A1c and fasting plasma glucose. Am J Med 2013; 126(11): 1017.e1-1017.e10.
[http://dx.doi.org/10.1016/j.amjmed.2013.04.015] [PMID: 23993260]
[58]
de Vos LC, Hettige TS, Cooper ME. New glucose-lowering agents for diabetic kidney disease. Adv Chronic Kidney Dis 2018; 25(2): 149-57.
[http://dx.doi.org/10.1053/j.ackd.2018.01.002] [PMID: 29580579]
[59]
Groop PH, Cooper ME, Perkovic V, Emser A, Woerle HJ, von Eynatten M. Linagliptin lowers albuminuria on top of recommended standard treatment in patients with type 2 diabetes and renal dysfunction. Diabetes Care 2013; 36(11): 3460-8.
[http://dx.doi.org/10.2337/dc13-0323] [PMID: 24026560]
[60]
Udell JA, Bhatt DL, Braunwald E, et al. SAVOR-TIMI 53 Steering Committee and Investigators. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes and moderate or severe renal impairment: observations from the SAVOR-TIMI 53 Trial. Diabetes Care 2015; 38(4): 696-705.
[PMID: 25552421]
[61]
Wheeler DC, Becker GJ. Summary of KDIGO guideline. What do we really know about management of blood pressure in patients with chronic kidney disease? Kidney Int 2013; 83(3): 377-83.
[http://dx.doi.org/10.1038/ki.2012.425] [PMID: 23325075]
[62]
Wanner C, Tonelli M. Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group Members. KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient. Kidney Int 2014; 85(6): 1303-9.
[http://dx.doi.org/10.1038/ki.2014.31] [PMID: 24552851]
[63]
Misra A, Tandon N, Ebrahim S, et al. Diabetes, cardiovascular disease, and chronic kidney disease in South Asia: current status and future directions. BMJ 2017; 357: j1420.
[http://dx.doi.org/10.1136/bmj.j1420] [PMID: 28400361]
[64]
Ahmad J. Management of diabetic nephropathy: Recent progress and future perspective. Diabetes Metab Syndr 2015; 9(4): 343-58.
[http://dx.doi.org/10.1016/j.dsx.2015.02.008] [PMID: 25845297]
[65]
AlAteeq M, Alrashoud AM, Khair M, Salam M. Smoking cessation advice: the self-reported attitudes and practice of primary health care physicians in a military community, central Saudi Arabia. Patient Prefer Adherence 2016; 10: 651-8.
[PMID: 27175065]
[66]
Perkovic V, Agarwal R, Fioretto P, et al. Conference Participants. Management of patients with diabetes and CKD: conclusions from a “Kidney Disease: Improving Global Outcomes” (KDIGO) Controversies Conference. Kidney Int 2016; 90(6): 1175-83.
[http://dx.doi.org/10.1016/j.kint.2016.09.010] [PMID: 27884312]
[67]
Saudi Center for Organ Transplantation (SCOT) Annual Report. Hemodialysis in the Kingdom of Saudi Arabia. KSA: Saudi Center for Organ Transplantation;. 2017. Available from: http://www.scot.gov.sa/images/Report_En_F_Hemodialysis%20in%20the%20KSA.pdf [Accessed on: May 15, 2019]
[68]
Kervinen MH, Lehto S, Helve J, Grönhagen-Riska C, Finne P. Type 2 diabetic patients on renal replacement therapy: Probability to receive renal transplantation and survival after transplantation. PLoS One 2018; 13(8)e0201478
[http://dx.doi.org/10.1371/journal.pone.0201478] [PMID: 30110346]
[69]
Almufleh A, Althebaity R, Alamri AS, et al. Organ donation awareness and attitude among Riyadh City Residents, Saudi Arabia. J Nat Sci Med 2018; 1: 59-63.


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 16
ISSUE: 2
Year: 2020
Published on: 29 April, 2020
Page: [95 - 101]
Pages: 7
DOI: 10.2174/1573404816666200206110002
Price: $65

Article Metrics

PDF: 9
HTML: 1