Determinants of Diabetic Nephropathy in Patients with Type 2 Diabetes in Northern Cameroon

Abstract

Background: Diabetic Nephropathy (DN) is the leading cause of End-Stage Renal Disease (ESRD) globally. This study aimed to identify determinants of DN in patients with Type 2 Diabetes (T2D) in northern Cameroon. Methods: We conducted an analytical cross-sectional study from December 2, 2024, to May 31, 2025, among outpatients with T2D at Garoua General Hospital and the Regional Hospitals of Garoua and Maroua. Patients who provided oral consent were included, while those with other causes of nephropathy or proteinuria were excluded. DN was defined as albuminuria (micro or macro) and/or an eGFR ≤ 60 mL/min in the presence of microvascular complications (diabetic retinopathy or neuropathy). Determinants of DN were identified using logistic regression, with significance set at p < 0.05. Results: A total of 327 patients were included, with a median age (IQR) of 54 (46 - 62) years; 55.4% were men. The median duration of diabetes (IQR) was 4.6 (2.7 - 10) years, and 89.3% had an HbA1c > 7%. Physical inactivity was the most common cardiovascular risk factor (66.1%). The overall prevalence of DN was 24.5% (95% CI: 19.9 - 29.5); macroalbuminuria: 5.5%, microalbuminuria: 17.8%, and eGFR ≤ 60 mL/min in the presence of microvascular complications: 1.2%. Determinants of DN [adjusted OR (95% CI), p] were age ≥ 60 years [10.33 (4.27 - 25.00), p = 0.004], diabetes duration ≥ 10 years [2.45 (1.02 - 6.03), p = 0.041], diabetic retinopathy [9.52 (3.14 - 28.83), p < 0.001], and diabetic neuropathy [41.35 (4.32 - 95.13), p < 0.001]. Conclusion: The high prevalence of DN and its determinants in our study highlights the importance of early screening and regular monitoring of patients.