Characteristics of end stage renal disease diabetic patients in two countries with different socioeconomic conditions.
OBJECTIVE
To identify differences that may affect morbidity and mortality of type 2 diabetic patients reaching ESRD between countries with different socioeconomic conditions.


METHODS
Comparison of clinical and laboratory features between 21 Nigerian (N) and 57 American patients (A) reaching ESRD over a 30 month period.


RESULTS
Differences were noted in age at ESRD (N, 55.5+/-9.8; A, 64.5+/-9.6 years), duration of diabetes (N, 5.2+/-2.8, A: 14.9+/-4.9 years), body mass index (N, 24.5+/-4.1; A; 27.6+/-6.3 kg/m2), prevalence of left ventricular hypertrophy (N; 14%; A, 89%) and ischemic heart disease (N, 26%; A, 67%), blood pressure (N, [166.2+/-26.7]/[98.6+/-16.5] mmHg; A, [146.8+/-23.6]/[72.5+/-13.3] mmHg), creatinine clearance (N, 6.1+/-3.6; A, 14.8+/-3.5 ml/min), urine protein excretion (N, 1.2+/-0.7; A, 6.1+/-4.9 g/24-h), hematocrit (N, 28.0+/-6.0; A, 35.0+/-5.0%), serum glucose (N, 5.6+/-1.6; A, 10.5+/-5.5 mmol/l), and serum cholesterol (N, 5.32+/-2.57; A, 4.19+/-1.16 mmol/l) (all at P < or = 0.05). Differences were also found in the number of antihypertensive medications (N 1.4+/-0.6; A 2.4+/-1.2 per patient), and use of medications for diabetes (N 29%, A 79%), statins (N zero, A 61 %) and erythropoietin (N zero, A 39%). 72% of the A, but none of the N patients had a functional dialysis access prior to ESRD.


CONCLUSIONS
Between A and N patients reaching ESRD, there are differences in clinical features and laboratory values that may affect morbidity, mortality and impact on the health care resources. These differences indicate areas where further studies that could assist in the planning for ESRD care in both Nigeria and USA are required.
Agaba
Emmanuel I
EI
Department of Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
Adeniyi
Oladipo
O
Servilla
Karen S
KS
Vanderjagt
Dorothy J
DJ
Glew
Robert H
RH
Tzamaloukas
Antonios H
AH
D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012959:Socioeconomic Factors; D014481:United States