Which factors actually influence the development and progression of overt nephropathy in Nigerian diabetics?

Abstract

Diabetes Mellitus (DM) is the commonest endocrine disease in the world, with a worldwide prevalence of 4% in adults.1 In Nigeria the prevalence of DM ranges from 2.4 to 6% and varies from relatively rural to urban communities.2 One of the most serious complications of DM is diabetic nephropathy (DN) with a prevalence of about 4Q%.3 Unlike the previous reports which documented the rarity of diabetic nephropathy amongst Nigerians4'11, it is now.a leading cause of end stage renal disease (ESRD) in the world, as it accounts for about half of the total population of patients recruited to renal replacement treatment programmes in the western world.12 Even locally, the prevalence of DN had increased significantly in the last 15 years from almost 0% of the causes of chronic renal failure to the third commonest cause accounting for 3 to 5% of the causes of ESRD.