SO SÁNH CÁC PHƯƠNG PHÁP CHẨN ĐOÁN BỆNH THẬN MẠN TRÊN BỆNH NHÂN ĐÁI THÁO ĐƯỜNG: NGHIÊN CỨU THỰC HIỆN TRONG CỘNG ĐỒNG

Abstract

Background: Early detection and treatment of chronic kidney disease (CKD) in diabetic patients are crucial, as several modifiable factors can prevent or slow disease progression. However, no studies in Vietnam have compared the effectiveness of different diagnostic methods in the community setting. Objectives: To compare the effectiveness of different diagnostic methods for CKD in diabetic patients in Can Tho, Vietnam. Materials and methods: A cross-sectional analytical study conducted on 791 residents of Can Tho City with a prior diagnosis of diabetes mellitus (DM) from January 2023 to September 2023. Results: Among the study participants, the mean age was 63.5 ± 10.1 years, with a female-to-male ratio of approximately 2:1. The prevalence of CKD was 19.2%. Diagnosis based on estimated glomerular filtration rate (eGFR) using creatinine (single measurement) had a specificity of 83.3%, a negative predictive value (NPV) of 98.9%, a sensitivity of 78.1%, and a low area under the curve (AUC) of 0.577 (95% CI: 0.522–0.631). Diagnosis based on urine albumin-to-creatinine ratio (ACR) abnormalities (single measurement) had a high specificity of 98.3%, an NPV of 90.1%, and an excellent AUC of 0.918 (95% CI: 0.891–0.944), but a lower sensitivity of 69.3%. Diagnosis combining both ACR and eGFR abnormalities (single measurement) had a specificity of 82.3%, an NPV of 82.3%, a sensitivity of 83.3%, and a low AUC of 0.547 (95% CI: 0.494–0.600). Conclusion: A single urinary ACR test for CKD screening in community demonstrated a high effectiveness for ruling out CKD in diabetic patients.