Objectives: The high prevalence of diabetes leads to an increase in diabetic complications, and diabetic nephropathy as one them is a leading cause of end stage renal disease and renal replacement therapies. Individual studies on the prevalence diabetic nephropathy in Eastern Mediterranean region (EMR) showed the high prevalence of diabetic nephropathy. Therefore, we conducted a systematic review and meta-analysis of relevant studies to estimate nephropathy among type two diabetes patients in EMR.
Method: We searched for the relevant keywords in title and abstract of Medline/PubMed, Scopus, Embase, and Web of knowledge, as well as Google Scholar and manual search to identify the published target studies from Jan 1st, 2000 to December 13, 2020. The two-step screening was carried out by two independent researchers and relevant data were extracted. Estimation of summary proportions, subgroup analysis, meta-regressions, and publication bias assessment were performed.
Results: Amongst 3225 identified citations, 38 articles were entered into meta-analysis, involving 112,235 patients. We found that the prevalence of nephropathy in type two diabetes was 26.34% (95% confidence interval (CI)= 21.04%, 32%). Prevalence of nephropathy was 30.42% (95% CI= 23.38%, 37.94%) in males 22.1% (95% CI= 16.05%, 28.79%) in females. Low HDI countries and very high HDI countries had the lowest (21.17% (95% CI= 1.1%, 56.22%)) and the highest (30.93% (95% CI= 22.16%, 40.44%)) prevalence rates. The meta-regression analysis showed that HDI, publication year, mean duration of diabetes, mean age, and diagnostic test were not significant moderators (p = .3323, .7247, .2802, .2199, and .4680, respectively).
Conclusions: We estimated a high prevalence of diabetic nephropathy in EMR. Our results implicate the importance of diabetes screening, on time and periodic examinations for nephropathy, diabetes care, and risk factor controls. Large-scale longitudinal studies should be conducted in EMR.