Prevalence of nephropathy among type two diabetes patients in Eastern Mediterranean Region: A systematic review and meta-analysis

Objectives: The global epidemic of Diabetes Mellitus exerts a substantial burden on health services. This high prevalence of diabetes leads to an increase in diabetic complications, especially diabetic nephropathy, a leading cause of end stage renal disease and renal replacement therapies. Due to its’ the high prevalence reported by Individual studies in EMR, we conducted a meta-analysis of relevant studies to estimate diabetic retinopathy in EMR. Method: We searched for the relevant keywords in title and abstract of Medline/PubMed, Scopus, Embase, Web of knowledge, and Gray literature from Jan 1st, 2000 to December 13, 2019. 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: Out of 3,225 identified citations, 38 articles were entered into meta-analysis, involving 112,235 patients. The prevalence of nephropathy in type two diabetes was 26.34% (95% confidence interval (CI)= 21.04, 32%); and it was 30.42% (95% CI= 23.38, 37.94%) in males and 22.1% (95% CI= 16.05, 28.79%) in females. The meta-regression analysis showed that HDI, publication year, mean duration of diabetes, mean age, and diagnostic test were not significant moderators ( p = .332, .725, .280, .220, and .468, respectively). Conclusions: Diabetic nephropathy high prevalence in EMR implicates the importance of diabetes screening, periodic examinations, diabetes care, and risk factor controls. Large-scale longitudinal studies should be conducted in EMR.