Prevalence and associated factors of diabetic kidney disease among rural patients with type 2 diabetes mellitus in Guangxi, China: a cross-sectional study.

Objective: To investigate the prevalence of diabetic kidney disease (DKD) and identify its associated factors among rural patients with type 2 diabetes mellitus (T2DM) in Guangxi, China. Methods: A multistage stratified random sampling method was applied. Five cities across Guangxi (Nanning, Guilin, Hechi, Chongzuo, and Yulin) were randomly selected, followed by three counties in each city, yielding 15 counties in total. One hospital from each county was chosen, and patients with T2DM were recruited for questionnaires and laboratory testing. Descriptive epidemiological methods were used to calculate the prevalence of DKD. Univariate and multivariate logistic regression analyses were performed to identify associated factors. Results: A total of 2,178 rural patients with T2DM were included (1,204 men and 974 women; mean age 63.25 ± 12.71 years; mean disease duration 7.96 ± 4.07 years). The HbA1c control rate was 22.68%, and the prevalence of DKD was 23.32% (95% CI: 21.6% to 25.1%; 508/2,178). Logistic regression analysis showed that higher diabetes knowledge levels were protective against DKD (OR = 0.936, 95% CI: 0.891-0.984). Independent associated factors. included elevated HbA1c (OR = 1.530, 95% CI: 1.389-1.686), serum creatinine (OR = 1.037, 95% CI: 1.033-1.041), uric acid (OR = 1.005, 95% CI: 1.004-1.007), and triglycerides (OR = 1.190, 95% CI: 1.010-1.403). Conclusion: The prevalence of DKD among rural patients with T2DM in Guangxi is relatively high. Enhancing diabetes-related knowledge and strengthening the monitoring and control of HbA1c, lipid profiles, creatinine, and uric acid may help reduce the risk of DKD and improve patient outcomes.