Prevalence of Diabetic Nephropathy among Patients with Type 2 Diabetes Mellitus in China: A Meta-Analysis of Observational Studies

Background. Diabetic nephropathy (DN) is an important cause of end-stage renal disease and is recognized as a public health problem worldwide. However, there have been no nationwide surveys of DN prevalence in China. This study is aimed at estimating the pooled prevalence of DN among patients with type 2 diabetes in China. Methods. Published studies on the prevalence of DN among patients with type 2 diabetes published from January 1980 to October 2019 were systematically reviewed using PubMed, Embase, Google Scholar, Chinese Wanfang databases, and Chinese National Knowledge Infrastructure. The pooled prevalence of DN was estimated with the random effects model using R software. Prevalence estimates were also stratified by study design, methodological approach, and study population characteristics. Results. Thirty studies with a total of 79,364 participants were included in our study. The overall pooled prevalence of DN was 21.8% [95% confidence interval (CI): 18.5-25.4%]. Subgroup analysis found that the prevalence of DN varied significantly according to different DM and DN diagnostic criteria (P<0.05); the pooling estimate was the highest in the west region of 41.3%, followed by that in the east region of China with 22.3%, northeast region with 20.7%, and central region with 15.6% (P<0.05), and was higher in the male-dominated studies 27.7%, compared with the female-dominated studies 17.6% (P<0.05). Conclusions. The prevalence of DN is high in Chinese patients with type 2 diabetes and shows geographic and gender variation. These data indicate that national strategies aimed at primary and secondary prevention of DN and screening programs for DN are urgently needed to reduce the risk and burden of DN in China.