Association Between Diabetic Nephropathy and Cardiovascular Complications in Patients with Type 2 Diabetes Mellitus.

Original Article

Abstract

Background: Diabetic nephropathy is one of the most common microvascular complications of type 2 diabetes mellitus (T2DM) and is associated with an increased risk of cardiovascular disease (CVD). Renal dysfunction and albuminuria may contribute to endothelial dysfunction, chronic inflammation, oxidative stress, and accelerated atherosclerosis, thereby increasing cardiovascular risk. Early recognition of this association may facilitate timely preventive and therapeutic interventions.

Objective: To determine the association between diabetic nephropathy and cardiovascular complications among patients with type 2 diabetes mellitus at a tertiary care teaching hospital.

Methods: This was an analytical cross-sectional study conducted in the Department of Nephrology at Maingul Jehgnazab Hospital, Swat, from January 2025 to June 2025. A total of 100 patients with type 2 diabetes mellitus, aged ≥30 years and having diabetes for at least five years, were enrolled using consecutive non-probability sampling. Diabetic nephropathy was assessed using urinary albumin-to-creatinine ratio and estimated glomerular filtration rate, while cardiovascular complications were assessed through clinical examination, electrocardiography, echocardiography, and review of medical records. Data were analyzed using SPSS version 27.0. Chi-square test, independent-samples t-test, and multivariable logistic regression were applied as appropriate. A p-value <0.05 was considered statistically significant.

Results: Among 100 participants, the mean age was 58.4 ± 9.8 years, with 62% males and 38% females. Diabetic nephropathy was present in 46% of patients, whereas 39% had at least one cardiovascular complication. Cardiovascular complications were significantly more frequent in patients with diabetic nephropathy than in those without nephropathy (60.9% vs. 20.4%; p=0.001). Coronary artery disease was the most common cardiovascular complication (34.8% vs. 11.1%; p=0.004). Patients with cardiovascular complications had significantly lower mean eGFR (56.8 ± 18.2 vs. 81.4 ± 16.5 mL/min/1.73 m²; p<0.001) and higher urinary albumin excretion (p=0.002). Multivariable logistic regression demonstrated that diabetic nephropathy was independently associated with cardiovascular complications (adjusted OR=3.42; 95% CI: 1.48–7.91), after adjustment for age, hypertension, HbA1c, and duration of diabetes.

Conclusion: Diabetic nephropathy was significantly associated with cardiovascular complications among patients with type 2 diabetes mellitus. Patients with diabetic nephropathy had a substantially higher frequency of cardiovascular complications than those without nephropathy. Routine assessment of albuminuria and renal function may help identify patients at increased cardiovascular risk and support timely preventive and therapeutic interventions