CENTRAL ASIAN JOURNAL OF NEPHROLOGY
Original Article
Apr 02, 2026 5 5

Diabetic Kidney Disease Prevention in Type 2 Diabetes: Knowledge, Attitudes and Practices Study from Kyrgyzstan

Aiperi Asanbek kyzy 1 2 * ,
Aizhan Omorova 1,
Altynai Sakibaeva 1,
Khadizha Zhumaeva 1,
Elmira Kudaiberdieva 3 4,
Gulnara Rysbekova 1 5,
Nobutoshi Nawa 2,
Keneshbek Ismanov 6,
Roman Kalmatov 1
1 International Medical Faculty, Osh State University, Osh, Kyrgyzstan2 Department of Global Environmental Health, Institute of Science Tokyo, Tokyo, Japan3 Department of Nephrology, Osh Inter-regional United Clinical Hospital, Osh, Kyrgyzstan4 Medical Faculty, Osh State University, Osh, Kyrgyzstan5 Department of Endocrinology, Osh Inter-regional United Clinical Hospital, Osh, Kyrgyzstan6 Kyrgyz State Medical Institute of Retraining and Advanced Training Named After S.B. Daniyarova, Bishkek, Kyrgyzstan* Corresponding Author
Central Asian Journal of Nephrology, 2(1), 2026, cajn012, https://doi.org/10.63946/cajn/18298
Publication date: Apr 02, 2026
Full Text (PDF)

ABSTRACT

Background: To evaluate diabetic kidney disease (DKD) knowledge, attitudes, and practices (KAP) among adults with type 2 diabetes (T2D) in southern Kyrgyzstan.
Methods: A cross-sectional survey assessed DKD KAP among adults with T2D recruited from public healthcare facilities in Osh, Kyrgyzstan. We used a structured questionnaire guided by the Health Belief Model and the Health Locus of Control. We used multiple linear regression models to examine factors associated with KAP scores.
Results: A total of 207 adults participated (mean age 61.0 ± 10.7 years; 61.4% female). Although 91.3% identified healthcare workers as their most trusted information source, only 49.3% reported receiving DKD-related information from a healthcare provider. Only 13.5% recognized that early kidney damage does not cause pain. Despite generally positive attitudes towards kidney protective behaviors, 72.9% of participants reported low personal control over their health outcomes. In adjusted models, prior receipt of provider DKD information was the sole factor consistently associated with higher knowledge (β = 1.25, 95% CI 0.43–2.08, p = 0.003), attitudes (β = 3.11, 95% CI 1.61–4.61, p < 0.001), and practices (β = 3.99, 95% CI 2.26–5.71, p < 0.001).
Conclusion: Adults with T2D in southern Kyrgyzstan experience significant knowledge gaps and misconceptions regarding kidney protection, despite high trust and willingness to learn from healthcare providers. Prior provider-delivered information was associated with better practices, highlighting the need for structured DKD counseling that explicitly addresses misconceptions and aligns health messages with local beliefs to strengthen self-efficacy.

KEYWORDS

Type 2 Diabetes Diabetic Kidney Disease Health Communication Central Asia Kyrgyzstan

CITATION (Vancouver)

Asanbek kyzy A, Omorova A, Sakibaeva A, Zhumaeva K, Kudaiberdieva E, Rysbekova G, et al. Diabetic Kidney Disease Prevention in Type 2 Diabetes: Knowledge, Attitudes and Practices Study from Kyrgyzstan. Central Asian Journal of Nephrology. 2026;2(1):cajn012. https://doi.org/10.63946/cajn/18298
APA
Asanbek kyzy, A., Omorova, A., Sakibaeva, A., Zhumaeva, K., Kudaiberdieva, E., Rysbekova, G., Nawa, N., Ismanov, K., & Kalmatov, R. (2026). Diabetic Kidney Disease Prevention in Type 2 Diabetes: Knowledge, Attitudes and Practices Study from Kyrgyzstan. Central Asian Journal of Nephrology, 2(1), cajn012. https://doi.org/10.63946/cajn/18298
Harvard
Asanbek kyzy, A., Omorova, A., Sakibaeva, A., Zhumaeva, K., Kudaiberdieva, E., Rysbekova, G., . . . Kalmatov, R. (2026). Diabetic Kidney Disease Prevention in Type 2 Diabetes: Knowledge, Attitudes and Practices Study from Kyrgyzstan. Central Asian Journal of Nephrology, 2(1), cajn012. https://doi.org/10.63946/cajn/18298
AMA
Asanbek kyzy A, Omorova A, Sakibaeva A, et al. Diabetic Kidney Disease Prevention in Type 2 Diabetes: Knowledge, Attitudes and Practices Study from Kyrgyzstan. Central Asian Journal of Nephrology. 2026;2(1), cajn012. https://doi.org/10.63946/cajn/18298
Chicago
Asanbek kyzy, Aiperi, Aizhan Omorova, Altynai Sakibaeva, Khadizha Zhumaeva, Elmira Kudaiberdieva, Gulnara Rysbekova, Nobutoshi Nawa, Keneshbek Ismanov, and Roman Kalmatov. "Diabetic Kidney Disease Prevention in Type 2 Diabetes: Knowledge, Attitudes and Practices Study from Kyrgyzstan". Central Asian Journal of Nephrology 2026 2 no. 1 (2026): cajn012. https://doi.org/10.63946/cajn/18298
MLA
Asanbek kyzy, Aiperi et al. "Diabetic Kidney Disease Prevention in Type 2 Diabetes: Knowledge, Attitudes and Practices Study from Kyrgyzstan". Central Asian Journal of Nephrology, vol. 2, no. 1, 2026, cajn012. https://doi.org/10.63946/cajn/18298

SUPPLEMENTARY FILES

Supplementary File

REFERENCES

  1. International Diabetes Federation. IDF Diabetes Atlas. Brussels: International Diabetes Federation; 2025.
  2. Liu J, Bai R, Chai Z, Cooper ME, Zimmet PZ, Zhang L. Low- and middle-income countries demonstrate rapid growth of type 2 diabetes: an analysis based on Global Burden of Disease 1990–2019 data. Diabetologia. 2022;65(8):1339–1352. https://doi.org/10.1007/s00125-022-05722-2
  3. Zhao L, Yuan J, Yang Q, Ma J, Yang F, Zou Y, Liu K, Liu F. Diabetes and its complications: molecular mechanisms, prevention and treatment. Signal Transduct Target Ther. 2026;11(1):22. https://doi.org/10.1038/s41392-025-01745-7
  4. Thomas MC, Brownlee M, Susztak K, Sharma K, Jandeleit-Dahm KAM, Zoungas S, Rossing P, Groop PH, Cooper ME. Diabetic kidney disease. Nat Rev Dis Primers. 2015;1:15018. https://doi.org/10.1038/nrdp.2015.18
  5. Alicic RZ, Rooney MT, Tuttle KR. Diabetic kidney disease: challenges, progress, and possibilities. Clin J Am Soc Nephrol. 2017;12(12):2032–2045. https://doi.org/10.2215/CJN.11491116
  6. Janota-Sosińska O, Mantovani M, Irlik K, et al. Diabetic kidney disease phenotypes and the risk of cardiovascular events: the Silesia Diabetes-Heart Project. Cardiovasc Diabetol. 2025;24(1):305. https://doi.org/10.1186/s12933-025-02123-5
  7. Norhammar A, Bodegard J, Eriksson JW, et al. Cost of healthcare utilization associated with incident cardiovascular and renal disease in individuals with type 2 diabetes: a multinational observational study across 12 countries. Diabetes Obes Metab. 2022;24(7):1277–1287. https://doi.org/10.1111/dom.14696
  8. KDIGO. KDIGO 2022 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2022;102(5 Suppl):S1–S127. https://doi.org/10.1016/j.kint.2022.06.008
  9. American Diabetes Association Professional Practice Committee. Chronic kidney disease and risk management: standards of care in diabetes—2025. Diabetes Care. 2024;48(Suppl 1):S239–S251. https://doi.org/10.2337/dc24-S011
  10. Shiffman RN, Michel G, Essaihi A, Thornquist E. Bridging the guideline implementation gap: a systematic, document-centered approach. J Am Med Inform Assoc. 2004;11(5):418–426. https://doi.org/10.1197/jamia.M1444
  11. UNICEF. Kyrgyz Republic Multiple Indicator Cluster Survey 2023: Survey Findings Report. Bishkek: National Statistical Committee and UNICEF; 2024.
  12. Moldoisaeva S, Kaliev M, Sydykova A, et al. Kyrgyzstan: Health system review. 2022.
  13. Sultanalieva RB, Abylova NK, Zhunusova BZ. Role of the state register of diabetes mellitus in assessing the epidemiological situation in Kyrgyzstan and Bishkek. Probl Endokrinol (Mosk). 2025;71(2):55–65. https://doi.org/10.14341/probl13123
  14. World Health Organization. Kyrgyzstan: analysing data on diabetes to underpin better care. WHO; 2021.
  15. Christofides EA, Desai N. Optimal early diagnosis and monitoring of diabetic kidney disease in type 2 diabetes mellitus. J Prim Care Community Health. 2021;12:21501327211003683. https://doi.org/10.1177/21501327211003683
  16. Jones CL, Jensen JD, Scherr CL, et al. The health belief model as an explanatory framework in communication research. Health Commun. 2015;30(6):566–576. https://doi.org/10.1080/10410236.2013.873363
  17. Przybylski M. Health locus of control theory in diabetes. J Wound Care. 2010;19(6):228–233. https://doi.org/10.12968/jowc.2010.19.6.48207
  18. World Health Organization. A scoping review on health services delivery in Kyrgyzstan. WHO; 2018.
  19. Goodwin R, Allen P, Nizharadze G, et al. Fatalism, social support, and mental health in four former Soviet cultures. Pers Soc Psychol Bull. 2002;28(9):1166–1171. https://doi.org/10.1177/01461672022812003
  20. National Statistical Committee of the Kyrgyz Republic. Population and Housing Census of the Kyrgyz Republic 2022. 2022.
  21. Badran A, Bahar A, Tammam M, et al. Relationship between diabetes-related knowledge and kidney disease knowledge. BMC Public Health. 2023;23(1):480. https://doi.org/10.1186/s12889-023-15362-0
  22. Dia N, Ferekh S, Jabbour S, et al. Knowledge, attitude, and practice of patients with diabetes. Pharm Pract (Granada). 2022;20(1):2608. https://doi.org/10.18549/PharmPract.2022.1.2608
  23. Wang D, Liu Z, Liu Y, et al. Knowledge, attitudes, and practices among patients with diabetes mellitus. Front Public Health. 2024;12:1426259. https://doi.org/10.3389/fpubh.2024.1426259
  24. Peduzzi P, Concato J, Kemper E, et al. A simulation study of the number of events per variable. J Clin Epidemiol. 1996;49(12):1373–1379. https://doi.org/10.1016/S0895-4356(96)00236-3
  25. von Elm E, Altman DG, Egger M, et al. The STROBE statement. Lancet. 2007;370(9596):1453–1457. https://doi.org/10.1016/S0140-6736(07)61602-X
  26. Shaw C. Quality of healthcare services in Kyrgyzstan: an overview. WHO Regional Office for Europe; 2018.
  27. Sahoo J, Mohanty S, Kundu A, Epari V. Medication adherence among patients with type 2 diabetes mellitus. Cureus. 2022;14(12):e33074. https://doi.org/10.7759/cureus.33074
  28. Karymsakov A, Foster F, Toleubekova L, et al. Nonadherence to prescriptions among type 2 diabetes patients. Electron J Gen Med. 2024;21(1):em565. https://doi.org/10.29333/ejgm/14021
  29. Mir TH. Adherence versus compliance. HCA Healthc J Med. 2023;4(2):219–220. https://doi.org/10.36518/2689-0216.1583
  30. Davis J, Fischl AH, Beck J, et al. National standards for diabetes self-management education and support. Diabetes Spectr. 2022;35(2):137–149. https://doi.org/10.2337/ds21-0058
  31. Babak A, Rouzbahani S, Safaeian A, Poonaki F. Type 2 diabetes and misconceptions. Health Sci Rep. 2025;8(10):e71308. https://doi.org/10.1002/hsr2.71308
  32. Liu L, Jia HH, Zhou YQ, et al. Illness perception and health promotion behaviour. Nurs Open. 2022;9(2):1343–1352. https://doi.org/10.1002/nop2.1175
  33. Chu L, Bhogal SK, Lin P, et al. Awareness of diagnosis and treatment of CKD in T2D. Can J Diabetes. 2022;46(5):464–472. https://doi.org/10.1016/j.jcjd.2021.12.007
  34. Kulakçı-Altıntaş H, Ayaz-Alkaya S. Fatalism tendency and health beliefs. Geriatr Nurs. 2024;55:29–34. https://doi.org/10.1016/j.gerinurse.2023.11.005
  35. Neale EP, Middleton J, Lambert K. Barriers to CKD detection and management. BMC Nephrol. 2020;21(1):83. https://doi.org/10.1186/s12882-020-01708-6
  36. Powers MA, Bardsley JK, Cypress M, et al. Diabetes self-management education and support. J Acad Nutr Diet. 2021;121(4):773–788.e7. https://doi.org/10.1016/j.jand.2020.12.003
  37. Konerding U, Bowen T, Elkhuizen SG, et al. Impact of travel time on quality of life. Diabetes Res Clin Pract. 2017;126:16–24. https://doi.org/10.1016/j.diabres.2017.01.014
  38. Tuobenyiere J, Mensah GP, Korsah KA. Patient perspective on barriers in diabetes self-management. Nurs Open. 2023;10(10):7003–7013. https://doi.org/10.1002/nop2.1857
  39. Health Action International. Diabet v Kyrgyzstane (factsheet). 2024.
  40. Harvard T H Chan School of Public Health. Where’s the Salt? 2024. Available from: https://content.sph.harvard.edu/wwwhsph/sites/21/2014/05/Wheres-the-salt.pdf
  41. Scott CK, Chi G, Glenna L. Household food security in rural southern Kyrgyzstan. Agric Food Secur. 2024;13(1):14. https://doi.org/10.1186/s40066-024-00452-7

LICENSE

Creative Commons License
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.