Incidence and predictors of chronic kidney diseases among type 2 diabetes mellitus patients at St. Paul’s Hospital, Addis Ababa, Ethiopia

BMC Research Notes, Jul 2018

Objective This study aimed to estimate the incidence of chronic kidney disease and its predictors among newly diagnosed type 2 diabetes patients attending St. Paul’s Hospital, Addis Ababa, Ethiopia. Results The overall incidence of chronic kidney disease was a major public health issue among type 2 diabetes mellitus patients with 2178 (95% CI 12,801, 21,286) cases per 10,000 patient-months. Moreover, 62(14.25%) patients in the sample experienced chronic kidney disease. Old age [adjusted hazard ratio (AHR) = 1.06, 95%CI 1.03, 1.09], no diabetic retinopathy [AHR = 0.13, 95%CI 0.07–0.24], high density lipoprotein cholesterol ≥ 40 mg/dl [AHR = 0.55, 95%CI 0.31, 0.97] and high body mass index [AHR = 1.17, 95%CI 1.1, 1.25] were common factors for chronic kidney diseases.

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Incidence and predictors of chronic kidney diseases among type 2 diabetes mellitus patients at St. Paul’s Hospital, Addis Ababa, Ethiopia

Geletu?et?al. BMC Res Notes Incidence and?predictors of?chronic kidney diseases among?type 2 diabetes mellitus patients at?St. Paul's Hospital, Addis Ababa, Ethiopia Alemayehu Hussen Geletu Alemayehu Shimeka Teferra 0 Malede Mequanent Sisay 0 Destaw Fetene Teshome 0 0 Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar , 196, Gondar , Ethiopia Objective: This study aimed to estimate the incidence of chronic kidney disease and its predictors among newly diagnosed type 2 diabetes patients attending St. Paul's Hospital, Addis Ababa, Ethiopia. Results: The overall incidence of chronic kidney disease was a major public health issue among type 2 diabetes mellitus patients with 2178 (95% CI 12,801, 21,286) cases per 10,000 patient-months. Moreover, 62(14.25%) patients in the sample experienced chronic kidney disease. Old age [adjusted hazard ratio (AHR) = 1.06, 95%CI 1.03, 1.09], no diabetic retinopathy [AHR = 0.13, 95%CI 0.07-0.24], high density lipoprotein cholesterol ? 40 mg/dl [AHR = 0.55, 95%CI 0.31, 0.97] and high body mass index [AHR = 1.17, 95%CI 1.1, 1.25] were common factors for chronic kidney diseases. Chronic kidney diseases; Type 2 diabetes; Diabetic complications; Predictors Introduction Chronic kidney disease contributes substantially to human suffering and death [ 1 ]. For instance, the estimated prevalence of people who have experienced CKD is 11?13% and 13.9% worldwide and sub-Saharan Africa respectively. chronic kidney disease is a critical issue in the management of patients with type 2 diabetes mellitus [ 1?5 ]. Previous studies in the area indicated that is mainly driven by diabetic mellitus (DM). For example, type 2 diabetes mellitus (T2DM) causes 30?50% of CKD cases [ 6?10 ]. According to recent literature, CKD is more prevalent (11?29%) are among type 2 diabetic patients in developed than in developing countries [ 11?13 ]. A similar h study done in Hong Kong and South Africa reported a development of CKD among type 2 DM patients at a rate of 12.7 and 94.9%, respectively [ 14, 15 ]. Although the prevalence of CKD ranged from 2 to 41% in Africa [ 5, 16 ], the growing burden of CKD among type 2 DM patients is not well explored in low and middle-income countries [ 17?20 ]. Several studies highlighted the risk factors for CKD complication of type 2 diabetic patients. For example, age and sex were significant risk factors for CKD in type 2 diabetic patients [ 21?23 ]. However, studies found disparities in the risk factors for chronic kidney diseases [ 13, 22, 24?26 ]. In another cohort study, physical activity reduces the incidence [ 21 ], whereas smoking history and lipid abnormalities have increased the risk of CKD in type 2 DM patients [ 12, 27?31 ]. In another prospective study done among type 2 diabetic patients, factors such as high systolic blood pressure (SBP), low diastolic blood pressure (DBP) and high body mass index (BMI) significantly affected the CKD [ 12, 29, 32, 33 ]. Moreover, hypoglycemia, history of hypertension and diabetic retinopathy were considerable risks [ 5, 12, 22, 34?36 ]. A systematic review and meta-analysis revealed that BP lowering medications and intensive blood-glucose control can reduce the risk of CKD [ 37, 38 ]. Previous studies showed that the incidence of diabetic kidney disease varied across countries. But this emerging global public health problem is not well investigated, rather it is overlooked in low-come countries including Ethiopia. Quantifying the burden of the disease and early detection of the risk factors is paramount in the prevention of CKD. Therefore, this study aimed to estimate the incidence of chronic kidney disease and its predictors among newly diagnosed type 2 diabetes patients attending St. Paul?s Hospital, Addis Ababa, Ethiopia. Main text Methods An institution-based retrospective follow-up study was conducted at St. Paul?s Hospital, Addis Ababa, Ethiopia. St. Paul?s Referral Hospital is found in the capital of Ethiopia, Addis Ababa. Since 1969 the hospital has been providing different medical care services included chronic problems like chronic kidney disease and supports to an estimated 200,000 people annually referred from all over the country. All newly diagnosed T2DM patients who enrolled at St. Paul?s Referral Hospital between January 2008 and November 2017 were considered in this study. The required sample (435) was determined by the incidence and predictors of CKD using STATA software. New T2DM diagnosed patients were eligible, while those who had CKD at the time of the diagnosis for T2DM were excluded from the study. The data were collected using a standard extraction checklist which was adapted from the World Health Organization (WHO) guidelines [ 39 ]. After they were checked for completeness, data were entered using Epi Info 7 and exported to STATA 12 for further analysis. The outcome variable in t (...truncated)


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Alemayehu Hussen Geletu, Alemayehu Shimeka Teferra, Malede Mequanent Sisay, Destaw Fetene Teshome. Incidence and predictors of chronic kidney diseases among type 2 diabetes mellitus patients at St. Paul’s Hospital, Addis Ababa, Ethiopia, BMC Research Notes, 2018, pp. 532, Volume 11, Issue 1, DOI: 10.1186/s13104-018-3618-9