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)