Patient Awareness, Prevalence, and Risk Factors of Chronic Kidney Disease among Diabetes Mellitus and Hypertensive Patients at Jimma University Medical Center, Ethiopia

Abstract

Background. There is an alarming rise of chronic kidney disease (CKD) prevalence globally, which is associated with significant morbidity and mortality necessitating special attention as one of the major public health problems. The burden of CKD disproportionately impacts low-income countries like Ethiopia where hypertension and diabetes mellitus, the two most important risk factors for CKD growth rate, are greatest. Objective. The aim of this study is to assess patient awareness, prevalence, and risk factors of chronic kidney disease among hypertensive and diabetes mellitus patients. Methods. Hospital based cross-sectional study design was conducted at Jimma University Medical Center among adult (≥18 years) hypertensive and diabetes mellitus patients. Informed written consent was obtained from each participant and data was collected by interview and chart review; blood and urine samples were collected for CKD screening. Glomerular filtration rate (GFR) was estimated from serum creatinine using CKD epidemiology collaboration (CKD-EPI) equation, and CKD was defined using estimated GFR (e-GFR) and albuminuria. Multivariate logistic regression was used to identify independent predictors of CKD and p-value <0.05 considered statistically significant. Result. Mean (±SD=standard deviation) age of participants was 54.81 ± 12.45 years and 110 (52.9%) of them were male. Only 59 (28.4%) of the participants had awareness about CKD and its risk factors. The prevalence of CKD was 26% (95% CI; 20.3%-31.8%). Factors associated with chronic kidney disease were uncontrolled blood pressure (adjusted odds ratio (AOR)=2.22,95% CI=1.01-4.76), fasting blood sugar ≥ 150 mg/dl, (AOR=3.70,95% CI=1.75-7.69), angiotensin converting enzyme inhibitors (ACEIs) nonusers, (AOR=4.35 ,95% CI=1.96-10.0), poor knowledge of CKD (AOR=3.69, 95% CI=1.48-9.20), and long duration of hypertension (AOR=4.55, 95%CI=1.72-11.11). Conclusion. Our study found out low level of patient awareness and high prevalence of CKD. The predictors of CKD were uncontrolled blood pressure, fasting blood sugar> 150 mg/dl, long duration of hypertension, ACEIs nonusers, and poor knowledge about CKD.

Chronic Kidney Disease among Diabetes Patients in Ethiopia: A Systematic Review and Meta-Analysis

“…The number of study participants per study ranged from 189 to 700. The included studies applied various estimators of GFR; four of the studies [ 48 , 55 – 57 ] used the CG formula in estimating GFR, four studies [ 31 , 50 , 51 , 53 ] used the MDRD, and two studies [ 52 , 54 ] used the CKD-EPI creatinine equation. The prevalence of CKD in patients with DM was obtained from various regions in Ethiopia; four studies were from Amhara [ 50 , 51 , 53 ], three from Addis Ababa [ 55 – 57 ], three from Oromia [ 48 , 49 , 52 ], one each from Tigray [ 58 ] and SNNPR [ 31 ].…”

“…The included studies applied various estimators of GFR; four of the studies [ 48 , 55 – 57 ] used the CG formula in estimating GFR, four studies [ 31 , 50 , 51 , 53 ] used the MDRD, and two studies [ 52 , 54 ] used the CKD-EPI creatinine equation. The prevalence of CKD in patients with DM was obtained from various regions in Ethiopia; four studies were from Amhara [ 50 , 51 , 53 ], three from Addis Ababa [ 55 – 57 ], three from Oromia [ 48 , 49 , 52 ], one each from Tigray [ 58 ] and SNNPR [ 31 ]. With regard to the sampling technique, four studies [ 50 , 51 , 53 , 56 ] used systematic random sampling, three studies [ 31 , 57 , 58 ] used simple random sampling, two studies [ 52 , 54 ] used convenience sampling, and three studies [ 48 , 49 , 55 ] used the census sampling method.…”

“…The prevalence of CKD in patients with DM was obtained from various regions in Ethiopia; four studies were from Amhara [ 50 , 51 , 53 ], three from Addis Ababa [ 55 – 57 ], three from Oromia [ 48 , 49 , 52 ], one each from Tigray [ 58 ] and SNNPR [ 31 ]. With regard to the sampling technique, four studies [ 50 , 51 , 53 , 56 ] used systematic random sampling, three studies [ 31 , 57 , 58 ] used simple random sampling, two studies [ 52 , 54 ] used convenience sampling, and three studies [ 48 , 49 , 55 ] used the census sampling method. The quality score of the included studies was assessed based on the Newcastle–Ottawa quality score ( Table 2 ).…”

“…Based on this meta-analysis, chronic kidney disease among diabetes patients in the Ethiopian context was associated with the duration of DM, female sex, age >60 years, family history of CKD, BMI ≥30 kg/m 2 , type 2 diabetes, FBG >150 mg/dl, HbA1c >7%, HDL ≥40 mg/dl, triglyceride >150 mg/dl, and systolic blood pressure >140 mmHg [ 31 , 48 , 51 , 52 , 54 , 55 , 57 ].…”

Pengembangan dan Validasi Kuesioner untuk Menilai Miskonsepsi tentang Pengobatan pada Hipertensi dan Diabetes Melitus dengan Kejadian Gagal Ginjal

“…Hal ini penting untuk ditindaklanjuti sebagai program promosi kesehatan yang efektif sehingga dapat menekan kejadian gagal ginjal [23] seperti yang telah dilakukan oleh tim peneliti (data tidak ditampilkan). Hal ini seiring dengan temuan penelitian bahwa pasien yang telah terdiagnosis baik DM maupun hipertensi [24] yang sudah berkomplikasi menjadi penyakit gagal ginjal dengan berbagai tingkat keparahan penyakitnya (tahap 1-5), memiliki tingkat kewaspadaan yang rendah [25]. Sementara itu, untuk mengetahui validitas konkruen dan konvergen yang terdapat pada skala Pengetahuan kuisoner yang dikembangkan, peneliti menguji hubungan antara skor total dan dimensi faktornya dengan skor total dan dimensi-dimensi pada skala Kepatuhan Berobat (Morisky Medication Adherence Scale MMAS-8) menggunakan analisis korelasi parsial dengan mengendalikan faktor social desirability.…”