scholarly journals The magnitude of undernutrition and associated factors among adult chronic kidney disease patients in selected hospitals of Addis Ababa, Ethiopia

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0251730
Author(s):  
Mahder Asefa ◽  
Amene Abebe ◽  
Behailu Balcha ◽  
Daniel Baza
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Serum Albumin ◽  
Associated Factors ◽  
Addis Ababa ◽  
Statistical Significance ◽  
P Value ◽  
Reference Laboratory

Background Undernutrition is a common comorbidity in chronic kidney disease patients which augments the progression of the disease to an end-stage renal disease, renal dysfunction and related morbidity and mortality. However, in Ethiopia, there is a dearth of research evidence in this regard. Therefore, this study aimed to assess the magnitude of undernutrition and its associated factors among adult chronic kidney disease patients. Methods An institution-based cross-sectional study was conducted in selected hospitals of Addis Ababa from May to August 2018. Data were collected by structured and pretested questionnaires. Patients’ charts were reviewed from their medical profiles. Body mass index was calculated from anthropometric measurements using calibrated instruments. Serum albumin level was determined by reference laboratory standard procedure. Data were entered into Epi- data version 3.1 and exported to SPSS version 21 for analysis. Descriptive statistics were calculated and presented by tables, graphs and texts. Binary and multivariable logistic regression analyses were computed and the level of statistical significance was declared at p-value <0.05. Results From the total sample size of 403 participants, 371 were involved in the study. The prevalence of undernutrition (BMI<18.5) among adult chronic kidney disease patients was 43.1% (95% CI: 38%-48%). Undernutrition (BMI<18.5) was significantly higher among patients with diabetic nephropathy [AOR = 2.00, 95% CI, 1.09–2.66], serum albumin value less than 3.8g/dl [AOR = 4.21: CI, 2.07–5.07], recently diagnosed with diabetes mellitus [AOR = 2.36, 95% CI, 1.03–3.14] and stage V chronic kidney disease [AOR = 3.25:95% CI, 1.00–3.87]. Conclusion Undernutrition in chronic kidney disease patients was significantly higher among patients with diabetic nephropathy, patients on stage V chronic kidney disease, recently diagnosed with diabetes mellitus and serum albumin value less than 3.8g/dl.

scholarly journals Prevalence and Associated Factors of Chronic Kidney Disease Among Diabetic and Hypertensive Patients at Ambo Town Public Hospitals of West Shewa Zone, Oromia Region, Ethiopia

2022 ◽  
Author(s):  
Haimanot Ewnetu Hailu ◽  
Belachew Dinku ◽  
Jimmawork Wondimu ◽  
Bilisuma Girma
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Logistic Regression ◽  
Kidney Disease ◽  
Associated Factors ◽  
Public Hospitals ◽  
P Value ◽  
Hypertensive Patients ◽  
Long Duration

Abstract Background: Chronic kidney disease is a global public health important disease that is associated with life threatening outcomes including renal failure and premature mortality unless diagnosed and treated promptly. Diabetes Mellitus and hypertension are the two major causes of chronic kidney disease worldwide. This study is aimed to determine prevalence and associated factors of chronic kidney disease among diabetes mellitus and hypertensive patients at Ambo town public hospitals, EthiopiaMethods: A cross-sectional study was conducted at Ambo University referral and general hospitals on 308 study participants. The participants were interviewed using interviewer administered questionnaire when they come for follow up at a chronic illness follow-up clinic. The patient charts were reviewed to retrieve information regarding medications, blood pressure, serum Creatinine and glucose level. A chronic kidney disease epidemiology collaboration equation was used to estimate Glomerular filtration rate from serum Creatinine. Data were analyzed SPSS version 23 for statistical analysis. Binary logistic regression analysis was used to identify factors associated with chronic kidney disease. Variables with a p-value below 0.2 at bivariable analysis were entered into the multivariable logistic regression model. Multivariable logistic regression analysis was used to examine the association between dependent and independent variable and p-value less than 0.05 was used to declare statistical significance.Results: A total of 308 diabetes mellitus and hypertensive patients were included in the study from Ambo town public hospitals. Of which 156 (50.6%) participants were female with mean (± SD) age of 47.15 ± 12.06 years. The prevalence of chronic kidney disease (stage 3–5) was 20.5% with (95% CI: 16%-25%). Long duration of hypertension (AOR=4.89, 95% CI=1.93-12.40), elevated systolic blood pressure (>140mmHG) (AOR=3.20, 95% CI=1.36-7.51), family history (AOR=3.36, 95% CI=1.56-7.24) and age greater than 55 years (AOR=2.17, 95% CI=1.09-4.31) were predictors of chronic kidney disease.Conclusion: The prevalence of chronic kidney disease was high. Older age, elevated SBP, long duration of hypertension and family history of kidney disease were independent predictors of chronic kidney disease. A preventive plan is mandatory to reduce the disease and complications in the community.

Chronic Kidney Disease in Cameroon: A scoping review

2020 ◽  
Author(s):  
Jerry Brown Aseneh ◽  
Ben-Lawrence A. Kemah ◽  
Stephane Mabouna ◽  
Njang Mbeng Emmanuel ◽  
Domin Sone Majunda Ekane ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Human Immunodeficiency Virus ◽  
Kidney Disease ◽  
Scoping Review ◽  
Associated Factors ◽  
Treatment Cost ◽  
Advanced Age ◽  
High Morbidity ◽  
Immunodeficiency Virus

Abstract ObjectivesThis scoping review sought to summarize available data on the prevalence, associated factors, etiology, comorbidities, treatment, cost, and mortality of chronic kidney disease (CKD) in Cameroon.MethodsWe searched PubMed, Scopus and African Journals Online from database inception to 31 March, 2020 to identify all studies published on the prevalence, associated factors, etiology, comorbidities, treatment, cost and mortality of CKD in Cameroon.ResultsThirty studies were included. The population prevalence of CKD varied from 3-14.1% and 10.0%-14.2% in rural and urban areas, respectively. The prevalence of CKD in patients with hypertension, diabetes mellitus, and human immunodeficiency virus was 12.4-50.0%, 18.5%, and 3.0-47.2%, respectively. Hypertension (22.3-59.1%), chronic glomerulonephritis (15.8-56.2%), and diabetes mellitus (15.8-56.2%) were the most common causes of CKD. The cause was unknown in 13.5-17.0% of the cases. Advanced age, hypertension, diabetes mellitus, and obesity were frequent associated factors. Hemodialysis was the main treatment modality in patients with End Stage Renal Disease (ESRD). The monthly cost of management of non-dialyzed CKD was 163 US dollars. The one-year mortality rate of ESRD was 26.8-38.6%.ConclusionChronic kidney disease in affects about one in ten adults in the general population in Cameroon Patients with hypertension, diabetes mellitus, and human immunodeficiency virus bear the greatest burden of CKD in Cameroon. Advanced age, hypertension, diabetes mellitus, and obesity are major factors associated with CKD. Chronic kidney disease in Cameroon is associated with high morbidity and mortality and huge economic cost on the patient.

Role of vasopressin signaling in the pathogenesis of diabetic nephropathy

2021 ◽  
pp. 9-20
Author(s):  
Arus Garikovna Margaryan ◽  
Svetlana Anatolievna Lebedeva ◽  
Dariya Mikhailovna Lisitsyna ◽  
Polina Igorevna Sirotkina ◽  
Lyudmila Aleksandrovna Yakubova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Major Complication ◽  
Epidemiological Studies ◽  
Animal Models Of Diabetes

The diabetic kidney disease (also known as diabetic nephropathy) is a major complication of diabetes mellitus and also the most common cause of chronic kidney disease. Elevated plasma levels of vasopressin are consistently observed in patients with either type 1 and type 2 diabetes mellitus and in animal models of diabetes mellitus. A role of enhanced vasopressin signaling in progression of the diabetic nephropathy to chronic kidney disease has been suggested in several epidemiological studies but the underlying pathogenetic mechanisms remain largely unclear and are the subject of current scientific research.

Diabetic nephropathy: modern principles of classification, diagnosis and features of antihyperglycemic therapy

2021 ◽  
Author(s):  
А.Г. Борисов ◽  
С.В. Чернавский ◽  
М.А. Смирнова ◽  
А.А. Стремоухов
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Diabetic Nephropathy ◽  
Kidney Disease ◽  
Developed Countries ◽  
Primary Diagnosis ◽  
Kidney Damage ◽  
Lipid Metabolism Disorders ◽  
Antihyperglycemic Therapy

Статья посвящена современным подходам к терапии сахарного диабета, осложненного поражением почек. Сахарный диабет является важнейшей проблемой современной медицины, что прежде всего обусловлено высокой распространенностью заболевания среди трудоспособного населения. Диабетическая нефропатия – одно из тяжелых хронических осложнений диабета, повышающее инвалидизацию и смертность пациентов. Диабетическая нефропатия является основной причиной развития терминальной почечной недостаточности в развитых странах и со временем затрагивает около 30% пациентов. Поражение почек у больных сахарным диабетом встречается в 6-7% случаев из общего числа нефропатий у пациентов, получающих лечение в специализированном нефрологическом отделении многопрофильного стационара. Первые проявления диабетической нефропатии развиваются через 3-4 года от дебюта заболевания и достигают своего пика через 15-20 лет. Понятие «хроническая болезнь почек» включает в себя поражение почек независимо от первичного диагноза, характеризующееся такими основными диагностическими критериями, как экскреция альбумина с мочой и значения скорости клубочковой фильтрации, которые являются маркерами повреждения почек. Методы предупреждения прогрессирования диабетической нефропатии включают в себя общие мероприятия по изменению образа жизни, контроль гликемии и артериального давления, коррекцию нарушений липидного обмена в сочетании с нефропротективной терапией. В настоящее время при выборе терапии у больных сахарным диабетом 2 типа в сочетании с хронической болезнью почек наряду с приемом метформина предпочтение отдается ингибиторам натрий-глюкозного котранспортера 2-го типа и агонистам рецепторов глюкагоноподобного пептида-1, обладающим нефропротективным эффектом. The article is devoted to modern approaches to the treatment of diabetes mellitus complicated by kidney damage. Diabetes mellitus is the most important problem of modern medicine, which is primarily due to the high prevalence of the disease among the working-age population. Diabetic nephropathy is one of the severe chronic complications of diabetes, which increases the disability and mortality of patients. Diabetic nephropathy is the main cause of the development of end-stage renal failure in developed countries and eventually affects about 30% of patients. Kidney damage in patients with diabetes occurs in 6-7% of cases out of the total number of nephropathies in patients receiving treatment in a specialized nephrological department of a multidisciplinary hospital. The first manifestations of diabetic nephropathy develop 3-4 years after the onset of the disease, and reach their peak in 15-20 years. The concept of «chronic kidney disease» includes kidney damage regardless of the primary diagnosis and is characterized by such basic diagnostic criteria as urinary albumin excretion and glomerular filtration rate values, which are markers of kidney damage. Methods for preventing the progression of diabetic nephropathy include general measures to change the lifestyle, control of glycemia and blood pressure, correction of lipid metabolism disorders in combination with nephroprotective therapy. Currently, when choosing therapy in patients with type 2 diabetes mellitus in combination with chronic kidney disease, along with taking metformin, preference is given to sodium-glucose cotransporter type 2 inhibitors and glucagon-like peptide-1 receptor agonists with a nephroprotective effect.

Potential drug-drug interactions among patients with chronic kidney disease admitted at National Hospital: a retrospective study in Tanzania

2020 ◽  
Author(s):  
Wigilya Mikomangwa ◽  
Jephter E. Malifa ◽  
Hamu Mlyuka ◽  
Ritah Mutagonda ◽  
Manase Kilonzi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Drug Interactions ◽  
P Value ◽  
Potential Drug ◽  
National Hospital ◽  
Prescribed Medicines ◽  
Prolonged Hospital ◽  
Social Demographic

Abstract Background: Drug related problems such as drug-drug interactions (DDI) are likely to occur in chronic kidney disease (CKD) patients due to polypharmacy practice. The DDI increases the risk of morbidity, mortality, prolonged hospital and cost of treatment. In most cases, the potential drug-drug interactions (pDDI) are not checked during prescribing or dispensing of polypharmacy for CKD patients in developing countries like Tanzania. Therefore, we documented the pattern and potential drug-drug interactions (DDIs) among CKD patients admitted at Muhimbili National Hospital (MNH).Methods: The study retrospectively reviewed 198 files for CKD patients admitted at MNH between January 2017 and December 2018. The social-demographic characteristics and comorbidities were documented using a checklist. Prescriptions with polypharmacy were reviewed and prescribed medicines were documented. Medscape drug interaction checker was used for pDDIs. The SPSS version 23.0 was used to carry out statistical analysis. Results: The study involved a total of 306 prescriptions with polypharmacy with a mean(±SD) of 6.21(±1.22) medicines per prescription. Majority of patients (77.2%) were in stage 5 of chronic kidney disease. Frequently prescribed medicines were pantoprazole 135(44.1%), furosemide 133(43.5%), ferrotone 101(33.0%), calcium carbonate 91(29.7%), amlodipine 121(39.5%), nifedipine 83(27.1%), bisoprolol 46(15.0%) and clonidine 38(12.4). The prevalence of pDDIs was 94.1%. The total of 1743 potential drug-drug interactions was observed with a mean of 6.03(±2.12) interactions per prescription. Majority of the pDDIs were moderate (67.5%) whereas, 29.5%, 2.6% and 0.3 were minor, serious and contraindicated respectively. The occurrence of pDDIs was associated with stroke (P-value=0.038), diabetes mellitus (p-value=0.049) and hypertension with diabetes mellitus (p-value=0.047).Conclusion: The prevalence of pDDIs was high among the CKD patients. The determinants of pDDIs among CKD patients were hypertension, diabetes mellitus and stroke. Interaction checkers should be incorporated in health system to guide the prescribing and dispensing of medicine for CKD patients.

scholarly journals Drug-Related Problems and Associated Factors among Patients Admitted with Chronic Kidney Disease at Jimma University Medical Center, Jimma Zone, Jimma, Southwest Ethiopia: A Hospital-Based Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Aster Wakjira Garedow ◽  
Eshetu Mulisa Bobasa ◽  
Amare Desalegn Wolide ◽  
Fantu Kerga Dibaba ◽  
Fanta Gashe Fufa ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Drug Therapy ◽  
Kidney Disease ◽  
Observational Study ◽  
Associated Factors ◽  
Prospective Observational Study ◽  
Medical Center ◽  
Statistical Significance ◽  
Morbidity And Mortality ◽  
Jimma University

Background. There is an alarming rise of chronic kidney disease prevalence globally associated with significant morbidity and mortality necessitating special attention as one of the major growing public health problems. Medication-related problems are common in hospitalized patients including chronic kidney disease and may lead to increase hospital stay and health care cost and augment the risk of morbidity and mortality. Objective. To determine prevalence of medication-related problems and associated factors among chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Methods. A hospital-based prospective observational study was conducted among 103 chronic kidney disease patients admitted to Jimma University Medical Center from April to September 2018. Data regarding patient characteristics, medications, diagnosis, length of hospitalization, and laboratory results were collected through review of patients’ medical charts. Data were analyzed by using Statistical Package for the Social Sciences (SPSS) version 21.0. Univariate and multivariate logistic regression was utilized to assess the associations between dependent and independent variables. Statistical significance was considered at p value <0.05. Results. Out of 103 chronic kidney disease patients, 81 (78.6%) of patients had MDRs, on average 1.94 ± 0.873 per patient. The rate of overall MRPs was 30.95 per 100 medication orders. The most common MRPs among CKD patients were need additional drug therapy (62 (31%)), nonadherence (40 (20%)), and dose too low (36 (18%)). The most common cause of need additional drug therapy (52 (26%)) was untreated medical conditions; nonadherence (19 (9.5%)) was mostly due to that the patient/caregiver forgets to take/give the medication, and dose too low (29 (14.5%)) was mostly due to that the dose is too low to produce the desired response. Polypharmacy (AOR = 4.695, 95% CI: 1.370–16.091), number of comorbidities (AOR = 3.616, 95% CI: 1.015–1.8741), and stage of CKD (AOR = 3.941, 95% CI: 1.221–12.715) were independent predictors for MRPs. Conclusions. We have demonstrated that medication-related problems are high among chronic kidney disease patients. Marital statuses, stage of CKD, polypharmacy, and comorbidity were independent predictors for MRPs. Interdisciplinary health professionals should work to decrease the high prevalence of MRPs among chronic kidney disease patients.

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