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

Author(s):  
Haimanot Ewnetu Hailu ◽  
Belachew Dinku ◽  
Jimmawork Wondimu ◽  
Bilisuma Girma

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.

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Belachew Tegegne ◽  
Tigist Demeke ◽  
Shemsedin Amme ◽  
Afework Edmealem ◽  
Sewunet Ademe

Background. Morbidity and mortality due to chronic kidney disease are increasing among hypertensive patients in Sub-Saharan Africa. The majority of hypertensive patients with chronic kidney disease are not diagnosed at an early stage because of poor knowledge. However, to the best of our knowledge, there is no study conducted in Ethiopia about knowledge of hypertensive patients towards prevention and early detection of chronic kidney disease. Thus, the aim of this study was to assess knowledge towards prevention and early detection of chronic kidney disease and associated factors among hypertensive patients at Jimma town public hospitals, Ethiopia. Methods. A hospital-based cross-sectional study was conducted among 332 hypertensive patients using an interviewer-administered questionnaire and medical record reviewing from April 5 to May 21, 2019. Study participants were selected using simple random sampling. Data were collected by using a standardized questionnaire. Data were entered into Epidata version 3.1 and analyzed by SPSS version 23. Descriptive statistics and bivariable and multivariable logistic regression were applied. To identify factors, a 95% confidence level and P value of less than 0.05 were considered. Results. Over half (59.6%) were males, and the mean (±SD) age of participants was 54.92 (12.91) years. Among the total participants, more than half of them (47.9%) had good knowledge. Attending secondary education ( AOR = 2.9 , P = 0.014 ), higher education ( AOR = 5.4 , P = 0.001 ), working in private sectors ( AOR = 4.3 , P = 0.001 ), taking three and above drugs per day ( AOR = 0.55 , P = 0.016 ), and having a family history of kidney disease ( AOR = 2.3 , P = 0.012 ) were significantly associated with knowledge. Conclusion and Recommendation. Near to half of the study participants had good knowledge towards prevention and early detection of chronic kidney disease. Attending secondary education and above, working in private sectors, taking three and above drugs per day, and having a family history of kidney disease were independent predictors of knowledge. Hypertensive patients should be encouraged to be aware of risk factors of CKD, and health care providers should educate hypertensive patients about the prevention and early detection of chronic kidney disease.


2020 ◽  
Vol 10 (3) ◽  
pp. 188-197
Author(s):  
Samira Behboudi-Gandevani ◽  
Mina Amiri ◽  
Maryam Rahmati ◽  
Saber Amanollahi Soudmand ◽  
Fereidoun Azizi ◽  
...  

Background: Although preeclampsia (PE), as an endothelial disorder can lead to renal dysfunction during pregnancy, results of studies focusing on the potential long-term potential effects of PE on renal function are insufficient and those available are controversial. This study investigated the incidence rate and risk of chronic kidney disease (CKD) among women with prior history of PE compared with healthy controls in a long-term population-based study. Methods: This was a prospective population-based cohort study. Subjects were 1,851 eligible women, aged 20–50 years, with at least 1 pregnancy (177 women with prior-PE and 1,674 non-PE controls) selected from among the Tehran-Lipid and Glucose-Study-participants. A pooled-logistic-regression-model and Cox’s-proportional-hazards-models were utilized to estimate the risk of CKD in women of both PE and without PE groups, after further adjustment for confounders. Results: Median and interquartile ranges for follow-up durations of the PE and non-PE groups were 7.78 (5.19–10.40) and 7.32 (4.73–11.00) years, respectively. Total cumulative incidence rates of CKD at the median follow-up time of each group were 35/100,000 (95% CI 25/100,000–50/100,000) and 36/100,000 (95% CI 32/100,000–39/100,000) in PE and non-PE women, respectively (p value = 0.90). Based on pooled-logistic-regression-analysis, OR of CKD progression (adjusted for age, body mass index [BMI], systolic blood pressure [SBP], and diastolic blood pressure [DBP]) for the PE group did not differ, compared to their non-PE counterparts (OR 1.04; p value = 0.80; 95% CI 0.77–1.40). Compared to non-PE women, women with prior PE did not have higher hazard ratios (HRs) of developing CKD in the unadjusted model (unadjusted HR 1.1, 95% CI 0.83–1.69, p = 0.35), results which remained unchanged after adjustment for age, BMI, baseline SBP, and DBP. Conclusion: PE was not found to be a risk factor for CKD. More studies using a prospective cohort design with long-term follow-ups are needed to investigate the relationship between preeclamsia and CKD.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0251730
Author(s):  
Mahder Asefa ◽  
Amene Abebe ◽  
Behailu Balcha ◽  
Daniel Baza

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.


2020 ◽  
Author(s):  
Shaowei Xu ◽  
Yim Chu Li ◽  
Catherine Xiaorui Chen

Abstract BackgroundTo identify the prevalence of Chronic Kidney Disease (CKD) in Chinese hypertensive population managed in a local public primary care clinic and to explore its associated risk factors. MethodsMedical records of Chinese adult hypertensive patients (> 18 years of age) who had been followed up in a public general outpatient clinic (GOPC) from 1 Jan 2018 to 30 Jun 2018 were retrieved and reviewed, and a sample group was randomly selected. Demographic, clinical parameters including age, gender, smoking status, body weight, height, systolic and diastolic blood pressure, biochemical data, and comorbidities were collected from the Computer Management System (CMS). Estimated glomerular filtration rate (eGFR) was calculated by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. CKD was defined as eGFR < 60 ml/min/1.73m2 and staged according to Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria. Student's t-test was used to analyze continuous variables and the Chi-squared test was used for categorical data. Multivariate Logistic regression was used to examine the association between CKD and variable associated factors. All statistical tests were two-sided, and a P-value of <0.05 was considered significant.ResultsAmong the 993 Chinese hypertensive patients included in the final analysis, 152 were found to have CKD, with overall prevalence being 15.3%. In addition, the prevalence of CKD increased with the ageing of the population. In multivariate analysis, associated factors for CKD included age (OR 4.3 for every 10 years increase), history of congestive heart failure (OR 7.2), diabetes mellitus (OR 1.8), gout (OR 3.2), number of anti-hypertensive medications (OR 1.6) and high-density lipoprotein cholesterol level (OR 0.38). Conclusions15.3% of Chinese adult hypertensive patients have CKD. Associated factors for CKD include older age, concomitant cardiovascular disease, diabetes mellitus, gout, and lipid disorder. Family physicians should make a concerted effort in early recognition of these risk factors for CKD among HT patients.


2021 ◽  
Vol 6 (14) ◽  
pp. 80-88
Author(s):  
Huseyin Duru ◽  
Ekrem KARA

Objective: To evaluate the effect of 24 hour systolic blood pressure (SBP) and diastolic blood pressure (DBP) variability (BPV) on renal progression in hypertensive patients with chronic kidney disease (CKD) Methods: A total 59 hypertensive patients (mean age: 54.2±14.6 years, 50.8% male) with CKD who underwent 24 hours ambulatory blood pressure measurement (ABPM) were included. Data on SBP, DBP, BPV coefficients (VC) for SBP (SBP-CV) and DBP (DBP-CV) were recorded. A decrease in e-GFR of <5 ml/min/year was considered as normal renal progression and a decrease in ≥5 ml/min/year was considered as rapid renal progression. Results: Overall, 40.6% of the patients had uncontrolled HT, while 45.8% had non-dipper pattern. Mean±SD daytime and night-time SBP and SBP-VC values were 135.3±17.9 mmHg, 128.6±23.0 mmHg, 11.7±2.8 and 9.5±3.6, respectively. Mean±SD daytime and nigh-time DBP and DBP-VC values were 84.5±13.4 mmHg, 77.2±16.1 mmHg, 13.8±3.8 and 12.0±3.7, respectively. Rapid renal progression was detected in 25.4% of patients with no significant difference in daytime, night-time and total SBP, SBP-VC, DBP and DBP-VC values between patients with rapid vs. natural renal progression. The regression analysis adjusted for age, gender, presence of DM, baseline e-GFR and dipping status revealed no significant impact of SBP-VC and DBP-VC in predicting rapid progression (p> 0.05). Conclusion: In conclusion, our finding revealed no significant association between BPV and renal progression in hypertensive patients with CKD. Larger scale prospective, randomized controlled trials with longer follow-up are needed to clarify this issue.


2020 ◽  
Author(s):  
Luciana Saraiva da Silva ◽  
Tiago Ricardo Moreira ◽  
Rodrigo Gomes da Silva ◽  
Rosângela Minardi Mitre Cotta

Abstract Background Recent studies suggest that the progression of chronic kidney disease (CKD) is not linear, but we do not have clear evidence on this issue, especially in hypertensive patients. We sought to evaluate the progression of CKD and associated factors over four years in a cohort of hypertensive patients. Methods We conducted a prospective cohort study during the years 2012 and 2016, with hypertensive patients diagnosed with CKD (n = 113). The progression of CKD was assessed through the evolution of the glomerular filtration rate (GFR) and the change in the stage of CKD between 2012 and 2016. Sociodemographic, economic, lifestyle, clinical, anthropometric, and biochemical variables were evaluated. The strength of the association between CKD progression and explanatory variables was assessed by odds ratio (OR) and their respective 95% confidence intervals using univariate and multivariate logistic regression. Results Regarding progression, 78.1% of the CKD patients did not progress over four years. When assessing the CKD trajectory (2012–2016) through the evolution of GFR, there was a mean reduction of 1.3 mL/min/1.73m² in four years. In the group that progressed, there was a reduction of 13 mL/min/1.73m², while in the group that did not progress, there was an increase of 2 mL/min/1.73m². In the multivariate analyses, age (p = 0.047), diabetes mellitus (DM) (p = 0.042), and urea (p = 0.050) were independently associated with CKD progression. Conclusions The findings of the present study showed a non-linear progression of CKD over the four years, contrary to what is traditionally expected. Age, DM and urea were independently associated with CKD progression.


2019 ◽  
Author(s):  
Hailemariam Adera ◽  
Workagegnehu Hailu ◽  
Ayineshet Adane ◽  
abilo tadesse

Abstract Background chronic kidney disease (CKD) is a global public health problem associated with progressive decline in kidney function and adverse cardiovascular outcome. Anemia in CKD has substantial adverse outcomes in CKD patients. There is paucity of published data on prevalence of anemia and its associated factors among CKD patients in Northwest Ethiopia. Objective This study aimed to determine the prevalence of anemia and its associated factors among CKD patients at University of Gondar hospital, Northwest Ethiopia. Methods A hospital-based cross-sectional study was conducted from May1, to September 30, 2018. Consecutive sampling was used to recruit 251 study subjects. Data regarding patient’s socio-demographics, clinical characteristics and laboratory parameters were collected from patients’ interview and medical records. Data was analyzed using SPSS version 20. Bi-variate and multi-variate logistic regression analyses were used to identify predictors of anemia in CKD patients. P<0.05 was used to declare association. Results The prevalence of anemia was high (64.5%), and tended to increase as eGFR declined. Hypertension (45%), chronic glomerulonephritis (24%) and diabetes (20%) were common causes of CKD. Multivariate logistic regression analysis revealed rural residence (AOR= 2.75, 95% CI: 1.34-5.65, p=0.006), BMI<18.5 kg/m2 (AOR=6.78, 95% CI: 1.32-34.73, p=0.022) and BMI of 18.5-24.9 kg/m2 (AOR=5.04, 95% CI: 1.26-20.10, p=0.022), and having hemodialysis history (AOR=3.59, 95% CI: 1.24-10.38, p=0.018) were predictors of anemia in CKD patients. Conclusion Prevalence of anemia in CKD patients was high (64.5%). Rural residence, non-obese body habitus and having hemodialysis history were found to be predictors of anemia in CKD patients. Periodic screening and intervention for anemia in CKD patients should be practiced to prevent its sequelae.


2019 ◽  
Author(s):  
Gebrewahd Bezabh Gebremichael ◽  
Teklewoini Mariye Zemichael

Abstract Background Hypoglycemia is an acute medical situation that occurs when blood sugar falls below the recommended level. Even though, hypoglycemia prevention practice in the management of diabetes mellitus is one cornerstone in controlling the effect of hypoglycemia, hypoglycemia prevention practice among patients with diabetes mellitus is insufficiently studied. Moreover, the existed scarce literature in Ethiopia revealed hypoglycemia prevention practice is inadequate. Thus, this study tried to assess hypoglycemia prevention practices and associated factors among diabetic patients. Methods Hospital-based, cross-sectional study design was employed from April one to March one 2018 in Central Zone of Tigray Regional state of Ethiopia. A total of 272 diabetes mellitus patients were selected by systematic random sampling method from study area. The collected data was checked for its completeness and then entered into Epi data version 3.1 then cleaned and analyzed using SPSS version 23. Binary logistic regression model (AOR, 95% CI and p-value < 0.05) was used to determine the predictors of hypoglycemia prevention practice. Results the mean age of respondents was 52.19 years and about 100 (63.2%) had good hypoglycemia prevention practice. Knowledge regarding hypoglycemia [AOR = 10.34; 95% CI [5.41, 19.89]], having a glucometer at home [AOR=3. 02; 95% CI [1.12, 8.12]], attitude regarding diabetes mellitus [AOR = 2.36 CI [1.26, 4.39]], being governmental employee [AOR=5. 19, 95% CI [1.63, 16.58]] and being divorced [AOR = 0.13, 95% CI [0.32, 0.53]] were found significantly associated with good hypoglycemia prevention practice. Conclusion Around two third of the study participants were found to have good hypoglycemia prevention practice. Good knowledge and favorable attitude toward diabetes mellitus, having glucometer at home, being governmental employee and divorced were found to be the predictors of good hypoglycemia prevention practice.


2020 ◽  
Author(s):  
Shubhadeep Sinha ◽  
Vamsi Krishna Bandi ◽  
Bala Reddy Bheemareddy ◽  
Pankaj Thakur ◽  
Sreenivasa Chary ◽  
...  

Abstract Background This post marketing surveillance, observational, prospective, safety study evaluated the safety, tolerability and long term immunogenicity of prescribed usage of Darbepoetin alfa, (DA-α, manufactured by Hetero Biopharma) in Indian patients with chronic kidney disease with anemia.Methods All patients with anemia of chronic kidney disease prescribed Hetero-Darbepoetin were the target patient population. The present study gathered the data from 503 Hetero-Darbepoetin alfa prescribed patients. This study collected information of patient demography, patient's medical history, concomitant medications, action taken with respect to Hetero-Darbepoetin-alfa, AE details (AE term, start date, stop date, severity, action taken, outcome and causality), periodic Hemoglobin (Hb) levels and abnormal laboratory tests results until treatment is discontinued or the patient is lost to follow-up. Immunogenicity data was collected in 121 patients at the end of treatment and after 1 year. Statistical analyses were performed to explore and analyze details of individual case safety reports of adverse events such as incidence, severity, seriousness, outcome, duration, action taken, and causality relationship of individual adverse event (AE) to the prescribed study drug. Results 87 AEs were reported in this study and most of them were mild to moderate in intensity. No deaths or serious adverse events (SAEs) were reported in this study. Anti-drug antibodies were not detected in any subject at the end of treatment phase and after 12 months long term follow up period. Baseline mean Hemoglobin value was 8.34 (SD 1.24) g/dL and last visit mean Hemoglobin value was 10.42 (SD 1.28) g/dL. The mean difference between baseline and last visit was 2.10 [2.00, 2.20], statistically significant (p-value <.0001). Conclusions The safety and tolerability of the usage of DA-α (manufactured by Hetero Biopharma) is similar to that reported in the published literature of the innovator. No patients showed anti-drug antibodies after treatment. Additionally, the patients also showed significant improvement in hemoglobin levels, compared to baseline.Clinical Trial Registry Number: CTRI/2017/04/008338 [Registered on CTRI http://ctri.nic.in/Clinicaltrials/login.php : 12/04/2017]; Trial Registered Retrospectively


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