Abstract
BackgroundChronic kidney disease (CKD) is the severest form of kidney disease characterized by poor filtration. The magnitude of chronic kidney disease is trending upward in the last few years linked with the rapidly escalating cases of non-communicable chronic diseases, particularly diabetes mellitus. However, little is known about when this problem may occur, the incidence as well as predictors of chronic kidney disease among type-II diabetes mellitus patients. Thus, this study was conducted to determine the incidence, time to the occurrence, and predictors of chronic kidney disease in type-II diabetic patients attending the Amhara region referral hospitals, Ethiopia.MethodsA retrospective follow-up study was conducted involving 415 participants with type-II diabetes mellitus that enrolled in the chronic follow-up from 2012 to 2017. Multivariable shared Frailty Weibull (Gamma) survival model was employed considering the hospitals as a clustering variable. Model fitness was checked by both the Akaike information criteria (AIC) and log-likelihood. Factors having a p-value of ≤0.2 in the bi-variable analysis were considered to enter the multivariable model. Variables that had a p-value of <0.05 with its corresponding 95% confidence level were deemed to be significant predictors of chronic kidney disease.ResultsThe overall cumulative incidence of chronic kidney disease was 10.8% [95%; CI: 7.7–14.0%] with a median occurrence time of 5 years. The annual incidence rate was 193/10,000 [95%; CI: 144.28–258.78]. Having cardiovascular disease/s [AHR = 3.82; 95%CI: 1.4470–10.1023] and hypercholesterolemia [AHR = 3.31; 95% CI: 1.3323–8.2703] were predictors of chronic kidney disease.ConclusionOne out of every ten diabetic patients experienced chronic kidney disease. The median time to develop chronic kidney disease was five years. Hypercholesterolemia and cardiovascular diseases have escalated the hazard of developing CKD. Thus, health promotion and education of diabetic patients to optimize cholesterol levels and prevent cardiovascular disease is recommended to limit the occurrence of this life-threatening disease.
Highlights
Diabetes mellitus (DM) is a metabolic disorder associated with either the failure of the pancreatic islet beta cells that produce insulin, or insulin resistant where the human body cannot uptake the available insulin effectively [1]
Little is known about when this problem may occur, the incidence as well as predictors of chronic kidney disease among type-II diabetes mellitus patients
Hypercholesterolemia and cardiovascular diseases have escalated the hazard of developing Chronic kidney disease (CKD)
Summary
Diabetes mellitus (DM) is a metabolic disorder associated with either the failure of the pancreatic islet beta cells that produce insulin, or insulin resistant where the human body cannot uptake the available insulin effectively [1]. DM is alarmingly increasing and becoming one of the pressing public health problems among other non-communicable chronic diseases (NCD) globally [2]. The prevalence of DM was 8.8% among people between the age group of 20 and 79 years, which indicates almost 440 million people are affected by the problem. The magnitude of chronic kidney disease is trending upward in the last few years linked with the rapidly escalating cases of non-communicable chronic diseases, diabetes mellitus. Little is known about when this problem may occur, the incidence as well as predictors of chronic kidney disease among type-II diabetes mellitus patients. This study was conducted to determine the incidence, time to the occurrence, and predictors of chronic kidney disease in type-II diabetic patients attending the Amhara region referral hospitals, Ethiopia
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