Abstract
Chronic kidney disease (CKD) is increasingly common in hospitalized patients and is associated with increased risk for in-hospital morbidity and mortality. However, data regarding the prevalence of CKD in the African hospitalized patient population are limited. We therefore examined the prevalence and associated factors of impaired renal function and albuminuria among adult patients admitted to the internal medicine wards of a hospital in Northeast Ethiopia. A cross-sectional study was conducted from January 1 to April 30, 2020 at the inpatient settings of Dessie referral hospital. Data on demographics and medical history were obtained, and serum creatinine and albuminuria were analyzed. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as impaired eGFR (<60 ml/min/1.73m2) and/or albuminuria. Univariate and multivariable analysis were conducted to determine factors associated with impaired eGFR and albuminuria. A total of 369 patients were included in this study. The prevalence of impaired eGFR was 19.0% (95%CI: 15.2%-23.2%) and albuminuria was 30.9% (95%CI: 26.3%-35.7%). Overall, 33.9% (95%CI: 29.2%-38.9%) of the patients had some degree of CKD, but only 21.6% (95%CI: 15.1%-29.4%) were aware of their renal disease. In multivariable analysis, older age, a family history of kidney disease, diabetes, hypertension and HIV were independently associated with both impaired eGFR and albuminuria while male gender was independently associated with only albuminuria. CKD is common in adult patients admitted to the internal medicine wards, but only few patients are aware of their condition. These findings highlight the need for feasible approaches to timely identify kidney disease and raise awareness on the importance of detection and early intervention in the inpatient settings.
Highlights
Chronic kidney disease (CKD), typically defined by impaired estimated glomerular filtration rate and albuminuria, is a major global public health problem [1]
Older age, a family history of kidney disease, diabetes, hypertension and HIV were independently associated with both impaired estimated glomerular filtration rate (eGFR) and albuminuria while male gender was independently associated with only albuminuria
CKD is common in adult patients admitted to the internal medicine wards, but only few patients are aware of their condition
Summary
Chronic kidney disease (CKD), typically defined by impaired estimated glomerular filtration rate (eGFR) and albuminuria, is a major global public health problem [1]. It has been shown to be a risk factor for cardiovascular disease and is associated with adverse outcomes, including hospitalizations and progression to kidney failure, which have enormous impacts on the quality of life and health care system [4, 5]. Intervention and management of patients with CKD is crucial to reduce the morbidity and mortality, delay the progression of disease and improve health outcomes. Detection is desirable because effective interventions can be implemented to reduce the risk of in-hospital morbidity and mortality associated with CKD, and improve outcomes. Chronic kidney disease (CKD) is increasingly common in hospitalized patients and is associated with increased risk for in-hospital morbidity and mortality.
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