Abstract
BackgroundChronic kidney disease (CKD) is a serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease and mortality. Despite this, data regarding the burden and awareness of CKD among adults with diabetes in Sub-Saharan Africa countries are lacking. The aim of this study was, therefore to determine the prevalence and awareness of CKD among diabetic outpatients attending a hospital in Northeast Ethiopia.MethodsWe conducted a cross-sectional study on 323 diabetic adults at the diabetes clinic of a hospital in Northeast Ethiopia, from February 1 to July 30, 2016. Each patient provided a blood sample for serum creatinine and urine for albuminuria. Glomerular filtration rate (eGFR) was estimated using the Modification of Diet in Renal Disease (MDRD) equation. CKD was defined as eGFR < 60 ml/min/1.73 m2 and/or albuminuria. Awareness was defined as a positive response to “Has a doctor or other health care professional ever told you that you had kidney disease?”ResultsOf the 323 patients, 85 (26.3%) had Stage 1–5 CKD, 42 (13.0%) had eGFR < 60 ml/min/1.73m2 and 58 (18.0%) had albuminuria. In patients with eGFR < 60 ml/min/1.73m2 (stage 3–5 CKD), serum creatinine was abnormal (> 1.5 mg/dl) in 23.5% and albuminuria was absent in 31.8%. Of the patients with CKD, only 10.6% of them were aware of their CKD. The proportion of patients who were aware of their disease increased with worsening of CKD stages, from 3.4% of with stage 1 to 75.0% with stage 4. Awareness for all individuals with advanced stages of CKD was only 11.9%. Having albuminuria, high serum creatinine, a family history of kidney disease and being obese were significantly associated with CKD awareness.ConclusionA high prevalence but low awareness of CKD was found in diabetic outpatients attending our clinic in Northeast Ethiopia. Our results highlight the need for more diagnostic strategies for CKD screening among diabetic adults and primary care education on the impact of detecting CKD in the early stage to prevent adverse outcomes and improve diabetes care.
Highlights
Chronic kidney disease (CKD) is a serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease and mortality
Chronic Kidney Disease (CKD) is a global public health problem associated with an increased risk of end stage renal disease (ESRD), cardiovascular disease (CVD) and premature mortality [1]
The overall prevalence of CKD observed in our study was higher than 21.8% prevalence reported from the University of Gondar Hospital study in Northwest Ethiopia [24] and closer to that of 27.5% reported in the Netherland study [25], 27.9% in the Spain PERCEDIME2 study [26] and 29.6% in the Chinese study [27]
Summary
Chronic kidney disease (CKD) is a serious complication of diabetes associated with adverse outcomes of renal failure, cardiovascular disease and mortality. Chronic Kidney Disease (CKD) is a global public health problem associated with an increased risk of end stage renal disease (ESRD), cardiovascular disease (CVD) and premature mortality [1]. The presence of CKD in diabetes is associated with an increased risk of CVD, all cause and cardiovascular mortality, and kidney failure; requiring costly renal replacement therapy [5, 6]. It is associated with significantly higher total all-cause health care costs and costs directly related to treatment of CKD in diabetes [7, 8]. Due to the rapidly rising incidence of diabetes, the prevalence of CKD as well as the already high medical costs of renal therapy in patients with diabetes are expected to rise further, adding to the global burden of disease and health-care expenditure [9, 10]
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