Prevalence of Chronic Kidney Disease and Associated Risk Factors among Diabetic Patients in Southern Ethiopia

Abstract

Background: Chronic kidney disease (CKD) in diabetes is associated with an increased risk of premature mortality, kidney failure and cardiovascular disease. No studies are available on the prevalence of CKD among diabetics in Ethiopia. The aim of this study was to determine the prevalence of CKD and its associated risk factors among diabetic adults attending Butajira hospital of Southern Ethiopia based on estimated glomerular filtration rate (GFR). Methods: A facility based cross sectional study was conducted in Butajira hospital, southern Ethiopia among 214 randomly selected diabetic adults. Demographic, clinical, and laboratory data were collected from September 1, 2013 to October 31, 2013. The simplified Modification of Diet in Renal Disease (MDRD) and Cockroft-Gault (CG) equations were used to estimate GFR (eGFR) from serum creatinine value. SPSS 20.0 Software was used for data analysis. Results: 39 (18.2%) and 51 (23.8%) of the study participants were found to have CKD, as defined by eGFR < 60 ml/min/1.73 m 2 , according to the MDRD and Cockroft-Gault equations, respectively. Of these; 17.3 and 22.9% have stage 3 CKD, and 0.9% have stage 4 CKD, respectively. Significant risk factors for CKD in the study subjects when using either the MDRD or C-G equation were older age, longer duration of diabetes, family history of kidney disease, and poor glucose control (P < 0.05). Additionally, female sex (P < 0.008) and obesity (P < 0.038) were independent risk factors for CKD when defined by the MDRD, and type 2 diabetes was when defined by C-G (P < 0.03). Conclusion: CKD was present in not less than 18.2% diabetic adults attending the follow up clinic at Butajira hospital, in southern Ethiopia. Risk factors for CKD were similar to those reported in developed country studies. Using the MDRD equation led to a lower prevalence of CKD and a better risk categorization than did by C-G equation, thus contributing to better management of clinical outcomes in diabetic care.