Prevalence and Risk Factors of chronic kidney disease among diabetic adult out-patients in ‘Ayder’ Referral and Teaching Hospital, Northern Ethiopia

Background: Chronic kidney disease (CKD) is one of the most common complications of diabetes mellitus and it is increasingly recognized as a leading global public health issue with an estimated CKD due to diabetes accounting for 30·7% (95% uncertainity interval 27·8 to 34·0), the largest contributionof any cause in 2017.. Furthermore, it has been established that CKD is a risk factor not only for progressive kidney failure, but also for cardiovascular morbidity and mortality. Early screening for CKD is not routinely performed in many diabetic clinics in sub-Saharan Africa due to late presentation of patients and/or limited diagnostic resources. Objective: to determine the prevalence and risk factors of CKD among adult diabetic outpatients attending the diabetes clinic for routine diabetes care at Ayder referral and teaching hospital. Methods:A cross-sectional study was conducted by including 199 study subjects. This study was conducted in the diabetes clinic of Ayder Referral and Teaching Hospital (ARTH) in Mekelle, Ethiopia. A convenience sampling technique was used to select the study participants. Data were collected using structured questionnaires. Fasting blood glucose level was measured. Fresh urine sample was used for a total protein by semi-quantitative urine dipstick test. Serum creatinine level was also measured to estimate glomerular filtration rate (eGFR) using the Cockroft-Gault equation. The collected data were sorted, coded and entered to Excel and finally exported to SPSS Version 20.0 for descriptive and regression analysis. Results:The mean creatinine clearance (CrCl) of 194 patients was 86.01 ± 31.4 and 40.2% were in stage 2 of CKD. None of the participants were in stage 4 or 5 CKD. The urine dipstick test showed that 8.0% had +2/+3 and 2.5% had +1 and 89.4% were negative for urinary protein. The prevalence of CKD was 60% among 194 study subjects of which 22% had an eGFR =56 (AOR, 6.3[95%CI, 1.69-23.6]; P=0.006) and (AOR, 91.4[95%CI,14.7-569.3]; P=0.000) respectively and BMI inKg/m2 19-24.9, 25-29.9 and >=30 with (AOR, 0.24[95%CI, 0.08-0.74]; P=0.013), (AOR, 0.06[95%CI, 0.01-0.24); P=0.000) and (AOR, 0.02[0.002-0.28]; P=0.003) respectively. Conclusion: The prevalence of CKD was foundto be high and age as well as BMI were significantly associated with CKD among diabetic patients. This alarms the need for timely screening of kidney function among diabetic patients and good management of diabetes mellitus.