Impaired glomerular filtration rate, high grade albuminuria and associated factors among adult patients admitted to tertiary Hospital in Ethiopia

Abstract

BackgroundChronic Kidney Disease (CKD), the worldwide Public Health problem, is also one of the rising non-communicable diseases in low and middle-income countries. Its early detection and treatment using readily available, inexpensive therapies can slow or prevent progression to end-stage renal disease. Hence, this study was aimed at assessing impaired estimated glomerular filtration rate (eGFR), high grade albuminuria, and associated factors among adult patients admitted to Jimma University Medical Center in South west Ethiopia.MethodsHospital based cross sectional study was conducted from November 1, 2016 to April 30, 2017. Consecutive sampling method was used to select study participants. Logistic regression analysis was conducted to generate factors associated with impaired estimated GFR and albuminuria. A P-value of < 0.05 was considered statistically significant.ResultsThe study involved 422 patients admitted to Jimma University Medical Center who had at least one test result for urinalysis and serum creatinine level during the study period. Fifty two (12.3%) of the study subjects had high grade albuminuria, 19.2, 19.4, and 32.7% had impaired estimated glomerular filtration rate according to Modification of Diet in Renal Disease (MDRD-4), Chronic Kidney Disease Epidemiology (CKD-EPI), and Cockcroft-Gault (CG) equations respectively. Old age (AOR = 2.4;95%CI:1.4–4.01), male sex (AOR = 2.1;95%CI:1.16–3.7), and hypertension (AOR = 2.23; 95%CI:1.24–4.01) were independently associated with impaired eGFR using one of the two equations while diabetes mellitus (AOR = 2.8; 95%CI:1.33–5.82) and BP measurement above optimal (AOR = 4.7; 95%CI:1.9–11.53) were associated with high grade albuminuria.ConclusionsHigh grade albuminuria and impaired eGFR were found in significant proportion of adults admitted to the hospital for various medical conditions. Old age, hypertension, diabetes mellitus and male gender were independently associated with these alterations. These findings necessitate routine urinalysis and estimation of GFR for all hospitalized adults with known CKD risk factors.

<p>Dietary Habit and Other Risk Factors of Chronic Kidney Disease Among Patients Attending Dessie Referral Hospital, Northeast Ethiopia</p>

“…34,35 In our study, the risk of having CKD was higher among those with a history of hypertension than those who do not have. This finding is consistent with several related studies, 23,[36][37][38] which reported hypertension as the main risk factor of CKD. This could be due to the kidney being unable to function properly unless adequately perfused with intact blood stream.…”

Chronic Kidney Disease among Diabetes Patients in Ethiopia: A Systematic Review and Meta-Analysis

“…Although there is still uncertainty about the root cause of CKD, studies suggest that numerous risk factors are responsible for CKD, such as obesity [ 6 – 11 ], old age [ 7 – 9 , 11 – 14 ], hypertension [ 3 , 7 , 9 – 13 , 15 – 17 ], diabetes mellitus [ 3 , 7 , 8 , 10 – 12 , 16 , 18 ], male gender [ 12 , 17 ], hyperlipidemia [ 7 ], use of nephrotoxic medications [ 7 ], family history of kidney disease [ 9 , 11 , 13 ], smoking [ 19 ], heavy drinking [ 19 ], HIV infection [ 13 ], electrolyte and acid-base disturbances [ 13 ], low-income occupation, use of traditional medication, and low hemoglobin [ 11 ]. Early detection and treatment of possible risk factors are readily available and often inexpensive.…”

Prevalence of chronic kidney disease and associated factors among patients with chronic illness in Ethiopia: A systematic review and meta-analysis

“…The highest magnitude of CKD is reported from Jimma University medical center (38.9%) 29 while the least is from Zewditu memorial hospital (12.2%). 30 The studies were conducted in five different regions of the country; 4 from Addis Ababa, 19 , 26 , 30 , 31 4 from Amhara, 20 , 21 , 27 , 28 2 from Oromia, 22 , 29 and 1 from SNNPR. 32 …”

“…Some of them are cholesterol level, 18 body mass index (BMI), 18 , 19 uncontrolled blood pressure age > 60, duration of noncommunicable diseases, 20 , 21 and residence. 22 …”