Incidence and Predictors of Acute Kidney Injury Among Newly Diagnosed Type 2 Diabetes Patients at Chronic Follow-Up Clinic of University of Gondar Comprehensive Specialized Hospital: A Retrospective Follow-Up Study

Abstract

Background: Acute kidney injury is a common disorder worldwide, occurring in more than 13 million per year, 85% of whom live in developing countries. The high incidence of acute kidney injury among type 2 diabetic patients is a major cause of morbidity and mortality. There is limited data that address the incidence and predictors of acute kidney injury to apply evidence-based interventions in developing countries including Ethiopia specifically in the study area. Methods: Institution-based retrospective follow-up study was conducted among 420 adults with newly diagnosed type 2 diabetes patients from January 1, 2014, to December 31, 2019. Log rank test and Kaplan-Meier curve were used to compare different categories of survival probability. In a multivariable analysis, variable having a p-value <0.05 in the Cox, proportional hazard model was considered as independent predictors. Results: Overall, 19.76% (95% CI; 16.2-23.8) of the study population developed acute kidney injury, with a median follow-up period of 30.75 months. Congestive heart failure [adjusted hazard ratio (AHR): 2.89 (95% CI; 1.62, 5.13)], chronic kidney disease [AHR: 2.92 (95% CI; 1.56, 5.48)], hypertension [AHR: 2.87 (95% CI; 1.20, 6.90)], and diabetic nephropathy [AHR: 2.04 (95% CI; 1.13, 3.68)] were found to be predictors of acute kidney injury. Conclusion:The incidence of acute kidney injury among type 2 diabetes patients was high in the study area. In patients with hypertension congestive heart failure, chronic kidney disease, and diabetic nephropathy efforts should be made to diagnose AKI early and treat itin addition to better control accordingly among type 2 diabetes mellitus patients.

Acute kidney injury in diabetes mellitus: Epidemiology, diagnostic, and therapeutic concepts

“…In China, a country with a large DM patient population, a national survey indicated that diabetic status was positively associated with the length of stay and hospital expenditure after adjusting for possible confounders 53 . In comparison, in fast‐growing economies, such as Ethiopia, 19.76% (95% CI; 16.2–23.8) of the study population (420 DM patients) developed AKI, with a median follow‐up period of 30.75 months 40 . In addition, blacks with DM had 50% higher age‐ and sex‐adjusted AKI odds than whites with DM (odds ratio [OR]: 1.51; 95% CI 1.37–1.66).…”

“…53 In comparison, in fast-growing economies, such as Ethiopia, 19.76% (95% CI; 16.2-23.8) of the study population (420 DM patients) developed AKI, with a median follow-up period of 30.75 months. 40 In addition, blacks with DM had 50% higher age-and sex-adjusted AKI odds than whites with DM (odds ratio [OR]: 1.51; 95% CI 1.37-1.66). There was no racial difference in length of stay or in-hospital mortality among AKI cases.…”

Incidence and Predictors of Acute Kidney Injury among Patients Admitted to Adult Intensive Care Unit at West Amhara Comprehensive Specialized Hospitals, Northwest Ethiopia: A multicenter retrospective follow-up study

“…University of Gondar Comprehensive Specialized Hospital is located in Gondar Town, which is the capital city central Gondar zone. It is 738 kilometers from Addis Ababa and 173 kilometers from Bahir Dar [14]. These hospitals currently have 51 adult ICU beds that are working and providing services to critically ill patients.…”

“…The average AKI incidence was 33.4% in developed nations and 37.7% in developing countries [5]. Studies conducted in Africa showed that the incidence of AKI ranges from 11% to 58.5% [6-12] and 14.5% to 17.76% in Ethiopia among Diabetic patients [13][14][15].…”

Prevalence and Factors Associated with Acute Kidney Injury in Sub-Saharan African Adults: A Review of the Current Literature

“…As in developed countries, the major risk factors for AKI in SSA are comorbidities such as diabetes mellitus, hypertension, cardiovascular disease, and obesity, which are a corollary of the progressive westernisation of SSA society [ 32 – 34 , 44 – 46 ]. As Olowu et al point out, the rapid urbanisation of SSA combined with an increase in the prevalence of these non-infectious comorbidities have significantly influenced the clinical features of AKI [ 8 ].…”