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Ghabisha A, AlShoaibi IA, Ahmed F, Ghabisha SA, Abdo B. Predictors of Mortality Among Hemodialysis Patients at Al-Thora General Hospital, Ibb Governate, Yemen: A Retrospective Study. Cureus 2024; 16:e65457. [PMID: 39184771 PMCID: PMC11345099 DOI: 10.7759/cureus.65457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND In addition to the global rise in the use of hemodialysis (HD) for end-stage renal disease, individuals receiving maintenance HD continue to have higher mortality rates than the general population. The mortality rates among HD patients in Yemen have not been studied because of the lack of a national registry system, and the impact of the disease on the country is yet to be evaluated. Our study aimed to assess the clinical characteristics and factors associated with mortality among patients with HD in a resource-limited setting. MATERIALS AND METHODS This retrospective study involved 4194 HD patients at the Nephrology Center of Al-Thora General Hospital, Ibb Governate, Yemen, between March 2014 and September 2023. Data on HD patients' demographic characteristics, risk factors, and comorbidities were gathered and analyzed. The Kaplan-Meier and log-rank tests were used to evaluate and compare survival curves, and the proportional Cox hazard model was used to investigate the factors associated with mortality. RESULT The mean age was 49.2 ± 16.5 years. The majority of cases were male (n= 2604, 62.1%) and from rural areas (3386, 80.7%), with 1226 (29.2%) living outside Ibb Governorate. Hepatitis C and B viruses were positive in 466 (11.1%) and 312 (7.4%) patients. The main comorbidity was hypertension (n= 3152, 75.2%), followed by diabetes mellitus (DM) (n= 1375, 32.8%). Five hundred and forty-eight patients died during the study period between 2017 and 2023, with an estimated mortality rate of 13.1%. The survival rates at 12, 24, 36, 48, and 60 months of follow-up were approximately 97.4%, 93.3%, 91.7%, 86.0%, and 74.6%, respectively. Predictive factors for mortality among HD patients in the Cox regression model were age >65 years (HR:1.41; 95 % CI: 1.15-1.74, p<0.001), cardiovascular disease (HR: 7.28; 95 % CI: 2.68-19.81, p<0.001), coming from other cities (HR: 1.32; 95% CI: 1.11-1.59, p= 0.002), DM (HR: 1.58; 95% CI: 1.23-2.01, p <0.001), and cerebral vascular accidents (HR:1.57; 95 % CI: 1.13-2.18, p= 0.007). CONCLUSION Instead of a higher mortality rate in this study, coming from other cities, DM, cardiovascular disease, cerebral vascular accidents, and age >65 years were predictive factors for mortality in HD patients. The study underlines the necessity of planning new HD facilities, avoiding and treating comorbidities, managing them early to decrease mortality, and educating regional administrative decision-makers on effective implementation techniques.
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Affiliation(s)
- Abdulghani Ghabisha
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Ismaeel A AlShoaibi
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | | | | | - Basheer Abdo
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
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Alosaimi HM, Alwatban RA, Alshammari HM, Alshammari AH, Alanazi SS, Alreshidi MA, Alreshidi AA, Alsayed AS, Alfaraj FA, Alzayer KA, Alzaher AA, Almutairi KM, Almutairi MS, Aljasir RH, Alshammari MK. Navigating nephrology: unveiling pharmacist perspectives on renal dose adjustment in Saudi Arabia - a comprehensive cross-sectional analysis. J Pharm Policy Pract 2024; 17:2344223. [PMID: 38798764 PMCID: PMC11123559 DOI: 10.1080/20523211.2024.2344223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Introduction Chronic kidney disease (CKD) is a major public health concern in Saudi Arabia. it is pertinent to mention that in the Southwestern region of Saudi Arabia. Hypertension and diabetes mellites are considered the major drivers of CKD. Research has documented worldwide the inappropriate dose adjustments in patients, ranging from 25% to 77%, of drugs requiring dose modifications. Pharmacists are pivotal members of the healthcare team, tasked with addressing issues pertaining to medications. This study aims to unveil pharmacist perspectives on renal dose adjustment in Saudi Arabia an important step in gauging their involvement in promoting healthy behaviours. Method A cross-sectional study design was conducted from December 2023 to January 2024 among pharmacists working in diverse healthcare settings, including clinical and hospital pharmacies, retail, and community pharmacies who had direct encounters with patients diagnosed with CKD. A validated questionnaire, the Renal Dose Adjustment-13 (RDQ-13) was used for this study. For comparing the knowledge, attitude, and perception scores of pharmacists statistical tests like One-Way ANOVA, and independent t-test; while for factors influencing the knowledge, attitude, and perception scores a multivariate linear regression was performed. The statistical significance level was set at 0.05. Results A total of 379 pharmacists completed the questionnaire, the knowledge score of pharmacists was 22.06 ± 2.81, while the attitude score was 8.56 ± 2.62 and the practice score was 5.75 ± 2.25. The findings of multivariate linear regression analysis indicated a statistically significant positive association between knowledge score and pharmacist's age while for practice score the findings revealed a statistically negative association between working setting and designation of pharmacists. Conclusion The pharmacist in Saudi Arabia exhibited a proficient knowledge score of drug dosage adjustment pertinent to renal function while the attitude and practice score was less as compared to the knowledge score.
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Affiliation(s)
- Hind M. Alosaimi
- Department of Pharmacy Services Administration, King Fahad Medical City, Riyadh Second Health Cluster, Riyadh, Kingdom of Saudi Arabia
| | - Rshed A. Alwatban
- Department of Clinical Pharmacy, Northern Border University, Rafha, Kingdom of Saudi Arabia
| | - Haifa M. Alshammari
- Department of Pharmacy, Aldawaa Pharmacy Eastern Region, Dammam, Kingdom of Saudi Arabia
| | - Ahmed H. Alshammari
- Pharmacy Department, Rafha Central Hospital, North Zone, Kingdom of Saudi Arabia
| | - Shatha S. Alanazi
- Department of Clinical Pharmacy, Northern Border University, Rafha, Kingdom of Saudi Arabia
| | - Meshal A. Alreshidi
- Department of Pharmaceutical Care, King Khaled Hospital, Hail, Kingdom of Saudi Arabia
| | - Abeer A. Alreshidi
- Department of Pharmaceutical Care, King Khaled Hospital, Hail, Kingdom of Saudi Arabia
| | - Abrar S. Alsayed
- Pharmacy Department, Royal Commission Hospital, Yanbu, Kingdom of Saudi Arabia
| | - Furat A. Alfaraj
- Department of Pharmacy, Eastern Health Cluster, Maternity and Children Hospital, Dammam, Kingdom of Saudi Arabia
| | - Kawther A. Alzayer
- Department of Nursing, Eastern Health Cluster, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia
| | - Aymen A. Alzaher
- Department of Pharmacy, Eastern Health Cluster, Maternity and Children Hospital, Dammam, Kingdom of Saudi Arabia
| | | | - Manar S. Almutairi
- Department of Pharmacy, Qassim University, Qassim, Kingdom of Saudi Arabia
| | - Reema H. Aljasir
- Department of Pharmacy, Qassim University, Qassim, Kingdom of Saudi Arabia
| | - Mohammed K. Alshammari
- Department of Clinical Pharmacy, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
- Department of Clinical Pharmacy, Rafha Central Hospital, Northern Borders Health Cluster, Rafha, Kingdom of Saudi Arabia
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Adem M, Mekonen W, Ausman A, Ahmed M, Yimer A. Prevalence of chronic kidney disease and its associated factors among diabetes mellitus patients in Dessie Referral Hospital, South Wollo, Ethiopia. Sci Rep 2024; 14:9229. [PMID: 38649429 PMCID: PMC11035645 DOI: 10.1038/s41598-024-59184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
Diabetes mellitus shares a large proportion of kidney failure. Despite many patients suffering from diabetes mellitus and its complications in Dessie City, no study was conducted in the study area that shows the prevalence and associated factors of chronic kidney disease among diabetes mellitus patients. Therefore, this study aims to assess the prevalence of chronic kidney disease and its associated factors among adult diabetes mellitus patients attending Dessie Referral Hospital, South Wollo, Northeast Ethiopia. An institutional-based cross-sectional study was conducted at Dessie Referral Hospital among 267 randomly selected adult diabetic patients. Data were collected using questionnaires administered by interviewers. The glomerular filtration rate was estimated from serum creatinine levels. Data were entered into Epi-data version 4.6 and analyzed using SPSS version 26 software. Multi-variable logistic regression was used to determine the strength of association for the associated factors of chronic kidney disease. Variables with a p value < 0.05 were used to ascertain statistically significant associations. A total of 267 diabetic patients participated in this study. About 104 (39%) of the respondents were female and from the total, 133 (48.1%) were hypertensive. The overall prevalence of chronic kidney disease in this study was 31.5% (95% CI 25.3-37.1%). Being older (p-value = 0.003) and having hypertension (p-value = 0.043) were significant factors for chronic kidney disease among diabetes mellitus patients. This study found a high prevalence (31.5%) of chronic kidney disease among diabetic patients. Older age, having hypertension, and elevated serum creatinine were statistically significant associated factors of chronic kidney disease among patients with diabetes mellitus. Thus, clinicians should be aware of the high prevalence of chronic kidney disease in Dessie City. Moreover, emphasis should be given for old age and hypertension as contributing factors to the high prevalence in diabetic patients.
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Affiliation(s)
- Mohammed Adem
- Department of Biomedical Science, School of Medicine, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia.
| | - Wondyefraw Mekonen
- Department of Physiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ahmed Ausman
- Department of Midwifery, College of Health Sciences, Samara University, Samara, Ethiopia
| | - Mohammed Ahmed
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Ali Yimer
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Azagew AW, Beko ZW, Mekonnen CK. Determinants of diabetic nephropathy among diabetic patients in Ethiopia: Systematic review and meta-analysis. PLoS One 2024; 19:e0297082. [PMID: 38306369 PMCID: PMC10836702 DOI: 10.1371/journal.pone.0297082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/22/2023] [Indexed: 02/04/2024] Open
Abstract
INTRODUCTION Diabetic nephropathy (DN) is a long-term kidney disease among diabetic patients. It is the leading cause of end-stage renal failure. In Ethiopia, DN affects the majority of diabetic populations, but there were inconsistent findings about the determinant factors across the studies. METHODS We have accessed studies using PubMed, Embase, EBSCO, Web of Science, OVID, and search engines including Google and Google Scholar published up to June 2023. The study populations were diabetic patients with nephropathy. The quality of each included article was assessed using the Newcastle-Ottawa quality assessment scale. The odds ratios of risk factors were pooled using a random-effect meta-analysis model. Heterogeneity was assessed using the Cochrane Q statistics and I-Square (I2). The publication bias was detected using the funnel plot and/or Egger's test (p< 0.05). Trim and fill analysis was carried out to treat the publication bias. The protocol has been registered with the reference number CRD42023434547. RESULTS A total of sixteen articles were used for this reviewed study. Of which, eleven articles were used for advanced age, ten articles for duration of diabetic illness, ten articles for poor glycemic control, and eleven articles for having co-morbid hypertension. Diabetic patients with advanced age (AOR = 1.11, 95% CI: 1.03-120, I2 = 0.0%, p = 0.488), longer duration of diabetic illness (AOR = 1.23, 95% CI = 1.05-1.45, I2 = 0.0%, p = 0.567), poor glycemic control (AOR = 2.57, 95% CI: 1.07-6.14; I2 = 0.0%, p = 0.996), and having co-morbid hypertension (AOR = 4.03, 95% CI: 2.00-8.12, I2 = 0.0%, p = 0.964) were found to be factors associated with DN. CONCLUSIONS The findings of the study revealed that diabetic patients with advanced age, longer duration of diabetic illness, poor glycemic control status, and co-morbid hypertension were the determinant factors of DN. Therefore, treatment of co-morbid hypertension and high blood glucose and regular screening of renal function should be implemented to detect, treat, and reduce the progression of DN. Furthermore, healthcare workers should give due attention to diabetes with advanced age and a longer duration of diabetes illness to prevent the occurrence of DN.
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Affiliation(s)
- Abere Woretaw Azagew
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zerko Wako Beko
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chilot Kassa Mekonnen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tesema B, Bogale EK, Wasihun Y, Anagaw TF. Intention to Donate Kidney and Associated Factors Among Students in Bahir Dar University: Application of Theory of Planned Behavior. Int J Gen Med 2023; 16:5363-5376. [PMID: 38021069 PMCID: PMC10674569 DOI: 10.2147/ijgm.s441636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
Background Kidney donation is the donation of a kidney from a living or dead person to another living person who requires transplantation. The scarcity of kidneys is a great public health concern worldwide, owing to an increase in end-stage renal failure. There is no sufficient evidence regarding the intention to donate kidneys in Ethiopia. Objective To assess the intention to donate kidneys and its associated factors among Bahir Dar University students in Ethiopia in 2023 by the application of theory of planned behavior. Method and Materials This institution-based cross-sectional study was conducted from March 7 to April 5, 2023. A multistage sampling technique was used to select 630 participants. Self-administered structured questionnaires were used to collect data. Data were entered into Epi-data version 4.6, and exported to the Statistical Package for the Social Sciences (SPSS) version 25 for analysis. Bivariate and multivariate linear regression analyses were performed. Findings with a p-value <0.05 at the 95% confidence interval were considered statistically significant and interpreted by the unstandardized beta (ß) coefficient. Results The mean score of intention to donate the kidney was 12.9 ± 4.1 standard deviation. Direct attitude (B = 0.341, 95% CI = 0.265, 0.416), direct subjective norm (B = 0.088, 95% CI = 0.010, 0.167), direct perceived behavioral control (B = 0.353, 95% CI 0.251, 0.455), knowledge (B = 0.417, 95% CI 0.251, 0.583), and previous experience of blood donation (B = 0.915, 95% CI 0.321, 1.510) were factors associated with intention to kidney donation. Conclusion The mean score of intention to donate kidneys was 12.9 ± 4.1 SD. Direct attitude, direct subjective norm, direct perceived behavioral control, experience with blood donation, and knowledge of participants were significant factors for the intention to donate kidneys. Therefore, social and behavioral change communication strategies should address these factors in order to increase kidney donation.
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Affiliation(s)
- Belete Tesema
- Department Public Health, College of Medicine and Health Science, Wolaita Sodo University, Wolaita, Ethiopia
| | - Eyob Ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yosef Wasihun
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadele Fentabil Anagaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Sweity R, Fanoun K, Jarrar T, Alqtishat BF, Abdelhafez M, Ereqat S. Systolic inter-arm blood pressure difference and estimated glomerular filtration rate in type 2 diabetic patients in Palestine: a cross-sectional study. Ann Med 2023; 55:2259927. [PMID: 37748114 PMCID: PMC10521340 DOI: 10.1080/07853890.2023.2259927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the association between systolic inter-arm blood pressure difference (IABPD) and the estimated glomerular filtration rate (eGFR), as well as chronic kidney disease (CKD), in patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS This cross-sectional study included 189 Palestinians diagnosed with T2DM. Data were collected through personal interviews, medical records and three separate blood pressure measurements from both arms. Patients were stratified in two ways: based on systolic IABPD ≥15 mmHg and the presence of CKD, indicated by an eGFR of <60 mL/min/1.73 m2 over a three months period. We used simple and multiple linear regression analyses to clarify the association between systolic IABPD (mmHg) and eGFR and to identify independent predictors for eGFR. RESULTS The mean age was 61.3 years, with a female percentage of 57.7%. The prevalence of systolic IABPD ≥15 mmHg and CKD was 27.5% and 30.2%, respectively. Among patients with eGFR <60 mL/min/1.73 m2, the median systolic IABPD was 12.5 mmHg (interquartile range (IQR), 13.5 mmHg), whereas in patients with eGFR ≥60 mL/min/1.73 m2, it was 7.5 mmHg (IQR, 9.8 mmHg) with a significant difference (p = .021). The results of the multiple linear regression model did not reveal an independent association between systolic IABPD and eGFR, with an unstandardized coefficient (B) of -0.257 (95% confidence interval (CI), -0.623 to 0.109; p = .167). However, older age (B, -0.886; 95% CI, -1.281 to -0.49; p < .001), hypertension (B, -12.715; 95% CI, -22.553 to -2.878; p = .012) and a longer duration of DM (B, -0.642; 95% CI, -1.10 to -0.174; p = .007) were significantly and negatively associated with eGFR. CONCLUSIONS Systolic IABPD did not exhibit an independent association with eGFR in T2DM patients. However, older age, a previous history of hypertension, and a longer duration of DM were all significantly associated with lower eGFR.
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Affiliation(s)
- Raghad Sweity
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Khadeeja Fanoun
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Tareq Jarrar
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Bayan F. Alqtishat
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Mohammad Abdelhafez
- Department of Internal Medicine, Faculty of Medicine, Al-Quds University, Abu Dis, Jerusalem, Palestine
| | - Suheir Ereqat
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Dis, Jerusalem, Palestine
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Ayalew TL, Haile KE, Feleke MG, Zewudie BT, Chichiabellu TY. A systematic review and meta-analysis of cardiovascular diseases and associated factors among diabetes mellitus patients in Ethiopia. BMC Cardiovasc Disord 2023; 23:413. [PMID: 37605128 PMCID: PMC10441723 DOI: 10.1186/s12872-023-03443-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 08/10/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is the most prevalent complication and the leading cause of death and disability among patients with diabetes mellitus (DM). Over time, diabetes-related cardiovascular disease has become more common worldwide. The aim of this study was to determine the cumulative prevalence of cardiovascular disease and associated factors among diabetic patients in Ethiopia. OBJECTIVE The main aim of this review was to estimate the pooled prevalence of cardiovascular disease and its associated factors among diabetic patients in Ethiopia. METHODS AND MATERIALS This review was searched using PubMed, Google, and Google Scholar search engines, and was accessed using medical subject heading (MeSH) terms for studies based in Ethiopia. Excel was used to extract the data. With a random-effects model, STATA Version 14 was used for all statistical analyses. The studies' heterogeneity and funnel plot were both examined. The study domain and authors' names were used in the subgroup analysis. RESULTS In this systematic review, 12 studies totaling 2,953 participants were included. The estimated overall prevalence of cardiovascular disease among diabetic patients in Ethiopia was 37.26% (95% CI: 21.05, 53.47, I2 = 99.3%, P ≤ 0.001). Study participants' age older than 60 years (AOR = 4.74, 95%CI: 1.05, 8.43), BMI > 24.9kg/m2 (AOR = 4.12, 95% CI: 2.33, 5.92), triglyceride > 200mg/dl (AOR = 3.05, 95% CI: 1.26, 4.83), Hypertension (AOR = 3.26, 95% CI: 1.09, 5.43) and duration of DM > 4 years (AOR = 5.49, 95% CI: 3.27, 7.70) were significantly associated with cardiovascular disease. CONCLUSIONS In conclusion, diabetic patients face a serious public health risk from cardiovascular disease. This review found the following factors, which is independent predictors of cardiovascular disease in diabetic patients: age over 60, BMI > 24.9kg/m2, triglycerides > 200 mg/dl, hypertension, and diabetes duration > 4 years. The results emphasize the need for a prospective study design with a longer follow-up period to assess the long-term effects of CVD predictors in diabetic patients as well as the significance of paying attention to cardiovascular disease in diabetic patients with comorbidity.
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Affiliation(s)
- Tadele Lankrew Ayalew
- Department of Nursing, School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, P.O. Box 138, Sodo, Ethiopia.
| | - Kirubel Eshetu Haile
- Department of Nursing, School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, P.O. Box 138, Sodo, Ethiopia
| | - Mulualem Gete Feleke
- Department of Nursing, School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, P.O. Box 138, Sodo, Ethiopia
| | - Bitew Tefera Zewudie
- Department of Nursing, School of Nursing, College of Health Sciences and Medicine, Wolaita Sodo University, P.O. Box 138, Sodo, Ethiopia
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Mulugeta G, Zewotir T, Tegegne AS, Juhar LH, Muleta MB. Classification of imbalanced data using machine learning algorithms to predict the risk of renal graft failures in Ethiopia. BMC Med Inform Decis Mak 2023; 23:98. [PMID: 37217892 DOI: 10.1186/s12911-023-02185-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION The prevalence of end-stage renal disease has raised the need for renal replacement therapy over recent decades. Even though a kidney transplant offers an improved quality of life and lower cost of care than dialysis, graft failure is possible after transplantation. Hence, this study aimed to predict the risk of graft failure among post-transplant recipients in Ethiopia using the selected machine learning prediction models. METHODOLOGY The data was extracted from the retrospective cohort of kidney transplant recipients at the Ethiopian National Kidney Transplantation Center from September 2015 to February 2022. In response to the imbalanced nature of the data, we performed hyperparameter tuning, probability threshold moving, tree-based ensemble learning, stacking ensemble learning, and probability calibrations to improve the prediction results. Merit-based selected probabilistic (logistic regression, naive Bayes, and artificial neural network) and tree-based ensemble (random forest, bagged tree, and stochastic gradient boosting) models were applied. Model comparison was performed in terms of discrimination and calibration performance. The best-performing model was then used to predict the risk of graft failure. RESULTS A total of 278 completed cases were analyzed, with 21 graft failures and 3 events per predictor. Of these, 74.8% are male, and 25.2% are female, with a median age of 37. From the comparison of models at the individual level, the bagged tree and random forest have top and equal discrimination performance (AUC-ROC = 0.84). In contrast, the random forest has the best calibration performance (brier score = 0.045). Under testing the individual model as a meta-learner for stacking ensemble learning, the result of stochastic gradient boosting as a meta-learner has the top discrimination (AUC-ROC = 0.88) and calibration (brier score = 0.048) performance. Regarding feature importance, chronic rejection, blood urea nitrogen, number of post-transplant admissions, phosphorus level, acute rejection, and urological complications are the top predictors of graft failure. CONCLUSIONS Bagging, boosting, and stacking, with probability calibration, are good choices for clinical risk predictions working on imbalanced data. The data-driven probability threshold is more beneficial than the natural threshold of 0.5 to improve the prediction result from imbalanced data. Integrating various techniques in a systematic framework is a smart strategy to improve prediction results from imbalanced data. It is recommended for clinical experts in kidney transplantation to use the final calibrated model as a decision support system to predict the risk of graft failure for individual patients.
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Affiliation(s)
- Getahun Mulugeta
- Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Temesgen Zewotir
- School of Mathematics, Statistics, and Computer Science, KwaZulu-Natal University, Durban, South Africa
| | | | - Leja Hamza Juhar
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Seifu L, Getachew S, Abebe B, Debay Z. Clinical and Epidemiological Profiles of Patients with End Stage Kidney Disease on Dialysis at Dialysis Centers in Addis Ababa, Ethiopia. Ethiop J Health Sci 2023; 33:499-506. [PMID: 37576172 PMCID: PMC10416342 DOI: 10.4314/ejhs.v33i3.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 01/04/2023] [Indexed: 08/15/2023] Open
Abstract
Background End-stage kidney disease is increasing worldwide, primarily in the developing countries. It is affecting mainly the productive age group. Though the prevalence of the disease is increasing in Ethiopia, there are few studies. We therefore sought to describe the clinical and epidemiological characteristics of hemodialysis patients. Methods A descriptive cross-sectional study was conducted at 17 hemodialysis centers in Addis Ababa. Patients who received hemodialysis for at least three months were included in the study. Socio-demographic and clinical data were collected via questionnaires from October to November 2021. Results This study involved 318 participants with males making up 197 (61.9%) of the participants. Among the total, 248 (78.0%) were in the age group of 20 to 60 years and 155 (48.7%) were unemployed. Hypertension and diabetes mellitus were the major risk factors for end-stage kidney disease. The mean duration of dialysis was 2.26 years. The frequency of dialysis was twice weekly in 150 (47.2%) of the patients and thrice weekly in 138 (43.4%) of the patients. Arterio veneous fistula was used in approximately three-quarters of patients, i.e. 237 (74.5%). The majority of the patients on hemodialysis, 193 (60.7%), pay their own expenses, and 52 (16.4%) of the patients received hemodialysis at public hemodialysis centers. More than two-third of the patients were not in the process of undergoing a kidney transplant due to a variety of factors, including inability to find a donor, 106 (47.7%), being unfit for surgery, 56 (25.2%), and financial constraints, 38 (17.1%). Conclusion The majority of the patients on dialysis were men, middle-aged, and unemployed. The majority of the patients underwent dialysis in private institutions and were self-funded, and most of them had inadequate dialysis doses. The inability to find a living donor was the most difficult aspect of undergoing kidney transplantation.
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Affiliation(s)
- Lissane Seifu
- Department of Internal Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Seifemichael Getachew
- Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Bezaye Abebe
- Department of Pediatrics, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zerihun Debay
- Santé Medical Center, Private Clinic, Addis Ababa, Ethiopia
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Melese DM, Mekonen W, Aragaw A, Asefa A, Belete AM. Distribution Width of Red Blood Cells and Related Factors Among Patients with End-Stage Renal Disease in Addis Ababa, Ethiopia. J Blood Med 2022; 13:537-548. [PMID: 36210887 PMCID: PMC9532257 DOI: 10.2147/jbm.s373280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/22/2022] [Indexed: 11/23/2022] Open
Abstract
Background RDW is critical to the clinical diagnosis and progression of ESRD. There is currently little data on the relationship between RDW and ESRD in sub-Saharan Africa. Because of this, the present study evaluates RDW in patients with ESRD and associated factors in Addis Ababa, Ethiopia. Methods The hospital-based cross-sectional study design was conducted on a total of 83 patients. RDW, MCV, SCR, BUN, GFR, FBS and serum albumin were determined. Blood pressure (mmHg), weight (kg), height (m), MUAC (cm) and BMI (kg/m2) were also measured. Data entry was via Epi-data version 3.4 and analyzed with SPSS version 26.0. A multivariate logistic regression analysis with a p-value < 0.05 at a 95% confidence interval was used to identify the associated factors of RDW. Results A total of 83 ESRD patients participated, with a response rate of 95.4%. RDW ranged from 15.5% to 23.6% with a mean of 17.40% + 1.46%. Anisocytosis was present in 98.8% of patients. Of 83 patients, 66.3% were hypertensive, 20.5% had diabetes, and the remaining 13.3% had other conditions (glomerulonephritis and peripheral vascular disease). The mean GFR value was 5.20 mL/min/1.73 + 1.58. RDW showed a significant association with GFR (AOR: 4.6, 95% CI [1.27, 20.74], P = 0.047), alcohol consumption (AOR: 13.4, P = 0.012, 95% CI [1.97, 22.62]), recurrent kidney disease (AOR=25.6, P=0.016, 95% CI [1.85, 53.71]) and use of medication (AOR=00.2, P=0.044), 95% CI [0.03, 0.95]). Conclusion RDW showed a significant association with GFR, recurrent kidney disease, alcohol consumption, and medication use in hemodialysis-dependent ESRD patients. The mechanisms of RDW disruption in ESRD patients need further investigation.
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Affiliation(s)
- Daniel Molla Melese
- Department of Biomedical Science, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
- Correspondence: Daniel Molla Melese, Department of Biomedical Science, Asrat Woldeyes Health Science Campus, Debre Berhan University, PO Box 445, Debre Berhan, Ethiopia, Tel +251 912204363, Email
| | - Wondyefraw Mekonen
- Department of Physiology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebaye Aragaw
- Department of Physiology, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adisu Asefa
- Department of Biomedical Science, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abebe Muche Belete
- Department of Biomedical Science, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
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11
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Animaw Z, Walle Ayehu G, Abdu H. Prevalence of chronic kidney disease and associated factors among patients with chronic illness in Ethiopia: A systematic review and meta-analysis. SAGE Open Med 2022; 10:20503121221089442. [PMID: 35465636 PMCID: PMC9019378 DOI: 10.1177/20503121221089442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 03/06/2022] [Indexed: 11/22/2022] Open
Abstract
Objective: The main aim of this systematic review and meta-analysis is to provide summarized evidence on the prevalence of chronic kidney disease and associated factors among patients with chronic illness in Ethiopia. Method: Databases of MEDLINE/PubMed, Embase, Google Scholar, CINAHL, Cochrane library, and ScienceDirect were searched. In addition, gray literatures were searched manually from university repositories. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist was used to select potential studies. Microsoft Excel 2013 sheet template was used to extract data. The quality of included studies was assessed by utilizing the Newcastle-Ottawa Scale. STATA software version 14.0 is used to compute the estimated pooled prevalence and associated factors of chronic kidney disease. Result: Twelve articles that fulfilled the inclusion criteria were included. The pooled estimate of chronic kidney disease among patients with chronic illnesses in Ethiopia is 21.71% (95% confidence interval: 17.67, 25.74). The highest prevalence of chronic kidney disease among patients with chronic illnesses is from Oromia (32.55% (confidence interval: 19.91, 45.19)). Glomerular filtration rate showed a comparable pooled prevalence from Cockroft-Gault and MDRD methods; 22.38% (confidence interval: 15.83, 28.92), 22.18 (confidence interval: 18.01, 26.34), respectively. Hypertensives become more likely to have chronic kidney disease compared with normotensive patients, (odds ratio = 3.01, 95% confidence interval: 1.33, 6.81). Conclusion: Prevalence of chronic kidney disease among chronic illness patients was significantly high. Hypertension is significantly associated with chronic kidney disease. Hence, we recommend that continuous screening of possible risk factors and proper follow-up and management strategies should be designed.
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Affiliation(s)
- Zelalem Animaw
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Walle Ayehu
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Hussen Abdu
- School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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12
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Uduagbamen PK, AdebolaYusuf AO, Ahmed SI, Thompson MU, Alalade BA, Ogunmola MI, Falana TE, Omokore OA, Emmanuel CC. Gender Differences in Chronic Kidney Disease. Findings from a Two Center Study in Nigeria. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/eoltidnxtq] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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13
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Tolossa T, Fetensa G, Regassa B, Yilma MT, Besho M, Fekadu G, Wakuma B, Bekele D, Mulisa D. Burden and Determinants of Chronic Kidney Disease Among Diabetic Patients in Ethiopia: A Systematic Review and Meta-Analysis. Public Health Rev 2021; 42:1603969. [PMID: 34692175 PMCID: PMC8377585 DOI: 10.3389/phrs.2021.1603969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/24/2021] [Indexed: 01/18/2023] Open
Abstract
Background: Chronic kidney disease (CKD) among diabetic patients is becoming a global health burden with a high economic cost to health systems. The incidence of CKD is higher in low-income countries such as Ethiopia. In Ethiopia, there is no national representative evidence on the burden and determinants of CKD among patients with diabetes. Therefore, this review aimed to estimates the pooled burden and determinants of CKD among patients with diabetes. Methods: Published articles from various electronic databases such as Pub Med, Google Scholar, CINAHL, Scopes, Cochrane library, the Web of Science, and African Journals Online were accessed. Also, unpublished studies from Addis Ababa digital library were identified. We included all observational studies (cross-sectional, case-control, and cohort) in the review. Data were extracted on the Microsoft Excel spreadsheet and analyzed using STATA 14.1 version. A random-effects model was used to estimate the pooled estimate with a 95% confidence interval (CI). Forest plots were used to visualize the presence of heterogeneity and estimate the pooled burden and determinants of chronic kidney disease among diabetic patients. The presence of publication bias was assessed by funnel plots and Egger's statistical tests. Results: Published (297) and unpublished (2) literature were identified from several databases and digital libraries, of which twelve articles were selected for final meta-analysis. Significant heterogeneity was observed across studies (I2 = 85.2%), which suggests a random-effects model to estimate pooled burden. The analysis found that the pooled burden of CKD among patients with diabetes was 18.22% (95% CI: 15.07-21.38). Factors such as hypertension (OR = 2.65, 95%, CI: 1.38, 5.09), type of DM (OR = 0.33, 95%, CI: 0.14-0.76), and duration of DM (OR = 0.51, 95%, CI: 0.34-0.77) were found to have significant association with CKD. Conclusion: The current review revealed a higher burden of CKD among patients with diabetes in Ethiopia. The presence of hypertension, type II diabetes, and duration of diabetes for a longer duration were found to be independent determinants of CKD among patients with diabetes. For better control of chronic kidney disease, integrated management of hypertension and DM should be designed with a special focus on chronic diabetic patients.
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Affiliation(s)
- Tadesse Tolossa
- Department of Public Health, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- Department of Nursing, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Bikila Regassa
- Department of Public Health, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Mekdes Tigistu Yilma
- Department of Public Health, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Merga Besho
- Department of Midwifery, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Ginenus Fekadu
- Department of Pharmacy, Institute of Health Science, Wollega University, Nekemte, Ethiopia.,School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
| | - Bizuneh Wakuma
- Department of Nursing, Institute of Health Science, Wollega University, Nekemte, Ethiopia
| | - Daniel Bekele
- Department of Statistics, College of Computational Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Diriba Mulisa
- Department of Nursing, Institute of Health Science, Wollega University, Nekemte, Ethiopia
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14
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Tsao CW, Hsu YJ, Tseng XT, Chang TC, Tsao CH, Liu CY. Does Coenzyme Q10 Supplementation Improve Testicular Function and Spermatogenesis in Male Mice with Chronic Kidney Disease? BIOLOGY 2021; 10:biology10080786. [PMID: 34440017 PMCID: PMC8389647 DOI: 10.3390/biology10080786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/02/2021] [Accepted: 08/14/2021] [Indexed: 12/02/2022]
Abstract
Simple Summary Chronic kidney disease (CKD) is found to be linked to elevated apoptosis, oxidative stress and inflammation. Moreover, lower testosterone, poorer sperm quality and lower reproductive function have also been observed. Coenzyme Q10 (CoQ10), a widely used antioxidant involved in mitochondrial energy production, is indispensable for maintaining the efficient energy system of spermatozoa and protecting their membranes from lipid peroxidation, yet there are few studies focusing on the effects of CoQ10 on CKD-induced male infertility. This study suggests that CoQ10 increases testosterone levels and improves spermatogenesis in CKD mice. Abstract The aim of the study was to examine the potential effects of coenzyme Q10 (CoQ10) on reproductive function in a chronic kidney disease (CKD) mouse model. Nine-week-old mice were randomly assigned to two groups: sham surgery (n = 18) and CKD surgery (n = 18). After surgery, the study groups received CoQ10 (10 mg/kg body weight dissolved in corn oil by oral gavage) or corn oil as a vehicle daily for 8 weeks. The groups that underwent 5/6 nephrectomy developed significant elevations of serum BUN and creatinine levels. The CoQ10 treatment significantly increased the serum and testicular CoQ10 levels and alleviated the poor semen quality from incomplete spermatogenesis. The testosterone concentration, in addition to the protein expression of enzymes related to testosterone biosynthesis, was also elevated, and the CKD-induced decrease in antioxidant activity in the testes was significantly ameliorated. The results suggest that CoQ10 could act against CKD-induced testicular dysfunction through improvements in the sperm function, testicular morphology, testosterone levels and related biosynthesis pathways, in addition to antioxidant activity.
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Affiliation(s)
- Chih-Wei Tsao
- Division of Urology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yu-Juei Hsu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Xiang-Ting Tseng
- Department of Nutritional Science, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (X.-T.T.); (T.-C.C.)
| | - Ting-Chia Chang
- Department of Nutritional Science, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (X.-T.T.); (T.-C.C.)
| | - Chang-Huei Tsao
- Department of Microbiology and Immunology, National Defense Medical Centre, Taipei 11490, Taiwan;
| | - Chin-Yu Liu
- Department of Nutritional Science, Fu Jen Catholic University, New Taipei City 242062, Taiwan; (X.-T.T.); (T.-C.C.)
- Correspondence:
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15
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Copper/reduced graphene oxide film modified electrode for non-enzymatic glucose sensing application. Sci Rep 2021; 11:9302. [PMID: 33927300 PMCID: PMC8085015 DOI: 10.1038/s41598-021-88747-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
Numerous studies suggest that modification with functional nanomaterials can enhance the electrode electrocatalytic activity, sensitivity, and selectivity of the electrochemical sensors. Here, a highly sensitive and cost-effective disposable non-enzymatic glucose sensor based on copper(II)/reduced graphene oxide modified screen-printed carbon electrode is demonstrated. Facile fabrication of the developed sensing electrodes is carried out by the adsorption of copper(II) onto graphene oxide modified electrode, then following the electrochemical reduction. The proposed sensor illustrates good electrocatalytic activity toward glucose oxidation with a wide linear detection range from 0.10 mM to 12.5 mM, low detection limit of 65 µM, and high sensitivity of 172 μA mM–1 cm–2 along with satisfactory anti-interference ability, reproducibility, stability, and the acceptable recoveries for the detection of glucose in a human serum sample (95.6–106.4%). The copper(II)/reduced graphene oxide based sensor with the superior performances is a great potential for the quantitation of glucose in real samples.
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16
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Taderegew MM. Assessment of renal impairment using estimated glomerular filtration rate among type 2 diabetes mellitus patients in North-East Ethiopia: a cross-sectional study. J Diabetes Metab Disord 2020; 19:1473-1481. [PMID: 33520848 PMCID: PMC7843698 DOI: 10.1007/s40200-020-00680-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 10/07/2020] [Accepted: 10/28/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic kidney disease (CKD) is the known cause of morbidity and mortality among diabetes mellitus (DM) patients. Targeted screening of renal impairment based on estimated glomerular filtration rate (eGFR) among DM patients has potential benefits in early identification and treatment of CKD. Hence, this study was aimed to estimate the magnitude of renal impairment using eGFR among type 2 DM patients. METHODS An institution-based cross-sectional study was conducted from February-1 to April 30/2020 among 422 type 2 DM patients in Northeast Ethiopia. Data were collected by the semi-structured questioner and serum creatinine measurement. The collected data were edited into Epi-data manager version 4.4.1.0, and the analysis was performed by SPSS-25. The Simplified Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI), and Cockcroft-Gault (C-G) equations were used to calculate eGFR. RESULTS Of all study participants, 82(19.4%), 92(21.8%), and 103(24.4%) had eGFR < 60 ml/min/1.73 m2, according to the MDRD, CKD-EPI, and C-G equations, respectively. Female sex, (MDRD:AOR = 4.44, 95%CI:1.97-9.97, CKD-EPI:AOR = 3.17, 95%CI:1.27-6.17, and C-G:AOR = 2.65, 95%CI:1.35-5.21), duration ≥ 10 years (MDRD:AOR = 3.38, 95%CI:1.45-7.92, CKD-EPI:AOR = 3.09, 95%CI:1.07-7.77, and C-G:AOR = 2.92, 95%CI:1.29-6.61), age ˃60 years (MDRD:AOR = 2.29, 95%CI:1.09-4.77, CKD-EPI:AOR = 4.12, 95%CI:1.68-6.78, and C-G: AOR = 3.42, 95%CI:1.77-6.60), hypertension (MDRD:AOR = 3.12, 95%CI:1.51-6.45, CKD-EPI: AOR = 4.21,95%CI:2.07-7.98, and C-G:AOR = 3.99, 95%CI:2.08-7.65), poor glycemic control (MDRD:AOR = 2.82, 95%CI:1.13-7.05, and C-G:AOR = 2.34, 95%CI:1.09-5.04), and body mass index (MDRD:AOR = 1.11, 95%CI:1.01-1.22, and CKD-EPI:AOR = 2.43, 95%CI:1.27-5.76) were significantly associated with renal impairment. CONCLUSION Renal impairment was prevalent among type 2 DM patients. Older age, female sex, duration, hypertension, poor glycemic control, and BMI were significantly associated with renal impairment.
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Affiliation(s)
- Mitku Mammo Taderegew
- Department of Biomedical Sciences, School of Medicine, College of Medicine and Health Sciences, Wolkite University, P.O. Box 07, Wolkite, Ethiopia
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Chronic Kidney Disease among Diabetes Patients in Ethiopia: A Systematic Review and Meta-Analysis. Int J Nephrol 2020; 2020:8890331. [PMID: 33101733 PMCID: PMC7569456 DOI: 10.1155/2020/8890331] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Though different primary studies have reported the burden of chronic kidney disease among diabetes patients, their results have demonstrated substantial variation regarding its prevalence in Ethiopia. Therefore, this study aimed to estimate the pooled prevalence of chronic kidney disease and its associated factors among diabetes patients in Ethiopia. Method PubMed, African Journals Online, Google Scholar, Scopus, and Wiley Online Library were searched to identify relevant studies. The I2 statistic was used to check heterogeneity across the included studies. A random-effects model was applied to estimate the pooled effect size across studies. A funnel plot and Egger's regression test were used to determine the presence of publication bias. All statistical analyses were performed using STATA™ version 14 software. Result In this meta-analysis, a total of 12 studies with 4,075 study participants were included. The estimated prevalence of CKD among diabetes patients was found to be 35.52% (95% CI: 25.9–45.45, I2 = 96.3%) for CKD stages 1 to 5 and 14.5% (95% CI: 10.5–18.49, I2 = 91.1%) for CKD stages 3 to 5. Age greater than 60 years (OR = 2.99; 95% CI: 1.56–5.73), female sex (OR = 1.68; 95% CI: 1.04–2.69), duration of diabetes >10 years (OR = 2.76; 95% CI: 1.38–5.51), body mass index >30 kg/m2 (OR = 2.06; 95% CI: 1.41–3.00), type 2 diabetes (OR = 2.54; 95% CI: 1.73–3.73), poor glycemic control (OR = 2.01; 95% CI: 1.34–3.02), fasting blood glucose >150 mg/dl (OR = 2.58; 95% CI: 1.79–3.72), high density lipoprotein >40 mg/dl (OR = 0.48; 95% CI: 0.30–0.85–25), systolic blood pressure>140 mmHg (OR = 3.26; 95% CI: 2.24–4.74), and diabetic retinopathy (OR = 4.54; CI: 1.08–25) were significantly associated with CKD. Conclusion This study revealed that the prevalence of chronic kidney disease remains high among diabetes patients in Ethiopia. This study found that a long duration of diabetes, age>60 years, diabetic retinopathy, female sex, family history of kidney disease, poor glycemic control, systolic blood pressure, overweight, and high level of high-density lipoprotein were associated with chronic kidney disease among diabetic patients. Therefore, situation-based interventions and context-specific preventive strategies should be developed to reduce the prevalence and risk factors of chronic kidney disease among diabetes patients.
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