Abstract:
Introduction: Hypertension is the second leading cause of Chronic Kidney Disease
(CKD) worldwide. CKD is the severest form of kidney disease characterized by poor
filtration rate. It is also the leading cause of morbidity and mortality in hypertensive
patients. However, little is known about when this problem may occur, the predictors of
time to chronic kidney disease, and its association with changes in blood pressure in
hypertensive patients.
Objectives: The aim of this study was to assess time to Chronic Kidney Disease and
its predictors as well as its association with change in Blood Pressure among
hypertensive patients in Ethiopia.
Methods: A retrospective follow-up study was conducted among hypertensive patients
at University of Gondar Comprehensive Specialized Referral Hospital, Northwest
Ethiopia. A total of 433 newly diagnosed hypertension patients who had follow-up from
2014 to 2023 were selected using a computer-generated simple random sampling
technique. The Cox Proportional Hazard and linear mixed effect models were fitted
separately, and later, the models were fitted jointly using Bayesian approach by using R
software, and 95% credible interval was used to select significant variables.
Results: The incidence rate of CKD was 2.5 cases per 100 patients per year (95% CI
[1.89-3.14]) with median follow-up time of 70 months [IQR, [43-97]. Current value of
Systolic Blood Pressure and Diastolic Blood pressure were significantly associated with
risk of CKD (AHR = 6.25; 95% CrI: [2.85 -9.85]) and (AHR = 4.32; 95% CrI: [2.35-8.27])
respectively. Age ≥ 65 years (AHR = 4.62; 95% CrI: [1.83, 12.21]), HDL_C <40 mg/dl
(AHR = 3.32; 95% CrI: [1.73-7.86]), having Diabetes mellitus (AHR = 3.08; 95% CrI:
[2.01-9.54]), and positive proteinuria (AHR = 2.85; 95% CrI: [1.48-5.55]) were significant
predictors of time to CKD.
Conclusions and recommendations: Time dependent SBP and DBP were strongly
associated with increased risk of CKD. Incidence of CKD was relatively high compared
with previous similar studies. Age, HDL-C level, presence Diabetes mellitus, and
proteinuria were found to be significant predictors for time to CKD. Health professionals
should give greater attention to the identified risk factors for CKD were recommended.
