Incidence and Predictors of Chronic Kidney Diseases among Adult Hypertensive Patients in Northwest Amhara Comprehensive Specialized Hospitals, Ethiopia: A Retrospective Follow up Study

Abstract

Background: Chronic kidney disease (CKD) is a global public health burden with more than 5million people die of it annually and it is expected to be the 5th leading cause of morbidity and mortality by 2040, with a high economic cost to health systems. Developing countries including Ethiopia have insufficient resources to address the CKD epidemic and its serious long-term complications.The incidence and predictors of chronic kidney disease (CKD) in most parts of Africa including Ethiopia were largely unknown. Objective: This study aimed to assess the incidence and predictors of chronic kidney diseases among adult hypertensive patients in northwest Amhara comprehensive specialized hospitals, Ethiopia, 2023. Methods: A Hospital-based multi-center retrospective follow up study was conducted among 718 adults hypertensive patients enrolled in chronic follow-up clinic. Log-rank test and Kaplan Meier curve were used to compare survival probability across different categories of the participants. A bi-variable and multivariable Gompertz parametric regression model was fitted to identify predictors of chronic kidney diseases. Factors having a p-value of <0.2 in the bi-variable analysis were entered to the multivariable model. Variables that had a p-value of <0.05 with its corresponding 95% confidence level were deemed to be significant predictors of chronic kidney disease. Results: A total of 118, 16.43% (95%CI: 13.89-19.33) patients developed CKD, with an incidence rate of 26 per 1,000 person years (PY) (95%CI: 21.83-31.31) observation time. Proteinuria (AHR=4.18, 95% CI=2.50-6.98), acute kidney injury (AKI) (AHR=2.12, 95% CI: 1.44-3.14), age≥65 (AHR=1.73, 95% CI: 1.89-2.51) and dyslipidemia (AHR=1.53, 95% CI: 1.05-2.23) were significant predictors of CKD among hypertensive patients. Conclusion: In this study, the incidence of CKD among hypertensive patients was 16.43%. The median time to develop CKD was seven years. Further, dyslipidemia, older age (≥65 years), proteinuria and AKI were accelerated the hazard of developing CKD. We recommend health professional to give more to HTN patients with the identified the risk factors