Abstract:
Background– Chronic kidney disease (CKD) is a world-wide public health problem
associated with adverse outcomes of kidney failure, cardiovascular disease (CVD),
and premature death. It is one of the rising non-communicable diseases in low and
middle income countries. Early detection and treatment of CKD using readily
available, inexpensive therapies can slow or prevent progression to end-stage renal
disease.
Objective–To assess impaired estimated glomerular filtration rate, macroscopic
albuminuria, and associated factors among adult patients admitted to Jimma
University Medical Center.
Method–Institution based cross sectional study was conducted from November 1,
2016-April 30, 2017. Consecutive sampling method was used to select study
participants. Bi-variate and multi-variable logistic regression analyses were conducted
to generate factors associated with impaired estimated GFR and albuminuria. A Pvalue
of <0.05 was considered statistically significant.
Results–The study involved 422 patients admitted to JUMC who had at least one
urine analysis and serum creatinine level during the study period. Fifty two (12.3%)
of the study subjects had macroscopic albuminuria, 19.2% and 32.7% had impaired
estimated glomerular filtration rate according to Modification of Diet in Renal
Disease (MDRD-4) and Cockcroft-Gault (CG) equations respectively. Old age
(P=.002, AOR=2.376; 95%CI: 1.378-4.095), male sex (P=.013, AOR=2.084; 95%CI:
1.167-3.721), and hypertension (P=.007, AOR=2.233; 95%CI:1.244-4.010) were
independently associated with impaired eGFR using one of the two equations while
diabetes mellitus (P=.006, AOR=2.785; 95%CI: 1.332-5.825) and BP measurement
above optimal (P<.001, AOR=4.757; 95%CI: 1.962-11.533) were associated with
macroscopic albuminuria.
Conclusion–Impaired estimated Glomerular Filtration Rate and macroscopic
albuminuria were found in significant proportion of study participants which
necessitates routine urine analysis and estimation of Glomerular Filtration Rate for
patients with CKD risk factors
