Impaired glomerular filtration rate, macroscopic Albuminuria, and associated factors among adult patients Admitted to jimma university medical center, south-west Ethiopia

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