Survival Time to Nephropathy and its Predictors Among Type 2 Diabetes Mellitus Patients in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2019.
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Date
2019-06
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Addis Ababa University
Abstract
Introduction: Diabetes is the most common cause of end-stage renal disease in most parts ofthe world. Kidney involvement both directly and indirectly increases involvement of otherorgans and increase morbidity and mortality in diabetic patients. However, little is known concerning when nephropathy develops once a person diagnosed with diabetes.
Objective: The aim of this study is to determine time to nephropathy and its predictors among type 2 diabetic patient attending at Tikur Anbessa Specialized Hospital, 2019. Methods and materials:Retrospective cohort study was employed among Type 2 diabetic patients attending their follow up at Tikur Anbessa Specialized Hospital from January 1, 2009 to December 31, 2018. KaplanMeier
method was used to determine time to nephropathy and log rank test was used to comparetime to nephropathy among different covariates in type 2 Diabetes Mellitus patients. Cox proportional hazard model was used to identify factors contributing to nephropathy in type 2 diabetic mellitus patients. Result: The overall incidence rate of diabetic nephropathy among
newly diagnosed type 2 diabetes was found to be 30.4 per 10,000 person-months follow up. The median time to develop nephropathy was 100.03 months (95% CI, 96.7 – 107). Predictors of nephropathy were being male [HR: 2.7 95%CI; 1.39, 5.23], duration of diabetes [HR:1.003,95% CI;1.001,1.006], hemoglobin A1c [HR: 1.74, 95% CI; 1.67,3.12], fasting bloodsugar [HR: 1.12, 95% CI; 1.03,1.97]. Whereas, high density lipoprotein greater than 40mg/dl
[HR: 0.37, 95% CI; 0.16, 0.83] and both oral and injection therapy [HR: 0.07, 95% CI; 0.01,0.59], were reduced the hazard of nephropathy. Conclusion: In this study, the incidence of diabetic nephropathy among type 2 DM patients was relatively high and which is becoming the raising national burden. Being male, longer duration of diabetes, hemoglobin A1c, and one unit increasing of fasting blood sugar were increase the hazard of diabetic nephropathy. On the
contrary high density lipoprotein greater than 40mg/dl and those diabetic clients who had received oral and injection therapy were reduced the hazard of diabetic nephropathy.
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Keywords
Nephropathy, Diabetics, Predictors and Ethiopia.