Determinants Of Diabetic Nephropathy Among Adult Diabetic Patients On Follow-Up In Public Hospitals Of Addis Ababa, Ethiopia, 2022: Case- Control Study

Abstract

Background: Diabetic nephropathy is a serious complication of diabetes, which is currently public health issue. However, not all diabetics develop diabetic nephropathy; progression varies, and some patients revert and the microalbuminuria disappears. It has potentially been prevented or delayed by inexpensive interventions on those determinant factors. However, factors associated with this particular complication have not yet been thoroughly studied. Objective: The study aims to identify determinants of diabetic nephropathy among adult diabetic patients on follow-up in public hospitals of Addis Ababa, Ethiopia, in 2022. Methods: A hospital-based unmatched case-control study design was conducted between September 6, to November 9, 2022. Using consecutive sampling techniques, 442 people (353 controls and 89 cases) were recruited, with controls to case ratio 4:1. The data were collected using a structured and interview-administered questionnaire and record review. The collected data were entered into Epidata 3.1 and analyzed by STATA 15. Variables with a p-value < 0.25 in the Bivariable binary logistic regression analysis were candidate variables for the final model. In multivariable binary logistic regression model analysis, variables with a p-value < 0.05 with 95% CI and AOR were declared statistically significant determinants of diabetic nephropathy. Results: In this study, out of 442 study participants, 334 controls and 89 cases were included in the analysis, with a response rate of 94.6% and 100%, respectively. Age 65 and above years old (AOR: 2.42; 95% CI: 1.28, 4.57); Smoking a cigarette (AOR: 2.22; 95% CI: 1.18, 4.16); Non-adherent to diet (AOR: 2.11; 95% CI: 1.15, 3.84); Drinking alcohols (AOR: 1.95; 95% CI: 1.07, 3.52); Duration with diabetes more than 10 years (AOR: 3.39; 95% CI: 1.76, 6.54); Poor glycemic control (AOR: 2.19; 95% CI: 1.23, 4.28); and Low-density lipoprotein (AOR: 2.97; 95% CI: 1.69, 5.28) were found to be statistically significant determinants of diabetic nephropathy Conclusion and Recommendation: This study found that old age, smoking cigarettes, non-adherence to diet, duration of diabetes, alcohol drinkers, Glycated hemoglobin A1c, and high low-density lipoprotein were determinants of diabetic nephropathy. Hence, continuous health education on lifestyle modifications and diabetic-related complications in each follow-up visit via front-line health professionals are very essential to avert the problem6