INCIDENCE OF DIABETIC NEPHROPATHY AND ITS PREDICTORS AMONG TYPE2 DIABETIC MELLITUS PATIENTS ATTENDING FOLLOW UP AT SELECTED PUBLIC HOSPITALS IN ADDIS ABABA CITY ADMINISTRATION, ETHIOPIA.

Abstract

Background: Diabetes is the leading cause of end-stage renal disease. Approximately, 40% or more of patients with diabetic mellitus develops diabetic nephropathy, which is the major cause of chronic kidney disease requiring dialysis or transplantation worldwide. Diabetic nephropathy in creases the risk of early death and cardiovascular morbidity and mortality. Despite, the rising num ber of patients with diabetic mellitus in Ethiopia, the incidence of diabetic nephropathy in people with diabetic mellitus has not been clearly defined. Objective: To determine the incidence of diabetic nephropathy and its predictors among type 2 diabetes patients at selected public hospitals from January 1, 2015, to December 31, 2022, in Addis Ababa, Ethiopia. Methods: Facility-based retrospective cohort study was conducted at the selected public hospitals in Addis Ababa, Ethiopia with a 614 newly diagnosed diabetes patients from January 1, 2015, to December 31, 2022. The data was collected by reviewing their medical records from April 1, 2023, to May 1, 2023. The Schoenfeld residuals test was used to check the proportional hazard assump tion. The best model was selected by using Akaike information criteria and Log-likelihood. Hazard ratios with a 95% confidence interval were reported to show significance and strength of associa tion. Results: Out of the 614 type 2 DM patients, 15.1% [95%CI: 0.12-0.18] developed diabetic nephropathy. The diabetic nephropathy incidence density rate was 3.3 per 1000 person-month ob servation. Having had hypertension (AHR= 3.8, 95% CI: 2.01-7.20), congestive heart failure (AHR: 1.92, 95% CI: 1.28-3.07), hemoglobinA1C level ≥ 7 mg/dl (AHR: 0.49, 95%CI: 0.29-0.83), high-density lipoprotein level< 40mg/dl (AHR: 1.72, 95%CI: 1.07- 2.7), and using mixed oral and injection hypoglycemic agents (AHR: 2.32, 95%CI: 1.2- 4.6) were independent predictors of dia betic nephropathy among type 2 DM patients. Conclusions: One out of every seven diabetic patients experienced diabetic nephropathy. Hyper tension, congestive heart failure, HgbA1C ≥ 7 mg/dl, high-density lipoprotein < 40 mg/dl, and mixed oral and insulin injection hypoglycemic agents have increased the hazard of diabetic nephropathy.